LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)

Chapter 8 Genetic Implications of Adult Health Nursing

1) A female patient reports being genetically predisposed to type 2 diabetes. What is the most important information that the nurse should provide?

1. The importance of maintaining a healthy weight and activity level

2. The need to avoid carbohydrate intake

3. The need to begin monitoring daily blood glucose levels

4. The need to address active health problems and not those that have yet to manifest

Page Ref: 193-194

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

2) A patient tells the nurse that she does not want to pass on a disease that is genetic in origin to any future children. How should the nurse respond to this patient?

1. "A complete genetic study could help guide you in your decision making."

2. "I suppose, then, that you are not going to have any children."

3. "Adoption is always a possibility."

4. "Are you sure that the disease is genetic in origin?"

Page Ref: 180

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

3) A patient expresses concern about transmitting genetic illnesses to any future children. What can the nurse do to help the patient determine which diseases might be transmitted?

1. Complete a pedigree.

2. Conduct a health promotion assessment.

3. Schedule a complete genetic analysis.

4. Refer to a geneticist for diagnosis.

Page Ref: 190

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

4) 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. What should the nurse discuss with the patient?

1. Importance of having screening for colorectal cancer at an earlier age

2. Importance of ingesting a diet high in protein and carbohydrates

3. Ways to maximize time spent in exercise

4. Reasons why having children would not be recommended for this patient

Page Ref: 193

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

5) While assessing a patient, the nurse notes an irregularity that has been observed in other patients, but on an inconsistent basis. What did the nurse most likely discover in this patient?

1. A polymorphism

2. A mutation

3. A single-gene inheritance pattern

4. An X-linked inheritance pattern

Page Ref: 184

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

6) A pregnant patient is informed that the fetus most likely has Down syndrome. With which genetic finding is this diagnosis most consistent?

1. Trisomy

2. Monosomy

3. Translocation

4. Deletions

Page Ref: 182

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

7) A patient reports that many family members have a type of anemia that is genetic. What should the nurse realize will occur in this patient?

1. The patient will develop the disease only if there is a mutation in the gene.

2. The patient will develop the same type of anemia.

3. The patient will die from the anemia.

4. The patient will develop the disease only if the gene translocates.

Page Ref: 182

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

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

1. "I realize that this news is difficult for you. Is there anything that I can do to help you at this time?"

2. "It's not too late to consider ending the pregnancy."

3. "You are young enough to be able to handle the baby's challenges."

4. "It does not matter if the baby has problems; all life is precious."

Page Ref: 193

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Therapeutic Communication

Standards: QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Caring

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

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

1. "All the chromosomes are the same size in males and females alike."

2. "Half of the sets of chromosomes come from the mother and the other half comes from the father."

3. "The 23rd pair of chromosomes will determine if our child will be male or female."

4. "One Y chromosome and one X sex chromosome will produce a male child."

Page Ref: 181

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

10) After genetic testing, a patient learns of having a predisposition for developing cardiovascular disease at a young age. What should the nurse instruct the patient regarding this information?

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

2. "At least you know now that you will need cardiac bypass surgery."

3. "Since you will most likely develop the disease early in life, enjoy your life as much as possible now."

4. "I would not place too much emphasis on these test results because most of the time they are inconclusive."

Page Ref: 188

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

11) A patient planning to be married has a strong family history of Huntington chorea but does not plan to inform the future spouse. How should the nurse respond to this patient?

1. "Is there any reason why you do not want your fiancé to know about the genetic illness?"

2. "It is probably best that the disease is not discussed."

3. "Are you afraid that your future marriage will be jeopardized?"

4. "There are worse disease processes than Huntington chorea."

Page Ref: 190

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Therapeutic Communication

Standards: QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care | AACN Essentials Competencies: VII.11. Access interprofessional and intraprofessional resources to resolve ethical and other practice dilemmas | NLN Competencies: Patient-Centered Care; Ethical Comportment; Respect the patient's dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing processes | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

12) A patient planning to have genetic testing prior to having children is fearful that too many people will learn about the test. How should the nurse respond to this patient?

