Genetics and Genomics For Nursing 1st Edition Kenner Test Bank

Genetics and Genomics for Nursing 1st
Edition Kenner Test Bank

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Kenner Genetics and Genomics for Nursing, 1/E
Chapter 7
Question 1
Type: MCSA
A client being treated for cancer is offended because she overheard a nurse say that the client had “wild-type
genes.” How should the nurse respond to calm this client?
1. “Wild-type genes are a type of gene that is stronger than normal.”
2. “The nurse was describing your resilience in fighting your illness so effectively.”
3. “The nurse was discussing a type of gene we are seeing in clients treated for cancer.”
4. “Wild-type genes are those that are normal and have not been affected by any mutation.”
Correct Answer: 4
Rationale 1: Wild-type genes are not stronger-than-normal genes.
Rationale 2: The term wild-type genes does not refer to resilience.
Rationale 3: Wild-type genes are not caused by cancer treatments.
Rationale 4: Wild-type genes are those found in the common phenotype of a population.
Global Rationale:
Cognitive Level: Applying

Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7-1: Describe Mendelian patterns of inheritance that contribute to inherited disorders.
Question 2
Type: MCMA
A client is diagnosed with a single-gene disorder on a non–sex chromosome. How would the nurse describe this
disorder?
Standard Text: Select all that apply.
1. X-linked
2. Y-linked
3. Monogenic
Kenner, Genetics and Genomics for Nursing, 1/E Test Bank
Copyright 2013 by Pearson Education, Inc.
4. Dominant
5. Autosomal
Correct Answer: 3,5
Rationale 1: X-linked disorders are associated with a sex chromosome.
Rationale 2: Y-linked disorders are associated with a sex chromosome.
Rationale 3: A single-gene disorder arises from a single defective gene; hence the term monogenic.
Rationale 4: The disorder may or may not be dominant.
Rationale 5: If the defective gene is not on a sex chromosome, it is termed autosomal.
Global Rationale:

Learning Outcome: 7-1: Describe Mendelian patterns of inheritance that contribute to inherited disorders.
Question 3
Type: MCMA
A client has been diagnosed with an autosomal recessive disorder that developed in middle adulthood. No other
people in his family have manifested the disorder. The client asks the nurse why he is affected and if his children
are at risk. What would the nurse consider when formulating a reply?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
1. The client’s mother is a carrier of the disorder.
2. The odds are high that at least one of the client’s four younger siblings either is a carrier for the disease or will
develop it in later life.
3. The client’s father is a carrier for the disorder.
4. Because the disorder is recessive, the client’s children have a 25% chance of having inherited it.
5. All of the client’s children are at least carriers of the disorder.

Correct Answer: 1,2,3,5
Rationale 1: For the client to inherit an autosomal recessive disorder, his mother must have the disorder or be a
carrier for it.
Rationale 2: Each sibling has a 50% chance of being a carrier and a 25% chance of developing the disease.
Rationale 3: For the client to inherit an autosomal recessive disorder, his father must have the disorder or be a
carrier for it.
Rationale 4: The client’s children have a 50% chance of being affected.
Rationale 5: As this client has manifested the disorder, it is clear he inherited two recessive genes. The father
must contribute one gene to each child, so it must be a recessive gene, making the children carriers. If the
children’s mother also has the disorder or is a carrier, the children’s chances of developing the disorder are higher.
Global Rationale:
Cognitive Level: Analyzing

Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7-2: Describe the major characteristics of single gene Mendelian autosomal recessive
disorders.
Question 4
Type: MCSA
The mother of a client with cystic fibrosis (CF) says, “I don’t understand why my son is sick so often when some
of the other children in our CF support group are hardly ever sick.” How should the nurse respond?
1. “We should probably test your son’s immune system.”
2. “There are many different type of CF, and they affect different people differently.”
3. “Are you certain you have been following his medication schedule exactly?”
4. “Children have different levels of disease because they have differing amounts of dysfunction in the gene that
causes CF.”
Correct Answer: 4
Rationale 1: If the frequency of illness is the only assessment finding, it is not necessary to test the child’s
immune system.
Rationale 2: This statement is not factual and does not explain the difference in the son’s illness.
Rationale 3: The nurse should not imply that the son’s frequent illnesses are the mother’s fault.

