Orthopaedic Technologist Certified (OTC) Examination — Questions and Answers

Question 1: A torus (buckle) fracture is most commonly seen in which population?

Middle-aged manual laborers
Elderly women with osteoporosis
Young adult athletes
Children under 10 years old (Correct answer)

Correct answer: Children under 10 years old

Torus fractures occur in pediatric bone where the cortex buckles under compression without complete cortical breach, typical of falls onto an outstretched hand.

Question 2: For obese patients requiring lower extremity casting, which casting consideration is most important?

Using plaster only due to its lower cost for larger casts
Using stronger fiberglass layers and ensuring adequate support to prevent cast breakage (Correct answer)
Limiting padding to reduce cast bulk
Applying the cast in a standing position

Correct answer: Using stronger fiberglass layers and ensuring adequate support to prevent cast breakage

Increased body weight places greater mechanical stress on the cast; additional fiberglass layers and structural support prevent early cast failure.

Question 3: Which cast is the standard immobilization for an uncomplicated Colles fracture after reduction?

Thumb spica cast
Short arm cast in slight flexion and ulnar deviation (Correct answer)
Short arm cast in full extension
Long arm cast in full supination

Correct answer: Short arm cast in slight flexion and ulnar deviation

A short arm cast with the wrist in slight flexion and ulnar deviation counteracts the deforming forces of a Colles fracture.

Question 4: What instruction should the patient receive about positioning the casted extremity immediately after application?

Apply ice directly on top of the cast
Elevate above the level of the heart (Correct answer)
Avoid any movement for 48 hours
Keep the extremity in a dependent position

Correct answer: Elevate above the level of the heart

Elevation reduces post-casting swelling and decreases the risk of cast tightness and neurovascular compromise.

Question 5: When converting a circumferential cast to a bivalved cast for home use, how are the two shells secured?

By applying a new thin layer of plaster over the cut lines
With an elastic (ACE) bandage wrapped over both halves (Correct answer)
By taping the shells together with duct tape
By stapling the edges of the shells

Correct answer: With an elastic (ACE) bandage wrapped over both halves

An elastic bandage holds bivalved cast shells in place while allowing removal for skin inspection and physical therapy.

Question 6: Why is hand hygiene essential before and after cast application?

To prevent infection transmission (Correct answer)
To improve glove grip
To dry hands quickly
To remove casting debris

Correct answer: To prevent infection transmission

Hand hygiene, encompassing washing with soap and water or using an alcohol-based hand rub, is a fundamental infection control practice. It is essential before and after cast application to prevent the transmission of microorganisms between the healthcare provider, the patient, and the environment. This practice significantly reduces the risk of healthcare-associated infections.

Question 7: When casting a pregnant patient, which body position is recommended during the procedure?

Prone to access posterior injuries
Seated upright in a chair
Left lateral tilt or left lateral decubitus to prevent aortocaval compression (Correct answer)
Supine flat with legs extended

Correct answer: Left lateral tilt or left lateral decubitus to prevent aortocaval compression

After the first trimester, supine positioning can compress the inferior vena cava; a left tilt maintains cardiac output.

Question 8: When is informed consent for cast application typically obtained?

By the casting technician immediately before applying the first layer
Only if the patient specifically requests it
After the cast is applied and the patient is comfortable
Before the procedure begins, after explaining risks, benefits, and alternatives (Correct answer)

Correct answer: Before the procedure begins, after explaining risks, benefits, and alternatives

Informed consent must be obtained before the procedure, giving the patient opportunity to ask questions and decline if desired.

Question 9: A patient reports a burning sensation under the cast just before scheduled removal. The correct response is:

Administer oral pain medication and wait
Remove the cast immediately and assess the skin (Correct answer)
Tell the patient to tolerate it until the next appointment
Apply ice over the cast surface

Correct answer: Remove the cast immediately and assess the skin

Burning under a cast suggests pressure necrosis or skin breakdown; prompt removal and assessment is required.

Question 10: A teenage athlete asks when they can return to sport after cast removal. The technician's correct response is:

After one week of normal activity without pain
Immediately, because the fracture has healed by the time the cast is removed
As soon as range of motion is fully restored
That decision belongs to the treating clinician and physical therapist, not the casting technician (Correct answer)

Correct answer: That decision belongs to the treating clinician and physical therapist, not the casting technician

Return-to-sport decisions involve fracture healing assessment, functional testing, and clinical judgment that are outside the casting technician's scope.

Question 11: When casting a child with an upper extremity fracture, the wrist is typically positioned in:

Full extension to maximize immobilization
Neutral (0 degrees) for all pediatric wrist injuries
Slight extension (10-15 degrees) for most forearm fractures (Correct answer)
Full flexion to relax the flexor tendons

Correct answer: Slight extension (10-15 degrees) for most forearm fractures

Slight wrist extension is the standard functional position for most pediatric forearm and wrist fractures unless otherwise specified by the clinician.

Question 12: Which nerve is assessed by testing sensation in the first dorsal web space (between the thumb and index finger) of the hand?

Anterior interosseous nerve
Ulnar nerve
Median nerve
Superficial radial nerve (Correct answer)

Correct answer: Superficial radial nerve

The superficial radial nerve provides sensory innervation to the first dorsal web space and dorsolateral hand.

Question 13: What should be done if a cast technician experiences a needle-stick injury?

Wash with water and resume work
Ignore it unless it bleeds
Wait and monitor for symptoms
Report it and follow post-exposure protocol (Correct answer)

Correct answer: Report it and follow post-exposure protocol

Any needle-stick injury is a serious occupational exposure that carries the risk of transmitting bloodborne pathogens. The immediate and correct action is to report the incident to a supervisor and follow the established post-exposure protocol. This protocol typically includes wound care, medical evaluation, and potential prophylactic treatment to ensure the healthcare worker's safety and health.

Question 14: Why should casting rooms have proper ventilation?

To dry the cast faster
To improve visibility
To reduce airborne irritants (Correct answer)
To control room temperature

Correct answer: To reduce airborne irritants

Casting materials, particularly during application and removal, can release fine dust particles, fumes, and odors into the air. Proper ventilation in casting rooms is essential to dilute and remove these airborne irritants. This protects both patients and healthcare workers from respiratory irritation, allergic reactions, and potential long-term health effects associated with inhaling these substances.

