Difficulty: Medium
Average Score: 77%
Simulated
Passage / Scenario
Exibit 1Medical 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
Exibit 2
Diagnostic Results
Initial visit:
Calcium 8.9 mg/dL (9 to 10.5 mg/dL)
Phosphorus 3.4 mg/dL (3 to 4.5 mg/dL)
Total 25-hydroxy D (vitamin D + D) 24 ng/dL. (25 to 80 ng/dL) 6-month follow-up:
Calcium 8.8 mg/dL (9 to 10.5 mg/dL)
Phosphorus 3.2 mg/dL (3 to 4.5 mg/dL)
Total 25-hydroxy D (vitamin D + D.) 15 ng/dL (25 to 80 ng/dL)
Exibit 3
Nurses' Notes
Initial visit:
Client instructed to take a calcium and vitamin D supplement and begin an exercise program, such as walking 3 times per week.
month follow-up:
Client states they frequently forget to take their calcium and vitamin D supplements and has been unable to exercise due to time constraints.
A nurse in a provider's office is caring for a client. 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.)
Correct answer
B,D
Rationale
The correct answers are B and D. Vitamin D is essential for calcium absorption, which is crucial for bone health. Low levels of vitamin D can lead to decreased bone density and increase the risk of osteoporosis. Adequate physical activity helps in building and maintaining bone strength. Smoking (choice E) is a risk factor for osteoporosis as it can lead to decreased bone mass. Alcohol use (choice A) can interfere with the body's ability to absorb calcium, contributing to bone loss. Lactose intolerance (choice C) can lead to reduced calcium intake but does not directly increase osteoporosis risk. Phosphorus level (choice F) is important for bone health but is not a primary risk factor for osteoporosis.