CRRN Review Exam 145 Questions with Verified Answers
Lydia Hall's three interrelated components include: - CORRECT ANSWER Care, core, and cure
K.
... [Show More] Warner Schaie - CORRECT ANSWER suggests that adults' thinking follows a set pattern of stages
goodness of fit (consonance) vs poorness of fit (dissonance)
Martha Rogers Theory - CORRECT ANSWER Science of Unitary Human Beings
Energetic being manifested as frequencies or energy waves
Jean Piaget's theory states a child passes through the cognitive development stages in what order? - CORRECT ANSWER Sensorimotor
Preoperational
Concrete
Formal
Rehabilitation team models include: - CORRECT ANSWER Interdisciplinary
Multidisciplinary
Trans-disciplinary
Age specific theory which helps when practicing rehab across the life span is: - CORRECT ANSWER Anne Casey: Model for Children and Families
Key criterion for determining trustworthiness in a qualitative study? - CORRECT ANSWER Demonstrating evidence for transfer-ability
Why are cognitive theories significant for rehab? - CORRECT ANSWER Building on previous learned tasks and developmental achievements can facilitate progress
How do Butts and Rich (2011) define theoretical thinking? - CORRECT ANSWER "The dynamic process of asking and answering specific types of questions"
Two behavioral learning theorists are: - CORRECT ANSWER Pavlov and Skinner
The Trans-disciplinary Model for team function: - CORRECT ANSWER The client has a *primary provider* from the team who is guided by the team in caring for the client
Models of care delivery include: - CORRECT ANSWER Client centered
Setting Centered
Provider Centered
Patient Centered
Case management
Who introduced the Open Systems Model? - CORRECT ANSWER Imogene King
What is the Open Systems Model? - CORRECT ANSWER personal, interpersonal, and social systems are open and interacting, focusing on goal attainment
What is the definition of evidence based practice? - CORRECT ANSWER The process of finding, appraising, and applying scientific evidence to the treatment and management of health care
The Medical Model for team function: - CORRECT ANSWER Physician centered
SMART goals are: - CORRECT ANSWER Specific
Measurable
Appropriate
Realistic
Timely
Which model shows how mental health theory assists patients with self-management skills? - CORRECT ANSWER Recovery Model
What is the ultimate result of applying and testing nursing theories? - CORRECT ANSWER Promote healthy lifestyles and improve quality of life
What are some of the major functions of skin? - CORRECT ANSWER Thermoregulation
Sensation
Metabolism
Communication
Types of exposure in PTSD - CORRECT ANSWER Direct experience
Witnessing traumatic event
Learning it happened to someone close to them
Experiencing first-hand repeated or extreme exposure to aversive details of traumatic event
Which facial nerve is affected when your patient can't keep his mouth closed and is drooling? - CORRECT ANSWER VII, facial
Which facial nerve is affected when the patient states "the food has no taste or flavor?" - CORRECT ANSWER IX, glossopharyngeal
What is an important activity for the patient when they are on a Fraizer Free Water Protocol? - CORRECT ANSWER Oral health care is important prior to implementing the Frazier Free Water protocol
What is the Frazier Free Water Protocol? - CORRECT ANSWER It allows clients with dsyphagia or NPO to drink water between meals. Rationale is that small amounts of water even when aspirated do not contribute to aspiration pneumonia as long as the client provides good oral care prior too
Which of the following diseases decreases a patient's metabolic rate? - CORRECT ANSWER Hypothyroidism
Underweight BMI:
Normal Weight BMI:
Overweight BMI:
Obese BMI: - CORRECT ANSWER < 18.5
18.5-24.9
25-29.9
>30
A patient with gout should follow what type of diet? - CORRECT ANSWER Low-purine diet
A lesion on which cranial nerve would cause it to be painful to chew? - CORRECT ANSWER V. trigeminal nerve
The nurse is preparing to help a patient with homonymous hemianopsia eat lunch, what should the nurse do? - CORRECT ANSWER Place the tray on the patient's affected side
Affects half of the visual field, causes patient to scan
What does body composition consist of? - CORRECT ANSWER Body minerals, cell mass, lean body mass, body fat, and body water
When assessing a patient with UC, which of the following findings would be of the most concern? - CORRECT ANSWER Rebound tenderness
Which types of strokes are more associated with dysphagia? - CORRECT ANSWER Hemispheric and Brainstem
Name the protein that is a byproduct of metabolism that increases with age - CORRECT ANSWER Lipoprotein
What can affect a patient's length of life and aging process? - CORRECT ANSWER Nutritional intake
In what order do the dysphagia diets go in? - CORRECT ANSWER The worse the diet, the higher rank level it is.
