Medical CRRN : Certified Rehabilitation Registered Nurse ExamExam Dumps Organized by Montgomery
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Test Number : CRRN
Test Name : Certified Rehabilitation Registered Nurse
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1. Rehabilitation nursing models and theories (6%)
2. Functional health patterns (theories, physiology, assessment, standards of care, and interventions in individuals with injury, chronic illness, and disability across the lifespan) (58%)
3. The function of the rehabilitation team and community reintegration (13%)
4. Legislative, economic, ethical, and legal issues (23%).
The CRRN test Content Outline lists each domain with related tasks, knowledge, and skill statements. It is the best source of information for test content.
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Domain I: Rehabilitation Nursing Models and Theories (6%)
Task 1: Incorporate evidence-based practice, models, and theories into patient-centered care.
a. Evidence-based practice
b. Nursing theories and models significant to rehabilitation (e.g., King, Rogers, Neuman, Orem)
c. Nursing process (i.e., assessment, diagnosis, outcomes identification, planning, implementation, evaluation)
d. Rehabilitation standards and scope of practice
e. Related theories and models (e.g., developmental, behavioral, cognitive, moral, personality, caregiver development and function)
f. Patient-centered care Skill in:
a. Applying nursing models and theories
b. Applying rehabilitation scope of practice
c. Applying the nursing process
d. Incorporating evidence-based practice
Domain II: Functional Health Patterns (theories, physiology, assessment, standards of care, and interventions in individuals with injury, chronic illness, and disability across the lifespan) (58%)
Task 1: Apply the nursing process to optimize the restoration and preservation of the individual's health and wellbeing.
a. Physiology and management of health, injury, acute and chronic illness, and adaptability
c. Rehabilitation standards and scope of practice
d. Technology (e.g., smart devices, internet sources, personal response devices, and telehealth)
e. Alterations in sexual function and reproduction
a. Assessing health status and health practices
b. Teaching interventions to manage health and wellness
c. Using rehabilitation standards and scope of practice
d. Using technology
e. Assessing goals related to sexuality and reproduction
f. Teaching interventions and technology related to sexuality and reproduction (e.g., body positioning, mirrors, adaptive equipment, medication)
Task 2: Apply the nursing process to promote optimal nutrition.
a. Adaptive equipment and feeding techniques (e.g., modified utensils, scoop plates, positioning)
b. Anatomy and physiology related to nutritional and metabolic patterns (e.g., endocrine, obesity, swallowing)
c. Diagnostic testing
d. Diet types (e.g., cardiac, diabetic, renal, dysphagia)
e. Fluid and electrolyte balance
f. Nutritional requirements
g. Skin integrity (e.g., Braden scale, pressure ulcer staging)
h. Pharmacology (e.g., anticholinergics, opioids, antidepressants)
i. Safety concerns and interventions (e.g., swallowing, positioning, food textures, fluid consistency)
a. Assessing nutritional and metabolic patterns (e.g., nutritional intake, fluid volume deficits, skin integrity, metabolic functions, feeding and swallowing)
b. Implementing and evaluating interventions for nutrition
c. Implementing and evaluating interventions for skin integrity (e.g., skin assessment, pressure relief, moisture reduction, nutrition and hydration)
d. Teaching interventions for swallowing deficits
e. Using adaptive equipment
Task 3: Apply the nursing process to optimize the individual's elimination patterns.
a. Anatomy and physiology of altered bowel and bladder function
b. Bladder and bowel adaptive equipment and technology (e.g., bladder scan, types of catheters, suppository inserter)
c. Bladder and bowel training (e.g., scheduled self -catheterization, timed voiding, elimination programs)
d. Pharmacologic and non-pharmacological interventions
a. Assessing elimination patterns (e.g., elimination diary, patients history)
b. Implementing and evaluating interventions for bladder and bowel management (e.g., nutrition, exercise, pharmacological, adaptive equipment)
c. Teaching interventions to prevent complications (e.g., constipation, urinary tract infections, autonomic dysreflexia)
d. Providing patient and caregiver education related to bowel and bladder management
e. Using adaptive equipment and technology
Task 4: Apply the nursing process to optimize the individuals highest level of functional ability.
a. Anatomy, physiology, and interventions related to musculoskeletal, respiratory, cardiovascular, and neurological function
b. Assistive devices and technology (e.g., mobility aids, orthostatic devices, orthotic devices)
c. Clinical signs of sensorimotor deficits
d. Activity tolerance and energy conservation
e. Pharmacology (e.g., antispasmodics, vasopressors, analgesics)
f. Safety concerns (e.g., falls, burns, skin integrity, infection prevention)
g. Self-care activities (e.g., activities of daily living, instrumental activities of daily living)
a. Assessing and implementing interventions to prevent musculoskeletal, respiratory, cardiovascular, and neurological complications (e.g., motor and sensory impairments, contractures, heterotrophic ossification, aspiration, pain)
b. Assessing, implementing, and evaluating interventions for self-care ability and mobility
c. Implementing safety interventions (e.g., sitters, reorientation, environment, redirection, nonbehavioral restraints)
d. Using technology (e.g., mobility aids, pressure relief devices, informatics, assistive software)
e. Teaching interventions to prevent complications of immobility (e.g., skin integrity, DVT prevention)
Task 5: Apply the nursing process to optimize the individual's sleep and rest patterns.
