NUR2214C Module 2 EAQs

What is true about psychosocial changes observed in adolescents? Select all that apply.

"They search for personal identity." "They develop their own ethical systems."

A patient diagnosed with major depressive disorder has a nursing diagnosis of chronic low self-esteem related to negative view of self. Which would be the most appropriate cognitive intervention by the nurse?

Focus on identifying strengths and accomplishments.

What information about karyotype analysis is accurate?

It represents the metaphase section of mitotic cell division.

What physiological change contributes to the development of breast cancer?

Mutation in BRCA 2 gene

Which disease has a complex inheritance and is seen in family clusters?

Parkinson's disease

What basic concept about genetics is correct?

There is a specific chromosome locus for every gene.

What is the most accurate statement about autosomal dominant disorders?

They can be passed on 50% of the time for each pregnancy in an affected person.

Which of the following legal defenses are the most important for a nurse to develop?

accountability

What are the bases found in DNA? Select all that apply.

adenine guanine thymine cytosine

Which care provided by the nurse is secondary preventive care? Select all that apply.

Encouraging the patient to screen for colorectal cancer Teaching the patient to perform breast self-examination Screening a patient for diabetes mellitus and hypertension

Which activity related to genetic counseling best illustrates the role of the medical-surgical nurse?

Ensures that the patient understands the consequences of having a genetic test performed

A nurse has conducted a primary prevention program for school children less than 10 years of age. Which nursing intervention is considered primary prevention?

Explaining the importance of a nutritious diet.

In analyzing a three-generation pedigree for a patient, which questions help determine the genetic implications of a health trait? Select all that apply.

Is a pattern evident, or does the trait appear to be sporadic? Do affected or unaffected individuals have children affected by the trait? Is the trait present in every generation, or does it skip one or more generations? Is the trait expressed equally among male and female family members, or is it expressed unequally?

How would the student nurse describe a quasi-intentional tort occurring during the practice of nursing?

It is an act that lacks intent but involves volitional action.

A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating?

Tertiary prevention

Which stage of Kohlberg's theory is an individual in if he or she wants to modify a law if it is not fair to a particular group?

Universal ethical principle orientation

Which component of decision-making refers to the duties and activities an individual is employed to perform?

responsibility

The nurse is caring for a Chinese patient who prefers traditional healing practices over Western medicine. Which health model should the nurse follow to promote the patient's health and wellness?

Holistic Health Model (HHM)

When illness occurs, different attitudes about it cause people to react in different ways. What do medical sociologists call this reaction to illness?

Illness behavior

The nurse finds that a patient is fasting for religious reasons. What would be the best nursing intervention?

Incorporate religious practice in the care plan.

A patient of Asian descent is diagnosed with a thromboembolism. Which treatment strategy does the nurse identify as beneficial for this patient?

Initiating the treatment with a low dose of warfarin

In genetics, what test is used to examine a person's chromosomes?

Karyotype

Which statement about sex chromosomes is correct?

Males have both X and Y chromosomes.

The nurse manager uses operant conditioning when managing the staff by providing positive reinforcement to motivate them to repeat constructive behavior. Which leadership theory is reflected in this practice?

Organizational behavior (OB) modification

A patient with a family history of ovarian cancer asks about the risk of developing the disorder. Which diagnostic test does the nurse identify as being the most helpful for this patient?

Predisposition testing

The nurse is providing restraint education to a group of nursing students. The nurse should include that it is inappropriate to use a restraint device to do what?

Prevent an adult client from getting up at night when there is insufficient staffing on the unit.

What legal complications might a nurse face for using a restraint without a legal warrant on a client?

The nurse may be charged with false imprisonment.

