# The public health nurse reviews osteoporosis screening plans. Which plans require follow-up? Highlight the plans that do not match current screening guidance.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=495005&lang=en  
> language: en  
> subject: Lifestyle Choices  
> category: HPM

## Question

The public health nurse reviews osteoporosis screening plans. Which plans require follow-up? Highlight the plans that do not match current screening guidance.

| Profile | Documented screening plan |
| --- | --- |
| A | Woman age 66 skips DXA because she has no bone symptoms |
| B | Woman age 68 schedules central DXA for routine screening |
| C | Postmenopausal woman age 58 has risk assessment before DXA |
| D | Healthy premenopausal woman age 52 defers routine screening |
| E | Postmenopausal smoker age 61 waits until 65 without risk assessment |
| F | Man age 70 discusses individualized screening with the clinician |
| G | Adult with a prior fragility fracture receives diagnostic evaluation and an individualized management plan |
| H | Woman age 72 substitutes heel ultrasound for central DXA |
| I | Woman age 63 on chronic glucocorticoids follows average-risk guidance |

## Explanation

Skipping screening in eligible women, omitting risk assessment before age 65, substituting heel ultrasound for DXA, and applying average-risk guidance to chronic glucocorticoid use require follow-up.

## In-depth explanation

Quick answer
Highlight skipping DXA for an asymptomatic woman age 66, delaying risk assessment for a postmenopausal smoker age 61, replacing central DXA with heel ultrasound, and treating chronic glucocorticoid use as average risk.

Why this is correct
Current guidance recommends DXA screening for women age 65 or older even without symptoms. A younger postmenopausal woman with a risk factor should first receive clinical risk assessment and then DXA if risk is increased. The recommendation does not establish routine screening for men and does not apply unchanged to secondary osteoporosis or chronic bone-loss medication exposure.[2]

Easy analogy or mental picture
Think of two doors. Age 65 opens the screening door for women; before that age, menopause plus risk assessment can open it. A separate side door is needed for secondary causes. The doors organize eligibility but do not replace clinical judgment.

Memory hook
Women 65 and older: DXA; younger after menopause: risk first, then DXA if increased.

NCLEX decision rule
When reviewing osteoporosis prevention, check age, menopause status, risk factors, and secondary causes before choosing a test. Use central DXA for screening, and do not turn insufficient evidence for men into a universal yes or no.

Why the other choices are wrong
Scheduling DXA for an older woman, using risk assessment for a younger postmenopausal woman, avoiding routine screening in a healthy premenopausal adult, individualizing decisions for men, and clinically evaluating a prior fragility fracture are appropriate plans.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]USPSTF: Osteoporosis Screening Clinician SummaryU.S. Preventive Services Task Force

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_For study reference only. Always follow current clinical guidelines and your institution’s protocols._