Pharm Musculoskeletal

4. the support provided by bones is important for the structural integrity of the body. Explanation: Calcium is bound as a hard matrix known as hydroxyapatite crystals that provides support to the skeleton.

1) The nurse, instructing a client on the prevention of osteoporosis, includes the importance of maintaining a normal serum calcium level because: 1. calcium influences the contraction of skeletal muscle. 2. calcium ions assist in blood clotting. 3. appropriate nerve conduction depends on an adequate calcium level. 4. the support provided by bones is important for the structural integrity of the body.

3. Reduces damage and delays disease progression Explanation: Disease-modifying antirheumatic drugs reduce joint damage and delay disease progression.

10) A client is prescribed a disease-modifying antirheumatic agent. What will the nurse explain as the mechanism of action for this medication? 1. Provides rapid relief of symptoms. 2. Prevents the need for orthopedic surgery. 3. Reduces damage and delays disease progression. 4. Allows the client to be more active.

3. acetaminophen Explanation: Acetaminophen is the preferred drug for osteoarthritis. It is effective and inexpensive.

11) The nurse should instruct a client with the initial stages of osteoarthritis to engage in low impact exercise and take: 1. opioid analgesics. 2. glucosamine and chondroitin agents. 3. acetaminophen. 4. high anti-inflammatory doses of aspirin.

3. "I can return to bed while I wait for the medication to work." Explanation: Bisphosphonates can irritate the esophagus, so clients should remain upright for at least 30 minutes after administration to reduce this risk.

12) The nurse is teaching a client about taking risedronate (Actonel) for osteoporosis. Which statement by the client indicates a need for further teaching? 1. "I will wait at least 30 minutes before eating." 2. "I will take the medication first thing in the morning, with water." 3. "I can return to bed while I wait for the medication to work." 4. "I will report difficulties with heartburn."

1. report blurred vision or decreased reading ability immediately. Explanation: Blindness can result from retinal damage and is the most serious adverse effect of this medication. Clients should report any indications of visual problems.

13) A client with rheumatoid arthritis is prescribed hydroxychloroquine (Plaquenil). The nurse should caution the client to: 1. report blurred vision or decreased reading ability immediately. 2. continue taking a glass of red wine before dinner to reduce cardiovascular risk. 3. take this drug with an antacid to decrease stomach distress. 4. expose skin to sunlight for at least 20 minutes every day to help with bone formation.

3. avoid taking calcium supplements with bran or whole-grain cereal. Explanation: Bran and whole-grain foods inhibit the absorption of calcium in the gastrointestinal tract.

14) A calcium supplement has been added to a client's drug regimen. The nurse should advise the client to: 1. decrease intake of dairy products to prevent hypercalcemia. 2. increase consumption of fruits and vegetables high in vitamin C. 3. avoid taking calcium supplements with bran or whole-grain cereal. 4. increase consumption of lean meats for additional protein intake.

2. reduce the formation of uric acid. Explanation: Gout is a disorder caused by the accumulation of uric acid in the body. Allopurinol (Zyloprim) inhibits xanthine oxidase, which is necessary for the formation of uric acid.

15) A client has been prescribed allopurinol (Zyloprim) for gout. The purpose of this medication is to: 1. relieve the inflammation caused by this disease process. 2. reduce the formation of uric acid. 3. help the body excrete excess uric acid. 4. prevent the joint damage associated with this disease.

1. Etanercept (Enbrel) Explanation: Etanercept is a tumor necrosis factor blocker. Because tumor necrosis factor is a cytokine that is important in cellular immunity, drugs that interfere with this cytokine increase the risk of infections and are contraindicated when a client has tuberculosis or a history of tuberculosis.

16) A client is being treated for type 2 diabetes mellitus, tuberculosis, and rheumatoid arthritis. The nurse would be most concerned about this patient being treated with which medication? 1. Etanercept (Enbrel) 2. Hydroxychloroquine (Plaquenil) 3. Methotrexate (Rheumatrex) 4. Sulfasalazine (Azulfidine)

3. "Have you ever had or been treated for blood clots?" Explanation: Raloxifene increases the risk of deep vein thrombosis and resulting pulmonary embolism. This history would contraindicate the use of raloxifene.

17) A client with osteoporosis has been prescribed raloxifene (Evista). Which question should the nurse ask to determine the client's risks for complications with this drug? 1. "Have you ever had esophageal or ulcer disease?" 2. "Do you have a history of abnormal breast biopsies?" 3. "Have you ever had or been treated for blood clots?" 4. "Have you ever had any broken bones?"

