Orthopedic Nurse Certification Exam
Questions and Answers
Question 1
What is Osgood-Schlatter disease?
Correct Answer
Disorder thought to be due to repetitive minor injury to attachment site of patellar
tendon on tibial tuberosity.
-More common in males, noted at time of growth spurt
- Will complain of pain/swelling at tibial tubercle
- Can be common in sports with plant and pivot and directional changes
Question 2
What is a scaphoid fracture?
Correct Answer
Most commonly broken carpal bone - at base of thumb, typically injured by falling
on outstretched hand
- tenderness in anatomical snuff box
- needs to be immobilized with radial gutter splint or ventral splint with thumb
extension
- After immobilized, consider short cast with thumb spica
- Can potentially tx with open reduction and screw placement
- Slow healing fracture
High risk of nonunion and avascular necrosis
Page 1 of 30
,Question 3
What is gout and what are risk factors for it?
Correct Answer
- Over-production or under-secretion of uric acid
- Leads to accumulation of uric acid within joint
- S/s: pain, swelling, redness, warmth over affected joint
- Over time, uric acid crystals can replace bone, can develop tophi and kidney
disease
- Risk factors: male gender, obesity, hyperlipidemia, excess alcohol
consumption/red meat/sardines/liver consumption
- TX: meds like diuretics, low-dose aspirin, B-complex vitamins, chemotherapy
Prophylactic meds: allopurinol, colchicine, probenecid
Acute attacks: indomethacin (can lead to GI inflammation - take with food
Question 4
List several factor that determine fracture-healing outcome.
Correct 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.
Page 2 of 30
, Question 5
Discuss temperature regulation in terms of operative complication.
Correct Answer
- Low body temp/hypothermia is below 96.8 F.
- Increases risk for infection, bleeding, heart issues, and delayed healing
- TX: monitor temp, use bair hugger, warm IV fluids, blankets, increased room tep
- Malignant hyperthermia: inherited trait, life threatening when temps are higher
than 110F
- Triggers: anesthetic agents
- Signs of MH: rigidity, increased arterial CO2, increased RR and HR
- Cardiac arrest will follow if not treated and reversed rapidly
- TX: normalize body temp, admin dantrolene, and use external cooling devices
Question 6
What is the difference between osteomalacia and osteoporosis?
Correct Answer
Osteomalacia: decrease in mineral composition of bone, causing softening of bone;
usually due to decreased vitamin D
- Causes: dysfunctional vitamin D absorption, decreased sun exposure, meds such
as seizure meds and fluoride
- Can be reversed and treated
Osteoporosis: decreased density and mass of bone, usually secondary to decreased
calcium
- Causes: age, lack of hormone & calcium, anti-inflams drugs
- Can be stabilized but not reversed
S/s of both: bone pain, muscle pain, fractures
Question 7
When is maximum bone density and mass achieved?
Correct Answer
About 20 years of age
Page 3 of 30
Questions and Answers
Question 1
What is Osgood-Schlatter disease?
Correct Answer
Disorder thought to be due to repetitive minor injury to attachment site of patellar
tendon on tibial tuberosity.
-More common in males, noted at time of growth spurt
- Will complain of pain/swelling at tibial tubercle
- Can be common in sports with plant and pivot and directional changes
Question 2
What is a scaphoid fracture?
Correct Answer
Most commonly broken carpal bone - at base of thumb, typically injured by falling
on outstretched hand
- tenderness in anatomical snuff box
- needs to be immobilized with radial gutter splint or ventral splint with thumb
extension
- After immobilized, consider short cast with thumb spica
- Can potentially tx with open reduction and screw placement
- Slow healing fracture
High risk of nonunion and avascular necrosis
Page 1 of 30
,Question 3
What is gout and what are risk factors for it?
Correct Answer
- Over-production or under-secretion of uric acid
- Leads to accumulation of uric acid within joint
- S/s: pain, swelling, redness, warmth over affected joint
- Over time, uric acid crystals can replace bone, can develop tophi and kidney
disease
- Risk factors: male gender, obesity, hyperlipidemia, excess alcohol
consumption/red meat/sardines/liver consumption
- TX: meds like diuretics, low-dose aspirin, B-complex vitamins, chemotherapy
Prophylactic meds: allopurinol, colchicine, probenecid
Acute attacks: indomethacin (can lead to GI inflammation - take with food
Question 4
List several factor that determine fracture-healing outcome.
Correct 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.
Page 2 of 30
, Question 5
Discuss temperature regulation in terms of operative complication.
Correct Answer
- Low body temp/hypothermia is below 96.8 F.
- Increases risk for infection, bleeding, heart issues, and delayed healing
- TX: monitor temp, use bair hugger, warm IV fluids, blankets, increased room tep
- Malignant hyperthermia: inherited trait, life threatening when temps are higher
than 110F
- Triggers: anesthetic agents
- Signs of MH: rigidity, increased arterial CO2, increased RR and HR
- Cardiac arrest will follow if not treated and reversed rapidly
- TX: normalize body temp, admin dantrolene, and use external cooling devices
Question 6
What is the difference between osteomalacia and osteoporosis?
Correct Answer
Osteomalacia: decrease in mineral composition of bone, causing softening of bone;
usually due to decreased vitamin D
- Causes: dysfunctional vitamin D absorption, decreased sun exposure, meds such
as seizure meds and fluoride
- Can be reversed and treated
Osteoporosis: decreased density and mass of bone, usually secondary to decreased
calcium
- Causes: age, lack of hormone & calcium, anti-inflams drugs
- Can be stabilized but not reversed
S/s of both: bone pain, muscle pain, fractures
Question 7
When is maximum bone density and mass achieved?
Correct Answer
About 20 years of age
Page 3 of 30
