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LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
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
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
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
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
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: Assessment
Learning Outcome: 1. Discuss the role of genetic concepts in health promotion and health maintenance.
MNL Learning Outcome:
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.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
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.
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.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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: 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: Assessment
Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
MNL Learning Outcome:
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
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
Cognitive Level: Analyzing
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: Assessment
Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
MNL Learning Outcome:
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?
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
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: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
MNL Learning Outcome:
Page Number: 139
Question 8
Type: MCSA
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
Cognitive Level: Analyzing
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: Assessment
Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
MNL Learning Outcome: 14.1.1. Explain the incidence, causes, and pathophysiology of the different types of
anemias.
Page Number: 140
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Client Need Sub:
QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in 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
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
Learning Outcome: 3. Describe the significance of delivering genetic education and counseling follow-up in a
professional manner.
MNL Learning Outcome:
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
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in 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: Evaluation
Learning Outcome: 3. Describe the significance of delivering genetic education and counseling follow-up in a
professional manner.
MNL Learning Outcome:
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.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in 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: 3. Describe the significance of delivering genetic education and counseling follow-up in a
professional manner.
MNL Learning Outcome:
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.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.”
Cognitive Level: Applying
Client Need: Psychosocial Integrity
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
Nursing/Integrated Concepts: Nursing Process: Implementation
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.
MNL Learning Outcome:
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.”
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
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.
Cognitive Level: Applying
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
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
Nursing/Integrated Concepts: Nursing Process: Implementation
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.
MNL Learning Outcome:
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.
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Monticello, December 13, 1818.
I thank your Excellency for the notice with which your letters favor
me, of the liberation of France from the occupation of the allied
powers. To no one, not a native, will it give more pleasure. In the
desolation of Europe, to gratify the atrocious caprices of Bonaparte,
France sinned much; but she has suffered more than retaliation.
Once relieved from the incubus of her late oppression, she will rise
like a giant from her slumbers. Her soil and climate, her arts and
eminent sciences, her central position and free constitution, will soon
make her greater than she ever was. And I am a false prophet, if
she does not at some future day, remind of her sufferings those who
have inflicted them the most eagerly. I hope, however, she will be
quiet for the present, and risk no new troubles. Her constitution, as
now amended, gives as much of self-government as perhaps she
can yet bear, and will give more, when the habits of order shall have
prepared her to receive more. Besides the gratitude which every
American owes her, as our sole ally during the war of independence,
I am additionally affectioned by the friendships I contracted there,
by the good dispositions I witnessed, and by the courtesies I
received.
I rejoice, as a moralist, at the prospect of a reduction of the duties
on wine, by our national legislature. It is an error to view a tax on
that liquor as merely a tax on the rich. It is a prohibition of its use to
the middling class of our citizens, and a condemnation of them to
the poison of whiskey, which is desolating their houses. No nation is
drunken where wine is cheap; and none sober, where the dearness
of wine substitutes ardent spirits as the common beverage. It is, in
truth, the only antidote to the bane of whiskey. Fix but the duty at
the rate of other merchandise, and we can drink wine here as cheap
as we do grog; and who will not prefer it? Its extended use will carry
health and comfort to a much enlarged circle. Every one in easy
circumstances (as the bulk of our citizens are) will prefer it to the
poison to which they are now driven by their government. And the
treasury itself will find that a penny a piece from a dozen, is more
than a groat from a single one. This reformation, however, will
require time. Our merchants know nothing of the infinite variety of
cheap and good wines to be had in Europe; and particularly in
France, in Italy, and the Græcian islands; as they know little also, of
the variety of excellent manufactures and comforts to be had
anywhere out of England. Nor will these things be known, nor of
course called for here, until the native merchants of those countries,
to whom they are known, shall bring them forward, exhibit and vend
them at the moderate profits they can afford. This alone will procure
them familiarity with us, and the preference they merit in
competition with corresponding articles now in use.
Our family renew with pleasure their recollections of your kind visit
to Monticello, and join me in tendering sincere assurances of the
gratification it afforded us, and of our great esteem and respectful
consideration.
TO NATHANIEL MACON, ESQ.
Monticello, January 12, 1819.
Dear Sir,—The problem you had wished to propose to me was one
which I could not have solved; for I knew nothing of the facts. I
read no newspaper now but Ritchie's, and in that chiefly the
advertisements, for they contain the only truths to be relied on in a
newspaper. I feel a much greater interest in knowing what has
passed two or three thousand years ago, than in what is now
passing. I read nothing, therefore, but of the heroes of Troy, of the
wars of Lacedæmon and Athens, of Pompey and Cæsar, and of
Augustus too, the Bonaparte and parricide scoundrel of that day. I
have had, and still have, such entire confidence in the late and
present Presidents, that I willingly put both soul and body into their
pockets. While such men as yourself and your worthy colleagues of
the legislature, and such characters as compose the executive
administration, are watching for us all, I slumber without fear, and
review in my dreams the visions of antiquity. There is, indeed, one
evil which awakens me at times, because it jostles me at every turn.
It is that we have now no measure of value. I am asked eighteen
dollars for a yard of broadcloth, which, when we had dollars, I used
to get for eighteen shillings; from this I can only understand that a
dollar is now worth but two inches of broadcloth, but broadcloth is
no standard of measure or value. I do not know, therefore,
whereabouts I stand in the scale of property, nor what to ask, or
what to give for it. I saw, indeed, the like machinery in action in the
years '80 and '81, and without dissatisfaction; because in wearing
out, it was working out our salvation. But I see nothing in this
renewal of the game of "Robin's alive" but a general demoralization
of the nation, a filching from industry its honest earnings, wherewith
to build up palaces, and raise gambling stock for swindlers and
shavers, who are too close to their career of piracies by fraudulent
bankruptcies. My dependence for a remedy, however, is with the
wisdom which grows with time and suffering. Whether the
succeeding generation is to be more virtuous than their
predecessors, I cannot say; but I am sure they will have more
worldly wisdom, and enough, I hope, to know that honesty is the
first chapter in the book of wisdom. I have made a great exertion to
write you thus much; my antipathy to taking up a pen being so
intense that I have never given you a stronger proof, than in the
effort of writing a letter, how much I value you, and of the
superlative respect and friendship with which I salute you.
TO MR. ADAMS.
Monticello, March 21, 1819.
Dear Sir,—I am indebted to you for Mr. Bowditch's very learned
mathematical papers, the calculations of which are not for every
reader, although their results are readily enough understood. One of
these impairs the confidence I had reposed in La Place's
demonstration, that the eccentricities of the planets of our system
could oscillate only within narrow limits, and therefore could
authorize no inference that the system must, by its own laws, come
one day to an end. This would have left the question one of
infinitude, at both ends of the line of time, clear of physical
authority.
Mr. Pickering's pamphlet on the pronunciation of the Greek, for
which I am indebted to you also, I have read with great pleasure.
Early in life, the idea occurred to me that the people now inhabiting
the ancient seats of the Greeks and Romans, although their
languages in the intermediate ages had suffered great changes, and
especially in the declension of their nouns, and in the terminations of
their words generally, yet having preserved the body of the word
radically the same, so they would preserve more of its pronunciation.
That at least it was probable that a pronunciation, handed down by
tradition, would retain, as the words themselves do, more of the
original than that of any other people whose language has no
affinity to that original. For this reason I learnt, and have used the
Italian pronunciation of the Latin. But that of the modern Greeks I
had no opportunity of learning until I went to Paris. There I became
acquainted with two learned Greeks, Count Carberri and Mr.
Paradise, and with a lady, a native Greek, the daughter of Baron de
Tott, who did not understand the ancient language. Carberri and
Paradise spoke it. From these instructors I learnt the modern
pronunciation, and in general trusted to its orthodoxy. I say, in
general, because sound being more fugitive than the written letter,
we must, after such a lapse of time, presume in it some
degeneracies, as we see there are in the written words. We may not,
indeed, be able to put our finger on them confidently, yet neither are
they entirely beyond the reach of all indication. For example, in a
language so remarkable for the euphony of its sounds, if that
euphony is preserved in particular combinations of its letters, by an
adherence to the powers ordinarily ascribed to them, and is
destroyed by a change of these powers, and the sound of the word
thereby rendered harsh, inharmonious, and inidiomatical, here we
may presume some degeneracy has taken place. While, therefore, I
gave in to the modern pronunciation generally, I have presumed, as
an instance of degeneracy, their ascribing the same sound to the six
letters, or combinations of letters, ε, ι, υ, ει, οι, υι, to all of which
they give the sound of our double e in the word meet. This useless
equivalence of three vowels and three diphthongs, did not probably
exist among the ancient Greeks; and the less probably as, while this
single sound, ee, is overcharged by so many different representative
characters, the sounds we usually give to these characters and
combinations would be left without any representative signs. This
would imply either that they had not these sounds in their language,
or no signs for their expression. Probability appears to me, therefore,
against the practice of the modern Greeks of giving the same sound
to all these different representatives, and to be in favor of that of
foreign nations, who, adopting the Roman characters, have
assimilated to them, in a considerable degree, the powers of the
corresponding Greek letters. I have, accordingly, excepted this in my
adoption of the modern pronunciation. I have been more doubtful in
the use of the αυ, ευ, ηυ, ωυ, sounding the υ, upsilon, as our f or v,
because I find traces of that power of υ, or of v, in some modern
languages. To go no further than our own, we have it in laugh,
cough, trough, enough. The county of Louisa, adjacent to that in
which I live, was, when I was a boy, universally pronounced Lovisa.
That it is not the gh which gives the sound of f or v, in these words,
is proved by the orthography of plough, trough, thought, fraught,
caught. The modern Greeks themselves, too, giving up υ, upsilon, in
ordinary, the sound of our ee, strengthens the presumption that its
anomalous sound of f or v, is a corruption. The same may be
inferred from the cacophony of ελαφνε (elavne) for ελαυνε,
(elawne,) Αχιλλεφς (Achillefs) for Αχιλλευς, (Achilleise,) εφς (eves)
for εϋς, (eeuse,) οφκ (ovk) for ouk, (ouk,) ωφτος (ovetos) for
ωϋτος, (o-u-tos,) Ζεφς (zevs) for Ζευς (zese,) of which all nations
have made their Jupiter; and the uselessness of the υ in ευφωνια
which would otherwise have been spelt εφωνια. I therefore except
this also from what I consider as approvable pronunciation.
Against reading Greek by accent, instead of quantity, as Mr. Ciceitira
proposes, I raise both my hands. What becomes of the sublime
measure of Homer, the full sounding rhythm of Demosthenes, if,
abandoning quantity, you chop it up by accent? What ear can
hesitate in its choice between the two following rhythms?
"Τὸν, δ' απαμειβὸμενος προσεφὴ πόδας ωκὺς Αχιλλευς,
and,
Τον, δ' απαμειβομενός προσεφὴ ποδας ώκυς Αχίλλευς,"
the latter noted according to prosody, the former by accent, and
dislocating our teeth in its utterance; every syllable of it, except the
first and last, being pronounced against quantity. And what becomes
of the art of prosody? Is that perfect coincidence of its rules with the
structure of their verse, merely accidental? or was it of design, and
yet for no use.
On the whole, I rejoice that this subject is taken up among us, and
that it is in so able hands as those of Mr. Pickering. Should he
ultimately establish the modern pronunciation of the letters without
any exception, I shall think it a great step gained, and giving up my
exceptions, shall willingly rally to him; and as he has promised us
another paper on the question whether we shall read by quantity or
by accent, I can confidently trust it to the correctness of his learning
and judgment. Of the origin of accentuation, I have never seen
satisfactory proofs. But I have generally supposed the accents were
intended to direct the inflections and modulations of the voice; but
not to affect the quantity of the syllables. You did not expect, I am
sure, to draw on yourself so long a disquisition on letters and
sounds, nor did I intend it, but the subject run before me, and yet I
have dropped much of it by the way.
I am delighted with your high approbation of Mr. Tracy's book. The
evils of this deluge of paper money are not to be removed, until our
citizens are generally and radically instructed in their cause and
consequences, and silence by their authority the interested clamors
and sophistry of speculating, shaving, and banking institutions. Till
then we must be content to return, quod hoc, to the savage state, to
recur to barter in the exchange of our property, for want of a stable,
common measure of value, that now in use being less fixed than the
beads and wampum of the Indian, and to deliver up our citizens,
their property and their labor, passive victims to the swindling tricks
of bankers and mountebankers. If I had your permission to put your
letter into the hands of the editor, (Milligan,) with or without any
verbal alterations you might choose, it would ensure the general
circulation, which my prospectus and prefatory letter will less
effectually recommend. There is nothing in the book of mine but
these two articles, and the note on taxation in page 202. I never
knew who the translator was; but I thought him some one who
understood neither French nor English; and probably a Caledonian,
from the number of Scotticisms I found in his MS. The innumerable
corrections in that, cost me more labor than would have done a
translation of the whole de novo; and made at last but an inelegant
although faithful version of the sense of the author. Dios guarde á V.
