Nokea
What factor describes the etiology of this genetic change?
- A. The mother also has genetic mutation of chromosome 21.
- B. The patient has a nondisjunction occurring during meiosis.
- C. During meiosis, a reduction of chromosomes resulted in 23.
- D. The patient will have a single X chromosome and infertility.
Correct Answer: B
Rationale: During meiosis, a pair of chromosomes may fail to separate completely, creating a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This sporadic event, called nondisjunction, can lead to trisomy. Down syndrome is an example of trisomy. The mother does not have a mutation of chromosome 21, which is indicated in the question. Also, trisomy does not produce a single X chromosome and infertility.
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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.
What should the nurse practitioner tell them about cystic fibrosis?
- A. It is an autosomal dominant disorder.
- B. It is passed by mitochondrial inheritance.
- C. It is an X-linked inherited disorder.
- D. It is an autosomal recessive disorder.
Correct Answer: D
Rationale: Cystic fibrosis is autosomal recessive. People who are related have more genes in common than those who are unrelated, thus increasing their chance for having children with autosomal recessive conditions like cystic fibrosis if both are carriers. It is not autosomal dominant, mitochondrial, or X-linked.
The nurse should recognize that this patients health status may be the result of what phenomenon?
- A. X-linked inheritance
- B. Autosomal recessive inheritance
- C. Autosomal dominant inheritance
- D. Multifactorial inheritance
Correct Answer: D
Rationale: Many birth defects and common health conditions, such as heart disease, high blood pressure, cancer, osteoarthritis, and diabetes, occur as a result of interactions of multiple gene mutations and environmental influences. Thus, they are called multifactorial or complex conditions. X-linked, autosomal recessive, and autosomal dominant conditions are caused by single gene mutations, not multiple gene interactions.
In this role, the nurse will aim to help individuals and families understand which of the following?
- A. How genetic and psychological factors influence coping
- B. How genomic and physical factors influence longevity
- C. How genetic and environmental factors influence health and disease
- D. How physical factors influence genetics and wellness
Correct Answer: C
Rationale: Nurses help individuals and families learn how genetic traits and conditions are passed on within families as well as how genetic and environmental factors influence health and disease. This is the primary focus of genetics nursing, not coping, longevity, or physical factors influencing genetics.
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.