Chapter 42 Drug Therapy to Regulate Calcium and Bone Metabolism


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Chapter 42  Drug Therapy to Regulate Calcium and Bone Metabolism



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Sample Questions



1. An elderly patient has been diagnosed with Paget’s disease. Which serum electrolyte is altered in this disease process?

  1. A)  Sodium
  2. B)  Potassium
  3. C)  Chloride
  4. D)  Calcium

Ans: D
Disorders of calcium and bone metabolism include hypocalcemia, hypercalcemia, osteoporosis, Paget’s disease, and bone breakdown associated with breast cancer and multiple myeloma. Sodium, potassium, and chloride alterations are not primarily associated with Paget’s disease.

2. A patient has been diagnosed with hyperplasia of the parathyroid gland. Which of the following alterations in blood values will you expect to observe?

  1. A)  Hypercalcemia
  2. B)  Hypoparathyroidism
  3. C)  Hyperthyroidism
  4. D)  Hypocalcemia

Ans: A
Hyperparathyroidism is most often caused by a tumor or hyperplasia of a parathyroid gland. Hypoparathyroidism, hyperthyroidism, and hypothyroidism are not associated with hyperplasia of the parathyroid gland. Clinical manifestations and treatment of hyperparathyroidism are the same as those of hypercalcemia.

3. When a patient has an increased serum level of ionized calcium, which hormone will be released?

  1. A)  Insulin
  2. B)  Estrogen
  3. C)  PTH
  4. D)  Calcitonin

Ans: D
Calcitonin is a hormone from the thyroid gland whose secretion is controlled by the concentration of ionized calcium in the blood flowing through the thyroid gland. When the serum level of ionized calcium is increased, secretion of calcitonin is increased. The serum level of calcium will not affect the release of insulin or estrogen. PTH is a response to low calcium levels.

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4. A patient has a decreased calcium level. Which of the following will participate in raising the patient’s calcium level?

  1. A)  Vitamin D
  2. B)  Vitamin C
  3. C)  Ferrous sulfate
  4. D)  Vitamin B12

Ans: A Feedback:

Vitamin D is a fat-soluble vitamin that plays an important role in calcium and bone metabolism. Vitamin C, ferrous sulfate, and vitamin B12 do not play a role in calcium and bone metabolism.

5. A 55-year-old woman is diagnosed with a vitamin D deficit. What disorder results from this deficit?

  1. A)  Chondromalacia
  2. B)  Chondritis
  3. C)  Osteomalacia
  4. D)  Osteopenia

Ans: C


In adults, vitamin D deficiency causes osteomalacia, a condition characterized by decreased bone density and strength. Chondromalacia is characterized as a softening of the patella. Chondritis is an inflammation of the cartilage. Osteopenia is a decrease in bone tissue.

6. The nurse is providing health education to an 80-year-old woman who has just been diagnosed with osteoporosis. Which of the following represents an accurate statement when teaching her about this diagnosis?

  1. A)  “Osteoporosis is usually a result of a bone injury.”
  2. B)  “Osteoporosis causes a risk for fractures.”
  3. C)  “Osteoporosis results from nonmodifiable risk factors.”
  4. D)  “Osteoporosis occurs only in women.”

Ans: B
Osteoporosis results when bone strength is impaired, leading to increased porousness and vulnerability to fracture. Osteoporosis is not a result of fracture. Osteoporosis is partially preventable. Osteoporosis is not limited to the female gender.

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