The nurse is caring for a client who is in pain following surgery. The nurse informs the primary health care provider about the client's request for pain medication. What is the role of the nurse in this situation?

advocate

A 45-year-old diabetic non-English speaking woman, whose husband died 12 years ago, was found unconscious at her home. Her neighbors brought her to the hospital, 60 km away. The patient was diagnosed with diabetic ketoacidosis (DKA). After initial interventions, the patient regained consciousness. Which internal variables may influence the health of the patient? Select all that apply.

language the patient's age and gender

The nurse receives information about a client through another nurse. The nurse then finds that information has some missing facts. Which critical thinking attitude would the nurse use to clarify the information after talking to the client directly?

preserverance

The nurse is participating in a community workshop for prevention of noncommunicable chronic diseases. Which diseases does the nurse educator emphasize while educating the community? Select all that apply.

stroke childhood obesity cardiovascular disease

The condition of a child dying of leukemia deteriorates, and the child becomes comatose. The parents state that a relative told them that they should not allow the child to be resuscitated, but they are unsure. Which response by the nurse best demonstrates recognition of the ethical issues involved?

"The final decision must be made by you and your doctor, but it's important to talk about it."

What does the nurse need to know about the inheritance of blood types?

A blood type O allele is a recessive allele.

Which nursing activity is found in a tertiary healthcare environment?

Admitting a patient following open heart surgery to the cardiovascular intensive care unit

Which term describes an altered gene?

Allele

The nurse is explaining the use of karyotype to a patient. What explanation does the nurse give to the patient when informing about a condition where a sperm or an egg has an irregular number of chromosomes?

Aneuploid

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of what?

Breach of confidentiality

The nurse collects data on a group of patients as a part of a survey using the Behavioral Risk Factor Surveillance System (BRFSS). To which website should the nurse refer patients to view the results of the survey?

Centers for Disease Control (CDC)

Which statements about DNA replication are most accurate? Select all that apply.

DNA replicates every time a cell divides. One set of DNA moves into one new cell. Two sets of double-stranded DNA are formed. Replicated DNA organizes into a chromosome form.

A nurse's coworker approaches the nurse to inquire about the test results of a friend who is being cared for by the nurse. How should the nurse respond?

Decline to discuss the friend's medical condition.

A nurse is caring for a patient who is quadriplegic. According to Maslow's hierarchy of needs, which patient needs should be given priority over others? Select all that apply.

Feeding the patient Ensuring adequate fluid intake Assisting with bladder or bowel elimination

The self-concept of an individual is influenced by various environmental, social, and psychological factors. How is a self-concept stressor defined?

A real or perceived change that threatens a person's identity and body image

Which intervention comes under active strategies of health promotion?

A weight reduction program for obese people.

A nurse providing care in a hospital witnesses a client's spouse shaking the client vigorously because the client has had an episode of incontinence. Because of the suspicion of physical abuse, legally the nurse should discuss the concerns with which party?

Adult Protective Services

What are the instances when an adult can give consent for medical treatment? Select all that apply.

Any guardian for the adult's ward Any parent for the adult's unemancipated minor A brother or sister of an adult's minor brother or sister

Which is an example of an autosomal recessive (AR) disorder?

Beta thalassemia

What important points should the nurse keep in mind when witnessing consent forms? Select all that apply.

Confirm that the client's signature is authentic. Ensure that the client has given the consent voluntarily. Refrain from asking the student nurse to witness consent forms.

What measures should the nurse take during genetic testing and counseling of a patient?

Consider cost and specificity of the test to help determine if testing is reasonable.

A nurse concludes that clients who receive intravenous (IV) fluids rather than total parenteral nutrition for gastrointestinal problems lose weight for what reason?

Deficient carbohydrate intake

A nurse on the medical-surgical unit tells other staff members, "That client can just wait for the lorazepam; I get so annoyed when people drink too much." What does this nurse's comment reflect?

Demonstration of a personal bias

A patient at the community clinic asks the nurse about health promotion activities that she can do because she is concerned about getting diabetes mellitus since her grandfather and father both have the disease. This statement reflects that the patient is in what stage of the health belief model?

Perceived susceptibility to the disease.

What are the criteria for an autosomal recessive (AR) pattern of inheritance? Select all that apply.

The children of two affected parents will be affected. The characteristic may not be observed in the parents. The characteristic is found in approximately 25% of the family members.

Which is a feature of a sex-linked recessive pattern of inheritance?

The father transmits the characteristic to all daughters.

In what instances can a minor give consent for himself or herself for medical treatment? Select all that apply.