1. "The results of the tests are confidential and no one can have the results without your permission."

2. "Most insurance companies will want the results before paying for the tests."

3. "The results will be available to anyone who reviews your medical record."

4. "The healthcare provider will most likely use the results when planning care and treatment for other patients with the same genetic disorder."

Page Ref: 189

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care | AACN Essentials Competencies: VII.11. Access interprofessional and intraprofessional resources to resolve ethical and other practice dilemmas | NLN Competencies: Context and Environment; Knowledge; ethical decision-making models | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

13) After learning of a genetic disease, a patient is upset because no other siblings have the disease and it is proof that the patient was unwanted by the parents. What should the nurse counsel this patient?

1. Suggest the patient talk with a counselor to discuss the results of the test and future options.

2. Ask the patient if thoughts and fears were discussed with the parents.

3. Encourage the patient to talk with the siblings about the illness and ask them for help now before the disease manifests.

4. Remind the patient that genetic testing is inconclusive, and there is a great chance that the results are wrong.

Page Ref: 190

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Therapeutic Communication

Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication | AACN Essentials Competencies: VII.11. Access interprofessional and intraprofessional resources to resolve ethical and other practice dilemmas | NLN Competencies: Context and Environment; Knowledge; ethical decision-making models | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

14) A patient believes that a newborn has a genetic disorder because someone gave the baby the "evil eye." What should this information suggest to the nurse?

1. The patient's culture supports the notion that a stranger looking at the baby caused the disorder.

2. The patient needs psychiatric counseling.

3. The patient is not going to be a good mother since strangers are permitted around the baby.

4. Healthcare dollars should not be spent trying to change this patient's opinion of why the baby has a genetic disorder.

Page Ref: 193

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values | AACN Essentials Competencies: VII.3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities and populations | NLN Competencies: Context and Environment; Ethical Comportment; Show respect for others' values; appreciate diversity | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

15) A patient has a strong family history of nonpolyposis colorectal cancer. What is the best advice the nurse can give to the patient?

1. Have predispositional genetic testing done to detect the presence of the genetic disorder even though the patient may never develop cancer.

2. Teach the patient the symptoms of colon cancer and suggest a high-fiber diet to prevent cancer.

3. Have regular colonoscopies; if one is abnormal, then predispositional genetic testing is indicated.

4. Have predispositional genetic testing done to detect the presence of colorectal cancer so that treatment can be initiated as early as possible.

Page Ref: 189

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.

16) Through genetic testing, a patient learns of having an apolipoprotein E2 gene. What should this information suggest to the nurse?

1. The patient is at reduced risk for developing Alzheimer disease.

2. The patient is at increased risk for developing Alzheimer disease.

3. The patient is at risk for contracting malaria.

4. The patient is at risk for developing colorectal cancer.

Page Ref: 184

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

17) From genetic testing, a patient learns that a specific medication can help a developing disease process. What does the nurse understand that genetic testing provided for the patient?

1. Biological marker

2. Phenotype

3. Genotype

4. Translocation

Page Ref: 184

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

18) A patient is having difficulty achieving adequate anticoagulation with prescribed doses of warfarin. What should the nurse suspect may be indicated for this patient?

1. Genetic testing to determine if the patient metabolizes warfarin slower

2. Use of a different anticoagulant

3. Review of the patient's diet

4. Analysis of the patient's lifestyle

Page Ref: 189

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.

19) A patient's mother has type 2 diabetes and heart problems. What should this information indicate to the nurse?

1. Patient will probably not change health habits

2. Can help predict the patient's future health problems

3. Helps predict the future health of the patient's children

4. Patient keeps in touch with parents

Page Ref: 190

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

20) A healthcare provider has prescribed a chromosomal analysis for a newborn baby. Which test does the nurse realize will most likely be performed with this baby?

