A client calls the nurse in the emergency department and states that he was just stung by a bumblebee while gardening. The client is afraid of a severe reaction because the client's neighbor experienced such a reaction just 1 week ago. Which action should the nurse take?

Correct Answer: B

Rationale: The correct answer is B: Ask the client if he ever sustained a bee sting in the past. This answer is correct because knowing the client's past history with bee stings can help the nurse assess the risk of a severe reaction. If the client has a history of severe reactions, the nurse may need to take immediate action. Choice A is incorrect because soaking the site in hydrogen peroxide is not the appropriate initial action for a bee sting. Choice C is incorrect because calling an ambulance is not necessary unless there are severe symptoms present, such as difficulty breathing or anaphylaxis. Choice D is incorrect because telling the client not to worry about the sting unless difficulty breathing occurs can be dangerous, as severe allergic reactions can happen rapidly and without warning.

Correct Answer: D

Rationale: The correct answer is D: Greater than 30% plasma cells in bone marrow. This scenario is indicative of multiple myeloma, a plasma cell disorder. High Ca and renal insufficiency suggest hypercalcemia and kidney damage due to monoclonal protein deposition. Anemia and MCV suggest bone marrow involvement. Choice A is not specific for multiple myeloma. Choice B is used to evaluate bone metastasis. Choice C is invasive and not typically done for initial diagnosis of multiple myeloma. Therefore, D is the best option for definitive diagnosis in this case.

Correct Answer: D

Rationale: The correct answer is D: MRI scan of spine. For a patient with thoracic pain, leg weakness, and incontinence during chemo for breast cancer, an MRI of the spine is crucial to evaluate for spinal cord compression, a serious complication. This can present with the mentioned symptoms and requires urgent intervention. Serum calcium (A) is not the most important study as it is less likely to explain the patient's symptoms. A bone scan (B) and plain radiographs (C) may not provide detailed imaging of the spinal cord to assess for compression. An MRI scan of the spine (D) offers the best visualization to identify spinal cord compression and guide appropriate management.

Correct Answer: D

Rationale: The correct answer is D: Adjuvant hormonal therapy. For ER/PR+ breast cancer, hormonal therapy is the standard treatment to reduce the risk of recurrence. This patient has a high-risk tumor with positive lymph nodes, making hormonal therapy crucial to target any remaining cancer cells. No further treatment (A) is not appropriate given the high-risk features. Radiation to mammary nodes (B) is not the standard of care for ER/PR+ breast cancer. Platinum chemotherapy (C) is not indicated for ER/PR+ breast cancer and is reserved for other subtypes.

Correct Answer: D

Rationale: The correct answer is D: No further testing. In this scenario, the patient has a clear risk factor for DVT (long flight) and is already on anticoagulation therapy. Further diagnostic tests are not necessary for the management of acute DVT in this case. Testing for Factor V Leiden or Protein C, S, antithrombin III levels would not change the management at this point. Antiphospholipid antibody test is not indicated as there are no signs or symptoms suggestive of antiphospholipid syndrome. The most appropriate action is to continue the current treatment and monitor the patient's response.