OTC Orthopaedic Technologist Certified Patient Assessment and Management 3 — Questions and Answers
Question 1: A patient presents with a suspected scaphoid fracture. X-rays are negative. The most appropriate clinical management is to:
- Immobilize in a thumb spica splint and arrange further imaging (Correct answer)
- Discharge with analgesics and no follow-up
- Apply a short arm cast and discharge
- Order immediate surgical consultation without imaging
Correct answer: Immobilize in a thumb spica splint and arrange further imaging
Scaphoid fractures are often radiographically occult initially; immobilization and follow-up MRI or CT are the standard of care to avoid missed diagnosis and avascular necrosis.
Question 2: During a McMurray test, a palpable click or clunk along the joint line with knee rotation indicates pathology of which structure?
- Meniscus (Correct answer)
- Anterior cruciate ligament
- Medial collateral ligament
- Patellar tendon
Correct answer: Meniscus
A positive McMurray test—click or pain at the joint line with tibial rotation—is indicative of a meniscal tear.
Question 3: When assessing edema in a lower extremity following ankle fracture repair, the OT should document pitting edema using which standardized grading?
- 1+ (2 mm) through 4+ (8 mm) depth of pitting (Correct answer)
- Grade 0 to Grade 3 by skin color change
- Mild, moderate, or severe based on patient pain
- Circumferential measurement only
Correct answer: 1+ (2 mm) through 4+ (8 mm) depth of pitting
The standard pitting edema scale grades indentation depth: 1+ (≤2 mm), 2+ (3–4 mm), 3+ (5–6 mm), and 4+ (7–8 mm).
Question 4: A patient in skeletal traction for a femur fracture develops pin site redness, warmth, and purulent drainage. The OT's priority action is to:
- Notify the supervising physician and document findings (Correct answer)
- Clean the pin site and apply antibiotic ointment independently
- Remove the traction pin immediately
- Increase the traction weight to reduce movement at the site
Correct answer: Notify the supervising physician and document findings
Signs of pin site infection require prompt physician notification; independent treatment or removal of traction hardware is outside OT scope and could cause harm.
Question 5: The Lachman test is used to assess the integrity of which ligament?
- Anterior cruciate ligament (ACL) (Correct answer)
- Posterior cruciate ligament (PCL)
- Medial collateral ligament (MCL)
- Lateral collateral ligament (LCL)
Correct answer: Anterior cruciate ligament (ACL)
The Lachman test evaluates ACL integrity by assessing anterior tibial translation on the femur with the knee flexed at 20–30 degrees.
Question 6: An orthopaedic technologist is assessing a patient's gait post-femoral fracture repair. A Trendelenburg gait pattern indicates weakness of which muscle group?
- Hip abductors (gluteus medius) (Correct answer)
- Hip flexors (iliopsoas)
- Knee extensors (quadriceps)
- Ankle plantar flexors (gastrocnemius)
Correct answer: Hip abductors (gluteus medius)
A Trendelenburg gait occurs when the contralateral pelvis drops during single-leg stance, indicating weakness of the weight-bearing hip abductors.
Question 7: Which dermatome assessment finding would suggest involvement of the L4 nerve root in a patient with lumbar spine pathology?
- Decreased sensation over the medial lower leg and great toe (Correct answer)
- Decreased sensation over the lateral foot and small toe
- Decreased sensation over the anterior thigh
- Decreased sensation over the posterior thigh
Correct answer: Decreased sensation over the medial lower leg and great toe
The L4 dermatome covers the medial lower leg and great toe; sensory changes in this distribution suggest L4 nerve root compression.
OTC Orthopaedic Technologist Certified Patient Assessment and Management 3
A patient presents with a suspected scaphoid fracture.
X-rays are negative.
The most appropriate clinical management is to: