Osteoporosis and Bone Health Practice Questions
20 free Osteoporosis and Bone Health practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
A nurse is conducting a screening for osteoporosis. Which female client is at the highest risk for developing this condition?
- A A 45-year-old African American woman who runs marathons.
- B A 65-year-old Caucasian woman with a sedentary lifestyle.
- C A 50-year-old Hispanic woman who takes vitamin D supplements.
- D A 70-year-old Asian woman who is overweight and active.
Correct answer: A 65-year-old Caucasian woman with a sedentary lifestyle.
Risk factors for osteoporosis include being Caucasian or Asian, postmenopausal status, and a sedentary lifestyle. African American women and those who are overweight or perform weight-bearing exercise generally have a lower risk.
Which diagnostic test is considered the 'gold standard' for measuring bone mineral density (BMD) and diagnosing osteoporosis?
- A Standard plain X-ray imaging of the long bones
- B Quantitative Computed Tomography (QCT)
- C Dual-energy X-ray absorptiometry (DEXA) scan
- D Bone biopsy and histomorphometry
Correct answer: Dual-energy X-ray absorptiometry (DEXA) scan
A DEXA scan is the primary diagnostic tool used to measure bone density in the hip and spine. It provides a T-score that compares the client's bone density to that of a healthy young adult.
A nurse is teaching a client about the prevention of osteoporosis. Which weight-bearing exercise should the nurse recommend?
- A Swimming in a heated pool
- B Bicycling on flat terrain
- C Brisk walking or hiking
- D Deep water aerobics
Correct answer: Brisk walking or hiking
Weight-bearing exercises, such as walking, jogging, or dancing, force the body to work against gravity and stimulate bone formation. Non-weight-bearing exercises like swimming or cycling are excellent for cardiovascular health but do not build bone density.
A client is prescribed Alendronate for the treatment of osteoporosis. Which administration instruction is critical for the nurse to include?
- A Take the medication with a full glass of warm milk right before bedtime.
- B Take the medication on an empty stomach and remain upright for 30 minutes.
- C Take the medication with a light snack to help prevent gastric upset and nausea.
- D Crush the tablet completely and mix it thoroughly with applesauce for easier swallowing.
Correct answer: Take the medication on an empty stomach and remain upright for 30 minutes.
Bisphosphonates like alendronate must be taken with plain water on an empty stomach to ensure absorption. Remaining upright for 30 to 60 minutes prevents esophageal irritation and ulceration.
A client's DEXA scan results show a T-score of -2.8. How should the nurse interpret this finding?
- A Normal bone density
- B Osteopenia (low bone mass)
- C Diagnosed osteoporosis
- D Severe or established osteoporosis
Correct answer: Diagnosed osteoporosis
According to the World Health Organization, a T-score of -2.5 or lower indicates osteoporosis. A score between -1.0 and -2.5 is classified as osteopenia, and a score of -1.0 or higher is normal.
Which laboratory value is the nurse most likely to monitor in a client with osteoporosis to rule out secondary causes?
- A Serum potassium and sodium
- B Blood urea nitrogen (BUN) and creatinine
- C Alanine aminotransferase (ALT) and AST
- D Serum calcium, phosphorus, and vitamin D
Correct answer: Serum calcium, phosphorus, and vitamin D
Calcium, phosphorus, and vitamin D are the primary minerals involved in bone metabolism. Abnormal levels of these can indicate secondary bone loss or nutritional deficiencies contributing to osteoporosis.
A client with osteoporosis reports a sudden onset of sharp back pain that increases with movement. What does the nurse suspect?
- A Osteoarthritis of the hip
- B Lumbar muscle strain
- C Herniated nucleus pulposus in the lumbar spine
- D A spinal compression fracture
Correct answer: A spinal compression fracture
Compression fractures of the spine are common in clients with osteoporosis, often occurring during simple activities like bending or lifting. They typically manifest as sudden, severe back pain and can lead to a loss of height or kyphosis.
The nurse is providing dietary education to a client with low bone mass. Which food choice provides the highest amount of calcium?
- A One cup of cooked brown rice
- B One cup of cooked spinach
- C One cup of plain low-fat yogurt
- D A 3-ounce serving of grilled chicken breast
Correct answer: One cup of plain low-fat yogurt
Dairy products like yogurt, milk, and cheese are the most concentrated sources of dietary calcium. While green leafy vegetables contain calcium, it is often less bioavailable than the calcium found in dairy.
Which medication is a Selective Estrogen Receptor Modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women?
- A Ibandronate
- B Teriparatide
- C Denosumab
- D Raloxifene
Correct answer: Raloxifene
Raloxifene is a SERM that mimics the effects of estrogen on bone density without stimulating the lining of the uterus or breasts. It helps reduce bone resorption and the risk of spinal fractures.
A nurse is assessing an older adult client with advanced osteoporosis. Which physical finding is characteristic of this disease?
- A Scoliosis of the thoracic spine
- B Lordosis of the lumbar spine
- C Prominent Heberden's nodes on the fingers
- D Kyphosis of the thoracic spine
Correct answer: Kyphosis of the thoracic spine
Kyphosis, or an outward curvature of the thoracic spine, results from multiple vertebral compression fractures. It is a classic sign of advanced osteoporosis and often leads to a decrease in overall height.
