Test Bank Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Lemone Burke Bauldoff Gubrud

Test Bank Medical-Surgical Nursing, Clinical Reasoning in Patient Care, 6th LeMone â€“ Burke
Test Bank Medical-Surgical Nursing, Clinical

Reasoning in Patient Care, 6th LeMone â€“ Burke â€“
Bauldoff â€“ Gubrud
To download the complete and accurate content document, go to:

https://testbankbell.com/download/test-bank-medical-surgical-nursing-clinical-reasoni
ng-in-patient-care-6th-lemone-burke-bauldoff-gubrud/
Visit TestBankBell.com to get complete for all chapters

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test
Bank
Chapter 8
Question 1
Type: MCSA
A female patient tells the nurse that she is genetically predisposed to type 2 diabetes. What is the most important
information that the nurse should provide?
1. the importance of maintaining a healthy weight and activity level
2. the need to avoid carbohydrate intake
3. the need to begin monitoring daily blood glucose levels
4. the need to address active health problems and not those that have yet to manifest
Correct Answer: 1
Rationale 1: The best way for this patient to avoid illness is to maintain a healthy weight and activity level.
Rationale 2: While nutrition is a significant factor, it is not necessary to avoid carbohydrates.
Rationale 3: Daily monitoring of blood glucose levels is not indicated for this patient.
Rationale 4: It is important to take action to prevent disease and not wait for the disease to manifest.
Global Rationale: The best way for this patient to avoid illness is to maintain a healthy weight and activity level.
While nutrition is a significant factor, it is not necessary to avoid carbohydrates. Daily monitoring of blood
glucose levels is not indicated for this patient. It is important to take action to prevent disease and not wait for the
disease to manifest.
Cognitive Level: Applying

Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health,
prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness,
using a constructed pedigree from collected family history information as well as standardized symbols and
terminology
NLN Competencies: Context and Environment; Practice; Conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1. Discuss the role of genetic concepts in health promotion and health maintenance.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
MNL Learning Outcome: 10.5.2. Differentiate the risk factors and manifestations for diabetes.
Page Number: 145
Question 2
Type: MCSA
A patient tells the nurse that she does not want to pass on a disease that is genetic in origin to any future children.
How should the nurse respond to this patient?
1. “A complete genetic study could help guide you in your decision making.”
2. “I suppose, then, that you are not going to have any children.”
3. “Adoption is always a possibility.”
4. “Are you sure that the disease is genetic in origin?”
Correct Answer: 1
Rationale 1: Findings from genetic research can be used by patients and family members to improve their own
health and prevent illness. According to the ANA/ISONG, all registered nurses must have an understanding of
genetics to identify, support, and care for patients who have or who may transmit genetic conditions.
Rationale 2: It is premature to suggest refraining from having children until the genetic study is completed.
Rationale 3: It is premature to suggest adoption until the genetic study is completed.
Rationale 4: Questioning whether a specific disease is genetic in origin may be helpful, but may not allay the
patient’s concerns about other diseases.
Global Rationale: Findings from genetic research can be used by patients and family members to improve their
own health and prevent illness. According to the ANA/ISONG, all registered nurses must have an understanding
of genetics to identify, support, and care for patients who have or who may transmit genetic conditions. It is
premature to suggest adoption or refraining from having children until the genetic study is completed.
Questioning whether a specific disease is genetic in origin may be helpful, but may not allay the patient’s
concerns about other diseases.

Client Need Sub:
terminology
MNL Learning Outcome:
Page Number: 137
Question 3
Type: MCSA
A patient expresses concern about transmitting genetic illnesses to any future children. What can the nurse do to
help the patient determine which diseases might be transmitted?
1. Complete a pedigree.
2. Conduct a health promotion assessment.
3. Schedule for a complete genetic analysis.
4. Refer to a geneticist for diagnosis.
Correct Answer: 1
Rationale 1: A pedigree is a pictorial representation or diagram of the medical history of a family that typically
includes three generations. Multiple symbols are utilized to present this picture, and the finished pedigree presents
a family’s medical data and biologic relationship information at a glance. Since a pedigree provides the nurse,
genetic counselor, or geneticist with a clear, visual representation of relationships of affected individuals to the
immediate and extended family, it needs to be completed before scheduling a complete genetic analysis or being
referred to a geneticist for diagnosis.
Rationale 2: Conducting a health promotion assessment will not provide information regarding the patient’s risk
for passing on genetic illnesses to future children.
Rationale 3: Scheduling a complete genetic analysis is not the first action a nurse should take take to address a
patient’s concern about transmitting genetic illnesses to children.
Rationale 4: Referring the patient to a geneticist is not the first action a nurse should take to address a patient’s
concern about transmitting genetic illnesses to children.
Global Rationale: A pedigree is a pictorial representation or diagram of the medical history of a family that
typically includes three generations. Multiple symbols are utilized to present this picture and the finished pedigree
presents a family’s medical data and biologic relationship information at a glance. Since a pedigree provides the
nurse, genetic counselor, or geneticist with a clear, visual representation of relationships of affected individuals to
the immediate and extended family, it needs to be completed before scheduling a complete genetic analysis or
being referred to a geneticist for diagnosis. Conducting a health promotion assessment will not provide
information regarding the patient’s risk for passing on genetic illnesses to future children.

Client Need Sub:
terminology
Nursing/Integrated Concepts: Nursing Process: Assessment
Page Number: 146
Question 4
Type: MCSA
At the completion of a genetic assessment, the nurse learns that a patient has three family members diagnosed
with rectal cancer before the age of 40 years. What should the nurse discuss with the patient?
1. importance of having screening for colorectal cancer at an earlier age
2. importance of ingesting a diet high in protein and carbohydrates
3. ways to maximize time spent in exercise
4. reasons why having children would not be recommended for this patient
Correct Answer: 1
Rationale 1: The information from the genetic assessment identified three family members diagnosed with rectal
cancer before the age of 40 years. The nurse should discuss with the patient the importance of having screening
for colorectal cancer at an earlier age.
Rationale 2: Ingesting a diet high in protein and carbohydrates is not going to reduce the patient’s risk for
developing the disease.
Rationale 3: Maximizing exercise is not going to reduce the patient’s risk for developing the disease.
Rationale 4: Counseling the patient on abstaining from having children is not going to improve the patient’s risk
for the disease.
Global Rationale: The information from the genetic assessment identified three family members diagnosed with
rectal cancer before the age of 40 years. The nurse should discuss with the patient the importance of having
screening for colorectal cancer at an earlier age. Ingesting a diet high in protein and carbohydrates is not going to
reduce the patient’s risk for developing the disease. Maximizing exercise is not going to reduce the patient’s risk
for developing the disease. Counseling the patient on abstaining from having children is not going to improve the
patient’s risk for the disease.

Client Need Sub:
terminology
MNL Learning Outcome: 11.12.1. Explain the incidence, risk factors, and pathophysiology of colorectal cancer.
Page Number: 145
Question 5
Type: MCSA
While assessing a patient, the nurse notes an irregularity that has been observed in other patients, but on an
inconsistent basis. What did the nurse most likely discover in this patient?
1. a polymorphism
2. a mutation
3. a single-gene inheritance pattern
4. an X-linked inheritance pattern
Correct Answer: 1
Rationale 1: A polymorphism is a change in DNA sequence that has been identified in more than 1% of the
population and is, thus, more commonly observed than a mutation. Polymorphisms differ from mutations in that
they are observed more frequently in the general population than mutations.
Rationale 2: A mutation is a change in DNA sequence that has been identified in less than 1% of the population.

Rationale 3: A single-gene inheritance pattern will follow a pattern of being present in every member of a
generation or will skip a generation, depending if the alteration is dominant or recessive.
Rationale 4: In the X-linked inheritance pattern, the mutant gene is located on the X chromosome. Males have
only one X chromosome with no counterpart for its genes therefore the alteration will appear in all males.
Because the female as two X chromosomes, the alteration may or may not occur.
Global Rationale: A polymorphism is a change in DNA sequence that has been identified in more than 1% of the
population and is, thus, more commonly observed than a mutation. Polymorphisms differ from mutations in that
they are observed more frequently in the general population than mutations. A mutation is a change in DNA
sequence that has been identified in less than 1% of the population. A single-gene inheritance pattern will follow a
pattern of being present in every member of a generation or will skip a generation, depending if the alteration is
dominant or recessive. In the X-linked inheritance pattern, the mutant gene is located on the X chromosome.
Males have only one X chromosome with no counterpart for its genes therefore the alteration will appear in all
males. Because the female as two X chromosomes, the alteration may or may not occur.
Cognitive Level: Analyzing

Client Need Sub:
terminology
Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
Page Number: 140
Question 6
Type: MCSA
A patient has been told that her unborn child will most likely have Down syndrome. The nurse realizes this
diagnosis is consistent with which genetic finding?
1. trisomy
2. monosomy
3. translocation
4. deletions
Correct Answer: 1
Rationale 1: Trisomy refers to the presence of a third or extra chromosome instead of the normal pair of a
particular chromosome. The most common type of trisomy in infants is trisomy 21 or Down syndrome.
Rationale 2: Monosomy refers to the presence of only one chromosome instead of the normal pair of
chromosomes.
Rationale 3: Translocation (chromosomal reshuffling) occurs when a segment of a chromosome transfers or

moves and attaches itself to another chromosome.
Rationale 4: Structural rearrangements of chromosomes may result from deletions or loss of a chromosome
segment or piece.
Global Rationale: Trisomy refers to the presence of a third or extra chromosome instead of the normal pair of a
particular chromosome. The most common type of trisomy in infants is trisomy 21 or Down syndrome.
Monosomy refers to the presence of only one chromosome instead of the normal pair of chromosomes.
Translocation (chromosomal reshuffling) occurs when a segment of a chromosome transfers or moves and
attaches itself to another chromosome. Structural rearrangements of chromosomes may result from deletions or
loss of a chromosome segment or piece.

