HESI Registered Nurse EXIT Practice Exam

What should be included in the care plan for a client in the late stage of multiple myeloma?

1. Monitor for hyperkalemia

2. Place in protective isolation

3. Precautions with position changes

4. Administer diuretics as ordered

The correct answer is: Precautions with position changes

In the late stage of multiple myeloma, clients are often at increased risk for skeletal complications due to bone lesions and possible fractures. Therefore, incorporating precautions with position changes is crucial in the care plan. This includes careful movements to avoid causing harm due to weakened bones and potential instability. Clients may experience pain, decreased mobility, and overall physical deconditioning, all of which necessitate careful handling to prevent any additional injury. Promoting safe transitions during position changes also helps to mitigate fall risks, which can have severe consequences for individuals already facing weakened bones and other systemic issues associated with multiple myeloma. Proper techniques and assistance should be emphasized to ensure the patient's safety, comfort, and dignity. The other choices, while relevant in certain contexts, do not specifically address the immediate risks faced by a client in the late stage of multiple myeloma in the same way. Monitoring for hyperkalemia may be important but is not as critical as ensuring the patient's physical safety through careful handling. Placing a patient in protective isolation is generally more applicable to those who are immunocompromised due to treatments such as chemotherapy, but this is not the first priority in late-stage multiple myeloma management. Administering diuretics may be indicated for managing fluid