ONC Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

Bending the hip past 90° or crossing the legs: Correct. After a posterior approach, hip flexion beyond 90°, adduction past midline and internal rotation can dislocate the prosthesis.

Lying supine with a pillow between the knees: An abduction pillow keeps the leg out of adduction and is encouraged.

Sitting upright in a raised chair with armrests: A firm, high chair keeps hip flexion under 90° and is recommended.

Standing with toes pointed straight ahead: Neutral rotation is safe; turning the toes inward (internal rotation) is what is avoided.

Posterior THA precautions: no flexion >90°, no adduction past midline, no internal rotation (the 'don't bend, cross or turn in' rule).

Answer: D

Elevate the arm well above the heart and apply ice packs: Elevation above heart level lowers arterial inflow and can worsen compartment ischemia.

Give another opioid dose and reassess in 2 hours: Pain out of proportion despite opioids is an early warning sign; waiting allows irreversible muscle and nerve damage.

Reassure him that the pulse and refill are normal: Pulses and capillary refill often stay normal until late; their presence does not rule out compartment syndrome.

Keep the arm at heart level and notify the provider now: Correct. Pain out of proportion and pain with passive stretch are early signs of compartment syndrome; keep the limb at heart level, loosen constriction per order and get urgent evaluation for fasciotomy.

Compartment syndrome: pain out of proportion and on passive stretch come first; limb at heart level, release constriction, urgent fasciotomy.

Answer: B

Soak the ankle in hot water several times a day: Heat increases blood flow and swelling during the acute phase.

Rest, ice, compression wrap and elevation: Correct. Protection, rest, ice, compression and elevation limit swelling and pain after an acute sprain.

Keep running to prevent the joint from stiffening: Continued running on an acute sprain risks further ligament injury.

Apply a tight elastic wrap overnight while sleeping: A tight wrap left on overnight can impair circulation; compression should be snug, not tight, and checked.

Acute sprain = PRICE for 48–72 hours, then early protected motion; avoid heat early.

Answer: D

Take it with breakfast and a glass of milk: Food, milk and calcium sharply reduce absorption of oral bisphosphonates.

Take it at bedtime so it is absorbed well overnight: Lying down after a dose increases the risk of esophageal irritation and ulceration.

Take it with orange juice to improve absorption: Only plain water should be used; juice and coffee reduce absorption.

Take it on waking with water; stay upright 30 minutes: Correct. Alendronate is taken on an empty stomach with 6–8 oz of plain water, and the patient remains upright and fasting for at least 30 minutes.

Oral bisphosphonates: first thing in the morning, plain water, upright and nothing else by mouth for 30 minutes.

Answer: B

Serum uric acid level: Uric acid relates to gout, not to the safety of TNF inhibitors.

Tuberculosis screening: Correct. TNF inhibitors can reactivate latent TB, so a TB skin test or interferon-gamma release assay is required before starting.

Bone density scan: Bone density may be relevant in RA but is not a required safety screen before TNF therapy.

Thyroid function panel: Thyroid tests are not part of standard pre-TNF inhibitor safety screening.

Before TNF inhibitors: screen for latent TB and hepatitis B, update non-live vaccines, and teach infection precautions.

Answer: A

Acknowledge her grief and offer to connect her with a peer amputee: Correct. Validating the loss and offering peer support with a teen who has adapted address body image and adolescent identity needs.

Insist that she look at the limb during today's dressing change: Forcing exposure before she is ready can increase distress; readiness is supported gradually.

Tell her that her friends will not even notice once she has a prosthesis: False reassurance dismisses her feelings and may not be true.

Change the subject to her chemotherapy schedule after discharge: Avoiding her concern blocks therapeutic communication.

After amputation, expect grieving and body-image disturbance; validate feelings, allow pacing, and use peer and family support.