A patient with multiple myeloma calls the home health nurse complaining of severe back pain of new onset. The appropriate response by the nurse is to do which of the following?

Inquire about the patient's use of NSAIDs and analgesics to manage pain.

Reassure the patient that bone pain is expected with this disease.

Suggest the use of a back brace to reduce pain.

Notify the healthcare provider of the onset of new pain.

Answer and Explanation

The Correct Answer is D

Choice A reason: While it is useful to know the patient's current pain management strategies, new onset severe back pain could indicate a serious complication such as a spinal fracture or compression, which requires immediate attention.

Choice B reason: Reassuring the patient is not appropriate without further assessment, as new onset severe pain could signify a serious issue that needs to be addressed.

Choice C reason: Suggesting a back brace may be part of the management plan, but it should not precede notifying the healthcare provider of new severe pain.

Choice D reason: Notifying the healthcare provider is the correct action because new onset severe back pain in a patient with multiple myeloma could indicate a serious condition such as a spinal fracture or compression, which requires prompt evaluation and treatment.

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Correct Answer is D

Explanation

Choice A reason: While painful and red-tinged urination is a concern, it is not directly related to the intravenous pyelogram procedure.

Choice B reason: The end of the menstrual period is not relevant to the intravenous pyelogram procedure.

Choice C reason: Drinking ﬂuids is generally encouraged but does not need to be reported unless it is restricted before the procedure.

Choice D reason: The client's allergy to shellfish is important to report because the contrast dye used in an intravenous pyelogram may contain iodine, which can cause a reaction in people with shellfish allergies.

A. Inadequate retention of serum sodium (Na). B. Inadequate production of erythropoietin. C. Blood loss in the urine. D. Renal desensitization to Vitamin D.

Correct Answer is B

Explanation

Choice A reason: Inadequate retention of serum sodium is not typically associated with anemia in chronic renal failure.

Choice B reason: Inadequate production of erythropoietin is the correct answer because the kidneys produce erythropoietin, which stimulates the bone marrow to produce red blood cells. In chronic renal failure, the kidneys cannot produce enough erythropoietin, leading to anemia.

Choice C reason: While blood loss in the urine can occur, it is not the primary cause of anemia in chronic renal failure.

Choice D reason: Renal desensitization to Vitamin D aﬀects bone health and calcium levels but is not the primary cause of anemia in chronic renal failure.

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A patient with multiple myeloma calls the home health nurse complaining of severe back pain of new onset. The appropriate response by the nurse is to do which of the following?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

Correct Answer is D

Explanation

A client who has chronic renal failure and has been on dialysis for 2 years has been wondering why he is anemic. The nurse explains that anemia accompanies chronic renal failure because of:

Correct Answer is B

Explanation

The normal PR interval is:

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