NURS 5450 Exam 2 - Basic Orthopedics: Questions With
Expert-Level Solutions
Orthopedics is: Correct Answer - "a branch of medicine concerned with the
correction or prevention of deformities, disorders, or injuries of the skeleton
& associated structures (as tendons & ligaments)"
History of Orthopedics Correct Answer - 1. Egyptian Artifacts
2. Early Interventions
3. Battlefield Innovations
4. Recent Progress
Which factors should you consider when planning an anesthetic for an ortho
case? Correct Answer - 1. Procedure; type of surgery
2. Procedure; time or length
3. Preference; patient or surgeon's
4. Position
5. Pre-existing comorbidities
6. Problem with airway
7. Pain considerations
8. Post operative; inpatient vs. outpatient
Which details need to be considered for a preop assessment for an ortho case?
Correct Answer - 1. Routine exam
2. Procedure specific
3. Context
4. Routine or Elective vs Non-elective
5. Labs
6. Blood product needs
What should your focused preop assessment include for an ortho case?
Correct Answer - 1. Pre-existing neuro or vascular injury
2. Pregnancy test
3. Pre-existing infection
A. UTI and joint replacement
B. Pre-operative antibiotic needs
C. Presence of MRSA
4. Estimate blood loss from long bone fractures
,5. Pre-existing anemia
6. Position related issues
What are the general goals of the 2006 Surgical Care Improvement Project
(SCIP)? Correct Answer - Goal: to reduce risk to patient
A. Surgical site infection
B. Post operative thromboembolism
C. Perioperative glucose management
D. Maintenance of core body temperature
What are the specific antibiotic-related goals of the 2006 Surgical Care
Improvement Project (SCIP)? Correct Answer - 1. Correct preoperative
antibiotics
Varies facility to facility
Cefazolin 2-3 grams IV
Vancomycin 1-1.5 grams
2. Correct timing (started)
Cephalosporins within 1 hour of incision (before tourniquet)
Vancomycin (others) within 2 hours of incision
Check facility guidelines
Osteoarthritis (OA) Correct Answer - 1. Degenerative joint disease (DJD)
2. Affects articular cartilage on one or more joints
3. Common sites:
A. Knees
B. Hips
4. C/O stiffness & pain w/ movement:
A. Relief w/ rest
Osteoarthritis (OA) (image) Correct Answer -
What is the etiology of OA? Correct Answer - 1. Joint trauma
2. Aging
3. Heredity
Spine involvement of OA includes: Correct Answer - 1. Affect vertebral
bodies & intervertebral discs
2. Primarily in cervical and lumbar spines
, If c-spine if affected with OA, why must position be carefully considered?
Correct Answer - 1. Can cause a nerve root compression or
2. Herniation of nucleus pulposus (HNP)
3. Consider glidescope
What are Heberden's nodes? Correct Answer - - Bony enlargements in
distal interphalangeal joints
- This is the distinguishing feature from rheumatoid arthritis (RA)
Heberden's nodes (image) Correct Answer -
What is Rheumatoid Arthritis (RA)? Correct Answer - 1. Systemic
autoimmune chronic inflammatory disease
2. Marked by:
A. Genetic predisposition
B. Exacerbations and remissions
3. Generally starts between ages of 25 to 55 years
4. Affects women 3x > men
5. Cervical joint involvement > in males
Rheumatoid Arthritis (image) Correct Answer -
What is the hallmark of RA? Correct Answer - - Morning stiffness
In RA, ______ joints are involved. Correct Answer - proximal interphalangeal
OA has bony enlargements or Heberden's nodes in _______ joints Correct
Answer - distal interphalangeal
Rheumatoid Arthritis (image) Correct Answer -
How does RA affect the heart? Correct Answer - 1. Conduction defects:
Result of formation of rheumatoid nodules in conduction pathway
2. Aortitis with dilation of the aortic root leads to:
A. Aortic regurgitation (AR)
B. Aortic insufficiency (AI)
How does RA affect the pulmonary system? Correct Answer - 1. Pleural
effusions & interstitial pulmonary fibrosis most common
Expert-Level Solutions
Orthopedics is: Correct Answer - "a branch of medicine concerned with the
correction or prevention of deformities, disorders, or injuries of the skeleton
& associated structures (as tendons & ligaments)"
History of Orthopedics Correct Answer - 1. Egyptian Artifacts
2. Early Interventions
3. Battlefield Innovations
4. Recent Progress
Which factors should you consider when planning an anesthetic for an ortho
case? Correct Answer - 1. Procedure; type of surgery
2. Procedure; time or length
3. Preference; patient or surgeon's
4. Position
5. Pre-existing comorbidities
6. Problem with airway
7. Pain considerations
8. Post operative; inpatient vs. outpatient
Which details need to be considered for a preop assessment for an ortho case?
