The home care nurse is providing teaching to the family of a patient with multiple myeloma. Which nursing diagnosis should guide the nurse for this teaching?

Ineffective airway clearance related to swelling of the lymph nodes

Ineffective tissue perfusion related to vascular occlusion

Risk for injury related to compromised bone integrity

Risk for deficit fluid volume related to a bleeding disorder

Answer and Explanation

The Correct Answer is C

A. Ineffective airway clearance related to swelling of the lymph nodes: Multiple myeloma primarily affects bone marrow and bones rather than lymph nodes, so this diagnosis is less relevant.

B. Ineffective tissue perfusion related to vascular occlusion: Vascular occlusion is not a common complication of multiple myeloma, although hyperviscosity can occur, especially in advanced stages. However, the primary concern is bone integrity.

C. Risk for injury related to compromised bone integrity: Multiple myeloma weakens bones due to the presence of osteolytic lesions, increasing the risk for fractures. Teaching the family about measures to prevent injury is crucial.

D. Risk for deficit fluid volume related to a bleeding disorder: Multiple myeloma does not usually cause a primary bleeding disorder that would result in fluid volume deficit. Bone fractures and hypercalcemia are more immediate concerns.

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Correct Answer is C

Explanation

A. Red blood cells (RBCs) 5.0 million/mm³ (F 4.2–5.4; M 4.7–6.1): This RBC count is within normal limits and does not indicate a concern related to thrombocytopenia.

B. Hemoglobin 14.5 g/100 mL (F 12–16; M 14–18): Hemoglobin is within normal limits and is not an immediate concern for a patient with ITP, as thrombocytopenia primarily affects platelets, not hemoglobin levels.

C. Platelets 50,000/mm³ (150,000–400,000): A platelet count of 50,000/mm³ is significantly below the normal range and poses a risk for bleeding, which is the primary concern in ITP (immune thrombocytopenic purpura).

D. White blood cells (WBCs) 7,400/mm³ (5,000–10,000): The WBC count is normal and not directly related to thrombocytopenia in ITP, which specifically affects platelets.

A. Myxedema B. Pathologic fracture C. Retinopathy D. Gastrointestinal bleeding

Correct Answer is B

Explanation

A. Myxedema: Myxedema is associated with hypothyroidism, not multiple myeloma.

B. Pathologic fracture: Advanced multiple myeloma causes bone demineralization and osteolytic lesions, making bones fragile and increasing the risk for pathologic fractures.

C. Retinopathy: Retinopathy is commonly associated with diabetes or hypertension, not with multiple myeloma.

D. Gastrointestinal bleeding: Gastrointestinal bleeding is not a typical complication of multiple myeloma.

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The home care nurse is providing teaching to the family of a patient with multiple myeloma. Which nursing diagnosis should guide the nurse for this teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing laboratory values for a patient with thrombocytopenia associated with ITP. Which result would concern the nurse the most?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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