Nursing Elites

1. The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?

• A. Polyuria
• B. Polyphagia
• C. Polydipsia
• D. Weight loss

Correct answer: A

Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.

2. A nurse knows that the patient with stage 3 based on Ann-arber staging has:

• A. 2 or more lymph node involvement and outside the lymph nodes
• B. 2 or more lymph node involvement on one side of the body
• C. 2 or more lymph nodes on the breasts
• D. 2 or more lymph node involvement on both sides of the body

Correct answer: D

Rationale: In the Ann Arbor staging system for lymphomas, Stage 3 indicates that the disease has spread beyond the initial lymph node region to involve lymph nodes on both sides of the diaphragm (i.e., the areas above and below the diaphragm). This includes lymphatic involvement in both the thoracic and abdominal regions, signifying a more advanced disease state.

3. A nurse working with oncology clients knows that an age-related decrease in which function increases the older client’s susceptibility to infection during chemotherapy?

• A. Immune function.
• B. Kidney function.
• C. Liver function.
• D. Cardiac function.

Correct answer: A

Rationale: As people age, the immune system becomes less efficient, a phenomenon known as immunosenescence. This decline in immune function includes reduced production of immune cells (such as T cells and B cells) and diminished responses to infections. During chemotherapy, which further suppresses the immune system, older clients are at a significantly higher risk of developing infections due to this age-related decrease in immune function. This is especially concerning because chemotherapy targets rapidly dividing cells, which include immune cells, making it even harder for the body to fight off infections.

4. All of the following are warning signs of cancer except:

• A. Patient palpates a bump on the side of the breast
• B. Bruises are found on the body that the client cannot explain
• C. Patient often complains of impaired digestion
• D. Patient has blood-tinged sputum

Correct answer: D

Rationale: The correct answer is D. Blood-tinged sputum is not a typical warning sign of cancer but rather a symptom that can indicate other serious conditions like respiratory issues or infections. Choices A, B, and C are common warning signs of cancer: palpable lumps or bumps, unexplained bruises, and persistent digestive issues are often associated with cancer and should be evaluated by a healthcare professional for further assessment and diagnosis.

5. The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

• A. Encouraging fluids
• B. Providing frequent oral care
• C. Coughing and deep breathing
• D. Monitoring the red blood cell count

Correct answer: A

Rationale: The correct answer is A: Encouraging fluids. In a client with multiple myeloma, encouraging fluids is a priority intervention to prevent kidney damage from high calcium levels. Adequate hydration helps maintain renal function and prevents complications. Providing frequent oral care (Choice B) is essential for clients at risk of mucositis or oral infections, such as those undergoing chemotherapy. Coughing and deep breathing exercises (Choice C) are commonly used for clients at risk of respiratory complications, like postoperative patients. Monitoring the red blood cell count (Choice D) is important for conditions like anemia but is not the priority in a client with multiple myeloma, where fluid management is crucial.

Similar Questions