You obtain the following data about a client admitted with multiple myeloma. Which information has the most immediate implications for the client's care?

Correct Answer: D

Rationale: In the context of a client admitted with multiple myeloma, the most immediate implication for the client's care is option D) The client is unable to plantarflex the feet. This finding indicates a potential complication of multiple myeloma known as spinal cord compression, which is a medical emergency requiring urgent intervention to prevent permanent neurological damage. Option A) The client complaining of chronic bone pain is a common symptom of multiple myeloma, but it does not indicate an immediate need for intervention. Option B) Elevated blood uric acid levels can occur in multiple myeloma due to increased cell turnover but do not pose an immediate threat. Option C) Bence-Jones protein in the urine is a hallmark of multiple myeloma, but its presence does not require immediate action compared to spinal cord compression. In an educational context, understanding the acute complications of multiple myeloma is crucial for nurses and healthcare providers to prioritize care and intervene promptly to prevent serious consequences for the patient. Recognizing signs of spinal cord compression, such as the inability to plantarflex the feet, can lead to timely assessment, imaging, and treatment to ensure the best outcomes for the client.

Correct Answer: D

Rationale: The most important information to communicate to the LTC charge nurse prior to transferring a client with newly diagnosed chronic myeloid leukemia is option D) The client's chemotherapy has resulted in neutropenia. Neutropenia is a critical concern in leukemia patients as it indicates a decreased number of neutrophils, which are important in fighting infections. Leukemia and its treatment compromise the immune system, making patients more susceptible to infections. This information is crucial for the LTC charge nurse to be vigilant about signs of infection and to implement appropriate infection control measures. Option A) The presence of the Philadelphia chromosome in the blood smear is important for diagnosing chronic myeloid leukemia but does not impact immediate care or management at the LTC facility. Option B) Elevated glucose levels due to prednisone therapy may be relevant for managing diabetes but are not as urgent as addressing neutropenia in a leukemia patient. Option C) Weight loss is a common symptom in leukemia, but it does not pose an immediate threat as neutropenia does. Educationally, understanding the priority of communicating critical health information when transferring patients is vital for healthcare professionals to ensure continuity of care and patient safety. This scenario highlights the importance of recognizing and addressing complications of leukemia and its treatment to prevent life-threatening infections in vulnerable patients.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Numbness and tingling of the feet. This symptom is of most concern because it can indicate peripheral neuropathy, a serious side effect of cyclosporine. Peripheral neuropathy is a condition that affects the nerves outside of the brain and spinal cord, and it can lead to significant complications if not addressed promptly. Option A) Bleeding of the gums while brushing the teeth could be a sign of gum disease or poor oral hygiene, which are common but less urgent issues compared to peripheral neuropathy. Option B) Non-tender swelling in the right groin could be related to various factors such as lymphadenopathy or a hernia, but these are not directly linked to cyclosporine use. Option C) Occasional nausea after taking the medication is a common side effect of many drugs, including cyclosporine, and may not be as concerning as peripheral neuropathy. From an educational standpoint, understanding the potential side effects of medications used in post-transplant care is crucial for healthcare professionals to provide safe and effective patient care. Recognizing and prioritizing symptoms like peripheral neuropathy can help prevent serious complications and improve patient outcomes. It is essential to monitor patients closely for such side effects and intervene promptly to ensure their well-being.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) A 20-year-old with possible acute myelogenous leukemia who has just arrived on the medical unit. This client should be assessed first because acute myelogenous leukemia is a potentially life-threatening condition that requires immediate intervention and close monitoring. Rapid assessment and initiation of appropriate treatment are crucial in managing this condition. Option B) A 38-year-old with aplastic anemia who needs teaching about decreasing infection risk prior to discharge is not the priority in this situation. While education is important, it is not as urgent as assessing and managing a potentially critical condition like acute myelogenous leukemia. Option C) A 40-year-old with lymphedema who requests help to put on compression stockings before getting out of bed is a lower priority compared to a client with a suspected serious hematological disorder like leukemia. Option D) A 60-year-old with non-Hodgkin's lymphoma who is refusing the ordered chemotherapy regimen, while important, is not the priority at this moment. The immediate focus should be on the client with possible acute myelogenous leukemia to ensure timely intervention and assessment. In an educational context, understanding the prioritization of patient care based on the urgency of conditions is crucial for nurses and healthcare providers. By prioritizing care effectively, they can ensure that critical conditions are addressed promptly, leading to better patient outcomes and safety. This question highlights the importance of quick decision-making and critical thinking in a clinical setting, especially in hematology where timely interventions can significantly impact patient health.

Correct Answer: B

Rationale: In the context of hematology and the classification of white blood cells, it is essential to understand the different types of leukocytes based on their characteristics and functions. Granulocytes are a category of white blood cells characterized by the presence of granules in their cytoplasm. In this question, the correct answer is B) Monocyte, which is not classified as a granulocyte. A) Basophils, C) Eosinophils, and D) Neutrophils are all examples of granulocytes. Basophils are involved in allergic reactions and the inflammatory response. Eosinophils play a role in combating parasitic infections and modulating allergic responses. Neutrophils are the most abundant type of white blood cell and are essential for fighting bacterial infections through phagocytosis. Monocytes, on the other hand, are classified as agranulocytes because they lack visible granules in their cytoplasm. Monocytes are crucial for immune responses as they can differentiate into macrophages and dendritic cells, which are involved in phagocytosis, antigen presentation, and regulation of the immune system. Understanding the classification of white blood cells, such as granulocytes and agranulocytes, is fundamental in hematology as it helps healthcare professionals diagnose and treat various conditions related to immune function and infection. By knowing the distinguishing features of each type of white blood cell, healthcare providers can better interpret lab results, assess a patient's immune status, and provide appropriate care.