Module 1- Chapter 6

A client is devastated by the results of genetic testing, stating, "How am I ever going to get a job with these kinds of risks?" What is the nurse's best response? A. "There's legislation that outlaws that kind of discrimination." B. "I know it's distressing, but try to wait until your employer responds." C. "I'm sure there are jobs that will still be very appropriate for you." D. "Nearly everyone has results like this when they undergo testing."

A. "There's legislation that outlaws that kind of discrimination."

To explain the concept of autosomal recessive inheritance, a nurse is using the example of two parents with two recessive genes each for six toes. What is the chance that this couple will have a child with six toes? A. 25% B. 50% C. 75% D. 100%

A. 25%

A client has an appointment at a genetic clinic for the first time. The client asks, "What makes me look the way I do?" What genetic process is responsible for the client's physical appearance? A. Phenotype B. Mitosis C. Meiosis D. Genotype

A. Phenotype

The occupational health nurse is conducting yearly health screenings. An adult client states, "My parent had colon cancer, but I really don't understand why that means that I need a colonoscopy." What could the nurse do to disseminate information about screening to more individuals? A. Plan a health fair for the employees that provides information about screening for diseases that have an inheritance pattern. B. Refer each employee over the age of 50 to a gastroenterologist. C. Create a website on diet and exercise as it relates to the prevention of colon cancer in people over 50. D. Place brochures in the nurses' facility for the employees to access in answering their questions.

A. Plan a health fair for the employees that provides information about screening for diseases that have an inheritance pattern.

Genetic testing reveals that an African man and woman who are engaged to be married are both carriers of the gene that causes sickle cell disease. When planning this couple's follow-up counseling, the nurse should recognize what implication of this assessment finding? A. There is a 25% chance that a child of the couple would have sickle cell disease. B. The man and woman each have an increased risk of developing sickle cell disease later in life. C. There is a 50% risk of sickle cell disease for each of the couple's children. D. Their children's risk of sickle cell disease will depend on a combination of genetics and lifestyle factors.

A. There is a 25% chance that a child of the couple would have sickle cell disease.

The nurse at a genetics clinic is reviewing the health and genetic history of a woman whose mother died of breast cancer. Which of the following is the most important factor documented in the client's genetic history? A. Three generations of information about the family B. Current medications taken C. Health problems present in the woman's children D. Immunizations received for the past three generations

A. Three generations of information about the family

A 22-year-old African American woman is admitted for sickle cell crisis and is thinking about having a baby with her husband. She states, "I know that I have sickle cell disease so it is not important that I get screened." The nurse's best response to this statement would be: A. "It is important that you do not consider getting pregnant at this time in your life since having a baby would probably cause major organ damage." B. "It is still important that both you and your husband consider genetic testing. Testing can detect the likelihood of your baby inheriting a variety of genetic conditions." C. "It is still important that you consider genetic testing. If you do not, the state will mandate that you receive genetic testing in your first trimester since you have sickle cell disease." D. "It is important that you consider preimplantation genetic testing (PGT) before discharge in order to have an informed choice on whether you want to become pregnant.

B. "It is still important that both you and your husband consider genetic testing. Testing can detect the likelihood of your baby inheriting a variety of genetic conditions."

A nurse is participating in the assessment portion of a couple's genetic screening and testing. Early in the assessment of the couple's family history, the nurse learns that the husband's father and the wife's father are brothers. The nurse recognizes that this greatly increases the couple's risk of what health problems? A. Diseases that have a multifactorial pattern of inheritance B. Diseases with autosomal recessive inheritance C. Autosomal dominant disease D. X-linked diseases

B. Diseases with autosomal recessive inheritance

A 45-year-old client has just been diagnosed with Huntington disease. The client and the client's spouse are concerned about their four children. What will the nurse understand about the children's possibility of inheriting the gene for the disease? A. Each child will have a 25% chance of inheriting the disease. B. Each child will have a 50% chance of inheriting the disease. C. Each child will have a 75% chance of inheriting the disease. D. Each child will have no chance of inheriting the disease.