The minor can give consent for any venereal disease. The minor can give consent if he or she is lawfully married. The minor can give consent for a drug or substance abuse.

The nurse suspects that a patient has an autosomal dominant genetic disorder. Which finding supports the nurse's suspicion?

The patient has increased blood glucose levels.

The nurse is attending to a patient diagnosed with an X-linked recessive condition. What does the nurse inform the patient about X-linked recessive inheritance pattern?

The trait is transmitted from all fathers to their daughters.

What information about chromosomes is correct?

A chromosome is a temporary structure.

Which statement is most accurate about human chromosomal analysis?

Humans have 46 chromosomes in each cell.

Which condition might require genetic counseling for a patient?

Huntington's disease

The nurse finds that an 80-year-old client's family is not caring for the client properly. Which action of the nurse indicates leadership quality?

Advocating on behalf of the client

A nurse who promotes freedom of choice for clients in decision-making best supports which principle?

Autonomy

While explaining mutations to a patient, how does the nurse characterize a germline mutation? Select all that apply.

DNA changes that occur in sex cells Mutations that can be passed on to children

Which statement about mutations is correct?

Germline mutations can be passed on to children.

Which statement about gene mutations is correct?

Mutations are DNA changes that are passed from one generation to another.

Which nursing action is not likely to cause legal issues?

Refraining from leaving the client during a staffing shortage

Which information about autosomal recessive disorders is correct?

If both the parents are affected, all children are affected.

What statements made by the patient indicate that the patient's self-concept is improving following treatment? Select all that apply.

"I am pretty comfortable with my crutches." "It is easier to administer insulin than I had imagined." "Physical therapy is going well. I'm going to be on my feet soon."

A nurse is educating a client regarding a do-not-resuscitate (DNR) order. What information should the nurse provide? Select all that apply.

"Do-not-resuscitate orders should be reviewed routinely by the primary healthcare provider." "Legally competent adults may issue a do-not-resuscitate order verbally or in writing after receiving proper information about it." "Primary healthcare providers should check for a DNR order before deciding to perform cardiopulmonary resuscitation."

Before a treatment requiring informed consent can be performed, what information must the client be given? Select all that apply.

Alternative treatment options The risks and benefits of the treatment The risks involved in refusing the treatment The nature of the problem requiring the treatment

A nursing student is recalling the definitions of acts that are classified as torts in nursing practice. Which tort involves intentional touching without the client's consent?

Battery

A registered nurse is educating a nursing student on the various classifications of torts. What acts are classified as intentional torts in nursing practice? Select all that apply.

Battery Assault False Imprisonment

What are the essential genetic competencies for medical-surgical nursing practice identified by the American Association of Colleges of Nursing? Select all that apply.

Be aware of individual variation in responses to drug therapy due to genes. Consider genetic transmission patterns when performing a detailed patient assessment. Identify patients or families that are at high risk of a genetic disorder.

The leader is devising a strategy to connect individuals, groups, and organizations to attune them toward a common goal. Which political strategy is the leader pursuing?

Building coalitions

Which statements about genes are correct? Select all that apply.

Erythropoetin is a gene product. A gene is a specific segment of DNA. A genome is a complete set of genes.

A nurse manager in charge of a unit overhears two nurses in a hall filled with visitors discussing a client on the unit who has AIDS. What should be the nurse manager's initial action?

Have a conference with the nurses and talk about the need for confidentiality.

The nurse is planning care for a patient who has a number of risk factors for cancer. Which health model should the nurse follow to determine the patient's readiness and motivation to make changes?

Health Belief Model (HBM)

What is the effect of gene mutation and amino acid sequencing on insulin and blood sugar control?

Ineffective insulin is produced.

A nurse is learning about the holistic health model of nursing. Which statements are true about this model? Select all that apply.

It attempts to create conditions for optimal health. It recognizes the natural healing abilities of the body. It incorporates complementary and alternative therapies into nursing care.

Which statement provides the most accurate piece of information about sex-linked recessive patterns of inheritance?

It is more common in male children.

What amount of physical activity should the nurse recommend for healthy adults?

