Ortho certification

 Ortho certification

What is a major difference between osteo and rheumatoid arthritis

Osteoarthritis is local versus systemic

Which test is used for diagnosing osteoarthritis

X-rays

Which describes joint crepitation

Grating sound

What is a presenting symptom of hip osteoarthritis

Groin pain

What is a Herberdens node

Osteophyte formation

Which of the following is often found in degenerative disc disease

A normal physical exam

Mrs. Rockwood is having more and more problems with her osteoarthritis her right shoulder and back have been really bothering her she enjoys housekeeping and takes pride in her clean house and is having difficulty getting it accomplished what would you suggest

Space the cleaning out throughout the week cleaning one room Per day

Mrs. Rockford is prescribed physical and occupational therapy is to help with her pain. What information should the nurse include in teaching?

Take oral pain medication 45 minutes before your therapy session

What is a management goal of osteoarthritis

Maintain joint function and mobility

What is an advantage of NSAIDS WITH COX2 selectivity

Les G.I. toxicity

Mrs. Myers a 57-year-old factory worker comes to the clinic complaining of right shoulder pain for two days. Denies trauma. Start of the day after she cleaned the kitchen cabinets. I sees her left hand to come her hair because of her pain. More bothersome at night and has had to sleep in a recliner for comfort. She's on Synthroid and has been on estrogen replacement for five years. She is prescribed NSAIDS what shows understanding

I should take it with food

An MRI is ordered what should be included in pretest teaching

Remove all jewelry

An MRI shows osteoarthritis and right shoulder what might be expected method of treatment

Heat or ice

If surgery becomes an indication for a shoulder what would be a treatment goal

Improvement of function

What is a surgical procedure for shoulder arthritis

Hemi arthroplasty

What is a consideration of a complication of Osteoarthritis

Loss of joint function

Mr. Baldwin has severe left shoulder arthritis related to repetitive heavy lifting at work. He wants conservative treatment not surgery. What is a likely treatment option for Mr. Baldwin

Corticosteroid injections

Which of the following will Mr. Baldwin likely need since is left is his dominant arm

Therapy

Mrs. Ray is a 62-year-old female admitted post shoulder arthroplasty the nurse is assisting her and placement of the sling how should the abduction sling be applied

Across the hips and slightly forward

How long should someone wear a sling after post shoulder arthroplasty

4 to 6 weeks

What is a safety issue for those with upper extremity surgery

Ambulation. Because of balance

Following a shoulder arthroplasty what can one accomplish with occupational therapy

ADLs

After shoulder arthroplasty what indicates a need for further teaching regarding signs and symptoms of shoulder dislocation

I should not worry about decreased ability to move

A patient is scheduled to have a cemented total shoulder arthroplasty. History includes sleep apnea obesity hypertension. Patient arrives with PCA patient states that she is in severe pain and doesn't want to push some buttons and the nurses instructed the patient on PCA use what is the next step

Call the doctor and make the suggestion for an NSAID an oral opioid

What non-pharmacological modalities can a nurse use to help relieve pain from a total shoulder arthroplasty

Supports affected arm on with pillows

How would you describe what a trapeze bar on the bed is. For a total shoulder patient

Using the trapeze bar allows you to move yourself around in bed by using only the unaffected arm

What position after a total shoulder arthroplasty Should the shoulder be placed in

A sling

Discharge teaching plan for a total left shoulder regarding future restriction

With nothing other than a glass with your affected hand

If a patient feels they do not need to do exercises at home what is the best response

Exercises will help your arm become strong

After a total left shoulder patient wants to know how she will perform her usual household duties what is the best intervention

Assist her and her family and the readjusting role expectations

A diagnosis of herniated nucleus pulposus The etiology of this condition is likely from what

Degeneration of the disc

What is now rarely used as a diagnostic for HNP since the availability of MRI

A myelogram

After lumbar percutaneous discectomy and what must you do immediately postop

Logroll when turning

An important nursing intervention in the postop. For a lumbar percutaneous discectomy

Perform frequent neurovascular checks

Patient had two pain pills one hour ago and his IV pain medication ordered for breakthrough pain. The patient rates his pain seven out of 10 what else can be done

Give the IV pain medication

The patient rings the call late for his pain medication exactly when it's due but does this most likely indicate

But his pain medicine is inadequate

What should be included in discharge teaching for lumbar percutaneous discectomy

Proper body mechanics are essential in all activities

Patient complains of numbness of the right lateral phi and top of the lower leg. He is unable to walk on his heels upon request which nerve root is likely affected

L5

L5 nerve root irritation is evidenced by

Sensory deficit in the lateral aspect of the thigh, anterior aspect of the lower leg, and the space between the great and second toes. Never deficit is noticed by week hip extensors difficulty with your walking we ankle inversion

Sensory deficit in the medial forearm and diminished or absent and finger flexion would be what cervical level

C8

What is removed in a total knee replacement

The distal femur and proximal tibial bone

A typical therapy of gold prior to discharge after a right total knee would be

Muscle strengthening

To establish a diagnosis of osteoporosis a DEXA a scan may be completed how will this show osteoporosis

The bone density of the person will be compared to that of a healthy young adult and age matched adults

Patient education regarding Actonel should include

After taking this medication you should remain in an upright position for at least 30 minutes

Bio phosphonate should be taken

On an empty stomach 30 minutes before breakfast and then remain upright for at least 30 minutes

If a patient has lactose intolerant they should be taught about non-dairy food sources of calcium what is a food source that has high calcium

One cup of spinach

If a mother has osteoporosis a 50-year-old daughter is at risk for this condition what factors place her at an increased risk

