MENOPAUSE SOCIETY CERTIFIED PRACTITIONER (MSCP)
EXAM| NAMS MENOPAUSE EXAM BANK| REAL EXAM
CURRENTLY TESTING | EXPERT VERIFIED FOR
GUARANTEED PASS 2026
1. Which bone mineral density (BMD) finding meets the World Health Organization
(WHO) definition of osteoporosis?
A. T-score ≤ −1.0 at the lumbar spine
B. T-score between −1.0 and −2.5 at the femoral neck
C. T-score ≤ −2.5 at the lumbar spine, femoral neck, or total hip
D. Z-score ≤ −2.0 at any site
Correct answer: C
Rationale:
WHO defines osteoporosis as a T-score ≤ −2.5 measured by DXA at the lumbar spine, femoral
neck, or total hip. Osteopenia is defined by a T-score between −1.0 and −2.5. Z-scores are not
used to define osteoporosis in postmenopausal women.
2. According to The Menopause Society, routine DXA screening for osteoporosis is
recommended in postmenopausal women beginning at what age?
A. 50 years
B. 55 years
C. 60 years
D. 65 years
Correct answer: D
1
,Rationale:
Routine DXA screening is recommended for all postmenopausal women aged 65 years and
older, or younger women with clinical risk factors for fracture.
3. Osteopenia on DXA is defined by which T-score range?
A. Greater than −1.0
B. −1.0 to −2.5
C. Less than −2.5
D. Less than −3.0
Correct answer: B
Rationale:
A T-score between −1.0 and −2.5 defines osteopenia. A score ≤ −2.5 defines osteoporosis.
4. What is the primary mechanism by which menopause accelerates bone loss?
A. Increased osteoblast activity
B. Decreased calcium absorption
C. Estrogen deficiency leading to increased bone resorption
D. Increased parathyroid hormone secretion
Correct answer: C
Rationale:
Loss of estrogen after menopause increases osteoclast-mediated bone resorption, resulting in
rapid bone loss, especially in the early postmenopausal years.
2
,5. Which of the following is a major risk factor for low bone mass and fracture in
postmenopausal women?
A. High dietary protein intake
B. Prior fragility fracture
C. Late menopause
D. Obesity
Correct answer: B
Rationale:
A prior fragility fracture is one of the strongest predictors of future fracture risk. Advanced age
and chronic glucocorticoid use are also major risk factors.
6. Which clinical tool is most commonly used to estimate 10-year fracture risk?
A. DXA
B. STRAW+10
C. FRAX
D. BMI
Correct answer: C
Rationale:
FRAX estimates the 10-year probability of hip and major osteoporotic fractures using clinical
risk factors, with or without BMD.
7. Pharmacologic therapy for osteoporosis is recommended when FRAX shows which risk
threshold?
A. Hip fracture ≥1% or major fracture ≥10%
B. Hip fracture ≥2% or major fracture ≥15%
3
, C. Hip fracture ≥3% or major fracture ≥20%
D. Any elevated FRAX score
Correct answer: C
Rationale:
Treatment is recommended when the 10-year hip fracture risk is ≥3% or major osteoporotic
fracture risk is ≥20%.
8. Which medication class is considered first-line therapy for osteoporosis in most
postmenopausal women?
A. Selective estrogen receptor modulators
B. Calcitonin
C. Bisphosphonates
D. Estrogen therapy
Correct answer: C
Rationale:
Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid) are first-line due to proven
fracture risk reduction and safety data.
9. What is the appropriate role of menopausal hormone therapy (HT) in bone health?
A. First-line treatment for established osteoporosis
B. Ineffective for bone protection
C. Useful for prevention of bone loss in early menopause
D. Contraindicated in all women at fracture risk
Correct answer: C
4
EXAM| NAMS MENOPAUSE EXAM BANK| REAL EXAM
CURRENTLY TESTING | EXPERT VERIFIED FOR
GUARANTEED PASS 2026
1. Which bone mineral density (BMD) finding meets the World Health Organization
(WHO) definition of osteoporosis?
A. T-score ≤ −1.0 at the lumbar spine
B. T-score between −1.0 and −2.5 at the femoral neck
C. T-score ≤ −2.5 at the lumbar spine, femoral neck, or total hip
D. Z-score ≤ −2.0 at any site
Correct answer: C
Rationale:
WHO defines osteoporosis as a T-score ≤ −2.5 measured by DXA at the lumbar spine, femoral
neck, or total hip. Osteopenia is defined by a T-score between −1.0 and −2.5. Z-scores are not
used to define osteoporosis in postmenopausal women.
2. According to The Menopause Society, routine DXA screening for osteoporosis is
recommended in postmenopausal women beginning at what age?
A. 50 years
B. 55 years
C. 60 years
D. 65 years
Correct answer: D
1
,Rationale:
Routine DXA screening is recommended for all postmenopausal women aged 65 years and
older, or younger women with clinical risk factors for fracture.
3. Osteopenia on DXA is defined by which T-score range?
A. Greater than −1.0
B. −1.0 to −2.5
C. Less than −2.5
D. Less than −3.0
Correct answer: B
Rationale:
A T-score between −1.0 and −2.5 defines osteopenia. A score ≤ −2.5 defines osteoporosis.
4. What is the primary mechanism by which menopause accelerates bone loss?
A. Increased osteoblast activity
B. Decreased calcium absorption
C. Estrogen deficiency leading to increased bone resorption
D. Increased parathyroid hormone secretion
Correct answer: C
Rationale:
Loss of estrogen after menopause increases osteoclast-mediated bone resorption, resulting in
rapid bone loss, especially in the early postmenopausal years.
2
,5. Which of the following is a major risk factor for low bone mass and fracture in
postmenopausal women?
A. High dietary protein intake
B. Prior fragility fracture
C. Late menopause
D. Obesity
Correct answer: B
Rationale:
A prior fragility fracture is one of the strongest predictors of future fracture risk. Advanced age
and chronic glucocorticoid use are also major risk factors.
6. Which clinical tool is most commonly used to estimate 10-year fracture risk?
A. DXA
B. STRAW+10
C. FRAX
D. BMI
Correct answer: C
Rationale:
FRAX estimates the 10-year probability of hip and major osteoporotic fractures using clinical
risk factors, with or without BMD.
7. Pharmacologic therapy for osteoporosis is recommended when FRAX shows which risk
threshold?
A. Hip fracture ≥1% or major fracture ≥10%
B. Hip fracture ≥2% or major fracture ≥15%
3
, C. Hip fracture ≥3% or major fracture ≥20%
D. Any elevated FRAX score
Correct answer: C
Rationale:
Treatment is recommended when the 10-year hip fracture risk is ≥3% or major osteoporotic
fracture risk is ≥20%.
8. Which medication class is considered first-line therapy for osteoporosis in most
postmenopausal women?
A. Selective estrogen receptor modulators
B. Calcitonin
C. Bisphosphonates
D. Estrogen therapy
Correct answer: C
Rationale:
Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid) are first-line due to proven
fracture risk reduction and safety data.
9. What is the appropriate role of menopausal hormone therapy (HT) in bone health?
A. First-line treatment for established osteoporosis
B. Ineffective for bone protection
C. Useful for prevention of bone loss in early menopause
D. Contraindicated in all women at fracture risk
Correct answer: C
4