2. Tetany Explanation: Tetany and its associated laryngospasm are manifestations of the severe hypocalcemia that is associated with hypoparathyroidism.

18) For which symptom is it critical for the nurse to monitor when caring for a client with hypoparathyroidism? 1. Decreased peristalsis 2. Tetany 3. Weakness 4. Vomiting

1. Renal disease Explanation: Renal damage can result in excessive loss of calcium in the urine.

19) The nurse is concerned that a client is at risk for the development of hypocalcemia because of which health problem? 1. Renal disease 2. Osteoporosis 3. Osteoarthritis 4. Cardiac damage

4. ionized Explanation: Ionized calcium is the only physiologically and clinically significant form of calcium.

2) The nurse is planning an educational program for a group of senior citizens on the importance of calcium intake. The nurse will explain that approximately 50% of the calcium in the body participates in intracellular functions and is: 1. nonionized. 2. bound to albumin. 3. complexed. 4. ionized.

1. "Calcium is needed to keep the nervous system working properly." 2. "Calcium is used by the body to make the muscles move." 3. "Calcium is used in the blood to help with clotting." Explanation: In the nervous system, calcium ions influence the release of neurotransmitters and the excitability of all neurons. Contraction is dependent on calcium ion movement in skeletal, smooth, and cardiac muscle cells. Calcium is important for blood coagulation; it converts prothrombin into thrombin.

20) A client who is experiencing no symptoms of a low calcium level asks why calcium is important. How should the nurse respond? Select all that apply. 1. "Calcium is needed to keep the nervous system working properly." 2. "Calcium is used by the body to make the muscles move." 3. "Calcium is used in the blood to help with clotting." 4. "Calcium maintains the normal respiratory rate." 5. "Calcium is needed to control blood glucose levels."

1. Client age 15 2. Pregnant client age 17 Explanation: The normal recommended intake of calcium for a 15-year-old client is 1,300 mg/day. The normal recommended intake of calcium for a 17-year-old pregnant client is 1,300 mg/day.

21) Which clients would the nurse identify as needing 1,300 mg of calcium per day? Select all that apply. 1. Client age 15 2. Pregnant client age 17 3. Client age 30 4. Client age 53 5. Client age 83

1. spend 15 minutes a day in the sun without sunscreen. 2. increase the intake of milk. 3. increase intake of vitamin-enriched foods. Explanation: In the skin, cholecalciferol, the inactive form of vitamin D, is synthesized from cholesterol. Exposing the skin to sunlight or ultraviolet light increases the level of cholecalciferol in the blood. Cholecalciferol, the inactive form of vitamin D, can be obtained from dairy products such as milk. Cholecalciferol, the inactive form of vitamin D, can be obtained from foods fortified with vitamin D.

22) A client is diagnosed with a vitamin D deficiency. To aid in the correction of this deficiency, the nurse instructs the client to: Select all that apply. 1. spend 15 minutes a day in the sun without sunscreen. 2. increase the intake of milk. 3. increase intake of vitamin-enriched foods. 4. increase intake of red meat. 5. increase intake of leafy greens.

1. taking a prescribed thiazide diuretic. 2. taking aspirin every day. 3. drinking four beers every night. 4. receiving treatment for polycythemia. Explanation: Gout can be caused by thiazide diuretics. Gout can be caused by chronic aspirin use. Gout can be caused by alcohol ingested on a chronic basis. Polycythemia can cause secondary gout.

23) When planning care for a client, the nurse will include interventions to address factors that predispose the client to developing gout, including: Select all that apply. 1. taking a prescribed thiazide diuretic. 2. taking aspirin every day. 3. drinking four beers every night. 4. receiving treatment for polycythemia. 5. being diagnosed with heart failure.

1. Begin a walking program. 2. Perform exercises to strengthen the quadriceps muscle. 3. Discuss the use of a brace with the healthcare provider. 4. Consider losing weight. Explanation: Walking helps maintain joint flexibility in the client with osteoarthritis. Improving the strength of the quadriceps muscle will enhance the ability to perform activities of daily living. Bracing may help keep joints positioned correctly and relieve pain. Weight reduction helps if the weight-bearing joints such as the hip and knee are affected.

