NURS 5334 Final Exam/Antimicrobial Review
Questions | Comprehensive Question Bank with
Verified Correct Answers and Detailed Rationales
| Latest Update 2026/2027 | The University of
Texas at Arlington (UTA) | Already Graded A+
Question 1
A 45-year-old African American woman who was a previous smoker has a BMI of
32 kg/m2. She is currently on a 1-week taper of Prednisone for an asthma flare.
She is also taking Lisinopril 20 mg for HTN. Which of the following is associated
with the most INCREASED risk for her developing osteoporosis in this patient?
A. AA ethnicity
B. Past smoker
C. Present use of steroids
D. Female gender
E. BMI > 30 kg/m2
Answer: D
Rationale: Female gender is the strongest risk factor for osteoporosis among the
options listed. While steroid use, smoking, and BMI are also risk factors, female
gender carries the highest risk. African American ethnicity is actually associated
with lower osteoporosis risk compared to Caucasian or Asian ethnicity.
Question 2
A 72-year-old woman with a history of vertebral compression fracture and a
DEXA T score of -2.7 in the left hip. What is the best initial therapy for this
patient?
A. Fosamax [Alendronate] 70 mg weekly
B. Calcitonin [1] spray to alternating nares qd
C. Prempro [estrogen/progestin] 0.625/2.5 mg [1] qd
D. Prolia [Denosumab] 60 mg SQ every 6 months
Answer: A
Rationale: Alendronate (Fosamax) is first-line therapy for osteoporosis in patients
with a history of fragility fracture and T-score < -2.5. It is a bisphosphonate that
pg. 1
,reduces fracture risk and is cost-effective. Denosumab is also effective but is
typically used as second-line or when bisphosphonates are contraindicated.
Question 3
A 75-year-old woman with newly diagnosed osteoporosis, being discharged after
total hip replacement due to right hip fracture. She has never been on medication
for osteoporosis. PMH is significant for severe GERD, DVT (20 years ago), atrial
fibrillation and family history of breast cancer. Which therapy may offer the
MOST benefit in this patient?
A. Prolia [Denosumab] 60 mg SQ every 6 months
B. Calcitonin [1] spray to alternative nares qd
C. Evista [Raloxifene] 60 mg daily
D. Forteo [Teriparatide] 20 mcg SC daily
E. Reclast [Zoledronic acid] 5 mg IV every 12 months
Answer: A
Rationale: Denosumab (Prolia) is the best option given her severe GERD
(bisphosphonates are contraindicated), history of DVT (raloxifene increases DVT
risk), and family history of breast cancer (raloxifene is used for breast cancer risk
reduction but has DVT risk). Denosumab does not cause GI irritation and is not
associated with DVT risk.
Question 4
A 68-year-old postmenopausal woman with a history of T2DM, CAD,
dyslipidemia, GERD, OA of knees, stage 3 CKD. Recent EGD was unremarkable.
DEXA scan showed T score of -3 of the left hip. Which of the following precludes
the use of a bisphosphonate?
A. Age
B. Renal disease
C. GERD
D. OA
E. DM
Answer: B
Rationale: Stage 3 CKD (eGFR < 60 mL/min) precludes the use of
bisphosphonates due to the risk of nephrotoxicity and accumulation.
Bisphosphonates are renally excreted and can cause acute kidney injury in patients
pg. 2
,with renal impairment.
Question 5
A 53-year-old woman with history of esophageal stricture—recently treated
successfully with dilatation—from longstanding GERD, and vasomotor symptoms
of menopause. A recent DEXA showed a T score of -2.5 of the LS spine and -2.6
in the left hip. Which therapy is MOST appropriate?
A. Prolia [Denosumab] 60 mg SQ every 6 months
B. Evista [Raloxifene] 60 mg po daily
C. Actonel [Risedronate] 35 mg po weekly
D. Boniva [Ibandronate] 150 mg po monthly
E. Calcitonin 200 units alternate nares qd
Answer: A
Rationale: Denosumab is the most appropriate therapy for this patient with a
history of esophageal stricture and GERD, which precludes the use of oral
bisphosphonates due to the risk of esophageal irritation and stricture recurrence.
Denosumab is a subcutaneous injection that bypasses the GI tract.