1. Karyotype

2. Newborn screen

3. Carrier testing

4. Preimplantation genetic diagnosis

Page Ref: 182

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

21) A 42-year-old pregnant patient asks if the baby will be born with Down syndrome because of a chromosomal abnormality. To which chromosomal abnormality should the nurse understand the patient is referring?

1. 23 pairs of chromosomes

2. 26 pairs of chromosomes

3. One member of a chromosome pair missing

4. One extra member of a chromosome pair

Page Ref: 182

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

22) A patient whose spouse has chronic myelogenous leukemia is concerned that future children will inherit that genetic disorder. How should the nurse respond to this patient?

1. "The genetic makeup that created the chronic myelogenous leukemia in your spouse is not inheritable."

2. "I would be concerned, too."

3. "Maybe you should re-think having children."

4. "It could cause the same disorder, but it's a decision that you will have to make."

Page Ref: 183

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

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

1. All genetic disorders are passed to future children.

2. If the genetic disorder is a disorder of metabolism, it will most likely not be passed to any children.

3. The best possible plan for this problem is to avoid children.

4. The children will inherit the disorder only if the disorder is on chromosomes 13, 18, and 21.

Page Ref: 183

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

24) A baby is born with a genetic disorder that did not affect either of the parents. What should the nurse realize about this baby's disorder?

1. The mother is the carrier of the disorder.

2. The father is the carrier of the disorder.

3. The father is not the biological father of the baby.

4. Both parents are carriers of the disorder.

Page Ref: 184

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

25) A baby is born with a genetic disorder, and neither parent has a history of this disorder. What should the nurse use to explain the baby's genetic disorder?

1. De novo

2. Penetrance

3. An X-linked dominant condition

4. Multifactorial conditions

Page Ref: 187

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

26) Upon the completion of genetic testing, a patient is happy to learn of a negative test result. What should the nurse explain to the patient?

1. The patient will never experience a genetically caused disease.

2. Any children will be free from genetic diseases.

3. Children might develop disease from genetic misplacement of chromosomes.

4. There is no guarantee that the patient will not develop the disease.

Page Ref: 189

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

27) A patient and future spouse are upset because genetic testing completed through a laboratory found on the Internet determined they are at risk for having children with congenital abnormalities. Which is an appropriate nursing response?

1. "A screening test should be confirmed with a diagnostic test."

2. "The decision about whether or not to have children has been made for you."

3. "Are you concerned that your future spouse won't want to get married now?"

4. "I wouldn't worry about those results."

Page Ref: 188

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.

28) A patient reports that an adolescent child with a congenital abnormality is demonstrating increasing anger and animosity toward the parents. In which way is the adolescent behaving?

1. As a normal teenager

2. Confused and unaware of how to express it

3. Fostering resentment toward his parents

4. Demonstrating disease from the congenital abnormality

Page Ref: 190

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Family Dynamics

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

29) At the conclusion of a genetic counseling session, a family member believes information is being withheld. In which way is this individual behaving?

1. Feeling guilty because of the outcome of the testing

2. Demonstrating signs of a congenital abnormality

3. Angry with the findings from the testing

4. Confused by the nondirective approach taken by the genetic healthcare providers

Page Ref: 193

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Therapeutic Communication

Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.

30) A baby with Down syndrome has been born to a patient who refuses to allow any family members to visit the newborn. What should the nurse realize this patient is demonstrating?

1. Postpartum depression

2. Denial

3. Anxiety and guilt

4. Poor bonding

Page Ref: 191

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Grief and Loss

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

31) A patient is upset to hear that the results of genetic testing revealed wild-type genes. In which way should the nurse explain this type of gene?