24) A client with osteoarthritis does not want to use medication for pain control. What can the nurse suggest to improve the symptoms of this disorder? Select all that apply. 1. Begin a walking program. 2. Perform exercises to strengthen the quadriceps muscle. 3. Discuss the use of a brace with the healthcare provider. 4. Consider losing weight. 5. Schedule joint replacement surgery as soon as possible.

1. Jaw pain and swelling 2. Several loose teeth Explanation: Symptoms of osteonecrosis of the jaw, which is a possible adverse effect of bisphosphonate therapy, include jaw pain and swelling. Symptoms of osteonecrosis of the jaw, which is a possible adverse effect of bisphosphonate therapy, include loose teeth.

25) While conducting a physical assessment, the nurse is concerned that the client, who is taking a bisphosphonate, is showing signs of osteonecrosis of the jaw. What did the nurse assess in this client? Select all that apply. 1. Jaw pain and swelling 2. Several loose teeth 3. Elevated blood pressure 4. Oral lesions 5. Difficulty swallowing

1. nausea and vomiting. 2. abdominal pain. 3. diarrhea. Explanation: Adverse effects of colchicine (Colcrys) include nausea and vomiting., abdominal pain, and diarrhea.

26) A client is prescribed colchicine (Colcrys) for gout. The nurse discusses possible adverse effects of this therapy, including: Select all that apply. 1. nausea and vomiting. 2. abdominal pain. 3. diarrhea. 4. constipation. 5. muscle pain.

1. "I should increase my fluid intake to 2 to 4 liters every day." 2. "I should avoid eating salmon, sardines, organ meats, alcohol, mushrooms, legumes, and oatmeal." 3. "I should notify my healthcare provider if my pain gets worse." 4. "I should weigh myself every day and notify my healthcare provider if I gain over 2 pounds in a day." Explanation: The client should be instructed to increase fluid intake to 2 to 4 L/day. These are foods that contain purine and should be avoided in the client with gout. Worsening pain could be an indication that the medication dosage needs to be adjusted and should be reported to the healthcare provider. The client should conduct daily weights and notify the healthcare provider about any weight gain of 2.2 pounds or more in a day.

27) The nurse determines that teaching about gout has been effective when the client makes which statements? Select all that apply. 1. "I should increase my fluid intake to 2 to 4 liters every day." 2. "I should avoid eating salmon, sardines, organ meats, alcohol, mushrooms, legumes, and oatmeal." 3. "I should notify my healthcare provider if my pain gets worse." 4. "I should weigh myself every day and notify my healthcare provider if I gain over 2 pounds in a day." 5. "I will expect to experience flank pain when taking this medication."

2. 1,000 to 1,200 mg/day. Explanation: The normal healthy adult should consume 1,000 to 1,200 mg of calcium per day.

3) The recommended dietary allowance for calcium in the normal healthy adult is: 1. 1,600 to 2,000 mg/day. 2. 1,000 to 1,200 mg/day. 3. 200 to 600 mg/day. 4. 2,400 to 2,800 mg/day.

2. metastatic bone tumor. Explanation: The bone destruction that occurs with metastatic bone tumors releases calcium into the bloodstream and elevates the serum calcium level.

4) A client has a serum calcium level of 12.0 mg/dL. The nurse suspects that the client is experiencing a pathophysiologic process such as: 1. osteomalacia. 2. metastatic bone tumor. 3. hypoparathyroidism. 4. chronic kidney disease.

2. "How many dairy products do you consume per day?" Explanation: Osteoporosis is associated with a deficiency of calcium. Milk provides the most readily available form of calcium.

5) Which question is most important for the nurse to ask the client who has been diagnosed with osteoporosis? 1. "How much weight have you gained in the last year?" 2. "How many dairy products do you consume per day?" 3. "Does someone in your household smoke?" 4. "What would you estimate your cholesterol intake to be?"

4. hypercalcemia Explanation: Calcitonin is the hormone that opposes parathyroid hormone and is released when the serum calcium level is increased.

6) A client with a calcium imbalance has an elevated calcitonin level. The nurse recognizes that the secretion of calcitonin is increased when the client experiences: 1. hypocalcemia. 2. hypothyroidism. 3. hyperthyroidism. 4. hypercalcemia.

4. vitamin D and parathyroid hormone. Explanation: Vitamin D and parathyroid hormone increase gastrointestinal absorption of calcium and decrease calcium excretion through the kidneys. These agents also increase bone resorption, which also increases calcium levels.

7) Normally, serum calcium level is maintained by: 1. folic acid and thyroxine. 2. vitamin C and prolactin. 3. vitamin B12 and aldosterone. 4. vitamin D and parathyroid hormone.

