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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.

MNL Learning Outcome: 10.5.2. Differentiate the risk factors and manifestations for diabetes.
Page Number: 145
Question 2
Type: MCSA
A patient tells the nurse that she does not want to pass on a disease that is genetic in origin to any future children.
How should the nurse respond to this patient?
1. “A complete genetic study could help guide you in your decision making.”
2. “I suppose, then, that you are not going to have any children.”
3. “Adoption is always a possibility.”
4. “Are you sure that the disease is genetic in origin?”
Correct Answer: 1
Rationale 1: Findings from genetic research can be used by patients and family members to improve their own
health and prevent illness. According to the ANA/ISONG, all registered nurses must have an understanding of
genetics to identify, support, and care for patients who have or who may transmit genetic conditions.
Rationale 2: It is premature to suggest refraining from having children until the genetic study is completed.
Rationale 3: It is premature to suggest adoption until the genetic study is completed.
Rationale 4: Questioning whether a specific disease is genetic in origin may be helpful, but may not allay the
patient’s concerns about other diseases.
Global Rationale: Findings from genetic research can be used by patients and family members to improve their
own health and prevent illness. According to the ANA/ISONG, all registered nurses must have an understanding
of genetics to identify, support, and care for patients who have or who may transmit genetic conditions. It is
premature to suggest adoption or refraining from having children until the genetic study is completed.
Questioning whether a specific disease is genetic in origin may be helpful, but may not allay the patient’s
concerns about other diseases.
Client Need Sub:
terminology

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

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

Global Rationale: The information from the genetic assessment identified three family members diagnosed with
rectal cancer before the age of 40 years. The nurse should discuss with the patient the importance of having
screening for colorectal cancer at an earlier age. Ingesting a diet high in protein and carbohydrates is not going to
reduce the patient’s risk for developing the disease. Maximizing exercise is not going to reduce the patient’s risk
for developing the disease. Counseling the patient on abstaining from having children is not going to improve the
patient’s risk for the disease.
Client Need Sub:
terminology
MNL Learning Outcome: 11.12.1. Explain the incidence, risk factors, and pathophysiology of colorectal cancer.
Page Number: 145
Question 5
Type: MCSA
While assessing a patient, the nurse notes an irregularity that has been observed in other patients, but on an
inconsistent basis. What did the nurse most likely discover in this patient?
1. a polymorphism
2. a mutation
3. a single-gene inheritance pattern
4. an X-linked inheritance pattern
Correct Answer: 1
Rationale 1: A polymorphism is a change in DNA sequence that has been identified in more than 1% of the
population and is, thus, more commonly observed than a mutation. Polymorphisms differ from mutations in that
they are observed more frequently in the general population than mutations.
Rationale 2: A mutation is a change in DNA sequence that has been identified in less than 1% of the population.

Rationale 3: A single-gene inheritance pattern will follow a pattern of being present in every member of a
generation or will skip a generation, depending if the alteration is dominant or recessive.
Rationale 4: In the X-linked inheritance pattern, the mutant gene is located on the X chromosome. Males have
only one X chromosome with no counterpart for its genes therefore the alteration will appear in all males.
Because the female as two X chromosomes, the alteration may or may not occur.
Global Rationale: A polymorphism is a change in DNA sequence that has been identified in more than 1% of the
population and is, thus, more commonly observed than a mutation. Polymorphisms differ from mutations in that
they are observed more frequently in the general population than mutations. A mutation is a change in DNA
sequence that has been identified in less than 1% of the population. A single-gene inheritance pattern will follow a
pattern of being present in every member of a generation or will skip a generation, depending if the alteration is
dominant or recessive. In the X-linked inheritance pattern, the mutant gene is located on the X chromosome.
Males have only one X chromosome with no counterpart for its genes therefore the alteration will appear in all
males. Because the female as two X chromosomes, the alteration may or may not occur.
Cognitive Level: Analyzing
Client Need Sub:
terminology
Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
Page Number: 140
Question 6
Type: MCSA
A patient has been told that her unborn child will most likely have Down syndrome. The nurse realizes this
diagnosis is consistent with which genetic finding?
1. trisomy
2. monosomy
3. translocation
4. deletions

