Orthopaedic Nurse Test Ultimate Orthopaedic Nurse 4 — Questions and Answers
Question 1: A nurse is educating a patient on crutch walking using the 3-point gait after a non-weight-bearing right ankle fracture. The correct sequence is:
- Both crutches forward → right foot forward → left foot advances
- Left foot forward → both crutches forward → right foot lifts
- Both crutches and right foot forward together → left foot advances (Correct answer)
- Right foot → both crutches forward → left foot advances
Correct answer: Both crutches and right foot forward together → left foot advances
In 3-point gait, both crutches and the affected non-weight-bearing limb advance simultaneously, then the unaffected limb follows.
Question 2: A patient's bone scan report describes 'increased uptake' at the distal femur. The nurse understands this finding MOST likely indicates:
- Decreased metabolic activity in the area
- Increased bone remodeling, infection, or malignancy (Correct answer)
- Normal bone density for the patient's age
- Successful bone healing after fracture
Correct answer: Increased bone remodeling, infection, or malignancy
Increased radionuclide uptake on bone scan reflects heightened osteoblastic activity, which can indicate fracture healing, infection, or tumor.
Question 3: Which nursing intervention is HIGHEST priority for a patient in skeletal traction?
- Ensure weights are hanging freely and not resting on the floor (Correct answer)
- Provide distraction activities to reduce boredom
- Offer a high-fiber diet to prevent constipation
- Change the traction pin site dressing every 8 hours
Correct answer: Ensure weights are hanging freely and not resting on the floor
Weights must hang freely at all times to maintain the therapeutic pulling force; resting weights eliminate traction effectiveness and can worsen injury.
Question 4: A patient with osteoporosis has a T-score of -2.8 on DEXA scan. The nurse interprets this as:
- Normal bone density
- Osteopenia
- Osteoporosis (Correct answer)
- Severe osteoporosis with high fracture risk
Correct answer: Osteoporosis
A T-score of -2.5 or below defines osteoporosis; -2.8 falls in this category and indicates significant bone loss.
Question 5: A patient with a right total shoulder replacement asks when they can resume driving. The nurse's BEST response is:
- As soon as you feel comfortable, usually 1 to 2 weeks
- Not until your surgeon clears you, typically 4 to 6 weeks or longer (Correct answer)
- Driving is permitted immediately since it is your non-dominant side
- You may drive once you can lift 10 pounds without pain
Correct answer: Not until your surgeon clears you, typically 4 to 6 weeks or longer
Driving after total shoulder arthroplasty requires surgeon clearance, typically at 4–6 weeks, due to sling use and impaired reaction ability.
Question 6: A patient with carpal tunnel syndrome reports pain and numbness waking them at night. The nurse should anticipate which initial non-surgical intervention?
- Immediate surgical referral for carpal tunnel release
- Wrist splinting in neutral position at night (Correct answer)
- Application of ice packs for 20 minutes four times daily
- Strengthening exercises for the thenar muscles
Correct answer: Wrist splinting in neutral position at night
Nighttime wrist splinting in the neutral position reduces nerve compression and is the first-line conservative treatment for carpal tunnel syndrome.
Question 7: After a total hip arthroplasty using an anterior approach, which restriction is MOST important to communicate to the patient?
- Avoid hip flexion beyond 90 degrees
- Avoid excessive hip extension and external rotation (Correct answer)
- Maintain abduction pillow between the knees at all times
- Avoid adduction and internal rotation of the hip
Correct answer: Avoid excessive hip extension and external rotation
The anterior approach places the hip at risk for dislocation with excessive extension and external rotation, unlike the posterior approach restrictions.
Orthopaedic Nurse Test Ultimate Orthopaedic Nurse 4
A nurse is educating a patient on crutch walking using the 3-point gait after a non-weight-bearing right ankle fracture.
The correct sequence is: