Ortho NCLEX Exam Questions with
Complete Solutions
A retired 66- year- old female patient is being evaluated for osteoporosis as part of a
yearly physical exam. The patient states that she is a smoker, watches television for
most of the day, and has been hospitalized twice with fractures within the last year.
Based on this information, the nurse suspects which condition?
A.Low bone mass leading to increased bone fragility
B.Degeneration of the articular cartilage
C.Recurrent attacks of acute arthritis
D.Personality changes caused by chronic nature of illness - ANS-A. Low bone mass
leading to increased bone fragility
'
Low bone mass, structural deterioration of bone tissue leading to bone fragility, and
increased susceptibility to fractures are seen with osteoporosis. The patient also has
risk factors associated with osteoporosis: smoking, sedentary lifestyle, and being female
and menopausal. Degenerative changes are associated with frequent exacerbations of
arthritis. There is no indication of personality change in this patient.
The nurse determines that a 55- year-old female patient is experiencing menopause
and is also at risk for osteoporosis. What foods other than milk can the nurse suggest to
this patient to increase calcium intake?
A. Seafood, wheat, corn, green vegetables
B. Chicken vegetables, green vegetables, pasta, broccoli
C. Green vegetables, sardines, salmon with bone, molasses
D. Fresh fruits, English muffins, black beans, asparagus - ANS-Answer C is correct.
Women of menopausal age are at risk for osteoporosis, and foods high in calcium
should be encouraged. A diet with green vegetables, sardines, salmon with bone, and
molasses provides high- quality calcium and is recommended for a patient experiencing
menopause in order to decrease the risk of osteoporosis. A diet with seafood, wheat,
corn, and green vegetables is more concentrated in carbohydrates than proteins
containing more calcium. A diet with chicken, green vegetables, sardines, and broccoli
contains some calcium but is lower than the other option. Foods such as fresh fruits,
English muffins, black beans, and asparagus are inadequate in calcium.
A patient with osteoporosis has been advised to increase the amount of calcium in her
diet. Which food provides the most calcium?
An 8- oz glass of milk
An ounce of cheddar cheese
, A half cup of raw broccoli
A 4- ounce salmon croquette - ANS-Answer A is correct. An 8-ounce glass of milk
contains 290mg of calcium. Answers B, C, and D contain lesser amounts; therefore,
they are incorrect. (Note: An ounce of cheddar cheese contains 205 mg of calcium; half
a cup of raw broccoli contains 175mg of calcium; and 4 ounces of salmon croquette
contains 165 mg of calcium).
Which of the following instructions should be included for the patient taking calcium
supplements?
A.The patient should take her calcium with meals
B.The patient should take all her daily calcium supplements at one time
C.The patient should take her calcium supplement after meals to prevent stomach upset
D.The patient can use calcium- based antacids for supplement. - ANS-Rationale:
Answer D is correct. Many people prefer to supplement their calcium intake with
calcium- based antacids. If calcium supplements are used, they should be administered
30 minutes before meals to maximize absorption, so answer A is wrong. Calcium
absorption is better if it is administered throughout the day rather than in a single dose,
making answer B wrong. Calcium supplements do not cause stomach upset, so answer
C is wrong.
Alendronate (Fosamax) is ordered for a patient with osteoporosis. Which information
should the nurse teach the patient about the medication?
A. Acts as a selective estrogen receptor modulator
B. Reduces risk of invasive breast cancer
C. May be obtained as a nasal spray
D. Inhibits bone resorption - ANS-Alendronate (Fosamax), a bisphosphonate, is a
potent inhibitor of bone resorption that preserves bone mass and increases bone
density. Raloxifene (Evista) is an example of a selective estrogen receptor modulator
that is used to treat osteoporosis, and which also reduces the risk of invasive breast
cancer. Calcitonin (Miacalcin) is dispensed as a nasal spray.
The nurse is caring for a patient with osteoporosis who is being discharged on
alendronate (Fosamax). Which statement would indicate effective teaching?
A. "I should take the medication immediately before bed"
B. "I should remain in an upright position for 30 minutes after taking the medication"
C. "The medication is more effective if I take it with milk or dairy products"
D. If I skip a dose, I can take two tablets the next time" - ANS-Answer: B- Rationale
should remain upright for 30 mins.
How long does a patient taking bisphosphonates need to stay upright after
administration?
