Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

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Subluxation of the shoulder in a patient with hemiplegia can be prevented by:

Exercise therapy
Medications
Positioning
Use of slings

The correct answer is: Positioning

Preventing subluxation of the shoulder in a patient with hemiplegia involves careful attention to positioning. Proper positioning is critical as it can help maintain the alignment of the shoulder joint and prevent excessive strain on the surrounding muscles and ligaments. When a hemiplegic patient lacks voluntary control or muscle tone on one side, the shoulder may become unstable, leading to subluxation. Correct positioning ensures that gravity does not pull the shoulder downward excessively, avoiding further joint laxity. Techniques such as placing the affected arm on a supportive surface, using pillows for elevation, or adjusting the patient's overall body alignment in bed or while sitting can significantly contribute to joint stability. Although exercise therapy, medications, and the use of slings may have roles in rehabilitation or symptom management, they do not specifically target the immediate prevention of shoulder subluxation as effectively as proper positioning. Exercise therapy may strengthen supporting muscles over time, medications can help relieve pain, and slings may offer some support, but without appropriate positioning, the risk of subluxation remains high.