OCC OCC Patient Assessment & Preparation 2 — Questions and Answers
Question 1: Which sensory test is used to assess nerve function in the hand before upper extremity casting?
- Two-point discrimination (Correct answer)
- Tuning fork vibration test
- Monofilament pressure test
- Dermatomal pinprick map
Correct answer: Two-point discrimination
Two-point discrimination evaluates sensory nerve integrity in the digits and is a key pre-cast neurological check.
Question 2: Why is skin temperature assessed on both extremities before casting?
- To detect unilateral coolness indicating vascular compromise (Correct answer)
- To determine ambient room temperature
- To select the appropriate cast padding thickness
- To confirm the patient does not have a fever
Correct answer: To detect unilateral coolness indicating vascular compromise
A cool extremity compared to the contralateral side may indicate impaired arterial flow requiring investigation before casting.
Question 3: Before applying a long arm cast, the technician should document motor function by asking the patient to:
- Flex and extend the fingers and wrist (Correct answer)
- Walk on the extremity
- Perform deep breathing
- Squeeze a blood pressure cuff
Correct answer: Flex and extend the fingers and wrist
Active range of motion of fingers and wrist documents baseline motor nerve function before the cast is applied.
Question 4: What does the acronym 'CSM' stand for in orthopedic casting assessment?
- Circulation, Sensation, Movement (Correct answer)
- Cast, Splint, Mobilize
- Compress, Stabilize, Monitor
- Contour, Secure, Mold
Correct answer: Circulation, Sensation, Movement
CSM — Circulation, Sensation, Movement — is the standard neurovascular checklist performed before and after cast application.
Question 5: A patient reports numbness and tingling in the fingers before cast application. This finding should be:
- Documented and reported to the supervising clinician before proceeding (Correct answer)
- Ignored as it is a normal response to injury
- Treated by applying the cast quickly to provide stability
- Resolved by elevating the arm for 2 minutes
Correct answer: Documented and reported to the supervising clinician before proceeding
Pre-existing neurological symptoms must be documented and reviewed by the clinician to distinguish pre-cast from post-cast nerve involvement.
Question 6: Which preparatory step reduces skin irritation under the cast?
- Applying stockinette smoothly without wrinkles (Correct answer)
- Wetting the skin before padding
- Shaving the extremity with a razor blade
- Applying petroleum jelly directly to the skin
Correct answer: Applying stockinette smoothly without wrinkles
A wrinkle-free stockinette prevents pressure points that can cause skin breakdown under the cast.
OCC OCC Patient Assessment & Preparation 2
Which sensory test is used to assess nerve function in the hand before upper extremity casting?