Question 1

A woman whose family history for breast cancer includes two paternal aunts who developed breast cancer before age 45.Which genetics professional would be most appropriate for assistance in helping this patient understand the health risk posed by this family history?

A)Medical geneticist
B)Genetic counselor
C)Clinical geneticist
D)Clinical laboratory geneticist

Genetic counselor

Accepted Answer

A genetic counselor is the most appropriate genetics professional to assist this patient in understanding the health risk posed by her family history of early-onset breast cancer. Genetic counselors are trained to provide risk assessment, genetic testing options, and supportive counseling for patients with a personal or family history of cancer.

Question 2

Which action reflects promotion of genomic care as part of comprehensive health care?&#10;A)Calculating the odds ratios and recurrence risks of common complex health problems for all people&#10;B)Ensuring that genomic issues potentially influencing a person's health are incorporated into routine care&#10;C)Encouraging all people to undergo genetic testing as part of a proactive health screening and prevention program&#10;D)Instructing patients who undergo genetic testing about their obligation to inform family members regarding test results

Accepted Answer

Genomic care should be incorporated into routine care to promote comprehensive health care. This involves assessing and addressing genomic issues that may potentially influence a person's health. Options A and C are not feasible as calculating odds ratios and recurrence risks for common complex health problems is not solely dependent on genetics, and not everyone needs to undergo genetic testing. Option D is important, but it is not the key action to promote genomic care as part of comprehensive health care.

Question 3

Julia (aged 32)is BRCA₁ positive,which is known to greatly increase the risk for breast and ovarian cancer.She was tested because her mother,who had ovarian cancer,was BRCA₁ positive.Julia has decided to have both of her ovaries removed because she believes that,in her family,being BRCA₁ positive increases the risk for ovarian cancer only.How should a genetic counselor respond to Julia's statement?

A)Encourage her to consider a bilateral mastectomy.
B)Accept Julia's explanation as a manifestation of her autonomy and remain nondirective in the interactions with her.
C)Clarify that a BRCA₁ mutation does not preferentially express ovarian cancer over breast cancer in any given family.
D)Discuss Julia's responsibility to inform all the other female members of her family about her BRCA₁ status and cancer risk.

Accepted Answer

A BRCA1 mutation increases the risk for both breast and ovarian cancer, and there is no preference for one over the other within a family. It is important to clarify this misconception with Julia and provide accurate information about her cancer risks. While options such as bilateral mastectomy or informing family members may also be discussed, the first step is to address her misunderstanding about the mutation's effects.

Question 4

Which statement or criteria correctly is a required component for certification as an Advanced Practice Nurse in Genetics (APNG)?&#10;A)A 2-year residency in clinical genetics&#10;B)An earned PhD or DNP with coursework focusing on genetics&#10;C)Completion of 500 hours of direct bedside care for patients with genetic disorders&#10;D)Completion of a 50-case log describing the nurse's actions that reflect the standards of clinical genetic nursing practice

Accepted Answer

Certification as an APNG requires completion of a minimum of 500 hours of clinical genetics nursing practice and a 50-case log that reflects the nurse's actions in accordance with clinical genetic nursing practice standards. While a 2-year residency in clinical genetics or an earned PhD or DNP with a genetics focus may provide additional education and training, they are not specifically required for APNG certification.

Question 5

Why do genetic counseling programs include extensive courses on laboratory methods in genetics?&#10;A)To serve as a backup genetics technician in small laboratories&#10;B)To perform standard karyotyping on routine blood specimens&#10;C)To help patients understand testing procedures and results&#10;D)To be able to draw blood proficiently and safely

Accepted Answer

Genetic counselors need to have a strong understanding of laboratory methods in genetics so that they can accurately explain testing procedures and results to patients in a clear and understandable manner. This includes understanding various types of genetic testing, such as karyotyping, and being able to interpret results to provide patients with informed decisions about their healthcare.

Question 6

A certified family nurse practitioner with an MSN degree in family practice who works in a clinic serving patients who have connective tissue disorders refers to himself as a clinical geneticist.Is this title appropriate?

A)Yes,he is an advanced practice nurse.
B)Yes,he is a clinician employed in a setting specializing in patients with genetic-based health problems.
C)No,a clinical geneticist must be certified as a genetic counselor.
D)No,a clinical geneticist is a physician who has completed a fellowship in clinical genetics.

Accepted Answer

Only a physician who has completed training in a clinical specialty residency, such as pediatrics, internal medicine, obstetrics/gynecology, or another relevant specialty, and completed a clinical genetics fellowship in a program accredited by the American Board of Medical Genetics can be called a clinical geneticist. Additionally, the clinical geneticist must acquire initial certification and continue to remain current within the specialty to maintain certification. An MSN-prepared nurse practitioner, even with a certified specialty in genetics, is not a clinical geneticist.

Question 7

Which genetics professional has the defined responsibility for overseeing the work in a cytogenetic laboratory?&#10;A)Clinical laboratory geneticist&#10;B)Genetic laboratory technician&#10;C)Cytogenetics technician&#10;D)Medical geneticist

Accepted Answer

The clinical laboratory geneticist is responsible for overseeing the work in a cytogenetic laboratory. They are experts in interpreting and analyzing genetic test results and ensuring the accuracy and quality of laboratory procedures. Genetic laboratory technicians and cytogenetics technicians work under the supervision of a clinical laboratory geneticist or other qualified genetics professional. Medical geneticists may also oversee the laboratory work, but their primary responsibility is the diagnosis and management of genetic conditions in patients.

Question 8

The patient who has been found to have a mutation in gene allele that greatly increases her risk for a serious health problem has asked a generalist nurse to be present when she discloses this information to her family.What is the nurse's role in this situation?

A)Primary health-care provider
B)Genetic counselor
C)Patient advocate
D)Patient support

Accepted Answer

The answer of The patient who has been found to...

Question 9

Why are general physicians and surgeons NOT considered to be genetics professionals?&#10;A)The typical patients seen by these health-care providers have acute conditions rather than chronic conditions,and thus genetic influence is irrelevant.&#10;B)Most of today's physicians and surgeons were educated before completion of the human genome research project.&#10;C)These health-care professionals have minimal experience with genetics laboratory techniques.&#10;D)The focus of their professional education is the study of medicine rather than genetics.

Accepted Answer

The focus of general physicians and surgeons' professional education is medicine, with comparatively less emphasis on genetics. While they may have some knowledge of genetics, their expertise lies in diagnosing and treating acute conditions rather than chronic conditions with genetic components.

Question 10

How do genetic counselors provide genetic/genomic information to patients and families in a nondirective manner?&#10;A)Providing only the information the patient or family specifically requests&#10;B)Skillfully directing the patient and family toward the best choice that is supported by appropriate research&#10;C)Presenting all facts and available options in a manner that neither promotes nor excludes any legally permitted decision or action&#10;D)Filtering management options and focusing on the information that will support the decision they believe is right for the individual patient/family

Accepted Answer

Providing genetic/genomic information in a nondirective manner means presenting all the facts and available options in a way that does not promote or exclude any legally permitted decision or action. This ensures that the patient or family makes a decision that is best for them based on their values, beliefs, and circumstances. It is important for the genetic counselor to remain unbiased and not filter management options or focus on information that supports their personal beliefs or values. Therefore, option C is the best choice as it aligns with the principles of genetic counseling.

Deck 16: Health Professionals and Genomic Care