OTC Orthopaedic Technologist Certified Patient Assessment and Management 4 — Questions and Answers
Question 1: When assessing a pediatric patient with a suspected supracondylar humerus fracture, which neurovascular structure is at greatest risk of injury?
- Anterior interosseous nerve and brachial artery (Correct answer)
- Radial nerve and radial artery
- Ulnar nerve and ulnar artery
- Median nerve and axillary artery
Correct answer: Anterior interosseous nerve and brachial artery
Supracondylar fractures in children most commonly injure the anterior interosseous nerve and brachial artery due to their proximity to the fracture site.
Question 2: A patient is being assessed for a potential hip fracture after a fall. Which physical finding best suggests an intracapsular femoral neck fracture?
- Shortened and externally rotated lower extremity with groin pain (Correct answer)
- Shortened and internally rotated extremity with thigh pain
- Valgus knee deformity with lateral hip pain
- Normal limb position with isolated greater trochanter tenderness
Correct answer: Shortened and externally rotated lower extremity with groin pain
Intracapsular femoral neck fractures typically present with a shortened, externally rotated limb and groin pain due to muscle forces and loss of bony stability.
Question 3: When conducting a pain assessment using the SOCRATES mnemonic, the letter 'R' stands for:
- Radiation (Correct answer)
- Response to treatment
- Rest pain
- Recurrence
Correct answer: Radiation
In SOCRATES (Site, Onset, Character, Radiation, Associated symptoms, Time course, Exacerbating/relieving factors, Severity), R stands for Radiation of the pain.
Question 4: A patient with a below-knee cast complains of new-onset calf pain and warmth 5 days post-injury. The OT's primary concern should be:
- Deep vein thrombosis (DVT) (Correct answer)
- Cast pressure sore
- Superficial wound infection
- Reflex sympathetic dystrophy
Correct answer: Deep vein thrombosis (DVT)
New calf pain and warmth in an immobilized patient are classic signs of DVT, which requires urgent physician evaluation and possible anticoagulation.
Question 5: The Phalen's test is used to assess for which condition?
- Carpal tunnel syndrome (Correct answer)
- De Quervain's tenosynovitis
- Cubital tunnel syndrome
- Trigger finger
Correct answer: Carpal tunnel syndrome
Phalen's test reproduces carpal tunnel syndrome symptoms by maximally flexing the wrist for 60 seconds to increase pressure on the median nerve.
Question 6: An OT documents '3/5' on a manual muscle test for knee extension. This finding means the patient can:
- Move through full range of motion against gravity but not against added resistance (Correct answer)
- Move only with gravity eliminated
- Move against moderate resistance
- Generate no visible contraction
Correct answer: Move through full range of motion against gravity but not against added resistance
MRC grade 3/5 means the muscle can move the joint through full range of motion against gravity alone, with no additional resistance applied.
Question 7: During post-operative assessment of a patient who underwent open reduction internal fixation (ORIF) of an ankle fracture, the OT notes absent dorsal pedis pulse but intact sensation and capillary refill. The most appropriate action is to:
- Immediately report to the surgeon and document the finding (Correct answer)
- Recheck the pulse in 30 minutes before reporting
- Reassure the patient as other signs are normal
- Apply a warm compress to improve circulation
Correct answer: Immediately report to the surgeon and document the finding
An absent pulse after ORIF is an urgent vascular finding that requires immediate surgeon notification regardless of other intact signs, as isolated arterial injury is possible.
OTC Orthopaedic Technologist Certified Patient Assessment and Management 4
When assessing a pediatric patient with a suspected supracondylar humerus fracture, which neurovascular structure is at greatest risk of injury?