Correct Answer - 1. Routine exam
2. Procedure specific
3. Context
4. Routine or Elective vs Non-elective
5. Labs
6. Blood product needs
What should your focused preop assessment include for an ortho case?
Correct Answer - 1. Pre-existing neuro or vascular injury
2. Pregnancy test
3. Pre-existing infection
A. UTI and joint replacement
B. Pre-operative antibiotic needs
C. Presence of MRSA
4. Estimate blood loss from long bone fractures
,5. Pre-existing anemia
6. Position related issues
What are the general goals of the 2006 Surgical Care Improvement Project
(SCIP)? Correct Answer - Goal: to reduce risk to patient
A. Surgical site infection
B. Post operative thromboembolism
C. Perioperative glucose management
D. Maintenance of core body temperature
What are the specific antibiotic-related goals of the 2006 Surgical Care
Improvement Project (SCIP)? Correct Answer - 1. Correct preoperative
antibiotics
Varies facility to facility
Cefazolin 2-3 grams IV
Vancomycin 1-1.5 grams
2. Correct timing (started)
Cephalosporins within 1 hour of incision (before tourniquet)
Vancomycin (others) within 2 hours of incision
Check facility guidelines
Osteoarthritis (OA) Correct Answer - 1. Degenerative joint disease (DJD)
2. Affects articular cartilage on one or more joints
3. Common sites:
A. Knees
B. Hips
4. C/O stiffness & pain w/ movement:
A. Relief w/ rest
Osteoarthritis (OA) (image) Correct Answer -
What is the etiology of OA? Correct Answer - 1. Joint trauma
2. Aging
3. Heredity
Spine involvement of OA includes: Correct Answer - 1. Affect vertebral
bodies & intervertebral discs
2. Primarily in cervical and lumbar spines
, If c-spine if affected with OA, why must position be carefully considered?
Correct Answer - 1. Can cause a nerve root compression or
2. Herniation of nucleus pulposus (HNP)
3. Consider glidescope
What are Heberden's nodes? Correct Answer - - Bony enlargements in
distal interphalangeal joints
- This is the distinguishing feature from rheumatoid arthritis (RA)
Heberden's nodes (image) Correct Answer -
What is Rheumatoid Arthritis (RA)? Correct Answer - 1. Systemic
autoimmune chronic inflammatory disease
2. Marked by:
A. Genetic predisposition
B. Exacerbations and remissions
3. Generally starts between ages of 25 to 55 years
4. Affects women 3x > men
5. Cervical joint involvement > in males
Rheumatoid Arthritis (image) Correct Answer -
What is the hallmark of RA? Correct Answer - - Morning stiffness
In RA, ______ joints are involved. Correct Answer - proximal interphalangeal
OA has bony enlargements or Heberden's nodes in _______ joints Correct
Answer - distal interphalangeal
Rheumatoid Arthritis (image) Correct Answer -
How does RA affect the heart? Correct Answer - 1. Conduction defects:
Result of formation of rheumatoid nodules in conduction pathway
2. Aortitis with dilation of the aortic root leads to:
A. Aortic regurgitation (AR)
B. Aortic insufficiency (AI)
How does RA affect the pulmonary system? Correct Answer - 1. Pleural
effusions & interstitial pulmonary fibrosis most common
