For which of the following conditions is a client with multiple myeloma (MM) monitored?
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Solution
Hypercalcemia
Calcium is released when the bone is destroyed. This causes an increase in serum calcium levels. MM doesn’t affect potassium, sodium, or magnesium levels.
Which of the following substances has abnormal values early in the course of multiple myeloma (MM)?
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Solution
Immunoglobulins
MM is characterized by malignant plasma cells that produce an increased amount of immunoglobulin that isn’t functional. As more malignant plasma cells are produced, there’s less space in the bone marrow for RBC production. In late stages, platelets and WBC’s are reduced as the bone marrow is infiltrated by malignant plasma cells.
Which of the following clients is most at risk for developing multiple myeloma?
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Solution
A 60-year-old Black man
Multiple myeloma is more common in middle-aged and older clients (the median age at diagnosis is 60 years) and is twice as common in Blacks as Whites. It occurs most often in Black men.
A client with leukemia has neutropenia. Which of the following functions must be frequently assessed?
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Solution
Breath sounds
Pneumonia, both viral and fungal, is a common cause of death in clients with neutropenia, so frequent assessment of respiratory rate and breath sounds is required. Although assessing blood pressure, bowel sounds, and heart sounds is important, it won’t help detect pneumonia.
Which of the following foods should a client with leukemia avoid?
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Solution
Carrot sticks
A low-bacteria diet would be indicated with excludes raw fruits and vegetables.
Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?
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Solution
Faster growing cells are more susceptible to chemotherapy
The faster the cell grows, the more susceptible it is to chemotherapy and radiation therapy. Slow-growing and non-dividing cells are less susceptible to chemotherapy. Repeated cycles of chemotherapy are used to destroy nondividing cells as they begin active cell division.
According to a standard staging classification of Hodgkin’s disease, which of the following criteria reflects stage II?
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Solution
Involvement of two or more lymph node regions or structures.
Stage II involves two or more lymph node regions. Stage I only involves one lymph node region; stage III involves nodes on both sides of the diaphragm; and stage IV involves extralymphatic organs or tissues.
At the time of diagnosis of Hodgkin’s lymphoma, which of the following areas is often involved?
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Solution
Neck
At the time of diagnosis, a painless cervical lesion is often present. The back, chest, and groin areas aren’t involved.
Which of the following laboratory values is expected for a client just diagnosed with chronic lymphocytic leukemia?
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Solution
Thrombocytopenia and increased lymphocytes
Chronic lymphocytic leukemia shows a proliferation of small abnormal mature B lymphocytes and decreased antibody response. Thrombocytopenia also is often present. Uncontrolled proliferation of granulocytes occurs in myelogenous leukemia.
Which of the following conditions is not a complication of Hodgkin’s disease?
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Solution
Myocardial Infarction
Complications of Hodgkin’s are pancytopenia, nausea, and infection. Cardiac involvement usually doesn’t occur.