Question 15: What is the medico-legal significance of thorough post-cast neurovascular documentation?

It allows the technician to discharge the patient independently
It provides evidence that complications were identified or excluded at the time of casting (Correct answer)
It speeds up insurance reimbursement
It is required only for surgical procedures, not casting

Correct answer: It provides evidence that complications were identified or excluded at the time of casting

Post-cast CSM documentation demonstrates that the technician checked for complications; absence of documentation creates liability if complications arise later.

Question 16: Which best describes the casting technician's responsibility when the clinician's written cast order appears incomplete?

Ask the patient what cast type the doctor mentioned
Clarify the order with the clinician before proceeding (Correct answer)
Document the incomplete order and apply the cast as best as possible
Proceed with the most common cast type for that injury

Correct answer: Clarify the order with the clinician before proceeding

Ambiguous or incomplete orders must be clarified with the ordering clinician before the procedure to ensure correct treatment and patient safety.

Question 17: Ear protection during cast removal with an oscillating saw is recommended primarily for:

The patient only, as technicians are trained to tolerate the noise
Only the technician performing frequent removals
Neither, as the saw is below OSHA noise thresholds
The patient and technician, as prolonged noise can cause discomfort (Correct answer)

Correct answer: The patient and technician, as prolonged noise can cause discomfort

Both patient and technician benefit from ear protection during cast removal, especially for children or those sensitive to noise.

Question 18: For a pediatric patient with an upper extremity fracture, what thumb position is standard in a thumb spica cast?

Thumb flexed completely into the palm
Thumb fully extended in line with the forearm
Thumb in palmar abduction and slight opposition, as if holding a glass (Correct answer)
Thumb fully adducted against the palm

Correct answer: Thumb in palmar abduction and slight opposition, as if holding a glass

The functional thumb position mimics a gentle grasp, preventing contracture while immobilizing the first ray structures.

Question 19: Why is it important to assess capillary refill in a casted limb?

To detect fractures
To test nerve function
To assess circulation (Correct answer)
To check for infection

Correct answer: To assess circulation

Assessing capillary refill time in a casted limb is essential to evaluate peripheral perfusion and arterial blood flow. A prolonged capillary refill time (typically greater than 2-3 seconds) can indicate impaired circulation, which may be due to a cast that is too tight or developing compartment syndrome. This assessment helps detect potential neurovascular compromise early.

Question 20: Which feature of a pediatric hip spica cast requires specific skin care instructions for parents?

The cast must be removed nightly for skin inspection
The cast must be painted weekly to maintain moisture resistance
The perineal opening must be kept clean and dry to prevent skin breakdown (Correct answer)
The child must remain completely supine for the full treatment period

Correct answer: The perineal opening must be kept clean and dry to prevent skin breakdown

The perineal area is prone to soiling and maceration in a spica cast; parents must receive detailed hygiene instructions to prevent infection.

Question 21: Before casting a patient who takes anticoagulant medication, the casting technician should:

Double the padding to account for anticipated swelling
Note the medication and alert the supervising clinician (Correct answer)
Delay casting for 24 hours
Proceed without modification

Correct answer: Note the medication and alert the supervising clinician

Anticoagulants increase bleeding risk and may affect cast management decisions; the supervising clinician must be informed.

Question 22: Which bone is most commonly fractured in the forearm?

Radius (Correct answer)
Scapula
Humerus
Ulna

Correct answer: Radius

The radius is the most commonly fractured bone in the forearm, particularly at its distal end, often resulting from falls onto an outstretched hand (Colles' fracture). Its anatomical position and role in wrist articulation make it highly susceptible to injury. While the ulna can also be fractured, the radius bears more of the impact in common injury mechanisms.

Question 23: In toddlers and infants, which type of cast is commonly used to treat developmental dysplasia of the hip (DDH)?

Slipper cast
Long leg cast
Short arm cast
Spica cast (Correct answer)

Correct answer: Spica cast

A hip spica cast holds the hips in the abducted, flexed position required to seat the femoral head in the acetabulum during DDH treatment.

Question 24: Which symptom listed in discharge instructions should prompt the patient to seek IMMEDIATE care?

Slight cast odor after two weeks
Mild itching under the cast after the first day
Some discomfort at the fracture site with movement
Increasing pain, numbness, or tingling in the casted extremity (Correct answer)

Correct answer: Increasing pain, numbness, or tingling in the casted extremity

Worsening pain, numbness, or tingling are warning signs of neurovascular compromise that require urgent evaluation.

Question 25: Before cast removal, what should the technician tell the patient to reduce anxiety about the saw?

The saw is completely painless and silent
The saw vibrates but will not cut skin if used correctly (Correct answer)
The patient should not look at the saw at any time
The process takes only a few seconds

Correct answer: The saw vibrates but will not cut skin if used correctly

Explaining how the oscillating saw works reassures patients and encourages cooperation, which improves safety during removal.

Question 26: A comminuted fracture is best described as:

A fracture with three or more bone fragments (Correct answer)
An incomplete fracture of one cortex
A fracture at the growth plate
A fracture with two clean fragments

Correct answer: A fracture with three or more bone fragments

Comminuted fractures involve multiple fragments, typically from high-energy trauma, and often require surgical fixation rather than casting alone.

Question 27: A Colles fracture is a distal radius fracture with which characteristic displacement?

Dorsal displacement and angulation of the distal fragment (dinner fork deformity) (Correct answer)
Impaction without angulation
Transverse fracture with lateral displacement
Volar displacement of the distal fragment

Correct answer: Dorsal displacement and angulation of the distal fragment (dinner fork deformity)

The classic Colles fracture produces dorsal tilt of the distal fragment, creating the dinner fork silhouette on lateral X-ray.

Question 28: Which protective technique is used over bony prominences when running the cast saw?

Mark the area and skip it with the saw
Apply extra stockinette over the prominence
Slow the saw speed to minimum
Slide a cast spreader or tongue depressor between the blade and the skin (Correct answer)

Correct answer: Slide a cast spreader or tongue depressor between the blade and the skin

Inserting a flat instrument between the blade and skin over bony areas protects against saw burns and lacerations.

Question 29: Which part of the bone contains the growth plate in children?