2. increasing the level of an inactive form of vitamin D in the blood. Explanation: Ultraviolet light increases the blood level of cholecalciferol synthesized from cholesterol in the skin.

8) The nurse is instructing a mother to encourage her school-age children to play out of doors because it will help reduce the risk of osteomalacia by: 1. increasing renal perfusion, which helps to activate vitamin D. 2. increasing the level of an inactive form of vitamin D in the blood. 3. increasing osteoblastic activity to maintain calcium in the bone. 4. enhancing activation of the parathyroid hormone.

4. 4 to 6 weeks. Explanation: Hydroxychloroquine (Plaquenil) requires 4 to 6 weeks to achieve a therapeutic response.

9) A client with rheumatoid arthritis is prescribed hydroxychloroquine (Plaquenil). To encourage compliance, the nurse should advise the client to expect the effects of this drug to begin within: 1. 3 to 6 days. 2. 6 to 9 months. 3. 7 days. 4. 4 to 6 weeks.

3. Spend at least 20 minutes/day in the sunlight. Rationale 3: Twenty minutes/day in the sun will provide all the vitamin D that is required.

A child has rickets, and is being treated at the clinic. In addition to taking vitamin D as prescribed, what is the best information the nurse can provide? 1. Avoid dairy products while taking vitamin D. 2. Be sure to take brand name, not generic, vitamin D. 3. Spend at least 20 minutes/day in the sunlight. 4. Take your vitamin D on an empty stomach

1. "I will give your medication in the form of an injection." 2. "You may feel more fatigued than usual when taking this drug." 3. "Be certain to keep your appointments for follow-up." 5. "We must monitor your cholesterol while you are taking this drug." Rationale 1: Denosumab is given subcutaneously. Rationale 2: An adverse reaction of this drug is fatigue. Rationale 3: This drug can cause severe hypocalcemia, so it is important to monitor lab values. Rationale 5: This drug may result in hypercholesterolemia.

A client has been prescribed denosumab (Prolia). What medication education should the nurse provide? Standard Text: Select all that apply. 1. "I will give your medication in the form of an injection." 2. "You may feel more fatigued than usual when taking this drug." 3. "Be certain to keep your appointments for follow-up." 4. "Do not take any kind of calcium supplement or vitamin D supplement while taking this drug." 5. "We must monitor your cholesterol while you are taking this drug."

1. "You should not drink alcohol". 4. "Increase your fluid intake to 2 to 4 liters each day." 5. "If your joint pain does not improve, let us know." Rationale 1: Limiting or eliminating alcohol consumption is standard treatment for gout. Rationale 4: Increasing fluid intake increases uric acid excretion. Rationale 5: The client should be taught to report worsening or continued inflammation or pain.

A client is receiving therapy for gout. Which information should the nurse provide? Standard Text: Select all that apply. 1. "You should not drink alcohol." 2. "You should increase intake of fatty fish like salmon and sardines." 3. "Take a vitamin C supplement while on your medication for gout." 4. "Increase your fluid intake to 2 to 4 liters each day." 5. "If your joint pain does not improve, let us know."

1. "The results from these medications are hard for you to see." 3. "When did you stop taking the medications?" 4. "Were there any other reasons that you decided to discontinue the medications?" Rationale 1: The changes from taking medications for osteoporosis are difficult for the client to measure. Rationale 3: The nurse should determine how long it has been since therapy was discontinued. Rationale 4: The nurse should determine if other reasons, such as adverse side effects or cost of medication, were factors in the client's decision.

A client states, "I stopped taking my medications for osteoporosis. I couldn't see how they were helping me any." How should the nurse respond? Standard Text: Select all that apply. 1. "The results from these medications are hard for you to see." 2. "It takes about 6 months to see any results." 3. "When did you stop taking the medications?" 4. "Were there any other reasons that you decided to discontinue the medications?" 5. "You are not helping us help you when you don't follow directions."

4. with food Rationale 4: Food helps to absorb the calcium.

A client takes calcium three times a day in the form of supplements. The nurse will advise the client to take the drug 1. with tea or coffee. 2. on an empty stomach. 3. with zinc supplements. 4. with food.

1. "What kind of exercises are you doing" 2. "You should try to exercise three to five times a week." 4. "Is there somewhere that you can walk on the days you don't go to the gym?" Rationale 1: In order to affect osteoporosis, exercise must be weight-bearing. Rationale 2: To affect osteoporosis, exercise should be done three to five times weekly. Rationale 4: This client should exercise more frequently and walking is a good form of exercise for those with osteoporosis.

