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A nurse cares for a client who recently completed genetic testing that revealed that she has a BRCA1 gene mutation. Which actions should the nurse take next? (Select all that apply.)
- A. Discuss potential risks for other members of her family.
- B. Assist the client to make a plan for prevention and risk reduction.
- C. Disclose the information to the medical insurance company.
- D. Assist the client to make a plan for prevention and risk reduction.
- E. Assess the clients response to the test results.
- F. Encourage support by sharing the results with family members.
Correct Answer: A,B,E
Rationale: The nurse should assess the client's emotional response, discuss familial risks, and assist with prevention and risk reduction plans. Disclosing to insurance companies violates confidentiality, and encouraging sharing with family is the client's decision, not the nurse's role.
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A nurse obtains health histories when admitting clients to a medical-surgical unit. With which client should the nurse discuss predisposition genetic testing?
- A. Middle-aged woman whose mother died at age 58 of breast cancer
- B. Middle-aged woman whose mother died at age 58 of breast cancer
- C. Pregnant woman whose father has sickle cell disease
- D. Middle-aged man of Eastern European Jewish ancestry
Correct Answer: A
Rationale: A family history of breast cancer, especially at a relatively young age, indicates a potential risk for hereditary breast cancer, warranting discussion about predisposition genetic testing for genes like BRCA1/2. The pregnant woman's father having sickle cell disease suggests carrier testing, and the man of Eastern European Jewish ancestry may need carrier testing for conditions like Tay-Sachs, not predisposition testing.
A nurse teaches clients about patterns of inheritance for genetic disorders among adults. Which disorders have an autosomal dominant pattern of inheritance? (Select all that apply.)
- A. Breast cancer
- B. Alzheimer's disease
- C. Hemophilia
- D. Huntington disease
- E. Marfan syndrome
- F. Cystic fibrosis
Correct Answer: A,D,E
Rationale: Breast cancer (via BRCA1/2 mutations), Huntington disease, and Marfan syndrome are autosomal dominant. Alzheimer's has complex inheritance, hemophilia is X-linked recessive, and cystic fibrosis is autosomal recessive.
A health care provider prescribes genetic testing for a client who has a family history of colorectal cancer. Which action should the nurse take before scheduling the client for the procedure?
- A. Confirm that informed consent was obtained and placed on the clients chart.
- B. Provide genetic counseling to the client and the clients family members.
- C. Provide genetic counseling to the client and the clients family members.
- D. Respect the clients right not to share the results of the genetic test.
Correct Answer: A
Rationale: Informed consent is a legal and ethical requirement before genetic testing to ensure the client understands the procedure, risks, and implications. Providing counseling or respecting confidentiality are important but secondary to confirming consent.
A nurse consults a genetic counselor for a client whose mother has Huntington disease and is considering genetic testing. The client states, 'I know I want this test. Why do I need to see a counselor?' How should the nurse respond?
- A. The advanced practice nurse will advise you on whether you should have children or adopt.
- B. Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process.
- C. There is no cure for this disease. The counselor will determine if there is any benefit to genetic testing.
- D. Genetic testing is expensive. The counselor will advocate for you and help you obtain financial support.
Correct Answer: B
Rationale: Genetic counseling provides education about the implications of testing, emotional support, and helps clients make informed decisions. It does not focus on advising about having children, determining testing benefits, or securing financial support.
A nurse cares for a pregnant client who has a family history of sickle cell disease. The client is unsure if she wants to participate in genetic testing. What action should the nurse take?
- A. Provide information about the risks and benefits of genetic testing.
- B. Emphasize with the client and share a personal story about a hereditary disorder.
- C. Teach the client that early detection can minimize transmission to the fetus.
- D. Advocate for the client and her baby by encouraging genetic testing.
Correct Answer: A
Rationale: Providing balanced information about the risks and benefits of genetic testing allows the client to make an informed decision without bias. Sharing personal stories or advocating for testing may influence the client's autonomy inappropriately.