Diaphysis
Periosteum
Epiphysis
Metaphysis (Correct answer)

Correct answer: Metaphysis

The metaphysis is the region of a long bone that connects the diaphysis (shaft) to the epiphysis (end). It contains the growth plate, or epiphyseal plate, which is crucial for longitudinal bone growth in children and adolescents. Damage to this area can significantly impact a child's bone development and length.

Question 30: During cast removal, the skin under a long-standing plaster cast is commonly found to be:

Dry, flaky, and possibly malodorous (Correct answer)
Deeply pigmented
Infected in most cases
Thickened from pressure

Correct answer: Dry, flaky, and possibly malodorous

Weeks of immobilization causes skin dryness, desquamation (scaling), and sometimes odor due to trapped dead skin cells and moisture.

Question 31: A patient refuses a cast recommended by the physician. The casting technician's role is to:

Document the refusal and notify the supervising clinician (Correct answer)
Attempt to convince the patient until they agree
Discharge the patient immediately without documentation
Apply the cast anyway to protect the patient's health

Correct answer: Document the refusal and notify the supervising clinician

Competent patients have the right to refuse treatment; the technician must document the refusal and inform the clinician so appropriate follow-up can be arranged.

Question 32: HIPAA regulations require the casting technician to:

Retain patient records for at least 30 days only
Protect patient health information and share it only with authorized individuals (Correct answer)
Share neurovascular findings with the patient's employer upon request
Post patient casting records in the waiting room for family access

Correct answer: Protect patient health information and share it only with authorized individuals

HIPAA mandates confidentiality of all patient health information and permits disclosure only with patient authorization or for treatment, payment, and operations.

Question 33: Why is it important to use gloves when handling casting material?

To avoid staining the cast
To shape the cast faster
To prevent skin irritation and burns (Correct answer)
To improve grip strength

Correct answer: To prevent skin irritation and burns

It is crucial to use gloves when handling casting material because both plaster and fiberglass resins undergo an exothermic reaction (heat-generating) during the setting process. Direct contact with these materials can cause skin irritation or thermal burns. Gloves provide a protective barrier, safeguarding the technician's skin from chemical exposure and heat.

Question 34: Which type of fracture is suggested by a spiral pattern on X-ray in a non-ambulatory infant?

Normal birth fracture pattern
Stress fracture from excessive swaddling
Pathologic fracture from bone tumor
Non-accidental trauma (child abuse) must be considered (Correct answer)

Correct answer: Non-accidental trauma (child abuse) must be considered

Spiral fractures in non-ambulatory infants are a well-recognized radiographic red flag for non-accidental trauma and mandate a mandatory report and full skeletal survey.

Question 35: Which instrument is the standard tool for cast removal?

Oscillating cast saw (Correct answer)
Electric drill
Bandage scissors
Plaster knife

Correct answer: Oscillating cast saw

The oscillating cast saw vibrates rather than rotates, cutting hard cast material while minimizing risk of skin laceration.

Question 36: The radial pulse is best assessed in a patient with a short arm cast by palpating at the:

Lateral wrist at the base of the thumb (Correct answer)
Dorsum of the hand
Antecubital fossa
Medial aspect of the wrist

Correct answer: Lateral wrist at the base of the thumb

The radial pulse is palpated at the radial aspect of the wrist, proximal to the base of the thumb, just lateral to the flexor carpi radialis tendon.

Question 37: 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 confirm the patient does not have a fever
To select the appropriate cast padding thickness

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 38: The OCC certification is maintained through:

Peer review by supervising physicians every 5 years
Annual employment in an orthopedic setting only
Passing the initial exam once with no further requirements
Continuing education credits and periodic recertification requirements (Correct answer)

Correct answer: Continuing education credits and periodic recertification requirements

Certification maintenance requires ongoing continuing education and recertification to ensure competency remains current.

Question 39: Which PPE is most appropriate when removing a fiberglass cast?

Apron and gloves
Mask and goggles (Correct answer)
Face shield only
Boot covers

Correct answer: Mask and goggles

When removing a fiberglass cast, a significant amount of fine dust particles and debris are generated. Therefore, wearing a mask (e.g., N95 or surgical mask) is crucial to protect the respiratory system from inhaling these irritants, and goggles are necessary to protect the eyes from airborne particles. This personal protective equipment (PPE) is vital for both patient and technician safety.

Question 40: Waterproof casting liner systems (e.g., Gore-Tex liner) allow patients to:

Shower and submerge the cast without damaging the padding (Correct answer)
Replace standard stockinette entirely in all cases
Remove the liner at home for drying
Swim competitively without any cast degradation

Correct answer: Shower and submerge the cast without damaging the padding

Waterproof liner systems allow the inner cast to get wet and dry without holding moisture, enabling showering and light water exposure.

Question 41: A boxer's fracture involves which bone?

Distal radius
First metacarpal base
Fifth metatarsal
Neck of the fifth metacarpal (Correct answer)

Correct answer: Neck of the fifth metacarpal

A boxer's fracture is a fracture of the neck of the fifth metacarpal, typically from striking with a closed fist.

Question 42: The classic '5 P's' of neurovascular assessment include all of the following EXCEPT:

Paresthesia
Perspiration (Correct answer)
Pain
Pallor

Correct answer: Perspiration

The 5 P's are Pain, Pallor, Paresthesia, Pulselessness, and Paralysis/Paresis — perspiration is not included.

Question 43: A patient reports numbness and tingling in the fingers before cast application. This finding should be:

Resolved by elevating the arm for 2 minutes
Treated by applying the cast quickly to provide stability
Documented and reported to the supervising clinician before proceeding (Correct answer)
Ignored as it is a normal response to injury

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 44: What is the purpose of cast windowing?

To ventilate the skin
To decorate the cast
To relieve pressure or provide wound access (Correct answer)
To keep the cast dry

Correct answer: To relieve pressure or provide wound access

Cast windowing involves cutting a small opening in the cast. This technique is used to relieve localized pressure over a bony prominence or a specific area of discomfort, or to provide direct access for inspecting, dressing, or treating an underlying wound without removing the entire cast. It helps prevent pressure sores and facilitates targeted wound management.

Question 45: Why is extra padding used when casting pediatric patients compared to adults?

Children require thicker casts for activity restriction
Children have more prominent bony areas and less subcutaneous tissue (Correct answer)
Children move less, so padding prevents cast loosening
Pediatric skin is thicker and requires more compression

Correct answer: Children have more prominent bony areas and less subcutaneous tissue

Bony prominences in children have less protective fat and are at greater risk for pressure injury, requiring additional padding.