S. muchos años.
TO DOCTOR VINE UTLEY.
Monticello, March 21, 1819.
Sir,—Your letter of February the 18th came to hand on the 1st
instant; and the request of the history of my physical habits would
have puzzled me not a little, had it not been for the model with
which you accompanied it, of Doctor Rush's answer to a similar
inquiry. I live so much like other people, that I might refer to
ordinary life as the history of my own. Like my friend the Doctor, I
have lived temperately, eating little animal food, and that not as an
aliment, so much as a condiment for the vegetables, which
constitute my principal diet. I double, however, the Doctor's glass
and a half of wine, and even treble it with a friend; but halve its
effects by drinking the weak wines only. The ardent wines I cannot
drink, nor do I use ardent spirits in any form. Malt liquors and cider
are my table drinks, and my breakfast, like that also of my friend, is
of tea and coffee. I have been blest with organs of digestion which
accept and concoct, without ever murmuring, whatever the palate
chooses to consign to them, and I have not yet lost a tooth by age. I
was a hard student until I entered on the business of life, the duties
of which leave no idle time to those disposed to fulfil them; and
now, retired, and at the age of seventy-six, I am again a hard
student. Indeed, my fondness for reading and study revolts me from
the drudgery of letter writing. And a stiff wrist, the consequence of
an early dislocation, makes writing both slow and painful. I am not
so regular in my sleep as the Doctor says he was, devoting to it from
five to eight hours, according as my company or the book I am
reading interests me; and I never go to bed without an hour, or half
hour's previous reading of something moral, whereon to ruminate in
the intervals of sleep. But whether I retire to bed early or late, I rise
with the sun. I use spectacles at night, but not necessarily in the
day, unless in reading small print. My hearing is distinct in particular
conversation, but confused when several voices cross each other,
which unfits me for the society of the table. I have been more
fortunate than my friend in the article of health. So free from
catarrhs that I have not had one, (in the breast, I mean) on an
average of eight or ten years through life. I ascribe this exemption
partly to the habit of bathing my feet in cold water every morning,
for sixty years past. A fever of more than twenty-four hours I have
not had above two or three times in my life. A periodical headache
has afflicted me occasionally, once, perhaps, in six or eight years, for
two or three weeks at a time, which seems now to have left me; and
except on a late occasion of indisposition, I enjoy good health; too
feeble, indeed, to walk much, but riding without fatigue six or eight
miles a day, and sometimes thirty or forty. I may end these
egotisms, therefore, as I began, by saying that my life has been so
much like that of other people, that I might say with Horace, to
every one "nomine mutato, narratur fabula de te." I must not end,
however, without due thanks for the kind sentiments of regard you
are so good as to express towards myself; and with my
acknowledgments for these, be pleased to accept the assurances of
my respect and esteem.
TO MR. SPAFFORD.
Monticello, May 11, 1819.
Dear Sir,—The interest on the late derangement of my health which
was so kindly expressed by many, could not but be gratifying to me,
as much as it manifested a sentiment that I had not been merely an
useless cypher of society. Yet a decline of health at the age of 76,
was naturally to be expected, and is a warning of an event which
cannot be distant, and whose approach I contemplate with little
concern; for indeed, in no circumstance has nature been kinder to
us, than in the soft gradations by which she prepares us to part
willingly with what we are not destined always to retain. First one
faculty is withdrawn and then another, sight, hearing, memory,
affections, and friends, filched one by one, till we are left among
strangers, the mere monuments of times, facts, and specimens of
antiquity for the observation of the curious.
To your request of materials for writing my life, I know not what to
say, although I have been obliged to say something to several
preceding applications of the same kind. One answer indeed is
obvious, that I am by decay of memory, aversion to labor, and cares
more suited to my situation, unequal to such a task. Of the public
transactions in which I have borne a part, I have kept no narrative
with a view of history. A life of constant action leaves no time for
recording. Always thinking of what is next to be done, what has
been done is dismissed, and soon obliterated from the memory. I
cannot be insensible to the partiality which has induced several
persons to think my life worthy of remembrance. And towards none
more than yourself, who give me so much credit more than I am
entitled to, as to what has been effected for the safeguard of our
republican constitution. Numerous and able coadjutors have
participated in these efforts, and merit equal notice. My life, in fact,
has been so much like that of others, that their history is my history,
with a mere difference of feature. The only valuable materials for
history which I possessed, were the pamphlets of the day, carefully
collected and preserved; but these past on to Congress with my
library, and are to be found in their depository. Except the Notes on
Virginia, I never wrote anything but acts of office, of which I rarely
kept a copy. These will all be found in the journals and gazettes of
the times. There was a book published in England about 1801, or
soon after, entitled "Public Characters," in which was given a sketch
of my history to that period. I never knew, nor could conjecture by
whom this was written; but certainly by some one pretty intimately
acquainted with myself and my connections. There were a few
inconsiderable errors in it, but in general it was correct. Delaplaine,
in his Repository, has also given some outlines on the same subject;
he sets out indeed with an error as to the county of my birth.
Chesterfield, which he states as such, was the residence of my
grandfather and remoter ancestors, but Albemarle was that of my
father, and of my own birth and residence. Excepting this error, I
remark no other but in his ascriptions of more merit than I have
deserved. Girardin's History of Virginia, too, gives many particulars
on the same subject, which are correct. These publications furnish
all the details of facts and dates which can interest anybody, and
more than I could now furnish myself from a decayed memory, or
any notes I retain. While, therefore, I feel just acknowledgments for
the partial selection of a subject for your employment, I am
persuaded you will perceive there is too little new and worthy of
public notice to devote to it a time which may be so much more
usefully employed; and with a due sense of the partiality of your
friendship, I salute you with assurances of the greatest esteem and
respect.
TO S. A. WELLS, ESQ.
Monticello, May 12, 1819.
Sir,—An absence of some time at an occasional and distant
residence must apologize for the delay in acknowledging the receipt
of your favor of April 12th. And candor obliges me to add that it has
been somewhat extended by an aversion to writing, as well as to
calls on my memory for facts so much obliterated from it by time as
to lessen my confidence in the traces which seem to remain. One of
the inquiries in your letter, however, may be answered without an
appeal to the memory. It is that respecting the question whether
committees of correspondence originated in Virginia or
Massachusetts? On which you suppose me to have claimed it for
Virginia. But certainly I have never made such a claim. The idea, I
suppose, has been taken up from what is said in Wirt's history of Mr.
Henry, p. 87, and from an inexact attention to its precise terms. It is
there said "this house [of burgesses of Virginia] had the merit of
originating that powerful engine of resistance, corresponding
committees between the legislatures of the different colonies." That
the fact as here expressed is true, your letter bears witness when it
says that the resolutions of Virginia for this purpose were
transmitted to the speakers of the different Assemblies, and by that
of Massachusetts was laid at the next session before that body, who
appointed a committee for the specified object: adding, "thus in
Massachusetts there were two committees of correspondence, one
chosen by the people, the other appointed by the House of
Assembly; in the former, Massachusetts preceded Virginia; in the
latter, Virginia preceded Massachusetts." To the origination of
committees for the interior correspondence between the counties
and towns of a State, I know of no claim on the part of Virginia; but
certainly none was ever made by myself. I perceive, however, one
error into which memory had led me. Our committee for national
correspondence was appointed in March, '73, and I well remember
that going to Williamsburg in the month of June following, Peyton
Randolph, our chairman, told me that messengers, bearing
despatches between the two States, had crossed each other by the
way; that of Virginia carrying our propositions for a committee of
national correspondence, and that of Massachusetts bringing, as my
memory suggested, a similar proposition. But here I must have
misremembered; and the resolutions brought us from Massachusetts
were probably those you mention of the town meeting of Boston, on
the motion of Mr. Samuel Adams, appointing a committee "to state
the rights of the colonists, and of that province in particular, and the
infringements of them, to communicate them to the several towns,
as the sense of the town of Boston, and to request of each town a
free communication of its sentiments on this subject"? I suppose,
therefore, that these resolutions were not received, as you think,
while the House of Burgesses was in session in March, 1773; but a
few days after we rose, and were probably what was sent by the
messenger who crossed ours by the way. They may, however, have
been still different. I must therefore have been mistaken in
supposing and stating to Mr. Wirt, that the proposition of a
committee for national correspondence was nearly simultaneous in
Virginia and Massachusetts.
A similar misapprehension of another passage in Mr. Wirt's book, for
which I am also quoted, has produced a similar reclamation of the
part of Massachusetts by some of her most distinguished and
estimable citizens. I had been applied to by Mr. Wirt for such facts
respecting Mr. Henry, as my intimacy with him, and participation in
the transactions of the day, might have placed within my knowledge.
I accordingly committed them to paper, and Virginia being the
theatre of his action, was the only subject within my contemplation,
while speaking of him. Of the resolutions and measures here, in
which he had the acknowledged lead, I used the expression that "Mr.
Henry certainly gave the first impulse to the ball of revolution."
[Wirt, p. 41.] The expression is indeed general, and in all its
extension would comprehend all the sister States. But indulgent
construction would restrain it, as was really meant, to the subject
matter under contemplation, which was Virginia alone; according to
the rule of the lawyers, and a fair canon of general criticism, that
every expression should be construed secundum subjectam
materiem. Where the first attack was made, there must have been
of course, the first act of resistance, and that was of Massachusetts.
Our first overt act of war was Mr. Henry's embodying a force of
militia from several counties, regularly armed and organized,
marching them in military array, and making reprisal on the King's
treasury at the seat of government for the public powder taken away
by his Governor. This was on the last days of April, 1775. Your
formal battle of Lexington was ten or twelve days before that, which
greatly overshadowed in importance, as it preceded in time our little
affray, which merely amounted to a levying of arms against the King,
and very possibly you had had military affrays before the regular
battle of Lexington.
These explanations will, I hope, assure you, Sir, that so far as either
facts or opinions have been truly quoted from me, they have never
been meant to intercept the just fame of Massachusetts, for the
promptitude and perseverance of her early resistance. We willingly
cede to her the laud of having been (although not exclusively) "the
cradle of sound principles," and if some of us believe she has
deflected from them in her course, we retain full confidence in her
ultimate return to them.
I will now proceed to your quotation from Mr. Galloway's statements
of what passed in Congress on their declaration of independence, in
which statement there is not one word of truth, and where, bearing
some resemblance to truth, it is an entire perversion of it. I do not
charge this on Mr. Galloway himself; his desertion having taken place
long before these measures, he doubtless received his information
from some of the loyal friends whom he left behind him. But as
yourself, as well as others, appear embarrassed by inconsistent
accounts of the proceedings on that memorable occasion, and as
those who have endeavored to restore the truth have themselves
committed some errors, I will give you some extracts from a written
document on that subject, for the truth of which I pledge myself to
heaven and earth; having, while the question of independence was
under consideration before Congress, taken written notes, in my
seat, of what was passing, and reduced them to form on the final
conclusion. I have now before me that paper, from which the
following are extracts:
"On Friday the 7th of June, 1776, the delegates from Virginia
moved, in obedience to instructions from their constituents, that the
Congress should declare that these united colonies are, and of right
ought to be, free and independent States; that they are absolved
from all allegiance to the British crown, and that all political
connection between them and the State of Great Britain is, and
ought to be totally dissolved; that measures should be immediately
taken for procuring the assistance of foreign powers, and a
confederation be formed to bind the colonies more closely together.
The house being obliged to attend at that time to some other
business, the proposition was referred to the next day, when the
members were ordered to attend punctually at ten o'clock. Saturday,
June 8th, they proceeded to take it into consideration, and referred
it to a committee of the whole, into which they immediately resolved
themselves, and passed that day and Monday the 10th in debating
on the subject.
"It appearing in the course of these debates, that the colonies of
New York, New Jersey, Pennsylvania, Delaware, Maryland, and South
Carolina were not yet matured for falling from the parent stem, but
that they were fast advancing to that state, it was thought most
prudent to wait awhile for them, and to postpone the final decision
to July 1st. But that this might occasion as little delay as possible, a
committee was appointed to prepare a Declaration of Independence.
