A 65-year-old patient with newly diagnosed multiple myeloma presents with bone pain and fatigue. Which of the following is the most appropriate initial nursing intervention?
Start the patient on a high-calcium diet to strengthen bones.
Encourage the patient to increase physical activity to build bone strength.
Advise the patient to limit fluid intake to prevent kidney damage.
Administer prescribed analgesics and educate the patient about pain management strategies.
The Correct Answer is D
Choice A Reason:
Starting the patient on a high-calcium diet is not the most appropriate initial intervention for multiple myeloma. Multiple myeloma often leads to hypercalcemia, a condition where calcium levels in the blood are abnormally high due to bone breakdown. Increasing calcium intake can exacerbate this condition, leading to further complications such as kidney stones and impaired kidney function. Therefore, this choice is not suitable for managing the patient’s immediate symptoms.
Choice B Reason:
Encouraging the patient to increase physical activity to build bone strength is beneficial in the long term but not the most appropriate initial intervention. While weight-bearing exercises can help strengthen bones, they should be introduced gradually and under medical supervision to avoid fractures and other injuries. The immediate priority is to manage the patient’s pain and fatigue effectively.
Choice C Reason:
Advising the patient to limit fluid intake to prevent kidney damage is not appropriate. In fact, adequate hydration is crucial for patients with multiple myeloma to help flush out toxins and prevent kidney damage. Limiting fluid intake can lead to dehydration and worsen kidney function, which is already at risk due to the disease.
Choice D Reason:
Administering prescribed analgesics and educating the patient about pain management strategies is the most appropriate initial intervention. Pain management is a critical aspect of care for multiple myeloma patients, as bone pain is a common and debilitating symptom. Effective pain management improves the patient’s quality of life and allows them to participate in other therapeutic activities. Education on pain management strategies, including the use of medications, physical therapy, and complementary therapies, empowers the patient to manage their symptoms effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Warm and moist skin is not a typical manifestation of hypoglycemia. Instead, hypoglycemia often causes symptoms such as cold, clammy skin due to the body’s response to low blood sugar levels. Warm and moist skin can be associated with other conditions, such as hyperthyroidism or fever, but not hypoglycemia.
Choice B Reason:
A decreased appetite is not a common symptom of hypoglycemia. In fact, hypoglycemia can sometimes cause increased hunger as the body signals the need for more glucose. Symptoms of hypoglycemia are more related to the body’s immediate response to low blood sugar, such as shakiness, sweating, and confusion.
Choice C Reason:
Increased thirst is a symptom more commonly associated with hyperglycemia (high blood sugar) rather than hypoglycemia. When blood sugar levels are high, the body tries to eliminate excess glucose through urine, leading to dehydration and increased thirst. Hypoglycemia, on the other hand, does not typically cause increased thirst.
Choice D Reason:
Feeling shaky is a classic symptom of hypoglycemia. When blood sugar levels drop, the body releases adrenaline, which can cause shakiness, sweating, and a rapid heartbeat. Recognizing this symptom is crucial for individuals with diabetes to take immediate action to raise their blood sugar levels and prevent severe hypoglycemia.
Correct Answer is B
Explanation
Choice A Reason:
Night blindness, or difficulty seeing in low light, is not a primary symptom of macular degeneration. This condition primarily affects the macula, the central part of the retina responsible for sharp, central vision. Night blindness is more commonly associated with conditions like retinitis pigmentosa or vitamin A deficiency.
Choice B Reason:
Central vision loss is the hallmark of macular degeneration. This condition leads to the deterioration of the macula, causing blurred or lost central vision while peripheral vision remains intact. Patients often report difficulty reading, recognizing faces, and performing tasks that require fine visual detail3.
Choice C Reason:
Peripheral vision loss is not typically associated with macular degeneration. This condition affects the central part of the retina, leaving peripheral vision largely unaffected. Peripheral vision loss is more commonly seen in conditions like glaucoma.
Choice D Reason:
Double vision, or diplopia, is not a characteristic symptom of macular degeneration. This condition affects the clarity of central vision but does not typically cause double vision. Double vision can result from issues with the eye muscles or nerves, such as in cases of strabismus or cranial nerve palsies.
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