Deck 8: Genetic Implications of Nursing Care of Adults

Question 1

A patient has been told that her unborn child will most likely have Down syndrome. The nurse realizes this diagnosis is consistent with which of the following?

A)trisomy
B)monosomy
C)translocation
D)deletions

Answer 1

trisomy

Question 2

A patient tells the nurse that many of her family members have a type of anemia that is genetic. The nurse realizes that this patient will do which of the following?

A)develop the disease only if there is a mutation in the gene
B)develop the same type of anemia
C)die from the anemia
D)develop the disease only if the gene translocates

Answer 2

develop the disease only if there is a mutation in the gene

Question 3

At the conclusion of genetic testing, a patient learns that he has a predisposition for developing cardiovascular disease at a young age. Which of the following can the nurse instruct the patient regarding this information?

A)"This information can help guide you to make lifestyle changes to reduce the chance of developing cardiovascular disease."
B)"At least you know now that you will need cardiac bypass surgery."
C)"Since you will most likely develop the disease early in life, enjoy your life as much as possible now."
D)"I would not place too much emphasis on these test results since most of the time they are inconclusive."

Answer 3

"This information can help guide you to make lifestyle changes to reduce the chance of developing cardiovascular disease."

Question 4

The nurse is developing a teaching plan for parents who need genetic counseling. Which statement by a parent would indicate the need for further education?

A)"All the chromosomes are the same size in males and females alike."
B)"Half of the sets of chromosomes come from the mother and the other half comes from the father."
C)"The 23^rd pair of chromosomes will determine if our child will be male or female."
D)"One Y chromosome and one X sex chromosomes will produce a male child."

Question 5

Through testing, a patient learns of a genetic disease that he has inherited from his parents yet none of his other siblings have inherited the same disease. The patient tells the nurse that he always believed his parents "didn't want him" and now he has proof. Which of the following should the nurse counsel this patient?

A)Suggest the patient talk with a counselor to discuss the results of the test and future options.
B)Ask the patient if he has ever discussed his thoughts and fears with his parents.
C)Encourage the patient to talk with his siblings about the illness and ask them for help now before he has manifestations of the disease.
D)Remind the patient that all genetic testing is inconclusive and there is a great chance that the results are wrong.

Question 6

A patient tells the nurse that she is concerned about transmitting genetic illnesses to any future children. Which of the following can the nurse do to help the patient determine which diseases might be transmitted?

A)Complete a pedigree.
B)Conduct a health promotion assessment.
C)Schedule for a complete genetic analysis.
D)Refer to a geneticist for diagnosis.

Question 7

While assessing a patient, the nurse notes an irregularity that has been observed in other patients, but on an inconsistent basis. This nurse has most likely discovered which of the following?

A)a polymorphism
B)a mutation
C)a single-gene inheritance pattern
D)an X-linked inheritance pattern

Question 8

A patient, learning that her newborn baby has a genetic disorder, tells the nurse that it was because a stranger gave her baby the "evil eye." Which of the following does this information suggest to the nurse?

A)The patient's culture supports that a stranger looking at the baby caused the disorder.
B)The patient needs psychiatric counseling.
C)The patient is not going to be a good mother since she permits strangers around the baby.
D)Healthcare dollars should not be spent trying to change this patient's opinion of why the baby has a genetic disorder.

Question 9

Through genetic testing, a patient learns that he has an apolipoprotein E2 gene. Which of the following does this information suggest to the nurse?

A)The patient is at reduced risk for developing Alzheimer's disease.
B)The patient is at increased risk for developing Alzheimer's disease.
C)The patient is at risk for contracting malaria.
D)The patient is at risk for developing colon-rectal cancer.

Question 10

A patient tells the nurse that she does not want to pass on a disease that is genetic in origin to any future children. The nurse would most correctly respond to this patient with which of the following statements?

A)"A complete genetic study could help guide you in your decision making."
B)"I supposed, then, that you are not going to have any children."
C)"Adoption is always a possibility."
D)"Are you sure that the disease is genetic in origin?"

Question 11

A female patient tells the nurse that she is genetically predisposed to type 2 diabetes. Which of the following is the most important information for this patient?

A)the importance of maintaining a healthy weight and activity level
B)the need to avoid carbohydrate intake
C)the need to begin monitoring daily blood glucose levels
D)the need to address active health problems and not those that have yet to manifest

Question 12

A patient has a strong family history of non-polyposis colorectal cancer. What is the best advice the nurse can give to the patient?

