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: C

Rationale: The most appropriate action for a concerned nurse when nurses are projected as sex symbols in a television advertisement is to make a position paper to denounce the advertisement. This approach allows the nurse to voice their concerns in a formal and professional manner. By creating a position paper, the nurse can clearly outline why the portrayal is inappropriate and advocate for more respectful representations of nursing in the media. This action is constructive, proactive, and focuses on initiating change through advocacy and education. It is a thoughtful and strategic way to address the issue and raise awareness about the importance of respecting the nursing profession.

Correct Answer: D

Rationale: When managing a patient with a suspected heat stroke, the appropriate action is to remove the patient from the hot environment and start cooling the body. Heat stroke is a medical emergency that can be life-threatening if not promptly treated. Cooling the body is essential to lower the core body temperature as quickly as possible. Ice packs should not be directly applied to the skin as they can cause vasoconstriction and may actually hinder heat dissipation. Administering warm intravenous fluids and encouraging the patient to drink cold water rapidly are also not recommended in the initial management of a heat stroke. The priority is to cool the patient down and seek medical attention immediately.

Correct Answer: C

Rationale: Bruxism is the dental condition characterized by the involuntary grinding or clenching of teeth, often occurring during sleep. This habitual behavior can lead to tooth wear, muscle pain, headaches, and temporomandibular joint dysfunction. Dental caries (choice A) refers to tooth decay, while attrition (choice B) specifically refers to the wearing down of teeth due to forces like chewing. Periodontitis (choice D) is a condition involving inflammation and infection of the gums and supporting structures of the teeth. Among the choices provided, bruxism is the most fitting description for the condition characterized by tooth grinding and clenching.

Correct Answer: C

Rationale: Cervical intraepithelial neoplasia (CIN) is a premalignant condition of the cervix that is characterized by the presence of high-risk human papillomavirus (HPV) types. HPV infection is a major risk factor for the development of cervical cancer. CIN is typically detected on routine cervical screening tests such as Pap smears or HPV testing. If left untreated, CIN can progress to invasive cervical cancer. Therefore, the presence of high-risk HPV types in CIN lesions indicates an increased risk of developing cervical cancer.

Correct Answer: C

Rationale: Nonverbal communication consists of gestures, facial expressions, body language, posture, tone of voice, touch, and eye contact, among other behaviors. Option C, words representing an object, refers to verbal communication rather than nonverbal communication. Nonverbal communication is the behavior that accompanies verbal communication, providing additional layers of meaning and adding context to the spoken words. Therefore, words representing an object are not indicators of nonverbal communication.

Correct Answer: A

Rationale: In the scenario described, the patient is experiencing refractory hypotension despite adequate fluid resuscitation, indicating the presence of septic shock. In septic shock, systemic vasodilation and vascular hyporesponsiveness contribute to hypotension. Therefore, the primary management approach is to restore vascular tone and blood pressure to maintain organ perfusion. Administering vasopressor medications (Choice A) is the crucial intervention to achieve this goal. Vasopressors, such as norepinephrine or vasopressin, constrict blood vessels and increase blood pressure, helping to stabilize the patient in septic shock. While options B and C (performing blood cultures and initiating broad-spectrum antibiotics) are important for identifying the causative pathogen and treating the infection, they are secondary to the immediate need for hemodynamic support in septic shock. Prophylactic anticoagulation (Choice D) is not the primary intervention for

Correct Answer: D

Rationale: Acute respiratory distress syndrome (ARDS) is a severe condition characterized by widespread inflammation in the lungs leading to increased pulmonary vascular permeability, non-cardiogenic pulmonary edema, and respiratory failure. In ARDS, the alveolar-capillary barrier is disrupted, resulting in fluid accumulation in the alveoli and impaired gas exchange.

Correct Answer: C

Rationale: Assessing the patient for respiratory distress is the important nursing intervention that must be done in this situation. The scenario provided indicates that the patient with chronic obstructive pulmonary disease (COPD) is experiencing increased work of breathing, which puts them at risk for respiratory distress. It is crucial for the nurse to monitor the patient's respiratory status closely, including assessing their oxygen saturations, respiratory rate, and effort, to identify any signs of respiratory distress early and intervene promptly. This proactive assessment can help prevent further deterioration of the patient's condition and ensure appropriate nursing interventions are implemented promptly.