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A patient has just been told that she has the genetic markers for a severe type of breast cancer. After the patient meets with the physician, the patient's daughter asks the nurse, -What did the doctor tell my mother? She seems upset.I What is the nurse's best response?
- A. I'm sorry, but I'm not allowed to discuss that.
- B. The physician will discuss this with you.
- C. It seems that your mother has the genetic markers for a type of breast cancer.
- D. This is information that your mother will need to discuss with you.
Correct Answer: D
Rationale: Maintaining privacy and confidentiality is of utmost importance during genetic testing and counseling. The patient (not the nurse or the physician) is the one who decides whether to include or exclude any family members from the discussion and from knowledge of the results of genetic testing. Telling the patient's daughter that you are not allowed to discuss the matter would cause more anxiety. Telling the daughter about the genetic markers would be a violation of the patient's privacy.
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The nurse is preparing a class on gene therapy for a group of students. Which statements about gene therapy are true?
- A. The FDA must review and approve all human clinical genetic trials.
- B. Gene therapy may involve creating new genes within a human.
- C. Gene therapy may involve replacing a mutated gene with a healthy copy of the gene.
- D. Some trials involve introducing a new gene into the body to help fight disease.
- E. Gene therapy may include inactivating a mutated gene that is not functioning properly.
Correct Answer: A,C,D,E
Rationale: Gene therapy may include: Replacing a mutated gene with a healthy copy of the gene; introducing a new gene into the body to help fight a disease; inactivating a mutated gene that is functioning improperly. In addition, the FDA must review and approve all human clinical genetic trials. Gene therapy does not include creating new genes.
The nurse is performing an assessment of a patient. Which assessment findings may indicate a higher risk for genetic disorders?
- A. The patient's father was diagnosed with heart disease at 60 years of age.
- B. The patient's mother was diagnosed with breast cancer at 33 years of age.
- C. The patient's grandfather died of a cerebral vascular accident at 78 years of age.
- D. The patient's sister has a history of both renal and lung cancer.
- E. The patient has two uncles and a grandparent who have been diagnosed with Alzheimer's disease.
Correct Answer: B,D,E
Rationale: The nurse should assess for factors that may indicate a risk for genetic disorders. A few examples of factors that may indicate a risk for genetic disorders are a higher incidence of a particular disease or disorder in the patient's family than in the general population; diagnosis of a disease in family members at an unusually young age; or diagnosis of a family member with an unusual form of cancer or with more than one type of cancer. The options regarding heart disease at 60 years of age and cerebral vascular accident at 78 years of age are not factors that indicate a higher risk for genetic disorders.
The nurse is asking a patient about his drug history, and the patient states, - Whenever I take any strong pain medications, I usually sleep for hours, I have no idea why that happens!! The nurse considers that which of these is true about this patient's statement?
- A. The patient is exaggerating about a normal side effect of pain medications.
- B. The patient's reaction to pain medications may point to a difference in his ability to metabolize certain drugs.
- C. The patient will need higher doses of medication for pain control.
- D. The patient should never receive strong pain medications.
Correct Answer: B
Rationale: It is important to inquire about any unusual reactions to a drug - on the part of the patient, family members, significant others, and/or caregivers. An unusual or other than expected reaction to a drug in family members may point to a difference in the patient's ability to metabolize certain drugs. Genetic factors may alter a patient's metabolism of a particular drug, resulting in either increased or decreased drug action. The other statements are not correct.
A patient will be receiving famotidine 20 mg at bedtime. A liquid form is ordered because the patient cannot swallow pills or capsules; the concentration of the liquid is 40 mg/5 mL. How many milliliters will the patient receive per dose?
Correct Answer: 2.5 mL
Rationale: 40 mg : 5 mL :: 20 mg : x mL; (40 * x) = (5 * 20); 40x = 100; x = 2.5 mL/dose.
The nurse is explaining the Human Genome Project to colleagues. Which of these is the main purpose of the Human Genome Project?
- A. The study of genetic diseases
- B. The study of genetic traits in humans
- C. The discovery new genetic diseases
- D. To describe the entire genome of a human being
Correct Answer: D
Rationale: The Human Genome Project was undertaken to describe in detail the entire genome of a human being. The other options do not describe the Human Genome Project.