Osteoporosis Nclex Questions

A patient started Alendronate (Fosamax) once a week for the treatment of osteoporosis. The nurse determines that further instruction about the drug is needed when what is said by the patient? "I should take the drug with a meal to prevent stomach irritation".

The Bisphosphonate, such as Alendronate, must be taken at least 30 minutes before food or other medications to promote absorption

The nurse should include which of the following client teachings for prevention of rapid progression of osteoporosis? avoid alcohol

Avoiding alcohol and cigarette smoking will prevent rapid progression of osteoporosis. Skim milk is indicated among elderly because it is low in fats. Protein foods are necessary for calcium absorption. Calcium supplements help maintain integrity of the bones

A nurse is conducting a health screening among females at the mall to assess those who are at risk for developing osteoporosis. Which of the following questions is most appropriate to be asked by the nurse in relation to development of osteoporosis? are you taking corticosteroids?

Corticosteroids promote calcium loss. This increases the risk for osteoporosis.

All of the following are risk factors for osteoporosis EXCEPT: Obesity

Risk factors for osteoporosis may be inherited or acquired. Inherited factors include female sex and white or Asian ancestry. Women with Turner's syndrome or any condition leading to low estrogen levels are at increased risk of osteoporosis. Women with a personal history of fracture as an adult or history of osteoporosis in a first-degree relative also are at increased risk. Acquired risk factors include current smoking (≥ 1 pack per day), alcohol use (≥ 2 drinks per day), low calcium intake (< 1200 mg per day), and sedentary lifestyle. Finally, women with low body weight (< 127 lb) are at in- creased risk for osteoporosis. Guidelines for osteo porosis screening and prevention are available only for women at this time.

Alendronate (Fosamax) is given to a client with osteoporosis. The nurse advises the client to? Take the medication with a glass of water after rising in the morning.

Alendronate needs to be taken with a glass of water after rising in the morning in order to prevent gastrointestinal effects. A, B, D: Not taking Alendronate on the specified time of the day could cause GI upset.

Which female patients are at risk for developing osteoporosis (Select all that apply) ? b-55 year old Asian American cigarette smoker. d-68 year old white who is underweight and inactive e-58 year old Native American who started menopause prematurely.

Risk factors for osteoporosis include age greater than 65, white or Asian ethnicity, cigarette smoking, inactive lifestyle, low weight and postmenopausal estrogen deficiency including premature menopause.

A 50 y/o African American woman visits your office for an annual examination. She takes inhaled steroids and Beta- agonists for mild intermittent asthma. Her past medical history is negative for any fracture. She has no family history of osteoporosis. She exercises regularly. Her menses are regular. Based on her history, what are your recommendations for osteoporosis prevention and screening?

(B) Take 1200 mg of calcium and 400 IU vitamin D daily. This patient has no risk factors for osteoporosis. Although oral steroids are a recognized cause of increased bone loss in adults, inhaled steroids are not. The National Osteoporosis Foundation (NOF)advises that all individuals consume at least 1200 mg of calcium and 400 to 800 IU vitamin D daily. The US Preventive Services Task Force recommends that physicians conduct routine BMD screening for all women older than 65 years. For women with risk factors for osteoporosis, screening is recommended beginning at age 60 years. FDA approved medication for prevention and treatment of osteoporosis. Calcitonin is approved for treatment of osteoporosis only, not prevention.

An 80 y/o Asian woman presents to your office with back pain. She notes that the pain began on the previous day after stepping off a curb. She has been unable to sleep due to the pain. Physical exam reveals she has a dorsal kyphosis and tenderness over a mid thoracic spinous process. Results of neurologic examination are negative for signs of cord compression. You prescribe a mild narcotic pain reliever and order thoracic spine films. Which of the following medications would be of most immediate benefit to this patient?

(C) Calcitonin. Sudden onset of severe back pain following minimal or no trauma suggests an osteo- porotic vertebral fracture. The presence of a dorsal kyphosis also points to osteoporosis. Treatment with narcotic analgesia is appropriate for a presumed ver tebral fracture. Plain radiographs may or may not reveal the acute fracture but are useful to rule out other bone pathology, such as metastatic disease. This patient should have calcium supplementation, but other med is indicated for tx of osteoporosis. Estrogen, alendronate, and risedronate are FDA- approved for the prevention and tx of osteoporosis but do not provide immediate relief. However, FDA recommends nonestrogen txs be considered first for osteoporosis. In addition to reducing vertebral fractures, calcitonin has been shown to produce significant alleviation of the acute pain from osteoporotic vertebral fractures.

