Osteoporosis
The nurse is providing teaching on the prevention of osteoporosis. Which modifiable risk factor can increase a client's risk of developing osteoporosis? (Select all that apply.) A. Excessive alcohol consumption B. Sedentary lifestyle C. Consumption of milk products D. Smoking E. Moderate exercise
A, B, D
The nurse is preparing medication teaching on a bisphosphonate for a client newly diagnosed with osteoporosis. The nurse should teach the client to monitor for which adverse effect? A. Vomiting B. Headaches C. Tinnitus D. Anorexia
A. Vomiting
The nurse is caring for several clients on the unit. Which client is at the greatest risk for osteoporosis? A. The client with impaired vision B. The client treated for withdrawal delirium tremens C. The client with early onset Alzheimer disease D. The client treated for an eating disorder
B. The client treated for withdrawal delirium tremens
The nurse is reviewing the chart of a pediatric client at risk for osteoporosis. Which factor in the client's history should the nurse identify as placing the client at risk for osteoporosis? A. Diabetes B. Congenital cardiac disease C. Systemic lupus erythematosus D. Cystic fibrosis
A. Diabetes
The nurse is reviewing the orders for a client with osteoporosis who has been prescribed a bisphosphonate. Which test should the nurse anticipate will be ordered while the client is on the medication? A. Serum bone Gla protein (osteocalcin) B. Ultrasound C. Dual-energy x-ray absorptiometry (DEXA) D. Alkaline phosphatase
A. Serum bone Gla protein (osteocalcin) Rationale: Serum bone Gla protein (osteocalcin) is most useful for evaluating the effects of treatment rather than to indicate the severity of the disease. Dual-energy x-ray absorptiometry (DEXA) and ultrasound both measure bone density, not efficacy of treatment. Alkaline phosphatase also does not indicate efficacy of treatment.
The nurse is caring for a client newly diagnosed with osteoporosis who states, "I know I need the extra calcium, but I don't eat any dairy products." Which statement by the nurse provides the client with information for obtaining additional dietary calcium? A. "Increase your consumption of vegetables." B. "You can increase your consumption of meat." C. "Seafood is an excellent source of calcium." D. "Many types of pasta are an excellent source of calcium."
A. "Increase your consumption of vegetables."
The nurse is caring for a client with advanced osteoporosis who implemented the use of a heating pad in the treatment of pain. Which action by the nurse demonstrates appropriate use of the heating pad? A. Encouraging the use of the heat before the client ambulates B. Removing the heat every 20 to 30 minutes C. Utilizing the heat if the prescribed pain medication does not work D. Alternating the heat with an ice pack every 30 minutes
B. Removing the heat every 20 to 30 minutes
The nurse is screening clients in the clinic for osteoporosis. Which client has the greatest risk factor for osteoporosis? A. The client with a BMI greater than 25 kg/m2 B. The client taking selective serotonin re-uptake inhibitors (SSRIs) C. The client who occasionally drinks a diet soda D. The client who walks at the park for 30 minutes each day
B. The client taking selective serotonin re-uptake inhibitors (SSRIs)
The nurse is caring for a postmenopausal client prescribed estrogen therapy to reduce the risk of osteoporosis. Which client statement indicates the need for further teaching? A. "I have completed my smoking cessation program." B. "I will be sure to maintain all follow-up appointments for evaluation." C. "I am glad I am not at risk for osteoporosis anymore." D. "I understand that I may experience hot flashes."
C. "I am glad I am not at risk for osteoporosis anymore."
The nurse is caring for a client with osteoporosis with a primary focus on preventing injury at night. Which is the best nursing intervention for the nurse to implement to maintain the safety of the client? A. Increasing the client's use of assistive devices B. Keeping the side rails up on the bed at all times C. Providing lighting in toilet facilities D. Restricting fluids at night to decrease nocturia
C. Providing lighting in toilet facilities
The nurse is reviewing the chart of a client with osteoporosis. Which physical assessment finding should the nurse anticipate? A. Generalized pain B. Unsteady gait C. Spinal curvature D. Poor posture
C. Spinal curvature
Which statement by the nurse indicates an understanding of the effects of vitamin D and calcium on osteoporosis? A. "A high intake of high-phosphate foods can help increase serum calcium." B. "Vitamin D is needed for renal absorption of phosphorus and calcium." C. "Acidosis causes calcium to be deposited into bone." D. "Impaired vitamin D activation reduces the serum calcium level."
D. "Impaired vitamin D activation reduces the serum calcium level."
The nurse is teaching a client with osteoporosis who has been prescribed calcium citrate supplements. Which information should the nurse include in the teaching? A. Take the calcium in the morning. B. Take the calcium on an empty stomach. C. Take the calcium within 2 hours after meals. D. Take the calcium with meals.
D. Take the calcium with meals.
The nurse is teaching health promotion behaviors to a client diagnosed with osteoporosis. Which behavior should the nurse include? A. Limiting alcohol intake B. Decreasing smoking C. Avoiding foods high in purine D. Exercising four times a week
A. Limiting alcohol intake
The nurse is caring for a client with osteoporosis. Which medication taken by the client may have contributed to this diagnosis? A. Prednisone B. Vitamin D supplements C. Acetaminophen D. Calcium supplements
A. Prednisone
The nurse is planning a presentation on osteoporosis to clients in an assisted-living center. Which group would be appropriate for the nurse to exclude from the presentation as being at risk of developing this disease process? A. Postmenopausal women B. Men with high testosterone levels C. Smokers D. Asian American women
B. Men with high testosterone levels
The nurse is reviewing the chart of an older adult client with a BMI of 19 kg/m2. Which implication does this clinical finding have on the risk for osteoporosis? A. The client's gender needs to be taken into consideration. B. The client is not at risk for osteoporosis. C. The client is at risk for osteoporosis. D. The client's age in relation to the BMI should be factored in.
C. The client is at risk for osteoporosis.
The nurse is caring for an older adult with a history of fractures as a result of osteoporosis. The client currently has a right radial fracture. Which is the priority nursing diagnosis for the client? A. Pain, Chronic B. Nutrition, Imbalanced: Less than Body Requirements C. Mobility: Physical, Impaired D. Activity Intolerance
D. Activity Intolerance
A client diagnosed with osteoporosis indicates reluctance to taking medication on a daily basis. Which class of medication should the nurse anticipate will be prescribed? A. Tetracycline B. Calcium channel blocker C. Oral calcium supplement D. Bisphosphonate
D. Bisphosphonate Rationale: Recent studies suggest that once-weekly dosing with bisphosphonates may give the same bone density benefits as daily dosing because of the extended duration of drug action.
The nurse is caring for an older adult who is visually impaired and at risk for osteoporosis. Which activity is most appropriate to implement for the prevention of osteoporosis? A. Aerobics B. Swimming C. Walking on a treadmill D. Strength and balance training
D. Strength and balance training