A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values?
White blood cell count (WBC)
Calcium
Absolute neutrophil count (ANC)
Platelets
The Correct Answer is B
Choice A reason : In multiple myeloma, the white blood cell count (WBC) is not typically elevated. Multiple myeloma primarily affects plasma cells, a type of white blood cell, but it does not usually result in an increased WBC count. Instead, the disease is characterized by the presence of abnormal plasma cells in the bone marrow, which can crowd out healthy blood cells¹.
Choice B reason : Patients with multiple myeloma often have elevated calcium levels, a condition known as hypercalcemia. This occurs because the cancerous plasma cells produce substances that cause bones to break down at a rate faster than they are made, releasing calcium into the bloodstream. Symptoms of hypercalcemia can include fatigue, weakness, confusion, and increased thirst and urination¹².
Choice C reason : The absolute neutrophil count (ANC) is not typically increased in multiple myeloma. ANC is a measure of the number of neutrophils, a type of white blood cell important for fighting infections. While multiple myeloma can affect overall bone marrow function, it does not specifically cause an increase in ANC.
Choice D reason : Platelet counts are not typically elevated in multiple myeloma. In fact, patients may experience thrombocytopenia, or a low platelet count, due to the overproduction of abnormal plasma cells in the bone marrow, which can interfere with the production of platelets¹.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Obsessive-Compulsive Disorder (OCD) is characterized by persistent, unwanted thoughts (obsessions) and behaviors (compulsions) that the individual feels the urge to repeat over and over. While OCD is a separate condition that can co-occur with many disorders, it is not commonly associated as a comorbidity with histrionic personality disorder⁴⁵.
Choice B reason: Schizophrenia is a severe mental disorder that affects how a person thinks, feels, and behaves. It is not typically associated with histrionic personality disorder, which is characterized by excessive emotionality and attention-seeking behaviors⁴⁵.
Choice C reason: Generalized Anxiety Disorder (GAD) is a common comorbidity with histrionic personality disorder. Individuals with histrionic personality disorder may experience high levels of anxiety, which can manifest as GAD. This anxiety often relates to fears of rejection or not being the center of attention⁴⁵.
Choice D reason: Anorexia Nervosa is an eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of body weight. It is more commonly associated with other conditions, such as obsessive-compulsive and avoidant personality disorders, rather than histrionic personality disorder⁴⁵.
Correct Answer is A
Explanation
Choice A reason : Reducing stimuli is crucial for a patient emerging from a coma, especially after a traumatic brain injury (TBI). Excessive sensory input can overwhelm the patient's already compromised neurological state. The goal is to provide a calm and controlled environment to prevent overstimulation, which can lead to increased intracranial pressure (ICP), agitation, and delayed recovery. Interventions may include minimizing noise, dimming lights, and limiting the number of visitors. It's important to tailor the level of stimuli to the individual patient's response and recovery stage.
Choice B reason : Darkening the room can be part of reducing stimuli, but it is not the sole intervention needed. While a darker environment may help some patients rest, it is not universally applicable and should be considered as one aspect of an overall strategy to reduce stimuli. The nurse must assess the patient's individual needs and responses to determine if darkening the room is beneficial.
Choice C reason : The application of restraints is generally considered a last resort due to the potential for physical and psychological harm. Restraints can increase agitation and disorientation, potentially leading to self-injury or interference with medical devices. The use of restraints requires careful consideration, adherence to protocols, and often legal documentation. Non-pharmacological interventions and environmental modifications should be attempted first to manage restlessness.
Choice D reason : The administration of opioids is not typically indicated solely for restlessness in patients emerging from a coma. Opioids can depress the central nervous system, potentially masking neurological assessments and delaying recovery. They are primarily used for pain management. If restlessness is due to pain, then appropriate analgesia, including opioids, may be considered, but the underlying cause of restlessness should be thoroughly assessed and treated.
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