Orthopaedic Nurse Test Regulatory Frameworks & Compliance 2 — Questions and Answers
Question 1: Under the Joint Commission's National Patient Safety Goals, which practice is specifically required to prevent wrong-site orthopaedic surgery?
- Verbal confirmation by the surgeon only
- Universal Protocol including site marking and time-out (Correct answer)
- Radiograph review before incision
- Patient signature on the surgical schedule
Correct answer: Universal Protocol including site marking and time-out
The Universal Protocol—comprising pre-procedure verification, site marking, and a time-out—is mandated by The Joint Commission to prevent wrong-site, wrong-procedure, and wrong-person surgery.
Question 2: Which federal law primarily governs the privacy of patient health information in orthopaedic practice settings?
- EMTALA
- HIPAA Privacy Rule (Correct answer)
- Stark Law
- False Claims Act
Correct answer: HIPAA Privacy Rule
HIPAA's Privacy Rule establishes national standards for protecting individually identifiable health information (PHI) in all healthcare settings, including orthopaedics.
Question 3: A patient admitted for total knee arthroplasty asks the nurse to share their diagnosis with their employer. What is the nurse's appropriate response?
- Provide information since employment status is relevant
- Refuse and explain that employer disclosure requires written patient authorization (Correct answer)
- Consult the surgeon before responding
- Share only the surgical procedure, not the diagnosis
Correct answer: Refuse and explain that employer disclosure requires written patient authorization
Under HIPAA, disclosing PHI to an employer requires the patient's written authorization unless a specific exception applies.
Question 4: The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard most directly applies to orthopaedic nurses when:
- Administering oral medications
- Handling surgical instruments contaminated with blood (Correct answer)
- Documenting post-operative vital signs
- Educating patients about home exercise programs
Correct answer: Handling surgical instruments contaminated with blood
OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) requires engineering controls, PPE, and exposure control plans when workers handle blood or other potentially infectious materials.
Question 5: Which accrediting body publishes the Orthopaedic Nursing Certification (ONC) credential and sets its competency standards?
- American Nurses Credentialing Center (ANCC)
- Orthopaedic Nurses Certification Board (ONCB) (Correct answer)
- National League for Nursing (NLN)
- American Board of Nursing Specialties (ABNS)
Correct answer: Orthopaedic Nurses Certification Board (ONCB)
The Orthopaedic Nurses Certification Board (ONCB) administers the ONC examination and establishes the competency framework for orthopaedic nursing practice.
Question 6: Under CMS Conditions of Participation, a hospital must ensure that patients receive written notice of their rights. Which of the following is included in these rights for an orthopaedic patient?
- Right to choose their own surgical technique
- Right to receive care in a safe setting and to be free from restraints used as punishment (Correct answer)
- Right to unlimited visitation at all hours
- Right to access other patients' medical records for comparison
Correct answer: Right to receive care in a safe setting and to be free from restraints used as punishment
CMS Conditions of Participation require hospitals to inform patients of their right to receive care in a safe setting and to be free from any form of restraint used as a means of coercion, discipline, or retaliation.
Question 7: When a nurse discovers that a total hip replacement implant was used past its manufacturer's expiration date, the appropriate initial reporting pathway is:
- Notify the patient immediately and document in the chart
- Report via MedWatch to the FDA and follow facility adverse event reporting policy (Correct answer)
- Inform the surgical vendor representative only
- File a complaint with the state nursing board
Correct answer: Report via MedWatch to the FDA and follow facility adverse event reporting policy
The FDA's MedWatch program and internal facility adverse event reporting policies are the required channels for reporting medical device problems, including use of expired implants.
Orthopaedic Nurse Test Regulatory Frameworks & Compliance 2
Under the Joint Commission's National Patient Safety Goals, which practice is specifically required to prevent wrong-site orthopaedic surgery?