Orthopedic Nurse Certification COMPLETE
EXAM LATEST VERSION QUESTIONS AND 100-
Verified ANSWERS.pdf
DEGENERATIVE DISORDERS
1. A 72-year-old female patient with osteoporosis presents after a fall. She
reports severe groin and buttock pain with inability to bear weight on the right
leg. The right leg appears shortened and externally rotated. The nurse suspects
which condition?
• A. Hip dislocation
• B. Femoral neck fracture
• C. Pelvic ramus fracture
• D. Lumbar compression fracture
Answer: B
Rationale: Femoral neck fractures present with severe groin pain, inability to bear
weight, and external rotation with shortening of the affected leg. Hip dislocation
typically presents with internal rotation. Pelvic fractures cause tenderness over the
pubic symphysis. Lumbar fractures cause back pain without leg deformity.
2. A patient with osteoarthritis is being discharged. Which instruction is most
important to include in the plan of care?
• A. "Limit physical activity to reduce joint stress."
• B. "Apply heat to a joint that is acutely inflamed and swollen."
• C. "Use a cane in the hand opposite the affected knee."
, • D. "Stop taking your anti-inflammatory medication if you experience
gastrointestinal upset."
Answer: C
Rationale: A cane should be held in the hand opposite the affected joint to reduce
the load on that knee and decrease pain. A balance of activity and rest is
preferred. Cold is for acute inflammation, heat is for stiffness. Patients should be
educated about GI side effects but should not stop NSAIDs without consulting their
provider.
3. A patient is 24 hours post-total knee arthroplasty. Which finding requires
immediate intervention?
• A. The patient reports pain of 6 on a 0-10 scale.
• B. The toes are warm with a capillary refill of 3 seconds.
• C. The patient is unable to perform plantar flexion.
• D. The patient has 1+ pitting edema around the surgical site.
Answer: C
Rationale: Inability to perform plantar flexion indicates motor nerve dysfunction,
which could be a sign of peroneal nerve palsy—a serious complication requiring
immediate intervention. Pain of 6 is expected postoperatively. Capillary refill of 3
seconds is within normal limits. 1+ edema is common after joint replacement.
4. A patient with lumbar spinal stenosis asks about non-surgical management.
Which instruction is most appropriate?
• A. "Avoid all forms of exercise to prevent further injury."
• B. "Flexion-based exercises, such as cycling, may reduce your pain."
• C. "Walking downhill is preferred over walking on flat surfaces."
• D. "Prolonged standing will help decompress your spine."
,Answer: B
Rationale: Lumbar spinal stenosis symptoms improve with lumbar flexion, which
increases spinal canal diameter and reduces nerve compression. Flexion-based
exercises including cycling are beneficial. Extension activities (standing, walking
downhill) worsen symptoms. Complete rest leads to deconditioning.
5. A patient is scheduled for a total hip arthroplasty. Which postoperative
precaution is most important?
• A. Maintain the hip in adduction and internal rotation.
• B. Use a high-seated chair with arms.
• C. Perform straight leg raises immediately post-op.
• D. Sleep on the affected side to prevent dislocation.
Answer: B
Rationale: To prevent dislocation, the patient must avoid adduction and internal
rotation. A high-seated chair with arms helps maintain hip flexion and prevents
the patient from leaning forward, which violates the 90-degree rule. Sleeping on
the affected side can put the hip in an unsafe position.
6. A patient is 24 hours post-operative following a laminectomy. The patient
reports a sudden, severe headache when standing up. What is the most likely
cause?
• A. A pulmonary embolism.
• B. Meningeal irritation.
• C. A cerebrospinal fluid (CSF) leak.
• D. A reaction to anesthetic agents.
Answer: C
Rationale: A positional headache that worsens when upright is a classic sign of a
, dural tear and subsequent CSF leak—a known complication of spinal surgery. The
patient should be placed flat to relieve the headache, and the provider should be
notified.
7. A nurse is teaching a patient with crutch walking using a three-point gait.
Which instruction is correct?
• A. "Move the affected leg and both crutches forward together, then bring
the unaffected leg forward."
• B. "Move the right crutch and left foot forward together, alternating sides."
• C. "Place both crutches forward first, then swing both legs forward
together."
• D. "Move one crutch forward, then the opposite leg, then the other crutch,
then the other leg."
Answer: A
Rationale: Three-point gait is used when one leg is non-weight-bearing. The
patient advances both crutches and the affected leg simultaneously, then bears
weight through the crutches while advancing the unaffected leg. Option B
describes two-point gait (partial weight-bearing). Option C describes swing-
through gait. Option D describes four-point gait.
