A 71-year-old White man with a history of hip fracture is diagnosed with osteoporosis. Which medication or class is considered first-line therapy for men with osteoporosis?
Bazedoxifene
Risedronate
Bisphosphonates
Denosumab
The Correct Answer is C
Choice A reason: Bazedoxifene is a selective estrogen receptor modulator (SERM) primarily used in postmenopausal women for osteoporosis prevention and treatment. It is not approved or recommended as first-line therapy for men with osteoporosis due to its estrogen-related mechanism of action.
Choice B reason: Risedronate is a bisphosphonate and is effective in treating osteoporosis. However, it is a specific agent within the bisphosphonate class. While it may be used, the broader class of bisphosphonates is considered first-line, allowing for individualized selection among agents like alendronate, risedronate, or zoledronic acid.
Choice C reason: Bisphosphonates are the first-line therapy for osteoporosis in men. They work by inhibiting osteoclast-mediated bone resorption, thereby increasing bone mineral density and reducing fracture risk. Their efficacy, safety profile, and long-term data support their use as the standard initial treatment.
Choice D reason: Denosumab is a monoclonal antibody that inhibits RANKL, reducing bone resorption. It is effective in treating osteoporosis and may be used in men, especially those who cannot tolerate bisphosphonates or have contraindications. However, it is considered second-line or alternative therapy, not first-line.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Structural group therapy may be beneficial for social skills and peer support but is not sufficient for managing medication nonadherence in chronic schizophrenia. It lacks the intensive, individualized outreach needed for this scenario.
Choice B reason: Inpatient hospitalization is appropriate for acute psychiatric crises, such as danger to self or others, but may not be necessary if the patient is stable and simply nonadherent. It is not a long-term solution for chronic management.
Choice C reason: Intensive outpatient programs provide structured treatment but may not offer the level of outreach and flexibility needed for patients who are resistant to care or disengaged from services.
Choice D reason: Assertive Community Treatment (ACT) is a multidisciplinary, team-based approach designed for individuals with severe mental illness who are nonadherent or difficult to engage. It includes outreach, medication management, and support in the community, making it the most appropriate choice for this client.
Correct Answer is D
Explanation
Choice A reason: The content of the voice (calling her name) does not determine whether the experience is psychotic. Psychotic hallucinations are typically persistent, intrusive, and occur during full wakefulness. Calling her name alone does not rule in or out psychosis.
Choice B reason: Hearing the voice of a close family member can occur in both psychotic and non-psychotic contexts. Bereavement-related hallucinations often involve familiar voices and are considered normal if they are transient and occur in specific emotional contexts.
Choice C reason: The absence of command hallucinations reduces the risk of harm but does not alone determine whether the experience is psychotic. Non-command hallucinations can still be part of psychosis if they are persistent and occur outside sleep transitions.
Choice D reason: Hypnagogic hallucinations—those occurring as one is falling asleep—are considered normal phenomena and not indicative of psychosis. In the context of recent bereavement and emotional triggers, this experience is consistent with a non-pathological grief response.
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