Chapter 12: Genetics and Genomics

Chapter 12: Genetics and Genomics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The sister of a patient diagnosed with BRCA gene–related breast cancer asks the nurse, “Do you think I should be tested for the gene?” Which response by the nurse is most appropriate?

a.	“In most cases, breast cancer is not caused by having the BRCA gene.”
b.	“It depends on how you will feel if the test is positive for the BRCA gene.”
c.	“There are many things to consider before deciding to have genetic testing.”
d.	“You should decide first whether you are willing to have a bilateral mastectomy.”

 

 

ANS:  C

Although presymptomatic testing for genetic disorders allows patients to take action (e.g., mastectomy) to prevent the development of some genetically caused disorders, patients also need to consider that test results in their medical record may affect insurance, employability, and so on. Telling a patient that a decision about mastectomy should be made before testing implies that the nurse has made a judgment about what the patient should do if the test result is positive. Although the patient may need to think about her reaction if the test is positive, other issues (e.g., insurance) also should be considered. Although most breast cancers are not related to BRCA gene mutations, the patient with a BRCA gene mutation has a markedly increased risk for breast cancer.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   188

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

2. When counseling a couple in which the man has an autosomal recessive disorder and the woman has no gene for the disorder, the nurse uses Punnett squares to show the couple the probability of their having a child with the disorder. Which statement by the nurse is accurate?

a.	“Each child would be a carrier of the disorder.”
b.	“Each child would have 50% chance of having the disorder.”
c.	“Your male children would display characteristics of the disorder.”
d.	“Your female children would display characteristics of the disorder.”

 

 

ANS:  A

When one parent has an autosomal recessive disorder and the other parent has no genes for the autosomal recessive disorder, the children will be carriers of the autosomal recessive disorder. The children will not have the disorder or display characteristics of the disorder, regardless of gender.

 

DIF:    Cognitive Level: Apply (application)           REF:               181

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

3. A patient with a family history of cystic fibrosis (CF) asks for information about genetic testing. Which response by the nurse is most appropriate?

a.	Refer the patient to a qualified genetic counselor.
b.	Ask the patient why genetic testing seems necessary.
c.	Remind the patient that genetic testing has many social implications.
d.	Tell the patient that cystic fibrosis is an autosomal recessive disorder.

 

 

ANS:  A

A genetic counselor is best qualified to address the multiple issues involved in genetic testing for a patient who is considering having children. Although genetic testing does have social implications, the patient will be better served by a genetic counselor, who will have more expertise in this area. CF is an autosomal recessive disorder, but the patient might not understand the implications of this statement. Asking why the patient feels genetic testing is important may imply to the patient that the nurse is questioning her value system.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   185

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

4. A male patient with hemophilia asks the nurse if his children will be hemophiliacs. Which response by the nurse is accurate?

a.	“All of your children will be at risk for hemophilia.”
b.	“Hemophilia is a multifactorial inherited condition.”
c.	“Only your male children are at risk for hemophilia.”
d.	“Your female children will be carriers for hemophilia.”

 

 

ANS:  D

Because hemophilia is caused by a mutation of the X chromosome, all female children of a man with hemophilia are carriers of the disorder and can transmit the mutated gene to their offspring. Sons of a man with hemophilia will not have the disorder. Hemophilia is caused by a single genetic mutation and is not a multifactorial inherited condition.

 

DIF:    Cognitive Level: Apply (application)           REF:               181