Which information obtained by the nurse assessing a patient admitted with multiple myeloma is most important to report to the health care provider?
Urine sample has Bence-Jones protein.
Patient is complaining of severe back pain.
Serum calcium level is 15 mg/dL.
Patient reports no stool for 5 days.
The Correct Answer is C
A. Presence of Bence-Jones protein in the urine is indicative of multiple myeloma, but hypercalcemia is a more urgent issue to address.
B. Severe back pain is common in multiple myeloma due to bone involvement, but it is not as immediately life-threatening as hypercalcemia.
C. Elevated serum calcium levels (hypercalcemia) are a common complication of multiple myeloma and can lead to various complications, including kidney damage, altered mental status, and cardiac arrhythmias. Therefore, it is crucial to report significantly elevated serum calcium levels promptly to the health care provider for appropriate management.
D. Patient reports no stool for 5 days may indicate constipation, which is important to address but is not as urgent as hypercalcemia in the context of multiple myeloma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Presence of plethora is a common symptom of polycythemia vera and indicates increased blood volume but is not immediately life-threatening.
B. Calf swelling and pain could indicate a deep vein thrombosis (DVT), which is a serious complication that requires immediate medical attention.
C. A platelet count of 450,000/microL is elevated but not as critical as the possibility of a DVT.
D. Hematocrit of 55% is high, which is expected in polycythemia vera, but it is not as immediately critical as the risk of thrombosis suggested by calf swelling and pain.
Correct Answer is A
Explanation
A. Given the low hemoglobin level and weight, the patient is likely experiencing fatigue due to decreased oxygen-carrying capacity of the blood, leading to activity intolerance.
B. While weight loss may contribute to body image disturbance, it is not the primary concern for a patient with iron-deficiency anemia and low hemoglobin levels.
C. Anxiety related to the hospital environment may be present, but it is not the most appropriate nursing diagnosis based on the patient's clinical presentation and laboratory findings.
D. Impaired tissue integrity related to immobility is not the most appropriate nursing diagnosis for a patient with iron-deficiency anemia. This diagnosis is more commonly associated with pressure ulcers or skin breakdown in patients who are immobile for extended periods, which is not described in this scenario.
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