Chapter 15: Perspectives in Genetics Nursing School Test Banks

Black & Hawks: Medical-Surgical Nursing, 8th Edition

Test Bank

Chapter 15: Perspectives in Genetics

MULTIPLE CHOICE

1. The Human Genome Project (HGP) was begun in 1990 to

a.

alter the course of inherited disorders.

b.

clone an animal, then a human.

c.

determine the location of genes on chromosomes.

d.

replicate the structure of deoxyribonucleic acid (DNA).

ANS: C

The HGP was organized in 1990 to determine the location of genes on the chromosomes by analyzing the structure of human DNA.

DIF: Knowledge/Remembering REF: p. 236 OBJ: N/A

MSC: N/A

2. Autosomes are the chromosomes that

a.

are common to males and females.

b.

are inherited from the paternal side.

c.

determine gender.

d.

exist in paired forms.

ANS: A

The chromosome pairs 1 through 22 are called autosomes and are present in males and females.

DIF: Knowledge/Remembering REF: pp. 237, 238 OBJ: N/A

MSC: N/A

3. The nurse explains to a client that the condition of a sperm or egg having an irregular number of chromosomes is called

a.

aneuploidy.

b.

genotype.

c.

phenotype.

d.

polypeptide.

ANS: A

Aneuploidy is the condition of a sperm or an egg having an irregular number of chromosomes. Genotype is all or part of the genetic constitution of an individual or group. Phenotype is the observable properties of an individual or group that results from the interaction of the genotype and the environment. A polypeptide is a molecular chain of amino acids.

DIF: Comprehension/Understanding REF: pp. 237, 238 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

4. A nurse counseling a couple about genetic disorders explains that Tay-Sachs disease is a genetically linked disorder seen in 7% of the

a.

African-American ethnic group.

b.

Ashkenazi Jewish ethnic group.

c.

Hispanic ethnic group.

d.

Northern European ethnic group.

ANS: B

The Ashkenazi Jewish ethnic group has a 7% incidence of Tay-Sachs disease, which is inherited as an autosomal recessive condition.

DIF: Comprehension/Understanding REF: p. 239 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

5. The nurse counseling a couple that wish to obtain genetic testing before starting a family explains that the purpose of such screening is to

a.

allow genetic-defect-free individuals to obtain insurance discounts.

b.

identify individuals who are healthy but carry a disease-carrying gene.

c.

prevent genetically-based diseases from being transmitted.

d.

provide genetic analysis to anyone who desires it.

ANS: B

Carrier screening focuses on individuals in high-risk groups and who have positive family histories for genetic diseases. Information is not released in order to obtain insurance discounts. The decision to have children is up to the couple; positive genetic screening does not prevent them from having children.

DIF: Comprehension/Understanding REF: pp. 245-246 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

6. A nurse educating clients in a genetic screening clinic explains that recessive genes on autosomal chromosomes can be passed on

a.

to children of either gender.

b.

only to males.

c.

only to females.

d.

to females after skipping a generation.

ANS: A

Autosomes are the 22 pairs that are common to males and females. Each child of heterozygous parents who are carriers of an autosomal recessive condition has a 25% chance of inheriting two copies of the mutated gene and therefore being affected, a 50% chance of being a carrier and unaffected, and a 25% chance of neither having the disorder nor being a carrier. These risks are independent of the gender of the child.

DIF: Comprehension/Understanding REF: pp. 238-239 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

7. A nurse explains to a family that if a man has a recessive gene on his X chromosome, that characteristic can be passed on to

a.

any child of either gender.

b.

his daughters.

c.

his sons.

d.

no child as it is a random mutation.

ANS: B

Females have X chromosome from their mother and receive the X chromosome from their father (boys receive X from the mother and Y from the father). Therefore if the X chromosome is present in the conception of a female, only females can inherit it.

DIF: Comprehension/Understanding REF: pp. 240-241 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

8. A nurse providing genetic counseling explains that when one parent has an autosomal dominant gene for an inherited disease, the chances of the child being affected are

a.

10%.

b.

25%.

c.

50%.

d.

100%.

ANS: C

If the mutated gene of one parent is dominant, it will dominate the other parents gene. The odds are 50% that the child will be affected.

DIF: Comprehension/Understanding REF: pp. 239-240 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

MULTIPLE RESPONSE

1. The nurse obtaining consent for genetic testing realizes that the elements of informed consent include (Select all that apply)

a.

other options for risk assessment.

b.

the possibility that the results will be ambiguous.

c.

procedures for giving results to insurance companies.

d.

risks that nonrelatedness will be discovered.

e.

the purpose of the test.

ANS: A, B, D, E

Other elements of informed consent can be found in Box 15-5. Third parties are not informed of genetic testing results unless the client (consultant) specifically gives permission.

DIF: Knowledge/Remembering REF: p. 247 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Informed Consent

2. The nurse working with clients who seek genetic testing has an important role in (Select all that apply)

a.

ensuring privacy and confidentiality.

b.

helping the client negotiate disruptions in family dynamics.

c.

recognizing the potential for stigmatization.

d.

understanding the process of informed consent.

ANS: A, B, C, D

All options are important issues that challenge the nurse working with clients who undergo genetic counseling or testing.

DIF: Comprehension/Understanding REF: p. 246 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Ethical Practice

3. The nurse working with clients who seek genetic counseling or testing helps the client and family manage potential psychosocial distress that can accompany test results, including (Select all that apply)

a.

disclosure of nonrelatedness.

b.

disrupted family processes.

c.

guilt feelings for passing on diseases.

d.

impairment in self-esteem.

e.

survivor guilt.

ANS: A, B, C, D, E

There is a wide range of psychological responses to the results of genetic testing. In fact, the nurse must realize that the results of the tests may cause psychological harm. This information must be included in the informed consent.

DIF: Application/Applying REF: p. 247 OBJ: Intervention

MSC: Psychosocial Integrity Coping and Adaptation-Support Systems

4. The nurse working on a general medical-surgical unit in the hospital cares for clients with a variety of diseases that have a genetic component, including (Select all that apply)

a.

Alzheimers disease.

b.

chronic obstructive pulmonary disease.

c.

diabetes.

d.

heart disease.

e.

sickle cell anemia.

ANS: A, C, D, E

Other diseases with a genetic component include cancer, Huntingtons disease, muscular dystrophy, essential hypertension, multiple sclerosis, many birth defects, and Tay-Sachs Disease. COPD does not seem to have a genetic component.

DIF: Knowledge REF: pp. 244, 246 OBJ: N/A

MSC: Physiological Integrity Physiological Adaptation-Alteration in Body Systems

Elsevier items and derived items 2009 by Saunders, an imprint of Elsevier Inc.

Some material was previously published.

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