The committee were J. Adams, Dr. Franklin, Roger Sherman, Robert
R. Livingston and myself. This was reported to the House on Friday
the 28th of June, when it was read and ordered to lie on the table.
On Monday the 1st of July the House resolved itself into a committee
of the whole, and resumed the consideration of the original motion
made by the delegates of Virginia, which being again debated
through the day, was carried in the affirmative by the votes of New
Hampshire, Connecticut, Massachusetts, Rhode Island, New Jersey,
Maryland, Virginia, North Carolina and Georgia. South Carolina and
Pennsylvania] voted against it. Delaware having but two members
present, they were divided. The delegates for New York declared
they were for it themselves, and were assured their constituents
were for it; but that their instructions having been drawn near a
twelvemonth before, when reconciliation was still the general object,
they were enjoined by them to do nothing which should impede that
object. They therefore thought themselves not justifiable in voting
on either side, and asked leave to withdraw from the question,
which was given them. The Committee rose and reported their
resolution to the House. Mr. Rutledge of South Carolina, then
requested the determination might be put off to the next day, as he
believed his colleagues, though they disapproved of the resolution,
would then join in it for the sake of unanimity. The ultimate question
whether the House would agree to the resolution of the committee
was accordingly postponed to the next day, when it was again
moved, and South Carolina concurred in voting for it; in the
meantime a third member had come post from the Delaware
counties, and turned the vote of that colony in favor of the
resolution. Members of a different sentiment attending that morning
from Pennsylvania also, their vote was changed; so that the whole
twelve colonies, who were authorized to vote at all, gave their votes
for it; and within a few days, [July 9th,] the convention of New York
approved of it, and thus supplied the void occasioned by the
withdrawing of their delegates from the vote." [Be careful to observe
that this vacillation and vote was on the original motion of the 7th of
June by the Virginia delegates, that Congress should declare the
colonies independent.]
"Congress proceeded the same day to consider the Declaration of
Independence, which has been reported and laid on the table the
Friday preceding, and on Monday referred to a committee of the
whole. The pusillanimous idea that we had friends in England worth
keeping terms with, still haunted the minds of many. For this reason
those passages which conveyed censures on the people of England
were struck out, lest they give them offence. The debates having
taken up the greater parts of the 2d, 3d and 4th days of July, were,
in the evening of the last, closed. The declaration was reported by
the committee, agreed to by the House, and signed by every
member present except Mr. Dickinson." So far my notes.
Governor McKean, in his letter to McCorkle of July 16th, 1817, has
thrown some lights on the transactions of that day, but trusting to
his memory chiefly at an age when our memories are not to be
trusted, he has confounded two questions, and ascribed proceedings
to one which belonged to the other. These two questions were, 1.
The Virginia motion of June 7th to declare independence, and 2. The
actual declaration, its matter and form. Thus he states the question
on the declaration itself as decided on the 1st of July. But it was the
Virginia motion which was voted on that day in committee of the
whole; South Carolina, as well as Pennsylvania, then voting against
it. But the ultimate decision in the House on the report of the
committee being by request postponed to the next morning, all the
States voted for it, except New York, whose vote was delayed for the
reason before stated. It was not till the 2d of July that the
declaration itself was taken up, nor till the 4th that it was decided;
and it was signed by every member present, except Mr. Dickinson.
The subsequent signatures of members who were not then present,
and some of them not yet in office, is easily explained, if we observe
who they were; to wit, that they were of New York and
Pennsylvania. New York did not sign till the 15th, because it was not
till the 9th, (five days after the general signature,) that their
convention authorized them to do so. The convention of
Pennsylvania, learning that it had been signed by a minority only of
their delegates, named a new delegation on the 20th, leaving out
Mr. Dickinson, who had refused to sign. Willing and Humphreys who
had withdrawn, reappointing the three members who had signed,
Morris who had not been present, and five new ones, to wit, Rush,
Clymer, Smith, Taylor and Ross; and Morris and the five new
members were permitted to sign, because it manifested the assent
of their full delegation, and the express will of their convention,
which might have been doubted on the former signature of a
minority only. Why the signature of Thornton of New Hampshire was
permitted so late as the 4th of November, I cannot now say; but
undoubtedly for some particular reason which we should find to
have been good, had it been expressed. These were the only post-
signers, and you see, Sir, that there were solid reasons for receiving
those of New York and Pennsylvania, and that this circumstance in
no wise affects the faith of this declaratory charter of our rights, and
of the rights of man.
With a view to correct errors of fact before they become inveterate
by repetition, I have stated what I find essentially material in my
papers; but with that brevity which the labor of writing constrains
me to use.
On the fourth particular articles of inquiry in your letter, respecting
your grandfather, the venerable Samuel Adams, neither memory nor
memorandums enable me to give any information. I can say that he
was truly a great man, wise in council, fertile in resources,
immovable in his purposes, and had, I think, a greater share than
any other member, in advising and directing our measures, in the
northern war especially. As a speaker he could not be compared with
his living colleague and namesake, whose deep conceptions, nervous
style, and undaunted firmness, made him truly our bulwark in
debate. But Mr. Samuel Adams, although not of fluent elocution, was
so rigorously logical, so clear in his views, abundant in good sense,
and master always of his subject, that he commanded the most
profound attention whenever he rose in an assembly by which the
froth of declamation was heard with the most sovereign contempt. I
sincerely rejoice that the record of his worth is to be undertaken by
one so much disposed as you will be to hand him down fairly to that
posterity for whose liberty and happiness he was so zealous a
laborer.
With sentiments of sincere veneration for his memory, accept
yourself this tribute to it with the assurances of my great respect.
P. S. August 6th, 1822, since the date of this letter, to wit, this day,
August 6th, '22, I received the new publication of the secret Journals
of Congress, wherein is stated a resolution, July 19th, 1776, that the
declaration passed on the 4th be fairly engrossed on parchment, and
when engrossed, be signed by every member; and another of
August 2d, that being engrossed and compared at the table, was
signed by the members. That is to say the copy engrossed on
parchment (for durability) was signed by the members after being
compared at the table with the original one, signed on paper as
before stated. I add this P. S. to the copy of my letter to Mr. Wells, to
prevent confounding the signature of the original with that of the
copy engrossed on parchment.
TO EZRA STYLES, ESQ.
Monticello, June 25, 1819.
Your favor, Sir, of the 14th, has been duly received, and with it the
book you were so kind as to forward to me. For this mark of
attention, be pleased to accept my thanks. The science of the
human mind is curious, but is one on which I have not indulged
myself in much speculation. The times in which I have lived, and the
scenes in which I have been engaged, have required me to keep the
mind too much in action to have leisure to study minutely its laws of
action. I am therefore little qualified to give an opinion on the
comparative worth of books on that subject, and little disposed to do
it on any book. Yours has brought the science within a small
compass, and that is the merit of the first order; and especially with
one to whom the drudgery of letter writing often denies the leisure
of reading a single page in a week. On looking over the summary of
the contents of your book, it does not seem likely to bring into
collision any of those sectarian differences which you suppose may
exist between us. In that branch of religion which regards the
moralities of life, and the duties of a social being, which teaches us
to love our neighbors as ourselves, and to do good to all men, I am
sure that you and I do not differ. We probably differ in the dogmas
of theology, the foundation of all sectarianism, and on which no two
sects dream alike; for if they did they would then be of the same.
You say you are a Calvinist. I am not. I am of a sect by myself, as far
as I know. I am not a Jew, and therefore do not adopt their
theology, which supposes the God of infinite justice to punish the
sins of the fathers upon their children, unto the third and fourth
generation; and the benevolent and sublime reformer of that religion
has told us only that God is good and perfect, but has not defined
him. I am, therefore, of his theology, believing that we have neither
words nor ideas adequate to that definition. And if we could all, after
this example, leave the subject as undefinable, we should all be of
one sect, doers of good, and eschewers of evil. No doctrines of his
lead to schism. It is the speculations of crazy theologists which have
made a Babel of a religion the most moral and sublime ever
preached to man, and calculated to heal, and not to create
differences. These religious animosities I impute to those who call
themselves his ministers, and who engraft their casuistries on the
stock of his simple precepts. I am sometimes more angry with them
than is authorized by the blessed charities which he preaches. To
yourself I pray the acceptance of my great respect.
TO JOHN ADAMS.
Monticello, July 9, 1819.
Dear Sir,—I am in debt to you for your letters of May the 21st, 27th,
and June the 22d. The first, delivered me by Mr. Greenwood, gave
me the gratification of his acquaintance; and a gratification it always
is, to be made acquainted with gentlemen of candor, worth, and
information, as I found Mr. Greenwood to be. That, on the subject of
Mr. Samuel Adams Wells, shall not be forgotten in time and place,
when it can be used to his advantage.
But what has attracted my peculiar notice, is the paper from
Mecklenburg county, of North Carolina, published in the Essex
Register, which you were so kind as to enclose in your last, of June
the 22d. And you seem to think it genuine. I believe it spurious. I
deem it to be a very unjustifiable quiz, like that of the volcano, so
minutely related to us as having broken out in North Carolina, some
half a dozen years ago, in that part of the country, and perhaps in
that very county of Mecklenburg, for I do not remember its precise
locality. If this paper be really taken from the Raleigh Register, as
quoted, I wonder it should have escaped Ritchie, who culls what is
good from every paper, as the bee from every flower; and the
National Intelligencer, too, which is edited by a North Carolinian; and
that the fire should blaze out all at once in Essex, one thousand
miles from where the spark is said to have fallen. But if really taken
from the Raleigh Register, who is the narrator, and is the name
subscribed real, or is it as fictitious as the paper itself? It appeals,
too, to an original book, which is burnt, to Mr. Alexander, who is
dead, to a joint letter from Caswell, Hughes, and Hooper, all dead, to
a copy sent to the dead Caswell, and another sent to Doctor
Williamson, now probably dead, whose memory did not recollect, in
the history he has written of North Carolina, this gigantic step of its
county of Mecklenberg. Horry, too, is silent in his history of Marion,
whose scene of action was the country bordering on Mecklenburg.
Ramsay, Marshall, Jones, Girardin, Wirt, historians of the adjacent
States, all silent. When Mr. Henry's resolutions, far short of
independence, flew like lightning through every paper, and kindled
both sides of the Atlantic, this flaming declaration of the same date,
of the independence of Mecklenburg county, of North Carolina,
absolving it from the British allegiance, and abjuring all political
connection with that nation, although sent to Congress too, is never
heard of. It is not known even a twelvemonth after, when a similar
proposition is first made in that body. Armed with this bold example,
would not you have addressed our timid brethren in peals of thunder
on their tardy fears? Would not every advocate of independence
have rung the glories of Mecklenberg county in North Carolina, in
the ears of the doubting Dickinson and others, who hung so heavily
on us? Yet the example of independent Mecklenberg county, in North
Carolina, was never once quoted. The paper speaks, too, of the
continued exertions of their delegation (Caswell, Hooper, Hughes) "in
the cause of liberty and independence." Now you remember as well
as I do, that we had not a greater tory in Congress than Hooper;
that Hughes was very wavering, sometimes firm, sometimes feeble,
according as the day was clear or cloudy; that Caswell, indeed, was
a good whig, and kept these gentlemen to the notch, while he was
present; but that he left us soon, and their line of conduct became
then uncertain until Penn came, who fixed Hughes and the vote of
the State. I must not be understood as suggesting any doubtfulness
in the State of North Carolina. No State was more fixed or forward.
Nor do I affirm, positively, that this paper is a fabrication; because
the proof of a negative can only be presumptive. But I shall believe
it such until positive and solemn proof of its authenticity be
produced. And if the name of McKnitt be real, and not a part of the
fabrication, it needs a vindication by the production of such proof.
For the present, I must be an unbeliever in the apocryphal gospel.
I am glad to learn that Mr. Ticknor has safely returned to his friends;
but should have been much more pleased had he accepted the
Professorship in our University, which we should have offered him in
form. Mr. Bowditch, too, refuses us; so fascinating is the vinculum of
the dulce natale solum. Our wish is to procure natives, where they
can be found, like these gentlemen, of the first order of requirement
in their respective lines; but preferring foreigners of the first order to
natives of the second, we shall certainly have to go for several of our
Professors, to countries more advanced in science than we are.
I set out within three or four days for my other home, the distance
of which, and its cross mails, are great impediments to epistolary
communications. I shall remain there about two months; and there,
here, and everywhere, I am and shall always be, affectionately and
respectfully yours.