Puree= #1 worst diet
Mechanical altered= #2
Dys. Advanced= #3
Define Reflex Urinary Incontinence - CORRECT ANSWER loss of urine when the person does not realize the bladder is full and has no urge to void
"uncontrolled urine loss occurring as a result of neurogenic disorders and caused by neurogenic detrusor overactivity; leakage occurs in the absence of a desire to void"
What are the defining characteristics of reflex urinary incontinence? - CORRECT ANSWER No sensation
Urinary Retention
Large residuals of urine
What level of interruption has occurred with Reflex Urinary Incontinence? - CORRECT ANSWER Ascending sensory tract above S2-S4
When a patient has a small loss of urine with increased abdominal pressure such as coughing, sneezing, laughing, and exercising what kind of incontinence is this? - CORRECT ANSWER Stress incontinence
What type of neurogenic bladder is associated with lower motor neuron spinal cord injuries? - CORRECT ANSWER Flaccid/atonic bladder (fails to empty resulting in urinary retention)
What type of bowel impairment is associated with afferent nerve root loss or damage? - CORRECT ANSWER Sensory paralytic bowel
produces diminished or absent ability to distinguish the need or time of defecation but rarely produces incontinence
What is the most appropriate way to empty an areflexic bladder? - CORRECT ANSWER Intermittent straight cath
What type of neurogenic bladder is associated with injury above T12-S1? - CORRECT ANSWER Relexic neurogenic bowel (upper motor neuron)
Tetraplegia is defined as: - CORRECT ANSWER Injury to one of the 8 segments of the cervical spinal cord
Results in loss of function in all 4 extremities
Upper motor neuron bowel: - CORRECT ANSWER Is capable of emptying by reflex
Define urge incontinence - CORRECT ANSWER involuntary loss of urine in response to strong sensation to go
Patient can follow simple commands but speech is very nonsensical, what do you suspect he's exhibiting? - CORRECT ANSWER Broca's dysphasia
Pressure garments are used for the burn patient in order to: - CORRECT ANSWER Reduce scar formation
Functional potential of the person with T11-L2 spinal cord injury is: - CORRECT ANSWER Potentially independent ambulation indoors with long leg brace and crutches
T7-T12 movement - CORRECT ANSWER - ABDOMINAL & LOWER BACK MUSCLES
- IMPROVED COUGH
L1-L5 movement - CORRECT ANSWER normal UE ROM and strength; partial paralysis in hips and legs
The cerebellum controls: - CORRECT ANSWER Balance, coordination and visual perception
How many stages are in Non-REM sleep? - CORRECT ANSWER Stage 1: brief transitional sleep, appears asleep but easily aroused
Stage 2: deeper sleep, lasts 10-25 mins
Stage 3 and 4: deep sleep
Common dx with Myasthenia Gravis? - CORRECT ANSWER Sleep apnea
What scales can be used to quantity fatigue? - CORRECT ANSWER Visual Analogue Scale for Fatigue
Fatigue Severity Scale
What is a sleep change that may occur with aging? - CORRECT ANSWER Circadian rhythm disturbance
Fragmented sleep, shorter duration of stages 3-4 sleep, reduced REM sleep
What is a circadian rhythm? - CORRECT ANSWER sleep/wake cycle
What anti-spasticity medication can be administered intrathecally? - CORRECT ANSWER ONLY baclofen
Levels of C SCI injuries include: - CORRECT ANSWER C5: manage your own health care by doing self assist coughs and pressure reliefs by leaning forward or side to side
C6: Independently do pressure relief, skin checks, and turn in bed
C7: Do wheelchair push ups for pressure relief
Which class of medications is first line treatment for neuropathic pain? - CORRECT ANSWER Tricyclics
Rancho Los Amigos Scale - CORRECT ANSWER Used to assess for cog deficits