Question 6
A 38-year-old woman who is at a health fair asks what she can do to maintain her
bone health. Her mum had severe osteoporosis with vertebral fractures, spinal
kyphosis, hip fracture and limited mobility. Your patient is 64 inches tall and
weighs 115 pounds. She is postmenopausal. Her meds include OCP and a
multivitamin daily; her DEXA scan shows a T score of 1.3 and a Z score of -8.
Which exercise regimen is going to be most helpful to improve her bone health?
A. Stair climbing
B. Cycling
C. Water aerobics
D. Yoga
E. Spin class
F. Running
G. A, D and F
H. A and F
Answer: G
Rationale: Weight-bearing exercises are most beneficial for bone health. Stair
pg. 3
, climbing (A), yoga (D), and running (F) are all weight-bearing exercises that stress
bones and promote bone density. Cycling, water aerobics, and spin class are non-
weight-bearing exercises that do not significantly improve bone density.
Question 7
A 68-year-old man with several risk factors for osteoporosis: cigarette smoking,
drinking 3-5 alcoholic drinks/day, low body weight and sedentary lifestyle. Labs
reveal a 25 Vitamin D level of 18 mcg. Of the following, what will you
recommend?
A. Increase dietary intake of milk, eggs and catfish
B. Increase sun exposure
C. Calcium citrate with Vitamin D [200/200 IU] BID
D. Vitamin D2 50,000 IU daily for 6-12 months
E. Vitamin D3 [Calcitriol] 0.5 mcg daily for 8 weeks, then 5,000 IU thereafter
Answer: E
Rationale: Vitamin D3 (calcitriol) 0.5 mcg daily for 8 weeks followed by 5,000 IU
daily is the most appropriate treatment for significant Vitamin D deficiency (level
< 20 ng/mL). This provides rapid correction followed by maintenance therapy.
Dietary changes and sun exposure are insufficient for this level of deficiency.
Question 8
Which agent(s) has/have a low likelihood of causing CV adverse effects in a
patient with BPH who is also taking medications for HTN?
1. Alfuzosin [Uroxatrol]
2. Tamsulosin [Flomax]
3. Finasteride [Proscar]
A. 1 only
B. 2 only
C. 3 only
D. 1 and 3
E. 2 and 3
F. 1, 2 and 3
Answer: E
pg. 4
Questions | Comprehensive Question Bank with
Verified Correct Answers and Detailed Rationales
| Latest Update 2026/2027 | The University of
Texas at Arlington (UTA) | Already Graded A+
Question 1
A 45-year-old African American woman who was a previous smoker has a BMI of
32 kg/m2. She is currently on a 1-week taper of Prednisone for an asthma flare.
She is also taking Lisinopril 20 mg for HTN. Which of the following is associated
with the most INCREASED risk for her developing osteoporosis in this patient?
A. AA ethnicity
B. Past smoker
C. Present use of steroids
D. Female gender
E. BMI > 30 kg/m2
Answer: D
Rationale: Female gender is the strongest risk factor for osteoporosis among the
options listed. While steroid use, smoking, and BMI are also risk factors, female
gender carries the highest risk. African American ethnicity is actually associated
with lower osteoporosis risk compared to Caucasian or Asian ethnicity.
Question 2
A 72-year-old woman with a history of vertebral compression fracture and a
DEXA T score of -2.7 in the left hip. What is the best initial therapy for this
patient?
A. Fosamax [Alendronate] 70 mg weekly
B. Calcitonin [1] spray to alternating nares qd
C. Prempro [estrogen/progestin] 0.625/2.5 mg [1] qd
D. Prolia [Denosumab] 60 mg SQ every 6 months
Answer: A
Rationale: Alendronate (Fosamax) is first-line therapy for osteoporosis in patients
with a history of fragility fracture and T-score < -2.5. It is a bisphosphonate that
pg. 1
,reduces fracture risk and is cost-effective. Denosumab is also effective but is
typically used as second-line or when bisphosphonates are contraindicated.
Question 3
A 75-year-old woman with newly diagnosed osteoporosis, being discharged after
total hip replacement due to right hip fracture. She has never been on medication
for osteoporosis. PMH is significant for severe GERD, DVT (20 years ago), atrial
fibrillation and family history of breast cancer. Which therapy may offer the
MOST benefit in this patient?