A 65 y/o white woman presents for interpretation of BMD testing. Her personal medical history is unremarkable, but her mother died at age 75 years due to complications of a hip fracture. Her T score is - 2. Which of the following choices is the correct interpretation of this patient's T score and treatment?

(D) Osteopenia; alendronate for treatment. The T score compares the patient's BMD in standard deviations with the average BMD of a young adult of the same gender. T score between 0 and - 1 indicates normal bone density. A T score between - 1 and - 2.5 are consistent with osteopenia. T score 2.5 standard deviations or more below the standard (T score ≤- 2.5) indicates osteoporosis. This patient is at increased risk for osteoporosis owing to her race and family history. Her BMD testing results indicate that she has osteopenia.

The daily requirement of calcium for an adult woman is

1200 mg

Intervention to prevent osteoporosis in women should start at which age?

20-35 years

The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most likely related to: Hormonal disturbances.

B: After menopause, women lack hormones necessary to absorb and utilize calcium. A&C: Doing weight-bearing exercises and taking calcium supplements can help to prevent osteoporosis but are not causes, so answers A and C are incorrect. D: Body types that frequently experience osteoporosis are thin Caucasian females, but they are not most likely related to osteoporosis, so answer D is incorrect.

A client with osteoporosis is asking the nurse regarding the use of Salmon calcitonin (Miacalcin) nasal spray. The nurse tells the client to do the following, except? If you do not feel the spray while using it, repeat the dose on the other nostrils.

B: Miacalcin spray delivers a fine mist into the nose. Even if the client does not feel the spray while using it, the medication is still being absorbed by the nasal passages. A: Discard any unused solution after 30 doses because spray may not deliver correct dose. C: Use the other nostril the next day and continue alternating back and forth for each daily dose. D: Vitamin D helps in treating osteoporosis by helping in maintaining healthy bones.

What is the best way to diagnose osteoporosis

Bone density scan

Which patient should NOT be prescribed alendronate (Fosamax) for osteoporosis? A patient on bed rest who must maintain a supine position

DAlendronate can cause significant gastrointestinal side effects, such as esophageal irritation, so it should not be taken if a patient must stay in supine position. A&B: ACE inhibitors are not contraindicated with alendronate and there is no iodine allergy relationship. C: The patient should not eat or drink for 30 minutes after administration and should not lie down.

Postmenopausal women are more prone to suffer from osteoporosis due to?

Decreased estrogen level

Which of the following medical conditions or med- ications can lead to secondary osteoporosis? Gonadotropin- releasing hormone (GnRH) agonists

GnRH agonists. Osteoporosis can occur sec- ondary to any condition or medication that causes accelerated bone loss. 2 Conditions that may cause secondary osteoporosis include athletic amenorrhea, anorexia nervosa, hyperthyroidism, type 1 diabetes mellitus, and malabsorption syndromes. Medications that can cause secondary osteoporosis include excessive use of thyroid hormone, oral corticosteroids (taken for > 3 months' duration), GnRH agonists, phenytoin, phenothiazines, long - term heparin, and phenobarbital. ACE inhibitors and zinc deficiency do not cause osteoporosis.

Alendronate is used in treatment of osteoporosis because it?

Inhibits osteoclastic activity

A client is diagnosed with osteoporosis. Which statements should the nurse include when teaching the client about the disease? SELECT ALL THAT APPLY a)"It's common in females after menopause." b) "It's a degenerative disease characterized by a decrease in bone density." d) "It can cause pain and injury."

Osteoporosis is degenerative metabolic bone disorder in which the rate of bone resorption accelerates and the rate of bone formation decelerates, thus decreasing bone density. Postmenopausal women are at increased risk for this disorder because of the loss of estrogen. The decrease in bone density can cause pain and injury. Osteoporosis isn't a congenital disorder; however, low calcium intake does contribute to the disorder. Passive range-of-motion exercises may be performed but they won't promote bone growth. The client should be encouraged to participate in weight-bearing exercise because it promotes bone growth.

Identify methods to specifically prevent osteoporosis in postmenopausal women (Select all that apply)? b-Eating 8 oz. of yogurt daily. c-performing weight bearing exercises.

To specifically prevent osteoporosis in postmenopausal women, increased calcium and vitamin D intake and weight bearing exercises (e.g. walking) are the best methods.

The nurse is instructing a 65-year-old female client diagnosed with osteoporosis. The most important instruction regarding exercise would be to: Exercise doing weight bearing activities.

Weight bearing exercises are beneficial in the treatment of osteoporosis. B, C, D: Although loss of bone cannot be substantially reversed, further loss can be greatly reduced if the client includes weight bearing exercises along with estrogen replacement and calcium supplements in their treatment protocol.