The nurse provides education to a patient who is diagnosed with breast cancer and asks about sites of metastases. Which is the best response by the nurse?

"Your type of cancer may spread to the bones."

"Your type of cancer may spread to the stomach."

"Your type of cancer may spread to the skin."

"Your type of cancer rarely spreads outside the chest."

Answer and Explanation

The Correct Answer is A

A. Breast cancer commonly metastasizes to the bones, liver, lungs, and brain. Bone metastasis is particularly common and is a frequent site for breast cancer to spread.
B. Although some cancers may metastasize to the stomach, breast cancer is more likely to spread to the bones, liver, lungs, and brain.
C. While breast cancer may spread to the skin, this is less common than metastasis to bones, liver, lungs, or brain.
D. Breast cancer can spread outside the chest to distant sites, so it's not accurate to say it "rarely" spreads.

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Correct Answer is B

Explanation

A. Delirium due to cardiac medications is a possibility, but the patient’s history of cerebrovascular accident (CVA) makes vascular neurocognitive disorder more likely. Delirium typically presents acutely and is often associated with medical or environmental triggers.
B. Vascular neurocognitive disorder (formerly vascular dementia) is often seen in clients with a history of cerebrovascular accidents (strokes). The client’s symptoms of memory problems, confusion, and disorientation could indicate this type of cognitive impairment, which is caused by reduced blood flow to the brain due to vascular damage.
C. Neurocognitive disorder due to Huntington's disease typically presents with movement disorders (chorea), mood changes, and gradual cognitive decline, rather than sudden memory loss and disorientation.
D. Alzheimer’s disease typically presents with gradual memory decline and cognitive impairment, but the sudden onset of symptoms in a patient with a history of CVA makes vascular neurocognitive disorder more probable.

A. HIV infection B. Prion disease C. Lewy body disease D. Frontotemporal lobar degeneration

Correct Answer is C

Explanation

A. HIV infection can cause dementia, but it typically presents with apathy, social withdrawal, and motor dysfunction—not parkinsonian features with fluctuating cognition.
B. Prion disease (such as Creutzfeldt-Jakob disease) presents with rapid progression of dementia, myoclonus, and ataxia, but not typically with parkinsonian features or fluctuating cognition.
C. Lewy body disease is characterized by fluctuating cognition, visual hallucinations, and parkinsonian motor symptoms. These features strongly suggest dementia with Lewy bodies, especially in the context of stroke or neurodegenerative changes.
D. Frontotemporal lobar degeneration primarily affects behavior, personality, and language. Parkinsonian symptoms and fluctuating cognition are not hallmark features.

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The nurse provides education to a patient who is diagnosed with breast cancer and asks about sites of metastases. Which is the best response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of cerebrovascular accident is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client's assessment data, on which medical diagnosis would the nurse focus the plan of care?

Correct Answer is B

Explanation

A nurse is caring for a client who has experienced a stroke and exhibits parkinsonian effects. The client's cognition fluctuates. Which of the following types of dementia should the nurse expect the client to have?

Correct Answer is C

Explanation

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