B. Each child will have a 50% chance of inheriting the disease.

What action should a nurse who practices in the area of genetics prioritize? A. Teaching families about the different patterns of inheritance B. Gathering relevant family and medical history information C. Providing advice on termination of pregnancy D. Discouraging conception to women after 40 years of age

B. Gathering relevant family and medical history information

A nurse educator is discussing the importance of including genetics and genomics in daily nursing practices. What areas of nursing practice would benefit the most from this inclusion? A. Discharge planning and ambulation B. Health assessment and planning nursing interventions C. Documentation and nutritional changes D. Health insurance needs and changes in computer formatting

B. Health assessment and planning nursing interventions

An adult client has undergone genetic testing, and the results reveal a genetic mutation that allows clinicians to make accurate predictions about disease onset and progression. This model for presymptomatic testing is being used to address what disease? A. Alzheimer disease B. Huntington disease C. Tay-Sachs disease D. Sickle cell disease

B. Huntington disease

A couple who can speak English (but cannot read or write it) request genetic testing. They are planning to start a family and are concerned because one of the spouse's siblings has cystic fibrosis. The clinic's consent form is only in English. What should the nurse do? A. Inform the clients they need to sign so the testing can be done. B. Inform the geneticist that the couple cannot give informed consent. C. Attempt to find a similar form in their language online and have them sign it. D. Explain the form to the client in simple English and have him sign it.

B. Inform the geneticist that the couple cannot give informed consent.

A nurse is participating in genetic counseling for a couple who is considering trying to conceive. After the couple receives the results of genetic testing, the nurse should prioritize which of the following? A. Secondary illness prevention B. Psychosocial assessment C. Gene therapy D. Assessing adherence to treatment

B. Psychosocial assessment

For what health problem would a client of African heritage most likely have genetic carrier testing? A. Meckel diverticulum B. Sickle cell disease C. Huntington disease D. Rubella

B. Sickle cell disease

An older adult male client has been diagnosed with prostate cancer. Neither the client nor his family has a history of cancer. What is the most likely genetic reason for his diagnosis? A. Germline mutation B. Single nucleotide polymorphism mutation C. Inherited gene mutation D. Hemoglobin S gene mutation

B. Single nucleotide polymorphism mutation

A baby is born with what the health care provider believes is a diagnosis of trisomy 21. This means that the infant has three copies of chromosome number 21. Which factor describes the etiology of this genetic change? A. The mother also has a genetic mutation of chromosome 21 B. The client has a nondisjunction occurring during meiosis. C. During meiosis, a reduction of chromosomes resulted in 23. D. The client will have a single X chromosome and infertility

B. The client has a nondisjunction occurring during meiosis.

Regardless of the setting in which they provide care, nurses are expected to know how to use the first step in establishing a pattern of inheritance. What is this first step? A. The developmental assessment B. The family history C. The physical assessment D. The psychosocial assessment

B. The family history

The nurse reviews a client's chart and reads that the client has a gene mutation that affects protein structure, producing hemoglobin S. The nurse knows that with this gene mutation, the client will experience symptoms of what condition? A. Peripheral and pulmonary edema B. Thrombotic organ damage C. Metastasis of a glioblastoma D. Amyotrophic lateral sclerosis

B. Thrombotic organ damage

A perinatal nurse is providing care for a primiparous woman who gave birth to a healthy infant yesterday. The nurse explains to the client the genetic screening that is mandated. What is the nurse's best rationale for this? A. "This screening is a way to determine the rate of infectious disease in babies during this vulnerable time in their lives." B. "It is important to screen newborns to determine their future cancer risk and appraise the quality of prenatal care they received." C. "This is a way many states assess your infant's risk for illnesses such as phenylketonuria, congenital hypothyroidism, and galactosemia." D. "This testing is required and you will not be able to refuse it. It usually is free, so there is no reason to refuse it."

C. "This is a way many states assess your infant's risk for illnesses such as phenylketonuria, congenital hypothyroidism, and galactosemia."

A client comes to the clinic for genetic testing. The nurse asks the client to sign consent forms to obtain the client's medical records. The client wants to know why the geneticist needs the old medical records. What is the nurse's best response? A. "We always get old medical records just in case we need them." B. "This is just part of the due diligence that we practice here at the clinic." C. "Your medical information is needed so we can provide you with the appropriate information and counseling." D. "We need your medical records in case there is something about your medical history that you forget to tell us."

