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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Explain disease course and expected signs and symptoms to the family. While education is essential, it is not directly related to addressing the acute pain associated with thrombotic crisis.
B. Check peripheral pulses, color, and temperature of extremities every 30 hours. This intervention is important for assessing peripheral perfusion but may not directly address the acute pain associated with thrombotic crisis.
C. Reposition the client, paying close attention to proper body alignment. Repositioning the client to ensure proper body alignment can help alleviate pressure points and discomfort associated with thrombotic crisis.

D. Provide active range of motion (ROM) every 2 hours. While ROM exercises are important for preventing complications such as joint stiffness, they may not directly address the acute pain associated with thrombotic crisis.

A. Urinary hesitancy and frequency B. Vaginal bleeding C. Vesicles and lesions on the labia D. Vaginal drainage with a fishy odor

Correct Answer is C

Explanation

A. Urinary hesitancy and frequency can occur with genital herpes due to the pain and discomfort of the lesions, but these are not the primary manifestations.
B. Vaginal bleeding is not a typical symptom of genital herpes.
C. Vesicles and lesions on the labia are characteristic symptoms of genital herpes, appearing as painful blisters that eventually ulcerate.
D. Vaginal drainage with a fishy odor is typically associated with bacterial vaginosis, not genital herpes.

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Which information obtained by the nurse assessing a patient admitted with multiple myeloma is most important to report to the health care provider?

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Naxlex Comprehensive Predictor Exams

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