Orthopedic Nurse Certification Exam Questions And Answers
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Course
ORTHOPEDIC NURSE
Institution
ORTHOPEDIC NURSE
Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a patient to a fracture. - ANS Biological:
1) Age: bone structure becomes less dense/more susceptible to injury
2) Type of bone involved: some are better equipped to handle difference stresses and forces without i...
Orthopedic Nurse Certification Exam
Questions And Answers
Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a patient to a
fracture. - ANS Biological:
1) Age: bone structure becomes less dense/more susceptible to injury
2) Type of bone involved: some are better equipped to handle difference stresses and forces
without injury
Extrinsic:
1) Amount of force applied
2) Angle of force applied
3) Duration of force
Behavioral:
1) Participating in adrenalin-seeking activities such as skydiving, rock-climbing, motor cross
Describe nursing instructions that may be given to a patient in a cast. - ANS 1) Cast should
be kept dry.
2) Monitor the skin areas at the end of the cast.
3) Never stick anything into or under the cast to scratch or itch.
4) Alert medical care in case of tightness or increasing pain, numbness, color change, or
temperature change in areas of distal ends of cast.
5) Follow up if cast gets loose or cracks.
What is the basic anatomy of a long bone? - ANS Typically has two main components:
1) Diaphysis - makes up long shaft of bone. Outer portion is made of compact bone. Inner layer
is made of marrow.
2) Epiphyses - set at either end of long bone. Outer layer is compact bone and inner core is
spongy bone.
Periosteum - membrane that lines both externally. - contains supply of nerve fibers, lymph,
blood vessels
Give examples of tapping fracture and penetrating fracture. - ANS 1) Tapping - sustained
from a small force to a concentrated area. Bone will absorb this force - may or may not be mild
soft tissue display of injury.
EX: fracture of forearm when blocking a hit with a fist or bat; being kicked in lower leg
,2) Penetrating - caused by large amount of force on small area. Object of force is usually small
and soft tissue involvement is minimal.
EX: stab wound, gunshot wound
Different from crush wound because object of force is much larger.
List several factor that determine fracture-healing outcome. - ANS 1) Skeletal maturity
decreases healing.
- Immature skeleton increases rate and success of healing.
2) Single bone fracture has better prognosis than multi-bone fracture.
3) Big displacement that affect surrounding tissues requires more healing time.
4) Thoracic spine injury heals better than unstable lumbar/cervical spine injuries.
5) Fracture of joint surfaces are more unstable/difficult to treat.
6) Fracture with nearby unaffected support bone has good prognosis - acts as natural splint.
Differentiate between linear, oblique, and transverse fractures. - ANS LINEAR: the fracture
forms a straight line through the bone; doesn't tell if fracture line is angled or horizontal; a linear
can be oblique or transverse
OBLIQUE: fracture line that travels at an angle through the bone
TRANSVERSE: break that travels in a horizontal line through the bone.
Don't ever just say a fracture line is linear - differentiate with oblique or transverse.
Describe/give examples of following bony injuries. - ANS 1) CRUSH - caused by large
stress on a small area; results in multiple break lines and severe soft tissue damage; EX:
sledgehammer coming down on a finger or heavy suspended mass falling on foot or leg
2) COMPRESSION - happens with large axial loading force; most often in vertebrae; EX:
landing on feet or butt, fall from a moderate height
3) STRESS - not sustained by one-time incident but instead with repetitive activity that stresses
a normal bone over time
Differences between plaster of Paris and fiberglass casting. - ANS PLASTER OF PARIS:
slightly cheaper, molds well but is heavier and has longer drying time/setting; not ideal for kids in
an outpatient setting/upper extremity injury
FIBERGLASS: more expensive, comes in different colors, molds well, lightweight, drying time is
as little as 5 minutes, more water resistant; BUT edges are more abrasive and they tend to be
hotter
, How to choose? - cost, physician comfort/familiarity, joint being immobilized, injury being treated
& patient type
Discuss the 4 main types of bone. - ANS 1) LONG BONE: longer than they are wide;
consist of shaft (diaphysis) and head (epiphysis); EX: humerus, femur
2) SHORT BONE: cubical in shape; consist of spongy bone; EX: carpals in wrist
3) FLAT BONE: thin and flat with slight curvature; contain mostly compact bone; EX: skull bones
4) IRREGULAR BONE: don't fit above classifications; consist of spongy bone with thin compact
outer layer; EX: vertebrae, pelvic girdle bones
Describe angulation and rotational fractures. - ANS ANGULATION FX: force that causes
bony fragment to become broken transversely, then misaligned; usually in a v shape; EX: same
as that of a tapping force, like using forearm to block a blow
ROTATIONAL FX: force causes a spiraling fracture line; seen in arms or lower leg - when seen
in child, raises question of abuse
Define fracture, dislocation, and subluxation. - ANS 1) FRACTURE: a break in a bone; may
or may not involve a joint surface; may be full thickness or partial thickness
2) DISLOCATION: complete disruption in a joint where joint surfaces of both bones no longer
make contact
3) SUBLUXATION: incomplete dislocation of joint from its normal position; still partial contact of
joint surfaces; "partial dislocation"
3 injuries that can be sustained from a knee that hits the dashboard in a MVA. - ANS 1)
DASHBOARD FRACTURE: fracture of the rim of the acetabulum; caused by impact of femoral
head
2) PATELLAR FRACTURE: force of kneecap on dash
3) POSTERIOR CRUCIATE LIGAMENT (PCL) TEAR
4 Main Components of describing and classifying a fracture - ANS 1) LOCATION: distal,
proximal, lateral, numbering (phalanges, tarsals, 3rd, 4th, etc.); can also describe the portion of
the bone involved (diaphysis, epiphyses)
2) DESCRIPTION OF FRACTURE LINE: comminuted, segmented, compressed, transverse
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