PCC 2 Test 1 (Osteoporosis Questions)

The nurse should include which of the following client teachings for prevention of rapid progression of osteoporosis? a) avoid taking skim milk b) avoid taking protein-rich foods c) avoid calcium supplement d) avoid alcohol

D - 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 50 - year - old 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? (A) Take 800 mg of calcium and 800 IU vitamin D daily (B) Take 1200 mg of calcium and 400 IU vitamin D daily (C) Bone mineral density (BMD) screening (D) Begin calcitonin therapy to increase bone density

(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. Alendronate is a Food

All of the following are risk factors for osteoporosis EXCEPT: (A) Low calcium intake (B) Smoking (C) Alcohol use (D) Turner's syndrome (E) Obesity

(E) Obesity. Risk factors for osteoporosis may be inherited or acquired. 1,2 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 rela- tive also are at increased risk. Acquired risk factors include current smoking (≥ 1 pack per day), alcohol use

You are teaching a patient with osteopenia. What is important to include in the teaching plan? a )Lose weight. b )Stop smoking. c )Eat high protein diet. d )Start swimming for exercise. Answer b Which female patients are at risk for developing osteoporosis (Select all that apply) ? a-60 year old white aerobic instructor. b-55 year old Asian American cigarette smoker. c-62 year old African American on estrogen therapy. d-68 year old white who is underweight and inactive e-58 year old Native American who started menopause prematurely.

b) d) e) 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.

You're teaching a patient with osteoporosis. What is important to include in the teaching plan? a) lose weight b) stop smoking c) eat high protein diet d) start swimming for exercise

b) stop smoking

The nurse is instructing a 65-year-old female client diagnosed with osteoporosis. The most important instruction regarding exercise would be to: a-Exercise doing weight bearing activities. b-Exercise to reduce weight. c-Avoid exercise activities that increase the risk of fracture. d-Exercise to strengthen muscles and thereby protect bones.

A: 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.

An 80 - year - old 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 examination reveals she has a dorsal kyphosis and tenderness over a midthoracic 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? (A) Calcium supplements (B) Residronate (C) Calcitonin (D) Estrogen (E) Alendronate (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 medication is indicated for treatment of osteoporosis. Estrogen, alendronate, and risedronate are FDA- approved for the prevention and treatment of osteoporosis but do not provide immediate relief. However, the FDA recommends nonestrogen treatments 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 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." c) "It's a congenital disease caused by poor dietary intake of milk products." d) "It can cause pain and injury." e) "Passive range-of-motion exercises can promote bone growth." f) "Weight-bearing exercise should be avoided."

Answer: a, b, d Osteoporosis is a 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.

The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most likely related to: a-Lack of exercise. b-Hormonal disturbances. c-Lack of calcium. d-Genetic predisposition

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