A 65-year-old patient with newly diagnosed multiple myeloma presents with bone pain and fatigue. Which of the following is the most appropriate initial nursing intervention?
Start the patient on a high-calcium diet to strengthen bones.
Encourage the patient to increase physical activity to build bone strength.
Advise the patient to limit fluid intake to prevent kidney damage.
Administer prescribed analgesics and educate the patient about pain management strategies.
The Correct Answer is D
Choice A Reason:
Starting the patient on a high-calcium diet is not the most appropriate initial intervention for multiple myeloma. Multiple myeloma often leads to hypercalcemia, a condition where calcium levels in the blood are abnormally high due to bone breakdown. Increasing calcium intake can exacerbate this condition, leading to further complications such as kidney stones and impaired kidney function. Therefore, this choice is not suitable for managing the patient’s immediate symptoms.
Choice B Reason:
Encouraging the patient to increase physical activity to build bone strength is beneficial in the long term but not the most appropriate initial intervention. While weight-bearing exercises can help strengthen bones, they should be introduced gradually and under medical supervision to avoid fractures and other injuries. The immediate priority is to manage the patient’s pain and fatigue effectively.
Choice C Reason:
Advising the patient to limit fluid intake to prevent kidney damage is not appropriate. In fact, adequate hydration is crucial for patients with multiple myeloma to help flush out toxins and prevent kidney damage. Limiting fluid intake can lead to dehydration and worsen kidney function, which is already at risk due to the disease.
Choice D Reason:
Administering prescribed analgesics and educating the patient about pain management strategies is the most appropriate initial intervention. Pain management is a critical aspect of care for multiple myeloma patients, as bone pain is a common and debilitating symptom. Effective pain management improves the patient’s quality of life and allows them to participate in other therapeutic activities. Education on pain management strategies, including the use of medications, physical therapy, and complementary therapies, empowers the patient to manage their symptoms effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Administering an alpha-adrenergic blocker is the highest priority intervention for a patient with pheochromocytoma and severe hypertension. Pheochromocytoma causes excessive secretion of catecholamines, leading to severe hypertension. Alpha-adrenergic blockers help to control blood pressure by blocking the effects of these catecholamines, thereby reducing vasoconstriction and lowering blood pressure. This intervention is crucial to prevent hypertensive crises and associated complications such as stroke or myocardial infarction.
Choice B Reason:
Administering intravenous fluids to maintain hydration is important but not the highest priority. While maintaining hydration is essential, it does not directly address the severe hypertension caused by pheochromocytoma. Intravenous fluids can help support overall patient stability but do not specifically target the underlying cause of the hypertension.
Choice C Reason:
Monitoring blood glucose levels every 4 hours is a necessary intervention, especially since pheochromocytoma can cause hyperglycemia due to increased catecholamine levels. However, this intervention is not the highest priority compared to controlling the severe hypertension, which poses a more immediate threat to the patient’s health.
Choice D Reason:
Preparing the patient for immediate surgery to remove the tumor is a critical step in the long-term management of pheochromocytoma. However, surgery is not typically performed until the patient’s blood pressure is stabilized with medications such as alpha-adrenergic blockers. Therefore, while surgery is essential, it is not the immediate priority in the acute management of severe hypertension.
Correct Answer is B
Explanation
Choice A Reason:
Increased appetite is not typically associated with anemia. Anemia generally leads to symptoms related to decreased oxygen-carrying capacity of the blood, such as fatigue, weakness, and shortness of breath. Increased appetite is more commonly linked to other conditions, such as hyperthyroidism or certain metabolic disorders.
Choice B Reason:
Fatigue is a common and significant symptom of anemia. When hemoglobin levels are low, the body’s tissues do not receive adequate oxygen, leading to feelings of tiredness and exhaustion. This is because hemoglobin is responsible for transporting oxygen from the lungs to the rest of the body. In anemia, the reduced oxygen delivery results in decreased energy levels and persistent fatigue.
Choice C Reason:
Weight gain is not typically associated with anemia. In fact, some forms of anemia, such as those caused by chronic diseases or malnutrition, may lead to weight loss rather than gain. Weight gain can be associated with other health issues, such as hypothyroidism or fluid retention, but not directly with anemia.
Choice D Reason:
Hypertension is not a common manifestation of anemia. Anemia usually leads to symptoms like pallor, shortness of breath, and fatigue due to the reduced oxygen-carrying capacity of the blood. Hypertension, or high blood pressure, is more commonly associated with cardiovascular diseases, kidney disorders, or endocrine conditions.
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