What action should the nurse implement first when a client with osteopenia reports chronic back pain?

• A. Reassure that back pain is due to osteopenia.
• B. Teach abdominal strengthening exercises.
• C. Determine if PRN ibuprofen provides adequate relief.
• D. Ask whether the client has discussed the symptom with their healthcare provider.

Answer: (D)

The main idea is to prioritize assessment for a possible serious cause of back pain in someone with osteopenia. Back pain in this context could signal a vertebral compression fracture, which needs medical evaluation rather than immediate reassurance or non-diagnostic self-management.

Asking whether the client has discussed the symptom with their healthcare provider helps determine if a diagnostic workup or treatment adjustment is already in progress or if new evaluation is needed. If a provider has already been informed, the nurse can review the plan, check for red flags, and ensure appropriate steps (imaging, pain control, osteoporosis management) are being pursued. If not, this question prompts timely escalation to obtain proper assessment and imaging as indicated.

Avoiding premature reassurance or starting interventions without medical guidance is important because undetected fractures require prompt treatment to prevent further injury and complications.