Free Ultimate Orthopaedic Nurse Questions and Answers — Questions and Answers
Question 1: Which of the following scenarios most frequently results in stiffness for a patient with osteoarthritis?
- After periods of weight-bearing exercises
- At the end of the day after periods of normal activity
- After periods of rest (Correct answer)
- After periods of stretching exercises
Correct answer: After periods of rest
A hallmark symptom of osteoarthritis is 'gelling' or stiffness that occurs after periods of inactivity, such as waking up in the morning or sitting for a prolonged time. This stiffness typically improves within 30 minutes of movement. This phenomenon is due to the synovial fluid becoming less viscous during rest, making initial movement more difficult.
Question 2: Osteomyelitis in the right knee and distal femur of a 48-year-old patient. Which of the ROM exercises for the right leg should the patient be instructed to perform?
- ROM exercises of the right hip and ankle (Correct answer)
- No exercises as the limb should rest
- ROM exercises of the right knee
- ROM exercises of the right ankle
Correct answer: ROM exercises of the right hip and ankle
In osteomyelitis of the knee and distal femur, the infected area needs to be immobilized and rested to promote healing and prevent further spread of infection. However, to prevent stiffness and maintain mobility in adjacent joints, range-of-motion (ROM) exercises should be performed on the unaffected joints, such as the hip and ankle, to preserve their function and prevent complications like contractures.
Question 3: A multiple myeloma patient has acquired a bone metastasis. Which kind of medical care is recommended to help avoid fractures?
- Radiation
- Chemotherapy
- Bisphosphonates (Correct answer)
- Calcium
Correct answer: Bisphosphonates
Multiple myeloma often leads to osteolytic lesions and bone metastases, significantly increasing the risk of pathological fractures. Bisphosphonates are a class of drugs that inhibit osteoclast activity, thereby reducing bone resorption and strengthening bone structure. They are commonly used to prevent and manage skeletal-related events, including fractures, in patients with bone metastases.
Question 4: A 10-year-old girl has a 15-degree scoliosis. Which of the following therapies is best to start with?
- Boston brace
- Milwaukee brace
- Surgical fusion
- Physical rehabilitation (Correct answer)
Correct answer: Physical rehabilitation
For a 10-year-old girl with a mild 15-degree scoliosis, the initial and most appropriate treatment is typically conservative management. Physical rehabilitation, including specific exercises to strengthen core muscles and improve posture, is often recommended to prevent curve progression and manage symptoms. Bracing or surgery are usually reserved for more severe or progressing curves.
Question 5: When a patient utilizes a walker to get around, the walker's height should be
- at the height of the elbow
- at the height of the hip
- slightly above the waist
- slightly below the waist (Correct answer)
Correct answer: slightly below the waist
The correct height for a walker ensures proper posture and minimizes strain on the patient. When standing upright with arms relaxed at the sides, the handgrips of the walker should be at the level of the patient's wrist crease or slightly below the waist. This allows for a slight bend in the elbows (15-30 degrees) when grasping the handles, providing optimal support and balance.
Question 6: Which period of the bone healing process allows the patient to resume bearing weight?
- Development of bony callus
- Remodeling (Correct answer)
- Inflammatory stage
- Development of fibrocartilaginous (soft) callus
Correct answer: Remodeling
Bone healing occurs in several stages, with remodeling being the final phase. During remodeling, the woven bone of the callus is gradually replaced by stronger lamellar bone, and the bone regains its original shape and strength. It is during this stage, once sufficient strength is achieved and confirmed by imaging, that the patient can safely resume bearing weight on the healed limb, often under medical guidance.
Question 7: A stable pelvic fracture patient is permitted to lean to one side. The nurse estimates that a patient can tilt their head a maximum of _________ degrees in any direction.
- 45 degrees (Correct answer)
- 30 degrees
- 10 degrees
- 20 degrees
Correct answer: 45 degrees
For a stable pelvic fracture, patients are typically advised to limit movement to prevent displacement or further injury to the healing bones. While some leaning is permissible to aid comfort or hygiene, a tilt of 45 degrees is generally considered the maximum safe angle. Exceeding this limit could put excessive stress on the healing pelvic bones and compromise the stability of the fracture.
Free Ultimate Orthopaedic Nurse Questions and Answers
Which of the following scenarios most frequently results in stiffness for a patient with osteoarthritis?