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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A Reason:

Advising the patient to increase their screen time to exercise their eye muscles is not appropriate for managing macular degeneration. Increased screen time can cause eye strain and does not benefit the condition. Instead, patients should be encouraged to engage in activities that do not exacerbate eye strain.

Choice B Reason:

Encouraging the patient to quit smoking is a crucial intervention for managing macular degeneration. Smoking is a significant risk factor for the progression of macular degeneration. Quitting smoking can help slow the progression of the disease and improve overall eye health. This intervention addresses a modifiable risk factor and can have a positive impact on the patient’s condition.

Choice C Reason:

Suggesting the patient avoid all physical activities to prevent further eye damage is not necessary for managing macular degeneration. Physical activity is important for overall health and does not directly impact the progression of macular degeneration. Patients should be encouraged to maintain a healthy lifestyle, including regular physical activity.

Choice D Reason:

Informing the patient to reduce their water intake to prevent fluid accumulation in the eyes is not relevant for managing macular degeneration. Adequate hydration is important for overall health, and there is no evidence to suggest that reducing water intake will benefit patients with macular degeneration. This advice could potentially lead to dehydration and other health issues.

A. Weight loss. B. Exophthalmos (bulging eyes). C. Thin and fragile hair. D. Enlarged hands and feet.

Correct Answer is D

Explanation

Choice A Reason:

Weight loss is not typically associated with acromegaly. Acromegaly is characterized by excessive growth hormone production, leading to the enlargement of bones and tissues. Patients often experience weight gain rather than loss due to increased bone and soft tissue mass.

Choice B Reason:

Exophthalmos, or bulging eyes, is not a common manifestation of acromegaly. This symptom is more commonly associated with Graves’ disease, a thyroid disorder. Acromegaly primarily affects the bones and soft tissues, leading to changes in facial features and extremities.

Choice C Reason:

Thin and fragile hair is not a typical symptom of acromegaly. While hormonal imbalances can affect hair quality, acromegaly is more commonly associated with changes in bone and soft tissue structure. Symptoms like coarse, oily skin and excessive sweating are more characteristic of this condition.

Choice D Reason:

Enlarged hands and feet are hallmark signs of acromegaly. The excessive production of growth hormone leads to the enlargement of bones in the hands, feet, and face. Patients may notice that their rings no longer fit and that their shoe size has increased. This symptom is a key indicator of acromegaly and is often used in the diagnosis of the condition.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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