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A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote?
- A. Daily performance of weight-bearing exercise to prevent muscle atrophy
- B. Close monitoring of urine output and kidney function
- C. Daily administration of warfarin (Coumadin) as ordered
- D. Safe use of supplementary oxygen in the home setting
Correct Answer: B
Rationale: Renal function must be monitored closely in the patient with multiple myeloma. Excessive weight-bearing can cause pathologic fractures. There is no direct indication for anticoagulation or supplementary oxygen.
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An adult patients abnormal complete blood count (CBC) and physical assessment have prompted the primary care provider to order a diagnostic workup for Hodgkin lymphoma. The presence of what assessment finding is considered diagnostic of the disease?
- A. Schwann cells
- B. Reed-Sternberg cells
- C. Lewy bodies
- D. Loops of Henle
Correct Answer: B
Rationale: The malignant cell of Hodgkin lymphoma is the Reed-Sternberg cell, a gigantic tumor cell that is morphologically unique and thought to be of immature lymphoid origin. It is the pathologic hallmark and essential diagnostic criterion. Schwann cells exist in the peripheral nervous system and Lewy bodies are markers of Parkinson disease. Loops of Henle exist in nephrons.
A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurses most appropriate action?
- A. Tell him that you will give him privacy and leave the room.
- B. Offer to call pastoral care.
- C. Ask if he would like you to sit with him while he collects his thoughts.
- D. Tell him that you can understand how hes feeling.
Correct Answer: C
Rationale: Providing emotional support and discussing the uncertain future are crucial. Leaving is incorrect because leaving the patient doesnt show acceptance of his feelings. Offering to call pastoral care may be helpful for some patients but should be done after the nurse has spent time with the patient. Telling the patient that you understand how hes feeling is inappropriate because it doesnt help him express his feelings.
A patient diagnosed with acute myelogenous leukemia has just been admitted to the oncology unit. When writing this patients care plan, what potential complication should the nurse address?
- A. Pancreatitis
- B. Hemorrhage
- C. Arteritis
- D. Liver dysfunction
Correct Answer: B
Rationale: Pancreatitis, arteritis, and liver dysfunction are generally not complications of leukemia. However, the patient faces a high risk of hemorrhage.
A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patients severe bone pain?
- A. Implementing distraction techniques
- B. Educating the patient about the effective use of hot and cold packs
- C. Teaching the patient to use NSAIDs effectively
- D. Helping the patient manage the opioid analgesic regimen
Correct Answer: D
Rationale: For severe pain resulting from multiple myeloma, opioids are likely necessary. NSAIDs would likely be ineffective and are associated with significant adverse effects. Hot and cold packs as well as distraction would be insufficient for severe pain.
A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition?
- A. The patient faces a significant risk of malignancy.
- B. The patient has a myeloid form of leukemia.
- C. The patient has a lymphocytic form of leukemia.
- D. The patient has a major risk factor for hemophilia.
Correct Answer: A
Rationale: Indolent neoplasms have the potential to develop into a neoplasm, but this is not always the case. The patient does not necessarily have, or go on to develop, leukemia. Indolent neoplasms are unrelated to the pathophysiology of hemophilia.