A)Have a genetic test to detect the presence of the genetic disorder, even though the patient may never develop cancer.
B)Teach the patient the symptoms indicating colon cancer and suggest a high fiber diet to prevent cancer.
C)Have regular colonoscopies.If the colonoscopy is abnormal, then genetic testing is indicated.
D)Have a genetic test to detect the presence of colorectal cancer so that treatment can be initiated as early as possible.

Question 13

A nurse is planning to teach the parents of a child with cystic fibrosis how the disease is manifested. Which of the following statements is the best explanation?

A)"While all people carry the gene for cystic fibrosis, those who develop the disease have a mutation in that gene."
B)"A small percentage of the general population carries the gene for cystic fibrosis.If two carriers have children, then 25% of those children will develop the disease."
C)"One in four people carry the gene for cystic fibrosis.If two carriers have children, then 25% of those children will develop the disease."
D)"Some people carry the gene for cystic fibrosis.Of those carriers, one in four will develop the disease."

Question 14

A patient planning to have genetic testing prior to having children tells the nurse that she is fearful that too many people will learn about the test. Which of the following should the nurse respond to this patient?

A)"The results of the tests are confidential and no one can have the results without your permission."
B)"Most insurance companies will want the results before paying for the tests."
C)"The results will be available to anyone who reviews your medical record."
D)"The doctor will most likely use the results when planning care and treatment for other patients with the same genetic disorder."

Question 15

At the completion of a genetic assessment, the nurse learns that a patient has three family members diagnosed with rectal cancer before the age of 40 years. Which of the following should the nurse discuss with the patient?

A)the importance of having screening for colon-rectal cancer at an earlier age
B)the importance of ingesting a diet high in protein and carbohydrates
C)ways to maximize time spent in exercise
D)reasons why having children would not be recommended for this patient

Question 16

From genetic testing, a patient learns that there is a specific medication that can help a developing disease process. The nurse realizes that the information provided through genetic testing served as which of the following?

A)biological marker
B)phenotype
C)genotype
D)translocation

Question 17

A patient is having difficulty achieving adequate anticoagulation with prescribed doses of warfarin. The nurse realizes that which of the following might be indicated for this patient?

A)genetic testing to determine if the patient metabolizes warfarin slower
B)use of a different anticoagulant
C)review of the patient's diet
D)analyzing of the patient's lifestyle

Question 18

A pregnant patient, learning that her unborn child has a high risk for Down syndrome, tells the nurse that she can just hear her mother now telling her "you should have had children when you were young and not in your late 30s." Which of the following should the nurse respond to this patient?

A)"There might be a higher risk for Down syndrome with an older mother but younger women have also given birth to babies with Down syndrome."
B)"Maybe you should have listened to your mother."
C)"I wish all women would have children before they were 30 to eradicate the disease."
D)"It's not too late to terminate the pregnancy and try again."

Question 19

At the completion of genetic testing it has been determined that a patient's baby will have Down syndrome. Which of the following should the nurse say to the patient after learning this information?

A)"I realize that this news is difficult for you.Is there anything that I can do to help you at this time?
B)"It's not too late to consider ending the pregnancy."
C)"You are young enough to be able to handle the baby's challenges."
D)"It does not matter if the baby has problems; all life is precious."

Question 20

A patient planning to be married tells the nurse that she has a strong family history of Huntington's chorea but does not plan to let her fiancé know. Which of the following should the nurse respond to this patient?

A)"Is there any reason why you do not want your fiancé to know about the genetic illness?"
B)"It is probably best that he is not aware of the disease."
C)"Are you afraid that he will not want to marry you if he knows?"
D)"There are worse disease processes than Huntington's chorea."

Question 21

While reviewing the male patient's history in the chart above, the nurse becomes concerned. The patient states, "I haven't been to see a physician in years and it's time for me to get a thorough check-up." Based on the nurse's understanding of genetically related diseases, which of the following diagnostic screening examinations may be ordered for this patient? 11ea992e_0a86_99d8_9f38_55cec3f78a2b

A)a mammogram
B)a prostate exam
C)a colonoscopy
D)a cardiovascular assessment

Question 22

A patient tells the nurse that her teenaged son, who has a congenital abnormality, is demonstrating increasing anger and animosity toward her and her husband. The nurse realizes that the son might be

A)behaving as a normal teenager.
B)confused.
C)fostering resentment towards his parents.
D)demonstrating disease from the congenital abnormality.

Question 23

The newborn has been diagnosed with cri du chat syndrome. The parents request information about this syndrome. Which of the following statements by the nurse are appropriate? Select all that apply.