TO JOHN BRAZIER, THE AUTHOR OF THE REVIEW OF
PICKERING ON GREEK PRONUNCIATION.
Poplar Forest, August 24, 1819.
Sir,—The acknowledgment of your favor of July 15th, and thanks for
the Review which it covered of Mr. Pickering's Memoir on the Modern
Greek, have been delayed by a visit to an occasional but distant
residence from Monticello, and to an attack here of rheumatism
which is just now moderating. I had been much pleased with the
memoir, and was much also with your review of it. I have little hope
indeed of the recovery of the ancient pronunciation of that finest of
human languages, but still I rejoice at the attention the subject
seems to excite with you, because it is an evidence that our country
begins to have a taste for something more than merely as much
Greek as will pass a candidate for clerical ordination.
You ask my opinion on the extent to which classical learning should
be carried in our country. A sickly condition permits me to think, and
a rheumatic hand to write too briefly on this litigated question. The
utilities we derive from the remains of the Greek and Latin
languages are, first, as models of pure taste in writing. To these we
are certainly indebted for the national and chaste style of modern
composition which so much distinguishes the nations to whom these
languages are familiar. Without these models we should probably
have continued the inflated style of our northern ancestors, or the
hyperbolical and vague one of the east. Second. Among the values
of classical learning, I estimate the luxury of reading the Greek and
Roman authors in all the beauties of their originals. And why should
not this innocent and elegant luxury take its preëminent stand ahead
of all those addressed merely to the senses? I think myself more
indebted to my father for this than for all the other luxuries his cares
and affections have placed within my reach; and more now than
when younger, and more susceptible of delights from other sources.
When the decays of age have enfeebled the useful energies of the
mind, the classic pages fill up the vacuum of ennui, and become
sweet composers to that rest of the grave into which we are all
sooner or later to descend. Third. A third value is in the stores of
real science deposited and transmitted us in these languages, to-wit:
in history, ethics, arithmetic, geometry, astronomy, natural history,
&c.
But to whom are these things useful? Certainly not to all men. There
are conditions of life to which they must be forever estranged, and
there are epochs of life too, after which the endeavor to attain them
would be a great misemployment of time. Their acquisition should
be the occupation of our early years only, when the memory is
susceptible of deep and lasting impressions, and reason and
judgment not yet strong enough for abstract speculations. To the
moralist they are valuable, because they furnish ethical writings
highly and justly esteemed: although in my own opinion, the
moderns are far advanced beyond them in this line of science, the
divine finds in the Greek language a translation of his primary code,
of more importance to him than the original because better
understood; and, in the same language, the newer code, with the
doctrines of the earliest fathers, who lived and wrote before the
simple precepts of the founder of this most benign and pure of all
systems of morality became frittered into subtleties and mysteries,
and hidden under jargons incomprehensible to the human mind. To
these original sources he must now, therefore, return, to recover the
virgin purity of his religion. The lawyer finds in the Latin language
the system of civil law most conformable with the principles of
justice of any which has ever yet been established among men, and
from which much has been incorporated into our own. The physician
as good a code of his art as has been given us to this day. Theories
and systems of medicine, indeed, have been in perpetual change
from the days of the good Hippocrates to the days of the good Rush,
but which of them is the true one? the present, to be sure, as long
as it is the present, but to yield its place in turn to the next novelty,
which is then to become the true system, and is to mark the vast
advance of medicine since the days of Hippocrates. Our situation is
certainly benefited by the discovery of some new and very valuable
medicines; and substituting those for some of his with the treasure
of facts, and of sound observations recorded by him (mixed to be
sure with anilities of his day) and we shall have nearly the present
sum of the healing art. The statesman will find in these languages
history, politics, mathematics, ethics, eloquence, love of country, to
which he must add the sciences of his own day, for which of them
should be unknown to him? And all the sciences must recur to the
classical languages for the etymon, and sound understanding of their
fundamental terms. For the merchant I should not say that the
languages are a necessary. Ethics, mathematics, geography, political
economy, history, seem to constitute the immediate foundations of
his calling. The agriculturist needs ethics, mathematics, chemistry
and natural philosophy. The mechanic the same. To them the
languages are but ornament and comfort. I know it is often said
there have been shining examples of men of great abilities in all the
businesses of life, without any other science than what they had
gathered from conversations and intercourse with the world. But
who can say what these men would not have been had they started
in the science on the shoulders of a Demosthenes or Cicero, of a
Locke or Bacon, or a Newton? To sum the whole, therefore, it may
truly be said that the classical languages are a solid basis for most,
and an ornament to all the sciences.
I am warned by my aching fingers to close this hasty sketch, and to
place here my last and fondest wishes for the advancement of our
country in the useful sciences and arts, and my assurances of
respect and esteem for the Reviewer of the Memoir on modern
Greek.
TO JUDGE ROANE.
Poplar Forest, September 6, 1819.
Dear Sir,—I had read in the Enquirer, and with great approbation,
the pieces signed Hampden, and have read them again with
redoubled approbation, in the copies you have been so kind as to
send me. I subscribe to every title of them. They contain the true
principles of the revolution of 1800, for that was as real a revolution
in the principles of our government as that of 1776 was in its form;
not effected indeed by the sword, as that, but by the rational and
peaceable instrument of reform, the suffrage of the people. The
nation declared its will by dismissing functionaries of one principle,
and electing those of another, in the two branches, executive and
legislative, submitted to their election. Over the judiciary
department, the constitution had deprived them of their control.
That, therefore, has continued the reprobated system, and although
new matter has been occasionally incorporated into the old, yet the
leaven of the old mass seems to assimilate to itself the new, and
after twenty years' confirmation of the federated system by the voice
of the nation, declared through the medium of elections, we find the
judiciary on every occasion, still driving us into consolidation.
In denying the right they usurp of exclusively explaining the
constitution, I go further than you do, if I understand rightly your
quotation from the Federalist, of an opinion that "the judiciary is the
last resort in relation to the other departments of the government,
but not in relation to the rights of the parties to the compact under
which the judiciary is derived." If this opinion be sound, then indeed
is our constitution a complete felo de se. For intending to establish
three departments, co-ordinate and independent, that they might
check and balance one another, it has given, according to this
opinion, to one of them alone, the right to prescribe rules for the
government of the others, and to that one too, which is unelected
by, and independent of the nation. For experience has already
shown that the impeachment it has provided is not even a scare-
crow; that such opinions as the one you combat, sent cautiously out,
as you observe also, by detachment, not belonging to the case
often, but sought for out of it, as if to rally the public opinion
beforehand to their views, and to indicate the line they are to walk
in, have been so quietly passed over as never to have excited
animadversion, even in a speech of any one of the body entrusted
with impeachment. The constitution, on this hypothesis, is a mere
thing of wax in the hands of the judiciary, which they may twist and
shape into any form they please. It should be remembered, as an
axiom of eternal truth in politics, that whatever power in any
government is independent, is absolute also; in theory only, at first,
while the spirit of the people is up, but in practice, as fast as that
relaxes. Independence can be trusted nowhere but with the people
in mass. They are inherently independent of all but moral law. My
construction of the constitution is very different from that you quote.
It is that each department is truly independent of the others, and
has an equal right to decide for itself what is the meaning of the
constitution in the cases submitted to its action; and especially,
where it is to act ultimately and without appeal. I will explain myself
by examples, which, having occurred while I was in office, are better
known to me, and the principles which governed them.
A legislature had passed the sedition law. The federal courts had
subjected certain individuals to its penalties of fine and
imprisonment. On coming into office, I released these individuals by
the power of pardon committed to executive discretion, which could
never be more properly exercised than where citizens were suffering
without the authority of law, or, which was equivalent, under a law
unauthorized by the constitution, and therefore null. In the case of
Marbury and Madison, the federal judges declared that commissions,
signed and sealed by the President, were valid, although not
delivered. I deemed delivery essential to complete a deed, which, as
long as it remains in the hands of the party, is as yet no need, it is in
posse only, but not in esse, and I withheld delivery of the
commissions. They cannot issue a mandamus to the President or
legislature, or to any of their officers.[3] When the British treaty of
—— arrived, without any provision against the impressment of our
seamen, I determined not to ratify it. The Senate thought I should
ask their advice. I thought that would be a mockery of them, when I
was predetermined against following it, should they advise its
ratification. The constitution had made their advice necessary to
confirm a treaty, but not to reject it. This has been blamed by some;
but I have never doubted its soundness. In the cases of two
persons, antenati, under exactly similar circumstances, the federal
court had determined that one of them (Duane) was not a citizen;
the House of Representatives nevertheless determined that the other
(Smith, of South Carolina) was a citizen, and admitted him to his
seat in their body. Duane was a republican, and Smith a federalist,
and these decisions were made during the federal ascendancy.
These are examples of my position, that each of the three
departments has equally the right to decide for itself what is its duty
under the constitution, without any regard to what the others may
have decided for themselves under a similar question. But you
intimate a wish that my opinion should be known on this subject.
No, dear Sir, I withdraw from all contests of opinion, and resign
everything cheerfully to the generation now in place. They are wiser
than we were, and their successors will be wiser than they, from the
progressive advance of science. Tranquillity is the summum bonum
of age. I wish, therefore, to offend no man's opinion, nor to draw
disquieting animadversions on my own. While duty required it, I met
opposition with a firm and fearless step. But loving mankind in my
individual relations with them, I pray to be permitted to depart in
their peace; and like the superannuated soldier, "quadragenis
stipendiis emeritis," to hang my arms on the post. I have unwisely, I
fear, embarked in an enterprise of great public concern, but not to
be accomplished within my term, without their liberal and prompt
support. A severe illness the last year, and another from which I am
just emerged, admonish me that repetitions may be expected,
against which a declining frame cannot long bear up. I am anxious,
therefore, to get our University so far advanced as may encourage
the public to persevere to its final accomplishment. That secured, I
shall sing my nunc demittas. I hope your labors will be long
continued in the spirit in which they have always been exercised, in
maintenance of those principles on which I verily believe the future
happiness of our country essentially depends. I salute you with
affectionate and great respect.
TO MR. MOORE.
Monticello, September 22, 1819.
I thank you, Sir, for the remarks on the pronunciation of the Greek
language which you have been so kind as to send me. I have read
them with pleasure, as I had the pamphlet of Mr. Pickering on the
same subject. This question has occupied long and learned inquiry,
and cannot, as I apprehend, be ever positively decided. Very early in
my classical days, I took up the idea that the ancient Greek
language having been changed by degrees into the modern, and the
present race of that people having received it by tradition, they had
of course better pretensions to the ancient pronunciation also, than
any foreign nation could have. When at Paris, I became acquainted
with some learned Greeks, from whom I took pains to learn the
modern pronunciation. But I could not receive it as genuine in toto. I
could not believe that the ancient Greeks had provided six different
notations for the simple sound of ι, iota, and left the five other
sounds which we give to η, υ, ει, οι, υι, without any characters of
notation at all. I could not acknowledge the υ, upsillon, as an
equivalent to our v, as in Αχιλλευς, which they pronounce Achillevs,
nor the γ gamma, to our y, as in αλγε', which they pronounce alye. I
concluded, therefore, that as experience proves to us that the
pronunciation of all languages changes, in their descent through
time, that of the Greek must have done so also in some degree; and
the more probably, as the body of the words themselves had
substantially changed, and I presumed that the instances above
mentioned might be classed with the degeneracies of time; a
presumption strengthened by their remarkable cacophony. As to all
the other letters, I have supposed we might yield to their
traditionary claim of a more orthodox pronunciation. Indeed, they
sound most of them as we do, and, where they differ, as in the β, δ,
χ, their sounds do not revolt us, nor impair the beauty of the
language.
If we adhere to the Erasmian pronunciation, we must go to Italy for
it, as we must do for the most probably correct pronunciation of the
language of the Romans, because rejecting the modern, we must
argue that the ancient pronunciation was probably brought from
Greece, with the language itself; and, as Italy was the country to
which it was brought, and from which it emanated to other nations,
we must presume it better preserved there than with the nations
copying from them, who would be apt to affect its pronunciation
with some of their own national peculiarities. And in fact, we find
that no two nations pronounce it alike, although all pretend to the
Erasmian pronunciation. But the whole subject is conjectural, and
allows therefore full and lawful scope to the vagaries of the human
mind. I am glad, however, to see the question stirred here; because
it may excite among our young countrymen a spirit of inquiry and
criticism, and lead them to more attention to this most beautiful of
all languages. And wishing that the salutary example you have set
may have this good effect, I salute you with great respect and
consideration.
TO MR. SHORT.