Client Need Sub:
terminology
disorders.
Page Number: 138
Question 7
Type: MCSA
A nurse is planning to teach the parents of a child with cystic fibrosis about the disorder. Which statement should
the nurse include in this explanation?

1. “While all people carry the gene CFTR, which is responsible for cystic fibrosis, those who develop the disease
have a mutation in that gene.”
2. “A small percentage of the general population carries the gene for cystic fibrosis. If two carriers have children,
then 25% of those children will develop the disease.”
3. “One in four people carry the gene for cystic fibrosis. If two carriers have children, then 25% of those children
will develop the disease.”
4. “Some people carry the gene for cystic fibrosis. Of those carriers, one in four will develop the disease.”
Correct Answer: 1
Rationale 1: Every individual carries the gene cystic fibrosis transference regulator (CTFR). Those who develop
the disease have a mutation in that gene.
Rationale 2: Every individual carries the gene cystic fibrosis transference regulator.
Rationale 3: Every individual carries the gene cystic fibrosis transference regulator.
Rationale 4: Every individual carries the gene cystic fibrosis transference regulator. Those who develop the
disease have a mutation in that gene.
Global Rationale: Every individual carries the gene cystic fibrosis transference regulator. Those who develop the
disease have a mutation in that gene. The other answer choices are all incorrect as they indicate that only a few
carry the gene for cystic fibrosis.

Client Need Sub:
terminology
disorders.
Page Number: 139
Question 8
Type: MCSA
A patient tells the nurse that many of her family members have a type of anemia that is genetic. What should the
nurse realize will occur in this patient?
1. The patient will develop the disease only if there is a mutation in the gene.
2. The patient will develop the same type of anemia.
3. The patient will die from the anemia.
4. The patient will develop the disease only if the gene translocates.
Correct Answer: 1
Rationale 1: All humans have essentially the same 20,000 to 25,000 genes; it is the mutation or polymorphism in
the gene that predisposes some individuals for disease, not translocation nor the gene itself.
Rationale 2: The patient may or may not develop anemia.
Rationale 3: The patient may or may not die from anemia.
Rationale 4: Translocation does not predispose some individuals for disease.
Global Rationale: All humans have essentially the same 20,000 to 25,000 genes; it is the mutation or
polymorphism in the gene that predisposes some individuals for disease, not translocation nor the gene itself. The
patient may or may not develop or die from anemia. Translocation does not predispose some individuals for
disease.

Client Need Sub:
terminology
disorders.
MNL Learning Outcome: 14.1.1. Explain the incidence, causes, and pathophysiology of the different types of
anemias.
Page Number: 140

Question 9
Type: MCSA
At the completion of genetic testing it has been determined that a patient’s baby will have Down syndrome. What
should the nurse say to the patient after learning this information?
1. “I realize that this news is difficult for you. Is there anything that I can do to help you at this time?”
2. “It’s not too late to consider ending the pregnancy.”
3. “You are young enough to be able to handle the baby’s challenges.”
4. “It does not matter if the baby has problems; all life is precious.”
Correct Answer: 1
Rationale 1: Nurses should encourage open discussions and the expression of fears and concerns. When
supporting a the pregnant patient who learns that the baby has Down syndrome, the best response for the nurse to
make would be to acknowledge that the news is difficult and offer to help the patient.
Rationale 2: The nurse should not suggest that the patient terminate the pregnancy.
Rationale 3: The nurse should not tell the patient that the baby will have challenges that will need to be met by a
young person.
Rationale 4: Stating that all life is precious is judgmental and should not be stated by the nurse.
Global Rationale: Nurses should encourage open discussions and the expression of fears and concerns. When
supporting a the pregnant patient who learns that the baby has Down syndrome, the best response for the nurse to
make would be to acknowledge that the news is difficult and offer to help the patient. The nurse should not
suggest that the patient terminate the pregnancy nor tell the patient that the baby will have challenges that will
need to be met by a young person. Stating that all life is precious is judgmental and should not be stated by the
nurse.

Client Need: Psychosocial Integrity
Client Need Sub:
QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in care
terminology

Learning Outcome: 3. Describe the significance of delivering genetic education and counseling follow-up in a
professional manner.
Page Number: 148
Question 10
Type: MCSA
The nurse is developing a teaching plan for parents who need genetic counseling. Which statement by a parent
indicates the need for further education?
1. “All the chromosomes are the same size in males and females alike.”
2. “Half of the sets of chromosomes come from the mother and the other half comes from the father.”
3. “The 23rd pair of chromosomes will determine if our child will be male or female.”
4. “One Y chromosome and one X sex chromosome will produce a male child.”
Correct Answer: 1
Rationale 1: A basic understanding of the cell, DNA, cell division, and chromosomes is important for young
families receiving genetic counseling. The cell nucleus contains about 6 feet of DNA that are tightly wound and
packaged into 23 pairs of chromosomes, making a complete set of 46 chromosomes. There are two copies of each
chromosome. One copy, or half of the complete set of these 46 chromosomes, is inherited from the mother, and
the other copy is inherited from the father. Chromosomes are numbered according to size, with chromosome 1
being the largest and chromosome 22 being the smallest.
Rationale 2: One copy, or half of the complete set of these 46 chromosomes, is inherited from the mother, and the
other copy is inherited from the father. The first 22 pairs of chromosomes are alike in males and females.
Rationale 3: The 23rd pair, the sex chromosomes, determines an individual’s gender.
Rationale 4: A female has two copies of the X chromosomes and a male has one X chromosome and a Y
chromosome. These X and Y chromosomes are known as sex chromosomes.
Global Rationale: A basic understanding of the cell, DNA, cell division, and chromosomes is important for
young families receiving genetic counseling. The cell nucleus contains about six feet of DNA that are tightly
wound and packaged into 23 pairs of chromosomes, making a complete set of 46 chromosomes. There are two
copies of each chromosome. One copy, or half of the complete set of these 46 chromosomes, is inherited from the
mother, and the other copy is inherited from the father. Chromosomes are numbered according to size, with
chromosome 1 being the largest and chromosome 22 being the smallest. The first 22 pairs of chromosomes are
alike in males and females. The 23rd pair, the sex chromosomes, determines an individual’s gender. A female has

two copies of the X chromosomes and a male has one X chromosome and a Y chromosome. These X and Y
chromosomes are known as sex chromosomes.

Client Need Sub:
terminology
Nursing/Integrated Concepts: Nursing Process: Evaluation
Page Number: 138
Question 11
Type: MCSA
At the conclusion of genetic testing, a patient learns that he has a predisposition for developing cardiovascular
disease at a young age. What should the nurse instruct the patient regarding this information?
1. “This information can help guide you to make lifestyle changes to reduce the chance of developing
cardiovascular disease.”
2. “At least you know now that you will need cardiac bypass surgery.”
3. “Since you will most likely develop the disease early in life, enjoy your life as much as possible now.”
4. “I would not place too much emphasis on these test results because most of the time they are inconclusive.”
Correct Answer: 1
Rationale 1: One benefit of genetic testing is that it allows for preventive measures and lifestyle adaptations. The
nurse should instruct the patient on how this information can serve as a guide to make lifestyle changes to reduce
the risk of developing cardiovascular disease.
Rationale 2: The nurse has no way of knowing whether the patient is going to need cardiac bypass surgery or not.
Rationale 3: The nurse should not encourage the patient to enjoy life as much as possible now since this might
lead to high-risk behaviors.

Rationale 4: The nurse should not minimize the importance of the genetic testing results.
Global Rationale: One benefit of genetic testing is that it allows for preventive measures and lifestyle
adaptations. The nurse should instruct the patient on how this information can serve as a guide to make lifestyle
changes to reduce the risk of developing cardiovascular disease. The nurse has no way of knowing whether the
patient is going to need cardiac bypass surgery or not. The nurse should not encourage the patient to enjoy life as
much as possible now since this might lead to high-risk behaviors. The nurse should not minimize the importance
of the genetic testing results.

Client Need Sub:
terminology
Page Number: 145
Question 12
Type: MCSA
A patient planning to be married tells the nurse that she has a strong family history of Huntington chorea but does
not plan to let her fiancé know. How should the nurse respond to this patient?
1. “Is there any reason why you do not want your fiancé to know about the genetic illness?”
2. “It is probably best that he is not aware of the disease.”
3. “Are you afraid that he will not want to marry you if he knows?”
4. “There are worse disease processes than Huntington chorea.”
Correct Answer: 1
Rationale 1: The nurse needs to support the patient in ethical and social issues. The best response from the nurse
would be to ask the patient if there is any reason why she does not want her fiancé to be aware of the genetic
illness.

Rationale 2: Agreeing that the fiancé should not be made aware would be an inappropriate response for the nurse
to make.
Rationale 3: Suggesting that the fiancé would not want to marry the patient if he was aware of the genetic disease
is also an inappropriate response for the nurse to make.
Rationale 4: The nurse should not make a judgment statement by saying that there are worse disease processes
than Huntington chorea.
Global Rationale: The nurse needs to support the patient in ethical and social issues. The best response from the
nurse would be to ask the patient if there is any reason why she does not want her fiancé to be aware of the
genetic illness. Agreeing that the fiancé should not be made aware would be an inappropriate response for the
nurse to make. Suggesting that the fiancé would not want to marry the patient if he was aware of the genetic
disease is also an inappropriate response for the nurse to make. The nurse should not make a judgment statement
by saying that there are worse disease processes than Huntington chorea.”

