An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood tests, the nurse should anticipate what imbalance?

Correct Answer: A

Rationale: The correct answer is A: Hypercalcemia. In multiple myeloma, bone destruction releases calcium into the bloodstream, leading to hypercalcemia. Elevated serum viscosity (C) is not typically associated with multiple myeloma. Hyperproteinemia (B) may be present due to increased production of abnormal proteins, but it does not directly cause bone destruction. Elevated RBC count (D) is not a common finding in multiple myeloma and is not directly related to bone destruction.

Correct Answer: B

Rationale: The correct answer is B: Promptly refer the patient for medical assessment. A firm, painless cervical lymph node in an adult without recent infectious diseases raises concerns for potential underlying serious conditions such as malignancy. Referring the patient for medical assessment allows for further evaluation, including physical examination, laboratory tests, and imaging studies if necessary, to determine the cause of the lymphadenopathy. This prompt referral is crucial for timely diagnosis and appropriate management. Summary: A: Calling 911 is not warranted as the patient is stable and does not have an emergency medical condition. C: Facilitating a radiograph may not provide sufficient information for evaluating the lymph node and delays definitive assessment. D: Encouraging the patient to wait and track the lymph node size can lead to delayed diagnosis and potentially worsening of the underlying condition.

Correct Answer: B

Rationale: Step-by-step rationale: 1. CLL is characterized by the proliferation of abnormal lymphocytes. 2. Increased lymphocyte levels are a hallmark of CLL due to the accumulation of these abnormal cells. 3. Lymphocytosis is a key diagnostic feature in CLL. 4. Other choices are incorrect because blast cells are characteristic of acute leukemia, bone pain is more common in multiple myeloma, and thrombocytopenia with no bleeding is not a specific finding in CLL. Summary: Increased lymphocyte levels are certain to be present in a patient with CLL due to the abnormal proliferation of lymphocytes. Other choices are incorrect as they do not align with the characteristic features of CLL.

Correct Answer: B

Rationale: The correct answer is B: Headache. Alteplase is a thrombolytic medication that can cause cerebral bleeding, leading to headaches. Monitoring for headaches is crucial as it can indicate a serious adverse effect. Bronchodilation (A) is not associated with alteplase therapy. Edema (C) is not a common adverse effect of alteplase. Hypertension (D) is a potential adverse effect, but it is not as specific or common as headaches in this context.

Correct Answer: B

Rationale: The correct answer is B: Aminocaproic acid. This drug is a fibrinolytic inhibitor that can be used to manage bleeding complications associated with alteplase therapy. It helps to prevent excessive bleeding by inhibiting the breakdown of blood clots. Having aminocaproic acid available is crucial in case the client experiences severe bleeding as a result of alteplase therapy. A: Vitamin K is used to reverse the effects of warfarin, a blood thinner, and is not indicated for managing bleeding due to alteplase therapy. C: Protamine is used to reverse the effects of heparin, not alteplase, and is not indicated for managing bleeding due to alteplase therapy. D: Deferoxamine is an antidote for iron poisoning and is not indicated for managing bleeding due to alteplase therapy. In summary, aminocaproic acid is the correct choice as it helps manage bleeding complications associated with alteplase therapy