OCC OCC Patient Assessment & Preparation 1 — Questions and Answers
Question 1: Before applying a cast, what is the FIRST step in patient assessment?
- Review neurovascular status distal to the injury (Correct answer)
- Select casting material
- Prepare stockinette
- Obtain patient weight
Correct answer: Review neurovascular status distal to the injury
Neurovascular assessment (circulation, sensation, movement) must be performed and documented before any cast application.
Question 2: Which finding during pre-cast assessment would require IMMEDIATE notification of the supervising clinician?
- Absent distal pulse (Correct answer)
- Minor skin abrasion at the injury site
- Mild soft tissue swelling
- Patient anxiety about the procedure
Correct answer: Absent distal pulse
Absent distal pulse indicates potential vascular compromise and must be reported immediately before casting proceeds.
Question 3: When assessing skin integrity before casting, which condition requires special padding or delay of casting?
- Open wound or skin breakdown over the cast area (Correct answer)
- Dry skin
- Hair on the extremity
- Mild redness from the injury
Correct answer: Open wound or skin breakdown over the cast area
Open wounds or skin breakdown over the planned cast area require special wound management or clinical consultation before casting.
Question 4: How is capillary refill time assessed in a patient about to receive a cast?
- Press the nail bed, release, and count seconds until color returns (Correct answer)
- Measure blood pressure distally
- Check skin temperature with a thermometer
- Auscultate for distal pulse with a stethoscope
Correct answer: Press the nail bed, release, and count seconds until color returns
Normal capillary refill is less than 2 seconds; prolonged refill suggests compromised circulation.
Question 5: Which question is MOST important to ask a patient before cast application regarding allergies?
- Allergy to latex or plaster (Correct answer)
- Allergy to penicillin
- Allergy to contrast dye
- Allergy to shellfish
Correct answer: Allergy to latex or plaster
Latex allergy is critical because stockinettes and gloves may contain latex, and plaster allergy can cause skin reactions.
Question 6: What position should a patient's extremity be in during pre-cast neurovascular assessment?
- Functional position appropriate for the injury (Correct answer)
- Fully extended
- Dependent (hanging down)
- Elevated above heart level only
Correct answer: Functional position appropriate for the injury
The extremity should be held in the planned functional casting position so that assessment reflects the post-cast condition.
OCC OCC Patient Assessment & Preparation 1
Before applying a cast, what is the FIRST step in patient assessment?