A client who has osteoporosis says, "I am exercising more. I go to the gym once a week." How should the nurse respond? Standard Text: Select all that apply. 1. "What kind of exercises are you doing" 2. "You should try to exercise three to five times a week." 3. "That is not enough." 4. "Is there somewhere that you can walk on the days you don't go to the gym?" 5. "Exercise will not improve your osteoporosis."

4. regulate nerve transmission. Rationale 4: Adequate calcium levels help to transmit nerve impulses.

An important function of calcium is to 1. regulate acid-base balance. 2. improve glucose absorption. 3. increase energy. 4. regulate nerve transmission.

1. "Calcitriol is a vitamin D supplement." 2. "What other medications do you take?" Rationale 1: Calcitriol is a vitamin D supplement. Rationale 2: Calcitriol is often taken with calcium supplementation and the client may have medication names confused.

During a medication history, the client states, "I take the calcium supplement called calcitriol." How should the nurse respond to this statement? Standard Text: Select all that apply. 1. "Calcitriol is a vitamin D supplement." 2. "What other medications do you take?" 3. "You don't understand the medications you are taking." 4. "Do you also take a vitamin D supplement?" 5. "Do you take the prescription strength or over-the-counter?"

3. You could try heat applications and splinting for discomfort. Rationale 3: Heat and splinting are appropriate nonpharmacological methods for arthritic pain during pregnancy.

The client has arthritis and has just learned that she is pregnant. What is the best instruction by the nurse? 1. An ice bath to the affected joint will help with discomfort. 2. Hydroxychloroquine (Plaquenil) is the best medication for you. 3. You could try heat applications and splinting for discomfort. 4. Glucocorticoids are considered safe during pregnancy.

1. "It may take a few days or weeks for me to get the full effect of this medication." 2. "I should not drink alcohol while taking this drug." 3. "If I develop a skin rash I should contact the prescriber." 5. "I should take this medication with food." Rationale 1: It may take 1-3 weeks for blood levels of uric acid to return to normal range. Rationale 2: Alcohol may inhibit the renal excretion of uric acid. Rationale 3: Skin rash is a possible adverse reaction of allopurinol and can be serious. Rationale 5: Allopurinol should be taken with or after meals.

The client has gout and receives allopurinol (Zyloprim). The nurse has completed medication education and evaluates that learning has occurred when the client makes which statements? Standard Text: Select all that apply. 1. "It may take a few days or weeks for me to get the full effect of this medication." 2. "I should not drink alcohol while taking this drug." 3. "If I develop a skin rash I should contact the prescriber." 4. "I should not crush this medication." 5. "I should take this medication with food."

4. Calcium supplements and vitamin D Rationale 4: Calcium supplements and vitamin D are considered the most effective treatments for osteomalacia

The client has osteomalacia and the physician has ordered a treatment to restore calcium balance. What will the nurse plan to administer to the client? 1. Calcium supplements and dark green, leafy vegetables 2. Calcium supplements and milk products 3. Calcium supplements and potassium 4. Calcium supplements and vitamin D

1. "I cannot lie down for at least 30 minutes after taking the medication." 3. "I should call my doctor if I experience heartburn." 4. "I must take this with a full glass of water." Rationale 1: The client must stay upright for at least 30 minutes to prevent GI upset. Rationale 3: Alendronate (Fosamax) is irritating to the esophagus; the client must contact the physician if heartburn occurs. Rationale 4: Alendronate (Fosamax) must be taken on an empty stomach with a full glass of water to ensure absorption.

The client receives alendronate (Fosamax) as treatment for osteoporosis. The nurse has completed medication education and evaluates learning has occurred when the client makes which statements? Standard Text: Select all that apply. 1. "I cannot lie down for at least 30 minutes after taking the medication." 2. "Milk will help with the absorption of this medication." 3. "I should call my doctor if I experience heartburn." 4. "I must take this with a full glass of water." 5. "The medication can be taken with or without food."

4. Muscle spasms and facial twitching Rationale 4: Muscle spasms and facial twitching indicate a low calcium level, which can be caused by alendronate (Fosamax), and should be reported immediately before the client has seizures.

