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LeMone/Burke/Bauldoff, Medical-Surgical Nursing 5th Edition Test Bank
Copyright 2011 by Pearson Education, Inc.
Chapter 8
Question 1
Type: MCSA
A female patient tells the nurse that she is genetically predisposed to type 2 diabetes. Which of the following is
the most important information for this patient?
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:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1. Discuss the role of genetic concepts in health promotion and health maintenance.
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.
The nurse would most correctly respond to this patient with which of the following statements?
1. “A complete genetic study could help guide you in your decision making.”

2. “I supposed, 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.
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. 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:
Question 3
Type: MCSA
A patient tells the nurse that she is concerned about transmitting genetic illnesses to any future children. Which of
the following 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: 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.
Rationale 4: 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 being referred to a geneticist for diagnosis.
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:
Nursing/Integrated Concepts: Nursing Process: Assessment
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. Which of the following should the nurse discuss with the patient?
1. the importance of having screening for colon-rectal cancer at an earlier age
2. the 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 colon-rectal 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 colon-rectal 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:
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. This nurse has most likely discovered which of the following?
1. a polymorphism
2. a mutation
3. a single-gene inheritance pattern
4. an X-linked inheritance pattern
Correct Answer: 1
Rationale 1: 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.
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.
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: 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 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. 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.
Client Need Sub:
Learning Outcome: 2. Apply knowledge of the principles of genetic transmission and risk factors for genetic
disorders.
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 of the following?
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: Translocations occur when there are breaks in two or more chromosomes with reattachments in new
combinations.
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.
Translocations occur when there are breaks in two or more chromosomes with reattachments in new
combinations. Structural rearrangements of chromosomes may result from deletions or loss of a chromosome
segment or piece.
Client Need Sub:
disorders.
Question 7
Type: MCSA
A nurse is planning to teach the parents of a child with cystic fibrosis how the disease is manifested. Which of the
following statements is the best explanation?
1. “While all people carry the gene 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. 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: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
disorders.
Question 8
Type: MCSA
A patient tells the nurse that many of her family members have a type of anemia that is genetic. The nurse realizes
that this patient will do which of the following?
1. develop the disease only if there is a mutation in the gene
2. develop the same type of anemia
3. die from the anemia
4. 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, not translocation nor the gene itself, which predisposes some individuals for disease.
Rationale 2: The patient may or may not develop anemia.
Rationale 3: The patient may or may not die from anemia.
Rationale 4: All humans have essentially the same 20,000 to 25,000 genes; it is the mutation or polymorphism in
the gene, not translocation nor the gene itself, which predisposes 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, not translocation nor the gene itself, which predisposes some individuals for disease.
The patient may or may not develop or die from anemia.
Cognitive Level: Analyzing

Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
disorders.
Question 9
Type: MCSA
At the completion of genetic testing it has been determined that a patient’s baby will have Down syndrome.
Which of the following 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: 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: 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 Sub:
Learning Outcome: 3. Describe the significance of delivering genetic education and counseling follow-up in a
professional manner.
Question 10
Type: MCSA

The nurse is developing a teaching plan for parents who need genetic counseling. Which statement by a parent
would indicate 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 chromosomes 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.
Cognitive Level: Analyzing
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
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. Which of the following can 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 since most of the time they are inconclusive.”
Correct Answer: 1
Rationale 1: One benefit of genetic testing is to provide 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 if the patient is going to need cardiac bypass surgery.
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 also not minimize the importance of the genetic testing results.
Global Rationale: One benefit of genetic testing is to provide 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 if the patient is going to
need cardiac bypass surgery. 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 also not minimize the importance of the genetic
testing results.
Client Need Sub:
Question 12
Type: MCSA
A pregnant patient, learning that her unborn child has a high risk for Down syndrome, tells the nurse that she can
just hear her mother now telling her “you should have had children when you were young and not in your late
30s.” Which of the following should the nurse respond to this patient?

1. “There might be a higher risk for Down syndrome with an older mother but younger women have also given
birth to babies with Down syndrome.”
2. “Maybe you should have listened to your mother.”
3. “I wish all women would have children before they were 30 to eradicate the disease.”
4. “It’s not too late to terminate the pregnancy and try again.”
Correct Answer: 1
Rationale 1: The patient is expressing guilt for waiting to have children. The nurse should explain that the risk
may be higher for a woman who is older to have a baby with Down syndrome however younger women have
given birth to a baby with the same genetic disorder.
Rationale 2: The nurse should not reinforce the patient’s guilt by agreeing with the patient’s mother.
Rationale 3: The nurse should not make the statement that all mothers should be under the age of 30. Down
syndrome is a genetic disorder and not a disease.
Rationale 4: It would be inappropriate for the nurse to suggest the patient terminate the pregnancy.
Global Rationale: The patient is expressing guilt for waiting to have children. The nurse should explain that the
risk may be higher for a woman who is older to have a baby with Down syndrome; however, younger women
have given birth to a baby with the same genetic disorder. The nurse should not reinforce the patient’s guilt by
agreeing with the mother. The nurse should not make the statement that all mothers should be under the age of 30.
Down syndrome is a genetic disorder and not a disease. It would be inappropriate for the nurse to suggest the
patient terminate the pregnancy.
Client Need Sub:
Question 13
Type: MCSA
A patient planning to be married tells the nurse that she has a strong family history of Huntington’s chorea but
does not plan to let her fiancé know. Which of the following 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’s 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’s 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’s chorea.”
Client Need Sub:
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.
Question 14
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. Which of the following 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

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