C. "Your medical information is needed so we can provide you with the appropriate information and counseling."

A woman has come to the clinic for her first prenatal visit after becoming pregnant for the first time. She asks the nurse about age guidelines for genetic counseling and prenatal testing. The nurse informs the client that genetic counseling and prenatal testing should be performed for all pregnant women in which age group? A. 18 to 21 B. 40 and older C. 35 and older D. 18 and under

C. 35 and older

A genetic testing study has begun to evaluate the incidence of breast cancer in the Jewish community for women over 50 years of age. In order for population screening to start; what are some conditions that must be met? A. A percentage of screened participants must agree to treatments if a mutation is found. B. A detailed family history of all the participants and information about gene distribution outside the population must occur. C. Appropriate medical management for asymptomatic participants with a mutation must be provided. D. Accurate prediction about the number of participants that have received any gene therapy in the last year is necessary.

C. Appropriate medical management for asymptomatic participants with a mutation must be provided.

The nurse is caring for a client who has the BRCA1 hereditary breast cancer gene mutation. What should the nurse teach the client about their risk for breast cancer? A. Breast cancer is an autosomal recessive inheritance in which each parent carries the gene mutation. B. Breast cancer is an X-linked inheritance and all males inherit an X chromosome from their mothers. C. Breast cancer has autosomal dominant inheritance that has incomplete penetrance and appears to skip a generation. D. Breast cancer has a pattern that is more horizontal than vertical; relatives of a single generation tend to have the condition.

C. Breast cancer has autosomal dominant inheritance that has incomplete penetrance and appears to skip a generation.

A 28-year-old client has come to the genetic clinic because a sibling has Lynch syndrome. The client requests testing and needs to limit costs due to being self-employed. What type of test would be most beneficial to this client? A. Population screening B. Presymptomatic testing C. Cascade screening D. Genomic testing

C. Cascade screening

While the nurse is taking the client's history, the client tells the nurse she is trying to get pregnant and she is very fearful she will have another miscarriage. She states she has miscarried twice and does not know why. Based on this client's history, what recommendation should the nurse make? A. Instruct her to continue to try to get pregnant. B. Let the client know that her loss may not occur again. C. Encourage her to explore the possibility of chromosome testing studies. D. Instruct her to have an amniocentesis with the next pregnancy

C. Encourage her to explore the possibility of chromosome testing studies.

Three sisters decide to have genetic testing done because their mother and their maternal grandmother died of breast cancer. Each of the sisters has the BRCA1 gene mutation. The nurse explains that just because they have the gene does not necessarily mean that they will develop breast cancer. On what does the nurse explain their chances of developing breast cancer depend? A. Gene sensitivity B. Conductivity C. Incomplete penetrance D. Susceptibility

C. Incomplete penetrance

The nurse is documenting the family history of an older adult client newly diagnosed with Alzheimer disease. What knowledge should influence nursing considerations for genetic testing? A. Which genetic tests predict the client's spouse's risk of Alzheimer disease B. Which actions the geneticist has recommended for treating the disease C. The genetic bases of adult-onset conditions such as Alzheimer disease D. Whether any of the client's peers have Alzheimer disease

C. The genetic bases of adult-onset conditions such as Alzheimer disease

A nurse has begun a new role in a clinic that focuses on genetics and genomics. In this role, the nurse will aim to help individuals and families understand how: A. genetic and psychological factors influence coping. B. genomic and physical factors influence longevity. C. genetic and environmental factors influence health and disease. D. physical factors influence genetics and wellness.

C. genetic and environmental factors influence health and disease.

Results of genetic testing have come back and the client has just been told they carry the gene for Huntington disease. The client asks the nurse if this information is confidential and if it will remain that way. The client is adamant that their partner and family members not be told of this finding. What is the nurse's best response? A. "I am ethically bound to tell your partner and family." B. "Your information will remain confidential until the geneticist reviews everything. Then the geneticist will have to tell your family." C. "Have you thought about what this disease will do to your partner and any children you may have?" D. "I will respect your wishes and keep your information confidential. However, I do wish you would reconsider."