Monticello, October 31, 1819.
Dear Sir,—Your favor of the 21st is received. My late illness, in which
you are so kind as to feel an interest, was produced by a spasmodic
stricture of the ilium, which came upon me on the 7th inst. The crisis
was short, passed over favorably on the fourth day, and I should
soon have been well but that a dose of calomel and jalap, in which
were only eight or nine grains of the former, brought on a salivation.
Of this, however, nothing now remains but a little soreness of the
mouth. I have been able to get on horseback for three or four days
past.
As you say of yourself, I too am an Epicurian. I consider the genuine
(not the imputed) doctrines of Epicurus as containing everything
rational in moral philosophy which Greece and Rome have left us.
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Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition LeMone Test Bank

  • 1. Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition LeMone Test Bank download pdf https://testbankdeal.com/product/medical-surgical-nursing-clinical- reasoning-in-patient-care-6th-edition-lemone-test-bank/ Visit testbankdeal.com today to download the complete set of test banks or solution manuals!
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  • 5. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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.
  • 6. 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. 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
  • 7. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. 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
  • 8. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. 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: Assessment Learning Outcome: 1. Discuss the role of genetic concepts in health promotion and health maintenance. MNL Learning Outcome: 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.
  • 9. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. 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. 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.
  • 10. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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: 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: Assessment Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic disorders. MNL Learning Outcome: 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
  • 11. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. Cognitive Level: Analyzing 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: Assessment Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic disorders. MNL Learning Outcome: 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?
  • 12. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. 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: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic disorders. MNL Learning Outcome: Page Number: 139 Question 8 Type: MCSA
  • 13. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. Cognitive Level: Analyzing 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: Assessment Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic disorders. MNL Learning Outcome: 14.1.1. Explain the incidence, causes, and pathophysiology of the different types of anemias. Page Number: 140
  • 14. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. Cognitive Level: Applying Client Need: Psychosocial Integrity Client Need Sub: QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in 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
  • 15. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. Learning Outcome: 3. Describe the significance of delivering genetic education and counseling follow-up in a professional manner. MNL Learning Outcome: 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
  • 16. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in 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: Evaluation Learning Outcome: 3. Describe the significance of delivering genetic education and counseling follow-up in a professional manner. MNL Learning Outcome: 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.
  • 17. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in 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: 3. Describe the significance of delivering genetic education and counseling follow-up in a professional manner. MNL Learning Outcome: 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.
  • 18. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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.” Cognitive Level: Applying Client Need: Psychosocial Integrity 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 Nursing/Integrated Concepts: Nursing Process: Implementation 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. MNL Learning Outcome: 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.”
  • 19. LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Copyright 2015 by Pearson Education, Inc. 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. Cognitive Level: Applying 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 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 Nursing/Integrated Concepts: Nursing Process: Implementation 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. MNL Learning Outcome: 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.
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  • 21. Monticello, December 13, 1818. I thank your Excellency for the notice with which your letters favor me, of the liberation of France from the occupation of the allied powers. To no one, not a native, will it give more pleasure. In the desolation of Europe, to gratify the atrocious caprices of Bonaparte, France sinned much; but she has suffered more than retaliation. Once relieved from the incubus of her late oppression, she will rise like a giant from her slumbers. Her soil and climate, her arts and eminent sciences, her central position and free constitution, will soon make her greater than she ever was. And I am a false prophet, if she does not at some future day, remind of her sufferings those who have inflicted them the most eagerly. I hope, however, she will be quiet for the present, and risk no new troubles. Her constitution, as now amended, gives as much of self-government as perhaps she can yet bear, and will give more, when the habits of order shall have prepared her to receive more. Besides the gratitude which every American owes her, as our sole ally during the war of independence, I am additionally affectioned by the friendships I contracted there, by the good dispositions I witnessed, and by the courtesies I received. I rejoice, as a moralist, at the prospect of a reduction of the duties on wine, by our national legislature. It is an error to view a tax on that liquor as merely a tax on the rich. It is a prohibition of its use to the middling class of our citizens, and a condemnation of them to the poison of whiskey, which is desolating their houses. No nation is drunken where wine is cheap; and none sober, where the dearness of wine substitutes ardent spirits as the common beverage. It is, in truth, the only antidote to the bane of whiskey. Fix but the duty at the rate of other merchandise, and we can drink wine here as cheap as we do grog; and who will not prefer it? Its extended use will carry health and comfort to a much enlarged circle. Every one in easy circumstances (as the bulk of our citizens are) will prefer it to the poison to which they are now driven by their government. And the treasury itself will find that a penny a piece from a dozen, is more
  • 22. than a groat from a single one. This reformation, however, will require time. Our merchants know nothing of the infinite variety of cheap and good wines to be had in Europe; and particularly in France, in Italy, and the Græcian islands; as they know little also, of the variety of excellent manufactures and comforts to be had anywhere out of England. Nor will these things be known, nor of course called for here, until the native merchants of those countries, to whom they are known, shall bring them forward, exhibit and vend them at the moderate profits they can afford. This alone will procure them familiarity with us, and the preference they merit in competition with corresponding articles now in use. Our family renew with pleasure their recollections of your kind visit to Monticello, and join me in tendering sincere assurances of the gratification it afforded us, and of our great esteem and respectful consideration. TO NATHANIEL MACON, ESQ. Monticello, January 12, 1819. Dear Sir,—The problem you had wished to propose to me was one which I could not have solved; for I knew nothing of the facts. I read no newspaper now but Ritchie's, and in that chiefly the advertisements, for they contain the only truths to be relied on in a newspaper. I feel a much greater interest in knowing what has passed two or three thousand years ago, than in what is now passing. I read nothing, therefore, but of the heroes of Troy, of the wars of Lacedæmon and Athens, of Pompey and Cæsar, and of Augustus too, the Bonaparte and parricide scoundrel of that day. I have had, and still have, such entire confidence in the late and present Presidents, that I willingly put both soul and body into their pockets. While such men as yourself and your worthy colleagues of the legislature, and such characters as compose the executive
  • 23. administration, are watching for us all, I slumber without fear, and review in my dreams the visions of antiquity. There is, indeed, one evil which awakens me at times, because it jostles me at every turn. It is that we have now no measure of value. I am asked eighteen dollars for a yard of broadcloth, which, when we had dollars, I used to get for eighteen shillings; from this I can only understand that a dollar is now worth but two inches of broadcloth, but broadcloth is no standard of measure or value. I do not know, therefore, whereabouts I stand in the scale of property, nor what to ask, or what to give for it. I saw, indeed, the like machinery in action in the years '80 and '81, and without dissatisfaction; because in wearing out, it was working out our salvation. But I see nothing in this renewal of the game of "Robin's alive" but a general demoralization of the nation, a filching from industry its honest earnings, wherewith to build up palaces, and raise gambling stock for swindlers and shavers, who are too close to their career of piracies by fraudulent bankruptcies. My dependence for a remedy, however, is with the wisdom which grows with time and suffering. Whether the succeeding generation is to be more virtuous than their predecessors, I cannot say; but I am sure they will have more worldly wisdom, and enough, I hope, to know that honesty is the first chapter in the book of wisdom. I have made a great exertion to write you thus much; my antipathy to taking up a pen being so intense that I have never given you a stronger proof, than in the effort of writing a letter, how much I value you, and of the superlative respect and friendship with which I salute you. TO MR. ADAMS. Monticello, March 21, 1819. Dear Sir,—I am indebted to you for Mr. Bowditch's very learned mathematical papers, the calculations of which are not for every reader, although their results are readily enough understood. One of
  • 24. these impairs the confidence I had reposed in La Place's demonstration, that the eccentricities of the planets of our system could oscillate only within narrow limits, and therefore could authorize no inference that the system must, by its own laws, come one day to an end. This would have left the question one of infinitude, at both ends of the line of time, clear of physical authority. Mr. Pickering's pamphlet on the pronunciation of the Greek, for which I am indebted to you also, I have read with great pleasure. Early in life, the idea occurred to me that the people now inhabiting the ancient seats of the Greeks and Romans, although their languages in the intermediate ages had suffered great changes, and especially in the declension of their nouns, and in the terminations of their words generally, yet having preserved the body of the word radically the same, so they would preserve more of its pronunciation. That at least it was probable that a pronunciation, handed down by tradition, would retain, as the words themselves do, more of the original than that of any other people whose language has no affinity to that original. For this reason I learnt, and have used the Italian pronunciation of the Latin. But that of the modern Greeks I had no opportunity of learning until I went to Paris. There I became acquainted with two learned Greeks, Count Carberri and Mr. Paradise, and with a lady, a native Greek, the daughter of Baron de Tott, who did not understand the ancient language. Carberri and Paradise spoke it. From these instructors I learnt the modern pronunciation, and in general trusted to its orthodoxy. I say, in general, because sound being more fugitive than the written letter, we must, after such a lapse of time, presume in it some degeneracies, as we see there are in the written words. We may not, indeed, be able to put our finger on them confidently, yet neither are they entirely beyond the reach of all indication. For example, in a language so remarkable for the euphony of its sounds, if that euphony is preserved in particular combinations of its letters, by an adherence to the powers ordinarily ascribed to them, and is destroyed by a change of these powers, and the sound of the word
  • 25. thereby rendered harsh, inharmonious, and inidiomatical, here we may presume some degeneracy has taken place. While, therefore, I gave in to the modern pronunciation generally, I have presumed, as an instance of degeneracy, their ascribing the same sound to the six letters, or combinations of letters, ε, ι, υ, ει, οι, υι, to all of which they give the sound of our double e in the word meet. This useless equivalence of three vowels and three diphthongs, did not probably exist among the ancient Greeks; and the less probably as, while this single sound, ee, is overcharged by so many different representative characters, the sounds we usually give to these characters and combinations would be left without any representative signs. This would imply either that they had not these sounds in their language, or no signs for their expression. Probability appears to me, therefore, against the practice of the modern Greeks of giving the same sound to all these different representatives, and to be in favor of that of foreign nations, who, adopting the Roman characters, have assimilated to them, in a considerable degree, the powers of the corresponding Greek letters. I have, accordingly, excepted this in my adoption of the modern pronunciation. I have been more doubtful in the use of the αυ, ευ, ηυ, ωυ, sounding the υ, upsilon, as our f or v, because I find traces of that power of υ, or of v, in some modern languages. To go no further than our own, we have it in laugh, cough, trough, enough. The county of Louisa, adjacent to that in which I live, was, when I was a boy, universally pronounced Lovisa. That it is not the gh which gives the sound of f or v, in these words, is proved by the orthography of plough, trough, thought, fraught, caught. The modern Greeks themselves, too, giving up υ, upsilon, in ordinary, the sound of our ee, strengthens the presumption that its anomalous sound of f or v, is a corruption. The same may be inferred from the cacophony of ελαφνε (elavne) for ελαυνε, (elawne,) Αχιλλεφς (Achillefs) for Αχιλλευς, (Achilleise,) εφς (eves) for εϋς, (eeuse,) οφκ (ovk) for ouk, (ouk,) ωφτος (ovetos) for ωϋτος, (o-u-tos,) Ζεφς (zevs) for Ζευς (zese,) of which all nations have made their Jupiter; and the uselessness of the υ in ευφωνια which would otherwise have been spelt εφωνια. I therefore except this also from what I consider as approvable pronunciation.