Glasgow Coma Scale - CORRECT ANSWER assess neurological deficits
Ashworth Scale - CORRECT ANSWER measure of spasticity
Level of Rancho Los Amigos - CORRECT ANSWER IV: Confused agitated max assistance
V: Confused, inappropriate, non-agitated, max assist
VI: confused appropriate, mod assist
Delirium - CORRECT ANSWER a disturbance in consciousness characterized by impaired attention and disorganized thinking with evidence of an underlying physiological or medical condition
Dementia - CORRECT ANSWER chronic state of confusion
Depression - CORRECT ANSWER mood disorder marked by loss of interest or pleasure in living
What are the 5 components of Crisis Response Plan Model? - CORRECT ANSWER Personal warning signs
self management strategies
social supports
contact info for clinician
Crisis hotline number
Polytrauma Rehab Centers 6 step program - CORRECT ANSWER 1. First Contact
2. Welcome
3. Develop a tx plan
4. Rehab: working toward a goal
5. Move forward
6. Stay connected
The American with Disabilities Act, Title IV - CORRECT ANSWER Requires telephone companies to establish telecommunication relay services for calls with speech and hearing disabilities
Section 508 of the Rehabilitation Act - CORRECT ANSWER Electronic and information technology accessible to people with disabilities
Section 255 of the Telecommunications Act - CORRECT ANSWER requires manufactures of telecommunication equipment services to ensure that such equipment and services are accessible to and usable by people with disabilities
What is the most common cause of pediatric stroke? - CORRECT ANSWER sickle cell disease
Rehabilitation Act of 1973 - CORRECT ANSWER provides supportive services in school for children with physical disabilities who do not qualify for special education
Title V of the Social Security Act - CORRECT ANSWER Provides funds from maternal-child programs as well as disabled children
Children's Bureau 1912 - CORRECT ANSWER Promote child welfare
Where do most brain (cerebral) aneurysms occur? - CORRECT ANSWER Circle of Willis
What is part of ethics? - CORRECT ANSWER Internal to oneself, values, beliefs, and individual interpretation
Which is the most commonly occluded vessel in a stroke? - CORRECT ANSWER Middle Cerebral Artery
supplies the frontal lobe and lateral surfaces of temporal and parietal lobes
Broca's aphasia (expressive aphasia) - CORRECT ANSWER Difficulty putting words together to form complete sentences
Wernicke's aphasia - CORRECT ANSWER inability to comprehend speech
interdisciplinary team - CORRECT ANSWER memebers work together to determine goals and tx and it is holistic
transdisciplinary team - CORRECT ANSWER one member is primary care provider
Multidisciplinary - CORRECT ANSWER members work independently towards goal
What are examples of internal barriers? - CORRECT ANSWER Poor self esteem and lack of motivation
What are examples of societal barriers? - CORRECT ANSWER reimbursement issues, ineligibility for services, cultural prejudices, social stimgas
The WeeFIM instrument is designed for which age group? - CORRECT ANSWER 6 months-7 years
Which part of Medicare allows for beneficiaries to enroll in a private health plan? - CORRECT ANSWER Part C
How often do you have get CARF accreditation? - CORRECT ANSWER 3 years
What does Medicare Part D cover? - CORRECT ANSWER prescription drugs
Persons receiving Part B Medicare benefits: - CORRECT ANSWER can purchase private Medicare SUPPLEMENT insurance
Medicare Part C Coverage - CORRECT ANSWER Includes optional private plans such as PPO, high deductible plans, special needs programs
Include hospital, physician benefit coverage, and often include prescription drugs