D. "I will respect your wishes and keep your information confidential. However, I do wish you would reconsider."

A 50-year-old client presents at the clinic with recent episodes of forgetfulness. The client reports that a parent had some kind of illness in which the parent had to be institutionalized at age 42 and passed away at age 45. The client states that the parent forgot who their children were when the parent was institutionalized. Based on this information, what should the nurse suspect? A. Huntington disease B. Schizophrenia C. Cerebrovascular disease D. Alzheimer disease

D. Alzheimer disease

A newly married couple are at a genetics clinic for testing. One of the clients tells the nurse, "I know that my new spouse is the type of person who'd rather not know about future risks until they come true." Based on this statement, which nursing diagnosis best applies to the spouse? A. Situational low self-esteem related to reluctance to have genetic testing B. Powerlessness related to results of genetic testing C. Ineffective health maintenance related to reluctance to have genetic testing D. Anxiety related to possible results of genetic testing

D. Anxiety related to possible results of genetic testing

The nurse in the genetics clinic is conducting an assessment of a young man and woman who have been referred to the clinic because they are trying to conceive. When performing an assessment in this care setting, the nurse should focus on what area(s) of assessment? Select all that apply. A. Assessing clients' personality strengths and weaknesses B. Performing assessments of clients' patterns of behavior C. Assessing the genetic characteristics of clients' blood samples D. Gathering family histories and health histories E. Performing comprehensive physical assessments

D. Gathering family histories and health histories E. Performing comprehensive physical assessments

A nurse who works in a hospital clinic is describing ways of integrating genetics and genomics into nursing practice. Which of the nurse's actions is most consistent with this role? A. Planning treatment modalities for diseases that have patterns of inheritance B. Documenting flaws in the collection of genetic sampling procedures C. Choosing options for clients after genetic testing and genomic counseling D. Informing clients about the ethics of genetics and genomic concepts

D. Informing clients about the ethics of genetics and genomic concepts

A couple wants to start a family and they are concerned that their child will be at risk for cystic fibrosis because they each have a cousin with cystic fibrosis. What should the nurse practitioner tell them about cystic fibrosis? A. It is an autosomal dominant disorder. B. It is passed by mitochondrial inheritance. C. It is an X-linked inherited disorder. D. It is an autosomal recessive disorder.

D. It is an autosomal recessive disorder.

A 47-year-old client with osteoarthritis and hypertension is diagnosed with breast cancer. The client tells the nurse that her mother also suffered from osteoarthritis and hypertension, and she developed breast cancer at the age of 51 years. The nurse should recognize that this client's health status may be the result of what phenomenon? A. X-linked inheritance B. Autosomal recessive inheritance C. Autosomal dominant inheritance D. Multifactorial inheritance

D. Multifactorial inheritance

A 40-year-old man who has been separated from his father since early childhood tells the nurse that his father recently contacted him to inform him that he is dying of Huntington disease. What is an essential component of care for this client? A. Assist the client in determining signs of neuromuscular weakness. B. Instruct the man on treatment options for Huntington disease. C. Teach the man how to avoid passing Huntington disease to his own children. D. Provide genetic counseling, evaluation, and testing for the disease

D. Provide genetic counseling, evaluation, and testing for the disease

A nurse is providing an overview of the new trends in genetics and genomics to a young couple who wish to start a family. What single trend in genomics and genomics is the most significant? A. To provide follow-up genetic counseling to only couples who have conception problems B. To include nursing practitioners in the collaboration process to determine treatment options C. To include an ethics committee in all decisions that involve minor couples genetic testing D. To use genetic testing for presymptomatic prediction of illness and treatment

D. To use genetic testing for presymptomatic prediction of illness and treatment

A couple states that they both take the same dose of hypertensive medication at the time and with the same meal each day. Recently the husband is requiring a lower dose of this medication due to toxicity. How does pharmacogenomics play a role in this situation? A. The difference in the husband's weight and percentage of fat contributed to his metabolism and absorption and toxicity of the drug. B. Multifactorial conditions account for the husband's absorption of the drug and toxicity. C. The husband's previous abdominal surgeries have contributed to his absorption of the drug and toxicity. D. Variations in the husband's genes contributed to his response to the drug and toxicity.

D. Variations in the husband's genes contributed to his response to the drug and toxicity.