# A nurse is caring for a 72-year-old male client diagnosed with osteoporosis. Which nursing intervention should be the priority to prevent complications?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=541080  
> language: ko  
> subject: Adult Health

## 문제

A nurse is caring for a 72-year-old male client diagnosed with osteoporosis. Which nursing intervention should be the priority to prevent complications?

## 보기

1. Implement fall prevention strategies and ensure a safe environment **✔ 정답**
2. Encourage high-impact weight-bearing exercises
3. Administer calcium supplements without vitamin D
4. Restrict mobility to prevent further bone loss

**정답: 1**

## 해설

Fall prevention is the priority for osteoporosis patients due to high fracture risk from weakened bones. Other options are less appropriate: high-impact exercises may increase fracture risk, calcium without vitamin D is ineffective, and restricting mobility accelerates bone loss.

## 심화 해설

Priority Intervention for Osteoporosis: Fall Prevention

The correct answer is implement fall prevention strategies and ensure a safe environment. For a 72-year-old client with osteoporosis, the most immediate and critical nursing priority is preventing fractures. Osteoporosis reduces bone mineral density and disrupts bone microarchitecture, making bones pathologically fragile and susceptible to fracture from minimal trauma, such as a fall from standing height. A fracture, particularly a hip fracture, is a sentinel event that can initiate a cascade of decline in older adults.

The rationale for prioritizing safety and fall prevention over the other options is directly supported by the clinical consequences of falls in this population. A retrospective cohort study comparing management of hip fractures in elderly patients found that such fractures are profoundly serious events, with the study exploring the direct association between treatment modalities and mortality [4]. This underscores that the primary goal is not merely to treat the underlying bone density loss in the moment, but to prevent the acute event—the fracture—that carries a high risk of death and disability. An internal audit of a multidisciplinary Geriatric Faller Protocol further validates this approach by demonstrating that structured, multifactorial fall prevention interventions are a standard of care in emergency settings to manage and mitigate fall-related injuries in older adults [1].

The incorrect options are contraindicated based on the pathophysiology of osteoporosis and principles of safe mobilization:

- Encouraging high-impact weight-bearing exercises is dangerous. While weight-bearing exercise is beneficial for bone health, high-impact activities can generate forces exceeding the mechanical strength of osteoporotic bone, directly causing vertebral compression or long bone fractures.

- Administering calcium supplements without vitamin D is ineffective and neglects a key physiological mechanism. Vitamin D is essential for intestinal calcium absorption; without adequate vitamin D, calcium supplementation will not be effectively utilized for bone mineralization.

- Restricting mobility to prevent further bone loss is counterproductive. Immobilization accelerates bone resorption, leading to disuse osteoporosis and rapid loss of bone density. Furthermore, it precipitates muscle atrophy and balance deficits, which paradoxically increase the risk of falls when the client eventually attempts to move. A study on housebound older adults highlights that fear of falling, which can lead to self-imposed mobility restriction, is a distinct psychological issue that profoundly influences behavioral patterns and diminishes quality of life, without reducing the actual physiological risk .

A comprehensive fall risk assessment is foundational to this intervention. A scoping review exploring fall risk assessment tools across Southeast Asia confirms that assessing fall risk is central to primary prevention, yet the tools used must be appropriate for the clinical setting . The nurse must evaluate intrinsic factors (e.g., orthostatic hypotension, muscle weakness, visual deficits, cognitive impairment) and extrinsic factors (e.g., environmental hazards, inadequate lighting, improper footwear) to implement tailored, multifactorial prevention strategies that directly protect the client from sustaining a life-altering fragility fracture [1][4].References (research sources)

- [1]Multidisciplinary interventions and outcomes of the Geriatric Faller Protocol in an emergency diagnostic treatment unit: an internal audit.Research articleTan HM, Yang C, Tay XY, Yap AFHW, Low KX, Ong ZY, Ting CWJ, Ho SF. (2026) · DOI: 10.4103/singaporemedj.smj-2025-145

- [4]Association Between Non-Operative versus Operative Management and Mortality in Elderly Patients with Hip Fracture: A Retrospective Cohort Study.Research articleJiang L, Zhu L, Jin Y, Yao M. (2026) · DOI: 10.2147/cia.s572082

## 임상 시나리오

Osteoporosis: Fall Prevention ProtocolProtecting Fragile Bones in Older Adults
For a client with osteoporosis, the immediate nursing priority is to prevent fractures, which are often caused by falls from standing height. A hip fracture is a sentinel event with a high mortality risk.

Implement a multifactorial fall prevention program: keep the environment free of clutter, ensure adequate lighting, use non-slip footwear, place the call bell within reach, and encourage the use of assistive devices. Avoid high-impact exercises and prolonged immobility.

CautionDo not restrict mobility to "protect" the patient; immobility accelerates bone loss and muscle weakness, paradoxically increasing fall risk. Calcium supplementation must always be paired with vitamin D to be effective.

## 핵심 개념

- **Osteoporosis** — A metabolic bone disease characterized by decreased bone mineral density and disrupted microarchitecture, leading to increased bone fragility and fracture risk.
- **Fall Prevention Strategies** — Multifactorial interventions including environmental safety checks, non-slip footwear, adequate lighting, and physical therapy to reduce the risk of falls in at-risk populations.
- **Pathologic Fracture** — A bone fracture that occurs with minimal or no trauma due to underlying disease weakening the bone structure, commonly seen in osteoporosis.
- **Sentinel Event** — An unexpected occurrence involving death or serious physical or psychological injury, such as a hip fracture in an older adult, which often signals the need for immediate investigation and response.
- **Hip Fracture** — A break in the upper quarter of the femur, a serious injury in older adults with osteoporosis that is associated with high morbidity, mortality, and loss of independence.

## 같은 주제 문제

- [A 68-year-old postmenopausal woman comes to the clinic for a routine health assessment. Wh…](https://mymerci.kr/pages/nclex_q.php?qn_id=541077)
- [A nurse is assessing a 72-year-old postmenopausal woman who reports chronic back pain and …](https://mymerci.kr/pages/nclex_q.php?qn_id=541078)
- [A nurse is assessing a 68-year-old postmenopausal woman who has been diagnosed with osteop…](https://mymerci.kr/pages/nclex_q.php?qn_id=541079)
- [A nurse is caring for a 68-year-old female client diagnosed with osteoporosis. Which nursi…](https://mymerci.kr/pages/nclex_q.php?qn_id=541081)
- [A nurse is caring for a 68-year-old female client diagnosed with osteoporosis. Which nursi…](https://mymerci.kr/pages/nclex_q.php?qn_id=541082)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._