Deck 4: Genetic and Hereditary Influences

Question 1

A nurse is reviewing the charts of children in the pediatric units to determine which parents would benefit from referral to the genetics clinic. The nurse recognizes that the parents of children with genetic and chromosomal disorders would benefit most from this referral. Therefore, the nurse refers the parents of the: Standard Text: Select all that apply.

A)Neonate born at 28 weeks with respiratory distress syndrome.
B)Two-year-old child who is terminally ill with a brain tumor.
C)Child diagnosed at age six with cystic fibrosis.
D)Four-year-old child with nephrotic syndrome.
E)Child with Duchenne muscular dystrophy being treated for respiratory symptoms.

Answer 1

Child diagnosed at age six with cystic fibrosis.
Child with Duchenne muscular dystrophy being treated for respiratory symptoms.

Question 2

The nurse is discussing autosomal recessive inheritance with a patient. The nurse will include which statements in the discussion? Standard Text: Select all that apply.

A)"The disorder may appear to skip generations."
B)"Boys and girls are affected in equal numbers."
C)"The disorder passes from mother to son but not from father to daughter."
D)"Daughters that are affected will be more severely involved than sons."
E)"Both parents must be carriers for the disorder."

Answer 2

"The disorder may appear to skip generations."
"Boys and girls are affected in equal numbers."
"Both parents must be carriers for the disorder."

Question 3

All five of the children in a family were born with a genetic disorder. The disorder is inherited as autosomal dominant. If this is not a statistical rarity, the likelihood would be that:

A)One parent has both chromosomes with the affected gene.
B)Both parents are carriers.
C)One parent is a carrier and the other parent is unaffected.
D)One parent has one chromosome affected and the other parent has none.

Answer 3

One parent has both chromosomes with the affected gene.

Question 4

Which parent statement shows understanding of the cause of the child's genetic condition in such a way that the nurse can document that no further teaching about the cause is needed?

A)"I was angry on the day he was conceived; that is why he got this sickness."
B)"My nephews had chickenpox in my seventh month of pregnancy with my son, so that is how he got this way."
C)"My child has this disease because the code in the genes just changed, and it is no one's fault."
D)"Our child is like this because I sunbathed too much during the pregnancy when I carried him."

Question 5

The nurse is discussing genetic referral with the parents of children being seen in the pediatric clinic. The child who would benefit from a genetic referral is the child whose family has a history of:

A)Prominent epicanthal folds, resonant lungs, or absent tinnitus in Asian families.
B)Broad face, lower-extremity lichenification, or spider angiomas.
C)Normocephalic head, euthyroid, or five digits per extremity.
D)Cleft lip and/or cleft palate, diaphragmatic hernia, or cataract.

Question 6

During a sports physical, a client is found to have myopia, long digits, tall stature, an arm span greater than his height, scoliosis, and a hollow chest. The nurse should suspect:

A)Phenylketonuria.
B)Turner's syndrome.
C)Huntington's chorea.
D)Marfan's syndrome.

Question 7

A couple is evaluated in the genetics clinic, and the male is found to be a carrier of an X-linked dominant disorder. The couple asks the nurse what this means in regard to their future children. The nurse's response will include the information that:

A)All girls born to the family will be affected.
B)About 25% of the boys born to the family will be affected.
C)About 25% of the girls born to the family will be affected.
D)All boys born to the family will be affected.

Question 8

A child has been diagnosed as having a genetic disorder based on a mosaic trisomy. The nurse recognizes that the mother understands the significance of this diagnosis when she states:

A)"Because my child has a mosaic trisomy, he will have some normal cells in his body, which means his disorder may not be as severe as in other children."
B)"Children born with mosaic trisomy do not pass the disorder on to their children."
C)"Mosaic trisomies are inherited from the father's side of the family."
D)"Mosaic trisomies occur in an ovum from an older woman."

Question 9

Parents of a baby who died shortly after birth from a genetic disorder have been referred to a genetics clinic. The physician has explained to the parents why the referral was made. Which statement by the parents indicates that they understand the reason for the referral?

A)"I think going to the genetics clinic will help us get over the loss of our baby."
B)"I'm afraid the genetics clinic will tell us we cannot have another baby."
C)"The genetics clinic will prevent this from happening to us again."
D)"The genetics clinic will give us the information we need to decide whether we want to try again."

Question 10

Following carrier testing, it is determined that both the husband and wife have sickle-cell trait. Which statement by the wife indicates correct understanding of autosomal recessive inheritance?

A)"Because both my husband and I carry the trait but do not have the disease, I don't need to have prenatal testing because my baby will also be a carrier."
B)"Because both my husband and I are both carriers, I don't need to have prenatal testing because all of our children will have the disease.
C)"When I become pregnant, I need to have an amniocentesis or other prenatal test to determine whether my baby is affected with sickle-cell disease."
D)"There is no use undergoing prenatal testing as sickle-cell anemia cannot be diagnosed prenatally."

Question 11

The nurse teaches children with genetic disorders ways to maintain health and avoid complications. The nurse will teach children with which genetic disorder to follow medical guidelines and maintain penicillin prophylaxis?

A)Sickle-cell disease
B)Hereditary idiopathic scoliosis
C)Klinefelter's syndrome
D)Recklinghausen's disease

Question 12

Advances in genetic screening provide information with high levels of certainty about genetic disorders a fetus might have. Which is an ethical implication of these advances?

A)The nurse must participate in actions that are completely contradictory to his personal ethics.
B)The nurse must be aware of his own personal feelings about the actions taken after the screening tests are completed.
C)The nurse must be aware of parent feelings regarding the information available to them.
D)The parents must be aware of the nurse's feelings regarding the information available about the fetus.

Question 13

The nurse in the genetics clinic is working with families undergoing testing for genetic disease. If the initial testing is positive, more extensive testing is required to confirm:

A)Prenatal diagnostic testing.
B)Carrier screening.
C)Newborn screening.
D)Pre-implantation genetic diagnosis.

Question 14

As medical care has evolved, it has become more common for children with genetic disorders to live longer. What impact does this have on health care delivery for the nurse providing care for these children?

A)Health care delivery is becoming more complex, despite these children requiring less care as they age.
B)Nurses should not spend much time at the bedside, as these children will eventually die of these disorders.
C)Nurses must be familiar with increasing numbers of genetic disorders and the care these children require.
D)Health care delivery will become more and more expensive until children with genetic disorders will have to do without.

Question 15

A couple has been referred for genetic counseling. Prior to making the appointment, the couple should understand that:

A)The cost of genetic counseling will be covered by their health insurance.
B)Genetic counseling and testing is voluntary.They have a right to decide not to seek the information.
C)Once genetic counseling has been completed, the physician may require sterilization of the man or woman.
D)Their extended family will benefit from the knowledge the couple gains.

Question 16

During genetic testing, one parent is found to have a chromosomal abnormality without any physical or mental disability; however, the offspring has inherited physical and/or mental disability. During patient education, the nurse explains that the type of individual who can have a chromosomal abnormality without any disability but can cause his offspring to receive chromosomal alterations and disability is the parent with:

A)Dominant-gene structural chromosomal inversions.
B)Mosaicism.
C)Dominant-gene structural chromosomal balanced translocations.
D)Dominant-gene structural chromosomal deletions.

Question 17

When a parent reports multiple male miscarriages, the nurse should confer with the health care provider about a possible genetics referral for which type of conditions?

A)Anticipation autosomal dominant conditions
B)X-linked recessive conditions
C)X-linked dominant conditions
D)Autosomal recessive conditions