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 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.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason : A nagging cough can be a warning sign of cancer, particularly lung cancer. If a cough persists for weeks or longer, especially if it's accompanied by blood or sputum, it should be evaluated by a healthcare professional. Persistent coughing can also be symptomatic of laryngeal or thyroid cancer¹.
Choice B reason : A nonhealing sore that persists for more than a few weeks can be a sign of skin cancer, including melanoma, basal cell carcinoma, or squamous cell carcinoma. It's also a common sign of oral cancer, especially in individuals who use tobacco or consume excessive alcohol¹.
Choice C reason : A change in moles or other skin lesions can be an early indication of skin cancer. The ABCDE rule is a guide to the usual signs of melanoma, looking for Asymmetry, Border irregularity, Color changes, Diameter greater than 6mm, and Evolving size, shape or color².
Choice D reason : While bloating can be caused by many benign conditions, persistent bloating that doesn't go away can be a sign of ovarian or other types of abdominal cancers. It's important to consider this symptom in conjunction with other signs and symptoms¹.
Choice E reason : A change in bowel pattern, such as persistent diarrhea or constipation, can indicate colorectal cancer. Any significant changes in bowel habits that do not resolve over time warrant medical evaluation¹.
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