Nokea
In caring for a patient with multiple myeloma, which should the nurse prioritize from the plan of care?
- A. Limit fluid intake to less than 1000 mL/day
- B. Closely supervise and assist when ambulating
- C. Strain all urine for kidney crystals
- D. Limit the use of an analgesic
Correct Answer: B
Rationale: Because of the constant threat of pathologic fractures, ambulation should be carefully supervised and assisted. Fluids are not restricted. Uric acid is increased and may crystalize in the kidney, but straining is not necessary. Analgesia is necessary for relief of bone pain.
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Approximately how much blood is stored in the spleen that can be released in a hypovolemic emergency?
- A. 100 mL
- B. 300 mL
- C. 500 mL
- D. 1000 mL
Correct Answer: C
Rationale: The spleen stores 1 pint of blood, approximately 500 mL, which can be released during emergencies.
The nurse explains that the treatment of hemophilia has been revolutionized with the advent of the use of which medical intervention?
- A. corticosteroids.
- B. large doses of testosterone.
- C. Prophylactic use of factors VIII and IX.
- D. transfusion with packed red cells.
Correct Answer: C
Rationale: Recombinant factor VIII and recombinant factor IX have been major forward steps in the treatment of hemophilia.
The peripheral smear is a diagnostic test performed for which reason?
- A. assesses the level of hemoglobin.
- B. measures antibody production.
- C. examines the shape and structure of cells.
- D. identifies possible sources of infection
Correct Answer: C
Rationale: The peripheral smear allows the study of the size, structure, and shape of cells.
The spleen is a highly vascularized organ located in the left upper quadrant of the abdominal cavity. Which is the main function of the spleen?
- A. Serve as reservoir for blood.
- B. Destroy worn-out RBCs.
- C. Promote phagocytosis.
- D. Responsible for development of T lymphocytes.
- E. Continuously produce RBCs during lifetime.
Correct Answer: A,B,C
Rationale: The spleen stores 500 mL of blood, which can be released during emergencies, such as hemorrhage. The main functions of the spleen are (1) to serve as a reservoir for blood; (2) to destroy old or imperfect RBCs; and (3) to remove bacteria by phagocytosis (engulfing and digesting).
The nurse will prepare the adult patient who will be undergoing bone marrow sampling by explaining the sample will be obtained from which site?
- A. Sternum
- B. Posterior superior iliac crest
- C. Posterior iliac crest
- D. Femur
Correct Answer: C
Rationale: The preferred site for bone marrow aspiration puncture in adults is the posterior iliac crest.