Certified Rehabilitation Registered Nurse (CRRN)
The Certified Rehabilitation Registered Nurse (CRRN) is a great asset to professional rehabilitation nurses that want to advance in their careers; and for patients to feel confident in their rehabilitation nurse’s level of expertise. Rehabilitation nurses deal with patients who have long-term or chronic injuries or illnesses that require care for an extended period of time.
To take the CRRN examination, applicants must meet the following eligibility requirements at the time that they submit their application:
- All applicants must hold a current and unrestricted Registered Nurse (RN) license.
- Within five years prior to taking the CRRN examination, applicants must have completed two years of practice as a registered professional nurse in rehabilitation nursing,
Within five years prior to taking the examination, applicants must have completed one year of practice as a registered professional nurse in rehabilitation nursing, and one year of advanced study (beyond a bachelor’s degree) in nursing.
1. Rehabilitation nursing models and theories: 11 percent
Identify nursing models and theories; use standards of care in order to plan, implement, and evaluate nursing practices.
2. Functional health patterns, including theories, physiology, assessment, standards of care, and interventions: 33 percent
Assess, plan, implement, and evaluate the outcome of health and disease management strategies; use standards of care for the restoration, maintenance, and promotion of a patient’s optimal health.
Assess and monitor the nutritional and metabolic needs of a patient through the interpretation of assessment data. Plan and implement an intervention strategy for reaching a patient’s optimal nutritional status, fluid volume, and skin integrity; then evaluate the outcome.
Determine a patient’s elimination needs using assessment data. Plan, implement, and evaluate the outcome of an individualized, regular, and predictable bowel and bladder management program.
Identify a patient’s tolerance to activities and to an exercise routine. Assess the patient’s functional abilities and lifestyle to plan and implement an optimal self-care program. Evaluate the outcome of the patient’s mobility, respiratory, and cardiovascular functions.
Assess and plan activities for a patient who suffers from sleep-rest disturbances. Implement and evaluate the outcome of the strategies used to promote adequate rejuvenation.
Assess the cognitive perception issues of a patient by using the tools and standards of care available. Plan, implement, and then evaluate the strategies used to help the patient reach achievable independence.
Identify a patient’s self-image using interview and observation skills. Plan, implement, and then evaluate the outcome of the interventions used to promote optimal self-worth.
Recognize the forced changes in a patient’s role in personal relationships due to injury or illness. Plan, implement, and then evaluate the outcome of the strategies used to improve his altered lifestyle.
Identify and assess the sexuality and reproductive cycles of a patient. Plan, implement, and then evaluate the outcome of the appropriate strategies used to improve his developmental and functional abilities.
Assess the coping and stress management strategies used by a patient and his family while implementing an at-home plan-of-care. Plan, implement, and then evaluate the outcome of intervention strategies used to promote optimal interactions.
Assess a patient’s values and belief system. Plan, implement, and then evaluate the outcome of intervention strategies used to achieve holistic wellness.
Assess a patient’s spirituality. Plan, implement, and then evaluate the outcome of intervention strategies used to attain holistic health, peace, and spiritual well-being.
Assess a patient’s communication abilities and deficits. Use established techniques, and standard protocols and tools to plan, implement, and then evaluate the outcome of improvement strategies used to promote a patient’s communication of needs.
3. The function of the rehabilitation team and community re-entry: 35 percent
Interact with the interdisciplinary team members using effective communication skills and goal-setting in order to ensure a patient attains and maintains the highest level of independence and optimal health.
Identify and teach life skills to a patient. Use a variety of strategies to effectively return the patient to, and ensure he remains in, a community setting.
Use available resources to identify and coordinate a discharge strategy for a patient and his at-home caregiver. Ensure the patient receives the prescribed level of service and care.
4. Legislative, economic, ethical, and legal issues: 21 percent
Identify legislative and regulatory issues that can affect a patient with an altered functional ability. Use practice standards to promote a patient’s independence and to ensure his access to care.
Use appropriate and available resources to identify and implement cost-effective strategies to promote a patient’s optimal health.
Integrate knowledge of ethical and legal considerations, and use practice standards to advocate for a patient’s chronic illness and disability.
CRRN Practice Questions
1. Orem’s theory of self-care states that the goal of nursing is to serve patients and assist them to provide self-care. According to this theory, which of the following comprise the 3 categories of needs?
