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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.
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A nurse cares for a client who has a specific mutation in the a1AT (alpha-1 antitrypsin) gene. Which action should the nurse take?
- A. Teach the client to perform monthly breast self-examinations and schedule an annual mammogram.
- B. Teach the client to perform monthly breast self-examinations and schedule an annual mammogram.
- C. Advise the client to limit exposure to secondhand smoke and other respiratory irritants.
- D. Obtain a complete health history to identify other genetic problems associated with this gene mutation.
Correct Answer: C
Rationale: The a1AT gene mutation increases the risk of early-onset emphysema, so advising the client to avoid respiratory irritants like secondhand smoke is appropriate. This mutation is not associated with breast cancer or other genetic conditions requiring a broad health history.
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 cares for an adult client who has received genetic testing. The clients mother asks to receive the results. How should the nurse respond?
- A. Obtain a signed consent from the client allowing test results to be released to the mother.
- B. Invite the mother and other family members to participate in genetic counseling with the client.
- C. Encourage the mother to undergo genetic testing to determine if she has the same mutation.
- D. Direct the mother to speak with the client and support the clients decision to share or not to share the results.
Correct Answer: D
Rationale: Client confidentiality is paramount, and only the client can decide to share genetic test results. The nurse should direct the mother to discuss with the client, respecting the client's autonomy and privacy.
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.
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.