A nurse in a provider's office is caring for a client.

Exhibit 1

Medical History

Initial visit:

Client reports a sedentary lifestyle.

Client is lactose intolerant and denies taking vitamin supplements.

Client is a nonsmoker.

Client does not drink alcohol.

The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for osteoporosis? (Select all that apply.)

A. Phosphorous level: While phosphorus is important for bone health, deficiencies are rare in individuals with a normal diet and are not typically associated with osteoporosis.

B. Vitamin D level: Vitamin D is essential for calcium absorption and bone health. Inadequate vitamin D levels can lead to decreased calcium absorption and increase the risk of osteoporosis.

C. Smoking history: Smoking is a risk factor for osteoporosis due to its adverse effects on bone metabolism, but the client is a nonsmoker, so this finding does not apply.

D. Alcohol use: Excessive alcohol consumption is a risk factor for osteoporosis, but the client does not drink alcohol, so this finding does not apply.

E. Activity level: A sedentary lifestyle is a risk factor for osteoporosis. Weight-bearing exercises and physical activity help maintain bone density and strength, reducing the risk of osteoporosis.

F. Lactose intolerant: Lactose intolerance may lead to decreased intake of dairy products, which are a significant source of calcium. Inadequate calcium intake can contribute to decreased bone density and increase the risk of osteoporosis.

A. Avoid pinching the skin when injecting the needle:

This instruction is not specific to the use of a prefilled, multidose pen for insulin administration. Pinching the skin may be necessary for some injection techniques but is not directly related to the use of a prefilled pen.

B. Use pen needles that have a safe-needle protection device attached.

Using pen needles with a safe-needle protection device attached ensures safe handling and disposal of the needle after use, reducing the risk of accidental needlestick injuries. These devices help prevent accidental needlesticks by covering the needle after use, reducing the risk of transmission of bloodborne pathogens.

C. Use the dominant hand to recap the needle before removing it from the pen device:

Recapping needles is not recommended as it increases the risk of needlestick injuries. Additionally, the use of the dominant hand for recapping is not essential and may not be safe practice.

D. Remove the needle from the pen device before placing the needle in a sharps container:

It's crucial to dispose of needles safely in a sharps container immediately after use without removing the needle from the pen device. Removing the needle before disposal increases the risk of needlestick injuries. The entire pen needle unit, including the needle, should be disposed of intact into an appropriate sharps container to minimize the risk of injury to healthcare workers and others handling the waste.