Question 46: A parent asks if their child can bathe with a fiberglass cast. The correct response is:

Bathing must be avoided entirely until cast removal
Sponge bath only is needed and the cast can get minimally wet
Fiberglass casts are fully waterproof and bathing is allowed
The cast must be kept dry; use a waterproof cast cover for bathing (Correct answer)

Correct answer: The cast must be kept dry; use a waterproof cast cover for bathing

Standard fiberglass casts are not fully waterproof because the inner padding absorbs water; a waterproof liner system is required for water exposure.

Question 47: Which finding during pre-cast assessment would require IMMEDIATE notification of the supervising clinician?

Minor skin abrasion at the injury site
Mild soft tissue swelling
Patient anxiety about the procedure
Absent distal pulse (Correct answer)

Correct answer: Absent distal pulse

Absent distal pulse indicates potential vascular compromise and must be reported immediately before casting proceeds.

Question 48: 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)
Squeeze a blood pressure cuff
Perform deep breathing
Walk on the extremity

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 49: Which standard precaution applies to all patient interactions?

Double glove for all procedures
Treat all body fluids as potentially infectious (Correct answer)
Use PPE only if infection is confirmed
Only isolate contagious patients

Correct answer: Treat all body fluids as potentially infectious

Standard precautions are a set of infection control practices where all human blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes are treated as potentially infectious. This universal approach applies to all patient interactions, regardless of their diagnosis, to prevent the transmission of infectious agents and protect both patients and healthcare workers.

Question 50: Which cast material requires the MOST caution during saw removal due to increased heat generation?

Fiberglass (Correct answer)
Cotton-based splint material
Plaster of Paris
Thermoplastic

Correct answer: Fiberglass

Fiberglass generates more heat during sawing than plaster, increasing burn risk if the saw lingers in one position.

Question 51: An error in a medical record should be corrected by:

Using correction fluid (white-out) to cover the mistake
Drawing a single line through the error, writing the correction, and initialing with date and time (Correct answer)
Deleting the entry in the electronic record without notation
Rewriting the entire note on a new page

Correct answer: Drawing a single line through the error, writing the correction, and initialing with date and time

Medical record corrections must be traceable; a single strikethrough with a dated, initialed correction preserves the original entry and the correction.

Question 52: Which fracture pattern describes a bone that bends but does not completely break, seen primarily in children?

Stress fracture
Greenstick fracture (Correct answer)
Comminuted fracture
Spiral fracture

Correct answer: Greenstick fracture

Greenstick fractures occur in pediatric patients whose immature, flexible bone bends and fractures on one cortex while the other remains intact.

Question 53: Before casting a diabetic patient, which additional assessment is MOST important?

Peripheral blood smear
Blood glucose level measurement
Dietary history for the past 24 hours
Detailed skin integrity check for neuropathic ulcers or insensate areas (Correct answer)

Correct answer: Detailed skin integrity check for neuropathic ulcers or insensate areas

Diabetic patients may have peripheral neuropathy and impaired wound healing, making skin inspection before casting critical.

Question 54: Which sensory test is used to assess nerve function in the hand before upper extremity casting?

Tuning fork vibration test
Two-point discrimination (Correct answer)
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 55: Why is elevation recommended immediately after cast placement?

To prevent itching
To ease mobility
To harden the cast faster
To reduce swelling and promote circulation (Correct answer)

Correct answer: To reduce swelling and promote circulation

Elevation of the casted limb above heart level immediately after cast placement is recommended to reduce swelling and promote circulation. This helps to decrease fluid accumulation in the tissues and promotes venous return, thereby minimizing pain and reducing the risk of complications such as compartment syndrome. It aids in maintaining adequate arterial blood flow to the injured area.

Question 56: A Jones fracture is located at which anatomical site?

Base of the fifth metatarsal at the metaphyseal-diaphyseal junction (Correct answer)
Calcaneus
Distal fifth metatarsal
Fifth metatarsal head

Correct answer: Base of the fifth metatarsal at the metaphyseal-diaphyseal junction

The Jones fracture occurs at the proximal fifth metatarsal junction, where poor vascularity makes healing difficult and often requires non-weight-bearing casting.

Question 57: When removing a cast, the saw should be moved in which pattern?

In a continuous drag along the length
In a single long cut straight down the center
In circular motions around the extremity
In and out (plunging motion) along the cast surface, not dragged (Correct answer)

Correct answer: In and out (plunging motion) along the cast surface, not dragged

A plunging in-and-out motion prevents overheating and reduces the risk of skin burns and lacerations.

Question 58: Why must growth plates (physes) receive special consideration when reviewing X-rays before pediatric casting?

Physeal injuries always require surgical repair, making casting unnecessary
Growth plates cause the cast to heat up during application
Physeal injuries can affect bone growth and require specific fracture classification (Correct answer)
Growth plates are not visible on X-ray and cannot be assessed

Correct answer: Physeal injuries can affect bone growth and require specific fracture classification

Salter-Harris physeal fractures have implications for long-term growth and may change cast type, duration, or referral urgency.

Question 59: Which tool is used to measure compartment pressure when acute compartment syndrome is suspected before or after casting?

Doppler ultrasound
Sphygmomanometer
Pulse oximeter
Intracompartmental pressure monitor (Correct answer)

Correct answer: Intracompartmental pressure monitor

Intracompartmental pressure monitoring (Stryker device or equivalent) directly measures pressures within fascial compartments.

Question 60: If a casting technician observes signs of abuse in a pediatric patient, they are legally obligated to:

Keep the suspicion confidential to protect patient privacy
Confront the caregiver directly before documenting anything
Document the findings but take no further action
Report the suspicion to the appropriate authority per mandatory reporting laws (Correct answer)

Correct answer: Report the suspicion to the appropriate authority per mandatory reporting laws

Healthcare workers are mandatory reporters in all US states; suspected child abuse must be reported to child protective services regardless of certainty.

Question 61: Heat generated by the oscillating saw can cause skin burns. This risk is BEST reduced by:

Using a plunging motion and limiting contact time at each point (Correct answer)
Cooling the blade with water during cutting
Pressing firmly to cut faster
Using a lower-frequency saw setting

Correct answer: Using a plunging motion and limiting contact time at each point

Repeated brief contacts with the oscillating saw prevent heat accumulation; prolonged contact causes thermal burns even without laceration.