Medicare Part A Coverage - CORRECT ANSWER inpatient services, hospital, inpatient rehab, skilled nursing, home health, and hospice
Types of Outcome Data - CORRECT ANSWER Integrative: measures mortality, longevity, and cost effectiveness
Clinical: individual health
Physiological: ADL's, loss of function
Psychosocial: feelings, role performance, perception
Perception: how pt sees themselves & disability
Organization-wide clinical: readmissions, adverse reactions, deaths
Kurt Lewin's Change Theory - CORRECT ANSWER - *Unfreezing*: the change agent
- *Movement*: identifies, plans, and implements appropriate strategies, ensuring that driving forces exceed restraining forces
- *Refreezing*: stabilizing the system change so that it becomes integrated into the status quo
Which type of dysphagia commonly occurs after strokes caused by damage to nerves and muscles in the throat? - CORRECT ANSWER Oropharyngeal dysphagia
commonly causes choking and aspiration
Which type of dsyphagia causes patients to complain of "food sticking" after swallowing? - CORRECT ANSWER Esophageal dysphagia
What is functional dsyphagia? - CORRECT ANSWER No known cause for dysphagia
What does SOAP stand for? - CORRECT ANSWER subjective, objective, assessment, plan
What does the Long Term Care Ombudsman Program mandate? - CORRECT ANSWER Care meets state standards in nursing homes and long term care facilities. Advocates for residents so their concerns can be met
Which nursing theory requires RN to recognize deficits but encourages independence, allow and encourage self care? - CORRECT ANSWER Orem's self care deficit model
Which theorist believes patients are one with the universe frequencies or energy waves? - CORRECT ANSWER Rogers
What is CARF's mission? - CORRECT ANSWER offer accreditation for standards for healthcare facilities
What is the purpose of Joint Commission? - CORRECT ANSWER excel in offering effective and safe care at the highest quality and value
What is the main goal of OSHA (Occupational Safety and Health Administration)? - CORRECT ANSWER provide a safe working environment for health care workers
Erik Erikson's stages of psychosocial development - CORRECT ANSWER
What does the upper urinary tract consist of?
Lower urinary tract? - CORRECT ANSWER Kidneys & ureters
Bladder & Urethra
Reflex neurogenic bladder is associated with which type of spinal cord injury? - CORRECT ANSWER Upper down to T11
Autonomous neurogenic bladder is associated with which type of spinal cord injury? - CORRECT ANSWER lower neural damage to the sacral reflex arc
Which level of injury does autonomic dysreflexia occur? - CORRECT ANSWER Above T6 level
Define hemianopia and homonymous hemianopia - CORRECT ANSWER Blindness affecting half of the visual field in one or both eyes after brain injuries/impairment
Vision lost in different visual fields of each eye
List functional assessment tools that are commonly used in rehabilitation - CORRECT ANSWER Barthel Index
FIM
Older American Resources and Services Scale
Glasgow Coma Scale
Mini-Mental State Exam- attention & recall
CES-D- depression
Medical Outcomes Study (MOS)
Minimum Data Set (MDS)- SNF
OASIS- Home Health
What is the Leap Program? - CORRECT ANSWER Lower Extremity Amputation Prevention Program
Define Alzheimer's disease - CORRECT ANSWER slowly and subtle destructive form of dementia, exact etiology is unknown
3 stages
Define Huntington's disease - CORRECT ANSWER hereditary degenerative neuromuscular disorder that presents in middle age
Define Parkinson's disease - CORRECT ANSWER Chronic progressive disorder. Degenerative disorder of the central nervous system. Characterized by abnormality in movement & posture. Clients have tremors, rigidity of joints and muscles.