Correct Answer: 1
Rationale 1: Trisomy refers to the presence of a third or extra chromosome instead of the normal pair of a
particular chromosome. The most common type of trisomy in infants is trisomy 21 or Down syndrome.
Rationale 2: Monosomy refers to the presence of only one chromosome instead of the normal pair of
chromosomes.
Rationale 3: Translocation (chromosomal reshuffling) occurs when a segment of a chromosome transfers or
moves and attaches itself to another chromosome.
Rationale 4: Structural rearrangements of chromosomes may result from deletions or loss of a chromosome
segment or piece.
Global Rationale: Trisomy refers to the presence of a third or extra chromosome instead of the normal pair of a
particular chromosome. The most common type of trisomy in infants is trisomy 21 or Down syndrome.
Monosomy refers to the presence of only one chromosome instead of the normal pair of chromosomes.
Translocation (chromosomal reshuffling) occurs when a segment of a chromosome transfers or moves and
attaches itself to another chromosome. Structural rearrangements of chromosomes may result from deletions or
loss of a chromosome segment or piece.
Client Need Sub:
terminology
disorders.
Page Number: 138
Question 7
Type: MCSA
A nurse is planning to teach the parents of a child with cystic fibrosis about the disorder. Which statement should
the nurse include in this explanation?

1. “While all people carry the gene CFTR, which is responsible for cystic fibrosis, those who develop the disease
have a mutation in that gene.”
2. “A small percentage of the general population carries the gene for cystic fibrosis. If two carriers have children,
then 25% of those children will develop the disease.”
3. “One in four people carry the gene for cystic fibrosis. If two carriers have children, then 25% of those children
will develop the disease.”
4. “Some people carry the gene for cystic fibrosis. Of those carriers, one in four will develop the disease.”
Correct Answer: 1
Rationale 1: Every individual carries the gene cystic fibrosis transference regulator (CTFR). Those who develop
the disease have a mutation in that gene.
Rationale 2: Every individual carries the gene cystic fibrosis transference regulator.
Rationale 3: Every individual carries the gene cystic fibrosis transference regulator.
Rationale 4: Every individual carries the gene cystic fibrosis transference regulator. Those who develop the
disease have a mutation in that gene.
Global Rationale: Every individual carries the gene cystic fibrosis transference regulator. Those who develop the
disease have a mutation in that gene. The other answer choices are all incorrect as they indicate that only a few
carry the gene for cystic fibrosis.
Client Need Sub:
terminology
disorders.
Page Number: 139
Question 8
Type: MCSA

A patient tells the nurse that many of her family members have a type of anemia that is genetic. What should the
nurse realize will occur in this patient?
1. The patient will develop the disease only if there is a mutation in the gene.
2. The patient will develop the same type of anemia.
3. The patient will die from the anemia.
4. The patient will develop the disease only if the gene translocates.
Correct Answer: 1
Rationale 1: All humans have essentially the same 20,000 to 25,000 genes; it is the mutation or polymorphism in
the gene that predisposes some individuals for disease, not translocation nor the gene itself.
Rationale 2: The patient may or may not develop anemia.
Rationale 3: The patient may or may not die from anemia.
Rationale 4: Translocation does not predispose some individuals for disease.
Global Rationale: All humans have essentially the same 20,000 to 25,000 genes; it is the mutation or
polymorphism in the gene that predisposes some individuals for disease, not translocation nor the gene itself. The
patient may or may not develop or die from anemia. Translocation does not predispose some individuals for
disease.
Client Need Sub:
terminology
disorders.
MNL Learning Outcome: 14.1.1. Explain the incidence, causes, and pathophysiology of the different types of
anemias.
Page Number: 140

Question 9
Type: MCSA
At the completion of genetic testing it has been determined that a patient’s baby will have Down syndrome. What
should the nurse say to the patient after learning this information?
1. “I realize that this news is difficult for you. Is there anything that I can do to help you at this time?”
2. “It’s not too late to consider ending the pregnancy.”
3. “You are young enough to be able to handle the baby’s challenges.”
4. “It does not matter if the baby has problems; all life is precious.”
Correct Answer: 1
Rationale 1: Nurses should encourage open discussions and the expression of fears and concerns. When
supporting a the pregnant patient who learns that the baby has Down syndrome, the best response for the nurse to
make would be to acknowledge that the news is difficult and offer to help the patient.
Rationale 2: The nurse should not suggest that the patient terminate the pregnancy.
Rationale 3: The nurse should not tell the patient that the baby will have challenges that will need to be met by a
young person.
Rationale 4: Stating that all life is precious is judgmental and should not be stated by the nurse.
Global Rationale: Nurses should encourage open discussions and the expression of fears and concerns. When
supporting a the pregnant patient who learns that the baby has Down syndrome, the best response for the nurse to
make would be to acknowledge that the news is difficult and offer to help the patient. The nurse should not
suggest that the patient terminate the pregnancy nor tell the patient that the baby will have challenges that will
need to be met by a young person. Stating that all life is precious is judgmental and should not be stated by the
nurse.
Client Need: Psychosocial Integrity
Client Need Sub:
QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in care
terminology