Moderate-intensity physical activity for 30 minutes 5 or more days per week

A pregnant woman is admitted with a tentative diagnosis of placenta previa. The nurse implements prescriptions to start an intravenous (IV) infusion, administer oxygen, and draw blood for laboratory tests. The client's apprehension is increasing, and she asks the nurse what is happening. The nurse tells her not to worry, that she is going to be alright, and that everything is under control. What is the best interpretation of the nurse's statement?

Questionable, because the client has the right to know what treatment is being given and why

It is determined that a staff nurse has a drug abuse problem. What approach to the staff nurse's addiction should be taken as an initial intervention?

Referred to the employee assistance program

A patient is at risk for a genetically inherited disorder and is advised genetic testing. Which nursing actions are appropriate? Select all that apply.

Referring the patient to any appropriate support groups Asking the patient whether an agency is insisting on the testing Inquiring privately about the patient's wishes regarding genetic testing

Which right of delegation refers to the giving of clear, concise descriptions of a task to the delegatee?

Right communication

A nurse works in a special care unit for children with severe immunology problems and is caring for a 3-year-old boy from Greece. The boy's father is with him while his mother and sister are back in Greece. The nurse is having difficulty communicating with the father. What action does the nurse take?

Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community

The nursing supervisor assigns a nurse to care for five clients in the intensive care unit (ICU). The nurse notes that all the clients in the ICU are at a risk of developing serious complications at any time. What course of action should the nurse take to handle the situation?

Submit a written protest to the nursing administrator If a nurse is given an assignment that appears to be unreasonable, the nurse should submit a written protest to the nursing administrator. Even though this does not relieve the nurse of responsibility, if a client is harmed due to inattention, it shifts some of the responsibility to the institution.

A client with end-stage renal disease needs a kidney transplant. Which statements regarding the National Organ Transplant Act are true? Select all that apply.

The National Organ Transplant Act of 1984 prohibits the purchase or sale of organs. The act provides civil and criminal immunity to the hospital and the healthcare provider. The act protects the donor's estate from liability for injuries or damage that results from the use of the gift.

Which statement is consistent with an autosomal dominant pattern of inheritance for a specific trait or characteristic?

The genotype cannot be predicted from the phenotype.

Which statement about DNA structure is most appropriate?

Two strands of DNA are twisted into a loose, helical shape.

Which actions should the nurse take when counseling a patient who is scheduled for genetic testing? Select all that apply.

Establish a trusting relationship. Obtain an informed consent form. Assess current use of medications. Assess the mental status of the patient.

Which statement is true about the structure and forms of DNA?

Every time a cell divides, it must replicate its DNA.

While attending to a couple who are planning to have a baby, the nurse learns that a family member has a history of sickle cell disease. The nurse recommends that the couple undergo carrier testing. What is the purpose of carrier testing?

To determine if they are carriers of the disease.

What are the elements of discovery of a lawsuit? Select all that apply.

experts medical records the depositions of witnesses

What is the nature of inheritance of schizophrenia?

familial clustering

Stroke is a lifestyle disease. Which lifestyle factors may increase the risk of developing a stroke? Select all that apply.

fast foods physical inactivity tobacco use

The nurse is obtaining a health history for a patient with a recent diagnosis of atherosclerosis and cardiovascular disease. The nurse determines that the patient's father also had a diagnosis of cardiac disease at the same age. Which risk factor does the nurse identify as significant in influencing the patient's health?

genetics

During a visit to a family clinic, the nurse teaches a mother about immunizations, car seat use, and home safety for an infant and toddler. Which type of nursing interventions are these?

health promotion activities

When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model?

holistic

A nursing instructor asks a nursing student to explain the pattern of inheritance of schizophrenia. Which student nurse response is accurate?

"Schizophrenia is a complex disorder and has familial clustering."

What symbol is the standard pedigree symbol to represent identical twins?

two circles connected with a triangle

What statement about blood type alleles is most accurate?

Blood type O is a recessive trait found on an autosomal chromosome.