A. Psychological, physiological, and social.
B. Universal, developmental, and health.
C. Food, air, and water.
D. Psychological, spiritual, and physical.
2. A 65-year-old woman has recovered well from a stroke but has become increasingly withdrawn and states she does not want to see friends or family because she looks “old and unattractive” and is afraid of dying. According to Erikson’s Stages of Development for older adults, for which of the following tasks does the patient show a NEGATIVE outcome?
A. Body transcendence vs body preoccupation.
B. Ego transcendence vs ego preoccupation.
C. Socializing vs sexualizing.
D. Ego differentiation vs work role preoccupation.
3. Following a TBI, a 57-year-old woman has a Functional Independence Measure (FIM) score of 40 on admission and 63 on discharge, with discharge scores in all areas ranging from 3 to 4. What level of independence or care in the home is MOST indicated by these scores?
A. Complete independence in care.
B. Modified independence, including use of assistive devices and activity modification.
C. Supervision only (stand by without physically assisting).
D. Minimal to moderate contact assistance (physically assisting).
4. A 40-year-old patient sustained a TBI and is in a vegetative state, maintained on life support. Prior to the accident, the patient was estranged and lived separately from her husband, who has a health care power of attorney for her. A decision regarding continuation of life support must be made, but the family members cannot agree. Who of the following has the LEGAL right to make the decision?
A. The patient’s mother.
B. The patient’s 18-year-old daughter.
C. The patient’s estranged husband.
D. The facility’s ethics committee.
5. A 15-month-old child is being evaluated for hearing deficit. Which of the following is a NORMAL hearing response for a 15-month-old child?
A. Coos and gurgles and looks in direction of sound.
B. Comforts at sound of parent’s voice and tries to emulate sounds.
C. Begins first words, imitates sounds, follows directions, and points to objects.
D. Knows about 20 to 50 words, and points to body parts or familiar objects when asked.
1. B: Orem’s theory of self-care states there are two agents, the self-care agent (individual) and dependent-care agent (other caregiver), and three categories of needs: universal needs (food, air), developmental needs (from maturation or events), and health needs (from illness, injury). Orem believed the goal of nursing was to serve patients and assist them to provide self-care through identifying the reason a patient needs care, planning for delivery of care, and managing care. A self-care deficit occurs if the self-care agent cannot provide for his/her own care. Nursing assists by providing care, guiding, instructing, supporting, and adjusting environment to aid patient in self-care.
2. A: Body transcendence versus body preoccupation is a task of older adulthood and a negative outcome can result in failure to accept the physical/functional changes of aging, leading to despair and fear of death. Other tasks of older adulthood include ego transcendence versus ego preoccupation and ego differentiation versus work role preoccupation. A positive outcome for all tasks of older adulthood leads to meaningful life after retirement, acceptance of bodily/functional changes, acceptance of death, and feeling that life has been good.
3. D: FIM scores range from 18 (total dependence) to 126 (total independence), and a score of 63 comprised of 3 or 4 in each of 18 categories suggests the need for minimal to moderate contact assistance. The patient will require an aide to assist with ambulation and other activities. Lower FIM scores on admission correlate with longer need for inpatient rehabilitation. FIM scores are included as part of the Inpatient Rehabilitation Facility Patient Assessment Instrument required by Medicare for reimbursement for care.
4. C: The patient’s estranged husband has been given health care power of attorney, which gives him the right to make decisions if the patient is unable to do so. While divorce may automatically revoke the health care power of attorney in some states, the patient and her husband are not divorced. The legal document takes precedence over family ties, such as those of the mother and daughter. This is not a decision rendered by ethics committees. If family members want to challenge the husband, their recourse is to take the matter to court.
5. C: At 12 to 18 months, a child should begin first words, imitate sounds, follow vocal directions, and point to familiar items when asked. Normal hearing responses:
- 3 months: Positive Moro (startle) reflex to sound. Noise disturbs sleep, and reacts to sounds by opening eyes or blinking.
- 3 to 6 months: Comforts at sound of parent’s voice and tries to emulate sounds. Looks in the direction of sound.
- 6 to 12 months: Begins to vocalize more with cooing and gurgling with different inflections. Responds to name and simple words and looks in the direction of sound.
- 18 to 24 months: More verbal with about half of vocabulary understandable and knows about 20 to 50 words. Points to body parts or familiar objects when asked.