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Chapter 39: Osteoporosis Treatment Test Bank

Chapter 39: Osteoporosis Treatment Test Bank

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Chapter 39: Osteoporosis Treatment
Test Bank
MULTIPLE CHOICE
1.   A 55-year-old woman who experienced menopause at age 50 years undergoes central dual-energy x-ray absorptiometry and has a T-score greater than 2.5. The patient weighs 130 lb and has a body mass index of 22. She sits at a computer all day at work. The primary care nurse practitioner (NP) caring for this patient should:
a.

prescribe a bisphosphonate.

b.

prescribe hormone replacement therapy.

c.

counsel the patient about diet and exercise.

d.

prescribe a selective estrogen receptor modulator.

 
2.   A 50-year-old white woman who is experiencing menopause asks the primary care NP what she can do to prevent osteoporosis. She has a negative family history and no risk factors. The NP should counsel her to:
a.

consider bisphosphonate therapy in 5 years.

b.

undergo bone density testing every 2 years.

c.

avoid high-impact sports that can lead to fractures.

d.

take supplemental calcium and vitamin D every day.

 
3.   A 60-year-old woman has a central dual-energy x-ray absorptiometry with a T-score of 1.9. A health history reveals no risk factors for osteoporosis. The primary care NP should:
a.

prescribe alendronate sodium (Fosamax).

b.

counsel her to increase her physical activity.

c.

prescribe calcitonin (Miacalcin nasal spray).

d.

prescribe supplemental calcium and vitamin D.

 
4.   A 70-year-old patient who has a high fracture risk has been taking alendronate (Fosamax) and calcium for 6 months. The primary care NP orders a urine NTx level, which is 42. The NP should discontinue the alendronate and prescribe:
a.

raloxifene (Evista).

b.

teriparatide (Forteo).

c.

calcitonin (Miacalcin nasal spray).

d.

ibandronate sodium (Boniva).

 
5.   A 60-year-old female patient has begun taking a daily bisphosphonate to prevent osteoporosis and complains of gastrointestinal (GI) upset and dyspepsia. The primary care NP’s initial response should be to:
a.

prescribe a proton pump inhibitor (PPI).

b.

order intravenous (IV) bisphosphonates.

c.

suggest that she take the drug with food.

d.

review the instructions for taking the drug with the patient.

 
6.   A 50-year-old woman with osteopenia will begin taking raloxifene (Evista). When counseling this patient about this drug regimen, the primary care NP should tell her to:
a.

go for walks daily.

b.

take the medication 1 hour before meals.

c.

sit upright for 30 minutes after taking the drug.

d.

avoid using diuretics while taking this medication.

 
7.   A 60-year-old woman is in the clinic for an annual well-woman examination. She has been taking alendronate (Fosamax) 10 mg daily for 4 years. Her last bone density test yielded a T-score of 2.0. Her urine NTx level today is 22. She walks daily. Her fracture risk is low. The primary care NP should recommend that she:
a.

take a 1- to 2-year drug holiday.

b.

change to 70 mg of alendronate weekly.

c.

decrease the alendronate dose to 5 mg daily.

d.

change to ibandronate (Boniva) 3 mg IV every 3 months.

 
8.   A patient who has several risk factors for osteoporosis has a bone density test that indicates osteopenia. The primary care NP plans to prescribe a bisphosphonate. Before initiating treatment, the NP should:
a.

order an upper GI x-ray.

b.

initiate PPI therapy.

c.

order serum calcium and vitamin D levels.

d.

prescribe a calcium and vitamin D supplement.


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