Certified Rehabilitation Registered Nurse (CRRN) Exam Review

The Rehabilitation Registered Nurse certification indicates a specialized level of nursing focused on caring for the patient undergoing physical rehabilitation. These nurses are employed in various practice settings and focus on providing a higher level of nursing care to those patients with physical disabilities due to acute or chronic illness.

In order to the take the Certified Rehabilitation Registered Nurse exam, the applicant must be a licensed Registered Nurse. In addition, the RN must have been employed for at least 2 years as a rehabilitation nurse within the past 5-year period, or have been employed as a rehabilitation nurse for at least 1 year within the past 5 years and completed at least 1 year of advanced training (beyond Baccalaureate degree) in the field of rehabilitation nursing.

The Certified Rehabilitation Registered Nurse exam is offered twice a year, during the month of June and again in December. This is available at various testing centers across the United States. The fee to take the exam is $235 for Association of Rehabilitation Nurses (ARN) members and $325 for non-members.

The Certified Rehabilitation Registered Nurse exam consists of 175 multiple-choice questions with 25 of these questions for pre-testing purposes for possible inclusion on future exams. The RN is allotted 3 hours in which to complete the exam. The majority of the Certified Rehabilitation Registered Nurse exam tests the RN's knowledge on patient care and assessment, along with nursing interventions, for the rehabilitation patient. A large portion of the exam also contains questions pertaining to working with the medical team to facilitate a smooth transition for the patient to re-enter the community after undergoing in-patient rehabilitation.

The Certified Rehabilitation Registered Nurse certification is valid for 5 years. At the end of that time period, the licensed RN should have worked at least 2 years out of the last 5 years in the field of rehabilitation nursing. In addition, at least 60 continuing education hours in the field of rehabilitation nursing should have been completed.

For more information regarding the Certified Rehabilitation Registered Nurse certification, go to the Association of Rehabilitation Nurses web site at www.rehabnurse.org.

Nursing Certification Central

Certified Rehabilitation Registered Nurse (CRRN) Practice Questions

1. Which of the following is the BEST description of naturopathy?

1. A system that focuses on strengthening the body's defense mechanisms rather than trying to heal particular disease symptoms.
2. A system that involves balancing qi (vital energy) by inserting tiny needles into specific sites referred to as acupoints.
3. A system that involves applying pressure or electric stimulation at acupoints to promote healing.
4. A system that involves various manipulations of muscles and joints and alignment of the spine to maintain health.

2. A patient with a spinal cord injury develops signs of autonomic dysreflexia (sweating and flushing above injury, severe headache, nasal congestion, anxiety, nausea). He first does a pressure release and checks his indwelling catheter, which is in place and draining freely. What should he do next?

1. Perform digital stimulation to stimulate a bowel movement.
2. Lie down flat.
3. Call 9-1-1.
4. Take nifedipine or nitroglycerine sublingually.

3. Constraint-induced movement therapy (CIMT) for those with stroke or traumatic brain injury (TBI) includes constraint of the uninvolved upper extremity and which of the following other measure(s)?

1. Forced use of weakened limbs for 90 minutes daily.
2. Massed practice.
3. Forced use of weakened limbs for 90% of waking hours and massed practice.
4. Doing progressively more difficult tasks in small steps for 90 minutes daily with positive reinforcement.

4. A patient with a spinal cord injury has developed a stage II pressure ulcer (4 cm in diameter) on the medial aspect of the right knee. In addition to relieving pressure, which of the following is the MOST appropriate treatment?

1. Cleanse with antiseptic and expose to the air.
2. Apply wet-to-dry saline dressings.
3. Cleanse with normal saline and apply a hydrocolloid dressing.
4. Apply a heat lamp to the area 3 times daily.

5. A 19-year-old man with an above-knee right amputation is depressed and refuses to see his parents. The parents ask the rehabilitation nurse for an update on their son's condition. Which of the following is MOST appropriate in accordance with HIPAA regulations?

1. Advise the parents that information regarding the patient's condition is private.
2. Provide a brief general update, without specific details
3. Refer the parents to the physician to get information.
4. Tell the patient he should speak to his parents.

Certified Rehabilitation Registered Nurse (CRRN) Answer Key

1. Answer: A

Naturopathy focuses on strengthening the body's defense mechanisms, rather than trying to heal particular disease symptoms, by various modalities, such as diet, herbs, hydrotherapy, acupuncture, physical therapy, counseling, and homeopathy. Naturopathy stresses that natural approaches to healing are preferable to surgery or medications, but it does not preclude the use of traditional medical treatment. Acupuncture uses needles inserted into acupoints to balance vital energy (qi) while acupressure applies pressure or electric stimulation to acupoints. Chiropractic therapy uses various manipulations of muscles and joints to relieve discomfort and pressure on nerves. Practitioners believe that aligning the spine is critical to maintenance of health.

2. Answer: A

Since the most common causes of autonomic dysreflexia are bladder distention and bowel distention (feces and/or gas), he should do a digital exam to promote a bowel movement. He may use an anesthetic ointment to prevent further stimulation. Because BP rises and heart rate falls, the patient should sit up in order to decrease BP and reduce risk of stroke. The patient should also loosen clothes and check for sores (such as on the feet) or ingrown toenails. Calling 9-1-1 for treatment in an emergency department is necessary only if other methods are unsuccessful. Medications may be indicated if trigger cannot be identified and remedied.

3. Answer: C

CIMT is characterized by constraint of an uninvolved upper extremity (usually through use of a mitt or sling), forced use of weakened limbs for 90% of waking hours, and massed practice exercises for at least 6 hours (with a 1-hour break), 5 days per week, usually for 2 or 3 weeks. Exercises typically involve functional activities performed repeatedly over 15 to 20 minutes. Massed practice for the lower limbs includes treadmill walking, climbing steps, and sit-and-stand exercises. Shaping, doing progressively more difficult tasks in small steps for 90 minutes daily with positive reinforcement, may be combined with CIMT.

4. Answer: C

A stage II pressure ulcer, characterized by broken skin, is best treated by cleansing with normal saline and applying a moist environment for healing, such as with a hydrocolloid dressing or semipermeable occlusive dressings. Wet-to-dry dressings are no longer advised for wound care because the dry dressing may damage the new tissue when it is removed. Antiseptics and heat treatments should be avoided as they may damage healthy tissue around the wound and delay overall healing. Further pressure to the area or friction and shear must be avoided to prevent further injury.

5. Answer: A

The nurse should advise the parents that information regarding the patient's condition is private because he is an adult. The Health Insurance Portability and Accountability Act (HIPAA) states that health care providers must not release any information or documentation about a patient's condition or treatment without consent, as the individual has the right to determine who has access to personal information. Personal information about the patient is considered protected health information (PHI), and consists of any identifying or personal information about the patient, such as health history, condition, or treatments in any form, and any documentation, including electronic, verbal, or written. Telling patients what they "should" do is inappropriate.

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