Smoking cigarettes

A 35-year-old patient that has intermittent swelling and pain in the joints of her hands feet and knees has been treating herself with non-steroid all anti-inflammatory drugs a friend who is a nurse suspects she might have rheumatoid arthritis based upon this early symptom

Fatigue. Rheumatoid arthritis usually begins gradually accompanied by systemic manifestations such as anorexia weight loss fatigue muscle aching and stiffness joints most commonly affected our fingers and wrist knees and feet

Bloodwork or labs that would likely be elevated during a rheumatoid arthritis flare up would include

An elevation in ESR

A newly diagnosed rheumatoid arthritis is typically given a non-steroid old anti-inflammatory drug and methotrexate because

It will help maximize the control of inflammation

One of the most common side effects of methotrexate occur in which body system

Gastrointestinal

Name the deformity th

Boutonniere deformity's

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PIP joint

Proximal interphalngeal

D IP joint

Distal interphalangeal joint

Hyper extension of the PIP joint with flexion of the metacarpal phalangeal in D IP joints

Swans neck deformity

A patient who is on Coumadin after total knee what should the nurse instruct the patient about urine

Report tea colored urine immediately

A 12-year-old patient experiences and Epicondyler fracture and a long arm cast as applied if the cast needs to be splint after application to allow for tissue swelling the nurse will buy them of the cast by splitting it in which direction

Medially and laterally

The use of bucks traction is used to

Minimize muscle spasms

A patient is placed in the CPM machine following a total knee arthroplasty he nurse recognizes one benefit of the CPM is decreased

Joint hemarthrosis

Following application of a short arm cast the nurse will assess sensation and motion in the patient's digits numbness and tingling in between the thumb and index finger may indicate compromise of which nerve

Radial

A patient receiving Mitroxantrone for treatment of an exacerbation of MS the nurse should be aware

The patient's urine may turn a blue green color and Initially

A patient is diagnosed with osteoio osteoma The nurses able to confirm this is a benign tumor that

Causes night paying that can be relieved by aspirin

The most common primary malignant bone tumor and children is the

Osteosarcoma greater occurrence in boys than girls

A patient is diagnosed with slipped capital femoral epiphysis. The nurse recognizes this patient is at high-risk the normal of developing

Degenerative arthritis

Patient teaching for Osgood Schlatter disease

Symptoms will stop by the end of skeletal growth this disease is self-limiting condition of preadolescence the symptoms stop when the epiphyses is fully ossified

A type of implant that would be considered a biological implant

An allograft bone

Which of the following nerves may sustain injury when the patient is placed in a lateral position and there is an adequate padding under the fibular head

Peroneal nerve

The best way to evaluate balance is two says strength of the opposing muscle groups while using and performing what kind of measurement devices

Isometric measuring devices

Extreme involves

Muscle or tendon trauma

A sprain involves

Ligament trauma

Most important therapeutic modality used in treating muscle strains is

Rest

Antioxidants that protect the body from oxidation stress and provide nutritional support during times of increased activity

Vitamins BC and E

Carb loading is important one to four hours prior to athletic performance which food is a good source of carbohydrates with low glycemic index

Apples

Which substance has been been banned from used by participants and athletic events by the national sports regulating agencies

Cardiovascular and antihypertensives

The best way to evaluate pounds is to sell strength of the opposing muscle groups are using performing which of the following

Isometric measuring device

What is the difference between a strain and sprain

Strain involves muscle or tendon drama. Sprain is a ligament drama

On exam patient complains of point tenderness and muscle spasms x-ray reveals no fracture patient unable to move ankle palpation reveals bolts at ankle what is the likely injury

3rd° angle strain

What is the most important treatment modality and treating muscle strains

Rest

Cryotherapy decreases blood flow to the vessels by causing them to contract what should be known about cryotherapy

Cold compress should be maintained for 30 minutes on and 15 minutes off for 72 hours

What should be taught regarding ace bandage wrapping

Should be applied tight enough to promote venous return

When I'm tanning a history during evaluation of a sports injury why is the mechanism of injury important

Helps determine diagnostic imaging that would be helpful

All strains are these type of injuries

Ligament injuries

There are three grades of muscle injury what would a grade to muscle injury involved

10 to 50% of muscle fibers are toward palpation reveals a defect of the muscle

There are three grades of injury describing a ligament what would describe a grade one ligament injury

0 to 20% of ligament fibers are torn

What is a common characteristic of a stress fracture

Full and painless range of motion at the adjacent joints

The apprehension test is used to test instability of what body part

The shoulder

Lesions may be detected on x-ray of the shoulder following dislocation what is the name of the lesion on the glenoid rim

Bankhart

Where is a hill Sachs lesion

Humeral head

Where is a Bennett's lesion found

In an avulsion fracture of the hand

Neurovascular assessment is important phone shoulder dislocation which artery may become impinged as a result of shoulder dislocation

Radial

Dequervein tenosynovitis is caused by repetitive and forceful exertions of the wrist and hand which of the following test is positive in dequerveins tenosynovitis

Finkelstein's test. Owner deviation of hand and thumb flexed against Palm

Gate used to comedy pain on weight-bearing

Antalgic

PRICEMM

...

Rotator cuff repair will exhibit pain and which position

Abduction and external rotation

Diagnosis of right full fitness rotator cuff pair what symptoms would be associated with this injury

Dropping on to waste upon passive abduction

After rotator cuff repair for rehabilitation after the surgery is

6 to 12 months

Sensitive to touch stiffness at The elbow function is normal what is likely the problem with elbow

Medial epicondylitis

Stiffness on the inside of the elbow is likely

Medial epicondylitis occurs with repeated stress on the muscle tendon units during pitching golfing results in pain and stiffness

Tennis players are at risk for elbow problems a high risk for lateral epicondylitis

40-year-old tennis player who plays daily

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