1. Normal

2. Abnormal with limitations

3. Defective

4. Unexpected

Page Ref: 184

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

32) A patient who is pregnant reports a family history of cystic fibrosis and asks about the risks for transmission to the baby. What concept should the nurse include in the discussion?

1. There is less risk for transmission to male children.

2. The condition does not skip generations.

3. Male and female children are equally affected.

4. Both parents must be affected with this disorder for transmission to occur.

Page Ref: 185

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

33) A newborn has just been diagnosed with a negative result from genetic testing. What should the nurse realize this finding means?

1. No further follow-up is needed.

2. There is no clinical explanation for the symptoms that are seen.

3. The baby is likely a carrier of a genetic abnormality.

4. The baby will develop symptoms of a genetic abnormality later in life.

Page Ref: 189

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.

34) A patient scheduled for a genetic evaluation has questions regarding the visit. Rank the steps in the order that they should most likely occur. Place in order the steps of the process.

Choice 1. The geneticist examines the patient.

Choice 2. The patient is scheduled for diagnostic tests.

Choice 3. The patient constructs a third-generation pedigree.

Choice 4. The geneticist discusses the findings with the patient and makes recommendations.

Choice 5. The genetic clinical nurse interviews the patient.

Page Ref: 192

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.

35) The parents of a newborn diagnosed with cri du chat syndrome request information about this disorder. What statement by the nurse is appropriate? Select all that apply.

1. "Your baby's chromosomal makeup is unbalanced."

2. "These types of genetic problems are often the result of the patient missing some genes or having too much genetic material."

3. "This syndrome is genetically related to trisomy 21."

4. "Your baby's syndrome is the result of a large deletion on the short arm of chromosome 5."

5. "Your baby has the low-set ears and mewing cry that is associated with this syndrome."

Page Ref: 182

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

36) The nurse working in a geneticist's office is reviewing information about human cells with a patient. Which patient statement indicates that an adequate amount of learning has occurred? Select all that apply.

1. "Every human cell has 23 pairs of chromosomes and a total of 46 chromosomes."

2. "Chromosome 1 will be the smallest while chromosome 46 will be the largest."

3. "Each human cell contains mitochondria."

4. "The 22nd pair of chromosomes determines the person's gender."

5. "Every human cell functions in the same way regardless of its location."

Page Ref: 181

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

37) The nurse is reviewing the process of cell division with a patient receiving care in a fertility clinic. Which statement should the nurse make to explain mitotic cell division? Select all that apply.

1. "Sperm cells use mitosis to divide."

2. "It is the process to heal a wound."

3. "It is the process to recover from bronchitis."

4. "Fetal tissue grows this way."

5. "Healing from a stomach ulcer occurs this way."

Page Ref: 181

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

38) A patient with blue eyes asks the nurse to explain eye color because one parent had blue eyes and the other parent had brown eyes. What should the nurse include in this explanation? Select all that apply.

1. "You have two identical alleles that are responsible for your eye color."

2. "The alleles that are responsible for your eye color are heterozygous."

3. "Your eye color is the result of an expressed gene."

4. "Alleles are forms of a gene."

5. "Your eye color is just one part of your phenotype."

Page Ref: 183

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

39) The parents learn that their newborn has the CFTR gene located on chromosome 7. During counseling, what should the parents be instructed about the way that this genetic alteration may be expressed as the child grows? Select all that apply.

1. The child develops normally without any clinical manifestations associated with cystic fibrosis.

2. The patient is placed on a lung transplant list.

3. The patient receives bilateral mastectomies.

4. The patient is counseled about the increased risk of developing Alzheimer disease.

5. The child exhibits some mild signs and symptoms associated with cystic fibrosis.

Page Ref: 183

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

40) A young adult patient is suspected of having a mitochondrial mutation. Which patient statement is consistent with this information? Select all that apply.

1. "My dad was unable to hear normally after the age of 15."

2. "My mom and my sister are really little when compared to the rest of my family."

3. "My mom and my grandmother have trouble with seizures."

