SCRN Post-acute Care 2 — Questions and Answers
Question 1: A stroke patient in inpatient rehabilitation is experiencing learned non-use of the affected arm. Which intervention best addresses this?
- Sling immobilization of the unaffected arm
- Constraint-induced movement therapy (CIMT) (Correct answer)
- Passive range-of-motion exercises only
- Botulinum toxin injection to the affected arm
Correct answer: Constraint-induced movement therapy (CIMT)
CIMT restrains the unaffected limb to force use of the affected arm, directly counteracting learned non-use.
Question 2: Which FIM (Functional Independence Measure) score indicates complete independence requiring no helper?
- Score of 5
- Score of 6
- Score of 7 (Correct answer)
- Score of 4
Correct answer: Score of 7
A FIM score of 7 indicates complete independence — the patient performs the activity safely without any helper or assistive device concerns.
Question 3: A post-stroke patient in a skilled nursing facility develops a DVT in the paretic leg. Which action takes priority?
- Apply warm compresses and elevate the limb
- Initiate anticoagulation therapy per provider order (Correct answer)
- Increase ambulation to promote circulation
- Apply pneumatic compression to the affected limb
Correct answer: Initiate anticoagulation therapy per provider order
Confirmed DVT requires prompt anticoagulation to prevent pulmonary embolism; compression and massage are contraindicated on an active thrombus.
Question 4: A stroke survivor is being discharged to home with dysphagia. Which instruction is most important for the caregiver?
- Offer thin liquids to ensure adequate hydration
- Position the patient upright at 90° during all meals (Correct answer)
- Avoid pureed foods as they reduce oral motor strength
- Allow the patient to self-pace without supervision
Correct answer: Position the patient upright at 90° during all meals
An upright 90° position during meals uses gravity to assist safe swallowing and minimizes aspiration risk.
Question 5: Post-stroke depression affects approximately what percentage of stroke survivors?
- 5–10%
- 15–20%
- 30–40% (Correct answer)
- 55–65%
Correct answer: 30–40%
Post-stroke depression occurs in approximately 30–40% of stroke survivors and significantly impairs rehabilitation outcomes.
Question 6: Which standardized tool is recommended to screen for post-stroke depression in the post-acute setting?
- Mini-Mental State Examination (MMSE)
- Patient Health Questionnaire-9 (PHQ-9) (Correct answer)
- Berg Balance Scale
- Montreal Cognitive Assessment (MoCA)
Correct answer: Patient Health Questionnaire-9 (PHQ-9)
The PHQ-9 is a validated, widely used depression screening tool recommended for post-stroke populations.
Question 7: A patient recovering from a right hemispheric stroke demonstrates left-sided neglect. Which rehabilitation strategy is evidence-based?
- Patching the patient's right eye to force left-field attention
- Prism adaptation therapy (Correct answer)
- Avoiding stimulation from the left side entirely
- Placing all essential items on the patient's right side only
Correct answer: Prism adaptation therapy
Prism adaptation therapy shifts the patient's spatial reference frame and has evidence for reducing hemispatial neglect.
SCRN Post-acute Care 2
A stroke patient in inpatient rehabilitation is experiencing learned non-use of the affected arm.
Which intervention best addresses this?