Client Need Sub:
QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care
AACN Essentials Competencies: VII.11. Access interprofessional and intraprofessional resources to resolve
ethical and other practice dilemmas
NLN Competencies: Context and Environment; Knowledge; ethical decision making models
Learning Outcome: 4. Explain the implications of genetic advances on the role of nurses with particular
attention to spiritual, cultural, ethical, legal, and social issues.
Page Number: 145
Question 13
Type: MCSA
A patient planning to have genetic testing prior to having children tells the nurse that she is fearful that too many
people will learn about the test. How should the nurse respond to this patient?
1. “The results of the tests are confidential and no one can have the results without your permission.”
2. “Most insurance companies will want the results before paying for the tests.”
3. “The results will be available to anyone who reviews your medical record.”
4. “The doctor will most likely use the results when planning care and treatment for other patients with the same
genetic disorder.”

Correct Answer: 1
Rationale 1: The nurse should explain that the results of genetic testing are confidential and that the written
permission to have access to the results will be needed by the patient.
Rationale 2: Insurance companies will not need the results of the tests before paying for the tests.
Rationale 3: The results will be confidential and not accessible by anyone who reviews the patient’s medical
record.
Rationale 4: The patient’s physician cannot use the test results when planning care and treatment for other
patients with the same genetic disorder.
Global Rationale: The nurse should explain that the results of genetic testing are confidential and that the written
permission to have access to the results will be needed by the patient. Insurance companies will not need the
results of the tests before paying for the tests. The results will be confidential and not accessible by anyone who
reviews the patient’s medical record. The patient’s physician cannot use the test results when planning care and
treatment for other patients with the same genetic disorder.

Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care
Page Number: 145
Question 14
Type: MCSA
Through testing, a patient learns of a genetic disease that he has inherited from his parents, yet none of his other
siblings have inherited the same disease. The patient tells the nurse that he has always believed his parents “didn’t
want him” and now he has proof. What should the nurse counsel this patient?
1. Suggest the patient talk with a counselor to discuss the results of the test and future options.
2. Ask the patient if he has ever discussed his thoughts and fears with his parents.

3. Encourage the patient to talk with his siblings about the illness and ask them for help now before he has
manifestations of the disease.
4. Remind the patient that genetic testing is inconclusive, and there is a great chance that the results are wrong.
Correct Answer: 1
Rationale 1: Individuals learning of genetic testing results can have feelings of anger, guilt, confusion, and
depression. The nurse should suggest that the patient talk with a counselor to discuss the test results and future
options to help the patient work through his feelings.
Rationale 2: The nurse should not suggest that the patient confront his parents with his thoughts and feelings.
Rationale 3: The nurse should also not suggest that the patient discuss the test results with his siblings in order to
elicit their help and support before the disease manifests.
Rationale 4: Genetic testing is not inconclusive. This would be an inappropriate suggestion to make to the
patient.
Global Rationale: Individuals learning of genetic testing results can have feelings of anger, guilt, confusion, and
depression. The nurse should suggest that the patient talk with a counselor to discuss the test results and future
options to help the patient work through his feelings. The nurse should not suggest that the patient confront his
parents with his thoughts and feelings. The nurse should also not suggest that the patient discuss the test results
with his siblings in order to elicit their help and support before the disease manifests. Genetic testing is not
inconclusive. This would be an inappropriate suggestion to make to the patient.

Client Need Sub:
QSEN Competencies: I.A.9. Discuss principles of effective communication
Page Number: 148
Question 15
Type: MCSA
A patient learning that her newborn baby has a genetic disorder tells the nurse that it was because a stranger gave
her baby the “evil eye.” What should this information suggest to the nurse?

1. The patient’s culture supports the notion that a stranger looking at the baby caused the disorder.
2. The patient needs psychiatric counseling.
3. The patient is not going to be a good mother since she permits strangers around the baby.
4. Healthcare dollars should not be spent trying to change this patient’s opinion of why the baby has a genetic
disorder.
Correct Answer: 1
Rationale 1: The nurse needs to be aware of the patient’s cultural and religious beliefs. The patient stating that the
newborn has a genetic disorder because a stranger gave the baby the “evil eye” is evidence that the patient
believes this is the cause of the disorder.
Rationale 2: This information does not suggest that the patient needs psychiatric counseling or that the patient is
not going to be a good mother.
Rationale 3: This information does not suggest that the patient is not going to be a good mother.
Rationale 4: Deciding whether healthcare dollars should be spent trying to change the patient’s opinion of why
the baby has a genetic disorder is beyond the scope of the nurse.
Global Rationale: The nurse needs to be aware of the patient’s cultural and religious beliefs. The patient stating
that the newborn has a genetic disorder because a stranger gave the baby the “evil eye” is evidence that the patient
believes this is the cause of the disorder. This information does not suggest that the patient needs psychiatric
counseling or that the patient is not going to be a good mother. Deciding whether healthcare dollars should be
spent trying to change the patient’s opinion of why the baby has a genetic disorder is beyond the scope of the
nurse.

Client Need Sub:
QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic and social backgrounds function as sources of
patient, family, and community values
AACN Essentials Competencies: VII.3. Assess health/illness beliefs, values, attitudes, and practices of
individuals, families, groups, communities and populations
NLN Competencies: Context and Environment; Ethical Comportment; Show respect for others' values;
appreciate diversity
Page Number: 148

Question 16
Type: MCSA
A patient has a strong family history of nonpolyposis colorectal cancer. What is the best advice the nurse can give
to the patient?
1. Have predispositional genetic testing done to detect the presence of the genetic disorder even though the patient
may never develop cancer.
2. Teach the patient the symptoms of colon cancer and suggest a high-fiber diet to prevent cancer.
3. Have regular colonoscopies; if one is abnormal, then predispositional genetic testing is indicated.
4. Have predispositional genetic testing done to detect the presence of colorectal cancer so that treatment can be
initiated as early as possible.
Correct Answer: 1
Rationale 1: The patient should be advised to have a predispositional test to detect the presence of the genetic
mutation that causes nonpolyposis colorectal cancer.
Rationale 2: Teaching the patient the symptoms of colon cancer and suggesting a high-fiber diet to prevent
cancer are important pieces of advice, but not the best advice for this patient at this time.
Rationale 3: In this case, genetic testing is indicated.
Rationale 4: Therapy would be started only if the cancer were present.
Global Rationale: The patient should be advised to have a predispositional test to detect the presence of the
genetic mutation that causes nonpolyposis colorectal cancer. Teaching the patient the symptoms of colon cancer
and suggesting a high-fiber diet to prevent cancer are important pieces of advice, but not the best advice for this
patient at this time. In this case, genetic testing is indicated. Therapy would only be started if the cancer were
present.

Client Need Sub:
QSEN Competencies: I.A.1.Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX.2.Recognize the relationship of genetics and genomics to health,
terminology
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
Learning Outcome: 5. Identify the significance of recent advances in human genetics and the effect on
healthcare delivery.
MNL Learning Outcome: 11.12.1. Explain the incidence, risk factors, and pathophysiology of colorectal cancer.
Page Number: 144
Question 17
Type: MCSA
Through genetic testing, a patient learns that he has an apolipoprotein E2 gene. What should this information
suggest to the nurse?
1. The patient is at reduced risk for developing Alzheimer disease.
2. The patient is at increased risk for developing Alzheimer disease.
3. The patient is at risk for contracting malaria.
4. The patient is at risk for developing colorectal cancer.
Correct Answer: 1
Rationale 1: The apolipoprotein E gene provides instructions to make a protein that combines with fats in the
body to form molecules called lipoproteins that are responsible for packaging cholesterol and other fats and
carrying them through the bloodstream. Research has shown that a person who inherits at least one E4 allele will
have a greater chance of developing Alzheimer disease. Inheriting the E2 allele seems to indicate that a person is
less likely to develop Alzheimer disease.
Rationale 2: Inheriting the E2 allele does not indicate that a person is more likely to develop Alzheimer disease.
Rationale 3: The apolipoprotein E gene is not a predictor for contracting malaria.
Rationale 4: The apolipoprotein E gene is not a predictor for developing colorectal cancer.
Global Rationale: The apolipoprotein E gene provides instructions to make a protein that combines with fats in
the body to form molecules called lipoproteins which are responsible for packaging cholesterol and other fats and
carrying them through the bloodstream. Research has shown that a person who inherits at least one E4 allele will
have a greater chance of developing Alzheimer disease. Inheriting the E2 allele does not indicate that a person is
more likely to develop Alzheimer disease. The apolipoprotein E gene is not a predictor for contracting malaria or
developing colorectal cancer.

Client Need Sub:
terminology
MNL Learning Outcome: 7.8.1. Explain the incidence, causes, risk factors, and pathophysiology of Alzheimer
disease.
Page Number: 140
Question 18
Type: MCSA
From genetic testing, a patient learns that a specific medication can help a developing disease process. What does
the nurse understand that genetic testing provided for the patient?
1. biological marker
2. phenotype
3. genotype
4. translocation
Correct Answer: 1
Rationale 1: Biological markers are easily tracked, stable segments of DNA. Information gained from biological
markers will provide information on how subtle differences in humans impact their response to drugs and the
environment, thus making medical treatment and pharmacologic management more individualized.
Rationale 2: The observable, outward expression of an individual’s entire physical, biochemical, and physiologic
makeup, as determined by their genotype and environmental factors, is referred to as phenotype.
Rationale 3: The specific sequence of nucleotides is referred to as the individual’s genotype.
Rationale 4: Translocation occurs when a segment of a chromosome transfers or moves and attaches itself to
another chromosome.

Global Rationale: Biological markers are easily tracked, stable segments of DNA. Information gained from
biological markers will provide information on how subtle differences in humans impact their response to drugs
and the environment; thus making medical treatment and pharmacologic management more individualized. The
observable, outward expression of an individual’s entire physical, biochemical, and physiologic makeup, as
determined by their genotype and environmental factors, is referred to as phenotype. The specific sequence of
nucleotides is referred to as the individual’s genotype. Translocation occurs when a segment of a chromosome
transfers or moves and attaches itself to another chromosome.

