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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.
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Based on the husbands statement, what nursing diagnosis most likely applies to the wife?
- A. Situational low self-esteem related to reluctance to have genetic testing
- B. Powerlessness related to results of genetic testing
- C. Ineffective health maintenance related to reluctance to have genetic testing
- D. Anxiety related to possible results of genetic testing
Correct Answer: D
Rationale: The husband's statement suggests that the wife is anxious or fearful of obtaining bad news from genetic testing. This aligns with a nursing diagnosis of anxiety, rather than low self-esteem, powerlessness, or ineffective health maintenance, which are less directly supported by the statement.
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 is an essential component of care for this patient?
- A. Assist the patient in determining signs of neuromuscular weakness
- B. Instruct the man on treatment options for Huntington disease
- C. Teach the man how to avoid passing Huntington disease to his own children
- D. Provide genetic counseling, evaluation, and testing for the disease
Correct Answer: D
Rationale: The provision of genetic counseling, evaluation, and testing for the disease is essential in care, especially given the family history of Huntington disease. This encompasses assessing risks to offspring and addressing symptoms, making it the most comprehensive option.
What is the nurses best response?
- A. We always get old medical records just in case we need them.
- B. This is just part of the due diligence that we practice here at the clinic.
- C. Your medical information is needed so we can provide the appropriate information and counseling to you.
- D. We need your medical records in case there is something about your medical history that you forget to tell us.
Correct Answer: C
Rationale: Nurses obtain patient consent to obtain medical records to ensure appropriate information and counseling, including risk interpretation, are provided. Vague responses like â??just in case' or â??due diligence' do not adequately explain the need for medical records.
The nurse informs the patient that genetic counseling and prenatal testing should be performed for all pregnant women in which age group?
- A. 18 to 21
- B. 40 and older
- C. 35 and older
- D. 18 and under
Correct Answer: C
Rationale: Women who are 35 years of age or older have an increasing chance of giving birth to infants with chromosomal differences, such as trisomy 21. For this reason, genetic counseling and prenatal testing are recommended for all pregnant women above this age.