ONC Degenerative Disease Practice Exam
ACTUAL QUESTIONS AND CORRECT
ANSWERS
A patient with a history of osteoarthritis states she has been using exercise as a means to
delay progression of the disease. However, she now complains of increased pain in her knees.
Given this complaint, which of the following forms of exercise should the nurse suspect the
patient uses?
a. Swimming
b. Water aerobics
c. Running
d. Stationary bicycling - CORRECT ANSWERS✅✅c. Running
Rationale: Activity modification in the treatment of OA may include switching from high-
impact exercise such as running and competitive sports to low-impact exercise such as
swimming and walking. Running could exacerbate joint symptoms.
Reference: An Introduction to Orthopaedic Nursing (5th ed.), 2018, p. 71
A patient recently underwent left hip arthroplasty. The nurse should do which of the
following to decrease the patient's risk of venous thromboembolism (VTE)?
a. Elevate the foot of the patient's bed.
b. Place an abductor pillow between the patient's legs.
c. Encourage the patient to begin ambulation.
d. Ensure the patient has adequate pain management. - CORRECT ANSWERS✅✅c.
Encourage the patient to begin ambulation.
Rationale: Patients undergoing orthopaedic surgery are at increased risk for VTE. Prevention
strategies are mechanical, physical, and pharmacological. Physically, the formation of clots
can be prevented with early ambulation and bed exercises such as ankle pumps.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 201; An Introduction
to Orthopaedic Nursing (5th ed.), 2018, p. 139
,Following total shoulder arthroplasty, a patient is wearing a complicated sling that is
unfamiliar to the nurse. What should be the nurse's best strategy when the patient asks for
help in dressing?
a. Find instructions on the Internet about how to remove the sling.
b. Tell the patient to have a family member help with dressing.
c. Tell the nursing assistant the patient needs help with dressing.
d. Ask the occupational therapist to review removal and application of the sling. - CORRECT
ANSWERS✅✅d. Ask the occupational therapist to review removal and application of the
sling.
Rationale: Patients who have shoulder surgery must adhere to postoperative precautions,
especially when completing ADLs. If the patient must wear a sling, an occupational therapist
will be an excellent resource in discussing removal and application of the device.
Reference: An Introduction to Orthopaedic Nursing (5th ed.), 2018, p. 175
The nurse is caring for a patient who underwent total knee arthroplasty. The nurse should
identify which of the following as a primary risk factor for possible development of deep vein
thrombosis (DVT)?
a. Poor nutritional status
b. Venous stasis
c. Low oxygen saturation
d. History of lung disease - CORRECT ANSWERS✅✅b. Venous stasis
Key: b
Rationale: The pathophysiology of deep vein thrombosis is explained by Virchow's Triad of
venous stasis, trauma, and hypercoagulability state. Venous stasis is caused by immobility
and leads to blood pooling, which can contribute to clot formation.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 200
, In providing a staff inservice on pain management after total knee arthroplasty, the nurse
should remind attendees that poor postoperative pain management can contribute to
a. increased patient satisfaction.
b. increased risk of infection.
c. decreased blood pressure and heart rate.
d. decreased effectiveness of rehabilitation. - CORRECT ANSWERS✅✅d. decreased
effectiveness of rehabilitation.
Rationale: Poor pain management can lead to decreased effectiveness of the rehabilitation
program, with physiologic, economic, and psychological consequences.
Reference: An Introduction to Orthopaedic Nursing (5th ed.), 2018, p. 130
A new nurse receives orders to administer enoxaparin (Lovenox) to a patient following
resurfacing hip arthroplasty. In reviewing a medication reference for information about
enoxaparin, the nurse should learn
a. this medication is given intramuscularly.
b. this drug is interchangeable with heparin.
c. the injection site should not be massaged after drug administration.
d. the platelet count need not be monitored during use of this drug. - CORRECT
ANSWERS✅✅c. the injection site should not be massaged after drug administration.
Key: c
Rationale: It is recommended to alternate sites of administration; do not rub injection site
after administration. Enoxaparin should not be given intramuscularly (IM) but should be
administered by subcutaneous injection. As a low molecular weight heparin, enoxaparin can
contribute to development of thrombocytopenia. The nurse should monitor results of
complete blood counts and assess for signs of bleeding.
Reference: Hochadel, M. (2016). Mosby's drug reference for health professions (5th ed.). St.