The client receives alendronate (Fosamax) as treatment for osteoporosis. Which symptoms, caused by an adverse effect of the medication, does the nurse teach should be reported to the physician? 1. Ringing of the ears 2. Hot and dry skin 3. Vision changes and photophobia 4. Muscle spasms and facial twitching

2. Eye exams Rationale 2: Blurred vision, inability to read, and visual field disturbances can occur when receiving hydroxychloroquine sulfate (Plaquenil) so the client must have regular eye exams

The client receives hydroxychloroquine sulfate (Plaquenil). Which test does the nurse tell the client should be done on a regular basis? 1. Serum potassium 2. Eye exams 3. Serum glucose 4. Blood pressure

3. Atorvastatin (Lipitor) Rationale 3: Antilipids and hormones are the only medications contraindicated with raloxifene (Evista).

The client receives raloxifene (Evista). Which other medication would the nurse hold and validate with the physician? 1. Lisinopril (Prinivil) 2. Paroxetine (Paxil) 3. Atorvastatin (Lipitor) 4. Diphenhydramine (Benadryl)

3. Bone density scan Rationale 3: The bone density scan is the best assessment tool to determine the effectiveness of bisphosphonates.

The client takes a bisphosphonate for osteoporosis. Which assessment is best in determining the effectiveness of the medication? 1. Normal serum calcium levels 2. Absence of fractures 3. Bone density scan 4. Absence of bone pain

2. "Take your calcium with a meal." Rationale 2: Calcium is best absorbed if taken with a meal.

The client takes calcium supplements. What is the best instruction by the nurse? 1. "This drug may cause insomnia." 2. "Take your calcium with a meal." 3. "It does not matter if Vitamin D is added." 4. "Take them on an empty stomach."

1. Seizures Rationale 1: A low calcium level puts the client at risk for seizures.

The client's calcium level is low. What will be the nurse's primary concern? 1. Seizures 2. Bone fractures 3. Hypoglycemia 4. Depression

4. increase bone mass and density. Rationale 4: Selective estrogen receptor modulators increase bone mass and density through the estrogen receptor.

The mechanism of action of selective estrogen receptor modulators (SERMs), such as raloxifene (Evista), is to 1. increase calcium levels in the bone. 2. slow bone resorption. 3. inhibit synthesis of microtubules. 4. increase bone mass and density.

2. Assess the intravenous (IV) site Rationale 2: The intravenous (IV) site must be assessed, as extravasation may lead to necrosis of tissue at the insertion site.

The nurse administers calcium intravenously (IV) to the client. What will a key assessment by the nurse include? 1. Assess the serum glucose levels. 2. Assess the intravenous (IV) site. 3. Assess the serum potassium levels. 4. Assess for peripheral edema.

2. "I have nausea, vomiting, and abdominal pain every day." Rationale 2: Nausea, vomiting, and abdominal pain are signs of colchicine toxicity

The nurse assesses the client might be experiencing toxicity from colchicine. Which statement by the client would most likely confirm the nurse's suspicion? 1. "My joints hurt more." 2. "I have nausea, vomiting, and abdominal pain every day." 3. "I don't see as well as I used to, and my taste has changed." 4. "I wake up at night with muscle cramps."

3. "I will take my calcium at bedtime." Rationale 3: Calcium should be taken with meals, not at bedtime.

The nurse has taught the client with osteoporosis about how to manage the illness. Which statement by the client indicates that she needs additional teaching? 1. "I will avoid drinking alcohol." 2. "I will walk for 30 minutes every day." 3. "I will take my calcium at bedtime." 4. "I will drink milk regularly."

1. Prevention of osteoporosis begins in early adulthood.

The nurse teaches a class for college students about osteoporosis. What is the best information to include? 1. Prevention of osteoporosis begins in early adulthood. 2. Medication is the primary treatment to prevent and halt bone loss. 3. Osteoporosis is an inevitable part of aging. 4. Men do not need to be concerned about osteoporosis.

2. buildup of uric acid in the blood. Rationale 2: Gout is due to buildup of uric acid in blood or joints.

The symptoms of gout are due to 1. an increase in the excretion of uric acid. 2. buildup of uric acid in the blood. 3. cartilage loss in the joints. 4. a decrease in uric acid in the blood.

4. Muscle spasms Rationale 4: Signs and symptoms of hypocalcemia are nerve and muscle excitability. Muscle spasms, tremors, or cramping can be evident. Numbness and tingling of the extremities can occur, and convulsions are possible.

Which of the following signs are common with hypocalcemia? 1. Bruising 2. Hypertension 3. Muscle wasting 4. Muscle spasms