10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The OPA-C exam has 200 questions and runs 3 hours 15 minutes.
These 10 free OPA-C questions are organized by exam domain, so you can see how each part of the Orthopaedic Physician's Assistant Certification blueprint is tested. Reveal the answer and explanation under each question.
Finger extension at the metacarpophalangeal joints and thumb extension are weak after an injury near the radial neck. Wrist extension remains possible, but the wrist deviates radially. Elbow extension and cutaneous sensation throughout the hand are intact. The deficit localizes most closely to which nerve?
Correct answer: A - Posterior interosseous nerve
Serial radiographs eight weeks after anatomic reduction and compression plating of a simple ulnar-shaft fracture show a progressively less distinct fracture line but little external callus. Alignment and fixation remain intact, and the fracture site is nontender. Which biological process best explains healing with this appearance?
Correct answer: C - Direct osteonal remodeling across the fracture
A 56-year-old woman with diabetes has four months of increasing shoulder stiffness without an injury. She struggles to fasten her bra and reach an overhead shelf. External rotation is markedly restricted during both active and passive testing, even with the scapula stabilized. Radiographs show preserved glenohumeral joint space. Which diagnosis best accounts for this pattern?
Correct answer: B - Adhesive capsulitis
A 13-year-old boy is referred for five weeks of right knee pain and a limp. His knee has no effusion, focal tenderness, or motion restriction. During the hip examination, flexion produces obligatory external rotation and internal rotation is markedly limited. He is afebrile and has a body mass index above the 95th percentile. What is the most likely source of his knee pain?
Correct answer: C - Slipped capital femoral epiphysis
A 72-year-old man can shop for 20 minutes while leaning on a cart but develops bilateral buttock and calf aching after two blocks of upright walking. Stopping while remaining upright gives little relief; sitting or bending forward relieves the symptoms within minutes. Pedal pulses are palpable. Which mechanism most convincingly explains the dependence on posture?
Correct answer: C - Nerve-root crowding in a narrowed lumbar canal
Before treatment for an upper-extremity injury, a patient had a QuickDASH disability/symptom score of 60/100. At follow-up, 10 of the 11 core items are answered; their coded responses total 26. The remaining item is blank. How should the follow-up score and direction of change be recorded?
Correct answer: B - 40/100; upper-limb disability has decreased.
Synovial fluid from a hot, swollen native knee contains 42,000 white cells/microliter with 88% neutrophils and needle-shaped, negatively birefringent crystals. Gram stain shows no organisms; cultures are pending. The patient has a temperature of 38.2°C and severe pain with passive motion. Which interpretation of the aspirate is justified?
Correct answer: D - Urate crystal arthritis is present, but concurrent bacterial infection remains possible.
After closed reduction of a distal-radius fracture, alignment is satisfactory and distal motor, sensory, and vascular findings are normal. The wrist remains swollen. The surgeon requests temporary immobilization that accommodates swelling and limits both wrist motion and forearm pronation-supination. Which device meets those requirements?
Correct answer: D - Sugar-tong forearm splint
A ball strikes the tip of an extended ring finger. The distal interphalangeal (DIP) joint now rests in flexion, cannot be actively straightened, and is fully correctable passively. The skin is intact. Radiographs show a small dorsal avulsion fragment involving 10% of the articular surface, with no joint subluxation. The patient can comply with splint care. Select the appropriate initial treatment.
Correct answer: A - Full-time DIP extension splinting for 6-8 weeks, with the PIP joint free
Six hours after a tibial-shaft fracture, a patient has escalating pain and severe pain with passive toe flexion. All constricting splint materials have been released, but the anterior compartment remains tense. Blood pressure is 108/60 mmHg and anterior-compartment pressure is 38 mmHg. Pedal pulses remain palpable. Which delta-pressure interpretation and immediate plan are appropriate?
Correct answer: A - 22 mmHg; proceed to emergency surgical decompression.
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