Nokea
After the couple receives the results of genetic testing, the nurse should prioritize which of the following?
- A. Secondary illness prevention
- B. Psychosocial support
- C. Gene therapy
- D. Assessing adherence to treatment
Correct Answer: B
Rationale: Following the communication of the findings of genetic testing, it is important that patients receive thoughtful and thorough support to address emotional and psychological impacts. Secondary prevention, gene therapy, or treatment adherence may not be immediately relevant.
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What is the nurses best response?
- A. I am ethically bound to tell your family and your fianc.
- B. Your information will remain confidential until the geneticist reviews everything. Then he or she will have to tell your family.
- C. Have you thought about what this disease will do to the person you are going to marry and any children you may have?
- D. I will respect your wishes and keep your information confidential. I do wish you would reconsider though.
Correct Answer: D
Rationale: The nurse must honor the patient's wishes while explaining the potential benefit this information may have for other family members. Breaching confidentiality or suggesting mandatory disclosure by a geneticist is incorrect. Encouraging reflection is secondary to respecting confidentiality.
Which of the following is the most important factor documented in the patients genetic history?
- A. Three generations of information about the family
- B. Current medications taken
- C. Health problems present in the womans children
- D. Immunizations received for the past three generations
Correct Answer: A
Rationale: A well-documented family history is a tool used by the health care team to make a diagnosis, identify teaching strategies, and establish a pattern of inheritance. The family history should include at least three generations, as well as information about the current and past health status of all family members, including the age of onset of any illnesses and cause of death and age at death. Medications and immunizations are part of the general health history, not specifically the genetic history.
What could the nurse do to disseminate information about screening to more individuals?
- A. Plan a health fair for the employees that provides information about screening for diseases that have an inheritance pattern.
- B. Refer each employee over the age of 50 to a gastroenterologist.
- C. Create a Web site on diet and exercise as it relates to the prevention of colon cancer in people over 50.
- D. Place brochures in the nurses facility for the employees to access in answering their questions.
Correct Answer: A
Rationale: The advantage of a health fair is that it will provide information on all age-related diseases and the prevention of disease, including those with genetic components like colon cancer. Referring all employees over 50 to a gastroenterologist is impractical, and a website or brochures may not reach as many people effectively as a health fair.
This model for presymptomatic testing is most likely being used to address what disease?
- A. Alzheimers disease
- B. Huntington disease
- C. Tay-Sachs disease
- D. Sickle cell disease
Correct Answer: B
Rationale: Huntington disease has served as the model for presymptomatic testing because the presence of the genetic mutation predicts disease onset and progression. This is not typically the case for Alzheimer's, Tay-Sachs, or sickle cell disease with current testing technologies.
Based on this information, what does the nurse suspect?
- A. Huntington disease
- B. Schizophrenia
- C. Cerebrovascular accident
- D. Alzheimers disease
Correct Answer: D
Rationale: Nurses must be alert for family histories indicating that multiple generations are affected with the same condition or that onset of disease is earlier than expected. The patient's symptoms of forgetfulness, jerky movements, and a family history of early-onset memory loss in her mother suggest Alzheimer's disease, which can have a genetic component, especially with early onset. Huntington disease involves more pronounced movement disorders, schizophrenia is less likely given the physical symptoms, and there is no evidence of a cerebrovascular accident.