Which patient would be at greatest risk for developing osteoporosis?

An 84-year-old man who has recently been diagnosed with hypothyroidism and is prescribed levothyroxine (Synthroid).

A 55-year-old woman who recently had a hysterectomy with bilateral salpingo-oophorectomy and refuses estrogen therapy.

A 69-year-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection.

A 73-year-old man who has 5 alcoholic drinks per week and limits sun exposure to prevent recurrence of skin cancer.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Hypothyroidism, particularly if untreated, can contribute to bone loss, but levothyroxine therapy typically normalizes thyroid function, mitigating this risk. While age is a risk factor, other choices present more significant and direct risks for accelerated bone demineralization and osteoporosis development.

Choice B rationale

Estrogen plays a crucial role in bone density maintenance by inhibiting osteoclast activity and promoting osteoblast activity. A bilateral salpingo-oophorectomy removes the primary source of estrogen, leading to premature menopause and rapid bone loss, significantly increasing osteoporosis risk if hormone therapy is refused.

Choice C rationale

Prednisone, a corticosteroid, is a potent cause of secondary osteoporosis. It directly inhibits osteoblast function, promotes osteoclast activity, and impairs calcium absorption, leading to significant bone density loss. Long-term use post-transplant makes this patient at exceptionally high risk.

Choice D rationale

Excessive alcohol intake (more than 2-3 drinks daily) is a risk factor for osteoporosis by impairing bone formation and nutrient absorption. Limiting sun exposure can cause vitamin D deficiency, also contributing to reduced bone density. However, this patient's alcohol intake is moderate, and vitamin D deficiency is more easily corrected.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A rationale

Kyphosis, an exaggerated outward curvature of the thoracic spine, is a common spinal deformity in older adults with osteoporosis. This occurs due to vertebral compression fractures, where the weakened bone structure collapses anteriorly, leading to a "hunchback" appearance and loss of height, affecting posture and balance.

Choice B rationale

Ankylosis refers to the stiffening and immobility of a joint due to fusion of bones. While joint issues can occur in older adults, ankylosis is not a direct spinal deformity associated with osteoporosis; rather, it is more commonly linked to inflammatory conditions like ankylosing spondylitis or severe osteoarthritis.

Choice C rationale

Scoliosis is a lateral curvature of the spine, often appearing as an S or C shape. While it can occur in older adults, it is not primarily a direct consequence or expected spinal deformity of osteoporosis. Adult degenerative scoliosis is often due to disc degeneration and facet joint arthritis, not solely bone demineralization.

Choice D rationale

Lordosis is an excessive inward curvature of the lumbar spine. While some degree of lumbar lordosis is normal, hyperlordosis can occur, but it is not the characteristic spinal deformity expected in osteoporosis. Osteoporosis typically leads to kyphosis due to anterior wedging of vertebral bodies, not increased lumbar curvature.

A. Dopamine and acetylcholine. B. An autosomal dominant genetic defect. C. Atherosclerosis and lack of blood supply. D. Estrogen and progesterone.

Correct Answer is A

Explanation

Choice A rationale

Idiopathic Parkinsonism is characterized by the degeneration of dopaminergic neurons in the substantia nigra, leading to a deficiency of dopamine in the basal ganglia. This creates an imbalance with acetylcholine, an excitatory neurotransmitter. Benztropine, an anticholinergic, helps restore this balance by blocking acetylcholine receptors, reducing tremors and rigidity.

Choice B rationale

While some forms of Parkinson's disease have genetic links, idiopathic Parkinsonism is not primarily defined by an autosomal dominant genetic defect. It is multifactorial, involving a complex interplay of genetic predispositions and environmental factors, with no single dominant gene responsible for the vast majority of cases.

Choice C rationale

Atherosclerosis and lack of blood supply are associated with vascular Parkinsonism, which is distinct from idiopathic Parkinsonism. Vascular Parkinsonism results from cerebrovascular disease leading to neuronal damage, while idiopathic Parkinsonism involves neurodegeneration of dopamine-producing neurons, not primarily ischemic injury.

Choice D rationale

Estrogen and progesterone are sex hormones and are not directly involved in the primary pathophysiological imbalance of neurotransmitters in idiopathic Parkinsonism. While hormonal fluctuations can influence neurological conditions, the core defect in Parkinsonism involves dopamine and acetylcholine dysregulation in the basal ganglia.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Which patient would be at greatest risk for developing osteoporosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client?

Correct Answer is A

Explanation

A client has idiopathic parkinsonism. Her physician prescribed benztropine mesylate (Cogentin) 1 mg po daily. The nurse explains to her that the pathophysiological defect is an imbalance between:

Correct Answer is A

Explanation

A nurse is assessing the reflexes of a client who has an unrepaired femur fracture and has suddenly become stuporous. For which of the following findings should the nurse identify that the client exhibits Babinski's sign?

A nurse is caring for a client who has had a spinal cord injury at the level of the T2-T3 vertebrae. When planning care, the nurse should anticipate which of the following types of disability?

Which patient would be at greatest risk for developing osteoporosis?

A nurse in a provider's office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply.)

A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

A nurse is caring for a client who has a T-4 spinal cord injury. Which of the following client findings should the nurse identify as an indication the client is at risk for experiencing autonomic dysreflexia?

A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan?