We must assume $q$ is odd (the statement certainly isn't true if $q$ is a power of $2$).
Note that if $m_1, m_2, \ldots, m_k$ are relatively prime, $x$ is a solution of $x^2 \equiv 1 \mod m_1 m_2 \ldots m_k$ iff $x^2 \equiv 1 \mod m_1$, $x^2 \equiv 1 \mod m_2,\ \ldots x^2 \equiv 1 \mod m_k$. If $S_j = \{x \in {\mathbb Z}_{m_j}: x^2 \equiv 1 \mod m_j\}$, then
$x$ is a solution of $x^2 \equiv 1 \mod m_1 \ldots m_j$ iff $x \in S_j \mod m_j$ for each $j$. By CRT the number of such solutions in ${\mathbb Z}_{m_1 \ldots m_k}$ is
$|S_1| |S_2| \ldots |S_k|$: each one corresponds to choosing one member $x_1$ of $S_1$, one member $x_2$ of $S_2$, etc, and then taking $x$ so $x \equiv x_1 \mod m_1$, $x \equiv x_2 \mod m_2$, etc. So you just have to see how many solutions there are mod $2^r$ (which you have already done) and mod $p^m$ if $p$ is an odd prime. For the latter,
note that $x^2 - 1 = (x-1)(x+1)$, and $x-1$ and $x+1$ can't both be divisible by $p$.