  • 26. Against reading Greek by accent, instead of quantity, as Mr. Ciceitira proposes, I raise both my hands. What becomes of the sublime measure of Homer, the full sounding rhythm of Demosthenes, if, abandoning quantity, you chop it up by accent? What ear can hesitate in its choice between the two following rhythms? "Τὸν, δ' απαμειβὸμενος προσεφὴ πόδας ωκὺς Αχιλλευς, and, Τον, δ' απαμειβομενός προσεφὴ ποδας ώκυς Αχίλλευς," the latter noted according to prosody, the former by accent, and dislocating our teeth in its utterance; every syllable of it, except the first and last, being pronounced against quantity. And what becomes of the art of prosody? Is that perfect coincidence of its rules with the structure of their verse, merely accidental? or was it of design, and yet for no use. On the whole, I rejoice that this subject is taken up among us, and that it is in so able hands as those of Mr. Pickering. Should he ultimately establish the modern pronunciation of the letters without any exception, I shall think it a great step gained, and giving up my exceptions, shall willingly rally to him; and as he has promised us another paper on the question whether we shall read by quantity or by accent, I can confidently trust it to the correctness of his learning and judgment. Of the origin of accentuation, I have never seen satisfactory proofs. But I have generally supposed the accents were intended to direct the inflections and modulations of the voice; but not to affect the quantity of the syllables. You did not expect, I am sure, to draw on yourself so long a disquisition on letters and sounds, nor did I intend it, but the subject run before me, and yet I have dropped much of it by the way. I am delighted with your high approbation of Mr. Tracy's book. The evils of this deluge of paper money are not to be removed, until our
  • 27. citizens are generally and radically instructed in their cause and consequences, and silence by their authority the interested clamors and sophistry of speculating, shaving, and banking institutions. Till then we must be content to return, quod hoc, to the savage state, to recur to barter in the exchange of our property, for want of a stable, common measure of value, that now in use being less fixed than the beads and wampum of the Indian, and to deliver up our citizens, their property and their labor, passive victims to the swindling tricks of bankers and mountebankers. If I had your permission to put your letter into the hands of the editor, (Milligan,) with or without any verbal alterations you might choose, it would ensure the general circulation, which my prospectus and prefatory letter will less effectually recommend. There is nothing in the book of mine but these two articles, and the note on taxation in page 202. I never knew who the translator was; but I thought him some one who understood neither French nor English; and probably a Caledonian, from the number of Scotticisms I found in his MS. The innumerable corrections in that, cost me more labor than would have done a translation of the whole de novo; and made at last but an inelegant although faithful version of the sense of the author. Dios guarde á V. S. muchos años. TO DOCTOR VINE UTLEY. Monticello, March 21, 1819. Sir,—Your letter of February the 18th came to hand on the 1st instant; and the request of the history of my physical habits would have puzzled me not a little, had it not been for the model with which you accompanied it, of Doctor Rush's answer to a similar inquiry. I live so much like other people, that I might refer to ordinary life as the history of my own. Like my friend the Doctor, I have lived temperately, eating little animal food, and that not as an aliment, so much as a condiment for the vegetables, which
  • 28. constitute my principal diet. I double, however, the Doctor's glass and a half of wine, and even treble it with a friend; but halve its effects by drinking the weak wines only. The ardent wines I cannot drink, nor do I use ardent spirits in any form. Malt liquors and cider are my table drinks, and my breakfast, like that also of my friend, is of tea and coffee. I have been blest with organs of digestion which accept and concoct, without ever murmuring, whatever the palate chooses to consign to them, and I have not yet lost a tooth by age. I was a hard student until I entered on the business of life, the duties of which leave no idle time to those disposed to fulfil them; and now, retired, and at the age of seventy-six, I am again a hard student. Indeed, my fondness for reading and study revolts me from the drudgery of letter writing. And a stiff wrist, the consequence of an early dislocation, makes writing both slow and painful. I am not so regular in my sleep as the Doctor says he was, devoting to it from five to eight hours, according as my company or the book I am reading interests me; and I never go to bed without an hour, or half hour's previous reading of something moral, whereon to ruminate in the intervals of sleep. But whether I retire to bed early or late, I rise with the sun. I use spectacles at night, but not necessarily in the day, unless in reading small print. My hearing is distinct in particular conversation, but confused when several voices cross each other, which unfits me for the society of the table. I have been more fortunate than my friend in the article of health. So free from catarrhs that I have not had one, (in the breast, I mean) on an average of eight or ten years through life. I ascribe this exemption partly to the habit of bathing my feet in cold water every morning, for sixty years past. A fever of more than twenty-four hours I have not had above two or three times in my life. A periodical headache has afflicted me occasionally, once, perhaps, in six or eight years, for two or three weeks at a time, which seems now to have left me; and except on a late occasion of indisposition, I enjoy good health; too feeble, indeed, to walk much, but riding without fatigue six or eight miles a day, and sometimes thirty or forty. I may end these egotisms, therefore, as I began, by saying that my life has been so much like that of other people, that I might say with Horace, to
  • 29. every one "nomine mutato, narratur fabula de te." I must not end, however, without due thanks for the kind sentiments of regard you are so good as to express towards myself; and with my acknowledgments for these, be pleased to accept the assurances of my respect and esteem. TO MR. SPAFFORD. Monticello, May 11, 1819. Dear Sir,—The interest on the late derangement of my health which was so kindly expressed by many, could not but be gratifying to me, as much as it manifested a sentiment that I had not been merely an useless cypher of society. Yet a decline of health at the age of 76, was naturally to be expected, and is a warning of an event which cannot be distant, and whose approach I contemplate with little concern; for indeed, in no circumstance has nature been kinder to us, than in the soft gradations by which she prepares us to part willingly with what we are not destined always to retain. First one faculty is withdrawn and then another, sight, hearing, memory, affections, and friends, filched one by one, till we are left among strangers, the mere monuments of times, facts, and specimens of antiquity for the observation of the curious. To your request of materials for writing my life, I know not what to say, although I have been obliged to say something to several preceding applications of the same kind. One answer indeed is obvious, that I am by decay of memory, aversion to labor, and cares more suited to my situation, unequal to such a task. Of the public transactions in which I have borne a part, I have kept no narrative with a view of history. A life of constant action leaves no time for recording. Always thinking of what is next to be done, what has been done is dismissed, and soon obliterated from the memory. I cannot be insensible to the partiality which has induced several
  • 30. persons to think my life worthy of remembrance. And towards none more than yourself, who give me so much credit more than I am entitled to, as to what has been effected for the safeguard of our republican constitution. Numerous and able coadjutors have participated in these efforts, and merit equal notice. My life, in fact, has been so much like that of others, that their history is my history, with a mere difference of feature. The only valuable materials for history which I possessed, were the pamphlets of the day, carefully collected and preserved; but these past on to Congress with my library, and are to be found in their depository. Except the Notes on Virginia, I never wrote anything but acts of office, of which I rarely kept a copy. These will all be found in the journals and gazettes of the times. There was a book published in England about 1801, or soon after, entitled "Public Characters," in which was given a sketch of my history to that period. I never knew, nor could conjecture by whom this was written; but certainly by some one pretty intimately acquainted with myself and my connections. There were a few inconsiderable errors in it, but in general it was correct. Delaplaine, in his Repository, has also given some outlines on the same subject; he sets out indeed with an error as to the county of my birth. Chesterfield, which he states as such, was the residence of my grandfather and remoter ancestors, but Albemarle was that of my father, and of my own birth and residence. Excepting this error, I remark no other but in his ascriptions of more merit than I have deserved. Girardin's History of Virginia, too, gives many particulars on the same subject, which are correct. These publications furnish all the details of facts and dates which can interest anybody, and more than I could now furnish myself from a decayed memory, or any notes I retain. While, therefore, I feel just acknowledgments for the partial selection of a subject for your employment, I am persuaded you will perceive there is too little new and worthy of public notice to devote to it a time which may be so much more usefully employed; and with a due sense of the partiality of your friendship, I salute you with assurances of the greatest esteem and respect.
  • 31. TO S. A. WELLS, ESQ. Monticello, May 12, 1819. Sir,—An absence of some time at an occasional and distant residence must apologize for the delay in acknowledging the receipt of your favor of April 12th. And candor obliges me to add that it has been somewhat extended by an aversion to writing, as well as to calls on my memory for facts so much obliterated from it by time as to lessen my confidence in the traces which seem to remain. One of the inquiries in your letter, however, may be answered without an appeal to the memory. It is that respecting the question whether committees of correspondence originated in Virginia or Massachusetts? On which you suppose me to have claimed it for Virginia. But certainly I have never made such a claim. The idea, I suppose, has been taken up from what is said in Wirt's history of Mr. Henry, p. 87, and from an inexact attention to its precise terms. It is there said "this house [of burgesses of Virginia] had the merit of originating that powerful engine of resistance, corresponding committees between the legislatures of the different colonies." That the fact as here expressed is true, your letter bears witness when it says that the resolutions of Virginia for this purpose were transmitted to the speakers of the different Assemblies, and by that of Massachusetts was laid at the next session before that body, who appointed a committee for the specified object: adding, "thus in Massachusetts there were two committees of correspondence, one chosen by the people, the other appointed by the House of Assembly; in the former, Massachusetts preceded Virginia; in the latter, Virginia preceded Massachusetts." To the origination of committees for the interior correspondence between the counties and towns of a State, I know of no claim on the part of Virginia; but certainly none was ever made by myself. I perceive, however, one error into which memory had led me. Our committee for national correspondence was appointed in March, '73, and I well remember that going to Williamsburg in the month of June following, Peyton Randolph, our chairman, told me that messengers, bearing
  • 32. despatches between the two States, had crossed each other by the way; that of Virginia carrying our propositions for a committee of national correspondence, and that of Massachusetts bringing, as my memory suggested, a similar proposition. But here I must have misremembered; and the resolutions brought us from Massachusetts were probably those you mention of the town meeting of Boston, on the motion of Mr. Samuel Adams, appointing a committee "to state the rights of the colonists, and of that province in particular, and the infringements of them, to communicate them to the several towns, as the sense of the town of Boston, and to request of each town a free communication of its sentiments on this subject"? I suppose, therefore, that these resolutions were not received, as you think, while the House of Burgesses was in session in March, 1773; but a few days after we rose, and were probably what was sent by the messenger who crossed ours by the way. They may, however, have been still different. I must therefore have been mistaken in supposing and stating to Mr. Wirt, that the proposition of a committee for national correspondence was nearly simultaneous in Virginia and Massachusetts. A similar misapprehension of another passage in Mr. Wirt's book, for which I am also quoted, has produced a similar reclamation of the part of Massachusetts by some of her most distinguished and estimable citizens. I had been applied to by Mr. Wirt for such facts respecting Mr. Henry, as my intimacy with him, and participation in the transactions of the day, might have placed within my knowledge. I accordingly committed them to paper, and Virginia being the theatre of his action, was the only subject within my contemplation, while speaking of him. Of the resolutions and measures here, in which he had the acknowledged lead, I used the expression that "Mr. Henry certainly gave the first impulse to the ball of revolution." [Wirt, p. 41.] The expression is indeed general, and in all its extension would comprehend all the sister States. But indulgent construction would restrain it, as was really meant, to the subject matter under contemplation, which was Virginia alone; according to the rule of the lawyers, and a fair canon of general criticism, that
  • 33. every expression should be construed secundum subjectam materiem. Where the first attack was made, there must have been of course, the first act of resistance, and that was of Massachusetts. Our first overt act of war was Mr. Henry's embodying a force of militia from several counties, regularly armed and organized, marching them in military array, and making reprisal on the King's treasury at the seat of government for the public powder taken away by his Governor. This was on the last days of April, 1775. Your formal battle of Lexington was ten or twelve days before that, which greatly overshadowed in importance, as it preceded in time our little affray, which merely amounted to a levying of arms against the King, and very possibly you had had military affrays before the regular battle of Lexington. These explanations will, I hope, assure you, Sir, that so far as either facts or opinions have been truly quoted from me, they have never been meant to intercept the just fame of Massachusetts, for the promptitude and perseverance of her early resistance. We willingly cede to her the laud of having been (although not exclusively) "the cradle of sound principles," and if some of us believe she has deflected from them in her course, we retain full confidence in her ultimate return to them. I will now proceed to your quotation from Mr. Galloway's statements of what passed in Congress on their declaration of independence, in which statement there is not one word of truth, and where, bearing some resemblance to truth, it is an entire perversion of it. I do not charge this on Mr. Galloway himself; his desertion having taken place long before these measures, he doubtless received his information from some of the loyal friends whom he left behind him. But as yourself, as well as others, appear embarrassed by inconsistent accounts of the proceedings on that memorable occasion, and as those who have endeavored to restore the truth have themselves committed some errors, I will give you some extracts from a written document on that subject, for the truth of which I pledge myself to heaven and earth; having, while the question of independence was
