A young woman tells the nurse that she has a strong family history of osteoporosis and that she has been taking calcium supplements. Which vitamin will the nurse recommend as an adjunct to calcium supplementation?

A. Vitamin K: Vitamin K supports bone health by aiding osteocalcin activation, but it does not significantly improve calcium absorption from the gut. Its role is secondary and not typically recommended as the primary adjunct for osteoporosis prevention. B. Vitamin D: Vitamin D enhances intestinal absorption of calcium, allowing more of the supplemented calcium to enter the bloodstream and be utilized for bone mineralization. Adequate vitamin D levels help maintain bone strength and reduce long-term osteoporosis risk. Pairing it with calcium provides the most effective preventive strategy. C. Vitamin A: Vitamin A is not involved in calcium absorption and, in excess, can even contribute to bone loss. High intake may interfere with bone remodeling and increase fracture risk. It does not complement calcium in preventing osteoporosis. D. Vitamin E: Vitamin E functions mainly as an antioxidant and has no direct role in bone mineral density or calcium utilization. Supplementing it would not enhance the effectiveness of calcium for bone health. It therefore offers no meaningful benefit in osteoporosis prevention.