Louis, MO: Elsevier. pp. 557-559
ACTUAL QUESTIONS AND CORRECT
ANSWERS
A patient with a history of osteoarthritis states she has been using exercise as a means to
delay progression of the disease. However, she now complains of increased pain in her knees.
Given this complaint, which of the following forms of exercise should the nurse suspect the
patient uses?
a. Swimming
b. Water aerobics
c. Running
d. Stationary bicycling - CORRECT ANSWERS✅✅c. Running
Rationale: Activity modification in the treatment of OA may include switching from high-
impact exercise such as running and competitive sports to low-impact exercise such as
swimming and walking. Running could exacerbate joint symptoms.
Reference: An Introduction to Orthopaedic Nursing (5th ed.), 2018, p. 71
A patient recently underwent left hip arthroplasty. The nurse should do which of the
following to decrease the patient's risk of venous thromboembolism (VTE)?
a. Elevate the foot of the patient's bed.
b. Place an abductor pillow between the patient's legs.
c. Encourage the patient to begin ambulation.
d. Ensure the patient has adequate pain management. - CORRECT ANSWERS✅✅c.
Encourage the patient to begin ambulation.
Rationale: Patients undergoing orthopaedic surgery are at increased risk for VTE. Prevention
strategies are mechanical, physical, and pharmacological. Physically, the formation of clots
can be prevented with early ambulation and bed exercises such as ankle pumps.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 201; An Introduction
to Orthopaedic Nursing (5th ed.), 2018, p. 139
,Following total shoulder arthroplasty, a patient is wearing a complicated sling that is
unfamiliar to the nurse. What should be the nurse's best strategy when the patient asks for
help in dressing?
a. Find instructions on the Internet about how to remove the sling.
b. Tell the patient to have a family member help with dressing.
c. Tell the nursing assistant the patient needs help with dressing.
d. Ask the occupational therapist to review removal and application of the sling. - CORRECT
ANSWERS✅✅d. Ask the occupational therapist to review removal and application of the
sling.
Rationale: Patients who have shoulder surgery must adhere to postoperative precautions,
especially when completing ADLs. If the patient must wear a sling, an occupational therapist
will be an excellent resource in discussing removal and application of the device.
Reference: An Introduction to Orthopaedic Nursing (5th ed.), 2018, p. 175
The nurse is caring for a patient who underwent total knee arthroplasty. The nurse should
identify which of the following as a primary risk factor for possible development of deep vein
thrombosis (DVT)?
a. Poor nutritional status
b. Venous stasis
c. Low oxygen saturation
d. History of lung disease - CORRECT ANSWERS✅✅b. Venous stasis
Key: b
Rationale: The pathophysiology of deep vein thrombosis is explained by Virchow's Triad of
venous stasis, trauma, and hypercoagulability state. Venous stasis is caused by immobility
and leads to blood pooling, which can contribute to clot formation.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 200
, In providing a staff inservice on pain management after total knee arthroplasty, the nurse
should remind attendees that poor postoperative pain management can contribute to
a. increased patient satisfaction.
b. increased risk of infection.
c. decreased blood pressure and heart rate.
d. decreased effectiveness of rehabilitation. - CORRECT ANSWERS✅✅d. decreased
effectiveness of rehabilitation.
Rationale: Poor pain management can lead to decreased effectiveness of the rehabilitation
program, with physiologic, economic, and psychological consequences.
Reference: An Introduction to Orthopaedic Nursing (5th ed.), 2018, p. 130
A new nurse receives orders to administer enoxaparin (Lovenox) to a patient following
resurfacing hip arthroplasty. In reviewing a medication reference for information about
enoxaparin, the nurse should learn
a. this medication is given intramuscularly.
b. this drug is interchangeable with heparin.
c. the injection site should not be massaged after drug administration.
d. the platelet count need not be monitored during use of this drug. - CORRECT
ANSWERS✅✅c. the injection site should not be massaged after drug administration.
Key: c
Rationale: It is recommended to alternate sites of administration; do not rub injection site
after administration. Enoxaparin should not be given intramuscularly (IM) but should be
administered by subcutaneous injection. As a low molecular weight heparin, enoxaparin can
contribute to development of thrombocytopenia. The nurse should monitor results of
complete blood counts and assess for signs of bleeding.
Reference: Hochadel, M. (2016). Mosby's drug reference for health professions (5th ed.). St.
Louis, MO: Elsevier. pp. 557-559