  • 34. under consideration before Congress, taken written notes, in my seat, of what was passing, and reduced them to form on the final conclusion. I have now before me that paper, from which the following are extracts: "On Friday the 7th of June, 1776, the delegates from Virginia moved, in obedience to instructions from their constituents, that the Congress should declare that these united colonies are, and of right ought to be, free and independent States; that they are absolved from all allegiance to the British crown, and that all political connection between them and the State of Great Britain is, and ought to be totally dissolved; that measures should be immediately taken for procuring the assistance of foreign powers, and a confederation be formed to bind the colonies more closely together. The house being obliged to attend at that time to some other business, the proposition was referred to the next day, when the members were ordered to attend punctually at ten o'clock. Saturday, June 8th, they proceeded to take it into consideration, and referred it to a committee of the whole, into which they immediately resolved themselves, and passed that day and Monday the 10th in debating on the subject. "It appearing in the course of these debates, that the colonies of New York, New Jersey, Pennsylvania, Delaware, Maryland, and South Carolina were not yet matured for falling from the parent stem, but that they were fast advancing to that state, it was thought most prudent to wait awhile for them, and to postpone the final decision to July 1st. But that this might occasion as little delay as possible, a committee was appointed to prepare a Declaration of Independence. The committee were J. Adams, Dr. Franklin, Roger Sherman, Robert R. Livingston and myself. This was reported to the House on Friday the 28th of June, when it was read and ordered to lie on the table. On Monday the 1st of July the House resolved itself into a committee of the whole, and resumed the consideration of the original motion made by the delegates of Virginia, which being again debated through the day, was carried in the affirmative by the votes of New
  • 35. Hampshire, Connecticut, Massachusetts, Rhode Island, New Jersey, Maryland, Virginia, North Carolina and Georgia. South Carolina and Pennsylvania] voted against it. Delaware having but two members present, they were divided. The delegates for New York declared they were for it themselves, and were assured their constituents were for it; but that their instructions having been drawn near a twelvemonth before, when reconciliation was still the general object, they were enjoined by them to do nothing which should impede that object. They therefore thought themselves not justifiable in voting on either side, and asked leave to withdraw from the question, which was given them. The Committee rose and reported their resolution to the House. Mr. Rutledge of South Carolina, then requested the determination might be put off to the next day, as he believed his colleagues, though they disapproved of the resolution, would then join in it for the sake of unanimity. The ultimate question whether the House would agree to the resolution of the committee was accordingly postponed to the next day, when it was again moved, and South Carolina concurred in voting for it; in the meantime a third member had come post from the Delaware counties, and turned the vote of that colony in favor of the resolution. Members of a different sentiment attending that morning from Pennsylvania also, their vote was changed; so that the whole twelve colonies, who were authorized to vote at all, gave their votes for it; and within a few days, [July 9th,] the convention of New York approved of it, and thus supplied the void occasioned by the withdrawing of their delegates from the vote." [Be careful to observe that this vacillation and vote was on the original motion of the 7th of June by the Virginia delegates, that Congress should declare the colonies independent.] "Congress proceeded the same day to consider the Declaration of Independence, which has been reported and laid on the table the Friday preceding, and on Monday referred to a committee of the whole. The pusillanimous idea that we had friends in England worth keeping terms with, still haunted the minds of many. For this reason those passages which conveyed censures on the people of England
  • 36. were struck out, lest they give them offence. The debates having taken up the greater parts of the 2d, 3d and 4th days of July, were, in the evening of the last, closed. The declaration was reported by the committee, agreed to by the House, and signed by every member present except Mr. Dickinson." So far my notes. Governor McKean, in his letter to McCorkle of July 16th, 1817, has thrown some lights on the transactions of that day, but trusting to his memory chiefly at an age when our memories are not to be trusted, he has confounded two questions, and ascribed proceedings to one which belonged to the other. These two questions were, 1. The Virginia motion of June 7th to declare independence, and 2. The actual declaration, its matter and form. Thus he states the question on the declaration itself as decided on the 1st of July. But it was the Virginia motion which was voted on that day in committee of the whole; South Carolina, as well as Pennsylvania, then voting against it. But the ultimate decision in the House on the report of the committee being by request postponed to the next morning, all the States voted for it, except New York, whose vote was delayed for the reason before stated. It was not till the 2d of July that the declaration itself was taken up, nor till the 4th that it was decided; and it was signed by every member present, except Mr. Dickinson. The subsequent signatures of members who were not then present, and some of them not yet in office, is easily explained, if we observe who they were; to wit, that they were of New York and Pennsylvania. New York did not sign till the 15th, because it was not till the 9th, (five days after the general signature,) that their convention authorized them to do so. The convention of Pennsylvania, learning that it had been signed by a minority only of their delegates, named a new delegation on the 20th, leaving out Mr. Dickinson, who had refused to sign. Willing and Humphreys who had withdrawn, reappointing the three members who had signed, Morris who had not been present, and five new ones, to wit, Rush, Clymer, Smith, Taylor and Ross; and Morris and the five new members were permitted to sign, because it manifested the assent
  • 37. of their full delegation, and the express will of their convention, which might have been doubted on the former signature of a minority only. Why the signature of Thornton of New Hampshire was permitted so late as the 4th of November, I cannot now say; but undoubtedly for some particular reason which we should find to have been good, had it been expressed. These were the only post- signers, and you see, Sir, that there were solid reasons for receiving those of New York and Pennsylvania, and that this circumstance in no wise affects the faith of this declaratory charter of our rights, and of the rights of man. With a view to correct errors of fact before they become inveterate by repetition, I have stated what I find essentially material in my papers; but with that brevity which the labor of writing constrains me to use. On the fourth particular articles of inquiry in your letter, respecting your grandfather, the venerable Samuel Adams, neither memory nor memorandums enable me to give any information. I can say that he was truly a great man, wise in council, fertile in resources, immovable in his purposes, and had, I think, a greater share than any other member, in advising and directing our measures, in the northern war especially. As a speaker he could not be compared with his living colleague and namesake, whose deep conceptions, nervous style, and undaunted firmness, made him truly our bulwark in debate. But Mr. Samuel Adams, although not of fluent elocution, was so rigorously logical, so clear in his views, abundant in good sense, and master always of his subject, that he commanded the most profound attention whenever he rose in an assembly by which the froth of declamation was heard with the most sovereign contempt. I sincerely rejoice that the record of his worth is to be undertaken by one so much disposed as you will be to hand him down fairly to that posterity for whose liberty and happiness he was so zealous a laborer. With sentiments of sincere veneration for his memory, accept yourself this tribute to it with the assurances of my great respect.
  • 38. P. S. August 6th, 1822, since the date of this letter, to wit, this day, August 6th, '22, I received the new publication of the secret Journals of Congress, wherein is stated a resolution, July 19th, 1776, that the declaration passed on the 4th be fairly engrossed on parchment, and when engrossed, be signed by every member; and another of August 2d, that being engrossed and compared at the table, was signed by the members. That is to say the copy engrossed on parchment (for durability) was signed by the members after being compared at the table with the original one, signed on paper as before stated. I add this P. S. to the copy of my letter to Mr. Wells, to prevent confounding the signature of the original with that of the copy engrossed on parchment. TO EZRA STYLES, ESQ. Monticello, June 25, 1819. Your favor, Sir, of the 14th, has been duly received, and with it the book you were so kind as to forward to me. For this mark of attention, be pleased to accept my thanks. The science of the human mind is curious, but is one on which I have not indulged myself in much speculation. The times in which I have lived, and the scenes in which I have been engaged, have required me to keep the mind too much in action to have leisure to study minutely its laws of action. I am therefore little qualified to give an opinion on the comparative worth of books on that subject, and little disposed to do it on any book. Yours has brought the science within a small compass, and that is the merit of the first order; and especially with one to whom the drudgery of letter writing often denies the leisure of reading a single page in a week. On looking over the summary of the contents of your book, it does not seem likely to bring into collision any of those sectarian differences which you suppose may exist between us. In that branch of religion which regards the moralities of life, and the duties of a social being, which teaches us
  • 39. to love our neighbors as ourselves, and to do good to all men, I am sure that you and I do not differ. We probably differ in the dogmas of theology, the foundation of all sectarianism, and on which no two sects dream alike; for if they did they would then be of the same. You say you are a Calvinist. I am not. I am of a sect by myself, as far as I know. I am not a Jew, and therefore do not adopt their theology, which supposes the God of infinite justice to punish the sins of the fathers upon their children, unto the third and fourth generation; and the benevolent and sublime reformer of that religion has told us only that God is good and perfect, but has not defined him. I am, therefore, of his theology, believing that we have neither words nor ideas adequate to that definition. And if we could all, after this example, leave the subject as undefinable, we should all be of one sect, doers of good, and eschewers of evil. No doctrines of his lead to schism. It is the speculations of crazy theologists which have made a Babel of a religion the most moral and sublime ever preached to man, and calculated to heal, and not to create differences. These religious animosities I impute to those who call themselves his ministers, and who engraft their casuistries on the stock of his simple precepts. I am sometimes more angry with them than is authorized by the blessed charities which he preaches. To yourself I pray the acceptance of my great respect. TO JOHN ADAMS. Monticello, July 9, 1819. Dear Sir,—I am in debt to you for your letters of May the 21st, 27th, and June the 22d. The first, delivered me by Mr. Greenwood, gave me the gratification of his acquaintance; and a gratification it always is, to be made acquainted with gentlemen of candor, worth, and information, as I found Mr. Greenwood to be. That, on the subject of Mr. Samuel Adams Wells, shall not be forgotten in time and place, when it can be used to his advantage.
  • 40. But what has attracted my peculiar notice, is the paper from Mecklenburg county, of North Carolina, published in the Essex Register, which you were so kind as to enclose in your last, of June the 22d. And you seem to think it genuine. I believe it spurious. I deem it to be a very unjustifiable quiz, like that of the volcano, so minutely related to us as having broken out in North Carolina, some half a dozen years ago, in that part of the country, and perhaps in that very county of Mecklenburg, for I do not remember its precise locality. If this paper be really taken from the Raleigh Register, as quoted, I wonder it should have escaped Ritchie, who culls what is good from every paper, as the bee from every flower; and the National Intelligencer, too, which is edited by a North Carolinian; and that the fire should blaze out all at once in Essex, one thousand miles from where the spark is said to have fallen. But if really taken from the Raleigh Register, who is the narrator, and is the name subscribed real, or is it as fictitious as the paper itself? It appeals, too, to an original book, which is burnt, to Mr. Alexander, who is dead, to a joint letter from Caswell, Hughes, and Hooper, all dead, to a copy sent to the dead Caswell, and another sent to Doctor Williamson, now probably dead, whose memory did not recollect, in the history he has written of North Carolina, this gigantic step of its county of Mecklenberg. Horry, too, is silent in his history of Marion, whose scene of action was the country bordering on Mecklenburg. Ramsay, Marshall, Jones, Girardin, Wirt, historians of the adjacent States, all silent. When Mr. Henry's resolutions, far short of independence, flew like lightning through every paper, and kindled both sides of the Atlantic, this flaming declaration of the same date, of the independence of Mecklenburg county, of North Carolina, absolving it from the British allegiance, and abjuring all political connection with that nation, although sent to Congress too, is never heard of. It is not known even a twelvemonth after, when a similar proposition is first made in that body. Armed with this bold example, would not you have addressed our timid brethren in peals of thunder on their tardy fears? Would not every advocate of independence have rung the glories of Mecklenberg county in North Carolina, in the ears of the doubting Dickinson and others, who hung so heavily
  • 41. on us? Yet the example of independent Mecklenberg county, in North Carolina, was never once quoted. The paper speaks, too, of the continued exertions of their delegation (Caswell, Hooper, Hughes) "in the cause of liberty and independence." Now you remember as well as I do, that we had not a greater tory in Congress than Hooper; that Hughes was very wavering, sometimes firm, sometimes feeble, according as the day was clear or cloudy; that Caswell, indeed, was a good whig, and kept these gentlemen to the notch, while he was present; but that he left us soon, and their line of conduct became then uncertain until Penn came, who fixed Hughes and the vote of the State. I must not be understood as suggesting any doubtfulness in the State of North Carolina. No State was more fixed or forward. Nor do I affirm, positively, that this paper is a fabrication; because the proof of a negative can only be presumptive. But I shall believe it such until positive and solemn proof of its authenticity be produced. And if the name of McKnitt be real, and not a part of the fabrication, it needs a vindication by the production of such proof. For the present, I must be an unbeliever in the apocryphal gospel. I am glad to learn that Mr. Ticknor has safely returned to his friends; but should have been much more pleased had he accepted the Professorship in our University, which we should have offered him in form. Mr. Bowditch, too, refuses us; so fascinating is the vinculum of the dulce natale solum. Our wish is to procure natives, where they can be found, like these gentlemen, of the first order of requirement in their respective lines; but preferring foreigners of the first order to natives of the second, we shall certainly have to go for several of our Professors, to countries more advanced in science than we are. I set out within three or four days for my other home, the distance of which, and its cross mails, are great impediments to epistolary communications. I shall remain there about two months; and there, here, and everywhere, I am and shall always be, affectionately and respectfully yours.