Define Myasthenia Gravis and what will your patient present with - CORRECT ANSWER Autoimmune disorder in which IgG class autoantibodies are generated against acetylcholine receptors
Muscle weakness (eye, throat, face)
Define multiple sclerosis and what will your patient present with - CORRECT ANSWER Demyelination of neuoronal axons in the CNS
Relapses/exacerbations
General fatigue
Issues with walking, spasms, elimination, swallowing
Define Amyotrophic Lateral Sclerosis (ALS) - CORRECT ANSWER rare, progressive, and fatal neurological disorder characterized by muscle weakness and atrophy
Typical symptoms= diff speaking, swallowing, and breathing
65-death (Erickson) - CORRECT ANSWER Integrity versus Despair (Retirement Years)
40-64 years - CORRECT ANSWER Generativity vs stagnation
21-39 years (Erickson) - CORRECT ANSWER Intimacy vs isolation
13-21 years (Erickson) - CORRECT ANSWER Identity vs role confusion
3-5 years (Erickson) - CORRECT ANSWER Initiative vs guilt
18 months-3 years (Erickson) - CORRECT ANSWER autonomy vs shame and doubt
Infancy Stage (Erickson) - CORRECT ANSWER trust vs mistrust
5-13 years (Erickson) - CORRECT ANSWER Industry vs inferiority
How many inches should a female insert an intermittent cath? - CORRECT ANSWER 2-3" initially, and then another 1" after urine flashback
What is the goal volume of urine for patients who perform straight caths? - CORRECT ANSWER Keep bladder below 500 cc
What is the equation for total fluid volume in a day for a patient? - CORRECT ANSWER 30mL/kg/day
Patient experiences spastic paresis, loss of sense of position and vibration on the injured side, and loss of pain and temperature on other side.
The cord is hemisected
Which type of spinal cord injury is this? - CORRECT ANSWER Brown Sequard
Patient has complete paralysis and loss of sensations of pain and temp.
Posterior column functions remain and there is some sensation below the injury.
Which type of spinal cord injury is this? - CORRECT ANSWER Anterior cord
Quadriparasis and some loss of sensation of pain and temp
Which spinal cord injury is this? - CORRECT ANSWER Central cord
Motor function is preserved by without sensation.
Which spinal cord injury is this? - CORRECT ANSWER Posterior cord
How do you promote phase delay in sleep disorders? - CORRECT ANSWER Expose light immediately before time of minimum body temp
avoid early mornings light and seek bright light in the evening
How do you promote phase advance in sleep disorders? - CORRECT ANSWER Expose light after time of minimum body temp
walk outside in sunlight after awakening and avoid bright light in evening
melatonin supplement at night
What are the five phases of aggression cycle? - CORRECT ANSWER Triggering
Escalation
Crisis
Recovery
Postcrisis
0.6-1.4 mEq/L
What is normal value correlated too? - CORRECT ANSWER Lithium Levels
Encase mattresses and pillowcases
Remove carpets
Keep humidity <50%
Limit exposure to outside
These are all ways to do what? - CORRECT ANSWER ways to help control asthma and eliminate exposure to allergens
The Randsford scoring system scores what? - CORRECT ANSWER Pain assessment (especially in lower back) evaluates the presence of pain that is physiologically improbable/ impossible
What is the PRIMARY purpose of using an orthotic device for a fixed deformity? - CORRECT ANSWER Prevent deformity from progressing
0.5-2.0 ng/mL is the normal level for what lab? - CORRECT ANSWER Digoxin level
What does the Abnormal Involuntary Movement Scale measure? - CORRECT ANSWER AIMS= tardive dyskinesia
What level of injury does autonomic dysreflexia occur at? - CORRECT ANSWER T5-T6 [Show Less]