Models + Theories
8%of exam
Functional Health Patterns
53%of exam
Team + Transitions
12%of exam
Legal + Quality
27%of exam
Quick Facts
- Exam
- CRRN
- Credential
- Rehab nursing
- Questions
- 175 MCQ
- Scored
- 150 scored
- Pretest
- 25 unscored
- Time
- 3 hours
- Pass
- 500 scaled
- Windows
- June and December
- Validity
- 5 years
Blueprint Order
Models, patterns, team, legal.
8%53%12%27%
Impairment vs Disability
Impairment
- Body problem
- Function loss
- Clinical finding
Disability
- Activity limit
- Participation barrier
- Context dependent
Body vs participation
Nursing Models
- Orem
- Self-care deficit
- Roy
- Adaptation model
- Neuman
- Systems model
- King
- Goal attainment
- Rogers
- Unitary humans
- ICF
- Function framework
Rehab Foundations
- Nursing process
- ADOPIE cycle
- EBP
- Evidence plus judgment
- Patient-centered
- Goals drive care
- Self-efficacy
- Confidence to act
- Scope
- Authorized nursing practice
- Standards
- Expected performance
AD First Actions
Sit, loosen, bladder, bowel, skin.
Sit uprightLoosen clothesDrain bladderCheck bowelInspect skin
FIM vs GG
FIM
- Legacy tool
- 18 items
- Seven-level scale
GG
- CMS items
- Self-care/mobility
- IRF-PAI focus
Know both
Dysreflexia Response
- SCI T6+→Suspect AD(Emergency)
- BP spikes→Sit upright
- Tight clothing→Loosen items
- Bladder full→Drain bladder
- Bowel trigger→Remove impaction
- BP persists→Antihypertensive(Protocol)
Health Patterns
- Health perception
- Wellness beliefs
- Nutrition
- Metabolic needs
- Elimination
- Bowel/bladder patterns
- Activity
- Mobility tolerance
- Sleep
- Rest recovery
- Cognition
- Perception processing
- Self-perception
- Body image
- Roles
- Relationship function
Skin Risk
Pressure, shear, moisture, nutrition.
RepositionOffloadDry skinProtein
Left vs Right Stroke
Left stroke
- Aphasia common
- Right weakness
- Cautious behavior
Right stroke
- Left neglect
- Impulsivity
- Poor judgment
Language vs neglect
Assessment Picker
- CMS function→GG items
- ADL independence→FIM/Barthel
- Pressure risk→Braden
- Fall risk→Morse
- Stroke severity→NIHSS
- TBI cognition→Rancho
Neuro-Rehab
- SCI T6+
- Dysreflexia risk
- TBI
- Cognitive recovery
- Stroke
- Hemisphere deficits
- Aphasia
- Language impairment
- Neglect
- Unattended side
- Spasticity
- Tone increase
- Dysphagia
- Swallowing impairment
- Neuroplasticity
- Relearning capacity
Expressive vs Receptive Aphasia
Expressive
- Knows message
- Cannot say
- Allow time
Receptive
- Poor understanding
- Fluent errors
- Use gestures
Output vs input
SCI Levels
- C1-C4
- Ventilator possible
- C5
- Elbow flexion
- C6
- Wrist extension
- C7-C8
- Elbow/finger function
- T1-T6
- Full arms
- T7-T12
- Better trunk
- L1-L5
- Leg movement
- S2-S4
- Bowel/bladder reflexes
Reflex vs Flaccid Bowel
Reflex
- UMN lesion
- Suppository helps
- Scheduled program
Flaccid
- LMN lesion
- Manual evacuation
- Prevent impaction
Upper vs lower
Functional Tools
- GG
- CMS function score
- FIM
- Independence measure
- Braden
- Pressure risk
- Morse
- Fall risk
- NIHSS
- Stroke severity
- Rancho
- TBI cognition
- PAINAD
- Dementia pain
- FLACC
- Behavioral pain
Skin + Nutrition
- Stage 1
- Nonblanchable erythema
- Stage 2
- Partial-thickness loss
- Stage 3
- Full-thickness loss
- Stage 4
- Exposed structures
- Unstageable
- Covered wound base
- Offloading
- Pressure relief
- Protein
- Wound substrate
- Moisture
- Breakdown risk
Bowel + Bladder
- Intermittent cath
- Scheduled emptying
- Bladder scan
- Residual check
- Timed voiding
- Predictable schedule
- Reflex bowel
- Upper motor pattern
- Flaccid bowel
- Lower motor pattern
- Suppository
- Bowel trigger
- UTI
- Catheter complication
- Impaction
- Dysreflexia trigger
Pain + Coping
- Neuropathic
- Nerve pain
- Nociceptive
- Tissue pain
- Phantom pain
- Missing limb pain
- CBT
- Thought reframing
- Mindfulness
- Attention regulation
- Grief
- Loss response
- Depression
- Screen early
- Peer support
- Lived experience
Team Core
Doctor, nurse, PT, OT, speech.
