OSTEOPOROSIS NCLEX COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔A 65 - year - old white woman presents for interpretation of BMD testing. Her
personal medical history is unremarkable, but her mother died at age 75 years
due to complications of a hip fracture. Her T score is - 2. Which of the following choices
is the correct interpretation of this patient's T score and treatment?
(A) Normal BMD; calcium supplementation
(B) Normal BMD; alendronate for prevention
(C) Osteopenia; zinc supplementation for preven-
tion
(D) Osteopenia; alendronate for treatment
(E) Osteoporosis; residronate for treatment - ✔✔(D) Osteopenia; alendronate for
treatment.
The T score compares the patient's BMD in standard
deviations with the average BMD of a young adult of the same gender. T score between
0 and - 1 indi-
cates normal bone density. A T score between - 1 and - 2.5 are consistent with
osteopenia. T score 2.5 standard deviations or more below the standard (T score
≤- 2.5) indicates osteoporosis. This patientis at increased risk for osteoporosis owing to
her
race and family history. Her BMD testing results indicate that she has osteopenia.
✔✔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 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 nurse is conducting a health screening among females at the mall to assess those
who are at risk for developing osteoporosis. Which of the following questions is most
appropriate to be asked by the nurse in relation to development of osteoporosis?
a) at what age did you have your menstruation?
b) did you have any fracture?
c) are you taking corticosteroids?
d) are you on the diet high in vitamin D? - ✔✔C
- corticosteroids promote calcium loss. This increases the risk for osteoporosis.
QUESTIONS AND SOLUTIONS RATED A+
✔✔A 65 - year - old white woman presents for interpretation of BMD testing. Her
personal medical history is unremarkable, but her mother died at age 75 years
due to complications of a hip fracture. Her T score is - 2. Which of the following choices
is the correct interpretation of this patient's T score and treatment?
(A) Normal BMD; calcium supplementation
(B) Normal BMD; alendronate for prevention
(C) Osteopenia; zinc supplementation for preven-
tion
(D) Osteopenia; alendronate for treatment
(E) Osteoporosis; residronate for treatment - ✔✔(D) Osteopenia; alendronate for
treatment.
The T score compares the patient's BMD in standard
deviations with the average BMD of a young adult of the same gender. T score between
0 and - 1 indi-
cates normal bone density. A T score between - 1 and - 2.5 are consistent with
osteopenia. T score 2.5 standard deviations or more below the standard (T score
≤- 2.5) indicates osteoporosis. This patientis at increased risk for osteoporosis owing to
her
race and family history. Her BMD testing results indicate that she has osteopenia.
✔✔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 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 nurse is conducting a health screening among females at the mall to assess those
who are at risk for developing osteoporosis. Which of the following questions is most
appropriate to be asked by the nurse in relation to development of osteoporosis?
a) at what age did you have your menstruation?
b) did you have any fracture?
c) are you taking corticosteroids?
d) are you on the diet high in vitamin D? - ✔✔C
- corticosteroids promote calcium loss. This increases the risk for osteoporosis.