Client Need Sub:
terminology
Page Number: 140
Question 19
Type: MCSA
A patient is having difficulty achieving adequate anticoagulation with prescribed doses of warfarin. The nurse
realizes that what might be indicated for this patient?
1. genetic testing to determine if the patient metabolizes warfarin slower
2. use of a different anticoagulant
3. review of the patient’s diet
4. analysis of the patient’s lifestyle
Correct Answer: 1
Rationale 1: One use of genetic testing involves predicting or studying the patient’s response to particular
medications. Pharmacogenetic testing has shown that 20% of Caucasians metabolize Warfarin more slowly and
take longer to achieve therapeutic dosing. Genetic testing could help determine why the patient has not achieved
successful anticoagulation.

Rationale 2: There might not be another anticoagulant available for the patient.
Rationale 3: Reviewing the patient’s diet might provide some information regarding dietary reasons for the
unsuccessful anticoagulation of the patient.
Rationale 4: An analysis of the patient’s lifestyle will not help determine why the patient has not been achieved
Global Rationale: One use of genetic testing involves predicting or studying the patient’s response to particular
medications. Pharmacogenetic testing has shown that 20% of Caucasians metabolize warfarin more slowly and
take longer to achieve therapeutic dosing. Genetic testing could help determine why the patient has not achieved
successful anticoagulation. There might not be another anticoagulant available for the patient. Reviewing the
patient’s diet might provide some information regarding dietary reasons for the unsuccessful anticoagulation of
the patient. An analysis of the patient’s lifestyle will not help determine why the patient has not been achieved

Client Need Sub:
terminology
Page Number: 144
Question 20
Type: MCSA
A patient tells the nurse that her mother has type 2 diabetes and heart problems. The nurse realizes that this
information:
1. means that the patient will probably not change her health habits.
2. can help predict the patient’s future health problems.
3. helps predict the future health of the patient’s children.
4. means that the patient keeps in touch with her parents.

Correct Answer: 2
Rationale 1: There is no evidence that the patient would not change any health habits.
Rationale 2: Even though most individuals do not know their genetic makeup, the nurse can help plan strategies
to promote and maintain health for the patient. Family history has long been a part of nursing assessment, but the
relative importance of obtaining a family history has recently increased as our knowledge of the interaction of
genes and the environment has expanded. In fact, it is an inexpensive first genetic screen, often underused by
healthcare professionals.
Rationale 3: Although the family health history is significant, it will not provide a direct prediction for the
patient’s children and is not the best answer.
Rationale 4: Information to determine the relationship between the patient and her family is not given.
Global Rationale: Even though most individuals do not know their genetic makeup, the nurse can help plan
strategies to promote and maintain health for the patient. Family history has long been a part of nursing
assessment, but the relative importance of obtaining a family history has recently increased as our knowledge of
the interaction of genes and the environment has expanded. In fact, it is an inexpensive first genetic screen, often
underused by healthcare professionals. There is no evidence that the patient would not change any health habits.
Although the family health history is significant it will not provide a direct prediction for the patient’s children
and is not the best answer. Information to determine the relationship between the patient and her family is not
given.

Client Need Sub:
terminology
MNL Learning Outcome: 10.5.2. Differentiate the risk factors and manifestations for diabetes.
Page Number: 146
Question 21
Type: MCSA
The physician has ordered chromosomal analysis for a newborn baby. Which test does the nurse realize will most
likely be performed with this baby?
1. karyotype
2. newborn screen
3. carrier testing
4. preimplantation genetic diagnosis
Correct Answer: 1
Rationale 1: The karyotype provides an analysis of the number and structure of the chromosomes.
Rationale 2: Newborn screening is performed shortly after birth. It seeks to identify inborn errors of metabolism.
Rationale 3: Carrier testing is completed on asymptomatic individuals who may be carriers of one copy of a gene
alteration that can be transmitted to future children in an autosomal recessive or X-linked pattern of inheritance.
Rationale 4: Preimplantation genetic testing involves the detection of disease causing gene alterations in human
embryos just after in vitro fertilization and before implantation in the uterus.
Global Rationale: The karyotype provides an analysis of the number and structure of the chromosomes.
Newborn screening is performed shortly after birth. It seeks to identify inborn errors of metabolism. Carrier
testing is completed on asymptomatic individuals who may be carriers of one copy of a gene alteration that can be
transmitted to future children in an autosomal recessive or X-linked pattern of inheritance. Preimplantation
genetic testing involves the detection of disease causing gene alterations in human embryos just after in vitro
fertilization and before implantation in the uterus.

Client Need Sub:
terminology
Page Number: 144
Question 22
Type: MCSA
A 42-year-old pregnant patient asks the nurse if the baby will be born with Down syndrome because of a
chromosomal abnormality. What chromosomal abnormality does the nurse know this to be?
1. 23 pairs of chromosomes
2. 26 pairs of chromosomes
3. One member of a chromosome pair missing
4. One extra member of a chromosome pair
Correct Answer: 4
Rationale 1: The abnormality being described is not 23 pairs of chromosomes.
Rationale 2: The abnormality being described is not 26 pairs of chromosomes.
Rationale 3: The abnormality being described is not one that has a missing member of a chromosome pair.
Rationale 4: A zygote that is trisomic, or one that has three chromosomes instead of the usual 2, can produce the
condition called trisomy 21 or Down syndrome. The specific chromosome involved with this disorder is number
21. That is the abnormality being described.
Global Rationale: The abnormality being described is not 23 pairs of chromosomes, 26 pairs of chromosomes, or
one with a missing member of a chromosome pair. A zygote that is trisomic, or one that has three chromosomes
instead of the usual two, can produce the condition called trisomy 21 or Down syndrome. The specific
chromosome involved with this disorder is number 21. That is the abnormality being described.

Client Need Sub:
terminology
disorders.
Page Number: 138
Question 23
Type: MCSA
A patient tells the nurse that her husband has chronic myelogenous leukemia, and she is concerned that their
children will inherit that genetic disorder. How should the nurse respond to this patient?
1. “The genetic makeup that created the chronic myelogenous leukemia in your husband is not inheritable.”
2. “I would be concerned, too.”
3. “Maybe you should re-think having children.”
4. “It could cause the same disorder, but it’s a decision that you will have to make.”
Correct Answer: 1
Rationale 1: The chromosome translocation that is responsible for chronic myelogenous leukemia occurs in
somatic cells, not germ cells, and therefore is not inheritable.
Rationale 2: It is not appropriate to agree with the patient at this time. This may increase her level of concern
needlessly.
Rationale 3: Offering advice that is not in the best interest of the patient and family is not considered therapeutic
communication.
Rationale 4: Offering advice that is not in the best interest of the patient and family is not considered therapeutic
communication.
Global Rationale: The chromosome translocation that is responsible for chronic myelogenous leukemia occurs in
somatic cells, not germ cells, and therefore is not inheritable. All other responses are offering advice, which is not
in the best interest of the patient and her family and is not considered therapeutic communication.

Client Need Sub:
terminology
Page Number: 139

Question 24
Type: MCSA
A male patient has a history of a genetic disorder and is concerned that this same disorder will be passed to his
children. What information should the nurse provide to this patient?
1. All genetic disorders are passed to future children.
2. If the genetic disorder is a disorder of metabolism, it will most likely not be passed to any children.
3. The best possible plan for this problem is to avoid children.
4. The children will inherit the disorder only if the disorder is on chromosomes 13, 18, and 21.
Correct Answer: 2
Rationale 1: Mitochondrial genes and any diseases due to DNA alterations on those genes are transmitted through
the mother in a matrilineal pattern. An affected female will pass the metabolism DNA mutation to all of her
children. An affected male will not pass the metabolism DNA mutation to any of his children.
the mother in a matrilineal pattern. An affected female will pass the metabolism DNA mutation to all of her
children. An affected male will not pass the metabolism DNA mutation to any of his children.
Rationale 3: It is inappropriate for the nurse to recommend that the patient not have children. This
recommendation steps beyond the scope of practice.
Rationale 4: Inherited disorders exist beyond those involving chromosomes 13, 18, and 21.
Global Rationale: Mitochondrial genes and any diseases due to DNA alterations on those genes are transmitted
through the mother in a matrilineal pattern. An affected female will pass the metabolism DNA mutation to all of
her children. An affected male will not pass the metabolism DNA mutation to any of his children. It is
inappropriate for the nurse to recommend the patient not have children. This recommendation steps beyond the
scope of practice. Inherited disorders exist beyond those involving chromosomes 13, 18, and 21.

Client Need Sub:
terminology

Page Number: 139
Question 25
Type: MCSA
A baby is born with a genetic disorder that did not affect either of the parents. What should the nurse realize about
this baby’s disorder?
1. The mother is the carrier of the disorder.
2. The father is the carrier of the disorder.
3. The father is not the biological father of the baby.
4. Both parents are carriers of the disorder.
Correct Answer: 4
Rationale 1: If only one parent were affected, the child would not be born with the disorder but simply would be
a carrier as well.
Rationale 2: If only one parent were affected, the child would not be born with the disorder but simply would be
a carrier as well.
Rationale 3: There is no evidence that the father is not the biological father.
Rationale 4: A child born with a recessive condition has inherited one altered gene from the mother and one from
the father. In most cases, neither of the parents is affected and therefore, each of the parents must have a single
gene alteration on one chromosome of a pair and the normal, wild-type, or unaltered, form of the gene on the
other chromosome. These parents would be known as carriers of the condition and they do not usually exhibit any
signs and symptoms of the condition.
Global Rationale: A child born with a recessive condition has inherited one altered gene from the mother and
one from the father. In most cases, neither of the parents is affected and therefore, each of the parents must have a
single gene alteration on one chromosome of a pair and the normal, wild-type, or unaltered, form of the gene on
the other chromosome. These parents would be known as carriers of the condition and they do not usually exhibit
any signs and symptoms of the condition. If only one parent was affected, the child would not be born with the

disorder but simply would be a carrier as well. There is no evidence to support the fact the father is not the
biological father.

