A student is reviewing a client's medications for osteoporosis. Which medication(s) will have the least effect in increasing the client's bone mass?

Choice A reason: Client who is ambulatory demonstrating a steady gait is not a priority for the nurse. This client is stable and does not require immediate intervention.

Choice B reason: Client scheduled for physical therapy for the first crutch-walking session is not a priority for the nurse. This client is not in acute distress and can wait for the physical therapist to assist them.

Choice C reason: Postoperative client who has just received an opioid pain medication is not a priority for the nurse. This client is expected to have pain relief from the medication and can be monitored for adverse effects later.

Choice D reason: Client with onset of new chest pain is the priority for the nurse. This client is potentially experiencing a life-threatening condition such as a myocardial infarction or a pulmonary embolism. The nurse should assess the client's vital signs, oxygen saturation, and electrocardiogram, and administer oxygen, nitroglycerin, and aspirin as ordered.

Choice A reason: Males with a cardiac history between the ages of 30 and 40 years old are not the most at risk for developing osteoporosis, as they have several protective factors, such as their gender, age, and hormone levels. Males have higher peak bone mass and lower bone loss rate than females, and they do not experience the rapid decline of estrogen that occurs after menopause. Cardiac history may affect the bone health indirectly, by limiting the physical activity or affecting the calcium absorption, but it is not a major risk factor.

Choice B reason: Females with a history of diabetes and are between the ages of 20 and 30 years old are not the most at risk for developing osteoporosis, as they have some protective factors, such as their age and hormone levels. Females in their reproductive years have higher estrogen levels than post-menopausal females, which helps to preserve the bone density and prevent the bone resorption. Diabetes may increase the risk of osteoporosis, by affecting the insulin, glucose, and inflammatory pathways, but it is not a definitive risk factor.

Choice C reason: Males who have had a previous fracture are not the most at risk for developing osteoporosis, as they have some protective factors, such as their gender and hormone levels. Males have higher peak bone mass and lower bone loss rate than females, and they do not experience the rapid decline of estrogen that occurs after menopause. A previous fracture may indicate a low bone density or a high fall risk, but it is not a conclusive risk factor.

Choice D reason: Females who have a history of estrogen deficiency and are post-menopausal are the most at risk for developing osteoporosis, as they have several risk factors, such as their gender, age, and hormone levels. Females have lower peak bone mass and higher bone loss rate than males, and they experience a significant drop of estrogen after menopause, which leads to increased bone resorption and decreased bone formation. Estrogen deficiency may also cause other symptoms, such as hot flashes, mood swings, or vaginal dryness, which may affect the quality of life and the bone health.