The nurse is teaching a patient with multiple myeloma how to remain safe in the home. Which problem should be a priority for this patient?

Fatigue

Unsteady gait

Back pain

Dyspnea on exertion

Answer and Explanation

The Correct Answer is B

A.   Fatigue is a common symptom in patients with multiple myeloma but may not directly impact safety in the home environment as much as other factors.
B.   An unsteady gait can increase the risk of falls and injuries, making it a priority for safety considerations in the home environment.
C.   Back pain is common in multiple myeloma but may not directly affect safety in the home environment unless it significantly impairs mobility.

D.   Dyspnea on exertion may limit physical activity but may not pose an immediate safety risk in the home environment unless it indicates a severe respiratory compromise.

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Correct Answer is B

Explanation

A. While atrial fibrillation with a rapid ventricular response requires attention, it is not an immediate concern unless associated with symptoms such as chest pain, shortness of breath, or hemodynamic instability.
B. A heart rate of 50 in a patient with a newly inserted permanent pacemaker may indicate bradycardia, which could be a sign of pacemaker malfunction or lead dislodgement. This patient requires immediate assessment to rule out complications.
C. While recent implantable cardioverter-defibrillator (ICD) discharge warrants evaluation, the patient is currently in normal sinus rhythm with a heart rate of 68, suggesting stability. This patient's assessment can be prioritized after the patient with the pacemaker issue is seen.
D. A heart rate of 58 in a patient with chronic atrial fibrillation on beta-blocker therapy may not be immediately concerning if the patient is asymptomatic and hemodynamically stable. This patient can be assessed after addressing the more urgent pacemaker issue.

A. Post chemotherapy B. Diagnosed with sickle cell anemia C. Diagnosed with multiple myeloma D. Post-splenectomy patient

Correct Answer is D

Explanation

A. While patients receiving chemotherapy are at risk for infections due to immunosuppression, the risk of overwhelming infection, particularly from encapsulated bacteria, is higher in post-splenectomy patients due to impaired immune function without the spleen.
B. Patients with sickle cell anemia are at increased risk of infections, particularly from encapsulated bacteria, due to functional asplenia or hyposplenism, but the risk of overwhelming infection is highest in post-splenectomy patients.
C. Patients with multiple myeloma are immunocompromised and at increased risk of infections, but they do not have the same risk of overwhelming infection as post- splenectomy patients.
D. Post-splenectomy patients are at highest risk of overwhelming infection due to impaired immune function resulting from the absence of the spleen, which plays a crucial role in immune surveillance and defense against encapsulated bacteria.

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The nurse is teaching a patient with multiple myeloma how to remain safe in the home. Which problem should be a priority for this patient?

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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