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According to this legislation, insurers may use genetics testing as a justification for what action?
- A. Denying the patient health insurance
- B. Charging the patient higher insurance premiums
- C. Requiring the patient to enroll in Medicaid
- D. Requiring the patient to carry out a health promotion plan
Correct Answer: B
Rationale: HIPAA prohibits the use of genetics information to establish insurance eligibility. However, it does not prohibit group plans from increasing premiums, excluding coverage for a specific condition, or imposing a lifetime cap on benefits. Mandating Medicaid enrollment or health promotion plans is not allowed.
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What would the nurse know about these two diseases?
- A. They are multifactorial.
- B. They are direct result of the patients lifestyle.
- C. They are caused by a single gene.
- D. They do not have a genetic basis.
Correct Answer: A
Rationale: Genomic or multifactorial influences involve interactions among several genes and between genes and the environment, as well as the individual's lifestyle. Heart disease and osteoarthritis are multifactorial, not caused by a single gene or solely lifestyle, and they do have a genetic basis.
What legislation has as its purpose to protect Americans against improper use of genetic and genomic information?
- A. Genetic Information Nondiscrimination Act
- B. Genetic Confidentiality Agreement
- C. The White Paper on Genetic Testing Results
- D. Genetic Equity Act
Correct Answer: A
Rationale: The Genetic Information Nondiscrimination Act (GINA), signed into law in 2008, protects Americans against improper use of genetic and genomic information in insurance and employment decisions. The other options do not exist.
The nurse knows that with this gene mutation, the patient will experience symptoms of what?
- A. Peripheral and pulmonary edema
- B. Thrombotic organ damage
- C. Metastasis of a glioblastoma
- D. Amyotrophic lateral sclerosis
Correct Answer: B
Rationale: Sickle cell anemia is an example of a genetic condition caused by a small gene mutation that affects protein structure, producing hemoglobin S. A person who inherits two copies of the hemoglobin S gene mutation has sickle cell anemia and experiences the symptoms of severe anemia and thrombotic organ damage resulting in hypoxia. Amyotrophic lateral sclerosis is a neurodegenerative disease that can occur as a result of an inherited mutation, but not a mutation of hemoglobin S. The patient with sickle cell anemia may experience edema, but it would not be related to the gene mutation.
On what does the nurse explain their chances of developing breast cancer depend?
- A. Sensitivity
- B. Conductivity
- C. Penetrance
- D. Susceptibility
Correct Answer: C
Rationale: A woman who has the BRCA1 hereditary breast cancer gene mutation has a lifetime risk of breast cancer that can be as high as 80%, not 100%. This quality, known as incomplete penetrance, indicates the probability that a given gene will produce disease. Sensitivity, conductivity, and susceptibility are not relevant terms in this context.
To explain this concept adequately, the nurse must understand which of the following?
- A. That personalized medicine is, by definition, holistic
- B. That collaboration is essential in genomic medicine
- C. The ethical basis for genomic medicine
- D. The new technologies and treatments of genetic- and genomic-based health care
Correct Answer: D
Rationale: To meet the challenges of personalized medicine, nurses must understand the new technologies and treatments of genetic- and genomic-based health care. This knowledge is critical for explaining personalized medicine, which tailors treatments based on genetic information, beyond just ethics or collaboration.