Adapative Quiz CH 5 Genes, Environment-Lifestyle and Common Diseases

The nurse prepares a presentation on sickle cell disease. Using the knowledge of genetic disease factors, which population will be the nurse's target audience? Asian Americans African Americans Hispanic Americans Caucasian Americans

African Americans

Which population is most susceptible to developing stomach cancer? Indian Chinese Japanese American

Japanese

A nurse educates a patient about hypertension. The patient asks, "Isn't hypertension genetic? Does that mean I can't do anything to prevent it?" How does the nurse respond? "Genetics and environment have equal influence on your risk of developing hypertension. There are some changes you can make to help." "Genetics may have a much higher influence on hypertension than environment, but there are still some things you can do to lower your risk." "Environment may have a higher influence on the development of hypertension than genetics does. You can make lifestyle changes to lower your risk." "The risk factors for hypertension are entirely environmental. There are many changes you can make to nearly eliminate your risk for hypertension."

"Environment may have a higher influence on the development of hypertension than genetics does. You can make lifestyle changes to lower your risk." Genetic factors cause about 20% to 40% of the variation in blood pressure. Therefore, environment may have a higher influence and the patient can therefore make lifestyle changes to mitigate the risk. Evidence does not suggest that genetics may have a much higher influence on risk of hypertension or that genetic and environmental factors are equally at fault. Hypertension risk has environmental and genetic factors, not just environmental factors.

A public health nurse plans the educational content on sexually transmitted infections (STIs) for a group of high school students. Which statement will the nurse include to describe the prevalence of STIs among young adults? "In our area schools last year, about 10% of students were found to have an STI." "Last month, there were 28 new cases of chlamydia for every 1,000 students in the state." "Six in 10 high school students report using condoms whenever they have sexual intercourse." "The annual number of new STI cases is about equal among young women and young men."

"In our area schools last year, about 10% of students were found to have an STI." Prevalence describes the proportion of a population affected by a disease at a given time. This includes new and existing cases. The statement that there were 28 new cases of chlamydia for every 1,000 students in the state describes incidence, not prevalence. Stating that six in 10 high school students report using condoms whenever they have sexual intercourse describes adherence to preventive measures, not prevalence. The statement that the annual number of new STI cases is about equal among young women and young men describes incidence, not prevalence.

The nurse educates a pregnant patient about congenital malformations. What guidance does the nurse offer the patient? "Knowing your health history is important to us because infections such as rubella can cause congenital heart defects in your child." "You can prevent congenital malformations by avoiding certain foods and medications. I'll provide you with a list for your reference." "The use of salicylic acid for acne can raise the risk of your child having congenital birth defects of the heart, ears, or central nervous system." "Congenital malformations are caused by genetic factors. You can't reduce your risk, but it's important to be educated and make informed choices."

"Knowing your health history is important to us because infections such as rubella can cause congenital heart defects in your child."

A nurse educates a patient about risk factors related to cancer. The patient is concerned, saying, "Isn't it all genetic? I feel like there's nothing I can do to help reduce my risk." How does the nurse respond? "The most important thing you can do is quit smoking as soon as possible." "The most important thing you can do is eat a healthy diet beginning today." "Genetic testing identifies your risk, but there's not much else available unfortunately." "You're right, genetics are a major cause, and I understand the unknown is frightening."

"The most important thing you can do is quit smoking as soon as possible." Tobacco use accounts for an estimated one-third of all cancer cases in the United States and is therefore the most important known cause of cancer. Quitting smoking is the most important thing a person can do to reduce his or her risk of cancer. Eating a healthy diet is important, but smoking is the more important factor. Genetics are a major cause, and it is important to be understanding of a patient's concern, but acknowledging that the situation is frightening does not address the patient's risk factors. Genetic testing is available, but the nurse is incorrect in stating that there is not much the patient can do to address risk.

A student nurse learns about genetic and environmental risk factors in development of coronary heart disease. Which statement made by the student nurse shows a need for further education? "The risk of heart disease increases with early onset in affected relatives." "The risk of heart disease increases with higher numbers of affected relatives." "The risk of heart disease increases if affected relatives are male rather than female." "The risk of heart disease increases with environmental factors such as cigarette smoking."

