ORTHOPAEDIC NURSE PRACTITIONER CERTIFIED
(ONP-C) EXAM WITH CORRECT ACTUAL
QUESTIONS AND CORRECTLY WELL DEFINED
ANSWERS LATEST ALREADY GRADED A+
(2025/2026)
Question 1
Which factor most strongly predicts progression from primary osteoarthritis to
total knee arthroplasty?
A. Age over 65
B. Body mass index ≥ 30 kg/m²
C. Presence of meniscal extrusion on MRI
D. Kellgren-Lawrence grade III or higher
Correct ,,,,answer,,,,: C. Presence of meniscal extrusion on MRI
Rationale: Meniscal extrusion indicates loss of joint stability and correlates with
faster cartilage loss, making it the strongest predictor for surgical intervention .
Question 2
In lumbar spinal stenosis, neurogenic claudication is distinguished from vascular
claudication by:
A. Relief with lumbar flexion (leaning forward)
B. Worsening when standing upright
C. Presence of diminished pedal pulses
D. Pain that improves with walking on a treadmill
,Correct ,,,,answer,,,,: A. Relief with lumbar flexion (leaning forward)
Rationale: Flexion opens the spinal canal, relieving neurogenic claudication,
whereas vascular claudication does not improve with posture changes .
Question 3
The hallmark radiographic finding of degenerative disc disease is:
A. End-plate sclerosis
B. Vacuum phenomenon within the disc space
C. Subchondral cysts
D. Osteophyte formation at facet joints
Correct ,,,,answer,,,,: B. Vacuum phenomenon within the disc space
Rationale: The vacuum phenomenon (intravertebral gas) is characteristic of disc
desiccation and degeneration .
Question 4
Which pre-operative optimization step most reduces the risk of postoperative
infection after total hip arthroplasty?
A. Pre-operative chlorhexidine shower
B. Smoking cessation at least 4 weeks prior
C. Intravenous cefazolin within 60 minutes of incision
D. Pre-operative vitamin D supplementation
Correct ,,,,answer,,,,: B. Smoking cessation at least 4 weeks prior
Rationale: Smoking impairs wound healing and immune function; cessation for
≥4 weeks significantly lowers infection rates .
Question 5
A 68-year-old patient receives a corticosteroid intra-articular injection for knee
OA. The most common serious adverse effect is:
A. Rapid cartilage loss
B. Septic arthritis
, C. Avascular necrosis of the femoral head
D. Tendon rupture
Correct ,,,,answer,,,,: B. Septic arthritis
Rationale: Intra-articular steroids can introduce bacteria, making septic arthritis
the most feared complication .
Question 6
According to the AO classification, a simple transverse fracture of the distal tibia is
designated as:
A. 42-A
B. 42-B
C. 42-C
D. 43-A
Correct ,,,,answer,,,,: A. 42-A
Rationale: AO type 42-A1 denotes a simple, extra-articular transverse fracture of
the tibia .
Question 7
In the management of acute deep-vein thrombosis after lower-extremity trauma,
the first-line pharmacologic agent is:
A. Warfarin
B. Low-molecular-weight heparin (LMWH)
C. Direct oral anticoagulant (DOAC)
D. Aspirin
Correct ,,,,answer,,,,: B. Low-molecular-weight heparin (LMWH)
Rationale: LMWH provides rapid anticoagulation and is preferred in the acute
setting .
Question 8
Which clinical sign is most specific for an anterior shoulder dislocation?
(ONP-C) EXAM WITH CORRECT ACTUAL
QUESTIONS AND CORRECTLY WELL DEFINED
ANSWERS LATEST ALREADY GRADED A+
(2025/2026)
Question 1
Which factor most strongly predicts progression from primary osteoarthritis to
total knee arthroplasty?
A. Age over 65
B. Body mass index ≥ 30 kg/m²
C. Presence of meniscal extrusion on MRI
D. Kellgren-Lawrence grade III or higher
Correct ,,,,answer,,,,: C. Presence of meniscal extrusion on MRI
Rationale: Meniscal extrusion indicates loss of joint stability and correlates with
faster cartilage loss, making it the strongest predictor for surgical intervention .
Question 2
In lumbar spinal stenosis, neurogenic claudication is distinguished from vascular
claudication by:
A. Relief with lumbar flexion (leaning forward)
B. Worsening when standing upright
C. Presence of diminished pedal pulses
D. Pain that improves with walking on a treadmill
,Correct ,,,,answer,,,,: A. Relief with lumbar flexion (leaning forward)
Rationale: Flexion opens the spinal canal, relieving neurogenic claudication,
whereas vascular claudication does not improve with posture changes .
Question 3
The hallmark radiographic finding of degenerative disc disease is:
A. End-plate sclerosis
B. Vacuum phenomenon within the disc space
C. Subchondral cysts
D. Osteophyte formation at facet joints
Correct ,,,,answer,,,,: B. Vacuum phenomenon within the disc space
Rationale: The vacuum phenomenon (intravertebral gas) is characteristic of disc
desiccation and degeneration .
Question 4
Which pre-operative optimization step most reduces the risk of postoperative
infection after total hip arthroplasty?
A. Pre-operative chlorhexidine shower
B. Smoking cessation at least 4 weeks prior
C. Intravenous cefazolin within 60 minutes of incision
D. Pre-operative vitamin D supplementation
Correct ,,,,answer,,,,: B. Smoking cessation at least 4 weeks prior
Rationale: Smoking impairs wound healing and immune function; cessation for
≥4 weeks significantly lowers infection rates .
Question 5
A 68-year-old patient receives a corticosteroid intra-articular injection for knee
OA. The most common serious adverse effect is:
A. Rapid cartilage loss
B. Septic arthritis
, C. Avascular necrosis of the femoral head
D. Tendon rupture
Correct ,,,,answer,,,,: B. Septic arthritis
Rationale: Intra-articular steroids can introduce bacteria, making septic arthritis
the most feared complication .
Question 6
According to the AO classification, a simple transverse fracture of the distal tibia is
designated as:
A. 42-A
B. 42-B
C. 42-C
D. 43-A
Correct ,,,,answer,,,,: A. 42-A
Rationale: AO type 42-A1 denotes a simple, extra-articular transverse fracture of
the tibia .
Question 7
In the management of acute deep-vein thrombosis after lower-extremity trauma,
the first-line pharmacologic agent is:
A. Warfarin
B. Low-molecular-weight heparin (LMWH)
C. Direct oral anticoagulant (DOAC)
D. Aspirin
Correct ,,,,answer,,,,: B. Low-molecular-weight heparin (LMWH)
Rationale: LMWH provides rapid anticoagulation and is preferred in the acute
setting .
Question 8
Which clinical sign is most specific for an anterior shoulder dislocation?
