The nurse is caring for a client with metastatic breast cancer ...

[V@ndy87]

The nurse is caring for a client with metastatic breast cancer receiving chemotherapy. Even though the prognosis is poor, the client tells the nurse that the plan is to do everything to survive.
 
  How should the nurse respond to this client?
  A) You have a great attitude and I am here to support you through education to help you survive.
  B) It is important to plan for your death, even though there is a chance you will survive.
  C) You should face the reality of the situation. You do not have a good chance of survival.
  D) I am going to speak with your family regarding your unrealistic expectations.

Question 2

The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer. What should the nurse include in this teaching?
 
  A) Perform monthly breast self-exams.
  B) See a healthcare provider if there is a strong family history of breast cancer.
  C) Have a yearly mammogram.
  D) Have a clinical breast exam performed by a healthcare provider every 5 years.

[mmpiza]

Answer to Question 1

Answer: A

This client is in the earliest stages of cancer treatment, with removal of the primary tumor about to take place. The nurse's role is to support this client's optimism and help in fighting the disease by teaching about nutrition and other supportive actions the client can take to minimize complications of treatment. While the prognosis may be poor, the outcome is not absolute, and the client's wish to do whatever is necessary to survive should be supported. Emphasizing the low survival rate, encouraging the client to prepare for death, and talking with the family about the client's unrealistic expectations would not support the client's optimism.

Answer to Question 2

Answer: C

Yearly mammography for all women over the age of 40 is encouraged, as it decreases the mortality from breast cancer. Breast self-exam is no longer recommended for all women. The American Cancer Society recommends that young women who choose to do breast self-exams have their technique validated by a healthcare practitioner at a yearly physical exam. The earlier a lump is discovered, the greater the effectiveness of treatment. Discussing a family history of breast cancer would be part of the annual breast exam performed by a healthcare provider. It is inappropriate for women in this age group to have a clinical breast exam every 5 years.