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

Answer and Explanation

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.

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Correct Answer is ["A","B","C","E","F"]

Explanation

Choice A reason : Morphine sulfate is used intravenously in acute heart failure with pulmonary edema because it can reduce preload and afterload, thereby decreasing the work of the heart and improving breathing.

Choice B reason : Administering oxygen is crucial for a client with pulmonary edema to improve oxygenation and relieve symptoms of hypoxia.

Choice C reason : Transporting the client to the coronary care unit is appropriate for continuous monitoring and management of acute heart failure and pulmonary edema.

Choice D reason : While placing the client in a high Fowler's position is recommended to ease breathing, the low Fowler's side-lying position is not typically indicated for pulmonary edema. Therefore, this choice is incorrect.

Choice E reason : Inserting a Foley catheter can help monitor urine output, especially important when administering diuretics like furosemide, and manage fluid status.

Choice F reason : Administering furosemide (Lasix), a diuretic, helps to reduce fluid overload and relieve pulmonary congestion in clients with heart failure and pulmonary edema.

A. A 40-year-old woman who came into the ER with a swollen, painful calf and now complains of chest pains and having trouble breathing, with tachycardia and tachypnea. B. A 60-year-old man who is tired and has been in the med-surg unit for 3 days with AKI after taking IV antibiotics. C. A 30-year-old man with a history of smoking and a sedentary lifestyle who had an appendectomy 1 day ago and is refusing to ambulate or wear compression stockings. D. A 55-year-old woman who came into the ER with chest pains, shortness of breath, nausea, tachypnea, and radiating jaw pain.

Correct Answer is A

Explanation

Choice A reason : The symptoms described for the 40-year-old woman align closely with the clinical presentation of a pulmonary embolism. Swelling and pain in the calf may indicate deep vein thrombosis (DVT), which can lead to PE. The presence of chest pain, difficulty breathing, rapid heart rate (tachycardia), and rapid breathing (tachypnea) are hallmark signs of PE³⁴.

Choice B reason : While the 60-year-old man is experiencing fatigue, which can be a symptom of many conditions, there is no direct indication of PE. Acute kidney injury (AKI) after IV antibiotics suggests a different pathophysiology unrelated to PE.

Choice C reason : The 30-year-old man's refusal to ambulate or wear compression stockings after surgery increases his risk for DVT and subsequently PE; however, he does not currently exhibit symptoms that are as indicative of PE as the 40-year-old woman.

Choice D reason : The 55-year-old woman's symptoms could suggest a cardiac event, such as a heart attack, especially with the radiating jaw pain. While PE can present with similar symptoms, the radiating pain is more characteristic of cardiac issues³.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","E","F"]

Explanation

Which patient is most likely experiencing a pulmonary embolism (PE)?

Correct Answer is A

Explanation

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