Answer each of the
following questions (there is only one correct answer to each question).
1
The percentage of older Americans with fractured hips
that will die from complications within a year of the fracture is:
A. 5% to 10%
B. 15% to 30%
C. 25% to 40%
D. 50% or more
2
Bone collagen is made of:
A. chains of peptide molecules
B. layers of calcium crystals
C. large sheets of hydroxyapatite
D. dense bricks containing carbon and iron
3
Trabecular bone is found primarily:
A. on the outside of the long bones of the legs
and arms
B. in the inner cavities of the bones, along
with marrow and fat
C. throughout the skull and pelvis
D. within the Haversian system of the cortical
bone
4
In addition to providing a supportive framework for
the body, the skeleton serves as a:
A. site for hormone production
B. filter for environmental toxins
C. reservoir for calcium and other minerals
D. breeding ground for beneficial bacteria
5
Maintenance of appropriate blood calcium levels involves
all of the following except :
A. vitamin D
B. calcitonin
C. strontium
D. parathyroid hormone
6
In order for vitamin D to aid in bone production it
must be converted to its active form in the:
A. skin
B. bone marrow
C. liver and kidneys
D. intestine
7
The cells responsible for bone resorption are known
as:
A. osteoblasts
B. osteoclasts
C. osteocytes
D. all of the above
8
The calcium dissolved as part of the bone repair process:
A. passes into the bloodstream
B. is used onsite for new bone formation
C. neutralizes the acid created in the process
D. assists with further bone erosion
9
The process of bone remodeling, from the initiation
of resorption to the completion of repairs, takes approximately:
A. one week
B. one month
C. 100 days
D. two years
10
Bone fragility results from reduction of all of the
following except :
A. bone mass
B. bone density
C. cross linkage
D. apoptosis
11
Often, the first warning signal of osteoporosis is:
A. elevated serum calcium
B. perceived loss of strength
C. low back pain
D. a fractured wrist
12
Of the following, the persons at highest risk for osteoporosis-related
fractures are:
A. African American men
B. vegetarians
C. women who have never been pregnant
D. those who had sports related injuries in childhood
13
Significant loss of trabecular bone is likely to cause:
A. crush fractures of the vertebrae
B. spiral fractures of the forearm
C. deformity of the hips
D. shortening of the legs
14
Over time, osteoporosis may cause shrinkage of the entire
spinal column, which may in turn lead to:
A. digestive problems
B. shortness of breath
C. susceptibility to lung infections
D. all of the above
15
The role of estrogen in the bone remodeling process
includes all of the following except :
A. promoting absorption of calcium in the intestine
B. blocking the action of Vitamin D
C. prolonging the life of osteoblasts
D. accelerating the death of osteoclasts
16
Age-related changes that increase risk for osteoporosis
include:
A. decreased excretion of calcium through the
kidneys
B. overproduction of Vitamin D
C. decline in secretion of calcitonin
D. cessation of production of PTH
17
The yearly rate of bone loss for women three to seven
years after menopause averages:
A. 0.3%
B. 0.5%
C. 1%
D. 3%
18
The disorder referred to as the “Hungry Bone Syndrome”
is caused by:
A. overactivity of the parathyroid gland
B. excessive amounts of thyroid hormone
C. pituitary dysfunction
D. fluctuations in estrogen level
19
Factors in patients with rheumatoid arthritis that may
contribute to osteoporosis include:
A. reduced bone calcium content
B. treatment with cortisone
C. use of antacids with anti-inflammatory drugs
D. all of the above
20
Risk for fractures associated with long-term glucocorticoid
use is greatest for:
A. cortical bone
B. trabecular bone
C. legs and hips
D. forearms and wrists
21
Which one of the following medications has not
been implicated in the development of osteoporosis?
A. Lasix
B. Dilantin
C. Zantac
D. Questran
22
At the present time, clinical diagnosis of osteoporosis
is made by:
A. evidence of reduced bone mass on simple x-ray
B. bone density measurement with dual x-ray absorptiometry
C. CT scan of the vertebral column
D. biochemical markers of bone turnover
23
Among American women, calcium intake is:
A. usually well below recommended levels throughout
the lifespan
B. deficient primarily in teenage girls who have
an eating disorder
C. on average 800mg to 1200mg a day in those
over age 35
D. a critical determiner of bone health only
after the menopause
24
How many mg of calcium are contained in one cup (8 oz.)
of milk?
