Critical Care Registered Nurse (CCRN) Practice Exam

What typically indicates a poor prognosis in patients with brain metastases?

1. The presence of multiple brain lesions

2. Being older than 60 years

3. Complete surgical resection of tumors

4. History of chemotherapy

The correct answer is: The presence of multiple brain lesions

The presence of multiple brain lesions is a significant indicator of poor prognosis in patients with brain metastases. When multiple lesions are observed, it often reflects a more advanced stage of cancer that has aggressively spread to the central nervous system. This suggests a higher tumor burden and usually correlates with a shorter survival time compared to patients with a single lesion, who might have a better chance of prolonged survival, especially if treated effectively. Moreover, the presence of multiple lesions can complicate treatment plans, making interventions such as surgery less feasible and more challenging, as complete surgical resection tends to be more favorable for prognosis. While older age can impact prognosis, it is not as definitive as the presence of multiple lesions. Similarly, a history of chemotherapy or complete surgical resection may suggest varying prognostic outcomes, but these factors do not have the same direct correlation with poor prognosis as multiple brain lesions do.