a. Factors affecting sleep and rest (e.g., diet, sleep habits, alcohol, pain, environment)
c. Physiology of sleep and rest cycles
a. Assessing sleep and rest patterns
b. Evaluating effectiveness of sleep and rest interventions
c. Teaching interventions and strategies to promote sleep and rest (e.g., energy conversation, environmental modifications)
d. Using technology (e.g., sleep study, CPAP, BiPAP, relaxation technology)
Task 6: Apply the nursing process to optimize the individual's neurological function.
a. Measurement tools (e.g., Rancho Los Amigos, Glasgow, Mini Mental State Examination, ASIA, pain analog scales)
b. Neuroanatomy and physiology (e.g., cognition, judgment, sensation, perception)
c. Pain (e.g., receptors, acute, chronic, theories)
e. Safety concerns (e.g., seizure precautions, fall precautions, impaired judgment)
a. Assessing cognition, perception, sensation, apraxia, perseveration, and pain
b. Implementing and evaluating strategies for safety (e.g., personal response devices, alarms, helmets, padding)
c. Teaching strategies for neurological deficits
d. Teaching strategies for pain and comfort management (e.g., pharmacological, non-pharmacological)
e. Using technology (e.g., TENS unit, baclofen pump)
f. Implementing behavioral management strategies (e.g., contracts, positive reinforcement, rule setting)
Task 7: Apply the nursing process to promote the individuals optimal psychosocial patterns and holistic wellbeing.
a. Individual roles and relationships (e.g., cultural, environmental, societal, familial, gender, age)
b. Role alterations
c. Psychosocial disorders (e.g., substance abuse, anxiety, depression, bipolar, PTSD, psychosis)
d. Theories (e.g., self-concept, role, relationship, interaction, developmental, human behaviors)
e. Traditional and alternative modalities (e.g., medications, healing touch, botanicals)
f. Cultural competence
a. Assessing and promoting self-efficacy, self-care, and self-concept
b. Accessing supportive team resources and services (e.g., psychologist, clergy, peer support, community support)
c. Promoting strategies to cope with role and relationship changes (e.g., individual and caregiver counseling, peer support, education)
d. Including the individual and caregiver in the plan of care
e. Incorporating cultural and spiritual values
f. Promoting positive interaction among individual and caregivers
g. Evaluating the effects of values, belief systems, and spirituality of the individual
Task 8: Apply the nursing process to optimize coping and stress management skills of the individual and
a. Community resources (e.g., face-to-face support groups, internet, respite care, clergy)
b. Coping and stress management strategies for individuals and support systems
c. Cultural competence
d. Physiology of the stress response
e. Safety concerns regarding harm to self and others
f. Technology for self-management
g. Theories (e.g., developmental, coping, stress, grief and loss, self-esteem, self-concept)
h. Types of stress and stressors
i. Stages of grief and loss
a. Assessing potential for harm to self and others
b. Assessing the ability to cope and manage stress
c. Facilitating appropriate referrals
d. Implementing and evaluating strategies to reduce stress and Excellerate coping (e.g., biofeedback, cognitive behavioral therapy, complementary alternative medicine, pharmacology)
e. Using therapeutic communication
Task 9: Apply the nursing process to optimize the individual's ability to communicate effectively.
a. Anatomy and physiology (e.g., cognition, comprehension, sensory deficits)
b. Communication techniques (e.g., active listening, anger management, reflection)
c. Cultural competence
d. Developmental factors
e. Linguistic deficits (e.g., aphasia, dysarthria, language barriers)
f. Assistive technology and adaptive equipment
a. Assessing comprehension and communication (e.g., oral, written, auditory, visual)
b. Implementing and evaluating communication interventions
c. Involving and educating support systems
d. Using assistive technology and adaptive equipment
e. Using communication techniques
Domain III: The Function of the Rehabilitation Team and Community Reintegration (13%)
Task 1: Collaborate with the interdisciplinary/interprofessional team to achieve patient-
centered goals. Knowledge of:
a. Goal setting and expected outcomes (e.g., SMART goals, functional independence measures [FIM], WeeFIM)
b. Types of healthcare teams (e.g., interdisciplinary/ interprofessional, multidisciplinary, transdisciplinary)
c. Rehabilitation philosophy and definition
d. Roles and responsibilities of team members
e. Theory (e.g., change, leadership, communication, team function, organizational)
a. Advocating for inclusion of appropriate team members
b. Applying appropriate theories (e.g., change, leadership, communication, team function, organizational)
c. Communicating and collaborating with the interdisciplinary/ interprofessional team
d. Developing and documenting plans of care to attain patient-centered goals
Task 2: Apply the nursing process to promote the individual's community reintegration.