PhysiatristRNPTOTSLP
IRF vs SNF
IRF
- Intensive therapy
- Physician oversight
- IRF-PAI
SNF
- Lower intensity
- Skilled nursing
- Longer recovery
Intensity drives placement
Discharge Picker
- Unsafe doorway→Home modification
- Needs wheelchair→DME order
- Caregiver strain→Respite referral
- Work return→Voc rehab
- School return→IEP/504
- Community isolation→Peer support
Team Roles
- Physiatrist
- Rehab physician
- RN
- 24-hour carryover
- PT
- Mobility training
- OT
- ADL training
- SLP
- Speech/swallow/cognition
- RT
- Leisure reintegration
- SW
- Resources planning
- Case manager
- Coverage coordination
Transitions Care
- Acute care
- Medical stabilization
- IRF
- Intensive rehab
- SNF
- Lower-intensity rehab
- Home health
- Home-based care
- Outpatient
- Clinic therapy
- DME
- Durable equipment
- Home visit
- Barrier check
- Self-advocacy
- Patient voice
Ethics Four
Choice, good, no harm, fairness.
AutonomyBeneficenceNonmaleficenceJustice
ADA vs IDEA
ADA
- Civil rights
- Work/public access
- Reasonable accommodation
IDEA
- Education law
- Eligible children
- IEP services
Access vs education
Law Picker
- Work accommodation→ADA
- School services→IDEA
- Program access→Section 504
- Privacy question→HIPAA
- IRF payment→CMS PPS
- Rehab accreditation→CARF
Laws + Agencies
- ADA
- Reasonable accommodation
- IDEA
- Special education
- Section 504
- Disability nondiscrimination
- HIPAA
- Health privacy
- CMS
- Medicare/Medicaid rules
- CARF
- Rehab accreditation
- OSHA
- Worker safety
- IMPACT Act
- PAC data standardization
Autonomy vs Beneficence
Autonomy
- Patient choice
- Informed refusal
- Self-determination
Beneficence
- Do good
- Promote welfare
- Clinical recommendation
Choice vs benefit
Reimbursement + Quality
- IRF-PAI
- IRF assessment
- PPS
- Prospective payment
- 60% rule
- IRF case mix
- 3-hour rule
- Therapy intensity
- QAPI
- Quality program
- PDSA
- Improvement cycle
- RCA
- Root-cause analysis
- Utilization review
- Medical necessity
Ethics + Safety
- Autonomy
- Patient choice
- Beneficence
- Promote good
- Nonmaleficence
- Avoid harm
- Justice
- Fair access
- POLST
- Portable orders
- Consent
- Informed permission
- Restraints
- Last resort
- Falls
- Primary safety risk
Common Traps
Old Blueprint Trap
6/58/13/23 old ≠ 8/53/12/27 current
Pretest Trap
25 unscored hidden ≠ Answer every item
Dysreflexia Trap
Do not lie flat ≠ Sit upright first
Stroke Trap
Left often aphasia ≠ Right often neglect
Skin Trap
Donut cushions harm ≠ Pressure redistribution helps
Education Trap
Lecture is weak ≠ Return demonstration proves
Ethics Trap
Capacity supports refusal ≠ Preference is not noncompliance
Renewal Trap
60 points required ≠ 40 nursing-approved
Last Minute
- 1.Blueprint: 8/53/12/27
- 2.Pass: 500 scaled
- 3.150 scored; 25 pretest
- 4.No penalty for guessing
- 5.T6+ headache = AD
- 6.AD first: sit upright
- 7.Bladder/bowel trigger AD
- 8.Right stroke: left neglect
- 9.Left stroke: aphasia
- 10.Braden = pressure risk
- 11.Rancho = TBI cognition
- 12.ADA = accommodation
- 13.IDEA = school services
- 14.IRF requires intensity
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