The nurse is preparing a teaching session for a client recently diagnosed with metastatic breast cancer.
Which of the following statements by the nurse is most appropriate to include in the education regarding metastatic disease?
"You should avoid social interactions to prevent infections due to weakened immunity from cancer treatments.”.
"Since the cancer has spread, treatment will focus on managing your symptoms and improving quality of life.”.
"Metastatic cancer treatment will be the same as the initial treatment you received for breast cancer.”.
"Metastatic cancer is often curable with aggressive treatment, so it's important to maintain hope.”.
The Correct Answer is B
Choice A rationale
While immunosuppression can occur with certain cancer treatments, advising complete social avoidance is generally not the most appropriate or practical advice. Instead, strategies like hand hygiene, avoiding sick individuals, and staying up-to-date on vaccinations are emphasized to manage infection risk while promoting quality of life. Social isolation can negatively impact mental health.
Choice B rationale
Metastatic cancer, by definition, implies that cancer cells have spread beyond the primary tumor site to distant organs. In most cases, metastatic breast cancer is considered incurable. Therefore, the primary focus of treatment shifts from curative intent to palliative care, aiming to control disease progression, manage symptoms, and enhance the client's quality of life.
Choice C rationale
Treatment for metastatic cancer often differs significantly from initial, localized treatment. While some targeted therapies or hormonal treatments might be continued, the overall approach evolves to address the widespread nature of the disease. This may involve systemic therapies like chemotherapy, hormone therapy, or targeted agents, tailored to the specific metastatic sites and tumor characteristics.
Choice D rationale
While maintaining hope is important, metastatic cancer is typically not curable with aggressive treatment. Presenting it as such can create unrealistic expectations and potentially lead to emotional distress when treatments do not achieve a cure. It's crucial for the nurse to provide accurate information about the disease trajectory while still supporting the client's emotional well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Hemoglobin levels are primarily indicative of the oxygen-carrying capacity of the blood and are not specific markers of cardiac injury. While low hemoglobin (anemia) can exacerbate myocardial ischemia, an elevated hemoglobin (normal range for males: 13.5-17.5 g/dL; females: 12.0-15.5 g/dL) does not signify cardiac cellular damage.
Choice B rationale
Troponins, specifically cardiac troponin I and T, are highly sensitive and specific biomarkers for myocardial necrosis. When cardiac muscle cells are damaged, these proteins are released into the bloodstream, making their elevation (normal range usually undetectable or very low) the most reliable indicator of cardiac injury.
Choice C rationale
B-type Natriuretic Peptide (BNP) is a neurohormone released primarily from ventricular myocytes in response to increased ventricular wall stretch and pressure. While elevated BNP (normal range typically <100 pg/mL) is a key marker for heart failure, it does not directly indicate acute myocardial cell death or injury.
Choice D rationale
Creatine Kinase (CK) is an enzyme found in various tissues, including skeletal muscle, brain, and heart. While an elevated total CK can indicate muscle damage, the CK-MB isoenzyme is more specific to cardiac muscle. However, troponins are now considered superior due to their higher specificity and earlier rise in acute MI compared to CK or CK-MB (normal CK levels: 22-198 U/L).
Correct Answer is A
Explanation
Choice A rationale
Human immunodeficiency virus (HIV) is transmitted through specific body fluids, including blood, semen, pre-ejaculatory fluid, rectal fluids, vaginal fluids, and breast milk. Standard precautions are universally applied infection control practices designed to prevent transmission of infectious agents from recognized or unrecognized sources in healthcare settings. This includes hand hygiene and the use of personal protective equipment.
Choice B rationale
Respiratory isolation, such as airborne or droplet precautions, is implemented for diseases spread via airborne particles or respiratory droplets. HIV is not transmitted through the airborne or droplet route; therefore, respiratory isolation is an unnecessary and inappropriate measure for routine care of an HIV-positive individual.
Choice C rationale
Contact isolation is employed for infections spread by direct or indirect contact with the client or their environment, such as methicillin-resistant Staphylococcus aureus. HIV is not primarily transmitted through casual contact or fomites; thus, contact isolation is not indicated for the daily care of an HIV-positive individual.
Choice D rationale
An isolation gown is a component of personal protective equipment used in contact or droplet isolation to prevent contamination of clothing from splashes or sprays of infectious materials. Since HIV transmission requires direct contact with specific body fluids, a gown is not routinely necessary for providing care unless exposure to such fluids is anticipated. .
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