A)"Your baby's chromosomal makeup is unbalanced."
B)"These types of genetic problems are often the result of the patient missing some genes or having too much genetic material."
C)"This syndrome is genetically related to trisomy 2
D)"Your baby's syndrome is the result of a large deletion the short arm of chromosome
E)"Your baby has the low-set ears and mewing cry that is associated with this syndrome."

Question 24

A patient has a history of a genetic disorder and is concerned that this same disorder will be passed to his children. What information should the nurse provide to this patient?

A)All genetic disorders are passed to future children.
B)If the genetic disorder is a disorder of metabolism, it will most likely not be passed to any children.
C)The best possible plan for this problem is to avoid children.
D)The children will inherit the disorder only if the disorder is on chromosomes 13, 18, and 21.

Question 25

The physician has ordered chromosomal analysis for a newborn baby. Based upon your knowledge, which of the following tests has been ordered?

A)karyotype
B)newborn screen
C)carrier testing
D)preimplantation genetic diagnosis

Question 26

A 42-year-old pregnant patient asks the nurse if the baby will be born with Down syndrome. The nurse realizes that, in this chromosome abnormality, the baby has which of the following?

A)23 pairs of chromosomes
B)26 pairs of chromosomes
C)One member of a chromosome pair missing
D)One extra member of a chromosome pair

Question 27

A baby is born with a genetic disorder that did not affect either of the parents. The nurse realizes which of the following?

A)The mother is the carrier of the disorder.
B)The father is the carrier of the disorder.
C)The father is not the biological father of the baby.
D)Both parents are carriers of the disorder.

Question 28

The patient is scheduled for a genetic evaluation. The patient has Click and drag the options below to move them up or down.

A)The geneticist examines the patient.
B)The patient is scheduled for diagnostic tests.
C)The patient constructs a 3-generation pedigree.
D)The geneticist discusses the findings with the patient and makes recommendations.
E)The genetic clinical nurse interviews the patient.

Question 29

The patient is 29-years-old. The patient's mother died from an unspecified cancer at the age of 33-years-old. Which of the following is appropriate for this patient? 11ea992e_0a86_72c7_9f38_8dd20ac570fd

A)The patient is scheduled for a prostate exam.
B)The patient is scheduled for a colonoscopy.
C)The patient is scheduled for a mammogram.
D)The patient is scheduled for an ovarian cancer screening examination.

Question 30

A patient tells the nurse that her husband has chronic myelogenous leukemia and is concerned that any of their children will inherit the same genetic disorder. Which of the following is an appropriate nursing response?

A)"The genetic makeup that created the chronic myelogenous leukemia in your husband is not inheritable."
B)"I would be concerned, too."
C)"Maybe you should re-think having children."
D)"It could cause the same disorder, but it's a decision that you will have to make."

Question 31

A patient who is pregnant reports a family history of cystic fibrosis and asks about the risks for transmission to her child. Which of the following concepts should be included in the discussion?

A)There is less risk for transmission to male children.
B)The condition does not skip generations.
C)Male and female children are equally affected.
D)The parents must both be affected with this disorder for transmission to occur.

Question 32

A patient and her future husband completed genetic testing through a laboratory that they found on the Internet. The patient is upset because the results determined that they are at risk for having children with congenital abnormalities. Which of the following is an appropriate nursing response?

A)"Not all genetic testing laboratories are the same.It might be beneficial to validate those results with another lab."
B)"The decision for children has been made for you."
C)"Are you concerned that your future husband won't want to get married now?"
D)"I wouldn't worry about those results."

Question 33

Upon the completion of genetic testing, a patient is happy to learn that she has a negative test result. The nurse realizes that this patient needs to understand that

A)she will never experience a genetically-caused disease.
B)any children she has will be free from genetic diseases.
C)her children might develop disease from genetic misplacement of chromosomes.
D)this is not a guarantee.

Question 34

A patient is upset to hear the nurse say that the results of genetic testing revealed "wild-type" genes. The nurse realizes that the patient does not understand that wild-type genes are which of the following?

A)normal normal.
B)abnormal with limitations
C)defective
D)unexpected

Question 35

A newborn has just been diagnosed with a negative result from genetic testing. The nurse realizes that this finding means which of the following?

A)No further follow-up is needed.
B)There is no clinical explanation for the symptoms that are seen.
C)The baby is likely a carrier of a genetic abnormality.
D)The baby will develop symptoms of a genetic abnormality later in life.

Question 36

Four hundred twenty-two people are involved in a research study regarding warfarin use. Twenty-three are African American, 14 are Asian, and the rest are Caucasian. Based on previous research, calculate how many of the Caucasian patients may metabolize warfarin at a slower rate due to a polymorphism on the cytochrome P450 CYP2C9 gene. _______

Question 37

A patient tells the nurse that her mother has type 2 diabetes and heart problems. The nurse realizes that this information

A)means that the patient will probably not change her health habits.
B)can help predict the patient's future health problems.
C)helps predict the future health of the patient's children.
D)means that the patient keeps in touch with her parents.