Client Need Sub:
terminology
disorders.
Page Number: 140
Question 26
Type: MCSA
A baby is born with a genetic disorder, and neither parent has a history of this disorder. What should the nurse use
to explain the baby’s genetic disorder?
1. de novo
2. penetrance
3. an X-linked dominant condition
4. multifactorial conditions
Correct Answer: 1
Rationale 1: When there is no previous history of a condition, including even subtle signs and symptoms of the
disease, in any immediate or distant family member, the disease may be caused by a spontaneous new mutation.
This is called de novo.
Rationale 2: Penetrance is the probability that a gene will be expressed phenotypically.
Rationale 3: X-linked conditions are recessive in nature.
Rationale 4: Multifactorial conditions occur as a result of genetic variations and lifestyle and environmental
influences that work together.
Global Rationale: When there is no previous history of a condition, including even subtle signs and symptoms of
the disease in any other immediate or distant family member, the disease may be caused by a spontaneous new
mutation. This is called de novo. Penetrance is the probability that a gene will be expressed phenotypically. X-
linked conditions are recessive in nature. Multifactorial conditions occur as a result of genetic variations and
lifestyle and environmental influences that work together.

Client Need Sub:
terminology
disorders.
Page Number: 143
Question 27
Type: MCSA
Upon the completion of genetic testing, a patient is happy to learn that she has a negative test result. The nurse
then explains to the patient that
1. she will never experience a genetically-caused disease.
2. any children she has will be free from genetic diseases.
3. her children might develop disease from genetic misplacement of chromosomes.
4. this is no guarantee that she will not develop the disease.
Correct Answer: 4
Rationale 1: A negative test result cannot guarantee that the disease or condition might not develop in the future.
Rationale 2: The patient’s children may experience random chromosomal abnormalities that are seen in the rest
of the population.
Rationale 3: This is not necessarily true.

Rationale 4: A negative test result cannot guarantee that the disease or condition might not develop in the future.
The patient’s children may experience random chromosomal abnormalities that are seen in the rest of the
population.
Global Rationale: A negative test result cannot guarantee that the disease or condition might not develop in the
future. The patient’s children may experience random chromosomal abnormalities, which are seen in the rest of
the population.

Client Need Sub:
terminology
Page Number: 145
Question 28
Type: MCSA
A patient and her future husband completed genetic testing through a laboratory that they found on the Internet.
The patient is upset because the results determined that they are at risk for having children with congenital
abnormalities. Which is an appropriate nursing response?
1. “A screening test should be confirmed with a diagnostic test.”
2. “The decision about whether or not to have children has been made for you.”
3. “Are you concerned that your future husband won’t want to get married now?”
4. “I wouldn’t worry about those results.”
Correct Answer: 1
Rationale 1: A positive screening genetic test result indicates an increased risk or probability but must always be
confirmed by diagnostic testing.
Rationale 2: The nurse is offering advice.

Rationale 3: This statement may be offensive to the patient.
Rationale 4: The nurse should not tell the patient and her husband that the testing is not valuable.
Global Rationale: A positive screening genetic test result indicates an increased risk or probability but must
always be confirmed by diagnostic testing. The other nursing responses are offering advice, which is not
considered therapeutic communication.

Client Need Sub:
terminology
Page Number: 144
Question 29
Type: MCSA
A patient tells the nurse that her teenaged son, who has a congenital abnormality, is demonstrating increasing
anger and animosity toward her and her husband. The nurse realizes that the son might be
1. behaving as a normal teenager.
2. confused and unaware of how to express it.
3. fostering resentment toward his parents.
4. demonstrating disease from the congenital abnormality.
Correct Answer: 3
Rationale 1: Normal teens do not have to manage the implications associated with the occurrence of a congenital
abnormality.
Rationale 2: The patient is not exhibiting behavior consistent with confusion.

Rationale 3: The individual who has inherited an altered disease-producing gene may foster deep resentment
toward the parent who carries the altered gene.
Rationale 4: There is no evidence that these behaviors are related to disease process. There is no information
provided to support this assumption.
Global Rationale: The individual who has inherited an altered disease-producing gene may foster deep
resentment toward the parent who carries the altered gene. There is no evidence that these behaviors are related to
disease process. Normal teens do not have to manage the implications associated with the occurrence of a
congenital abnormality. The patient is not exhibiting behavior consistent with confusion.

Client Need Sub:
terminology
Page Number: 145
Question 30
Type: MCSA
At the conclusion of a genetic counseling session, a family member says to the nurse, “There’s got to be
something that you aren’t telling us.” The nurse realizes that this individual is
1. feeling guilty because of the outcome of the testing.
2. demonstrating signs of a congenital abnormality.
3. angry with the findings from the testing.
4. confused by the nondirective approach taken by the genetic healthcare providers.
Correct Answer: 4
Rationale 1: Feelings of guilt are not manifested in the demeanor demonstrated by the patient.

Rationale 2: There is no information provided concerning the genetic disorder being evaluated. There is an
inadequate amount of data presented to link the behaviors with the disorder.
Rationale 3: Feelings of anger are not manifested in the demeanor demonstrated by the patient.
Rationale 4: Many patients are accustomed to practitioners and nurses who provide decision-making direction
and guidance, so patients may be uncomfortable when the nurse takes the opposite approach. They may believe
that the nurse or healthcare provider is withholding very bad news. The nurse should discuss the positives and
negatives of each decision and present as many options as possible through the use of therapeutic listening and
communication skills.
Global Rationale: Many patients are accustomed to practitioners and nurses who provide decision-making
direction and guidance, so patients may be uncomfortable when the nurse takes the opposite approach. They may
believe that the nurse or healthcare provider is withholding very bad news. The nurse should discuss the positives
and negatives of each decision and present as many options as possible through the use of therapeutic listening
and communication skills. Feelings of guilt and anger are not manifested in the demeanor demonstrated by the
patient. There is no information provided concerning the genetic disorder being evaluated. There is an inadequate
amount of data presented to link the behaviors with the disorder.

Client Need Sub:
terminology
Page Number: 148
Question 31
Type: MCSA
A baby with Down syndrome has been born to a mother who refuses to allow any family members to visit her or
the newborn. What should the nurse realize this patient is demonstrating?
1. postpartum depression
2. denial

3. anxiety and guilt
4. poor bonding
Correct Answer: 3
Rationale 1: Postpartum depression is not an immediate response.
Rationale 2: There is no evidence that the mother is in denial.
Rationale 3: Nurses must also provide care to help alleviate any patient anxiety or guilt. Anxiety of the unknown
is common when awaiting diagnosis or test results, but individuals also experience anxiety from not
understanding the future implications of a confirmed genetic disease. Guilt and shame are very common as a
patient deals with the loss of the expectation and dream of a healthy child. Guilt may be associated with
knowledge of the existence of a genetic condition being in a family. The nurse must support patients as they
contemplate telling extended family members, friends, and neighbors about a confirmed diagnosis. Patients often
do not want to tell extended family members until they are ready. The nurse should encourage open discussion
and expressing fears and concerns.
Rationale 4: There is no evidence to suggest that the mother is not bonding well with the infant.
Global Rationale: Nurses must also provide care to help alleviate any patient anxiety or guilt. Anxiety of the
unknown is common when awaiting diagnosis or test results, but individuals also experience anxiety from not
understanding the future implications of a confirmed genetic disease. Guilt may be associated with knowledge of
the existence of a genetic condition being in a family. The nurse must support patients as they contemplate telling
extended family members, friends, and neighbors about a confirmed diagnosis. Patients often do not want to tell
extended family members until they are ready. The nurse should encourage open discussion and expressing fears
and concerns. Guilt and shame are very common as a patient deals with the loss of the expectation and dream of a
healthy child. There is no evidence to suggest that the mother is in denial or has poor bonding with the infant.
Postpartum depression is not an immediate response.

Client Need Sub:
terminology
Page Number: 148
Question 32
Type: MCSA
A patient is upset to hear the nurse say that the results of genetic testing revealed wild-type genes. The nurse
should explains that this type of gene is
1. normal.
2. abnormal with limitations.
3. defective.
4. unexpected.
Correct Answer: 1
Rationale 1: A normal or unaltered form of a gene is known as wild-type.
Rationale 2: Wild-type genes are normal, not abnormal with limitations.
Rationale 3: Wild-type genes are normal, not defective.
Rationale 4: Wild-type genes are normal, not unexpected.
Global Rationale: A normal or unaltered form of a gene is known as wild-type. Wild-type genes are not
abnormal with limitations, defective, or unexpected.

Client Need Sub:
terminology
Page Number: 140

Question 33
Type: MCSA
A patient who is pregnant reports a family history of cystic fibrosis and asks about the risks for transmission to
her child. What concepts should the nurse include in the discussion?
1. There is less risk for transmission to male children.
2. The condition does not skip generations.
3. Male and female children are equally affected.
4. Both parents must be affected with this disorder for transmission to occur.
Correct Answer: 3
Rationale 1: Autosomal recessive disorders such as cystic fibrosis are transmitted equally between male and
female children.
Rationale 2: The disorder may appear to skip a generation.
Rationale 3: Autosomal recessive disorders such as cystic fibrosis are transmitted equally between male and
female children.
Rationale 4: The parents of this disorder may be carriers but not affected.
Global Rationale: Autosomal recessive disorders such as cystic fibrosis are transmitted equally between male
and female children. The disorder may appear to skip a generation. The parents of this disorder may be carriers
but not affected.

Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
terminology
disorders.
Page Number: 141

Question 34
Type: MCSA
A newborn has just been diagnosed with a negative result from genetic testing. What should the nurse realize this
finding means?
1. No further follow-up is needed.
2. There is no clinical explanation for the symptoms that are seen.
3. The baby is likely a carrier of a genetic abnormality.
4. The baby will develop symptoms of a genetic abnormality later in life.
Correct Answer: 1
Rationale 1: If the genetic test was for newborn screening and the result is negative, the newborn will not need
diagnostic testing. No follow-up is needed.
Rationale 2: There is no evidence of a manifestation. Newborn screening is often routine.
Rationale 3: The test results indicate the baby does not have a genetic disorder.
Rationale 4: There is no way to predict the baby’s future health status.
Global Rationale: If the genetic test was for newborn screening and the result is negative, the newborn will not
need diagnostic testing. No follow-up is needed. There is no evidence of a manifestation. Newborn screening is
often routine. The test results indicate the baby does not have a genetic disorder. There is no way to predict the
baby’s future health status.

Client Need Sub:
terminology
Page Number: 144

Question 35
Type: FIB
Four hundred twenty-two people are involved in a research study regarding warfarin use. Twenty-three are
African American, fourteen are Asian, and the rest are Caucasian. Based on previous research, calculate how
many of the Caucasian patients may metabolize warfarin at a slower rate due to a polymorphism on the
cytochrome P450 CYP2C9 gene. _______
Standard Text:
Correct Answer: 77
Rationale: Three hundred eighty-five of the 422 research participants are Caucasian. Twenty percent of
Caucasians have a polymorphism on the cytochrome P450 CYP2C9 gene and consequently metabolize warfarin
more slowly and take longer to achieve therapeutic dosing. Twenty percent of 385 patients is 77 people.
Global Rationale:

QSEN Competencies: I.A 1. Integrate understanding of multiple dimensions of patient centered care
terminology
disorders.
Page Number: 144
Question 36
Type: SEQ
A patient scheduled for a genetic evaluation has questions regarding the visit. Rank the steps in the order that they
should most likely occur.
Standard Text: Click and drag the options below to move them up or down.
Choice 1. The geneticist examines the patient.

Choice 2. The patient is scheduled for diagnostic tests.
Choice 3. The patient constructs a 3-generation pedigree.
Choice 4. The geneticist discusses the findings with the patient and makes recommendations.
Choice 5. The genetic clinical nurse interviews the patient.
Correct Answer: 3,5,1,2,4
Rationale 1: The third step is for the geneticist to examine the patient.
Rationale 2: The fourth step is for the patient to be scheduled for diagnostic tests.
Rationale 3: The first step is for the nurse and patient to construct a 3-generation pedigree.
Rationale 4: The fifth step is when the geneticist discusses the findings with the patient and makes specific
recommendations.
Rationale 5: The second step is for the genetic clinical nurse to interview the patient.
Global Rationale: The patient should be prepared to give as exact a family history as possible so that a detailed
three-generation pedigree can be constructed. During the appointment, a genetic clinical nurse, genetic counselor,
and/or a physician will perform an initial interview with the patient. A geneticist will examine the patient in order
to establish an accurate diagnosis. Tests may be ordered. After the exam and the completion of any applicable
testing, the geneticist and/or genetic counselor will discuss the findings with the patient and make
recommendations.

terminology
Page Number: 146
Question 37
Type: MCSA
A 29-year-old patient whose mother died from an unspecified cancer at the age of 33 has the following diagnostic
test results. What would be appropriate for this patient?
1. The patient is scheduled for a prostate exam.
2. The patient is scheduled for a colonoscopy.
3. The patient is scheduled for a mammogram.
4. The patient is scheduled for an ovarian cancer screening examination.
Correct Answer: 2
Rationale 1: A prostate exam is not indicated for this patient.
Rationale 2: This patient should be scheduled for a colonoscopy at least every 2 years beginning at age 25. This
is important for this patient because the patient may have a positive family history and mutations in the
MLH1/MSH2 gene, which increase the risk for hereditary nonpolyposis colorectal cancer.
Rationale 3: A mammogram is not indicated for this patient.
Rationale 4: Patients with breast cancer should be screened for ovarian cancer because they are closely related
genetically.
Global Rationale: This patient should be scheduled for a colonoscopy at least every 2 years beginning at age 25.
This is important for this patient because the patient may have a positive family history and mutations in the
MLH1/MSH2 gene, which increase the risk for hereditary nonpolyposis colorectal cancer. Prostate exam and
mammogram are not indicated for this patient. Patients with breast cancer should be screened for ovarian cancer
because they are closely related genetically.

Client Need Sub:
terminology
Nursing/Integrated Concepts: Nursing Process: Planning
MNL Learning Outcome: 11.12.3. Examine the diagnosis and treatment of colorectal cancer.
Page Number: 145
Question 38
Type: MCSA
While reviewing a male patient’s history in the chart provided, the nurse becomes concerned. The patient states,
“I haven’t been to see a physician in years, and it’s time for me to get a thorough check-up.” Based on the nurse’s
understanding of genetically related diseases, which diagnostic screening examination may be ordered for this
patient?
1. a mammogram
2. a prostate exam
3. a colonoscopy
4. a cardiovascular assessment
Correct Answer: 4
Rationale 1: This patient does not necessarily have an increased risk of breast cancer because the patient’s mother
was diagnosed with breast cancer after the age of 50.
Rationale 2: The patient does not have an increased risk of prostate cancer because the patient’s uncle was
diagnosed with prostate cancer after the age of 60.
Rationale 3: The patient does not have an increased risk of developing colon cancer because the patient’s sister
was diagnosed with colon cancer after the age of 50.

Rationale 4: This patient should receive a cardiovascular assessment. The patient has an increased risk of being
diagnosed with a cardiovascular disease because the patient has two family members that were diagnosed with
cardiovascular disorders that developed early, when compared to other people.
Global Rationale: This patient should receive a cardiovascular assessment. The patient has an increased risk of
being diagnosed with a cardiovascular disease because the patient has two family members that were diagnosed
with cardiovascular disorders that developed early, when compared to other people. This patient does not
necessarily have an increased risk of breast cancer because the patient’s mother was diagnosed with breast cancer
after the age of 50. The patient does not have an increased risk of prostate cancer because the patient’s uncle was
diagnosed with prostate cancer after the age of 60. The patient does not have an increased risk of developing
colon cancer because the patient’s sister was diagnosed with colon cancer after the age of 50.

Client Need Sub:
terminology
MNL Learning Outcome: 6.4.2. Differentiate the risk factors and diagnostic tests for cardiac perfusion
disorders.
Page Number: 147
Question 39
Type: MCMA
The parents of a newborn diagnosed with cri du chat syndrome request information about this disorder. What
statements by the nurse are appropriate?
Standard Text: Select all that apply.
1. “Your baby’s chromosomal makeup is unbalanced.”
2. “These types of genetic problems are often the result of the patient missing some genes or having too much
genetic material.”
3. “This syndrome is genetically related to trisomy 21.”
4. “Your baby’s syndrome is the result of a large deletion on the short arm of chromosome 5.”
5. “Your baby has the low-set ears and mewing cry that is associated with this syndrome.”
Correct Answer: 1, 2, 4, 5
Rationale 1: A chromosomal alteration that includes a missing or additional whole chromosome or segment of a
chromosome is an unbalanced rearrangement.
Rationale 2: An unbalanced rearrangement can result in missing genes, confusing directions from the genes, or
too much gene product.
Rationale 3: Translocation between chromosomes 9 and 22 is responsible for trisomy 21.
Rationale 4: Cri du chat syndrome results from a large deletion on the short arm of chromosome 5.
Rationale 5: Patients with cri du chat have mental retardation, crying that sounds like a cat mewing, and low-set
ears.
Global Rationale: A chromosomal alteration that includes a missing or additional whole chromosome or segment
of a chromosome is an unbalanced rearrangement. An unbalanced rearrangement can result in missing genes,
confusing directions from the genes, or too much gene product. Cri du chat syndrome results from a large deletion
on the short arm of chromosome 5. Patients with cri du chat have mental retardation, crying that sounds like a cat
mewing, and low-set ears. Translocation between chromosomes 9 and 22 is responsible for trisomy 21.

AACN Essentials Competencies: IX 2. Recognize the relationship of genetics and genomics to health,
terminology
Page Number: 139
Question 40
Type: MCMA
The nurse working in a geneticist’s office is reviewing information about human cells with a patient. Which
patient statements indicate that an adequate amount of learning has occurred?

1. “Every human cell has 23 pairs of chromosomes and a total of 46 chromosomes.”
2. “Chromosome 1 will be the smallest while chromosome 46 will be the largest.”
3. “Each human cell contains mitochondria.”
4. “The 22nd pair of chromosomes determines the person’s gender.”
5. “Every human cell functions in the same way regardless of its location.”
Correct Answer: 1, 3
Rationale 1: Every human cell has 23 pairs of chromosomes. There are 46 chromosomes in each cell.
Rationale 2: Chromosomes are numbered according to size, largest to smallest. Chromosome 1 is largest and
chromosome 46 is smallest.
Rationale 3: Each human cell contains organelles such as mitochondria.
Rationale 4: The 23rd pair of chromosomes determines the person’s gender.
Rationale 5: Human cells function very differently based on their location.
Global Rationale: Every human cell has 23 pairs of chromosomes. There are 46 chromosomes in each cell.
Chromosomes are numbered according to size, largest to smallest. Chromosome 1 is largest and chromosome 46
is smallest. Each human cell contains organelles such as mitochondria. The 23rd pair of chromosomes determines
the person’s gender. Human cells function very differently based on their location.

