Osteoporosis

Which statement by the nurse indicates an understanding of the effects of vitamin D and calcium on​ osteoporosis? A. ​"Vitamin D is needed for renal absorption of phosphorus and​ calcium." ​B. "Impaired vitamin D activation reduces the serum calcium​ level." ​C. "A high intake of​ high-phosphate foods can help increase serum​ calcium." ​D. "Acidosis causes calcium to be deposited into​ bone."

B. "Impaired vitamin D activation reduces the serum calcium​ level."

The nurse is providing care for an older adult female patient who states, "I have been experiencing low back pain, which has been causing me to lose sleep." Which question will best help the nurse determine if the patient's pain is associated with osteoporosis? A. "Do you have a history of fractures?" B. "Are you experiencing decreased range of motion?" C. "Do you have pain in your joints?" D. "What position do you sleep in?"

A. "Do you have a history of fractures?"

The nurse who is caring for an older adult at risk for osteoporosis discusses the importance of weight-bearing activity. Which statement made by the patient requires further teaching? A. "I enjoy swimming, so I will try and swim at least 3 times a week." B. "I will attend a tai chi class at least 4 times a week." C. "I will join a gym and begin a weight-lifting program." D. "I used to be an avid golfer, and I will get back out on the course at least 4 times a week."

A. "I enjoy swimming, so I will try and swim at least 3 times a week."

The nurse is obtaining a health history on a patient diagnosed with osteoporosis. Which patient statement has the strongest association with osteoporosis? A. "I try to walk twice a week." B. "I am lactose intolerant and do not eat any dairy products." C. "I do not smoke and occasionally drink alcohol." D. "I follow a strict vegan diet."

A. "I try to walk twice a week."

The nurse has completed the medication teaching for the patient prescribed a bisphosphonate for osteoporosis. Which patient statement indicates that further teaching is required? A. "I will take my medication with my breakfast, so I do not get nauseated." B. "I will keep a dietary log to track my intake of foods high in calcium, vitamin D, and phosphate." C. "I will make sure that I walk 30-40 minutes a day four times a week." D. "After I take my medication, I will wait for 1 hour before I take my calcium and vitamin D supplements."

A. "I will take my medication with my breakfast, so I do not get nauseated."

The nurse is providing nutritional teaching for a newly diagnosed pregnant patient. Which dietary intervention should the nurse suggest in order for the growing fetus to obtain enough maternal dietary calcium without having to pull calcium from the maternal bones? A. "Increase your dietary intake of beans." B. "Increase your dietary intake of chicken." C. "Increase your dietary intake of beef." D. "Increase your dietary intake of wheat."

A. "Increase your dietary intake of beans."

A pregnant woman asks, "Can you tell me about breastfeeding and bone loss? I read an article stating that I am at risk for bone loss if I breastfeed." Which response by the nurse demonstrates an understanding of breastfeeding and its effects on loss of maternal bone mass? A. "Loss of maternal bone mass does occur with breastfeeding but is restored after weaning." B. "Loss of maternal bone mass does not occur; the infant obtains calcium from your dietary intake." C. "Loss of maternal bone mass will not occur if you continue to take your prenatal vitamins while breastfeeding." D. "You will be supplemented with extra calcium and vitamin D while breastfeeding to prevent loss of maternal bone mass."

A. "Loss of maternal bone mass does occur with breastfeeding but is restored after weaning."

A 65-year-old female patient has been recently diagnosed with osteoporosis. Which information should the nurse include in the teaching related to the patient's diagnosis? A. "Walk 30-40 minutes per day." B. "Consume foods low in iron." C. "Increase dietary protein." D. "Abstain from any caffeine intake."

A. "Walk 30-40 minutes per day."

A patient is prescribed estrogen replacement therapy for treatment of osteoporosis. The patient states to the nurse, "I heard that estrogen is associated with an increased risk of uterine cancer." Which response made by the nurse provides the patient with accurate information? A. "You will be prescribed progesterone with the estrogen to protect you from uterine cancer." B. "Your provider will prescribe bisphosphonates to decrease the risk of cancer." C. "The dose of estrogen is too low to increase your risk of cancer." D. "The new research does not link estrogen replacement therapy to increased risk of cancer."

A. "You will be prescribed progesterone with the estrogen to protect you from uterine cancer."

The nurse is performing a yearly health screening on a patient at risk for osteoporosis. Which clinical assessment finding should the nurse associate with osteoporosis? A. A decrease in height over time B. An increase in weight over time C. Chronic episodes of vertebral pain D. Vertebral pain with substantial movement

A. A decrease in height over time

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. Activity Intolerance ​B. Mobility: Physical, Impaired ​C. Nutrition, Imbalanced: Less than Body Requirements ​D. Pain, Chronic

A. Activity Intolerance

A patient diagnosed with osteoporosis states to the nurse, "I don't understand how my bones can be so brittle and break easily." Before responding to the patient, the nurse should understand that which process is involved in the pathophysiology of osteoporosis? A. An imbalance between osteoblasts and osteoclasts has occurred. B. Osteoclasts are unable to produce new bone. C. Osteoblasts are not able to reabsorb bone. D. Excessive bone reabsorption has occurred.

