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OR Nurse:
doi: 10.1097/01.ORN.0000445266.96353.28
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Osteoporosis, fragility fractures, and associated surgeries

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INSTRUCTIONS Osteoporosis, fragility fractures, and associated surgeries

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Osteoporosis, fragility fractures, and associated surgeries

General Purpose: To provide current information about osteoporosis, fragility fractures, and associated surgeries. Learning Objectives: After participating in this educational activity, the participant should be better able to: 1. Discern the different types of osteoporosis, fragility fractures, risk factors and testing modalities recommended for diagnosing osteoporosis. 2. Identify lifestyle changes, medications, and surgical procedures recommended for patients diagnosed with osteoporosis with/without associated fractures.

  1. Primary type I osteoporosis
    1. affects infants and children.
    2. occurs due to underlying disease.
    3. results from hyperparathyroidism.
    4. develops in women after menopause.
  2. The most common drug-related cause of osteoporosis in men is chronic use of
    1. antidepressants.
    2. antihypertensives.
    3. corticosteroids.
    4. diuretics.
  3. The risk for osteoporosis is greater in
    1. Asian and Black women.
    2. Asian and White women.
    3. obese women.
    4. women with late onset of menopause.
  4. A risk factor for osteoporosis includes a diet that is high in
    1. protein.
    2. calcium.
    3. vitamin D.
    4. dairy products.
  5. How much higher is the risk of fracture for the person with osteoporosis?
    1. two times
    2. four times
    3. six times
    4. 10 times
  6. A World Health Organization T-score indicating osteoporosis is
    1. 1.0 or higher.
    2. between 0 and -1.
    3. between -1 and -2.5.
    4. -2.5 or lower.
  7. The most widely recognized test for measuring BMD is
    1. quantitative ultrasound.
    2. DXA.
    3. QCT.
    4. peripheral DXA.
  8. The NOF recommends that women age 51 and older should have a daily intake of
    1. calcium 500 mg.
    2. calcium 1,000 mg.
    3. vitamin D 400 to 800 international units.
    4. calcium 1200 mg.
  9. Which exemplifies the exercise recommendation for strengthening bones?
    1. once per week for 60 minutes
    2. twice per week for 40 minutes
    3. three times per week for 20 minutes
    4. four times per week for 10 minutes
  10. Which therapy increases bone density by interfering with bone resorption?
    1. anabolic therapy
    2. bisphosphonates
    3. estrogen therapy
    4. calcium
  11. Which medication is a SERM?
    1. alendronate
    2. denosumab
    3. raloxifene
    4. zoledronic acid
  12. Which is not an example of an occurrence causing a fragility fracture?
    1. coughing
    2. sneezing
    3. rolling over in bed
    4. falling down stairs
  13. For both women and men after the age of 65, the risk of hip fracture from osteoporosis
    1. remains stable.
    2. doubles.
    3. triples.
    4. quadruples.
  14. Intertrochanteric hip fractures
    1. are extracapsular.
    2. occur in the proximal femur.
    3. heal more slowly than other hip fractures.
    4. interfere with blood supply to the head of the femur.
  15. How does the kyphoplasty procedure differ from vertebroplasty?
    1. A balloon is inserted into the vertebrae.
    2. Plaster is used for a cast-like effect.
    3. It is a noninvasive surgical procedure.
    4. Ultrasound imaging is used during the procedure.
  16. To help reduce the postoperative wound infection risk for a patient having a prosthetic device implanted
    1. a prophylactic antibiotic is given.
    2. the surgical site is cleaned with povidone-iodine daily.
    3. the surgical dressing remains intact for 7 days.
    4. the patient is given a daily bath with antibacterial soap.
  17. Which statement is not accurate regarding intraoperative procedures?
    1. The circulating nurse should inform the team of a patient diagnosis of low bone mass.
    2. Extra care should be taken for patients in the lateral position.
    3. CPR compressions should not be done to reduce the risk of sternal fracture.
    4. The circulating nurse should coordinate patients transfers in the OR.
  18. Hardware failure is a common complication in patients with osteoporosis due to
    1. increased cortical bone.
    2. reduced bone resorption rate.
    3. decreased remodeling process.
    4. angulated spinal screw positioning.
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