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For which of the following problems should the nurse monitor in the patient with multiple myeloma?
- A. Uncontrolled bleeding
- B. Liver engorgement
- C. Respiratory distress
- D. Pathological fractures
Correct Answer: A
Rationale: Patients with multiple myeloma are at an increased risk of bleeding due to low levels of platelets, which play a key role in blood clotting. Uncontrolled bleeding can occur in multiple myeloma patients, leading to serious complications such as hemorrhage and anemia. Therefore, the nurse should monitor for signs of bleeding, such as easy bruising, petechiae, or prolonged bleeding from minor cuts or procedures, and take appropriate interventions to manage and prevent further bleeding episodes in the patient with multiple myeloma. Monitoring for and addressing uncontrolled bleeding is crucial in ensuring the safety and well-being of the patient.
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A patient is admitted with a 2-month history of fatigue, SOB, pallor, and dizziness. The patient is diagnosed with idiopathic autoimmune haemolytic anemia. On reviewing the laboratory results, the nurse notes which of the following that confirms this diagnosis?
- A. RBC fragments
- B. Microcytic, hypochromic RBCs
- C. Macrocytic, normochromic RBCs
- D. Hemoglobin molecules
Correct Answer: A
Rationale: In patients with idiopathic autoimmune hemolytic anemia, the immune system mistakenly targets and destroys its own red blood cells (RBCs). When the red blood cells are destroyed, they can break apart, leading to the presence of fragmented RBCs, also known as schistocytes or red cell fragments, in the peripheral blood. The presence of RBC fragments is a characteristic finding in this type of hemolytic anemia and helps confirm the diagnosis.
Which of the following malignant tumors is least likely to occur in adults in comparison with children?
- A. acute Lymphoblastic Leukemia (ALL)
- B. osteosarcoma
- C. medulloblastoma
- D. retinoblastoma
Correct Answer: D
Rationale: Retinoblastoma predominantly occurs in children under 5 years of age, making it the least likely to occur in adults.
Potential sources of mercury include all of the following EXCEPT
- A. swordfish
- B. old teething powders
- C. quicksilver
- D. milk
Correct Answer: D
Rationale: Mercury is not typically found in milk. It is commonly found in fish, old teething powders, quicksilver, and other sources.
Which of the ff. is a normal hemoglobin value?
- A. 38% to 48%
- B. 48 to 54 mg%
- C. 12 to 18 g/100mL
- D. 27 to 36 g/dL
Correct Answer: C
Rationale: The normal hemoglobin values are typically expressed in grams per deciliter (g/dL) or grams per 100 milliliters (g/100mL) of blood. The range of 12 to 18 g/100mL is considered the normal range for hemoglobin levels in adults. Hemoglobin values outside of this range may indicate various health conditions such as anemia or polycythemia. Option A (38% to 48%) is a range for hematocrit, not hemoglobin. Option B (48 to 54 mg%) and Option D (27 to 36 g/dL) are not within the standard normal range for hemoglobin levels.
Several hours after returning from surgery, the nurse tells the patient that she is ordered to be ambulated. The patient asks, "Why?" Which of the following complications would the nurse correctly explain can be prevented by early postoperative ambulation?
- A. Increased peristalsis
- B. Coughing
- C. Pneumonia
- D. Wound healing  A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET K
Correct Answer: C
Rationale: Early postoperative ambulation is important for preventing complications such as pneumonia. When a patient remains immobile for an extended period after surgery, they are at an increased risk of developing pneumonia due to decreased lung expansion and secretions pooling in the lungs. Ambulation helps improve lung function, promote better oxygenation, and prevent respiratory complications like pneumonia. In contrast, increased peristalsis helps prevent constipation, coughing helps prevent respiratory complications as well, and wound healing is not directly related to the need for early postoperative ambulation.