4. "My dad and my uncle both had heart attacks when they were in their 40s."

5. "I have some trouble walking and my muscles seem to be getting weaker."

Page Ref: 183

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8.1 Outline the basics of genetics including cell division, chromosomal alterations, and the role of genes.

MNL Learning Outcome: 1. Demonstrate understanding of the basics of genetics.

41) A 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 statement made by a parent indicates that further education is required? Select all that apply.

1. "This condition is related to a genetic alteration of the X chromosome."

2. "This condition is a Mendelian condition."

3. "So, we are carriers of this condition because we don't have any signs of symptoms of this condition."

4. "Our baby would have a better chance of living if we would have both been positive for an autosomal dominant condition."

5. "The problem is the result of an alteration of just one single gene."

Page Ref: 184

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

42) A married couple with two children who have the same autosomal dominant health problem is pregnant with a third child. Which statement by the patient may be expected? Select all that apply.

1. "I feel so guilty."

2. "I feel like my daughter is angry with me because I am the one who has this bad gene in my body."

3. "I am depressed and angry with myself."

4. "My son has been smoking marijuana and skipping school."

5. "I hope the new baby is a boy so he won't have the same illness."

Page Ref: 190

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Family Dynamics

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

43) The manager determines that a new staff nurse is capable of caring for patients with genetic disorders. What information did the manager use to make this decision? Select all that apply.

1. The nurse evaluates care provided to patients.

2. The nurse identifies patients' needs for referrals.

3. The nurse advocates for pregnancy terminations.

4. The nurse performs physical assessments accurately and thoroughly.

5. The nurse consistently completes a genetic-focused family history with patients.

Page Ref: 190

Cognitive Level: Analyzing

Client Need & Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

44) The nurse is preparing information for a group of parents as part of genetic counseling. What basic principle of inheritance should the nurse include in this presentation? Select all that apply.

1. All genes are paired.

2. Only one gene is passed on to offspring.

3. The mother's genes are transmitted to offspring.

4. The father's genes are used to fill in genetic deficits in offspring.

5. One copy of a gene comes from the mother and the other copy from the father.

Page Ref: 184

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning

Learning Outcome: 8.2 Describe the principles of inheritance.

MNL Learning Outcome: 2. Demonstrate understanding of the principles of inheritance.

45) A patient pregnant with a first child needs genetic testing that will be partially covered by the health insurance plan. What should the nurse encourage the patient to consider before making a decision about the testing? Select all that apply.

1. Extended family members may resent the patient.

2. There might not be treatment available for the genetic disorder.

3. The patient may terminate the pregnancy before family is informed.

4. The patient must determine whether she is prepared for lifestyle alterations based upon the results.

5. The insurance company will have information about the genetic testing.

Page Ref: 190

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Coping Mechanisms

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

46) The nurse is concerned that a patient pregnant with a fetus with a genetic disorder is experiencing moral and ethical problems. What should the nurse offer to support the patient at this time? Select all that apply.

1. The patient's use of coping mechanisms

2. Actions to take to reduce stress and anxiety

3. Reasons for terminating the pregnancy at this time

4. Assistance with thinking through the process to increase optimism

5. Ask if the patient has any particular spiritual advisor that can be contacted

Page Ref: 191

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Support Systems

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 4. Implement the nursing process to provide care to patients with a genetic disorder.

47) At the conclusion of a health history and physical assessment, the nurse determines that a patient might benefit from genetic testing. What did the nurse assess to come to this conclusion? Select all that apply.

1. Infertility

2. Seizure disorder

3. Menopause at age 32

4. Neighbor committed suicide

5. Cousin addicted to heroin

Page Ref: 192

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Practice-Know-How; 1. Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Describe the interprofessional care, nursing care, and transitions of care for patients with genetic disorders.

MNL Learning Outcome: 3. Consider intraprofessional care for patients with a genetic disorder.