A. Prolia [Denosumab] 60 mg SQ every 6 months
B. Calcitonin [1] spray to alternative nares qd
C. Evista [Raloxifene] 60 mg daily
D. Forteo [Teriparatide] 20 mcg SC daily
E. Reclast [Zoledronic acid] 5 mg IV every 12 months
Answer: A
Rationale: Denosumab (Prolia) is the best option given her severe GERD
(bisphosphonates are contraindicated), history of DVT (raloxifene increases DVT
risk), and family history of breast cancer (raloxifene is used for breast cancer risk
reduction but has DVT risk). Denosumab does not cause GI irritation and is not
associated with DVT risk.
Question 4
A 68-year-old postmenopausal woman with a history of T2DM, CAD,
dyslipidemia, GERD, OA of knees, stage 3 CKD. Recent EGD was unremarkable.
DEXA scan showed T score of -3 of the left hip. Which of the following precludes
the use of a bisphosphonate?
A. Age
B. Renal disease
C. GERD
D. OA
E. DM
Answer: B
Rationale: Stage 3 CKD (eGFR < 60 mL/min) precludes the use of
bisphosphonates due to the risk of nephrotoxicity and accumulation.
Bisphosphonates are renally excreted and can cause acute kidney injury in patients
pg. 2
,with renal impairment.
Question 5
A 53-year-old woman with history of esophageal stricture—recently treated
successfully with dilatation—from longstanding GERD, and vasomotor symptoms
of menopause. A recent DEXA showed a T score of -2.5 of the LS spine and -2.6
in the left hip. Which therapy is MOST appropriate?
A. Prolia [Denosumab] 60 mg SQ every 6 months
B. Evista [Raloxifene] 60 mg po daily
C. Actonel [Risedronate] 35 mg po weekly
D. Boniva [Ibandronate] 150 mg po monthly
E. Calcitonin 200 units alternate nares qd
Answer: A
Rationale: Denosumab is the most appropriate therapy for this patient with a
history of esophageal stricture and GERD, which precludes the use of oral
bisphosphonates due to the risk of esophageal irritation and stricture recurrence.
Denosumab is a subcutaneous injection that bypasses the GI tract.
Question 6
A 38-year-old woman who is at a health fair asks what she can do to maintain her
bone health. Her mum had severe osteoporosis with vertebral fractures, spinal
kyphosis, hip fracture and limited mobility. Your patient is 64 inches tall and
weighs 115 pounds. She is postmenopausal. Her meds include OCP and a
multivitamin daily; her DEXA scan shows a T score of 1.3 and a Z score of -8.
Which exercise regimen is going to be most helpful to improve her bone health?
A. Stair climbing
B. Cycling
C. Water aerobics
D. Yoga
E. Spin class
F. Running
G. A, D and F
H. A and F
Answer: G
Rationale: Weight-bearing exercises are most beneficial for bone health. Stair
pg. 3
, climbing (A), yoga (D), and running (F) are all weight-bearing exercises that stress
bones and promote bone density. Cycling, water aerobics, and spin class are non-
weight-bearing exercises that do not significantly improve bone density.
Question 7
A 68-year-old man with several risk factors for osteoporosis: cigarette smoking,
drinking 3-5 alcoholic drinks/day, low body weight and sedentary lifestyle. Labs
reveal a 25 Vitamin D level of 18 mcg. Of the following, what will you
recommend?
A. Increase dietary intake of milk, eggs and catfish
B. Increase sun exposure
C. Calcium citrate with Vitamin D [200/200 IU] BID
D. Vitamin D2 50,000 IU daily for 6-12 months
E. Vitamin D3 [Calcitriol] 0.5 mcg daily for 8 weeks, then 5,000 IU thereafter
Answer: E
Rationale: Vitamin D3 (calcitriol) 0.5 mcg daily for 8 weeks followed by 5,000 IU
daily is the most appropriate treatment for significant Vitamin D deficiency (level
< 20 ng/mL). This provides rapid correction followed by maintenance therapy.
Dietary changes and sun exposure are insufficient for this level of deficiency.
Question 8
Which agent(s) has/have a low likelihood of causing CV adverse effects in a
patient with BPH who is also taking medications for HTN?
1. Alfuzosin [Uroxatrol]
2. Tamsulosin [Flomax]
3. Finasteride [Proscar]
A. 1 only
B. 2 only
C. 3 only
D. 1 and 3
E. 2 and 3
F. 1, 2 and 3
Answer: E
pg. 4
