Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

Before starting alendronate (Fosamax®), what should the nurse advise the patient to complete?

1. Cardiac evaluation

2. Renal function testing

3. Bone densitometry

4. Dental evaluation

The correct answer is: Dental evaluation

Alendronate (Fosamax®) is a bisphosphonate medication used primarily to treat osteoporosis and other conditions that lead to bone loss. Before starting this medication, it is particularly important for a patient to undergo a dental evaluation. This is due to the risk of osteonecrosis of the jaw, a rare but serious side effect associated with bisphosphonate therapy. A dental evaluation helps identify any existing dental issues that could be exacerbated by the medication or increase the likelihood of complications during the course of treatment. This proactive assessment allows healthcare providers to ensure that the patient's oral health is stable before initiating therapy, thus minimizing the risk of complications later on. Such evaluations typically include assessing for any pending dental procedures, current dental disease, or other factors that could pose a risk during treatment with alendronate. In contrast, while renal function testing is important for all medications that are eliminated from the body through the kidneys, it is not specific to alendronate or a unique precursor to its administration. Bone densitometry is used to assess bone density and diagnose conditions like osteoporosis, but it is not a prerequisite that must be completed immediately before starting alendronate. Similarly, cardiac evaluations are not directly related to the use