8. A patient with cervical radiculopathy reports pain radiating down the arm.
This is most likely due to:
• A. Spinal stenosis
• B. Herniated cervical disc
• C. Degenerative joint disease
• D. Muscle strain
EXAM LATEST VERSION QUESTIONS AND 100-
Verified ANSWERS.pdf
DEGENERATIVE DISORDERS
1. A 72-year-old female patient with osteoporosis presents after a fall. She
reports severe groin and buttock pain with inability to bear weight on the right
leg. The right leg appears shortened and externally rotated. The nurse suspects
which condition?
• A. Hip dislocation
• B. Femoral neck fracture
• C. Pelvic ramus fracture
• D. Lumbar compression fracture
Answer: B
Rationale: Femoral neck fractures present with severe groin pain, inability to bear
weight, and external rotation with shortening of the affected leg. Hip dislocation
typically presents with internal rotation. Pelvic fractures cause tenderness over the
pubic symphysis. Lumbar fractures cause back pain without leg deformity.
2. A patient with osteoarthritis is being discharged. Which instruction is most
important to include in the plan of care?
• A. "Limit physical activity to reduce joint stress."
• B. "Apply heat to a joint that is acutely inflamed and swollen."
• C. "Use a cane in the hand opposite the affected knee."
, • D. "Stop taking your anti-inflammatory medication if you experience
gastrointestinal upset."
Answer: C
Rationale: A cane should be held in the hand opposite the affected joint to reduce
the load on that knee and decrease pain. A balance of activity and rest is
preferred. Cold is for acute inflammation, heat is for stiffness. Patients should be
educated about GI side effects but should not stop NSAIDs without consulting their
provider.
3. A patient is 24 hours post-total knee arthroplasty. Which finding requires
immediate intervention?
• A. The patient reports pain of 6 on a 0-10 scale.
• B. The toes are warm with a capillary refill of 3 seconds.
• C. The patient is unable to perform plantar flexion.
• D. The patient has 1+ pitting edema around the surgical site.
Answer: C
Rationale: Inability to perform plantar flexion indicates motor nerve dysfunction,
which could be a sign of peroneal nerve palsy—a serious complication requiring
immediate intervention. Pain of 6 is expected postoperatively. Capillary refill of 3
seconds is within normal limits. 1+ edema is common after joint replacement.
4. A patient with lumbar spinal stenosis asks about non-surgical management.
Which instruction is most appropriate?
• A. "Avoid all forms of exercise to prevent further injury."
• B. "Flexion-based exercises, such as cycling, may reduce your pain."
• C. "Walking downhill is preferred over walking on flat surfaces."
• D. "Prolonged standing will help decompress your spine."
,Answer: B
Rationale: Lumbar spinal stenosis symptoms improve with lumbar flexion, which
increases spinal canal diameter and reduces nerve compression. Flexion-based
exercises including cycling are beneficial. Extension activities (standing, walking
downhill) worsen symptoms. Complete rest leads to deconditioning.
5. A patient is scheduled for a total hip arthroplasty. Which postoperative
precaution is most important?
• A. Maintain the hip in adduction and internal rotation.
• B. Use a high-seated chair with arms.
• C. Perform straight leg raises immediately post-op.
• D. Sleep on the affected side to prevent dislocation.
Answer: B
Rationale: To prevent dislocation, the patient must avoid adduction and internal
rotation. A high-seated chair with arms helps maintain hip flexion and prevents
the patient from leaning forward, which violates the 90-degree rule. Sleeping on
the affected side can put the hip in an unsafe position.
6. A patient is 24 hours post-operative following a laminectomy. The patient
reports a sudden, severe headache when standing up. What is the most likely
cause?
• A. A pulmonary embolism.
• B. Meningeal irritation.
• C. A cerebrospinal fluid (CSF) leak.
• D. A reaction to anesthetic agents.
Answer: C
Rationale: A positional headache that worsens when upright is a classic sign of a
, dural tear and subsequent CSF leak—a known complication of spinal surgery. The
patient should be placed flat to relieve the headache, and the provider should be
notified.
7. A nurse is teaching a patient with crutch walking using a three-point gait.
Which instruction is correct?
• A. "Move the affected leg and both crutches forward together, then bring
the unaffected leg forward."
• B. "Move the right crutch and left foot forward together, alternating sides."
• C. "Place both crutches forward first, then swing both legs forward
together."
• D. "Move one crutch forward, then the opposite leg, then the other crutch,
then the other leg."
Answer: A
Rationale: Three-point gait is used when one leg is non-weight-bearing. The
patient advances both crutches and the affected leg simultaneously, then bears
weight through the crutches while advancing the unaffected leg. Option B
describes two-point gait (partial weight-bearing). Option C describes swing-
through gait. Option D describes four-point gait.
8. A patient with cervical radiculopathy reports pain radiating down the arm.
This is most likely due to:
• A. Spinal stenosis
• B. Herniated cervical disc
• C. Degenerative joint disease
• D. Muscle strain
