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What should the nurse do?
- A. Call the patients brother and inform him of his risk for development of Alzheimers disease.
- B. Notify the geneticist and have him instruct the patient on his siblings and parents risk.
- C. Notify the siblings physicians about the patients risk for development of Alzheimers disease.
- D. Instruct the patient on the importance of notifying the siblings and keep his information confidential.
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 by contacting siblings or their physicians is unethical. Involving a geneticist may be helpful, but the primary action is to respect the patient's confidentiality while encouraging disclosure.
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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.
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.
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.
What action should a nurse who practices in the area of genetics prioritize?
- A. Teaching families about the different patterns of inheritance
- B. Gathering relevant family and medical history information
- C. Providing advice on termination of pregnancy
- D. Discouraging females from conceiving after the age of 40 years
Correct Answer: B
Rationale: The nurse's role in genetic counseling is to provide information, collect relevant data, offer support, and coordinate resources. Gathering family and medical history is a priority to establish patterns of inheritance and assess risks, unlike the other options, which are either inappropriate or secondary.
What is this foundational genetic test?
- A. The developmental assessment
- B. The family history
- C. The physical assessment
- D. The psychosocial assessment
Correct Answer: B
Rationale: The family history is considered the first genetic test. It is expected that all nurses will know how to use this genetic tool to assess potential genetic risks and patterns of inheritance.