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

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

Rationale 4: The nurse should not minimize the importance of the genetic testing results.
Global Rationale: One benefit of genetic testing is that it allows for preventive measures and lifestyle
adaptations. The nurse should instruct the patient on how this information can serve as a guide to make lifestyle
changes to reduce the risk of developing cardiovascular disease. The nurse has no way of knowing whether the
patient is going to need cardiac bypass surgery or not. The nurse should not encourage the patient to enjoy life as
much as possible now since this might lead to high-risk behaviors. The nurse should not minimize the importance
of the genetic testing results.
Client Need Sub:
terminology
Page Number: 145
Question 12
Type: MCSA
A patient planning to be married tells the nurse that she has a strong family history of Huntington chorea but does
not plan to let her fiancé know. How should the nurse respond to this patient?
1. “Is there any reason why you do not want your fiancé to know about the genetic illness?”
2. “It is probably best that he is not aware of the disease.”
3. “Are you afraid that he will not want to marry you if he knows?”
4. “There are worse disease processes than Huntington chorea.”
Correct Answer: 1
Rationale 1: The nurse needs to support the patient in ethical and social issues. The best response from the nurse
would be to ask the patient if there is any reason why she does not want her fiancé to be aware of the genetic
illness.

Rationale 2: Agreeing that the fiancé should not be made aware would be an inappropriate response for the nurse
to make.
Rationale 3: Suggesting that the fiancé would not want to marry the patient if he was aware of the genetic disease
is also an inappropriate response for the nurse to make.
Rationale 4: The nurse should not make a judgment statement by saying that there are worse disease processes
than Huntington chorea.
Global Rationale: The nurse needs to support the patient in ethical and social issues. The best response from the
nurse would be to ask the patient if there is any reason why she does not want her fiancé to be aware of the
genetic illness. Agreeing that the fiancé should not be made aware would be an inappropriate response for the
nurse to make. Suggesting that the fiancé would not want to marry the patient if he was aware of the genetic
disease is also an inappropriate response for the nurse to make. The nurse should not make a judgment statement
by saying that there are worse disease processes than Huntington chorea.”
Client Need Sub:
QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care
AACN Essentials Competencies: VII.11. Access interprofessional and intraprofessional resources to resolve
ethical and other practice dilemmas
NLN Competencies: Context and Environment; Knowledge; ethical decision making models
Learning Outcome: 4. Explain the implications of genetic advances on the role of nurses with particular
attention to spiritual, cultural, ethical, legal, and social issues.
Page Number: 145
Question 13
Type: MCSA
A patient planning to have genetic testing prior to having children tells the nurse that she is fearful that too many
people will learn about the test. How should the nurse respond to this patient?
1. “The results of the tests are confidential and no one can have the results without your permission.”
2. “Most insurance companies will want the results before paying for the tests.”
3. “The results will be available to anyone who reviews your medical record.”
4. “The doctor will most likely use the results when planning care and treatment for other patients with the same
genetic disorder.”

Correct Answer: 1
Rationale 1: The nurse should explain that the results of genetic testing are confidential and that the written
permission to have access to the results will be needed by the patient.
Rationale 2: Insurance companies will not need the results of the tests before paying for the tests.
Rationale 3: The results will be confidential and not accessible by anyone who reviews the patient’s medical
record.
Rationale 4: The patient’s physician cannot use the test results when planning care and treatment for other
patients with the same genetic disorder.
Global Rationale: The nurse should explain that the results of genetic testing are confidential and that the written
permission to have access to the results will be needed by the patient. Insurance companies will not need the
results of the tests before paying for the tests. The results will be confidential and not accessible by anyone who
reviews the patient’s medical record. The patient’s physician cannot use the test results when planning care and
treatment for other patients with the same genetic disorder.
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care
Page Number: 145
Question 14
Type: MCSA
Through testing, a patient learns of a genetic disease that he has inherited from his parents, yet none of his other
siblings have inherited the same disease. The patient tells the nurse that he has always believed his parents “didn’t
want him” and now he has proof. What should the nurse counsel this patient?
1. Suggest the patient talk with a counselor to discuss the results of the test and future options.
2. Ask the patient if he has ever discussed his thoughts and fears with his parents.

