Nokea
The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder?
- A. Increased calcium level
- B. Increased white blood cells
- C. Decreased blood urea nitrogen level
- D. Decreased number of plasma cells in the bone marrow
Correct Answer: A
Rationale: In multiple myeloma, the nurse would expect to note an increased calcium level in the laboratory results. This elevation is due to bone destruction caused by the disease, releasing calcium into the bloodstream. Increased white blood cells (Choice B) are not typically associated with multiple myeloma. Additionally, a decreased blood urea nitrogen level (Choice C) is not a common finding in this disorder. Multiple myeloma is characterized by the proliferation of abnormal plasma cells in the bone marrow, leading to an increased number of plasma cells, not a decreased number (Choice D). Therefore, the correct answer is an increased calcium level.
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A clinic patient is being treated for polycythemia vera, and the nurse is providing health education. What practice should the nurse recommend to prevent the complications of this health problem?
- A. Avoiding natural sources of vitamin K
- B. Avoiding altitudes of 1500 feet (457 meters)
- C. Performing active range of motion exercises daily
- D. Avoiding tight and restrictive clothing on the legs
Correct Answer: D
Rationale: The correct answer is D: Avoiding tight and restrictive clothing on the legs. Patients with polycythemia vera are at risk of deep vein thrombosis (DVT), so it is essential to avoid tight and restrictive clothing that can impede circulation. Choices A, B, and C are incorrect because avoiding natural sources of vitamin K, altitudes of 1500 feet, and performing active range of motion exercises are not directly related to preventing complications of polycythemia vera.
A patient with multiple myeloma is receiving chemotherapy and is at risk for bone fractures. What intervention should the nurse prioritize to reduce this risk?
- A. Encouraging bed rest
- B. Promoting bed rest to avoid injury
- C. Encouraging weight-bearing exercises
- D. Ensuring adequate hydration
Correct Answer: B
Rationale: The correct answer is B: 'Promoting bed rest to avoid injury.' In patients with multiple myeloma undergoing chemotherapy, encouraging bed rest can lead to muscle weakness and bone loss, increasing the risk of fractures. Promoting bed rest to avoid injury means advising the patient on safe movement and activities to prevent fractures. Encouraging weight-bearing exercises (choice C) would be more beneficial than bed rest as it helps in maintaining bone density and strength. Ensuring adequate hydration (choice D) is essential for overall health but does not directly address the risk of bone fractures associated with multiple myeloma and chemotherapy. Choice A, 'Encouraging bed rest,' is incorrect as it may worsen the risk of fractures rather than reduce it.
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?
- A. Impaired nutritional status
- B. Cognitive changes
- C. Diarrhea
- D. Alopecia
Correct Answer: A
Rationale: Corrected Rationale: Impaired nutritional status is a potential adverse effect of radiotherapy to the head and neck due to alterations in oral mucosa and taste. While cognitive changes, diarrhea, and alopecia can be side effects of other treatments or conditions, they are not typically associated with external radiation for a malignant tumor of the neck. Therefore, the nurse should primarily focus on discussing the risk of impaired nutritional status with the patient.
Which of the following management strategies is not included for a patient taking chemotherapeutic drugs?
- A. Limit exposure of pregnant visitors
- B. Protect client from infection
- C. Allow client to use makeup and wig
- D. Administer IV fluids as ordered
Correct Answer: C
Rationale: The correct answer is C. Chemotherapy can lead to hair loss, and while using wigs is common, it is not a primary management strategy. The focus should be on limiting exposure to pregnant visitors to prevent harm to the fetus, protecting the client from infections due to a compromised immune system, and administering IV fluids as ordered to maintain hydration levels. Allowing the client to use makeup and wigs is not a primary concern when managing a patient taking chemotherapeutic drugs.
Nurse Rose is caring for a client with cancer who has developed spinal cord compression. Which of the following symptoms would the nurse expect to find?
- A. Decreased deep tendon reflexes
- B. Severe headache
- C. Back pain
- D. Loss of bladder control
Correct Answer: C
Rationale: The correct answer is C: 'Back pain.' Back pain is a common symptom of spinal cord compression in cancer patients. This condition can cause localized or radiating back pain due to the compression of the spinal cord or nerves. While symptoms such as decreased deep tendon reflexes, severe headache, and loss of bladder control can occur in other conditions, back pain is specifically associated with spinal cord compression in cancer patients.