A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?

Correct Answer: D

Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.

Correct Answer: B

Rationale: In patients with Rheumatic fever, typical manifestations include an increase in body temperature, non-pruritic rashes, and migratory joint pains. Voluntary muscle spasm is not a typical manifestation of Rheumatic fever. The main clinical features of Rheumatic fever are related to the inflammation of the heart, joints, skin, and central nervous system. Muscle spasms are not a prominent feature of this condition. It is important for the nurse to be aware of these typical manifestations to effectively monitor and manage the patient's condition.

Correct Answer: B

Rationale: Cohort studies are types of epidemiological studies that involve a group of individuals who share a common characteristic or experience and are followed over time to observe the development of a particular health outcome. This type of study is useful in determining the incidence of a disease, identifying risk factors, and studying the natural history of a disease. Cohort studies allow researchers to investigate the relationship between exposure and outcome by following participants forward in time. It helps in establishing causality and is particularly useful for studying rare exposures or outcomes. In contrast, cross-sectional studies involve collecting data from a population at a single point in time, experimental studies involve interventions and control groups, and case-control studies involve comparing individuals with a particular health outcome (cases) to those without the outcome (controls) retrospectively.

Correct Answer: D

Rationale: Involution refers to the process of the uterus returning to its nonpregnant state after childbirth. During pregnancy, the uterus undergoes significant changes and enlarges to accommodate the growing fetus. After childbirth, the uterus begins to contract, leading to a decrease in its size and a return to its pre-pregnant state. This process involves the shedding of the excess endometrial tissue and the reduction of the size of the uterine muscle fibers. It is a normal and essential process for postpartum recovery. Failure of the uterus to undergo proper involution is known as subinvolution, which can lead to complications such as postpartum hemorrhage.

Correct Answer: D

Rationale: A family history of breast cancer is a known risk factor for the development of ovarian cancer. Individuals with a close relative (such as a mother, sister, or daughter) who has had breast cancer have a higher risk of developing ovarian cancer. This increased risk is due to shared genetic factors that can predispose individuals to both breast and ovarian cancers. Therefore, having a family history of breast cancer is an important risk factor to consider in the assessment of ovarian cancer risk.