ADVANCED MED SURG PRINCIPLES STUDY
GUIDE 2026 COMPREHENSIVE CLINICAL
QUESTIONS AND SOLUTIONS
◉ Ch 41: What diagnostic test is used to measure bone density and
diagnose osteoporosis?
Answer: DEXA (dual-energy x-ray absorptiometry) scan: T score of -
2.5
◉ Ch 41: What does long time use of antibiotics put a pt at increases
risk for?
Answer: superinfections (oral or vaginal candidiasis,
pseudomembranous colitis)
◉ Ch 41: What two things does the med bisphosphonates
(alendronate) treat for in a osteoporosis pt?
Answer: - inhibits osteoclaststic activity
- promotes calcium deposition into bone
◉ Ch 41: What is a potential complication for the pt from the use of
bisphosphonates in the treat of osteoporosis?
,Answer: osteoencrosis of the jaw (oral lesion involving bare
mandibular or maxillary bone) so encourage yearly dental evals
◉ Ch 41: How would the pt take oral bisphosphonates?
Answer: - on an empty stomach
- with 8 oz of water
- sit upright for at least 30 - 60 mins afterwards
(if done otherwise could put the pt at risk for esophageal ulcers)
◉ Ch 41: What are some non-pharmacological pain mgmt
strategies?
Answer: - physical modalities
- mind-body methods
- biologic therapies
- energy based therapies
◉ Ch 41: How is osteroporosis formed?
Answer: when osteoclastic activity is greater that osteoblastic
activity bones become porous and brittle
◉ Ch 41: What will weaken the bone and typically requires weight-
bearing restrictions?
Answer: osteomyelitis
,◉ Ch 41: What are S/S of osteomyelitis?
Answer: - pain
- swelling
- warmth
- elevated ESR (erythrocyte sedimentation rate)
- leukocytosis
◉ Ch 41: What are two things that osteoporosis can lead to?
Answer: - painful vertebral compression fractures
- reduction in height
◉ Ch 41: What group of people are at the greatest risk for
osteoporosis?
Answer: - thin women
- Asian women
- Causasian women
◉ Ch 41: When pain stimulates the sympathetic nervous system it
can result in?
Answer: - increase in BP
- Increase in HR
, - increase in RR
◉ Ch 41: What does a comprehensive pain assessment include?
Answer: - duration (includes when it started)
- type (include intensity, associated factors, in fluencing factors, what
makes it better or worse)
- location
◉ Ch 41: What do you manage nociceptive (type of receptor that
exists to feel all and any pain that's likely to be caused by the body
being harmed) pain with?
Answer: - local anesthetics
- non-opioids
- opioids
◉ Ch 41: What proper body mechanic instructions would you give to
a pt to help relieve pain?
Answer: - weight reduction
- strengthening exercises
- lift objects using a wide base of support, use the leg and arm
muscles, not the back, bend knees, avoid twisting the back, keep
objects close to the body
- push don't pull objects/things
GUIDE 2026 COMPREHENSIVE CLINICAL
QUESTIONS AND SOLUTIONS
◉ Ch 41: What diagnostic test is used to measure bone density and
diagnose osteoporosis?
Answer: DEXA (dual-energy x-ray absorptiometry) scan: T score of -
2.5
◉ Ch 41: What does long time use of antibiotics put a pt at increases
risk for?
Answer: superinfections (oral or vaginal candidiasis,
pseudomembranous colitis)
◉ Ch 41: What two things does the med bisphosphonates
(alendronate) treat for in a osteoporosis pt?
Answer: - inhibits osteoclaststic activity
- promotes calcium deposition into bone
◉ Ch 41: What is a potential complication for the pt from the use of
bisphosphonates in the treat of osteoporosis?
,Answer: osteoencrosis of the jaw (oral lesion involving bare
mandibular or maxillary bone) so encourage yearly dental evals
◉ Ch 41: How would the pt take oral bisphosphonates?
Answer: - on an empty stomach
- with 8 oz of water
- sit upright for at least 30 - 60 mins afterwards
(if done otherwise could put the pt at risk for esophageal ulcers)
◉ Ch 41: What are some non-pharmacological pain mgmt
strategies?
Answer: - physical modalities
- mind-body methods
- biologic therapies
- energy based therapies
◉ Ch 41: How is osteroporosis formed?
Answer: when osteoclastic activity is greater that osteoblastic
activity bones become porous and brittle
◉ Ch 41: What will weaken the bone and typically requires weight-
bearing restrictions?
Answer: osteomyelitis
,◉ Ch 41: What are S/S of osteomyelitis?
Answer: - pain
- swelling
- warmth
- elevated ESR (erythrocyte sedimentation rate)
- leukocytosis
◉ Ch 41: What are two things that osteoporosis can lead to?
Answer: - painful vertebral compression fractures
- reduction in height
◉ Ch 41: What group of people are at the greatest risk for
osteoporosis?
Answer: - thin women
- Asian women
- Causasian women
◉ Ch 41: When pain stimulates the sympathetic nervous system it
can result in?
Answer: - increase in BP
- Increase in HR
, - increase in RR
◉ Ch 41: What does a comprehensive pain assessment include?
Answer: - duration (includes when it started)
- type (include intensity, associated factors, in fluencing factors, what
makes it better or worse)
- location
◉ Ch 41: What do you manage nociceptive (type of receptor that
exists to feel all and any pain that's likely to be caused by the body
being harmed) pain with?
Answer: - local anesthetics
- non-opioids
- opioids
◉ Ch 41: What proper body mechanic instructions would you give to
a pt to help relieve pain?
Answer: - weight reduction
- strengthening exercises
- lift objects using a wide base of support, use the leg and arm
muscles, not the back, bend knees, avoid twisting the back, keep
objects close to the body
- push don't pull objects/things