3. Encourage the patient to talk with his siblings about the illness and ask them for help now before he has
manifestations of the disease.
4. Remind the patient that genetic testing is inconclusive, and there is a great chance that the results are wrong.
Correct Answer: 1
Rationale 1: Individuals learning of genetic testing results can have feelings of anger, guilt, confusion, and
depression. The nurse should suggest that the patient talk with a counselor to discuss the test results and future
options to help the patient work through his feelings.
Rationale 2: The nurse should not suggest that the patient confront his parents with his thoughts and feelings.
Rationale 3: The nurse should also not suggest that the patient discuss the test results with his siblings in order to
elicit their help and support before the disease manifests.
Rationale 4: Genetic testing is not inconclusive. This would be an inappropriate suggestion to make to the
patient.
Global Rationale: Individuals learning of genetic testing results can have feelings of anger, guilt, confusion, and
depression. The nurse should suggest that the patient talk with a counselor to discuss the test results and future
options to help the patient work through his feelings. The nurse should not suggest that the patient confront his
parents with his thoughts and feelings. The nurse should also not suggest that the patient discuss the test results
with his siblings in order to elicit their help and support before the disease manifests. Genetic testing is not
inconclusive. This would be an inappropriate suggestion to make to the patient.
Client Need Sub:
QSEN Competencies: I.A.9. Discuss principles of effective communication
Page Number: 148
Question 15
Type: MCSA
A patient learning that her newborn baby has a genetic disorder tells the nurse that it was because a stranger gave
her baby the “evil eye.” What should this information suggest to the nurse?

1. The patient’s culture supports the notion that a stranger looking at the baby caused the disorder.
2. The patient needs psychiatric counseling.
3. The patient is not going to be a good mother since she permits strangers around the baby.
4. Healthcare dollars should not be spent trying to change this patient’s opinion of why the baby has a genetic
disorder.
Correct Answer: 1
Rationale 1: The nurse needs to be aware of the patient’s cultural and religious beliefs. The patient stating that the
newborn has a genetic disorder because a stranger gave the baby the “evil eye” is evidence that the patient
believes this is the cause of the disorder.
Rationale 2: This information does not suggest that the patient needs psychiatric counseling or that the patient is
not going to be a good mother.
Rationale 3: This information does not suggest that the patient is not going to be a good mother.
Rationale 4: Deciding whether healthcare dollars should be spent trying to change the patient’s opinion of why
the baby has a genetic disorder is beyond the scope of the nurse.
Global Rationale: The nurse needs to be aware of the patient’s cultural and religious beliefs. The patient stating
that the newborn has a genetic disorder because a stranger gave the baby the “evil eye” is evidence that the patient
believes this is the cause of the disorder. This information does not suggest that the patient needs psychiatric
counseling or that the patient is not going to be a good mother. Deciding whether healthcare dollars should be
spent trying to change the patient’s opinion of why the baby has a genetic disorder is beyond the scope of the
nurse.
Client Need Sub:
QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic and social backgrounds function as sources of
patient, family, and community values
AACN Essentials Competencies: VII.3. Assess health/illness beliefs, values, attitudes, and practices of
individuals, families, groups, communities and populations
NLN Competencies: Context and Environment; Ethical Comportment; Show respect for others' values;
appreciate diversity
Page Number: 148

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

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

Client Need Sub:
terminology
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
Learning Outcome: 5. Identify the significance of recent advances in human genetics and the effect on
healthcare delivery.
MNL Learning Outcome: 7.8.1. Explain the incidence, causes, risk factors, and pathophysiology of Alzheimer
disease.
Page Number: 140
Question 18
Type: MCSA
From genetic testing, a patient learns that a specific medication can help a developing disease process. What does
the nurse understand that genetic testing provided for the patient?
1. biological marker
2. phenotype
3. genotype
4. translocation
Correct Answer: 1
Rationale 1: Biological markers are easily tracked, stable segments of DNA. Information gained from biological
markers will provide information on how subtle differences in humans impact their response to drugs and the
environment, thus making medical treatment and pharmacologic management more individualized.
Rationale 2: The observable, outward expression of an individual’s entire physical, biochemical, and physiologic
makeup, as determined by their genotype and environmental factors, is referred to as phenotype.
Rationale 3: The specific sequence of nucleotides is referred to as the individual’s genotype.
Rationale 4: Translocation occurs when a segment of a chromosome transfers or moves and attaches itself to
another chromosome.

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