A. 150
B. 250
C. 350
D. 500
25
Consumption of large amounts of phosphorus:
A. is common due to its use in processed foods
and drinks
B. is recommended to prevent secondary hyperparathyroidism
C. may protect the bones of those who have a
low calcium intake
D. all of the above
26
The most common calcium supplement in the U.S. today
is:
A. calcium gluconate
B. calcium chloride
C. calcium phosphate
D. calcium carbonate
27
Use of bone meal for calcium supplementation is not recommended because they have been shown to:
A. cause kidney stones in susceptible people
B. aggravate gastric secrection problems
C. contain trace amounts of toxic metals
D. be poorly absorbed in comparison to other available preparations
28
The elderly are at greater risk for vitamin D deficiency
because of:
A. limited intake of magnesium and trace minerals
B. decreased exposure to the sun
C. reluctance to use nutritional supplements
D. diets low in protein and fat
29
The best diet for prevention of osteoporosis:
A. is low in protein and high in carbohydrates
B. is based on cereal grains enriched with vitamins
C. emphasizes consumption of citrus fruits
D. contains a low ratio of animal vegetable
to protein
30
Increasing one’s vegetable intake from 3 to 9 servings
a day may:
A. result in a protein deficiency
B. lead to development of metabolic acidosis
C. significantly decrease urinary calcium excretion
D. balance one’s intake of calcium and phosphorus
31
Urinary calcium losses in the elderly may be reduced
by:
A. modest salt restriction
B. magnesium supplementation
C. taking manganese along with a calcium supplement
D. all of the above
32
The synthesis of key proteins in the bone matrix requires
adequate amounts of vitamin:
A. A
B. B12
C. C
D. K
33
The most common bone destroying disease in men under
the age of 60 is:
A. alcoholism
B. arthritis
C. cancer
D. osteoporosis
34
Smoking has been associated with an increase in the
incidence of hip fracture of:
A. 10% - 20%
B. 20% - 40%
C. 40% - 50%
D. 50% - 60%
35
An adequate program of physical activity for the prevention
and treatment of osteoporosis should include:
A. short bursts of strenuous exercise such as
running
B. a comprehensive series of muscle strengthening
exercises
C. three to four hours a week of weight bearing
activity such as walking
D. all of the above
36
Exercise regimens for post-menopausal
women have shown clear benefit on
A. total bone mass
B. total bone density
C. lean muscle tissue
D. all of the above
37
Regular exercise that puts mechanical
stress and weight bearing on bones
A. decreases strength only
B. increases strength and retards bone
loss
C. has short-term benefits only
D. does not affect bone health and
development
38
Drugs that help slow the progression of
bone loss include:
A. Biophosphonates
B. Selective Estrogen Receptor Modulators
C. Antiresorptive Agents
D. All of the above affect bone loss
39
A good alternative treatment for those post-menopausal
women who choose not to use hormone replacement therapy is:
A. alendronate
B. raloxifene
C. calcitonin nasal spray
D. ipriflavone
40
As a treatment for osteoporosis, parathyroid hormone
differs from the antiresorptive agents in that it:
A. may cause long-term gastrointestinal problems
B. is better tolerated in elderly patients
C. can be administered in a single infusion per
month
D. may actually alter the architecture of existing
bone
41
The incidence and risk of osteoporosis in men is less
than in women because men have:
A. a higher peak bone mass in early adulthood
B. a shorter life expectancy overall
C. no dramatic hormonal change comparable to
menopause
D. all of the above
42
Buidling bone blocks include:
A. calcium & Vitamin D
B. magnesium
C. copper & strontium
D. all help with building bone
43
Which herb contains a powerful tonic
for bones?
A. Red rice yeast
B. Red oat bran
C. Red clover leaf
D. Vitamin E
44
Whole body vibration is a machine that
vibrates to:
A. Improve muscle tone and strength
B. Flexability
C. Increased Circulation
D. All of the Above
45
Your risk of developing osteoporosis
depends on how much bone mass you
attained between what ages :
A. 15 and 25
B. 25 and 35
C. 65 and 75
D. 80 to 90
46
In educating your patients, bone density
depends in part on the amount of:
A. reduced bone formation
B. hormones produced in our bones
C. occurs mainly in cortical bone
D. in part on the amount of calcium,
phosphorus and other minerals
bones contain.
47
Fruits that are high in calcium include:
A. peaches and nectarines
B. apples and pears
C. oranges and papayas
D. bananas and pineapple
48
Environmental changes that can help an older person
compensate for poor vision include all of the following except :
A. removing throw rugs and other hard to see
obstacles
B. using a consistent low level of illumination
in every room
C. increasing contrast on steps with white paint
D. creating clear paths from room to room
49
Factors contributing to limited mobility in older persons
include:
A. changes in the inner ear
B. decreased joint flexibility
C. alterations in gait pattern
D. all of the above
50
The best way to prevent falls in individuals with dementia
is to:
A. encourage ambulation as much as possible
B. place them in wheelchairs with seat belts
during waking hours
C. use bed rails and other restraints as needed
at night
D. provide adequate levels of supervision
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