Author Question: A patient who has several risk factors for osteoporosis has a bone density test that indicates ... (Read 81 times)

kfurse · **on:** Jul 24, 2018

A patient who has several risk factors for osteoporosis has a bone density test that indicates osteopenia. The primary care NP plans to prescribe a bisphosphonate. Before initiating treatment, the NP should:

a. order an upper GI x-ray.
b. initiate PPI therapy.
c. order serum calcium and vitamin D levels.
d. prescribe a calcium and vitamin D supplement.

Question 2

A postpartum woman will begin taking the minipill while she is nursing her infant. The primary care NP should instruct the patient:

a. to use backup contraception while taking the minipill.
b. to continue using the minipill for 6 months after she stops nursing.
c. that irregular periods while taking the minipill may indicate she is pregnant.
d. that this method does not increase her risk of thromboembolic events.

wfdfwc23 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

C
Patients must have adequate nutrition, calcium, and vitamin D. Hypocalcemia and vitamin D deficiency must be corrected before therapy is initiated. An upper GI x-ray is indicated only if the patient is symptomatic. Patients at risk for fracture should not take PPIs. Calcium and vitamin D supplements should be given with bisphosphonate therapy; however, the first action is to evaluate current serum levels.

Answer to Question 2

D
Minipills are used primarily in breastfeeding women. There is no increased risk for thromboembolic events for women taking these pills. It is not necessary to use a backup method of contraception. Women should be advised to contact the provider when they stop nursing so that a COCP can be prescribed. The more disrupted the bleeding pattern, the more likely it is that ovulation is inhibited.