ONC General Practice Exam Questions
with100% Correct answers
Quiz To establish the diagnosis of osteoporosis, a patient's primary care provider
orders a DEXA scan (dual energy x-ray absorptiometry). The patient asks the
nurse, "How will the test show if I have osteoporosis?" The nurse's response
should be based on knowledge that which of the following accurately describes
this procedure?
a. The patient will be given a radioactive isotope several hours before the scan,
and its uptake into the patient's bones will be measured.
b. The patient's bone density will be compared to the reference range of healthy
young adults.
c. The amount of calcium in the patient's bones will be compared to the patient's
serum values of osteocalcin and alkaline phosphatase.
d. The patient's peak bone mass will be measured by comparing the ratio of
cortical to cancellous bone in her distal forearm.
ANS: b. The patient's bone density will be compared to the reference range of
healthy young adults.
Rationale: DEXA compares a patient's bone density in the hip and spine to that of
a mean young adult normal reference range (known as the T-score). DEXA is a
noninvasive diagnostic that does not require the use of a radioisotope. There are
,also no associated laboratory studies, and assessment of the distal forearm is not
completed as part of DEXA scanning.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 96
Quiz A patient is newly diagnosed with osteoporosis and risedronate sodium
(Actonel®) is prescribed. The nurse should give which of these instructions about
the drug to the patient?
a. "Take the Actonel at night immediately before you got to bed."
b. "Take a multivitamin that contains 400 IU of vitamin D every day to promote
absorption of the Actonel."
c. "After taking Actonel, remain in an upright position for at least 30 minutes."
d. "Before taking Actonel, eat a small amount of food to prevent stomach
irritation."
ANS: c. "After taking Actonel, remain in an upright position for at least 30
minutes."
Rationale: Bisphosphonates such as Actonel need to be taken on an empty
stomach at least 30 minutes before breakfast, and the patient should remain in an
upright position.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 380, Table
14-1
Quiz A patient is suspected of having osteomalacia and is undergoing diagnostic
testing. The patient understands this disease is caused by inadequate intake of
vitamin D, but asks the nurse what other factors may have contributed to
development of this condition. Based on the patient's history, the nurse should
identify which of the following as a risk factor for decreased synthesis of vitamin
D?
a. Having renal disease
b. Having light skin
, c. Living at low altitude
d. Living on a farm
ANS: a. Having renal disease
Rationale: Adults affected by chronic diseases of the liver, kidney, and small
intestine have decreased bone mineralization related to vitamin D deficiency.
Dark skin does not synthesize vitamin D as easily as fair skin. Persons who live at
high altitudes also do not synthesize vitamin D as readily as those living at lower
altitudes. Living on a farm has no direct impact, but living in long-term care
facilities with limited exposure to sunlight can affect vitamin D synthesis.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 383
Quiz The mother of a 50-year-old patient has been diagnosed with osteoporosis.
The patient asks about her own risk for the disease. Based on discussion with the
patient about her history and lifestyle, the nurse should identify which of the
following as a risk factor for osteoporosis?
a. She is 10 pounds overweight.
b. She smokes one pack of cigarettes per day.
c. She drinks two cups of coffee every morning.
d. She never had children.
ANS: b. She smokes one pack of cigarettes per day.
Rationale: Smoking has been shown to increase the incidence of osteoporosis by
influencing the onset of menopause and the lowering of bone mineral density.
Being overweight does not contribute to osteoporosis; two cups of coffee a day is
moderate intake of caffeine and not considered a risk factor. Never having had
children is only a factor if it contributes to early menopause.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 379
with100% Correct answers
Quiz To establish the diagnosis of osteoporosis, a patient's primary care provider
orders a DEXA scan (dual energy x-ray absorptiometry). The patient asks the
nurse, "How will the test show if I have osteoporosis?" The nurse's response
should be based on knowledge that which of the following accurately describes
this procedure?
a. The patient will be given a radioactive isotope several hours before the scan,
and its uptake into the patient's bones will be measured.
b. The patient's bone density will be compared to the reference range of healthy
young adults.
c. The amount of calcium in the patient's bones will be compared to the patient's
serum values of osteocalcin and alkaline phosphatase.
d. The patient's peak bone mass will be measured by comparing the ratio of
cortical to cancellous bone in her distal forearm.
ANS: b. The patient's bone density will be compared to the reference range of
healthy young adults.
Rationale: DEXA compares a patient's bone density in the hip and spine to that of
a mean young adult normal reference range (known as the T-score). DEXA is a
noninvasive diagnostic that does not require the use of a radioisotope. There are
,also no associated laboratory studies, and assessment of the distal forearm is not
completed as part of DEXA scanning.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 96
Quiz A patient is newly diagnosed with osteoporosis and risedronate sodium
(Actonel®) is prescribed. The nurse should give which of these instructions about
the drug to the patient?
a. "Take the Actonel at night immediately before you got to bed."
b. "Take a multivitamin that contains 400 IU of vitamin D every day to promote
absorption of the Actonel."
c. "After taking Actonel, remain in an upright position for at least 30 minutes."
d. "Before taking Actonel, eat a small amount of food to prevent stomach
irritation."
ANS: c. "After taking Actonel, remain in an upright position for at least 30
minutes."
Rationale: Bisphosphonates such as Actonel need to be taken on an empty
stomach at least 30 minutes before breakfast, and the patient should remain in an
upright position.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 380, Table
14-1
Quiz A patient is suspected of having osteomalacia and is undergoing diagnostic
testing. The patient understands this disease is caused by inadequate intake of
vitamin D, but asks the nurse what other factors may have contributed to
development of this condition. Based on the patient's history, the nurse should
identify which of the following as a risk factor for decreased synthesis of vitamin
D?
a. Having renal disease
b. Having light skin
, c. Living at low altitude
d. Living on a farm
ANS: a. Having renal disease
Rationale: Adults affected by chronic diseases of the liver, kidney, and small
intestine have decreased bone mineralization related to vitamin D deficiency.
Dark skin does not synthesize vitamin D as easily as fair skin. Persons who live at
high altitudes also do not synthesize vitamin D as readily as those living at lower
altitudes. Living on a farm has no direct impact, but living in long-term care
facilities with limited exposure to sunlight can affect vitamin D synthesis.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 383
Quiz The mother of a 50-year-old patient has been diagnosed with osteoporosis.
The patient asks about her own risk for the disease. Based on discussion with the
patient about her history and lifestyle, the nurse should identify which of the
following as a risk factor for osteoporosis?
a. She is 10 pounds overweight.
b. She smokes one pack of cigarettes per day.
c. She drinks two cups of coffee every morning.
d. She never had children.
ANS: b. She smokes one pack of cigarettes per day.
Rationale: Smoking has been shown to increase the incidence of osteoporosis by
influencing the onset of menopause and the lowering of bone mineral density.
Being overweight does not contribute to osteoporosis; two cups of coffee a day is
moderate intake of caffeine and not considered a risk factor. Never having had
children is only a factor if it contributes to early menopause.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 379
