Correct Answer: A

Rationale: Epoetin alfa stimulates the production of red blood cells, which is important for a client who refuses blood transfusions.

Correct Answer: C

Rationale: The nurse should encourage the patient to consume 2 to 4 liters of fluid daily to reduce the risk of hypercalcemia.

Correct Answer: A

Rationale: Skipping oral hygiene is not appropriate for a client, even if they are tired, as it increases the risk of infection.

Correct Answer: A

Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.

Correct Answer: D

Rationale: In the immediate postoperative period following a gastrectomy, any bloody drainage from the nasogastric (NG) tube is concerning and requires prompt evaluation. This could indicate potential complications such as bleeding from the surgical site, erosion, or other postoperative issues. Notifying the healthcare provider immediately is crucial to ensure that the patient receives timely assessment and intervention. The presence of blood may necessitate further diagnostic procedures, interventions, or changes in management to prevent serious complications.