ONP-C General Practice Exam Questions and Answers with Rationale.
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ONP-C General
Institution
ONP-C General
ONP-CGeneralPracticeExamQuestions andAnswers
withRationale.
Previously diagnosed with an Achilles tendon tear, a patient has been limping on the leg.
The most important consideration for the NP in determining the need for surgical repair
should be the patient's
a. age less than 65.
b. injury ...
ONP-C General Practice Exam Questions and Answers
with Rationale.
Previously diagnosed with an Achilles tendon tear, a patient has been limping on the leg.
The most important consideration for the NP in determining the need for surgical repair
should be the patient's
a. age less than 65.
b. injury occurrence 10 days ago.
c. recent contralateral DVT.
d. lack of active exercise. - Correct Answer b. injury occurrence 10 days ago.
Rationale: RICE is generally indicated for the first 5-6 days after injury, with home exercise
often started on day 7 and stretching on day 14. Surgery would not be indicated only 10
days after injury as conservative treatment still would be continued.
When evaluating a radiograph of a patient's knee, the NP should be suspicious of an
anterior cruciate ligament injury if a fracture is noted in which of the following?
a. Tibial plateau
b. Tilleaux
c. Segond
d. Tibial plafond - Correct Answer c. Segond
Rationale: Avulsion fracture of the lateral capsular margin of the tibia (lateral capsular sign
or Segond fracture) is possible with anterior cruciate ligament injury.
A patient presents to the clinic with a history of non-traumatic right elbow swelling and joint
pain. Which of the following findings should the NP consider most important in the
differential diagnosis of rheumatoid arthritis?
,a. Concurrent urethritis and abnormal liver function tests
b. Loss of full extension along with a locking sensation
c. Periarticular osteopenia and erosion at joint margin on x-ray
d. Serology testing including HLA-B27 and anti-CCP antibodies - Correct Answer c.
Periarticular osteopenia and erosion at joint margin on x-ray
Rationale: Radiographic changes of rheumatoid arthritis commonly include periarticular
osteopenia and bony erosion at the joint margin. Urethritis and positive human leukocyte
antigen are associated with seronegative arthropathies. Ligamentous laxity is expected.
The NP is working with a trainer at a local college. A member of the tennis team presents
with onset of left shoulder pain localized to the deltoid area after playing in a practice
match 24 hours ago. After clinical evaluation, the NP should suspect tendinitis based on
the
a. history of competitive training.
b. X-ray revealing acromion spurs.
c. anterior shoulder instability.
d. paresthesia to the dorsum of the hand. - Correct Answer a. history of competitive
training.
Rationale: Rotator cuff tendinitis is an overuse syndrome related to repetitive motions, as
occur with an overhead sport such as tennis.
After evaluating a patient's complaint of shoulder pain, the NP should suspect tendinitis
with a positive
a. cross-body test.
, b. sulcus sign.
c. apprehension test.
d. Neer sign. - Correct Answer d. Neer sign.
Rationale: The Neer sign elicits discomfort in patients who have a rotator cuff tear or
rotator cuff tendinitis. The cross-body sign is used to suggest acromioclavicular arthritis or
other joint pathology. The sulcus sign is used to demonstrate inferior shoulder laxity. The
apprehension test is used to assess anterior shoulder instability.
A 30-year-old male presents to the Urgent Care Center with pain and swelling of his right
elbow sustained during what the patient described as "a friendly arm wrestling match." X-
rays reveal a spiral fracture of the distal humerus. The NP should expect to find which of
the following?
a. Hill-Sachs lesion
b. Injury of the axillary nerve
c. Deltoid dysfunction
d. Hemarthrosis of the elbow - Correct Answer d. Hemarthrosis of the elbow
Rationale: Bleeding into the joint (hemarthrosis) is likely with a distal humeral fracture,
often from an occult fracture.
A 30-year-old male presents to the Urgent Care Center with pain and swelling of his right
elbow sustained during what the patient described as "a friendly arm wrestling match." X-
rays reveal a spiral fracture of the distal humerus.
In addition to the humeral fracture, the NP should expect what additional finding on the x-
rays?
a. Osteochondral loose bodies
b. Posterior fat pad sign
c. Radiocapitellar degeneration
d. Medial nerve entrapment - Correct Answer b. Posterior fat pad sign
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