med surg chapter 6

A primary health care provider prescribes genetic testing for a client who has a family history of colorectal cancer. Which action would the nurse take before scheduling the client for the procedure? a. Confirm that informed consent was obtained and placed on the patient's chart. b. Provide genetic counseling to the client and the patient's family members. c. Assess if the client is prepared for the risk of psychological side effects. d. Respect the patient's right not to share the results of the genetic test.

a. Confirm that informed consent was obtained and placed on the patient's chart.

A nurse obtains health histories when admitting clients to a medical-surgical unit. With which client would the nurse discuss predisposition genetic testing? a. Middle-age woman whose mother died at age 48 of breast cancer. b. Young man who has all the symptoms of rheumatoid arthritis. c. Pregnant woman whose father has sickle cell disease. d. Middle-age man of Eastern European Jewish ancestry.

a. Middle-age 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 would the nurse take? a. Provide information about the risks and benefits of genetic testing. b. Empathize with the client and share a personal story about a hereditary disorder. c. Teach the client that early detection can minimize transmission to the fetus. d. Advocate for the client and her baby by encouraging genetic testing.

a. Provide information about the risks and benefits of genetic testing.

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 would the nurse respond? a. "The counselor will advise you on whether you can have children or need to adopt." b. "Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process." c. "There is no cure for this disease. The counselor will determine if there is any benefit to genetic testing." d. "Genetic testing is expensive. The counselor will advocate for you and help you obtain financial support."

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

A client is typed and crossmatched for a unit of blood. Which statement by the nurse indicates a need for further genetic education? a. "Blood type is formed from three gene alleles: A, B, and O." b. "Each blood type allele is inherited from the mother or the father." c. "If the patient's blood type is AB, then the client is homozygous for that trait." d. "If the client has dominant and recessive alleles, the dominant will be expressed."

c. "If the patient's 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/she does not want any family to know about this result. How would the nurse respond? a. "It is required by law that you inform your siblings and children about this result so that they also can be tested and monitored for colon cancer." b. "It is not necessary to tell your siblings because they are adults, but you would tell your children so that they can be tested before they decide to have children of their own." c. "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." d. "It is your decision to determine with whom, if anyone, you discuss this test result. However, you may be held liable if you withhold this information and a family member gets colon cancer."

c. "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 is educating a client about genetic screening. The client asks why red-green color blindness, an X-linked recessive disorder noted in some family members, is expressed more frequently in males than females. How would the nurse respond? a. "Females have a decreased penetrance rate for this gene mutation and are therefore less likely to express the trait." b. "Females have two X chromosomes and one is always inactive. This inactivity decreases the effect of the gene." c. "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." d. "Males have only one X chromosome, which allows the X-linked recessive disorder to be transmitted from father to son."

c. "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 would the nurse respond? a. "You are not genetically predisposed for this disease but you could still become ill. Let's discuss a plan for prevention." b. "Since many of your family members are carriers, you would undergo further testing to verify the results are accurate." c. "We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you?" d. "It is normal to feel this way. I think you would share this news with your family so that they can support you."

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

A nurse cares for a client who has a specific mutation in the a1AT (alpha1-antitrypsin) gene. What action would the nurse take? a. Teach the client to perform monthly breast self-examinations and schedule an annual mammogram. b. Support the client when sharing test results and encourages family members to be screened for cancer. c. Advise the client to limit exposure to secondhand smoke and other respiratory irritants. d. Obtain a complete health history to identify other genetic problems associated with this gene mutation.

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

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 would the nurse respond? a. "I will request a genetic counselor who is more qualified to be present for this conversation." b. "The test results can be confusing; I will help you interpret them for your daughter." c. "Are you sure you want to share this information with your daughter, who may not test positive for this gene mutation?" d. "This conversation may be difficult for both of you; I will be there to provide support."

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

A nurse cares for an adult client who has received genetic testing. The patient's mother asks to receive the results of the genetic tests. Which action would the nurse take? a. Obtain a signed consent from the client allowing test results to be released to the mother. b. Invite the mother and other family members to participate in genetic counseling with the client. c. Encourage the mother to undergo genetic testing to determine if she has the same risks as her child. d. Direct the mother to speak with the client and support the client's decision to share or not share the results.

d. Direct the mother to speak with the client and support the client's decision to share or not share the results.