ONCB - METABOLIC/INFLAMMATORY/TUMORS
PRACTICE EXAM WITH ALL CORRECT
ANSWERS WITH DETAILED RATIONALES AND
REFERENCES GRADED A+
A 65-year-old Caucasian female sustained a right wrist fracture
from a fall in her garden. During her follow-up appointment in the
orthopaedic clinic, she tells the nurse, "I am glad I don't have
osteoporosis like my neighbor." What should be the nurse's
MOST appropriate response?
a. "You are so lucky it was your wrist and not your hip."
b. "When is the last time you had a bone mineral density test?"
c. "You should be sure the paths are clear in your garden."
d. "Because you are active outdoors, you are not at risk for
osteoporosis." Correct Answer b. "When is the last time you had a
bone mineral density test?"
,Rationale: Wrist fractures are a type of fragility fracture
experienced as a complication of osteoporosis. Age, sex, and
ethnicity place this patient at risk for this disease. Bone mineral
density testing is used to evaluate for the presence of
osteoporosis.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.),
2013, pp. 379-380
Category: Metabolic bone disorders
A 2-year-old child has been diagnosed with rickets. When talking
with the child's parents, the nurse should tell them the disease
can affect all bones but the most common deformities are located
in the
a. spine and lower extremities.
b. feet and hands.
c. upper extremities.
d. pelvic girdle. Correct Answer a. spine and lower extremities
,Rationale: The most common deformities occur in the spine and
long bones of the lower extremities, possibly leading to deformity
and the need for surgical intervention.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.),
2013, p. 385
Category: Metabolic bone disorders
The nurse is providing education on musculoskeletal conditions at
a community center. The nurse should include discussion of the
critical need for adequate vitamin D intake to decrease risk for:
a. Paget's disease.
b. osteomyelitis.
c. osteomalacia.
d. systemic sclerosis. Correct Answer c. osteomalacia
Rationale: Osteomalacia is often due to inadequate intake of
vitamin D. It can also be related to abnormal metabolism of
vitamin D due to hepatic or renal disease and the side effect of
, medications used to treat these diseases. Vitamin D is not a
factor in the other listed diseases.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.),
2013, p. 383
Category: Metabolic bone disorders
In assessing a patient, which of the following findings should the
nurse identify as suggestive of a diagnosis of
hypoparathyroidism?
a. Newly negative Trousseau's phenomenon
b. Hypoactive deep tendon reflexes (DTRs)
c. Bradycardia
d. Newly positive Chvostek's sign Correct Answer d. Newly
positive Chvostek's sign
Rationale: Positive Chvostek's sign is ipsilateral contraction of the
facial muscles elicited by tapping the facial nerve just anterior to
the ear. This sign cannot be considered diagnostic of
PRACTICE EXAM WITH ALL CORRECT
ANSWERS WITH DETAILED RATIONALES AND
REFERENCES GRADED A+
A 65-year-old Caucasian female sustained a right wrist fracture
from a fall in her garden. During her follow-up appointment in the
orthopaedic clinic, she tells the nurse, "I am glad I don't have
osteoporosis like my neighbor." What should be the nurse's
MOST appropriate response?
a. "You are so lucky it was your wrist and not your hip."
b. "When is the last time you had a bone mineral density test?"
c. "You should be sure the paths are clear in your garden."
d. "Because you are active outdoors, you are not at risk for
osteoporosis." Correct Answer b. "When is the last time you had a
bone mineral density test?"
,Rationale: Wrist fractures are a type of fragility fracture
experienced as a complication of osteoporosis. Age, sex, and
ethnicity place this patient at risk for this disease. Bone mineral
density testing is used to evaluate for the presence of
osteoporosis.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.),
2013, pp. 379-380
Category: Metabolic bone disorders
A 2-year-old child has been diagnosed with rickets. When talking
with the child's parents, the nurse should tell them the disease
can affect all bones but the most common deformities are located
in the
a. spine and lower extremities.
b. feet and hands.
c. upper extremities.
d. pelvic girdle. Correct Answer a. spine and lower extremities
,Rationale: The most common deformities occur in the spine and
long bones of the lower extremities, possibly leading to deformity
and the need for surgical intervention.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.),
2013, p. 385
Category: Metabolic bone disorders
The nurse is providing education on musculoskeletal conditions at
a community center. The nurse should include discussion of the
critical need for adequate vitamin D intake to decrease risk for:
a. Paget's disease.
b. osteomyelitis.
c. osteomalacia.
d. systemic sclerosis. Correct Answer c. osteomalacia
Rationale: Osteomalacia is often due to inadequate intake of
vitamin D. It can also be related to abnormal metabolism of
vitamin D due to hepatic or renal disease and the side effect of
, medications used to treat these diseases. Vitamin D is not a
factor in the other listed diseases.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.),
2013, p. 383
Category: Metabolic bone disorders
In assessing a patient, which of the following findings should the
nurse identify as suggestive of a diagnosis of
hypoparathyroidism?
a. Newly negative Trousseau's phenomenon
b. Hypoactive deep tendon reflexes (DTRs)
c. Bradycardia
d. Newly positive Chvostek's sign Correct Answer d. Newly
positive Chvostek's sign
Rationale: Positive Chvostek's sign is ipsilateral contraction of the
facial muscles elicited by tapping the facial nerve just anterior to
the ear. This sign cannot be considered diagnostic of