A. An imbalance between osteoblasts and osteoclasts has occurred.

A patient with osteoporosis has been prescribed calcium citrate supplements. Which topic should the nurse include in the patient's medication teaching? A. Best taken with meals B. Increased risk for depression C. Decreasing overall caloric intake D. Necessity for additional iron supplementation

A. Best taken with meals

The nurse is preparing to provide dietary teaching for the patient who is diagnosed with osteoporosis. Which food should the nurse recommend to provide dietary calcium? A. Canned sardines B. Wine C. Organ meats D. Brown rice

A. Canned sardines

The nurse is caring for a patient suspected of having osteoporosis. Which diagnostic test should the nurse anticipate to be ordered to specifically diagnose osteoporosis? A. Dual-energy x-ray absorptiometry (DEXA) B. Magnetic resonance imaging (MRI) C. Ultrasound D. Computerized tomography (CT) scan with contrast

A. Dual-energy x-ray absorptiometry (DEXA)

The nurse is providing teaching to a patient diagnosed with osteoporosis about how to slow the disease process. Which information is the most appropriate to provide? A. Encouraging smoking cessation B. Decreasing fluid intake C. Encouraging use of prescribed pain medications D. Discouraging further physical activity

A. Encouraging smoking cessation

The nurse is assessing a patient who is postmenopausal and at risk for osteoporosis. The nurse notes a 3-in decrease in height from last year's assessment. Laboratory and radiological studies confirm osteoporosis. Which collaborative intervention should the nurse anticipate to further prevent decrease in bone loss? A. Estrogen replacement therapy B. Bisphosphonate C. Vitamin D supplementation D. Calcium supplementation

A. Estrogen replacement therapy

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. Moderate exercise C. Smoking D. Sedentary lifestyle E. Consumption of milk products

A. Excessive alcohol consumption C. Smoking D. Sedentary lifestyle

A 62-year-old female patient presents with a possible wrist fracture and reports no other health problems. This is the third such injury that the patient has had in the past year, and the nurse suspects osteoporosis. Which assessment finding in the patient's health history supports the diagnosis of osteoporosis? A. History of alcoholism B. Increased BMI C. Active lifestyle D. Daily vitamin D intake

A. History of alcoholism

A 65-year-old man with a low testosterone and lifetime calcium level has had two bone fractures in the past 2 years. Which intervention should the nurse suggest to prevent or slow the development of osteoporosis? A. Increasing calcium intake B. Implementing corticosteroid use C. Implementing estrogen therapy D. Exercising less to avoid injury

A. Increasing calcium intake

An older adult female patient is diagnosed with osteoporosis. Which risk factor should the nurse recognize as a contributing to this disease? A. Lack of vitamin D B. Low testosterone C. Diet rich in calcium D. Aerobic exercise 3 times per week

A. Lack of vitamin D

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. Men with high testosterone levels B. Smokers C.Postmenopausal women D. Asian American women

A. Men with high testosterone levels

The nurse is providing dietary teaching for a patient newly diagnosed with osteoporosis. Included in the teaching is the importance of dietary intake of calcium and vitamin D. Which foods that are high in vitamin D should the nurse recommend? A. Milk B. Beef C. Orange juice D. Beans

A. Milk

The nurse is caring for a patient diagnosed with osteoporosis. When planning the patient's care, which nursing diagnosis is most appropriate? A. Mobility: Physical, Impaired B. Hypothermia C. Hyperthermia D. Neurovascular Dysfunction: Peripheral, Risk for

A. Mobility: Physical, Impaired

The nurse is caring for an older adult who has advanced dementia, osteoporosis, and frequently gets out of bed throughout the night. Which nursing intervention is most appropriate for the nurse to include in the plan of care? A. Placing the bed in the lowest position B. Medicating the patient C. Providing the patient with an assistive device D. Obtaining an order for restraints

A. Placing the bed in the lowest position

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. Providing lighting in toilet facilities B. Increasing the​ client's use of assistive devices C. Keeping the side rails up on the bed at all times D. Restricting fluids at night to decrease nocturia

A. Providing lighting in toilet facilities

The nurse is caring for an older adult at risk for osteoporosis who frequently experiences a loss of balance. Which activity should the nurse encourage the patient to do to prevent osteoporosis? A. Tai chi B. Increasing calcium supplementation C. Walking when they feel stable D. Obtaining an assistive device, so the patient can walk