Client Need Sub:
terminology
disorders.
Page Number: 137

Question 41
Type: MCMA
The nurse is reviewing the process of mitosis and meiosis with a patient receiving care in a fertility clinic. Which
patient statements are examples of scenarios that involve mitotic cell division?
1. “Sperm cells use mitosis to divide.”
2. “The patient has a healing wound on the coccyx.”
3. “The patient has acute bronchitis.”
4. “A fetus grows using mitosis.”
5. “The patient has acute gastritis.”
Rationale 1: Sperm cells use meiosis to divide.
Rationale 2: Mitosis is the process of making new cells in bodily tissue. Cell division through mitosis heals
wounds on skin surfaces.
Rationale 3: The lining of the respiratory tract is replaced through mitosis.
Rationale 4: A fetus grows through mitotic cell division.
Rationale 5: The lining of the gastrointestinal tract is replaced by mitosis.
Global Rationale: Mitosis is the process of making new cells in bodily tissue. Cell division through mitosis heals
wounds on skin surfaces. The lining of the gastrointestinal tract is replaced by mitosis. A fetus grows through
mitotic cell division. The lining of the respiratory tract is replaced through mitosis. Sperm cells use meiosis to
divide.

Client Need Sub:
terminology

disorders.
Page Number: 138
Question 42
Type: MCMA
During a visit to a geneticist’s practice a patient with blue eyes asks the nurse to explain eye color, adding that his
mother had blue eyes and his father had brown eyes. What should the nurse include in this explanation?
1. “You have two identical alleles that are responsible for your eye color.”
2. “The alleles that are responsible for your eye color are heterozygous.”
3. “Your eye color is the result of an expressed gene.”
4. “Alleles are forms of a gene.”
5. “Your eye color is just one part of your phenotype.”
Rationale 1: This patient has a blue-eyed mother and a brown-eyed father, so the patient has two different forms
of the gene responsible for his eye color. The patient’s alleles are heterozygous.
Rationale 2: The patient’s alleles are heterozygous.
Rationale 3: The patient’s blue eyes are the result of an expressed gene. An expressed gene impacts the patient’s
outward experience.
Rationale 4: Alleles are versions or forms of a gene. The patient’s eye color is part of his phenotype.
Rationale 5: The phenotype is the patient’s entire physical, biochemical, and physiologic makeup and is
influenced by genetic and environmental factors.
Global Rationale: This patient has a blue-eyed mother and a brown-eyed father, so the patient has two different
forms of the gene responsible for his eye color. The patient’s alleles are heterozygous. The patient’s blue eyes are
the result of an expressed gene. An expressed gene impacts the patient’s outward experience. Alleles are versions
or forms of a gene. The patient’s eye color is part of his phenotype. The phenotype is the patient’s entire physical,
biochemical, and physiologic makeup and is influenced by genetic and environmental factors.

Client Need Sub:
terminology
Page Number: 139
Question 43
Type: MCMA
The parents learn that their newborn has the CFTR gene located on chromosome 7. During counseling, what
should the parents be told about the ways that this genetic alteration may be expressed as the child grows?
1. The child develops normally without any clinical manifestations associated with cystic fibrosis.
2. The patient is placed on a lung transplant list.
3. The patient receives bilateral mastectomies.
4. The patient is counseled about the increased risk of developing Alzheimer disease.
5. The child exhibits some mild signs and symptoms associated with cystic fibrosis.
Correct Answer: 1, 2, 5
Rationale 1: The CFTR gene is a very large gene that is located on chromosome 7. Many different mutations of
the CFTR gene have been reported to be associated with the disease. The area of the CFTR gene that controls
mucous production can have more than 300 different gene alterations, resulting in a variety of symptoms that
range from no clinical manifestations at all to severe problems.

Rationale 2: The area of the CFTR gene that controls mucous production can have more than 300 different gene
alterations, resulting in a variety of symptoms that range from no clinical manifestations at all to severe problems.
The patient with severe cystic fibrosis may be placed on a lung transplant list.
Rationale 3: The CFTR gene does not necessarily increase the patient’s risk for developing breast cancer.
Rationale 4: The CFTR gene does not necessarily increase the patient’s risk for developing Alzheimer disease.
Rationale 5: The area of the CFTR gene that controls mucous production can have more than 300 different gene
alterations resulting in a variety of symptoms that range from no clinical manifestations at all to severe problems.
The child may experience a mild form of cystic fibrosis.
Global Rationale: The CFTR gene is a very large gene that is located on chromosome 7. Many different
mutations of the CFTR gene have been reported to be associated with the disease. The area of the CFTR gene that
controls mucous production can have more than 300 different gene alterations resulting in a variety of symptoms
that range from no clinical manifestations at all to severe problems. The patient with severe cystic fibrosis may be
placed on a lung transplant list. The child may experience a mild form of cystic fibrosis. The CFTR gene does not
necessarily increase the patient’s risk for developing breast cancer or Alzheimer disease.

Client Need Sub:
terminology
disorders.
Page Number: 139
Question 44
Type: MCMA
The nurse at the geneticist’s office is caring for a 22-year-old patient who might have a mitochondrial mutation.
Which patient statements are most consistent with this information?
1. “My dad was unable to hear normally after the age of 15.”

2. “My mom and my sister are really little when compared to the rest of my family.”
3. “My mom and my grandmother have trouble with seizures.”
4. “My dad and my uncle both had heart attacks when they were in their 40s.”
5. “I have some trouble walking and my muscles seem to be getting weaker.”
Rationale 1: The patient’s father developed deafness at an early age, and while this may be the result of a
mitochondrial genetic alteration, it is not necessarily as concerning to learn about because the father will be
unable to pass this mitochondrial mutation to his child.
the mother in a matrilineal pattern. An affected female will pass the mtDNA mutation to all of her children.
However, an affected male will not pass the mtDNA mutation to any of his children. The patient’s mother and
sister have small statures, and this may be related to a mitochondrial mutation.
Rationale 3: The patient’s mother and grandmother have a history of seizures, and this can indicate that they are
experiencing clinical manifestations associated with mitochondrial mutations.
Rationale 4: The patient’s father and uncle experienced myocardial infarctions at abnormally early ages, and
while this may be the result of a mitochondrial mutation, it is not as concerning because the father will be unable
to pass this mitochondrial mutation to his child.
Rationale 5: The patient’s development of ataxia and hypotonia is concerning for the nurse to learn about because
this can be associated with mitochondrial mutations.
Global Rationale: Mitochondrial genes and any diseases due to DNA alterations on those genes are transmitted
through the mother in a matrilineal pattern. An affected female will pass the mtDNA mutation to all of her
children. However, an affected male will not pass the mtDNA mutation to any of his children. The patient’s
mother and sister have small statures and this may be related to a mitochondrial mutation. The patient’s mother
and grandmother have a history of seizures and this can indicate that they are experiencing clinical manifestations
associated with mitochondrial mutations. The patient’s development of ataxia and hypotonia is concerning for the
nurse to learn about because this can be associated with mitochondrial mutations. The patient’s father developed
deafness at an early age and while this may be the result of a mitochondrial genetic alteration, it is not necessarily
as concerning to learn about because the father will be unable to pass this mitochondrial mutation to his child. The
patient’s father and uncle experienced myocardial infarctions at abnormally early ages and while this may be the
result of a mitochondrial mutation, it is not as concerning because the father will be unable to pass this
mitochondrial mutation to his child.

terminology
disorders.
Page Number: 139
Question 45
Type: MCMA
A fetus is found to have an autosomal recessive condition. After genetic testing is completed, both of the fetus’
parents are found to have this same autosomal recessive genetic alteration. Which statements made by a parent
indicate that further education is required?
1. “This condition is related to a genetic alteration of the X chromosome.”
2. “This condition is a Mendelian condition.”
3. “So, we are carriers of this condition because we don’t have any signs of symptoms of this condition.”
4. “Our baby would have a better chance of living if we would have both been positive for an autosomal dominant
condition.”
5. “The problem is the result of an alteration of just one single gene.”
Correct Answer: 1, 4
Rationale 1: Genetic alterations of the X chromosome are referred to as X-linked recessive or X-linked dominant
conditions.
Rationale 2: This is a Mendelian condition because it follows Mendel’s laws of inheritance.
Rationale 3: The parents denied having any clinical manifestations associated with the condition, so they are
most likely carriers of the condition.

Rationale 4: It is not necessarily true that the infant will die due to an autosomal recessive condition. The baby
that is affected by a homozygous autosomal dominant condition is much more likely to die from problems
associated with that type of condition.
Rationale 5: These types of conditions are monogenic because they affect one single gene.
Global Rationale: Genetic alterations of the X chromosome are referred to as X-linked recessive or X-linked
dominant conditions. Autosomal recessive conditions are the result of an alteration of any of the 22 non-sex
chromosomes. It is not necessarily true that the infant will die due to an autosomal recessive condition. The baby
that is affected by a homozygous autosomal dominant condition is much more likely to die from problems
associated with that type of condition. This is a Mendelian condition because it follows Mendel’s laws of
inheritance. The parents denied having any clinical manifestations associated with the condition so they are most
likely carriers of the condition. These types of conditions are monogenic because they affect one single gene.

terminology
disorders.
Page Number: 140
Question 46
Type: MCMA
A married couple has two children at home who have been diagnosed with the same autosomal dominant
condition. The nurse is interviewing the couple after they become pregnant with their third child. Based on the
nurse’s understanding of related psychosocial issues, which statements by the mother may be expected?
1. “I feel so guilty.”
2. “I feel like my daughter is angry with me because I am the one who has this bad gene in my body.”
3. “I am depressed and angry with myself.”

4. “My son has been smoking marijuana and skipping school.”
5. “I hope the new baby is a boy so he won’t have the same illness.”
Correct Answer: 1,2,3,4
Rationale 1: The parents of a child with a genetically transmitted disease may feel guilty.
Rationale 2: Some children may feel angry toward the parent who carries the altered gene.
Rationale 3: The parent or parent may feel angry or depressed.
Rationale 4: A child with a late-onset disease may be more likely to engage in risky and less socially acceptable
behaviors.
Rationale 5: Both males and females are equally affected with an autosomal dominant genetic disorder.
Global Rationale: The parents of a child with a genetically transmitted disease may feel guilty. Some children
may feel angry toward the parent who carries the altered gene. The parent or parents may feel angry or depressed.
A child with a late-onset disease may be more likely to engage in risky and less socially acceptable behaviors.
Both males and females are equally affected with an autosomal dominant genetic disorder.