Rationale 4: The greater the alteration in the CFTR gene, the more severe the symptoms associated with CF.
Global Rationale:

disorders.
Question 5
Type: MCSA
A client has been diagnosed with a rare autosomal recessive disorder. Which finding is the nurse most likely to
assess in the client’s pedigree?
1. Deaths from other autosomal recessive disorders
2. Many families units with only one child
3. Marriages between first cousins
4. An unusual number of adopted children
Correct Answer: 3
Rationale 1: This disease could be the only autosomal recessive disorder in the family.
Rationale 2: There is no reason to believe that the presence of an autosomal recessive disorder would limit the
number of children born in a family.
Rationale 3: Consanguinity narrows the gene pool in a family and results in more cases in which two persons
with an autosomal recessive disease have children together.
Rationale 4: The number of adopted children and the presence of an autosomal recessive disorder have no effect
on each other.
Global Rationale:

Nursing/Integrated Concepts: Nursing Process: Assessment
disorders.
Question 6

Type: MCSA
The evaluation of a family pedigree reveals numerous cases of an autosomal dominant disorder. The client does
not have the disorder. What does the nurse teach the client about her children’s chances of having the disorder?
1. “Your children have a 50% chance of developing the disorder.”
2. “If your children’s father does not have the disease, they will not have the disease.”
3. “Your children cannot develop the disease.”
4. “These disorders tend to skip a generation, so there is a good chance your children will develop it.”
5.
Correct Answer: 2
Rationale 1: This is not true of autosomal dominant disorders.
Rationale 2: This is the best way to explain the chances of the children having the disease. The mother cannot
pass it to them, but if the children’s father has the disorder, they could develop it.
Rationale 3: If the children’s father has the disorder, there is a 50% chance they will develop it.
Rationale 4: Autosomal dominant disorders do not “skip a generation.”
Rationale 5:
Global Rationale:

Learning Outcome: 7-3: Describe the major characteristics of single gene Mendelian autosomal dominant
disorders.
Question 7
Type: MCSA
A client is diagnosed with a disorder that has an autosomal dominant inheritance pattern. A review of the client’s
family history and pedigree does not reveal any ancestors with the disorder. How should the nurse interpret this
finding?
1. Errors have been made in the documentation of the client’s history.
2. Some ancestors experienced effects that were so minor they were not recognized.

3. A de novo mutation has occurred.
4. The client’s genetic testing should be repeated.
Correct Answer: 3
Rationale 1: The client’s history could be accurate.
Rationale 2: This could be correct, but it is not the likeliest reason for the finding.
Rationale 3: A de novo mutation is a new, spontaneous mutation that then appears in succeeding generations.
Rationale 4: The scenario is consistent with basic Mendelian inheritance patterns. There is no reason to repeat
testing.
Global Rationale:

Learning Outcome: 7-3: Describe the major characteristics of single gene Mendelian autosomal dominant
disorders.
Question 8
Type: FIB
A woman who is a carrier of an X-linked recessive genetic disorder has a child with a man who is not affected by
the disorder. The chance that a son born to this couple will have the disease is ________ percent.
Standard Text:
Correct Answer: 50
Rationale : A woman who is a carrier of an X-linked recessive disease has one mutated X chromosome. If this
woman has a son with a man who is not affected, the man will contribute a wild-type Y chromosome. The child
has a 50% chance of inheriting a mutated X chromosome from the mother.
Global Rationale:

Learning Outcome: 7-4: Describe the major characteristics of single gene X-linked recessive and dominant
disorders.
Question 9

