Orthopedic Nurse Certification Exam Questions with
Rationalized Answers 2025 Verified
1. Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a patient to
a fracture.: 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
2. Describe nursing instructions that may be given to a patient in a cast.: 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.
3. What is the basic anatomy of a long bone?: Typically has two main compo- nents:
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
4. Give examples of tapping fracture and penetrating fracture.: 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 sma
and soft tissue involvement is minimal.
EX: stab wound, gunshot wound
,Different from crush wound because object of force is much larger.
5. List several factor that determine fracture-healing outcome.: 1) Skeletal ma- turity
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.
6. Differentiate between linear, oblique, and transverse fractures.: 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.
7. Describe/give examples of following bony injuries.: 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
8. Differences between plaster of Paris and fiberglass casting.: 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 i
, as little as 5 minutes, more water resistant; BUT edges are more abrasive and they tend to be
hotter
Rationalized Answers 2025 Verified
1. Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a patient to
a fracture.: 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
2. Describe nursing instructions that may be given to a patient in a cast.: 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.
3. What is the basic anatomy of a long bone?: Typically has two main compo- nents:
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
4. Give examples of tapping fracture and penetrating fracture.: 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 sma
and soft tissue involvement is minimal.
EX: stab wound, gunshot wound
,Different from crush wound because object of force is much larger.
5. List several factor that determine fracture-healing outcome.: 1) Skeletal ma- turity
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.
6. Differentiate between linear, oblique, and transverse fractures.: 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.
7. Describe/give examples of following bony injuries.: 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
8. Differences between plaster of Paris and fiberglass casting.: 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 i
, as little as 5 minutes, more water resistant; BUT edges are more abrasive and they tend to be
hotter
