CRRN Rehabilitation Registered Nurse Certification 5 — Questions and Answers
Question 1: A patient with rheumatoid arthritis participates in a rehabilitation program. The nurse should schedule physical activity during which time of day to minimize the impact of morning stiffness?
- Immediately upon waking before stiffness worsens
- After the morning stiffness period has resolved, typically mid-morning (Correct answer)
- Late evening when joints are most rested
- Stiffness does not affect optimal scheduling
Correct answer: After the morning stiffness period has resolved, typically mid-morning
Morning stiffness in RA typically lasts 30 minutes to several hours; scheduling therapy after this period improves participation, range of motion, and patient comfort.
Question 2: A rehabilitation nurse is conducting a community reintegration assessment for a patient with TBI. Which factor is MOST critical to evaluate for return to work?
- Pre-injury job title and salary
- Cognitive, behavioral, and physical demands of the specific job (Correct answer)
- Distance from home to workplace
- Patient's desire to return to work alone
Correct answer: Cognitive, behavioral, and physical demands of the specific job
Matching the patient's current cognitive, behavioral, and physical abilities to the specific functional demands of their job is essential for safe and successful return-to-work planning.
Question 3: Which patient is at highest risk for developing heterotopic ossification (HO) after a spinal cord injury?
- A 65-year-old with an incomplete C6 injury
- A 25-year-old with a complete T4 injury and spasticity (Correct answer)
- A 50-year-old with a lumbar disc herniation
- A 40-year-old with peripheral neuropathy
Correct answer: A 25-year-old with a complete T4 injury and spasticity
Heterotopic ossification most commonly occurs in young patients with complete cervical or thoracic SCI who also exhibit spasticity, which is a recognized risk factor.
Question 4: A CRRN notices that a patient's family frequently completes tasks the patient is capable of performing independently. The nurse's best approach is to:
- Exclude the family from care sessions to allow independent practice
- Educate the family about the therapeutic value of allowing the patient to attempt tasks independently (Correct answer)
- Document the behavior and take no action to preserve family relationships
- Praise the family for their helpfulness and encourage them to continue
Correct answer: Educate the family about the therapeutic value of allowing the patient to attempt tasks independently
Educating the family about how learned helplessness can undermine rehabilitation progress empowers them to become facilitators of independence rather than barriers.
Question 5: A patient with complete C7 tetraplegia will be discharged home. Which functional skill should the CRRN prioritize in the discharge plan?
- Independent manual wheelchair propulsion on all surfaces (Correct answer)
- Independent ambulation with bilateral forearm crutches
- Full independent transfers without any equipment
- Independent driving without adaptive equipment
Correct answer: Independent manual wheelchair propulsion on all surfaces
C7 tetraplegia preserves wrist extension and finger flexion, enabling independent manual wheelchair propulsion, which is a realistic and critical mobility goal for this level.
Question 6: When using the Braden Scale to assess a patient's pressure injury risk, which subscale score of '1' indicates the GREATEST risk?
- Moisture: Rarely moist
- Activity: Walks frequently
- Sensory perception: No impairment
- Mobility: Completely immobile (Correct answer)
Correct answer: Mobility: Completely immobile
A Braden mobility score of 1 (completely immobile) indicates the highest risk in that subscale; lower total Braden scores reflect higher overall pressure injury risk.
Question 7: A patient with post-polio syndrome (PPS) reports new-onset muscle weakness and fatigue 40 years after the original illness. The CRRN should advise the patient that the most appropriate exercise strategy is:
- High-intensity resistance training to rebuild lost strength
- Complete rest and avoidance of all physical exertion
- Non-fatiguing aerobic and strengthening exercise with emphasis on avoiding overexertion (Correct answer)
- Aquatic therapy is contraindicated due to the risk of respiratory compromise
Correct answer: Non-fatiguing aerobic and strengthening exercise with emphasis on avoiding overexertion
PPS management focuses on non-fatiguing exercise, energy conservation, and avoiding overuse, as overexertion can accelerate motor neuron loss and worsen weakness.
CRRN Rehabilitation Registered Nurse Certification 5
A patient with rheumatoid arthritis participates in a rehabilitation program.
The nurse should schedule physical activity during which time of day to minimize the impact of morning stiffness?