Orthopaedic Nurse Test Ultimate Orthopaedic Nurse 5 — Questions and Answers
Question 1: A patient who had a below-knee amputation reports sharp, burning pain in the missing foot. The nurse recognizes this as:
- Residual limb contracture
- Phantom limb pain (Correct answer)
- Referred pain from surgical wound
- Neuroma formation at the stump
Correct answer: Phantom limb pain
Phantom limb pain is the perception of pain in an amputated body part, caused by continued nerve signaling from the severed neural pathways.
Question 2: A nurse is preparing to apply a figure-8 bandage to a patient's clavicle fracture. The PRIMARY goal of this bandage is to:
- Immobilize the shoulder completely
- Retract the shoulders to reduce fracture displacement (Correct answer)
- Prevent pneumothorax complications
- Provide compression to control bleeding
Correct answer: Retract the shoulders to reduce fracture displacement
A figure-8 clavicle bandage holds the shoulders back, pulling the clavicle fragments into better alignment by retracting the shoulder girdle.
Question 3: Which sign is the nurse assessing when testing for pain with passive stretch of the fingers in a patient with forearm compartment syndrome?
- Homans' sign
- Tinel's sign
- Compartment stretch sign (Correct answer)
- Phalen's sign
Correct answer: Compartment stretch sign
The compartment stretch sign (pain with passive muscle stretch) is the most sensitive early indicator of compartment syndrome in a limb.
Question 4: A patient on long-term corticosteroid therapy for inflammatory arthritis is at GREATEST risk for which orthopaedic complication?
- Heterotopic ossification
- Avascular necrosis of the femoral head (Correct answer)
- Stress fracture of the metatarsals
- Trigger finger
Correct answer: Avascular necrosis of the femoral head
Long-term corticosteroid use impairs blood supply to the femoral head, leading to avascular necrosis (osteonecrosis), a well-known complication.
Question 5: A patient with a pelvic fracture is at risk for which LIFE-THREATENING complication in the immediate period?
- Urinary tract infection
- Hypovolemic shock from retroperitoneal hemorrhage (Correct answer)
- Foot drop due to nerve compression
- Deep vein thrombosis
Correct answer: Hypovolemic shock from retroperitoneal hemorrhage
Pelvic fractures can cause massive retroperitoneal hemorrhage due to disruption of the pelvic venous plexus and arterial structures, leading to fatal blood loss.
Question 6: A patient with a newly applied hip spica cast complains of severe abdominal cramping and vomiting. The nurse suspects:
- Postoperative ileus from anesthesia
- Cast syndrome (superior mesenteric artery syndrome) (Correct answer)
- Narcotic-induced nausea
- Urinary retention causing referred abdominal pain
Correct answer: Cast syndrome (superior mesenteric artery syndrome)
Cast syndrome (SMA syndrome) occurs when a body or hip spica cast compresses the superior mesenteric artery against the duodenum, causing obstruction.
Question 7: When performing pin site care for a patient in external fixation, which technique reflects current evidence-based practice?
- Vigorous scrubbing with hydrogen peroxide twice daily
- Cleaning with normal saline or chlorhexidine and allowing crusts to form naturally (Correct answer)
- Packing pin sites tightly with betadine-soaked gauze
- Leaving pin sites completely uncovered without cleaning
Correct answer: Cleaning with normal saline or chlorhexidine and allowing crusts to form naturally
Current evidence supports cleaning pin sites with normal saline or dilute chlorhexidine and allowing natural crust formation, which protects the site.
Orthopaedic Nurse Test Ultimate Orthopaedic Nurse 5
A patient who had a below-knee amputation reports sharp, burning pain in the missing foot.
The nurse recognizes this as: