Chapter 6: Genetic Concepts for Medical-Surgical Nursing

Chapter 6: Genetic Concepts for Medical-Surgical Nursing

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which statement by the nurse indicates correct understanding of the purpose of a pedigree?

a.	“It is used for genetic counseling of the client by the geneticist.”
b.	“It is used to show family history of a trait over at least three generations.”
c.	“It is used to show a specific pattern of inheritance of a trait.”
d.	“It is used to identify penetrance of a gene in a family.”

 

 

ANS:  B

A pedigree is a graph of a family history for a specific trait or health problem over several generations. The other statements are inaccurate descriptions of the purpose of a pedigree.

 

DIF:    Cognitive Level: Knowledge/Remembering                       REF:   p. 72

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Alterations in Body Systems)                   MSC:  Integrated Process: Nursing Process (Assessment)

 

2. The client exhibits a trait that has appeared in every generation of his or her family. This is an example of which type of inheritance?

a.	Autosomal recessive
b.	Sex-linked recessive
c.	Autosomal dominant
d.	Sex-linked dominant

 

 

ANS:  C

Autosomal dominant (AD) single-gene traits require that the gene alleles controlling the trait be located on an autosomal chromosome. A dominant gene allele is expressed even when only one allele of the pair is dominant. Other criteria for AD patterns of inheritance include that the trait appears in every generation with no skipping. Autosomal recessive, sex-linked recessive, and sex-linked dominant types of inheritance do not require that the trait appear in every generation of a family. Rather, in the case of sex-linked traits, the gender of family members determines whether a trait will appear in a family.

 

DIF:    Cognitive Level: Knowledge/Remembering                       REF:   p. 73

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Alterations in Body Systems)                   MSC:  Integrated Process: Nursing Process (Assessment)

 

3. The client has a family history of breast cancer. The physician has recommended that she undergo genetic testing. What action is most important for the nurse to take before scheduling the client for the procedure?

a.	Making certain the client is prepared for the risk of psychological side effects
b.	Obtaining informed consent from the client and placing it on the chart
c.	Simultaneously scheduling genetic counseling with an advanced practice nurse
d.	Carefully explaining the procedure to the client and assuring her confidentiality

 

 

ANS:  B

Informed consent is required before genetic testing is undertaken. The person tested is the one who gives consent, even though genetic testing always gives information about a family and family members, not just the client. Although the procedure must be explained to the client and she must be prepared for the psychological effect of undergoing testing, the procedure cannot occur without an informed consent.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Safe and Effective Care Environment (Management of Care—Informed Consent)

MSC:  Integrated Process: Communication and Documentation

 

4. The client undergoes genetic testing but chooses not to be told the results of the testing once it is completed. Which action is most important for the nurse to implement?

a.	Encourage the client to ask for the results of the genetic testing.
b.	Share the results of the testing with the client’s family members.
c.	Explain to the client how this choice may affect other family members.
d.	Respect the client’s right to not know the results of the testing.

 

 

ANS:  D

The right to know genetic risk versus the right to not know is the individual client’s choice. The nurse should respect the client’s rights. It would not be appropriate for the nurse to encourage the client to ask for the results because this is a personal issue. The nurse would never share results with others because this is a violation of the Health Insurance Portability and Accountability Act (HIPAA). The client probably realizes that this choice affects other family members. The nurse would not have to explain this.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Safe and Effective Care Environment (Management of Care—Client Rights)         MSC:           Integrated Process: Caring