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Orthopedic Nursing Care: Exam Q&A 2025, Exams of Medicine

Kent State University (KSU) - East Liverpool CampusMedicine

A concise overview of orthopedic nursing care, focusing on common injuries, fracture types, and their management. It covers topics such as contusions, strains, sprains, joint dislocations, and various fractures affecting different body parts, including the skull, spine, clavicle, humerus, elbow, radius, ulna, wrist, hand, ribs, pelvis, femur, and hip. Additionally, it addresses repetitive use injuries, carpal tunnel syndrome, bursitis, epicondylitis, and the stages of fracture healing. The document also discusses complications like compartment syndrome, fat embolism syndrome, deep venous thrombosis, delayed union, and complex regional pain syndrome, along with treatments such as traction, casts, and external fixators. It serves as a quick reference for understanding orthopedic conditions and nursing interventions, useful for students and healthcare professionals alike. This guide is designed to aid in exam preparation and clinical practice, offering verified information for 2025.

Typology: Exams

2024/2025

Available from 05/18/2025

Nurseexcel
Nurseexcel 🇺🇸

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Orthopedic Nursing Care Cert Exam
Questions and elaborated Answers 100% Verified 2025
1. What is the most commonly reported injuries?: Contusions, Strains, and Sprains.
2. Contusion: Blunt force-bleeding into soft tissue, but skin remains intact.
(Swelling, discoloration of skin) Least serious
3. Strain: Stretching injury to a muscle or a muscle-tendon unit. Caused by mechan- ical
overloading. (Pain, limited motion, muscle spasms/weakness, swelling.) Most common:
lower abck and Hamstring muscle
4. Sprain: Stretch/tear of ligaments surrounding joint. (Loss of the ability to move or use
the joint, feeling a "pop" or tear, discoloration, pain, rapid swelling.) Most common: ankles
and knees
5. RICE: Rest Ice Compression Elevation 24-48hrs do RICE.
6. Joint dislocation: Trauma or illness forces ends of the bones from normal position.
(Pain, deformity, limited motion, shorter limb) Care: Reduction by manual traction or
surgery immobilization, hip dislocation requires immediate reduction to prevent
complications to prevent necrosis.
7. Subluxation: partial dislocation is which the bones of the joint remain in partial contact
8. Necrosis: Death of bone tissue
9. Electrical Bone Stimulation: Used to treat fractures that aren't healing appropri- ately,
increases migration of osteoblasts and osteoclasts to fracture site.Application of an
electrical current
10. What to do for fracture of the skull?: Assess patient for neurologic changes, document
LOC, depressed skull fracture can cause neurologic damage.
11. Fracture Care: Emergency Care: Immobilize the fracture, maintain tissue perfu- sion,
prevent infection. Medications: Analgesics, NSAIDs, antibiotics,anticoagulants, stool
softeners, antacids. Surgery: External fixation device, ORIF
12. Fracture of the Face: Manifestations: Hematoma, pain, edema, bony deformity. Focus on
airway, assess neurologic, body image disturbance, assess pain
13. Fracture of the Spine: Cervical, lumbar, thoracic, or sacral...damage to spinal cord.
MOST SEVERE, can result in ischemia and cause permanent paralysis.
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Orthopedic Nursing Care Cert Exam

Questions and elaborated Answers 100% Verified 2025

  1. What is the most commonly reported injuries?: Contusions, Strains, and Sprains.
  2. Contusion: Blunt force-bleeding into soft tissue, but skin remains intact. (Swelling, discoloration of skin) Least serious
  3. Strain: Stretching injury to a muscle or a muscle-tendon unit. Caused by mechan- ical overloading. (Pain, limited motion, muscle spasms/weakness, swelling.) Most common: lower abck and Hamstring muscle
  4. Sprain: Stretch/tear of ligaments surrounding joint. (Loss of the ability to move or use the joint, feeling a "pop" or tear, discoloration, pain, rapid swelling.) Most common: ankles and knees
  5. RICE: Rest Ice Compression Elevation 24 - 48hrs do RICE.
  6. Joint dislocation: Trauma or illness forces ends of the bones from normal position. (Pain, deformity, limited motion, shorter limb) Care: Reduction by manual traction or surgery immobilization, hip dislocation requires immediate reduction to prevent complications to prevent necrosis.
  7. Subluxation: partial dislocation is which the bones of the joint remain in partial contact
  8. Necrosis: Death of bone tissue
  9. Electrical Bone Stimulation: Used to treat fractures that aren't healing appropri- ately, increases migration of osteoblasts and osteoclasts to fracture site.Application of an electrical current
  10. What to do for fracture of the skull?: Assess patient for neurologic changes, document LOC, depressed skull fracture can cause neurologic damage.
  11. Fracture Care: Emergency Care: Immobilize the fracture, maintain tissue perfu- sion, prevent infection. Medications: Analgesics, NSAIDs, antibiotics,anticoagulants, stool softeners, antacids. Surgery: External fixation device, ORIF
  12. Fracture of the Face: Manifestations: Hematoma, pain, edema, bony deformity. Focus on airway, assess neurologic, body image disturbance, assess pain
  13. Fracture of the Spine: Cervical, lumbar, thoracic, or sacral...damage to spinal cord. MOST SEVERE, can result in ischemia and cause permanent paralysis.

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  1. Fracture of the Clavicle: Usually midclavicular, can damage subclavian vessels or lung. Seen most common with falls
  2. Fracture of Humerus: Complications: nerve and ligament damage, frozen or stiff joints, and malunion--fractured fragments are not in good position... Fractures of the proximal humerus are more common in older adults.
  3. Fracture of the Elbow: Usually distal humerus, common complications: nerve or artery damage, hemiartrosis, Volkmann's contracture (claw deformity of hand and fingers). Fall or direct blow is main report.