"The risk of heart disease increases if affected relatives are male rather than female." The student nurse is incorrect in stating that the risk of heart disease increases if affected relatives are male rather than female. The student nurse should be educated that the opposite is true. The other statements are accurate and show understanding of the genetic and environmental risk factors in development of coronary heart disease. The risk of heart disease increases with early onset in affected relatives. The risk of heart disease increases with higher numbers of affected relatives. The risk of heart disease increases with environmental factors such as cigarette smoking.

A nurse educates expectant parents who already have two children born with a congenital heart defect that is a multifactorial disease. What does the nurse tell the parents regarding the recurrence risk of their third child being born with the defect? "As you have more children, the recurrence risk of having the heart defect will change." "The risk of your third child being born with the defect is lower than it was for your second child." "The risk of your third child being born with the defect is higher than it was for your second child." "The risk of your third child being born with the defect is the same as it was for your second child."

"The risk of your third child being born with the defect is higher than it was for your second child."

Which population is most likely to have an allele of the ALDH2 gene, which results in facial flushing, nausea, palpitations, and lightheadedness when drinking alcohol? Black Asian Hispanic Caucasian

Asian Rationale: The Asian population is most likely to have an allele of the ALDH2 gene that results in facial flushing, nausea, palpitations, and lightheadedness with the ingestion of alcohol. Individuals with this allele are much less likely to become alcoholics. Black, Hispanic, and Caucasian people are less likely to have this allele.

Which traits and diseases have a heritability estimate exceeding 1? Select all that apply. Autism Clubfoot Schizophrenia Diabetes mellitus Body fat percentage Affective disorder (bipolar)

Autism Diabetes mellitus Body fat percentage Affective disorder (bipolar) Autism, diabetes mellitus, body fat percentage, and affective disorder (bipolar) have heritability estimates that exceed 1, which indicates that other factors, such as shared environmental factors, must be operating. Clubfoot has a heritability factor of 0.58 and schizophrenia has a heritability factor of 0.7.

Which gene mutations are the most common known causes of inherited breast cancer? Select all that apply. ATM CHK2 TP53 BRCA1 BRCA2 PALB2

BRCA1 BRCA2 BRCA1 and BRCA2 are the gene mutations that are the most common known causes of inherited breast cancer. Inherited breast cancer can also be caused by mutations in genes including ATM, CHK2, TP53, and PALB2, but these are not as common.

A patient with Cowden disease most likely develops which type of cancer? Liver cancer Lung cancer Colon cancer Breast cancer

Breast cancer Cowden disease is characterized by multiple benign tumors and an increased susceptibility to breast cancer.

Which secondary conditions are often associated with spina bifida? Select all that apply. Clubfoot Hydrocephaly Pyloric stenosis Cleft lip and/or palate Congenital heart defects

Clubfoot Hydrocephaly

If a woman has a BRCA1 mutation, she has an increased risk of developing which cancers? Select all that apply. Liver cancer Lung cancer Colon cancer Breast cancer Ovarian cancer Cervical cancer

Colon cancer Breast cancer Ovarian cancer Having a BRCA1 mutation increases the risk of a woman developing colon cancer, breast cancer, and ovarian cancer. A BRCA1 mutation does not increase the risk of developing liver cancer, lung cancer, or cervical cancer.

Polymorphism of chromosome 8q24 increases the risk of which types of cancer? Select all that apply. Liver cancer Breast cancer Colon cancer Prostate cancer Pancreatic cancer Esophageal cancer

Colon cancer Prostate cancer Pancreatic cancer Esophageal cancer

Which diseases will a public health nurse's education strategies focus on awareness rather than prevention? Select all that apply. Influenza Cystic fibrosis Type 1 diabetes Type 2 diabetes Down Syndrome

Cystic fibrosis Type 1 diabetes Down Syndrome rationale: Cystic fibrosis, type 1 diabetes, and Down Syndrome are determined by genetic factors. Therefore, the nurse will focus educational efforts on awareness rather than prevention. Influenza and type 2 diabetes have environmental factors that prevention strategies can mitigate.