Question 62: A Maisonneuve fracture is characterized by:

A mid-shaft tibial stress fracture
A distal fibula avulsion at the lateral malleolus
A calcaneus fracture from axial load
A proximal fibula fracture associated with a medial ankle injury (Correct answer)

Correct answer: A proximal fibula fracture associated with a medial ankle injury

Maisonneuve fractures result from external rotation forces causing a proximal fibula fracture with associated ankle ligamentous or medial malleolus injury — easy to miss without a full-leg X-ray.

Question 63: After both medial and lateral cuts are made during bivalving, which instrument is used to separate the cast halves?

Bandage scissors
Kelly forceps
Hemostat
Cast spreader (Correct answer)

Correct answer: Cast spreader

A cast spreader (or cast bender) is inserted into the saw cuts to gently pry the two halves apart without stressing the extremity.

Question 64: Which cast technician action constitutes practicing outside the scope of practice?

Educating the patient about cast care
Applying a cast per a written clinician order
Documenting neurovascular findings
Independently diagnosing a fracture and prescribing a cast without clinician order (Correct answer)

Correct answer: Independently diagnosing a fracture and prescribing a cast without clinician order

Diagnosis and prescription are physician functions; casting technicians apply casts based on clinician orders and do not independently diagnose or prescribe treatment.

Question 65: Which information is REQUIRED to be included on every cast application record?

Date, time, type of cast, materials used, neurovascular status, and technician name (Correct answer)
Only the cast type and date
Patient's insurance information and billing codes only
The patient's diagnosis and surgical history

Correct answer: Date, time, type of cast, materials used, neurovascular status, and technician name

A complete cast record includes procedure details, materials, neurovascular findings, and technician identification to ensure accountability and continuity of care.

Question 66: Which Salter-Harris fracture type passes completely through the physis and is associated with the highest risk of growth disturbance?

Type II (through physis and metaphysis)
Type III (through physis and epiphysis)
Type V (crush injury to the physis) (Correct answer)
Type I (through the physis only)

Correct answer: Type V (crush injury to the physis)

Salter-Harris Type V is a compression (crush) injury of the growth plate that may appear normal on initial X-ray but carries the greatest risk of growth arrest.

Question 67: What is the purpose of bivalving a cast?

To reinforce the cast with additional layers
To remove the cast entirely
To apply a new synthetic cast over the existing one
To split the cast into two halves to relieve pressure or allow for swelling (Correct answer)

Correct answer: To split the cast into two halves to relieve pressure or allow for swelling

Bivalving cuts both sides of the cast and releases the underlying padding, reducing circumferential pressure while maintaining some immobilization.

Question 68: What position should a patient's extremity be in during pre-cast neurovascular assessment?

Dependent (hanging down)
Functional position appropriate for the injury (Correct answer)
Fully extended
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.

Question 69: Which preparatory step reduces skin irritation under the cast?

Applying stockinette smoothly without wrinkles (Correct answer)
Applying petroleum jelly directly to the skin
Shaving the extremity with a razor blade
Wetting the skin before padding

Correct answer: Applying stockinette smoothly without wrinkles

A wrinkle-free stockinette prevents pressure points that can cause skin breakdown under the cast.

Question 70: What does the acronym 'CSM' stand for in orthopedic casting assessment?

Compress, Stabilize, Monitor
Circulation, Sensation, Movement (Correct answer)
Cast, Splint, Mobilize
Contour, Secure, Mold

Correct answer: Circulation, Sensation, Movement

CSM — Circulation, Sensation, Movement — is the standard neurovascular checklist performed before and after cast application.

Question 71: Which cast provides the best immobilization for a metatarsal shaft fracture that requires protected weight-bearing?

Foot slipper cast only
Cylinder cast
Short leg walking cast or walking boot (Correct answer)
Long leg cast

Correct answer: Short leg walking cast or walking boot

A short leg walking cast or removable walking boot immobilizes the forefoot while allowing controlled weight-bearing and ambulation.

Question 72: Which modification is typically made when casting an elderly patient with osteoporotic skin?

Use of only plaster to allow custom molding
Thinner padding to keep the cast lightweight
Omitting stockinette to reduce layers
Increased padding and lower circumferential pressure (Correct answer)

Correct answer: Increased padding and lower circumferential pressure

Elderly patients have fragile, atrophic skin prone to tearing and pressure injury, requiring extra padding and careful tensioning.

Question 73: What is the function of the periosteum?

Cushions joints
Attaches muscles to bone
Stores calcium
Protects and nourishes bone (Correct answer)

Correct answer: Protects and nourishes bone

The periosteum is a dense, vascular connective tissue membrane that covers the outer surface of most bones. Its primary functions include protecting the bone, providing a surface for muscle and ligament attachment, and containing cells vital for bone growth, repair, and nourishment. It also houses nerve endings, contributing to bone sensitivity.

Question 74: The Ottawa Ankle Rules help clinicians determine:

When to remove an ankle cast
The grade of ligamentous ankle sprain
Whether ankle X-rays are needed based on specific tenderness and weight-bearing ability (Correct answer)
What cast type to apply to an ankle fracture

Correct answer: Whether ankle X-rays are needed based on specific tenderness and weight-bearing ability

The Ottawa Ankle Rules are validated clinical criteria that guide X-ray ordering for ankle injuries, reducing unnecessary imaging.

Question 75: When caring for a patient with dementia in a cast, which instruction to caregivers is MOST critical?

Lock all cutting instruments to prevent cast removal
Apply additional restraints to prevent the patient from moving
Monitor for signs of cast removal attempts and skin breakdown daily (Correct answer)
Sedate the patient if they attempt to touch the cast

Correct answer: Monitor for signs of cast removal attempts and skin breakdown daily

Dementia patients may attempt cast removal and cannot communicate discomfort reliably; daily visual inspection and behavioral monitoring are essential.

Question 76: Pallor of the fingers in a patient with a freshly applied long arm cast most likely indicates:

Venous congestion
Arterial compromise (Correct answer)
Adequate venous return
Normal post-application swelling

Correct answer: Arterial compromise

Pallor signifies lack of oxygenated blood reaching the digits, indicating arterial compromise that requires immediate intervention.