Type: MCMA
A nurse is providing preconception counseling to a healthy woman and her husband, who has hemophilia A. They
are very concerned about passing the disorder on to their children. What should the nurse consider before
addressing this concern?
1. Hemophilia A is diagnosed in men and women in equal numbers.
2. The daughters produced by this union will be carriers of the disorder.
3. The sons of this union will have hemophilia A.
4. The daughters of this union will have a 50% chance of passing hemophilia A on to their daughters.
5. None of the children of this union will manifest hemophilia A.
Correct Answer: 2,5
Rationale 1: Hemophilia A is diagnosed almost exclusively in men.
Rationale 2: The father will contribute his lone X chromosome to his daughters. Because hemophilia is an X-
linked disorder, that X must be affected. Daughters will be carriers of the disease.
Rationale 3: Hemophilia A is an X-linked disorder. The father contributes a Y chromosome to his sons, so there
is no direct transfer of the disorder.
Rationale 4: The daughters of this union will have a 50% chance of passing this disorder to their sons.
Rationale 5: Hemophilia affects males. The father cannot pass his affected X chromosome to sons, so they will
not be affected.
Global Rationale:

disorders.
Question 10
Type: MCSA

A man who has a Y-linked disorder has married a healthy woman. The couple is concerned about passing the
man’s disorder to their children. What should the nurse consider before responding to this concern?
1. Only the female children will be affected.
2. Female fetuses with this genotype do not survive to birth.
3. Only male children will be affected.
4. The chance the father will pass the disease on to male children is 1 in 2.
Correct Answer: 3
Rationale 1: Females cannot be affected because the disorder requires a Y chromosome.
Rationale 2: The female fetus cannot have this genotype as it requires a Y chromosome.
Rationale 3: Because the disorder is Y-linked, only males are affected.
Rationale 4: The father has only one Y chromosome to contribute, so the affected chromosome will be passed to
each son.
Global Rationale:

disorders.
Question 11
Type: MCSA
A male infant is diagnosed with a disorder of mitochondrial inheritance. What should the nurse consider when
developing a teaching plan about this disorder for the parents?
1. This disorder will affect the baby’s immunity.
2. It is very rare for a male child to be affected.
3. The child inherited this disorder from the mother.
4. This baby will likely not live past a few weeks.
Correct Answer: 3
Rationale 1: Mitochondrial disorders affect the energy production of the cells.

Rationale 2: Males and females are affected in equal numbers.
Rationale 3: Inheritance is through the maternal line.
Rationale 4: Expression of these disorders is variable. There is no indication of how affected this child is or how
long he may live.
Global Rationale:

Learning Outcome: 7-5: Identify nontraditional Mendelian disorders such as mitochondrial disorders, genomic
imprinting, unipaternal disomy, and unstable triplet repeat mutations.
Question 12
Type: MCMA
A teenager is diagnosed with a disorder of mitochondrial inheritance. What assessment findings would the nurse
expect to find in this client’s history?
1. Hearing loss
2. Loss of ability to taste
3. Frequent nosebleeds
4. Exercise intolerance
5. Generalized fatigue
Correct Answer: 1,4,5
Rationale 1: Unexplained hearing loss is a finding associated with mitochondrial disorders.
Rationale 2: Taste disturbances are not associated with mitochondrial disorders.
Rationale 3: Frequent nosebleeds are not associated with mitochondrial disorders.
Rationale 4: Mitochondrial disorders affect energy supply.
Rationale 5: Mitochondrial disorders affect energy supply.

Global Rationale:

Question 13
Type: MCMA
A child has been diagnosed with Fragile X syndrome. The nurse would explain that this child is at risk for which
other disorders?
1. Autism
2. Hyperactivity
3. Mitral valve prolapse
4. Learning disabilities
5. Huntington disease
Rationale 1: Fragile X syndrome is associated with autism.
Rationale 2: Fragile X syndrome is associated with hyperactivity.
Rationale 3: The connective tissue weakness common in Fragile X syndrome puts the client at risk for mitral
valve prolapse.
Rationale 4: Fragile X syndrome is the most common hereditary disorder associated with mental retardation.
Rationale 5: The gene alterations that cause Fragile X are not associated with Huntington disease.
Global Rationale:


Question 14
Type: MCSA
The nurse is reviewing an obstetric client’s history and physical assessment. Which finding is most likely to alert
the nurse to the possibility of a genetic disorder in the infant?
1. Family history of genetic disorders
2. Infant’s large size for gestational age
3. Low serum glucose in mother on initial screening
4. History of smoking in mother and father
Correct Answer: 1
Rationale 1: Of all the diagnostic tools used by health care providers, the family history is most indicative of a
potential genetic disorder.
Rationale 2: Being large for gestational age may be associated with any number of diseases that are not genetic in
nature.
Rationale 3: Low serum glucose is a common finding and would not alert the nurse to a possible genetic disorder.
Rationale 4: Smoking during pregnancy may adversely affect the fetus but is unlikely to cause genetic disorders.
Global Rationale:

Learning Outcome: 7-6: Describe the role of nurses and other health care professionals in providing information
about Mendelian disease to patients and families.
Question 15
Type: MCMA
A couple has delivered an infant with a serious genetic disorder. Which nursing diagnoses would likely apply to
this family?

