CH 63 - Metabolic Bone Diseases

Peak bone mass occurs before which age? 10 20 30 40

20 Peak bone mass occurs before age 20. The age of 10 years is too early for peak bone mass, and the ages of 30 and 40 years are past the development of peak bone mass.

Bone density tests are recommended for all women over which age? 45 50 55 65

65 Bone density tests are recommended for all women over age 65. Women under 65 are recommended to have bone density tests only if they have risk factors like low body weight, smoking, and a history of fracture.

Which medication may help to slow bone reabsorption for a patient with Paget's disease? Calcium Vitamin D Denosumab Alendronate

Alendronate Alendronate is a bisphosphonate drug that inhibits bone reabsorption and increases total bone mass. Both calcium and vitamin D are supplements that are usually given to decrease hypocalcemia as a result of the patient taking a bisphosphonate drug. Denosumab is given to postmenopausal females experiencing osteoporosis.

Which x-ray findings are associated with Paget's disease? Ribbons of decalcification Overgrowth of cartilage and bone Curved shape of the affected bone More than 25% to 40% of bone loss

Curved shape of the affected bone X-ray reports for a patient with Paget's disease reveal a curved shape of the structurally weak bone. X-rays of patients with osteomalacia are characterized by ribbons of decalcification. X-ray reports that reveal overgrowth of cartilage and bone confirm osteochondroma in the patient. X-rays detect osteoporosis only after more than 25% to 40% of bone is lost.

Paget's disease is characterized by which effect on the bone? Excessive bone resorption followed by bone regeneration Benign tumor, which is an overgrowth of cartilage and bone Structural deterioration of bone tissue leading to bone fragility Decalcification and softening of bones due to vitamin D deficiency

Excessive bone resorption followed by bone regeneration Paget's disease is a skeletal bone disorder in which excessive bone resporption is followed by bone regeneration. The new bone that is formed is bigger but disorganized, as well as weaker than the normal bone. Osteochondroma is a benign bone tumor that is characterized by an overgrowth of cartilage and bone near the end of the bone at the growth plate. Osteoporosis is characterized by low bone mass and structural deterioration of bone tissue leading to bone fragility. Osteomalacia is caused by a vitamin D deficiency, resulting in decalcification and softening of bones.

Which procedure is the preferred surgical treatment for vertebral compression fractures? Kyphoplasty Spinal fusion Vertebroplasty Bone mineral density (BMD)

Kyphoplasty Kyphoplasty is the preferred treatment for vertebral compression fractures and uses a balloon inflation to insert bone cement. Vertebroplasty provides bone cement to stabilize the area and reduce pain. BMD is a test to determine peak bone mass. Spinal fusion uses bone to make a bridge between vertebrae that are next to one another.

Which distinct feature of new bone are revealed in the x-ray of a patient with Paget's disease? Brittle and porous Overgrowth of bone Large and disorganized Soft with ribbons of decalcification

Large and disorganized In Paget's disease, excessive bone resorption is followed by bone replacement. The new bone is large, disorganized, and structurally weak. In osteoporosis, the bones are porous and brittle, making the patient prone to fractures. Osteochondroma reveals an overgrowth of cartilage and bone near the end of the bone at the growth plate. In osteomalacia, the bones get decalcified and softened, and x-rays reveal ribbonlike decalcification of bones.

A patient with morbid obesity has an increased risk for which condition? Osteopenia Osteoporosis Osteomalacia Osteoarthritis

Osteomalacia Morbidly obese patients should be assessed for osteomalacia due to the risk for metabolic bone diseases caused by vitamin deficiency, low bone calcium, and sedentary lifestyle. Osteopenia and osteoporosis are characterized by low bone mass and are not associated with morbid obesity. Osteoarthritis is a joint disease of unknown origin and is difficult to assess.

Bone remodeling is consistent in reducing fractures unless the patient has which condition? Cancer Osteoporosis Osteomyelitis Osteochondroma

Osteoporosis Bone remodeling is not consistent in patients with osteoporosis because bone loss exceeds building of bone with osteoclasts. Cancer does not cause bone remodeling to occur, but cancer treatment may alter the rate of osteoclasts. Osteomyelitis is an infection of the bone and does not affect remodeling. Osteochondroma is a common benign bone tumor, an overgrowth of cartilage and bone near the end of the growth plate, and does not affect remodeling.

Which dietary supplements will the nurse encourage a patient with Paget's disease to take? Select all that apply. Protein Calcium Fluoride Vitamin D Phosphorous

Protein Calcium Vitamin D A well-balanced diet is important in managing metabolic bone disorders such as Paget's disease. Vitamin D, calcium, and protein are especially important to ensure available components for bone formation. Adequate fluoride intake is associated with a decreased risk of developing osteoporosis. Phosphorous supplements may be prescribed for a patient with osteomalacia.

A patient with osteomalacia may be prescribed vitamin D 3 and vitamin D 2 supplements for which treatment goal? Relief from back pain Regeneration of the bones Recalcification of the bones Replenishment of bone mass

Recalcification of the bones Vitamin supplements are used in the recalcification and remineralization of softened bones. Mild analgesics and antidepressants provide pain relief and comfort to a patient rather than working on bone recalcification. Teriparatide is used in bone regeneration; this drug stimulates the formation of new bones. It is used to treat osteoporosis in men and postmenopausal women at high risk for fractures. Bisphosphonates inhibit osteoclastic bone resorption and thereby replenish the bone mass and increase the bone density.

Which route will the nurse expect to give teriparatide for a patient with osteoporosis? Orally IV IM Subcutaneously

Subcutaneously Teriparatide is a recombinant form of the parathyroid hormone that increases the action of osteoblasts and needs to be administered subcutaneously. It is administered as a dose of one injection a day. It cannot be administered orally, IV, or IM.