The nurse is caring for a client who has prostate cancer. Which of the following manifestations does the nurse attribute to advancing disease process?

Rationale: A. Anemia due to long-term bleeding can occur with various chronic conditions, but it is not specific to prostate cancer progression. It is more common in gastrointestinal or hematologic malignancies. B. An enlarged liver or gallbladder indicates metastasis, most likely to the liver, which is a common site for advanced prostate cancer spread. This finding suggests that the disease has progressed beyond the prostate gland to distant organs. C. Blood in the urine or semen (hematuria or hematospermia) is an early sign of prostate or urinary tract involvement rather than a sign of advancing disease. D. A dark-colored or elevated lesion is more characteristic of skin cancer, such as melanoma, not prostate cancer.