Question 77: A scaphoid fracture is typically immobilized in which cast?

Long arm cast
Thumb spica cast (Correct answer)
Ulnar gutter splint
Short arm cast

Correct answer: Thumb spica cast

Thumb spica immobilization includes the thumb and wrist to protect the scaphoid's tenuous blood supply and prevent non-union.

Question 78: In patients with peripheral vascular disease, casting should be approached with caution because:

Impaired circulation reduces wound healing and increases ischemia risk under the cast (Correct answer)
Vascular disease makes the skin too slippery for cast adhesion
Arterial stents may be damaged by cast pressure
Peripheral vascular disease causes abnormally fast cast setting

Correct answer: Impaired circulation reduces wound healing and increases ischemia risk under the cast

Poor peripheral circulation compromises tissue oxygenation; even mild cast pressure can precipitate ischemic skin breakdown.

Question 79: Which scenario represents a reportable incident in a healthcare setting?

Patient requesting cast removal sooner than planned
Mild skin dryness found after cast removal
A cast saw laceration of the patient's skin during removal (Correct answer)
Normal cast drying time during application

Correct answer: A cast saw laceration of the patient's skin during removal

Any unintended patient injury — such as a saw laceration — is an adverse event that must be documented in the medical record and reported per facility policy.

Question 80: What is the correct instruction for skin care immediately after cast removal?

Vigorously scrub dead skin with a brush
Avoid washing for 48 hours
Apply rubbing alcohol to disinfect the skin
Gently wash with mild soap and water; apply moisturizer (Correct answer)

Correct answer: Gently wash with mild soap and water; apply moisturizer

Gentle cleansing and moisturization remove accumulated dead skin and restore normal hydration without traumatizing fragile post-cast skin.

Question 81: Which standard of practice determines what a casting technician is legally permitted to do?

The preferences of the supervising orthopedic physician
The policies of the employing hospital or clinic alone
The tasks described in the casting technician's job posting
Scope of practice defined by the certifying body and state law (Correct answer)

Correct answer: Scope of practice defined by the certifying body and state law

Scope of practice is legally defined by state statutes and regulations, as well as the certification body's standards, which supersede employer policies.

Question 82: Which question is MOST important to ask a patient before cast application regarding allergies?

Allergy to contrast dye
Allergy to penicillin
Allergy to shellfish
Allergy to latex or plaster (Correct answer)

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 83: Which fracture results from repetitive loading rather than acute trauma?

Comminuted fracture
Avulsion fracture
Pathologic fracture
Stress fracture (Correct answer)

Correct answer: Stress fracture

Stress fractures develop from cumulative microtrauma — such as repetitive impact in athletes — rather than a single traumatic event.

Question 84: An ankle fracture involving only the lateral malleolus without ligamentous instability is MOST commonly treated with:

Long leg cast in full extension
Thumb spica cast
Cylinder cast
Short leg cast or walking boot for 4-6 weeks (Correct answer)

Correct answer: Short leg cast or walking boot for 4-6 weeks

Stable isolated lateral malleolus fractures are managed conservatively with a short leg cast or functional brace allowing controlled weight-bearing.

Question 85: Edema assessment before casting is BEST performed by:

Reviewing the X-ray for soft tissue shadow
Asking the patient if the extremity feels swollen
Comparing circumference measurements of both extremities (Correct answer)
Pressing the skin and observing for pitting

Correct answer: Comparing circumference measurements of both extremities

Objective circumferential measurements document baseline swelling and allow comparison after casting to detect increasing edema.

Question 86: Which of the following is a critical first step in cast application?

Choosing cast color
Applying padding over bony prominences (Correct answer)
Shaping the cast edges
Mixing the casting material

Correct answer: Applying padding over bony prominences

A critical first step in cast application is to apply adequate padding, especially over bony prominences. This padding protects the patient's skin and underlying tissues from pressure sores, skin breakdown, and nerve compression that can result from the rigid casting material. Proper padding ensures patient comfort and prevents complications throughout the immobilization period.

Question 87: Which structure connects muscles to bones?

Bursae
Cartilage
Tendons (Correct answer)
Ligaments

Correct answer: Tendons

Tendons are strong, fibrous connective tissues that serve to connect muscles to bones. They are essential for transmitting the force generated by muscle contractions to the skeletal system, thereby facilitating movement. In contrast, ligaments connect bones to other bones, providing stability to joints.

Question 88: How does an oscillating cast saw avoid cutting the patient's skin?

Its blade is coated with a protective plastic layer
The blade automatically stops when it contacts skin
It uses suction to pull the cast away from the skin
It vibrates rapidly but does not rotate, cutting rigid material but bouncing off soft tissue (Correct answer)

Correct answer: It vibrates rapidly but does not rotate, cutting rigid material but bouncing off soft tissue

The oscillating motion cuts through hard fiberglass or plaster but does not slice soft, pliable skin when proper technique is used.

Question 89: What is the primary advantage of fiberglass casting material over plaster?

It sets slower
It is cheaper than plaster
It is more flexible
It is lighter and water-resistant (Correct answer)

Correct answer: It is lighter and water-resistant

Fiberglass casting material offers several advantages over plaster, most notably being significantly lighter and water-resistant. Its lighter weight enhances patient comfort and mobility, while its water-resistant property allows patients to shower or bathe with proper precautions, improving hygiene and quality of life during immobilization. These features contribute to better patient compliance and overall experience.

Question 90: Which nerve must be assessed in a distal humerus fracture?

Sciatic nerve
Ulnar nerve
Radial nerve (Correct answer)
Median nerve

Correct answer: Radial nerve

The radial nerve runs in close proximity to the posterior aspect of the humerus, making it particularly vulnerable to injury in distal humerus fractures. Damage to this nerve can result in 'wrist drop' and sensory deficits in the hand. Therefore, assessing radial nerve function (e.g., thumb extension, sensation) is a critical step to detect potential nerve impingement or transection.

Question 91: Which part of the body would most likely require a short arm cast?

Ankle
Wrist and forearm (Correct answer)
Upper arm
Knee

Correct answer: Wrist and forearm

A short arm cast extends from just below the elbow to the metacarpal heads, effectively immobilizing the wrist and forearm. This type of cast is commonly used for fractures of the distal radius, ulna, or carpal bones, as well as for severe sprains in this region. It allows for full elbow and finger movement while stabilizing the injured area.

