OSTEOPOROSIS NCLEX FINAL EXAM 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔All of the following are risk factors for osteoporo-sis EXCEPT:
(A) Low calcium intake
(B) Smoking
(C) Alcohol use
(D) Turner's syndrome
(E) Obesity - ✔✔(E) Obesity.
Risk factors for osteoporosis may be
inherited or acquired.
1,2
Inherited factors include
female sex and white or Asian ancestry. Women with
Turner's syndrome or any condition leading to low
estrogen levels are at increased risk of osteoporosis.
Women with a personal history of fracture as an
adult or history of osteoporosis in a first-degree rela-
tive also are at increased risk. Acquired risk factors
include current smoking (
≥
1 pack per day), alco-
hol use (
≥
2 drinks per day), low calcium intake
(< 1200 mg per day), and sedentary lifestyle. Finally,
women with low body weight (< 127 lb) are at in-
creased risk for osteoporosis. Guidelines for osteo-
porosis screening and prevention are available only
for women at this time.
✔✔Which of the following medical conditions or med-
ications can lead to secondary osteoporosis?
(A) Hypothyroidism
(B) Zinc deficiency
(C) Type 2 diabetes mellitus
(D) Gonadotropin- releasing hormone (GnRH)
agonists
(E) Angiotensin- converting enzyme (ACE)
inhibitors - ✔✔(D) GnRH agonists.
Osteoporosis can occur sec-
ondary to any condition or medication that causes
accelerated bone loss.
2
Conditions that may cause
, secondary osteoporosis include athletic amenor-
rhea, anorexia nervosa, hyperthyroidism, type 1 dia-
betes mellitus, and malabsorption syndromes. Med-
ications that can cause secondary osteoporosis
include excessive use of thyroid hormone, oral corti-
costeroids (taken for > 3 months' duration), GnRH
agonists, phenytoin, phenothiazines, long - term
heparin, and phenobarbital. ACE inhibitors and zinc
deficiency do not cause osteoporosis.
✔✔A 50 - year - old African American woman visits your office for an annual
examination. She takes inhaled steroids and Beta- agonists for mild intermittent
asthma. Her past medical history is negative for any fracture. She has no family history
of osteoporosis. She exercises regularly. Her menses are
regular. Based on her history, what are your recommendations for osteoporosis
prevention and screening?
(A) Take 800 mg of calcium and 800 IU vitamin D
daily
(B) Take 1200 mg of calcium and 400 IU vitamin
D daily
(C) Bone mineral density (BMD) screening
(D) Begin calcitonin therapy to increase bone
density
(E) Begin alendronate therapy to increase bone
density - ✔✔(B) Take 1200 mg of calcium and 400 IU vitamin D daily.
This patient has no risk factors for osteoporosis. Although oral steroids are a recognized
cause of
increased bone loss in adults, inhaled steroids are not. The National Osteoporosis
Foundation (NOF)advises that all individuals consume at least 1200 mg
of calcium and 400 to 800 IU vitamin D daily.
The US Preventive Services Task Force recommends that physicians conduct routine
BMD screening for all women older than 65 years.
For women with risk
factors for osteoporosis, screening is recommended beginning at age 60 years.
Alendronate is a Food
and Drug Administration (FDA)-approved medication for prevention and treatment of
osteoporosis.
Calcitonin is approved for treatment of osteoporosis
only, not prevention.
✔✔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
QUESTIONS AND SOLUTIONS RATED A+
✔✔All of the following are risk factors for osteoporo-sis EXCEPT:
(A) Low calcium intake
(B) Smoking
(C) Alcohol use
(D) Turner's syndrome
(E) Obesity - ✔✔(E) Obesity.
Risk factors for osteoporosis may be
inherited or acquired.
1,2
Inherited factors include
female sex and white or Asian ancestry. Women with
Turner's syndrome or any condition leading to low
estrogen levels are at increased risk of osteoporosis.
Women with a personal history of fracture as an
adult or history of osteoporosis in a first-degree rela-
tive also are at increased risk. Acquired risk factors
include current smoking (
≥
1 pack per day), alco-
hol use (
≥
2 drinks per day), low calcium intake
(< 1200 mg per day), and sedentary lifestyle. Finally,
women with low body weight (< 127 lb) are at in-
creased risk for osteoporosis. Guidelines for osteo-
porosis screening and prevention are available only
for women at this time.
✔✔Which of the following medical conditions or med-
ications can lead to secondary osteoporosis?
(A) Hypothyroidism
(B) Zinc deficiency
(C) Type 2 diabetes mellitus
(D) Gonadotropin- releasing hormone (GnRH)
agonists
(E) Angiotensin- converting enzyme (ACE)
inhibitors - ✔✔(D) GnRH agonists.
Osteoporosis can occur sec-
ondary to any condition or medication that causes
accelerated bone loss.
2
Conditions that may cause
, secondary osteoporosis include athletic amenor-
rhea, anorexia nervosa, hyperthyroidism, type 1 dia-
betes mellitus, and malabsorption syndromes. Med-
ications that can cause secondary osteoporosis
include excessive use of thyroid hormone, oral corti-
costeroids (taken for > 3 months' duration), GnRH
agonists, phenytoin, phenothiazines, long - term
heparin, and phenobarbital. ACE inhibitors and zinc
deficiency do not cause osteoporosis.
✔✔A 50 - year - old African American woman visits your office for an annual
examination. She takes inhaled steroids and Beta- agonists for mild intermittent
asthma. Her past medical history is negative for any fracture. She has no family history
of osteoporosis. She exercises regularly. Her menses are
regular. Based on her history, what are your recommendations for osteoporosis
prevention and screening?
(A) Take 800 mg of calcium and 800 IU vitamin D
daily
(B) Take 1200 mg of calcium and 400 IU vitamin
D daily
(C) Bone mineral density (BMD) screening
(D) Begin calcitonin therapy to increase bone
density
(E) Begin alendronate therapy to increase bone
density - ✔✔(B) Take 1200 mg of calcium and 400 IU vitamin D daily.
This patient has no risk factors for osteoporosis. Although oral steroids are a recognized
cause of
increased bone loss in adults, inhaled steroids are not. The National Osteoporosis
Foundation (NOF)advises that all individuals consume at least 1200 mg
of calcium and 400 to 800 IU vitamin D daily.
The US Preventive Services Task Force recommends that physicians conduct routine
BMD screening for all women older than 65 years.
For women with risk
factors for osteoporosis, screening is recommended beginning at age 60 years.
Alendronate is a Food
and Drug Administration (FDA)-approved medication for prevention and treatment of
osteoporosis.
Calcitonin is approved for treatment of osteoporosis
only, not prevention.
✔✔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
