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

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason : A sore throat is a common side effect of radiation therapy to the neck area, particularly for cancer of the larynx. The radiation can cause inflammation and irritation of the throat and laryngeal tissues, leading to pain and discomfort when swallowing¹⁵. This side effect can be managed with pain relief medications and dietary adjustments to include softer foods and liquids.

Choice B reason : Dry mouth, or xerostomia, occurs when radiation damages the salivary glands, reducing saliva production. This can lead to difficulties in speaking, tasting, chewing, and swallowing, as well as an increased risk of dental problems¹³. Patients undergoing radiation therapy are often advised to stay hydrated and may be prescribed saliva substitutes or stimulants.

Choice C reason : Radiation to the neck might damage the thyroid gland, leading to hypothyroidism. Symptoms of thyroid problems due to radiation can include fatigue, weight gain, feeling cold, and having dry skin or hair³. Regular monitoring of thyroid function is recommended for patients who have received radiation therapy in the neck area.

Choice D reason : Lymphedema is swelling that can occur when radiation therapy affects the lymph nodes and vessels, impeding the flow of lymph fluid. In the context of neck radiation, this can lead to swelling in the neck and face³. Management includes physical therapy, compression garments, and careful skin care to prevent infection.

A. Tarry stools B. Blood in the urine C. Moist skin D. Spider angiomas

Correct Answer is D

Explanation

Choice A reason : Tarry stools, also known as melena, can be a sign of gastrointestinal bleeding, which may occur in cirrhosis due to the development of esophageal varices. However, it is not a direct symptom of cirrhosis itself but rather a complication that can arise from the condition¹.

Choice B reason : Blood in the urine is not a typical finding associated with cirrhosis. While cirrhosis can lead to problems with kidney function, hematuria is not a direct symptom of liver disease and may indicate other urological conditions¹.

Choice C reason : Moist skin is not commonly associated with cirrhosis. Patients with cirrhosis often experience skin changes, but these typically include jaundice, bruising, and spider angiomas, not increased moisture of the skin¹.

Choice D reason : Spider angiomas are a common finding in cirrhosis. They are small, spider-like capillaries visible under the skin and are caused by the increased estrogen levels that occur due to the liver's inability to metabolize hormones properly. They are most often found on the face, neck, upper chest, and arms¹².

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client scheduled to receive external radiation to the neck for cancer of the larynx. During a pre-treatment exam, the nurse explains to the client that the most likely side effect would be :

Correct Answer is A

Explanation

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client?

Correct Answer is D

Explanation

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