Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

Metastasis to the bone primarily causes local stimulation of which cells?

1. Chondrocytes

2. Osteoblasts

3. Osteoclasts

4. Fibroblasts

The correct answer is: Osteoclasts

When cancer metastasizes to the bone, it primarily influences the activity of osteoclasts. These are specialized cells responsible for bone resorption, which is the process of breaking down bone tissue and releasing minerals, leading to a decrease in bone density. Tumors can produce various factors that stimulate osteoclast activity, promoting bone destruction and contributing to complications such as pain, fractures, and hypercalcemia. The local stimulation of osteoclasts by metastatic tumors is a key aspect of the pathophysiology of bone metastases. It leads to an imbalance in the normal remodeling processes between osteoclasts and osteoblasts (the cells that build bone). This dysregulation often results in more bone being resorbed than formed, causing weakened bone structure and increased susceptibility to skeletal-related events. Understanding the role of osteoclasts in bone metastases is critical for oncology nursing, as it underlies both the management of symptoms and the treatment strategies aimed at mitigating the effects of bone metastases, such as the use of bisphosphonates or denosumab to inhibit osteoclast activity and prevent complications.