Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What diagnostic result should the nurse expect for a patient suspected of having multiple myeloma?

1. X-ray report of multiple lytic lesions

2. Pathology report of spindle-shaped tumor cells

3. X-ray report of "ground glass" appearance

4. Pathology report of densely packed small cells with round nuclei

The correct answer is: X-ray report of multiple lytic lesions

In patients suspected of having multiple myeloma, the most pertinent diagnostic result to anticipate is an X-ray report indicating multiple lytic lesions. Multiple myeloma is a malignancy characterized by the infiltration of monoclonal plasma cells in the bone marrow, which often leads to the destruction of bone. This bone destruction manifests as lytic lesions visible on X-ray imaging. These lesions typically appear as areas of radiolucency on the X-ray, suggesting significant bone loss or erosion that is a hallmark of the disease. The presence of these lytic lesions is key in supporting the diagnosis of multiple myeloma, as they indicate the disease's impact on the skeletal system. The other diagnostic indications mentioned do not specifically correlate with the typical findings seen in multiple myeloma; for instance, spindle-shaped tumor cells are more characteristic of sarcomas or certain other malignancies, while a "ground glass" appearance may suggest conditions such as osteoporosis. Densely packed small cells with round nuclei might be indicative of lymphoproliferative disorders but are not specific to multiple myeloma. Therefore, the identification of lytic lesions on X-ray is the most direct and relevant diagnostic result for this condition.