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What should the nurse do?
- A. Inform the patients they need to sign so the testing can be done
- B. Inform the geneticist that the couple cannot give informed consent
- C. Let the wife translate the form for her husband
- D. Explain the form to the patient in simple English and have him sign it
Correct Answer: B
Rationale: Nurses assess the patient's capacity and ability to give voluntary consent. Language differences prevent the husband from giving informed consent without a translator. Having the wife translate or explaining in simple English does not ensure accurate understanding, and signing without comprehension is unethical.
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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.
What knowledge would influence your nursing considerations for genetic testing?
- A. What genetic tests predict the patients husbands risk of Alzheimers disease
- B. What actions the geneticist has recommended for treating the disease
- C. The genetic bases of adult-onset conditions such as Alzheimers disease
- D. Whether any of the patients peers have Alzheimers disease
Correct Answer: C
Rationale: Knowledge of adult-onset conditions and their genetic bases (i.e., mendelian versus multifactorial conditions) influences the nursing considerations for genetic testing and health promotion. The husband's risk or peers' conditions are not relevant, and geneticists do not typically make treatment recommendations.
When performing an assessment in this care setting, the nurse would focus on what areas of assessment? Select all that apply.
- A. Assessing patients personality strengths and weaknesses
- B. Performing assessments of patients patterns of behavior
- C. Assessing the genetic characteristics of patients blood samples
- D. Gathering family histories and health histories
- E. Performing comprehensive physical assessments
Correct Answer: D,E
Rationale: Nurses obtain genetics information by gathering family and health histories and conducting physical and developmental assessments. Behavior, personality, and blood sample analysis are not typically part of the nurse's role in this context.
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.
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.