A. 10 minutes
B. 20 minutes
C. 30 minutes
D. 120 minutes - ANS-30 minutes
Complete Solutions
A retired 66- year- old female patient is being evaluated for osteoporosis as part of a
yearly physical exam. The patient states that she is a smoker, watches television for
most of the day, and has been hospitalized twice with fractures within the last year.
Based on this information, the nurse suspects which condition?
A.Low bone mass leading to increased bone fragility
B.Degeneration of the articular cartilage
C.Recurrent attacks of acute arthritis
D.Personality changes caused by chronic nature of illness - ANS-A. Low bone mass
leading to increased bone fragility
'
Low bone mass, structural deterioration of bone tissue leading to bone fragility, and
increased susceptibility to fractures are seen with osteoporosis. The patient also has
risk factors associated with osteoporosis: smoking, sedentary lifestyle, and being female
and menopausal. Degenerative changes are associated with frequent exacerbations of
arthritis. There is no indication of personality change in this patient.
The nurse determines that a 55- year-old female patient is experiencing menopause
and is also at risk for osteoporosis. What foods other than milk can the nurse suggest to
this patient to increase calcium intake?
A. Seafood, wheat, corn, green vegetables
B. Chicken vegetables, green vegetables, pasta, broccoli
C. Green vegetables, sardines, salmon with bone, molasses
D. Fresh fruits, English muffins, black beans, asparagus - ANS-Answer C is correct.
Women of menopausal age are at risk for osteoporosis, and foods high in calcium
should be encouraged. A diet with green vegetables, sardines, salmon with bone, and
molasses provides high- quality calcium and is recommended for a patient experiencing
menopause in order to decrease the risk of osteoporosis. A diet with seafood, wheat,
corn, and green vegetables is more concentrated in carbohydrates than proteins
containing more calcium. A diet with chicken, green vegetables, sardines, and broccoli
contains some calcium but is lower than the other option. Foods such as fresh fruits,
English muffins, black beans, and asparagus are inadequate in calcium.
A patient with osteoporosis has been advised to increase the amount of calcium in her
diet. Which food provides the most calcium?
An 8- oz glass of milk
An ounce of cheddar cheese
, A half cup of raw broccoli
A 4- ounce salmon croquette - ANS-Answer A is correct. An 8-ounce glass of milk
contains 290mg of calcium. Answers B, C, and D contain lesser amounts; therefore,
they are incorrect. (Note: An ounce of cheddar cheese contains 205 mg of calcium; half
a cup of raw broccoli contains 175mg of calcium; and 4 ounces of salmon croquette
contains 165 mg of calcium).
Which of the following instructions should be included for the patient taking calcium
supplements?
A.The patient should take her calcium with meals
B.The patient should take all her daily calcium supplements at one time
C.The patient should take her calcium supplement after meals to prevent stomach upset
D.The patient can use calcium- based antacids for supplement. - ANS-Rationale:
Answer D is correct. Many people prefer to supplement their calcium intake with
calcium- based antacids. If calcium supplements are used, they should be administered
30 minutes before meals to maximize absorption, so answer A is wrong. Calcium
absorption is better if it is administered throughout the day rather than in a single dose,
making answer B wrong. Calcium supplements do not cause stomach upset, so answer
C is wrong.
Alendronate (Fosamax) is ordered for a patient with osteoporosis. Which information
should the nurse teach the patient about the medication?
A. Acts as a selective estrogen receptor modulator
B. Reduces risk of invasive breast cancer
C. May be obtained as a nasal spray
D. Inhibits bone resorption - ANS-Alendronate (Fosamax), a bisphosphonate, is a
potent inhibitor of bone resorption that preserves bone mass and increases bone
density. Raloxifene (Evista) is an example of a selective estrogen receptor modulator
that is used to treat osteoporosis, and which also reduces the risk of invasive breast
cancer. Calcitonin (Miacalcin) is dispensed as a nasal spray.
The nurse is caring for a patient with osteoporosis who is being discharged on
alendronate (Fosamax). Which statement would indicate effective teaching?
A. "I should take the medication immediately before bed"
B. "I should remain in an upright position for 30 minutes after taking the medication"
C. "The medication is more effective if I take it with milk or dairy products"
D. If I skip a dose, I can take two tablets the next time" - ANS-Answer: B- Rationale
should remain upright for 30 mins.
How long does a patient taking bisphosphonates need to stay upright after
administration?
A. 10 minutes
B. 20 minutes
C. 30 minutes
D. 120 minutes - ANS-30 minutes