What is the term for risks based on direct observation of data? Relative risks Empirical risks Recurrence risks Observable risks

Empirical risks rationale: Empirical risks are based on direct observation of data. Relative risk measures the effect of a specific risk factor. Recurrence risk is the risk of a disease occurring in the same family multiple times. Observable risk is not a term used in study of genetics and disease

Which population is most likely to have cystic fibrosis? Asian African European Middle Eastern

European Cystic fibrosis is most common among Europeans. Asian, African, and Middle Eastern people are less likely to develop cystic fibrosis.

Which statement accurately describes the calculation of relative risk for a disease? Increased rate of the disease among individuals exposed to a risk factor divided by incidence rate among those not exposed to the risk factor Increased rate of the disease among individuals exposed to a risk factor divided by prevalence of the disease among those not exposed to the risk factor Increased rate of the disease among individuals exposed to two or more risk factors divided by incidence rate among those exposed to one or zero risk factors Increased rate of the disease among individuals exposed to two or more risk factors divided by prevalence of the disease among those exposed to one or zero risk factors

Increased rate of the disease among individuals exposed to a risk factor divided by incidence rate among those not exposed to the risk factor rationale: Relative risk is calculated in the following way: Increased rate of the disease among individuals exposed to a risk factor divided by incidence rate among those not exposed to the risk factor. Prevalence is not considered in calculating relative risk. Relative risk is calculated for a single risk factor, not for two at a time.

Which hormone secreted by adipocytes binds to receptors in the hypothalamus which is the site of the body's appetite control center? Leptin Estrogen Adrenaline Testosterone

Leptin

Mouse studies have shown the genes that encode which hormone may play an important role in obesity and weight loss? Leptin Insulin Oxytocin Endothelin

Leptin Mouse studies have shown that the genes that encode leptin may play an important role in obesity and weight loss. Insulin is related to type 1 and type 2 diabetes. Oxytocin is released during breast feeding. Endothelin is involved in smooth muscle contraction.

What is the most likely cause of diseases that are either present or absent in individuals but do not follow the inheritance patterns expected of single-gene diseases? Quantitative traits Multifactorial traits Liability distribution Environmental factors

Liability distribution Rationale The liability distribution is a commonly used explanation for diseases that do not follow the bell-shaped distribution; instead, they appear to be either present or absent in individuals but do not follow the inheritance patterns expected of single-gene diseases, which requires that the threshold must be crossed before the disease is expressed. Quantitative traits are those, such as blood pressure, that are measured on a continuous numeric scale. Multifactorial traits occur when environmental factors are also believed to cause variation in the trait. Environmental factors do not explain why some disease do not follow the inheritance patterns expected of single-gene diseases.

Patients with a1-Antitrypsin (AAT) deficiency are more likely to develop which conditions? Select all that apply. Diabetes Lung disease Liver cirrhosis Heart disease Inflammatory bowel disease

Lung disease Liver cirrhosis

Which genes are associated with susceptibility to type 1 diabetes? Select all that apply. MHC CHK2 CTLA4 BRCA1 PTPN22

MHC CTLA4 PTPN22 MHC, CTLA4, and PTPN22 are associated with susceptibility to type 1 diabetes. CHK2 and BRCA1 are associated with breast cancer.

What is believed to be a cause of the increased risk in stomach cancer among the Japanese population? A high-fat, low-fiber daily diet Impurities within the drinking water High consumption of soy-based foods Methods of preserving and seasoning fish

Methods of preserving and seasoning fish

What is the proportion of the population affected by a disease at a specific point in time? Relative risk Incidence rate Prevalence rate Liability distribution

Prevalence rate Prevalence rate is the proportion of the population affected by a disease at a specific point in time. Relative risk is the increased rate of the disease among individuals exposed to a risk factor compared to individuals who weren't exposed to a risk factor. Incidence rate is the number of new cases of a disease reported during a specific period (typically one year) divided by the number of individuals in the population. The liability distribution is used to explain why some diseases appear to be either present or absent in individuals but do not follow the inheritance patterns expected of single-gene diseases

Variations in the PTPN22 gene are associated with which diseases? Select all that apply. Osteoarthritis Type 1 diabetes Type 2 diabetes Rheumatoid arthritis Autoimmune thyroid disease Systemic lupus erythematosus

Type 1 diabetes Rheumatoid arthritis Autoimmune thyroid disease Systemic lupus erythematosus