  • 42. TO JOHN BRAZIER, THE AUTHOR OF THE REVIEW OF PICKERING ON GREEK PRONUNCIATION. Poplar Forest, August 24, 1819. Sir,—The acknowledgment of your favor of July 15th, and thanks for the Review which it covered of Mr. Pickering's Memoir on the Modern Greek, have been delayed by a visit to an occasional but distant residence from Monticello, and to an attack here of rheumatism which is just now moderating. I had been much pleased with the memoir, and was much also with your review of it. I have little hope indeed of the recovery of the ancient pronunciation of that finest of human languages, but still I rejoice at the attention the subject seems to excite with you, because it is an evidence that our country begins to have a taste for something more than merely as much Greek as will pass a candidate for clerical ordination. You ask my opinion on the extent to which classical learning should be carried in our country. A sickly condition permits me to think, and a rheumatic hand to write too briefly on this litigated question. The utilities we derive from the remains of the Greek and Latin languages are, first, as models of pure taste in writing. To these we are certainly indebted for the national and chaste style of modern composition which so much distinguishes the nations to whom these languages are familiar. Without these models we should probably have continued the inflated style of our northern ancestors, or the hyperbolical and vague one of the east. Second. Among the values of classical learning, I estimate the luxury of reading the Greek and Roman authors in all the beauties of their originals. And why should not this innocent and elegant luxury take its preëminent stand ahead of all those addressed merely to the senses? I think myself more indebted to my father for this than for all the other luxuries his cares and affections have placed within my reach; and more now than when younger, and more susceptible of delights from other sources. When the decays of age have enfeebled the useful energies of the mind, the classic pages fill up the vacuum of ennui, and become sweet composers to that rest of the grave into which we are all
  • 43. sooner or later to descend. Third. A third value is in the stores of real science deposited and transmitted us in these languages, to-wit: in history, ethics, arithmetic, geometry, astronomy, natural history, &c. But to whom are these things useful? Certainly not to all men. There are conditions of life to which they must be forever estranged, and there are epochs of life too, after which the endeavor to attain them would be a great misemployment of time. Their acquisition should be the occupation of our early years only, when the memory is susceptible of deep and lasting impressions, and reason and judgment not yet strong enough for abstract speculations. To the moralist they are valuable, because they furnish ethical writings highly and justly esteemed: although in my own opinion, the moderns are far advanced beyond them in this line of science, the divine finds in the Greek language a translation of his primary code, of more importance to him than the original because better understood; and, in the same language, the newer code, with the doctrines of the earliest fathers, who lived and wrote before the simple precepts of the founder of this most benign and pure of all systems of morality became frittered into subtleties and mysteries, and hidden under jargons incomprehensible to the human mind. To these original sources he must now, therefore, return, to recover the virgin purity of his religion. The lawyer finds in the Latin language the system of civil law most conformable with the principles of justice of any which has ever yet been established among men, and from which much has been incorporated into our own. The physician as good a code of his art as has been given us to this day. Theories and systems of medicine, indeed, have been in perpetual change from the days of the good Hippocrates to the days of the good Rush, but which of them is the true one? the present, to be sure, as long as it is the present, but to yield its place in turn to the next novelty, which is then to become the true system, and is to mark the vast advance of medicine since the days of Hippocrates. Our situation is certainly benefited by the discovery of some new and very valuable medicines; and substituting those for some of his with the treasure
  • 44. of facts, and of sound observations recorded by him (mixed to be sure with anilities of his day) and we shall have nearly the present sum of the healing art. The statesman will find in these languages history, politics, mathematics, ethics, eloquence, love of country, to which he must add the sciences of his own day, for which of them should be unknown to him? And all the sciences must recur to the classical languages for the etymon, and sound understanding of their fundamental terms. For the merchant I should not say that the languages are a necessary. Ethics, mathematics, geography, political economy, history, seem to constitute the immediate foundations of his calling. The agriculturist needs ethics, mathematics, chemistry and natural philosophy. The mechanic the same. To them the languages are but ornament and comfort. I know it is often said there have been shining examples of men of great abilities in all the businesses of life, without any other science than what they had gathered from conversations and intercourse with the world. But who can say what these men would not have been had they started in the science on the shoulders of a Demosthenes or Cicero, of a Locke or Bacon, or a Newton? To sum the whole, therefore, it may truly be said that the classical languages are a solid basis for most, and an ornament to all the sciences. I am warned by my aching fingers to close this hasty sketch, and to place here my last and fondest wishes for the advancement of our country in the useful sciences and arts, and my assurances of respect and esteem for the Reviewer of the Memoir on modern Greek. TO JUDGE ROANE. Poplar Forest, September 6, 1819. Dear Sir,—I had read in the Enquirer, and with great approbation, the pieces signed Hampden, and have read them again with
  • 45. redoubled approbation, in the copies you have been so kind as to send me. I subscribe to every title of them. They contain the true principles of the revolution of 1800, for that was as real a revolution in the principles of our government as that of 1776 was in its form; not effected indeed by the sword, as that, but by the rational and peaceable instrument of reform, the suffrage of the people. The nation declared its will by dismissing functionaries of one principle, and electing those of another, in the two branches, executive and legislative, submitted to their election. Over the judiciary department, the constitution had deprived them of their control. That, therefore, has continued the reprobated system, and although new matter has been occasionally incorporated into the old, yet the leaven of the old mass seems to assimilate to itself the new, and after twenty years' confirmation of the federated system by the voice of the nation, declared through the medium of elections, we find the judiciary on every occasion, still driving us into consolidation. In denying the right they usurp of exclusively explaining the constitution, I go further than you do, if I understand rightly your quotation from the Federalist, of an opinion that "the judiciary is the last resort in relation to the other departments of the government, but not in relation to the rights of the parties to the compact under which the judiciary is derived." If this opinion be sound, then indeed is our constitution a complete felo de se. For intending to establish three departments, co-ordinate and independent, that they might check and balance one another, it has given, according to this opinion, to one of them alone, the right to prescribe rules for the government of the others, and to that one too, which is unelected by, and independent of the nation. For experience has already shown that the impeachment it has provided is not even a scare- crow; that such opinions as the one you combat, sent cautiously out, as you observe also, by detachment, not belonging to the case often, but sought for out of it, as if to rally the public opinion beforehand to their views, and to indicate the line they are to walk in, have been so quietly passed over as never to have excited animadversion, even in a speech of any one of the body entrusted
  • 46. with impeachment. The constitution, on this hypothesis, is a mere thing of wax in the hands of the judiciary, which they may twist and shape into any form they please. It should be remembered, as an axiom of eternal truth in politics, that whatever power in any government is independent, is absolute also; in theory only, at first, while the spirit of the people is up, but in practice, as fast as that relaxes. Independence can be trusted nowhere but with the people in mass. They are inherently independent of all but moral law. My construction of the constitution is very different from that you quote. It is that each department is truly independent of the others, and has an equal right to decide for itself what is the meaning of the constitution in the cases submitted to its action; and especially, where it is to act ultimately and without appeal. I will explain myself by examples, which, having occurred while I was in office, are better known to me, and the principles which governed them. A legislature had passed the sedition law. The federal courts had subjected certain individuals to its penalties of fine and imprisonment. On coming into office, I released these individuals by the power of pardon committed to executive discretion, which could never be more properly exercised than where citizens were suffering without the authority of law, or, which was equivalent, under a law unauthorized by the constitution, and therefore null. In the case of Marbury and Madison, the federal judges declared that commissions, signed and sealed by the President, were valid, although not delivered. I deemed delivery essential to complete a deed, which, as long as it remains in the hands of the party, is as yet no need, it is in posse only, but not in esse, and I withheld delivery of the commissions. They cannot issue a mandamus to the President or legislature, or to any of their officers.[3] When the British treaty of —— arrived, without any provision against the impressment of our seamen, I determined not to ratify it. The Senate thought I should ask their advice. I thought that would be a mockery of them, when I was predetermined against following it, should they advise its ratification. The constitution had made their advice necessary to confirm a treaty, but not to reject it. This has been blamed by some;
  • 47. but I have never doubted its soundness. In the cases of two persons, antenati, under exactly similar circumstances, the federal court had determined that one of them (Duane) was not a citizen; the House of Representatives nevertheless determined that the other (Smith, of South Carolina) was a citizen, and admitted him to his seat in their body. Duane was a republican, and Smith a federalist, and these decisions were made during the federal ascendancy. These are examples of my position, that each of the three departments has equally the right to decide for itself what is its duty under the constitution, without any regard to what the others may have decided for themselves under a similar question. But you intimate a wish that my opinion should be known on this subject. No, dear Sir, I withdraw from all contests of opinion, and resign everything cheerfully to the generation now in place. They are wiser than we were, and their successors will be wiser than they, from the progressive advance of science. Tranquillity is the summum bonum of age. I wish, therefore, to offend no man's opinion, nor to draw disquieting animadversions on my own. While duty required it, I met opposition with a firm and fearless step. But loving mankind in my individual relations with them, I pray to be permitted to depart in their peace; and like the superannuated soldier, "quadragenis stipendiis emeritis," to hang my arms on the post. I have unwisely, I fear, embarked in an enterprise of great public concern, but not to be accomplished within my term, without their liberal and prompt support. A severe illness the last year, and another from which I am just emerged, admonish me that repetitions may be expected, against which a declining frame cannot long bear up. I am anxious, therefore, to get our University so far advanced as may encourage the public to persevere to its final accomplishment. That secured, I shall sing my nunc demittas. I hope your labors will be long continued in the spirit in which they have always been exercised, in maintenance of those principles on which I verily believe the future happiness of our country essentially depends. I salute you with affectionate and great respect.
  • 48. TO MR. MOORE. Monticello, September 22, 1819. I thank you, Sir, for the remarks on the pronunciation of the Greek language which you have been so kind as to send me. I have read them with pleasure, as I had the pamphlet of Mr. Pickering on the same subject. This question has occupied long and learned inquiry, and cannot, as I apprehend, be ever positively decided. Very early in my classical days, I took up the idea that the ancient Greek language having been changed by degrees into the modern, and the present race of that people having received it by tradition, they had of course better pretensions to the ancient pronunciation also, than any foreign nation could have. When at Paris, I became acquainted with some learned Greeks, from whom I took pains to learn the modern pronunciation. But I could not receive it as genuine in toto. I could not believe that the ancient Greeks had provided six different notations for the simple sound of ι, iota, and left the five other sounds which we give to η, υ, ει, οι, υι, without any characters of notation at all. I could not acknowledge the υ, upsillon, as an equivalent to our v, as in Αχιλλευς, which they pronounce Achillevs, nor the γ gamma, to our y, as in αλγε', which they pronounce alye. I concluded, therefore, that as experience proves to us that the pronunciation of all languages changes, in their descent through time, that of the Greek must have done so also in some degree; and the more probably, as the body of the words themselves had substantially changed, and I presumed that the instances above mentioned might be classed with the degeneracies of time; a presumption strengthened by their remarkable cacophony. As to all the other letters, I have supposed we might yield to their traditionary claim of a more orthodox pronunciation. Indeed, they sound most of them as we do, and, where they differ, as in the β, δ, χ, their sounds do not revolt us, nor impair the beauty of the language. If we adhere to the Erasmian pronunciation, we must go to Italy for it, as we must do for the most probably correct pronunciation of the
  • 49. language of the Romans, because rejecting the modern, we must argue that the ancient pronunciation was probably brought from Greece, with the language itself; and, as Italy was the country to which it was brought, and from which it emanated to other nations, we must presume it better preserved there than with the nations copying from them, who would be apt to affect its pronunciation with some of their own national peculiarities. And in fact, we find that no two nations pronounce it alike, although all pretend to the Erasmian pronunciation. But the whole subject is conjectural, and allows therefore full and lawful scope to the vagaries of the human mind. I am glad, however, to see the question stirred here; because it may excite among our young countrymen a spirit of inquiry and criticism, and lead them to more attention to this most beautiful of all languages. And wishing that the salutary example you have set may have this good effect, I salute you with great respect and consideration. TO MR. SHORT. Monticello, October 31, 1819. Dear Sir,—Your favor of the 21st is received. My late illness, in which you are so kind as to feel an interest, was produced by a spasmodic stricture of the ilium, which came upon me on the 7th inst. The crisis was short, passed over favorably on the fourth day, and I should soon have been well but that a dose of calomel and jalap, in which were only eight or nine grains of the former, brought on a salivation. Of this, however, nothing now remains but a little soreness of the mouth. I have been able to get on horseback for three or four days past. As you say of yourself, I too am an Epicurian. I consider the genuine (not the imputed) doctrines of Epicurus as containing everything rational in moral philosophy which Greece and Rome have left us.
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