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  1. Dislocation: injury in which the ends of the bones are displaced out of their normal position and joint articulation is lost
  2. Carpal Tunnel: a cannal through which flexor tendons and the median nerve pass from the wrist to the hand. Sybdrome: compression of the median nerve as a

5 / result of inflammation and swelling of the synovial lining. Alleviated by shaking or massaging the fingers.

  1. Bursitis: an enclosed sac found between muscles, tendons, and bony promi- nences, inflammation of these. Caused by friction between bursa and surrounding tissue. Common Places: Shoulder, hip, knee, elbow.
  2. Epicondylitis: inflammation of the tendon at its point of origin into the humerus. Increase mobility and alleviate pain
  3. Hematoma Formation: First Phase of Fracture healing. Localized necrosis, heightened inflammatory response. Inflammation, bleeding and hemotoma. Fibrob- lasts, lymphocytes (inflammation), macrophages migrate to fracture site.
  4. Fibrocartilaginous Callus Formation: Second Phase of Fracture Healing. Oc- curs within 48 hours of injury, granulation tissue replaces hematoma. base is laid for bone growth, and they cannot yet bear weight.
  5. Bony Callus Formation: Third Phase of Fracture healing. Occurs 3-4 weeks after injury, formation and gradual mineralization of collagen fibers and bone matrix
  6. Remodeling: Last stage of Fracture healing (4th). Removal of excess callus, remodeling by osteoblasts and osteoclasts. Compact bone replaces spongey bone.
  7. Compartment syndrome: Occurs when pressure within a confined space con- stricts and entraps the structures within. Can lead to limb loss, sepsis, ARF. Early signs: pain, normal or decreased peripheral pulse. Later signs: cyanosis, parethe- sias, paresis, severe pain. Tx: alleviate pressure, removal of cast, fasciotomy. Do NOT elevate or use ice
  8. Fat embolism Syndrome: Characterized by neurologic dysfunction, pulmonary insufficiency, and a petechial rash on the chest, axilla, and upper arms. Bone fracture results in a rise of pressure in the bone marrow, fet globules enter the bloodstream and combine with platelets. They occlude small blood vessels, and cause tissue ischemia. Signs: confusion, changes in LOC, petechiae, soft palate, conjunctiva.TX: Intubation, fluid balance, corticosteriods.
  9. Deep Venous Thrombosis (DVT): Blood clot forms along the intimal lining of a large vein, accompanied by inflammation of the vein wall. Can lead to venous insufficiency, pulmonary embolism. Signs: Swelling, pain, tenderness, or cramping of the affected extremity.Can be asymptomatic TX: prevention is best.

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  1. Complex Regional Pain Syndrome: may occur after musculoskeletal or nerve trauma. Causes extremity pain that is severe, diffues, and burning. Initially appearing inflamed, edematous but later becomes cool and pale. Muscle wasting, skin and nail changes and bone abnormalities can occur. TX: Sympathetic nervous system blocking agent.
  2. Traction: applies a straightening or pulling force to return or maintain the frac- tured bones in normal anatomic position.
  3. Casts: Rigid device applied to immobilize the injured bones and promote heal- ing. Immobilizes the joint above the joint below the fractured bone so that the bone will not move during healing. Nursing: Monitor for "hot spots", pain, and drainage. Neurovascular assess, and teaching care of this device.
  4. External Fixator: consists of a frame connected to pins that are inserted per- pindicular to the long axis of the bone. The number of pins depends on the type and site of fracture.Monitor Neurovascular assess and infection
  5. Closed "Simple" fracture: skin is intact
  6. Open "Compound" fracture: The skin intergrity is interrupted. Allows bacteria to move into open area and can cause complications.
  7. Complete fractures: Involve the entire width of the bone
  8. Incomplete fractures (Greenstick): involve only part of the width of the bone.
  9. Oblique fracture line: ar an angle to the bone
  10. Avulsed fracture: when the fracture pulls bone and other tissue awayfrom the point of attachment
  11. Spiral fracture line: curves around the bone
  12. Comminuted Bone: bone breaks into many pieces
  13. Compressed Bone: Bone is crushed
  14. Impacted Bone: Broken bone ends are forced into each other
  15. Depressed Bone: the broken bone is forced inward
  16. Stable (nondisplaced) Fracture: fracture where bones maintain their anatomic alighment
  17. Unstable (Displaced) Fracture: Fracture occurs when the bones move out of the correct amatomical alignment
  18. Faciotomy: Surgical insicion of a muscle or Fascia to relieve pressure within the

8 / compartment.. Afterwards the incision is left open, leading to possible infection

  1. Volkmann's Contracture: uncommon complication of elbow or forearm frac- tures, can result from unresolved compartment syndrome. Signs: Ischemia, degen- eration, and contraction of forearm muscles
  2. Manual Traction: applied by physically pulling on the extremity. often is used to reduce a fracture or dislocation.

10 /

  1. Post-amputation care: rigid or compression dressing is applied to prevent infection and minimize edema. dressing is made by placing a cast on the stump and molding the stump to fit a prosthesis.
  2. Complications of Amputation: Infection: drainage odor, redness, increased discomfort, chills, + wound and blood cultures.

11 / Delayed healing:`electolytes imbalance or infections prolong process, smoking, circulatory or cardiac problems. Chronic Stump pain: Neuroma formation- severe burning pain;TENS, surgical pro- cedure, meds Phantom Pain, and Contracures

  1. Contracture: abnormal flexion and fixation of a joint caused by muscle atrophy and shortening. Most common site is above the joint of the amputation. Exercising is VERY important. AKA: should lie prone for periods of the day. BKA: can prop the leg up with a pillow.