Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

After a right hemisphere stroke, Ms. H's extremities are likely to be positioned in what pattern?

1. Upper extremity flexion and adduction with lower extremity extension

2. Upper extremity extension and adduction with lower extremity flexion

3. Lower extremity abduction and extension with upper extremity flexion

4. Lower extremity extension and adduction with upper extremity abduction

The correct answer is: Upper extremity flexion and adduction with lower extremity extension

After a right hemisphere stroke, it is common for the affected side of the body to display what is known as a hemiplegic or hemiparetic posturing pattern, particularly due to changes in muscle tone and motor control. The typical positioning of the extremities after a right hemisphere stroke involves upper extremity flexion and adduction along with lower extremity extension. This can be attributed to the fact that the right hemisphere of the brain is primarily responsible for motor function on the left side of the body. When there is an injury to this hemisphere, it can lead to muscle hypertonicity or spasticity. In this pattern, the upper extremity often demonstrates flexed and adducted positions, which can present as the arm being drawn up toward the body with the elbow bent and wrist flexed. The lower extremity usually exhibits an extended position, with the leg straightened out. This picture reflects the imbalance in muscle activity that often occurs after a stroke, as certain muscle groups may become more dominant in tone while others weaken or remain unresponsive. This understanding of post-stroke positioning is crucial for rehabilitation nursing practice, as it helps inform appropriate interventions aimed at improving mobility, reducing spasticity, and enhancing functional outcomes for patients