Within 20 minutes of the start of transfusion, the client develops a sudden fever. What is the nurse's first action?

Correct Answer: D

Rationale: The sudden onset of fever early in a blood transfusion can indicate a transfusion reaction, such as a febrile non-hemolytic reaction or a hemolytic reaction. The nurse's first action in this situation should be to stop the transfusion immediately to prevent further complications. Continuing to administer the blood product could worsen the reaction and harm the client. Once the transfusion is stopped, the nurse can then assess the client's condition, provide appropriate interventions, and notify the healthcare provider as needed.

Correct Answer: B

Rationale: Clients with multiple myeloma are at increased risk for pathologic bone fractures due to the disease's effects on bone tissue. Multiple myeloma is a cancer of plasma cells, a type of white blood cell found in the bone marrow. The growth of abnormal plasma cells weakens the bone structure, leading to bone lesions and an increased risk of fractures. The bone lesions can cause pain, bone deformities, and complications such as hypercalcemia. Therefore, nurses caring for clients with multiple myeloma should prioritize interventions to prevent pathologic bone fractures and manage bone health.

Correct Answer: C

Rationale: Administering metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed should be the highest priority intervention for a client experiencing nausea and vomiting after cancer chemotherapy. Metoclopramide is a commonly used antiemetic medication that helps to reduce nausea and vomiting by enhancing gastric emptying and decreasing nausea. Dexamethasone, a corticosteroid, can also help alleviate inflammation that may contribute to the nausea and vomiting. By administering these medications as prescribed, the nurse can effectively address the client's symptoms and improve their comfort level. The other options, such as serving small portions bland food, encouraging rhythmic breathing exercises, and withholding fluids, are important interventions but should not take precedence over providing the prescribed antiemetic medications to manage the client's post-chemotherapy symptoms.

Correct Answer: D

Rationale: Papillary carcinoma is the most common form of thyroid cancer in adults, accounting for approximately 80% of all thyroid cancers. It typically affects individuals in their 30s and 40s and has an excellent prognosis with high survival rates, especially when detected early. Papillary carcinoma arises from the follicular cells of the thyroid gland and is known for its characteristic papillary growth pattern. It often presents as a painless thyroid nodule and may be associated with a history of radiation exposure. Treatment usually involves surgery to remove the thyroid gland (thyroidectomy) followed by radioactive iodine therapy and thyroid hormone replacement.

Correct Answer: D

Rationale: The assessment finding that suggests the client is experiencing an adverse effect of morphine (Duramorph) is a respiratory rate of 8 breaths/min. Morphine is a potent opioid analgesic that can cause respiratory depression as a side effect. When the respiratory rate decreases significantly, it indicates the potential for compromised breathing, which could progress to respiratory failure. This is a serious adverse effect that requires immediate attention and evaluation by healthcare providers. The client receiving continuous infusion of morphine should be closely monitored for signs of respiratory depression to prevent life-threatening consequences.