a. Technology and adaptive equipment (e.g., electronic hand-held devices, electrical simulation, service animals, equipment to support activities of daily living)
b. Community resources (e.g., housing, transportation, community support systems, social services, recreation, CPS, APS)
c. Personal resources (e.g., financial, caregiver support systems, caregivers, spiritual, cultural)
d. Professional resources (e.g., psychologist, neurologist, clergy, teacher, case manager, vocational rehabilitation counselor, home health, outpatient therapy)
e. Teaching and learning strategies for self-advocacy
a. Accessing community resources
b. Assessing readiness for discharge
c. Assessing barriers to community reintegration
d. Evaluating outcomes and adjusting goals (e.g., interdisciplinary/interprofessional team and patientcentered)
e. Identifying financial barriers and providing appropriate resources
f. Initiating referrals
g. Participating in team and patient caregiver conferences
h. Planning discharge (e.g., home visits, caregiver teaching)
i. Teaching health and wellness maintenance
j. Teaching life skills
k. Using adaptive equipment and technology (e.g., voice activated call systems, computer supported prosthetics)
Domain IV: Legislative, Economic, Ethical, and Legal Issues (23%)
Task 1: Integrate legislation and regulations to guide management of care.
a. Agencies related to regulatory, disability, and rehabilitation (e.g., CARF, The Joint Commission, APS, CPS, CMS, SSA, OSHA)
b. Specific legislation related to disability and rehabilitation (e.g., Medicare, Medicaid, ADA, rehabilitation acts, HIPAA, Affordable Care Act, workers compensation, IDEA, Vocational, IMPACT Act)
a. Accessing, interpreting, and applying legal, regulatory, and accreditation information
b. Using assessment, measurement, and reporting tools (e.g., functional independence measures [FIM], patient satisfaction, IRF-PAI)
Task 2: Use the nursing process to deliver cost effective patient-centered care.
a. Clinical practice guidelines
b. Community and public resources
c. Insurance and reimbursement (e.g., PPS, workers compensation)
d. Regulatory agency audit process
e. Staffing patterns and policies
f. Utilization review processes
a. Analyzing quality and utilization data
b. Collaborating with private, community, and public resources
c. Incorporating clinical practice guidelines
d. Managing current and projected resources in a cost effective manner
Task 3: Integrate ethical considerations and legal obligations that affect nursing practice.
a. Ethical theories and resources (e.g., deontology, ombudsperson, ethics committee)
b. Legal implications of healthcare related policies and documents (e.g., HIPAA, advance directives, powers of attorney, POLST/MOLST, informed consent)
a. Advocating for the individual
b. Documenting services provided
c. Identifying appropriate resources to assist with legal documents
d. Implementing strategies to resolve ethical dilemmas
e. Applying ethics in the delivery of care
Task 4: Integrate quality and safety in patient-centered care.
a. Quality measurement and performance improvement processes (e.g., Agency for Healthcare Research and Quality; Institute of Medicine; National Database of Nursing Quality Indicators)
b. Models and tools used in process improvement (e.g., Plan, Do, Check, Act; Six Sigma; Lean approach)
c. Federal quality measurement efforts
d. Reporting requirements (e.g., infection rates, healthcare acquired pressure injury, sentinel events, discharge to community, readmission rates)
a. Assessing safety risks
b. Minimizing safety risk factors
c. Implementing safety prevention measures
d. Utilizing assessment, measurement, and reporting tools (e.g., functional independence measurement; patient satisfaction)
e. Incorporating standards of professional performance
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As education in every single place is still disrupted by way of the pandemic, scientific students are being primarily impacted. college students of their third and fourth years of medical school are losing useful opportunities to apply their expertise in hospitals and clinics.
without a sequence of longer-time period rotations via numerous specialties and patient interactions, the concern is their schooling may be subpar. This issue has been more than twenty years in the making, even though it took the pandemic to position it within the spotlight: in-grownup, on-the-job experiences and talent construction can be too without difficulty disrupted.