According to ethical principles, the nurse recognizes that which person makes the final decision on genetic testing?

patient

Which parameter describes how often a mutated gene is expressed in a given population?

penetrance

Which term describes a person's observable characteristics?

phenotype

Which statement about the genetic component of human insulin is correct?

The insulin gene is found in all nucleated cells.

Which nursing action indicates that the nurse is actively listening to the client?

The nurse interprets what the client is saying and reiterates in his or her own words.

Which information does the nurse need to remember about genetic mutations?

Mutation in the BRCA2 gene increases the risk of breast cancer.

What is the karyotype of an organism called if it contains the required number of chromosome pairs?

Euploid

What is the pattern of inheritance of schizophrenia in adults?

Familial clustering

A patient is unable to see the colors red or green. Which pattern of inheritance caused this genetic disorder?

Sex-linked

What disorders have an autosomal dominant pattern of inheritance? Select all that apply.

Familial melanoma Huntington's disease Myotonic dystrophy

The nurse is preparing a client for epidural anesthesia. Which client statement would cause the nurse to stop the placement of the epidural catheter?

"I'm not exactly sure how an epidural works."

A nurse is teaching a nursing student about the ethical duty of the nurse to maintain the privacy and confidentiality of a patient's genetic testing results. Which nursing student statement indicates a need for further teaching?

"It is always appropriate to discuss the results with the patient's spouse."

How many rights of delegation are there in the nursing practice? Record your answer using a whole number. _______________

5

The family of an older adult who is aphasic reports to the nurse manager that the primary nurse failed to obtain a signed consent before inserting an indwelling catheter to measure hourly output. What should the nurse manager consider before responding?

A separate signed informed consent for routine treatments is unnecessary.

A nurse assisting in a research study calculates the risk-benefit ratio and concludes that there were no harmful effects associated with a survey of diabetic clients. This researcher was applying which principle?

Beneficence

A pregnant patient with an allele of sickle cell anemia wants to know if the fetus is at risk for developing the disorder. Which genetic testing is recommended for this patient?

Carrier testing

A nursing student wants to know how DNA bases are linked on the opposite strands of DNA. What is the most appropriate pairing of the DNA bases?

Cytosine binds with guanine.

The nurse is caring for a patient diagnosed with breast cancer. The nurse suggests genetic testing for the immediate family members of the patient. What are the benefits of genetic testing?

Detects cancer before symptoms appear

What is the purpose of genetic testing?

Determines whether a mutation exists

The spouse of a comatose client who has severe internal bleeding refuses to allow transfusions of whole blood because they are Jehovah's Witnesses. The client does not have a Durable Power of Attorney for Healthcare. What action should the nurse take?

Give the spouse a treatment refusal form to sign and notify the primary healthcare provider that a court order now can be sought.

What information should the registered nurse provide when educating a nursing student about living wills? Select all that apply.

Health care workers should always follow the directions of a client's living will. Clients use living wills to declare any medical procedures they want or do not want when terminally ill. Living wills are written documents that direct the client's treatments in the event of a terminal illness or condition.

A client requires emergency cardiac surgery. The leader nurse wants to make the client aware of the situation and wants the client to decide what should be done. Which ethical model does the leader nurse follow here?

Patient-benefit model

In order to prolong a hospitalization stay, the nurse documents in a client's electronic health record (EHR) that there are no signs of recovery. However, in reality, the client appears to be cured of the illness. What legal implication does the nurse's action have?

The nurse may be charged with libel.

What professional responsibility does the nurse display as a client's advocate?

The nurse protects the client's human and legal rights and provides assistance in asserting said rights.

What stage of Kohlberg's theory of moral development defines "right" by the decision of the conscience?

Universal ethical principle orientation

A nurse is obtaining consent from an unemancipated minor to perform an abortion. When would the nurse consider the consent-giving process to be appropriately completed? Select all that apply.

When consent has been given specifically by a court When self-consent has been granted by a court order When consent has been obtained from at least one parent of the minor

A nurse is caring for a client with renal failure. The client wants to go back home but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. What role does the nurse play here?

advocate

The nurse informs a client's family that the client is in pain and does not wish to proceed with chemotherapy. What is the role of the nurse in this situation?

advocate