Client Need Sub:
AACN Essentials Competencies: IX. 2. Recognize the relationship of genetics and genomics to health,
terminology
Page Number: 145
Question 47
Type: MCMA
The nurse manager determines that a new staff nurse is capable of caring for patients with genetic disorders. What
information did the manager use to make this decision?

1. The nurse evaluates care provided to patients.
2. The nurse identifies patients’ needs for referrals.
3. The nurse advocates for pregnancy terminations.
4. The nurse performs physical assessments accurately and thoroughly
5. The nurse consistently completes a genetic-focused family history with patients.
Rationale 1: Basic interventions that meet the standards of genetic nursing include evaluating care provided to
patients.
Rationale 2: Basic interventions that meet the standards of genetic nursing include identifying patients’ needs for
referrals.
Rationale 3: The nurse should advocate for the patient based upon sound information and decisions. This does
not include advocating for pregnancy terminations.
Rationale 4: Basic interventions that meet the standards of genetic nursing include performing accurate and
thorough physical assessments.
Rationale 5: Basic interventions that meet the standards of genetic nursing include completing genetic-focused
family histories with patients.
Global Rationale: Basic interventions that meet the standards of genetic nursing include evaluating care provided
to patients, identifying patients’ needs for referrals, performing accurate and thorough physical assessments, and
completing genetic-focused family histories with patients. The nurse should advocate for the patient based upon
sound information and decisions. This does not include advocating for pregnancy terminations.

Client Need Sub:
terminology
Page Number: 137
Question 48
Type: MCMA

The nurse is preparing information for a group of parents as part of genetic counseling. What basic principles of
inheritance should the nurse include in this presentation?
1. All genes are paired.

2. Only one gene is passed on to offspring.
3. The mother’s genes are transmitted to offspring.
4. The father’s genes are used to fill in genetic deficits in offspring.
5. One copy of a gene comes from the mother and the other copy from the father.
Answer: 1, 2, 5
Rationale 1: The basic underlying principles of inheritance that nurses can apply to inheritance risk assessment
and teaching include that all genes are paired.
and teaching include that only one gene of each pair is transmitted (passed on) to an offspring.
Rationale 3: Both parents’ genes are transmitted to offspring.
Rationale 4: The father’s genes are not used to fill in genetic deficits in offspring.
and teaching include that one copy of each gene in the offspring comes from the mother and the other copy comes
from the father.
Global Rationale: The basic underlying principles of inheritance that nurses can apply to inheritance risk
assessment and teaching include: (1) all genes are paired, (2) only one gene of each pair is transmitted (passed on)
to an offspring, and (3) one copy of each gene in the offspring comes from the mother and the other copy comes
from the father. Both parents’ genes are transmitted to offspring. The father’s genes are not used to fill in genetic
deficits in offspring.

Client Need Sub:
terminology
disorders.
Page Number: 140
Question 49
Type: MCMA
A patient pregnant with her first child is in need of genetic testing. The health plan will cover the testing to an
extent. What should the nurse encourage the patient to consider before making a decision about the testing?
1. Extended family members may resent the patient.

2. There might not be treatment available for the genetic disorder.
3. The patient may terminate the pregnancy before family is informed.
4. The patient must determine whether she is prepared for lifestyle alterations based upon the results.
5. The insurance company will have information about the genetic testing.
Answer: 1, 2, 4, 5
Rationale 1: Depending upon the results, family members may resent the patient for having a baby with a genetic
disorder.
Rationale 2: Depending upon the results, there might not be a treatment available for the disorder.
Rationale 3: Termination of pregnancy is not something that should be discussed at this time.
Rationale 4: The patient may or may not be able to care for the baby depending upon the genetic disorder.
Rationale 5: Since the health plan does provide genetic testing coverage, the plan will have information about the
testing.
Global Rationale: Depending upon the results, family members may resent the patient for having a baby with a
genetic disorder. Depending upon the results, there might not be a treatment available for the disorder.
Termination of pregnancy is not something that should be discussed at this time. The patient may or may not be
able to care for the baby depending upon the genetic disorder. Since the health plan does provide genetic testing
coverage, the plan will have information about the testing.

Client Need Sub:
terminology
Page Number: 144-148
Question 50
Type: MCMA
The nurse is concerned that a patient pregnant with a fetus with a genetic disorder is experiencing moral and
ethical problems. What should the nurse offer to support the patient at this time?
1. The patient’s use of coping mechanisms

2. Actions to take to reduce stress and anxiety
3. Reasons for terminating the pregnancy at this time
4. Assistance with thinking through the process to increase optimism
5. Ask if the patient has any particular spiritual advisor that can be contacted
Rationale 1: Problems that a patient facing a genetic disorder may experience include spiritual distress,
ineffective coping, anxiety, and powerlessness. The use of coping mechanisms helps with the problem of
ineffective coping.
ineffective coping, anxiety, and powerlessness. Actions to reduce stress and anxiety help with the problem of
anxiety.
Rationale 3: The nurse should help the patient with problem solving and not suggest termination of the
pregnancy.
ineffective coping, anxiety, and powerlessness. Assisting the patient to think through the process to increase
optimism helps with the problem of powerlessness.
ineffective coping, anxiety, and powerlessness. Asking about a spiritual advisor helps with the problem of
spiritual distress.
Global Rationale: Problems that a patient facing a genetic disorder may experience include spiritual distress,
ineffective coping, anxiety, and powerlessness. The use of coping mechanisms helps with the problem of
ineffective coping. Actions to reduce stress and anxiety help with the problem of anxiety. Assisting to think
through the process to increase optimism helps with the problem of powerlessness. Asking about a spiritual
advisor helps with the problem of spiritual distress. The nurse should help the patient with problem solving and
not suggest termination of the pregnancy.

Client Need Sub:
terminology
Page Number: 146
Question 51
Type: MCMA
At the conclusion of a health history and physical assessment, the nurse determines that a patient might benefit
from genetic testing. What did the nurse assess to come to this conclusion?
1. Infertility
2. Seizure disorder
3. Menopause at age 32
4. Neighbor committed suicide
5. Cousin addicted to heroin
Rationale 1: Indications for a referral to a genetic specialist include infertility.
Rationale 2: Indications for a referral to a genetic specialist include seizure disorder.
Rationale 3: Indications for a referral to a genetic specialist include premature ovarian failure as might be seen
with early menopause.
Rationale 4: A neighbor’s suicide is not an indication for a genetic specialist.
Rationale 5: A cousin’s drug addiction is not an indication for a genetic specialist.
Global Rationale: Indications for a referral to a genetic specialist include infertility, seizure disorder, and
premature ovarian failure as might be seen with early menopause. A neighbor’s suicide and a cousin’s drug
addiction are not indications for a genetic specialist.

Test Bank Medical-Surgical Nursing, Clinical Reasoning in Patient Care, 6th LeMone â€“ Burke
terminology
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Page Number: 147

Visit TestBankBell.com to get complete for all chapters

Test Bank Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Lemone Burke Bauldoff Gubrud

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Test Bank Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Lemone Burke Bauldoff Gubrud

Uploaded by

Copyright:

Available Formats

Test Bank Medical-Surgical Nursing, Clinical Reasoning in Patient Care, 6th LeMone â€“ Burke

Test Bank Medical-Surgical Nursing, Clinical

To download the complete and accurate content document, go to:

Visit TestBankBell.com to get complete for all chapters

1. the importance of maintaining a healthy weight and activity level

2. the need to avoid carbohydrate intake

3. the need to begin monitoring daily blood glucose levels

Rationale 2: While nutrition is a significant factor, it is not necessary to avoid carbohydrates.

Cognitive Level: Applying

3. “Adoption is always a possibility.”

4. “Are you sure that the disease is genetic in origin?”

Rationale 3: It is premature to suggest adoption until the genetic study is completed.

Cognitive Level: Applying

2. Conduct a health promotion assessment.

3. Schedule for a complete genetic analysis.

4. Refer to a geneticist for diagnosis.

Cognitive Level: Applying

1. importance of having screening for colorectal cancer at an earlier age

2. importance of ingesting a diet high in protein and carbohydrates

3. ways to maximize time spent in exercise

Cognitive Level: Applying

3. a single-gene inheritance pattern

4. an X-linked inheritance pattern

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Analyzing

Rationale 3: Translocation (chromosomal reshuffling) occurs when a segment of a chromosome transfers or

Cognitive Level: Analyzing

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

2. The patient will develop the same type of anemia.

3. The patient will die from the anemia.

Rationale 2: The patient may or may not develop anemia.

Rationale 3: The patient may or may not die from anemia.

Rationale 4: Translocation does not predispose some individuals for disease.

Cognitive Level: Analyzing

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

2. “It’s not too late to consider ending the pregnancy.”

3. “You are young enough to be able to handle the baby’s challenges.”

Cognitive Level: Applying

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Analyzing

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

2. “It is probably best that he is not aware of the disease.”

4. “There are worse disease processes than Huntington chorea.”

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

2. The patient needs psychiatric counseling.

Cognitive Level: Analyzing

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Rationale 3: In this case, genetic testing is indicated.

Rationale 4: Therapy would be started only if the cancer were present.

Cognitive Level: Analyzing

1. The patient is at reduced risk for developing Alzheimer disease.

2. The patient is at increased risk for developing Alzheimer disease.

3. The patient is at risk for contracting malaria.

4. The patient is at risk for developing colorectal cancer.

Rationale 3: The apolipoprotein E gene is not a predictor for contracting malaria.