Question 38

A baby is born with a genetic disorder. Neither parent has a history of this disorder. The nurse realizes that this cause of this disorder can be explained as being which of the following?

A)de novo
B)penetrance
C)an X-linked dominant condition
D)evidence to justify the need for a paternity test

Question 39

A baby with Down syndrome has been born to a mother who refuses to allow any family members to visit her or the newborn. The nurse realizes that this patient is demonstrating which of the following?

A)postpartum depression
B)denial
C)anxiety and guilt
D)poor bonding

Question 40

At the conclusion of a genetic counseling session, a family member says to the nurse, "There's got to be something that you aren't telling us." The nurse realizes that this individual is

A)feeling guilty because of the outcome of the testing.
B)demonstrating signs of a congenital abnormality.
C)angry with the findings from the testing.
D)with the non-directive approach taken by the genetic healthcare providers.

Question 41

The newborn has the CFTR gene located on chromosome 7. The parents are discussing this information with the geneticist during counseling. In which of the following ways may the newborn express this genetic alteration as the child grows? Select all that apply.

A)The child develops normally without any clinical manifestations associated with cystic fibrosis.
B)The patient is placed on a lung transplant list.
C)The patient receives bilateral mastectomies.
D)The patient is counseled about the increased risk of developing Alzheimer's disease.
E)The child exhibits some mild signs and symptoms associated with cystic fibrosis.

Question 42

The fetus is found to have an autosomal recessive condition. After genetic testing is completed, both of the fetus' parents are found to have this same autosomal recessive genetic alteration. Which of the following statements by a parent indicate that further education is required? Select all that apply.

A)"This condition is related to a genetic alteration of the X chromosome."
B)"This condition is a Mendelian condition."
C)"So, we are carriers of this condition because we don't have any signs of symptoms of this condition."
D)"Our baby would have a better chance of living if we would have both been positive for an autosomal dominant condition."
E)"The problem is the result of an alteration of just one single gene."

Question 43

A married couple has two teenaged children at home who have been diagnosed with the same autosomal dominant condition. The nurse is interviewing the couple after they become pregnant with their third child. Based on the nurse's understanding of related psychosocial issues, which of the following statements by the mother may be expected? Select all that apply.

A)"I feel so guilty."
B)"I feel like my daughter is angry with me because I am the one who has this bad gene in my body."
C)"I am depressed and angry with myself."
D)"My mother has been buying the kids a lot more gifts now that they've started to display problems related to their condition."
E)"My son has been smoking marijuana and skipping school."

Question 44

The nurse works in a geneticist's office and is educating a student nurse about human cells. Which of the following statements by the student indicate that an adequate amount of learning has occurred? Select all that apply.

A)"Every human cell has 23 pairs of chromosomes and a total of 46 chromosomes."
B)"Chromosome 1 will be the smallest while chromosome 46 will be the largest."
C)"Each human cell contains mitochondria."
D)"The 22^nd pair of chromosomes determines the person's gender."
E)"Every human cell functions in the same way regardless of their location."

Question 45

The nurse at the geneticist's office is interviewing the 22-year-old patient. The patient may have a mitochondrial mutation. Which of the following statements made by the patient are most consistent with this information? Select all that apply.

A)"My dad was unable to hear normally after the age of 15
B)"My mom and my sister are really little when compared to the rest of my family."
C)"My mom and my grandmother have trouble with seizures."
D)"My dad and my uncle both had heart attacks when they were in their 40s."
E)"I have some trouble walking and my muscles seem to be getting weaker."

Question 46

The patient has blue eyes. During the interview with the nurse at the geneticist's office, the patient states that his mother has blue eyes and his father has brown eyes. The patient has some Select all that apply.

A)"You have two identical alleles that are responsible for your eye color."
B)"The alleles that are responsible for your eye color are heterozygous."
C)"Your eye color is the result of an expressed gene."
D)"Alleles are forms of a gene."
E)"Your eye color is just one part of your phenotype."

Question 47

The nurse is teaching the student nurse about mitosis and meiosis. Which of the following statements by the student nurse are examples of scenarios that involve mitotic cell division? Select all that apply.

A)"Sperm cells use mitosis to divide."
B)"The patient has a healing wound on the coccyx."
C)"The patient has acute bronchitis."
D)"A fetus grows using mitosis."
E)"The patient has acute gastritis."