Orthopedic Nurse Certification Exam 72
Complete Solutions.
Orthopedic Nurse Certification Exam 72
Complete Solutions.
Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a patient to a fracture. -
ANSWER 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. - ANSWER 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? - ANSWER 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.
,Orthopedic Nurse Certification Exam 72
Complete Solutions.
Periosteum - membrane that lines both externally. - contains supply of nerve fibers, lymph, blood
vessels
Give examples of tapping fracture and penetrating fracture. - ANSWER 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. - ANSWER 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. - ANSWER 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
, Orthopedic Nurse Certification Exam 72
Complete Solutions.
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. - ANSWER 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. - ANSWER 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. - ANSWER 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
Complete Solutions.
Orthopedic Nurse Certification Exam 72
Complete Solutions.
Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a patient to a fracture. -
ANSWER 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. - ANSWER 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? - ANSWER 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.
,Orthopedic Nurse Certification Exam 72
Complete Solutions.
Periosteum - membrane that lines both externally. - contains supply of nerve fibers, lymph, blood
vessels
Give examples of tapping fracture and penetrating fracture. - ANSWER 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. - ANSWER 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. - ANSWER 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
, Orthopedic Nurse Certification Exam 72
Complete Solutions.
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. - ANSWER 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. - ANSWER 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. - ANSWER 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
