An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse?

"I wouldn't tell, if I were you."

“In my experience, clients who know are more likely to be involved with their plan of care."

"The shock of learning the diagnosis may be too much stress for an elderly person.”

"This is a private concern that should include the physician, not me."

Answer and Explanation

The Correct Answer is B

A. "I wouldn't tell if I were you." This response is inappropriate because it imposes the nurse's personal opinion rather than supporting the family in making an informed decision.

B. "In my experience, clients who know are more likely to be involved with their plan of care." This is the best response because it encourages transparency and patient autonomy, allowing the client to participate in their care decisions.

C. "The shock of learning the diagnosis may be too much stress for an elderly person.” This response is not based on evidence and may discourage the family from being honest with the client, which could prevent the client from making informed decisions.

D. "This is a private concern that should include the physician, not me." While the physician should be involved in the discussion, the nurse also plays a crucial role in providing support and guidance to the family. This response dismisses the nurse's role in the situation.

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Correct Answer is A

Explanation

A. Hematologic spread: Hematologic spread (through the bloodstream) is a common mechanism for metastasis to distant organs like bones and liver. This is the most likely mechanism for the spread described.

B. Lymphatic circulation: Lymphatic spread often leads to regional lymph nodes rather than distant organs like bones and liver.

C. Invasion: Invasion involves local spread into adjacent tissues but does not typically account for distant metastasis.

D. Angiogenesis: Angiogenesis refers to the formation of new blood vessels to supply the tumor, not the mechanism by which cancer cells spread to distant sites.

A. the client feels vulnerable to stigma B. young adults tend to use manipulation C. this is a standard assessment D. the client lives with extended family

Correct Answer is C

Explanation

A. the client feels vulnerable to stigma: While stigma can prevent clients from reporting suicidal thoughts, this is not the primary reason for initiating a suicide risk assessment.

B. young adults tend to use manipulation: Assuming that young adults manipulate their symptoms is not a valid reason for initiating a suicide risk assessment. This response is inappropriate and can harm the therapeutic relationship.

C. this is a standard assessment: A suicide risk assessment is a standard part of care for clients with depression and thoughts of hopelessness, even if suicidal ideation is not explicitly reported. This ensures comprehensive evaluation and appropriate intervention.

D. the client lives with extended family: The living situation may influence the support system, but it is not the primary reason to initiate a suicide risk assessment.

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An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client's most recent diagnostic imaging has revealed that lung cancer has metastasized to the bones and liver. What is the most likely mechanism by which the client's cancer cells spread?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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