1. Altered Family Processes
2. Anticipatory Grieving
3. Anxiety
4. Ineffective Denial
5. Ineffective Management: Therapeutic Family Regimen
Rationale 1: The normal rhythms of this family have been disrupted.
Rationale 2: The family will grieve for the loss of a normal child.
Rationale 3: The time of the first diagnosis will be a time of great anxiety.
Rationale 4: Denial is a common coping mechanism for parents who have just been told their child has a
disability.
Rationale 5: The family is more likely to be very attuned to prescribed therapies, especially at the time of initial
diagnosis.
Global Rationale:

Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 7-6: Describe the role of nurses and other health care professionals in providing information
about Mendelian disease to patients and families.


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Genetics and Genomics for Nursing 1st

Edition Kenner Test Bank

1. “Wild-type genes are a type of gene that is stronger than normal.”

Rationale 1: Wild-type genes are not stronger-than-normal genes.

Rationale 2: The term wild-type genes does not refer to resilience.

Rationale 3: Wild-type genes are not caused by cancer treatments.

Cognitive Level: Applying

Standard Text: Select all that apply.

Correct Answer: 3,5

Rationale 1: X-linked disorders are associated with a sex chromosome.

Rationale 2: Y-linked disorders are associated with a sex chromosome.

Rationale 4: The disorder may or may not be dominant.

Rationale 5: If the defective gene is not on a sex chromosome, it is termed autosomal.

Cognitive Level: Applying

Standard Text: Select all that apply.

1. The client’s mother is a carrier of the disorder.

3. The client’s father is a carrier for the disorder.

5. All of the client’s children are at least carriers of the disorder.

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank

Rationale 4: The client’s children have a 50% chance of being affected.

Cognitive Level: Analyzing

1. “We should probably test your son’s immune system.”

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank

Cognitive Level: Applying

1. Deaths from other autosomal recessive disorders

2. Many families units with only one child

3. Marriages between first cousins

4. An unusual number of adopted children

Cognitive Level: Analyzing

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank

1. “Your children have a 50% chance of developing the disorder.”

3. “Your children cannot develop the disease.”

Rationale 1: This is not true of autosomal dominant disorders.

Rationale 4: Autosomal dominant disorders do not “skip a generation.”

Cognitive Level: Analyzing

1. Errors have been made in the documentation of the client’s history.

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank

4. The client’s genetic testing should be repeated.

Rationale 1: The client’s history could be accurate.

Cognitive Level: Analyzing

Cognitive Level: Analyzing

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank

Standard Text: Select all that apply.

1. Hemophilia A is diagnosed in men and women in equal numbers.

2. The daughters produced by this union will be carriers of the disorder.

3. The sons of this union will have hemophilia A.

5. None of the children of this union will manifest hemophilia A.

Correct Answer: 2,5

Rationale 1: Hemophilia A is diagnosed almost exclusively in men.

Cognitive Level: Analyzing

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank

1. Only the female children will be affected.

2. Female fetuses with this genotype do not survive to birth.

3. Only male children will be affected.

Rationale 1: Females cannot be affected because the disorder requires a Y chromosome.

Rationale 3: Because the disorder is Y-linked, only males are affected.

Cognitive Level: Analyzing

1. This disorder will affect the baby’s immunity.

2. It is very rare for a male child to be affected.

3. The child inherited this disorder from the mother.

4. This baby will likely not live past a few weeks.

Rationale 1: Mitochondrial disorders affect the energy production of the cells.

Kenner, Genetics and Genomics for Nursing, 1/E Test Bank