Question 92: Which joint is classified as a hinge joint?

Shoulder
Hip
Elbow (Correct answer)
Wrist

Correct answer: Elbow

The elbow is classified as a hinge joint because it primarily allows movement in one plane, similar to a door hinge, permitting flexion and extension. This type of joint provides stability while facilitating a specific range of motion. The shoulder and hip, for example, are ball-and-socket joints, offering a much wider range of multi-directional movement.

Question 93: A child is very anxious and uncooperative during casting. The BEST approach is:

Reschedule until the child is calmer
Administer sedation before proceeding
Firmly restrain the child and complete the cast quickly
Involve the caregiver, explain each step simply, and work calmly and efficiently (Correct answer)

Correct answer: Involve the caregiver, explain each step simply, and work calmly and efficiently

Caregiver involvement, age-appropriate explanations, and a calm demeanor reduce anxiety and improve cooperation without restraint or medication.

Question 94: How is capillary refill time assessed in a patient about to receive a cast?

Measure blood pressure distally
Auscultate for distal pulse with a stethoscope
Press the nail bed, release, and count seconds until color returns (Correct answer)
Check skin temperature with a thermometer

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 95: Which assessment finding in a casted lower extremity requires IMMEDIATE notification of the supervising provider?

Mild swelling of the toes
Warm and pink toes with brisk capillary refill
Absence of the dorsalis pedis pulse (Correct answer)
Slight itching sensation under the cast

Correct answer: Absence of the dorsalis pedis pulse

Absence of a pedal pulse indicates potential vascular occlusion and is an emergency requiring immediate physician notification.

Question 96: A casting record that is incomplete or falsified could result in:

Only a verbal warning from the supervising clinician
Professional discipline, civil liability, and potential criminal charges (Correct answer)
Loss of the patient's insurance coverage
A requirement to retake the OCC examination

Correct answer: Professional discipline, civil liability, and potential criminal charges

Falsifying or omitting medical records constitutes fraud and negligence, with serious legal and professional consequences.

Question 97: 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)
Hair on the extremity
Dry skin
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 98: A patient's family member asks for the patient's cast care instructions while the patient is recovering. The technician may share them if:

The patient has provided consent for the family member to receive health information (Correct answer)
The family member is an adult
The request is made in person at the facility
The family member is listed as an emergency contact

Correct answer: The patient has provided consent for the family member to receive health information

HIPAA requires patient authorization before sharing protected health information with family members, regardless of relationship or setting.

Question 99: Which sign is most concerning for compartment syndrome in a casted limb?

Severe pain unrelieved by analgesics (Correct answer)
Dry skin under cast
Mild swelling
Pain on light touch

Correct answer: Severe pain unrelieved by analgesics

Severe pain that is disproportionate to the injury and unrelieved by standard analgesics is the most concerning sign for compartment syndrome in a casted limb. This condition occurs when increased pressure within a confined muscle compartment compromises circulation and nerve function. It is a medical emergency requiring immediate intervention to prevent permanent tissue damage.

Question 100: What is the primary contraindication for closed casting of an open (compound) fracture?

Open fractures always require amputation
High infection risk requires wound management before casting (Correct answer)
Open fractures require immediate casting to prevent further bone displacement
The cast would not adhere over an open wound

Correct answer: High infection risk requires wound management before casting

Open fractures carry high infection risk; wound irrigation, debridement, and often surgical fixation are performed before any definitive cast application.

Question 101: Which patient statement indicates the need for immediate cast evaluation?

It itches a little under the cast
My toes are warm and pink
I feel numbness and tingling in my fingers (Correct answer)
My cast feels snug but okay

Correct answer: I feel numbness and tingling in my fingers

A patient statement indicating numbness and tingling in the fingers or toes of a casted limb is a critical concern. These symptoms (paresthesia) are signs of potential nerve compression or impaired circulation, which could be an early indicator of compartment syndrome or a cast that is too tight. Immediate medical evaluation is necessary to prevent permanent neurovascular damage.

Question 102: After bivalving, what is the NEXT step to fully relieve circumferential pressure?

Apply an elastic bandage over the bivalved cast
Cut and spread the underlying cast padding (Correct answer)
Soak the cast in warm water
Remove one shell and discard it

Correct answer: Cut and spread the underlying cast padding

The inner padding layer also contributes to circumferential pressure and must be cut along the same bivalve lines to fully decompress.

Question 103: Which cast saw blade type is recommended for cutting fiberglass casts?

Diamond-tip rotary blade
Fine-toothed oscillating blade designed for synthetic materials (Correct answer)
Serrated hacksaw blade
Standard plaster blade with wide teeth

Correct answer: Fine-toothed oscillating blade designed for synthetic materials

Fine-toothed blades designed for synthetic casting materials cut fiberglass efficiently while minimizing heat generation.

Question 104: Patient discharge instructions for cast care should be provided in which format?

Verbal only to save paper
Both verbal and written instructions (Correct answer)
Pictographic instructions only for universal accessibility
Written only to save appointment time

Correct answer: Both verbal and written instructions

Both verbal and written instructions ensure patient understanding and provide a reference the patient can consult at home.

Question 105: Which technique is used to relieve pressure in a circumferential cast?

Wrapping
Stripping
Padding
Bivalving (Correct answer)

Correct answer: Bivalving

Bivalving is the technique of cutting a circumferential cast lengthwise into two halves. This procedure is performed to relieve pressure, particularly in cases of anticipated or actual swelling that could lead to compartment syndrome, or to allow for wound care and physical therapy access. It helps prevent neurovascular compromise and facilitates ongoing patient management.

Question 106: Before applying a cast, what is the FIRST step in patient assessment?

Select casting material
Review neurovascular status distal to the injury (Correct answer)
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 107: Which color-coded system is used to guide padding at vulnerable areas in pediatric casts?

Red padding for high-risk areas, green for low-risk
Blue marks for bony prominences, yellow for skin folds
Standard hospital color bands matching allergy status
There is no color system; anatomy landmarks guide extra padding placement (Correct answer)

Correct answer: There is no color system; anatomy landmarks guide extra padding placement

Padding placement in pediatric casts is guided by anatomical landmarks rather than a color-coded system; extra padding is placed over identified bony prominences.

