Chapter 4: Genetic and Genomic Concepts for Medical-Surgical Nursing

A nurse completes pedigree charts for clients at a community health center. Which diagnosis should the nurse refer for carrier genetic testing?

Hemophilia Sickle cell disease Cystic fibrosis

A client is typed and crossmatched for a unit of blood. Which statement by the nurse indicates a need for further genetic education?

If the clients blood type is AB, then the client is homozygous for that trait

A nurse cares for a client who has a genetic mutation that increases the risk for colon cancer. The client states that he does not want any family to know about this result. How should the nurse respond?

It is not required that you tell anyone about this result. However, your siblings and children may also be at risk for colon cancer and this information might help them

A nurse teaches clients about patterns of inheritance for genetic disorders among adults. Which disorders have an autosomal dominant pattern of inheritance?

Breast cancer Huntington disease Marfan syndrome

A client who tests positive for a mutation in the BRCA1 gene allele asks a nurse to be present when she discloses this information to her adult daughter. How should the nurse respond?

This conversation may be difficult for both of you; I will be there to provide support

A nurse cares for a client who has a specific mutation in the a1AT (alpha1-antitrypsin) gene. Which action should the nurse take?

Advise the client to limit exposure to secondhand smoke and other respiratory irritants

A health care provider prescribes genetic testing for a client who has a family history of colorectal cancer. Which action should the nurse take before scheduling the client for the procedure?

Confirm that informed consent was obtained and placed on the clients chart

A nurse cares for a client of Asian descent who is prescribed warfarin (Coumadin). What action should the nurse perform first?

Confirm the prescription starts warfarin at a lower-than-normal dose

A nurse cares for an adult client who has received genetic testing. The clients mother asks to receive the results of her daughters genetic tests. Which action should the nurse take?

Direct the mother to speak with the client and support the clients decision to share or not share the results

A nurse cares for a client who recently completed genetic testing that revealed that she has a BRCA1 gene mutation. Which actions should the nurse take next?

Discuss potential risks for other members of her family Assist the client to make a plan for prevention and risk reduction Assess the clients response to the test results

A nurse consults a genetic counselor for a client whose mother has Huntington disease and is considering genetic testing. The client states, I know I want this test. Why do I need to see a counselor? How should the nurse respond?

Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process

A nurse obtains health histories when admitting clients to a medical-surgical unit. With which client should the nurse discuss predisposition genetic testing?

Middle-aged woman whose mother died at age 48 of breast cancer

A nurse cares for a pregnant client who has a family history of sickle cell disease. The client is unsure if she wants to participate in genetic testing. What action should the nurse take? a. Provide information about the risks and benefits of genetic testing

Provide information about the risks and benefits of genetic testing

A nurse is educating a client about genetic screening. The client asks why red-green color blindness, an X-linked recessive disorder noted in some of her family members, is expressed more frequently in males than females. How should the nurse respond?

The incidence of X-linked recessive disorders is higher in males because they do not have a second X chromosome to balance expression of the gene

A nurse cares for a client who recently completed genetic testing and received a negative result. The client states, I feel guilty because so many of my family members are carriers of this disease and I am not. How should the nurse respond?

We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you?