A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patient's severe bone pain?

Correct Answer: D

Rationale: The correct answer is D because severe bone pain in multiple myeloma often requires strong analgesics like opioids for effective pain management. Distraction techniques (A) may provide temporary relief but may not address the underlying pain. Hot and cold packs (B) are more suited for musculoskeletal injuries, not severe bone pain. NSAIDs (C) are usually not sufficient for managing severe bone pain in multiple myeloma. Therefore, helping the patient manage the opioid analgesic regimen (D) is the priority for effective pain control.

Correct Answer: B

Rationale: The correct answer is B because assisting the patient to a chair during awake times allows for gradual physical activity, promoting mobility without overwhelming the patient. This option supports the patient's need for movement while considering their current level of fatigue. A is incorrect because educating the patient about the benefits of exercise may not be feasible or appropriate given the patient's current fatigue levels. C is incorrect as stair exercises may be too strenuous for a patient experiencing debilitating fatigue, potentially leading to further exhaustion and risk of injury. D is incorrect because deep breathing and coughing exercises primarily focus on respiratory health and may not directly address the patient's need for physical activity to combat fatigue.

Correct Answer: A

Rationale: The correct answer is A: Clarify the prescription with the provider. Desmopressin is a medication that can cause hyponatremia, especially in patients with low sodium levels like this client. Before administering desmopressin, the nurse should consult with the provider to ensure it is safe to administer the medication given the client's sodium level. Administering the drug without clarifying may worsen the hyponatremia. Choice B is incorrect because administering the drug with an analgesic is not necessary or relevant in this situation. Choice C is incorrect because desmopressin is typically administered via injection, not orally. Choice D is incorrect because assessing factor IX levels is not directly related to the administration of desmopressin in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Thrombocytopenia. Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation. Therefore, monitoring for thrombocytopenia, a decrease in platelet count, is crucial to assess the drug's effectiveness and potential side effects. Hyperuricemia (A) is not directly associated with clopidogrel use. Hyponatremia (B) is not a common adverse reaction of clopidogrel. Lymphocytopenia (C) is not typically linked to clopidogrel and is more commonly seen with other medications or conditions.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Filgrastim stimulates the production of neutrophils. 2. An enlarged spleen can indicate an increase in neutrophils. 3. Therefore, assessing the client for an enlarged spleen is crucial to monitor the drug's effectiveness and potential adverse effects. Summary of why other choices are incorrect: A: Dusky nail beds - Not directly related to filgrastim or neutropenia. B: Petechiae - Typically associated with low platelet count, not neutrophil increase. D: Swollen calf - Unlikely to be a direct adverse effect of filgrastim for neutropenia.