A client is prescribed Teriparatide for severe osteoporosis. The nurse understands that this medication works by which mechanism?
- A Inhibiting osteoclast activity to reduce bone breakdown.
- B Binding to bile acids in the gut to increase calcium absorption.
- C Stimulating osteoblast activity to increase new bone formation.
- D Replacing lost estrogen to maintain bone density.
Correct answer: Stimulating osteoblast activity to increase new bone formation.
Teriparatide is a recombinant form of parathyroid hormone that acts as a bone-forming (anabolic) agent. Unlike bisphosphonates, which stop bone loss, teriparatide actually stimulates the formation of new bone.
Which lifestyle factor significantly increases the risk of bone loss and hip fractures in both men and women?
- A Use of glucocorticoids for more than 3 months
- B High intake of caffeine
- C Consumption of one glass of red wine every day
- D A diet high in complex carbohydrates
Correct answer: Use of glucocorticoids for more than 3 months
Long-term use of corticosteroids (such as prednisone) is a leading cause of secondary osteoporosis. These medications interfere with the body's ability to absorb calcium and increase the rate of bone resorption.
A client asks the nurse why vitamin D is necessary for bone health. What is the best response?
- A 'Vitamin D is required for the absorption of calcium from the intestines.'
- B 'Vitamin D prevents the kidneys from excreting calcium.'
- C 'Vitamin D directly stimulates the thyroid gland to produce more calcitonin hormone.'
- D 'Vitamin D directly hardens the outer layer of the bone.'
Correct answer: 'Vitamin D is required for the absorption of calcium from the intestines.'
Without adequate vitamin D, the body cannot absorb calcium from the diet, regardless of how much calcium is consumed. Vitamin D acts as a hormone to regulate calcium and phosphorus levels in the blood.
A nurse is planning a safety home assessment for a client with osteoporosis. Which intervention is most important to reduce the risk of fractures?
- A Removing all area rugs and clutter from walkways.
- B Installing dim lighting to reduce eye strain.
- C Ensuring the client has a high-protein diet.
- D Instructing the client to wear soft-soled slippers.
Correct answer: Removing all area rugs and clutter from walkways.
Falls are the primary cause of fractures in clients with osteoporosis. Removing trip hazards like rugs and clutter is a high-priority intervention to prevent falls and subsequent injury.
Which hormonal change contributes most directly to the rapid decline in bone mass in women during the first few years after menopause?
- A Increased levels of parathyroid hormone
- B Decreased levels of progesterone
- C Increased levels of calcitonin
- D Decreased levels of estrogen hormone
Correct answer: Decreased levels of estrogen hormone
Estrogen inhibits bone resorption by osteoclasts. When estrogen levels drop significantly during menopause, the rate of bone breakdown exceeds the rate of bone formation, leading to rapid bone loss.
A client receiving a Denosumab injection every 6 months should be monitored for which potential complication?
- A Hypocalcemia
- B Hypercalcemia
- C Gastrointestinal bleeding
- D Hypotension
Correct answer: Hypocalcemia
Denosumab is a RANK ligand inhibitor that can cause significant hypocalcemia. Clients must be instructed to ensure adequate intake of calcium and vitamin D while on this therapy.
A nurse is teaching a community class about bone health. At what age does peak bone mass usually occur?
- A Between ages 12 and 18
- B Between ages 18 and 25
- C Between ages 40 and 45
- D Between ages 25 and 30
Correct answer: Between ages 25 and 30
Peak bone mass, the maximum amount of bone a person has, is typically reached between the ages of 25 and 30. After this peak, bone resorption slowly begins to exceed bone formation.
A male client is diagnosed with osteoporosis. Which risk factor is specifically relevant for men?
- A Low testosterone levels
- B High levels of growth hormone
- C Excessive intake of lean protein
- D History of BPH
Correct answer: Low testosterone levels
In men, testosterone is partially converted into estrogen, which protects bone density. Low testosterone (hypogonadism) is a major risk factor for the development of osteoporosis in men.
The nurse is caring for a client with a new hip fracture secondary to osteoporosis. Which nursing diagnosis is the priority?
- A Acute pain related to the fracture
- B Risk for impaired skin integrity
- C Disturbed body image
- D Deficient knowledge regarding calcium intake
Correct answer: Acute pain related to the fracture
Following an acute fracture, the priority is pain management and stabilization of the client. Pain can also lead to secondary complications like respiratory issues or refusal to move, which worsens the prognosis.
A client taking calcium carbonate supplements should be instructed to take the supplement in which manner?
- A In divided doses of 500 mg or less with food.
- B Once daily with a large glass of juice.
- C On an empty stomach at least 2 hours after a meal.
- D Only when experiencing symptoms of leg cramps.
Correct answer: In divided doses of 500 mg or less with food.
The body can only absorb about 500 mg of calcium at one time; therefore, large daily requirements should be split into smaller doses. Calcium carbonate also requires stomach acid for absorption and should be taken with meals.