The implications go well past medical colleges. The huge conversion of education from mostly in-grownup to on-line — too commonly, ineffectively — has eliminated crucial opportunities to practice and follow abilities until it becomes 2nd nature, or what they call achieving automaticity.
clinical schooling often has been one or two decades forward of corporate gaining knowledge of — and pilot training has been even additional ahead in many ways. The cause may be that the lives of pilots and their passengers are at risk, making practicing the entire extra critical. The equal applies in drugs when it comes to holding sufferers’ lives.
therefore, as scientific colleges combat with the way to supply the types of experiences gained in rotations, enterprise leaders can locate parallels to make sure that their staff is ready for the long run. As McKinsey followed, “know-how and americans interacting in new ways is at the coronary heart of the brand new operating mannequin for company — and of creating an excellent post-pandemic company.”
The magnitude of making use of potential
From scientific school lectures to the regular company training session, the focal point historically has been on imparting as a lot competencies as possible. however cramming counsel into brief-time period reminiscence is not true gaining knowledge of. (The Ebbinghaus’ forgetting curve suggests that in the first 24 hours, 70 % of newly got guidance can not be recalled, and as a whole lot as 90 percent is misplaced inside the first two weeks. equivalent experiences have been repeated right through the a long time, coming to identical conclusions.) That’s why applying skills to increase retention is so important.
For medical college students, this cause has been taken up by the association of yankee medical faculties (AAMC), which stated in an Aug. 14 letter that, whereas scientific college students are not considered essential health care worker's, they are “the standard, emerging physician workforce.” AAMC pointed out: “close and ongoing collaboration between clinical faculties and their medical partners is specially crucial to make sure that these country wide body of workers wants continue to be addressed.”
With all due respect to the AAMC, the solution isn't effortlessly putting clinical students into hospitals to deal with Covid-19 patients and others. a long-term solution is needed to be sure that these doctors-in-practicing have impactful the right way to follow their knowledge, and never simply via having entry to “affected person fabric” (a term that should still provide us pause) — meaning the their bodies and organic samples of real individuals.
Working with others does increase the twenty first century abilities of communications, important considering, collaboration, and creativity. For medical doctors, affected person contact allows for these “gentle capabilities” to be honed and practiced, just as customer contact makes for more suitable business outcomes. however for the building of many other forms of capabilities, reminiscent of determination-making beneath force, committed learning environments akin to simulators are crucial.
As researchers accompanied, “Simulation is used to educate many certified together with pilots, militia personnel, enterprise managers, and health care professionals, and is a fantastic active-studying method that encourages the utility of abilities and potential in real-world scenarios.”
The significance of Simulation
Simulators immerse learners in an array of issues and crises. beginners profit determination-making experience to help them determine issues and find the right options — a lot like a doctor learns to diagnose a affected person’s condition and prescribe a direction of medication.
A classic instance is training of U.S. army medics in the early 2000s earlier than being deployed to Iraq and Afghanistan. using 142 existence-dimension human patient simulators at castle Sam Houston revolutionized medic practicing, involving everything from making use of tourniquets and inserting IVs to dealing with gunshot wounds, lack of limbs, and chemical burns. These mannequins (which charge $37,000 each and every on the time) weren’t just about establishing medical knowledge; they additionally allowed the medics to observe scientific determination-making below power. Describing the simulation practicing, the manhattan instances referred to as it “as shut an approximation to battlefield circumstances as anything else this side of Kandahar.”
Admittedly, awesome simulators are very expensive, and scientific colleges have generally deferred investing in them. For these days’s medical students, this choice is proving to be a expensive mistake. It’s no longer in contrast to some shortfalls we’re experiencing in an absence of vaccine building before the pandemic and low inventories of ventilators. Given the pressures on fitness care to treat more patients (often with advanced medical circumstances) in a system it truly is resource-confined, improving medical education with the use of extra simulators is an investment in public fitness.
Twenty years in the past, when my colleagues and i were developing the way to Excellerate medical education, they were motivated to help be sure that vital abilities changed into retained. otherwise, advantage gaps enhance, and mistaken assumptions cause “unconscious incompetence,” which is when individuals trust they understand anything however, definitely, don't.
Unconscious incompetence amongst medical doctors and other clinicians can lead to medical blunders, every so often with tragic effects. in the late 1990s, the seminal document To Err is Human discovered that as many as ninety eight,000 avoidable deaths a yr had been due to human clinical error. This revelation led to a wave of innovations, together with the importance of checklists to make certain no steps had been missed and strategies have been at all times followed, and the construction of computer-primarily based solutions to follow scientific resolution-making.
Unconscious incompetence is a problem in each industry, affecting freshmen in as plenty as 30% or forty% of the cloth they are getting to know of initiatives they are performing. company leaders cannot count on that on-the-job practicing will suffice as a result of such getting to know regularly occurs most effective sporadically, and infrequently now not at all. simply because the wheels retain turning each day and business is being carried out, leaders cannot expect that personnel are studying. Too commonly, “heroic efforts” via employees who step up to do what needs to get performed cowl up the studying gaps of others.
If agencies are going to circulation forward put up-pandemic, the secret's having beneficial training that imparts potential and provides alternatives to follow it.
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