Question 108: A pathologic fracture is defined as a fracture occurring:

After normal-energy trauma in a healthy individual
In the growth plate of a child
At the site of a previous surgical repair
Through bone weakened by underlying disease such as tumor or osteoporosis (Correct answer)

Correct answer: Through bone weakened by underlying disease such as tumor or osteoporosis

Pathologic fractures occur through abnormal bone and may occur with minimal trauma; the underlying condition must be addressed alongside fracture management.

Question 109: What is the purpose of maintaining a quality assurance log for casting procedures?

To track patient billing for insurance purposes
To document how many casts each technician applies per day
To comply with OSHA physical hazard reporting requirements
To identify patterns of complications or errors and improve outcomes (Correct answer)

Correct answer: To identify patterns of complications or errors and improve outcomes

Quality assurance data identifies systemic issues — such as recurring pressure injuries — allowing process improvements that enhance patient safety.

Question 110: In a patient with a spinal cord injury who lacks sensation, the primary casting concern is:

Pressure injury that the patient cannot feel or report (Correct answer)
Bone healing being slower due to paralysis
Autonomic dysreflexia triggered by the cast saw
Muscle spasticity breaking the cast

Correct answer: Pressure injury that the patient cannot feel or report

Lack of sensation means pressure sores can develop silently; aggressive padding and very frequent skin checks are mandatory.

Question 111: Which material is preferred for initial casting when significant swelling is expected?

Fiberglass
Plaster (Correct answer)
Plastic
Resin

Correct answer: Plaster

Plaster of Paris casts are generally preferred for initial casting when significant swelling is expected because they are more conformable and allow for slight expansion as swelling fluctuates. Unlike fiberglass, plaster can be easily molded to the limb and, if needed, removed or modified more readily in the acute phase. This flexibility helps prevent complications such as compartment syndrome in the early stages of injury.

Question 112: After cast removal, which skin finding requires the clinician's evaluation before the patient is discharged?

Mild skin dryness and scaling
Muscle atrophy visible in the limb
Open pressure sore or wound (Correct answer)
Slight pallor of the skin

Correct answer: Open pressure sore or wound

Any open wound or pressure injury discovered post-removal must be assessed by the clinician for infection and wound care planning.

Question 113: What is the professional responsibility of a certified orthopedic technician?

Ensure safe and ethical practice (Correct answer)
Limit communication with patients
Work independently without oversight
Follow only verbal instructions

Correct answer: Ensure safe and ethical practice

A certified orthopedic technician has a professional responsibility to ensure safe and ethical practice in all aspects of their work. This includes adhering to established protocols, maintaining patient confidentiality, communicating effectively, and working within their scope of practice under appropriate supervision. Prioritizing patient well-being and upholding high standards of care are paramount.

Question 114: What is a common skin complication associated with long-term casting?

Hives
Psoriasis
Maceration (Correct answer)
Eczema

Correct answer: Maceration

Maceration is a common skin complication associated with long-term casting, characterized by the softening and breakdown of skin due to prolonged exposure to moisture. The warm, moist environment within a cast, often from sweat or inadequate drying, creates ideal conditions for skin maceration, leading to irritation, itching, and an increased risk of infection.

Question 115: A capillary refill time greater than how many seconds is considered abnormal in a casted extremity?

2 seconds (Correct answer)
1 second
6 seconds
4 seconds

Correct answer: 2 seconds

Capillary refill greater than 2 seconds indicates impaired peripheral perfusion and requires prompt evaluation.

Question 116: A long arm cast is indicated instead of a short arm cast for which type of fracture?

Boxer's fracture
Isolated distal radius torus fracture
Scaphoid fracture (stable)
Both-bone forearm fracture (radius and ulna) requiring rotational control (Correct answer)

Correct answer: Both-bone forearm fracture (radius and ulna) requiring rotational control

Both-bone forearm fractures require elbow immobilization to control forearm rotation, which a short arm cast cannot provide.

Question 117: Which elements MUST be documented before a cast is applied to meet the standard of care?

The name of the ordering physician and clinic location
Pre-cast neurovascular assessment (CSM), skin integrity, patient consent, and allergy history (Correct answer)
Only the type of cast material used
The patient's height and weight

Correct answer: Pre-cast neurovascular assessment (CSM), skin integrity, patient consent, and allergy history

Pre-procedure documentation of CSM, skin status, allergies, and consent establishes a baseline and demonstrates that safety checks were performed.

Question 118: The 'three-point mold' technique is especially important in pediatric casting because:

Children require casts to be removed more frequently
Children have softer bones that may angulate if the cast is not properly molded (Correct answer)
Pediatric casts use faster-setting plaster
Children cannot tolerate fiberglass materials

Correct answer: Children have softer bones that may angulate if the cast is not properly molded

Proper three-point molding maintains fracture alignment in children whose immature bone remodeling relies heavily on correct cast geometry.

Question 119: Which sign or symptom is typically the EARLIEST indicator of acute compartment syndrome?

Pallor of the distal extremity
Paralysis of affected muscles
Pulselessness
Pain with passive stretch of muscles in the compartment (Correct answer)

Correct answer: Pain with passive stretch of muscles in the compartment

Pain with passive stretch is the earliest and most sensitive clinical indicator of compartment syndrome, preceding pulselessness and paralysis.

Question 120: Which complication is most directly prevented by prompt bivalving of a tight cast?

Wound dehiscence
Acute compartment syndrome (Correct answer)
Bone non-union
Skin maceration

Correct answer: Acute compartment syndrome

Bivalving relieves circumferential pressure that, if left unaddressed, can progress to compartment syndrome and ischemia.

Question 121: A patient has a known latex allergy. The casting technician should use:

No gloves since direct contact is minimal
Vinyl gloves only and standard stockinette
Latex-free gloves and non-latex stockinette (Correct answer)
Standard latex gloves covered by a second glove

Correct answer: Latex-free gloves and non-latex stockinette

All materials contacting the patient and technician must be latex-free to prevent allergic reaction in latex-allergic patients.

Orthopaedic Technologist Certified (OTC) Examination

The OTC exam certifies orthopaedic technologists in patient assessment, casting and splinting techniques, surgical procedures, and clinic management. It is administered by the National Board for Certification of Orthopaedic Technologists (NBCOT).

165

Questions

180 min

Time Limit

70%

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