A. Tai chi

The nurse is caring for several clients on the unit. Which client is at the greatest risk for​ osteoporosis? A. The client treated for withdrawal delirium tremens B. The client treated for an eating disorder C. The client with early onset Alzheimer disease D. The client with impaired vision

A. The client treated for withdrawal delirium tremens

The nurse working in a clinic is screening female adolescent patients for risk factors of osteoporosis. Which patient has the greatest risk for osteoporosis? A. The female adolescent on a cross-country running team B. The female adolescent that is on the golf team C. The female adolescent that is sedentary D. The female adolescent that is on a chess team

A. The female adolescent on a cross-country running team

The nurse is providing care for a patient diagnosed with osteoporosis who is recovering from a wrist fracture. Which outcome should the nurse expect the patient to meet? A. The patient identifies and eliminates safety hazards. B. The patient achieves adequate calcium and vitamin D intake. C. The patient incorporates weight-bearing exercises. D. The patient maintains a healthy weight.

A. The patient identifies and eliminates safety hazards.

During a home visit, the nurse is concerned that a patient recovering from an osteoporosis-related fracture is at risk for future fractures. Which assessment finding supports the nurse's conclusion? A. The patient is smoking cigarettes. B. The patient is using a treadmill every day. C. The patient drinks an occasional glass of wine. D. The patient is consuming fresh fruits and vegetables every day.

A. The patient is smoking cigarettes.

The nurse is caring for a postmenopausal patient who reports difficulty sleeping and low back pain. Which testing procedure should the nurse anticipate being ordered to screen the patient for osteoporosis? A. Ultrasound B. Alkaline phosphatase C. Gla protein D. Dual-energy x-ray absorptiometry (DEXA)

A. Ultrasound

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. Calcium channel blocker B. Bisphosphonate C. Oral calcium supplement D. Tetracycline

B. Bisphosphonate

The nurse is teaching health promotion behaviors to a client diagnosed with osteoporosis. Which behavior should the nurse​ include? A. Avoiding foods high in purine B. Limiting alcohol intake C. Decreasing smoking D. Exercising four times a week

B. Limiting alcohol intake

The nurse is reviewing the chart of a client with osteoporosis. Which physical assessment finding should the nurse​ anticipate? A. Poor posture B. Spinal curvature C. Unsteady gait D. Generalized pain

B. Spinal curvature

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 at risk for osteoporosis. C. The​ client's age in relation to the BMI should be factored in. D. The client is not at risk for osteoporosis.

B. The client is at risk for osteoporosis.

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 understand that I may experience hot​ flashes." ​C. "I am glad I am not at risk for osteoporosis​ anymore." ​D. "I will be sure to maintain all​ follow-up appointments for​ evaluation."

C. "I am glad I am not at risk for osteoporosis​ anymore."

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. Alternating the heat with an ice pack every 30 minutes B. Encouraging the use of the heat before the client ambulates C. Removing the heat every 20 to 30 minutes D. Utilizing the heat if the prescribed pain medication does not work

C. Removing the heat every 20 to 30 minutes

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. Ultrasound B. Alkaline phosphatase C. Serum bone Gla protein​ (osteocalcin) ​D. Dual-energy x-ray absorptiometry​ (DEXA)

C. Serum bone Gla protein​ (osteocalcin)

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. Walking on a treadmill C. Strength and balance training D. Swimming

C. Strength and balance training

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. Tinnitus B. Headaches C. Vomiting D. Anorexia

C. Vomiting

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. Congenital cardiac disease B. Cystic fibrosis C. Systemic lupus erythematosus D. Diabetes

D. Diabetes

The nurse is caring for a client with osteoporosis. Which medication taken by the client may have contributed to this​ diagnosis? A. Acetaminophen B. Calcium supplements C. Vitamin D supplements D. Prednisone

D. Prednisone

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 within 2 hours after meals. C. Take the calcium on an empty stomach. D. Take the calcium with meals.

D. Take the calcium with meals.

The nurse is screening clients in the clinic for osteoporosis. Which client has the greatest risk factor for​ osteoporosis? A. The client who occasionally drinks a diet soda B. The client with a BMI greater than 25 ​kg/m2 C. The client who walks at the park for 30 minutes each day D. The client taking selective serotonin reuptake inhibitors​ (SSRIs)

D. The client taking selective serotonin reuptake inhibitors​ (SSRIs)

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. "Seafood is an excellent source of​ calcium." ​B. "Increase your consumption of​ vegetables." ​C. "You can increase your consumption of​ meat." ​D. "Many types of pasta are an excellent source of​ calcium."

​B. "Increase your consumption of​ vegetables."