Deck 13: Family History Tool

Question 1

The nurse is recording a woman's obstetrical history as part of a comprehensive genetic history.Which information should the nurse include?

A)The client has delivered two healthy infants in the last three years.
B)The client's last pregnancy was not planned.
C)The client had pregnancy-induced hypertension while carrying her last child.
D)The client revealed that she is not certain of the paternity of her first child.
E)The client has had two spontaneous abortions.

Answer 1

The client has delivered two healthy infants in the last three years.
The client had pregnancy-induced hypertension while carrying her last child.
The client has had two spontaneous abortions.

Question 2

An autosomal dominant trait is discovered by a nurse constructing a client pedigree.The trait has not appeared in two generations but was strongly evident three generations ago.What advice should the nurse provide for the client?

A)"Your family should be genetically tested for this trait."
B)"The men in your family should be genetically tested for this trait."
C)"This trait existed in your past,but will not be transmitted now."
D)"Your children have a 25% risk of inheriting this trait."

Answer 2

"This trait existed in your past,but will not be transmitted now."

Question 3

When reviewing a completed pedigree,the nurse notes the strong presence of a heritable trait and discusses the situation with the client and the physician.The client declines to notify relatives.Under what circumstances can the wishes of this client be disregarded?

A)Under no circumstances
B)When a relative is at risk for an untreatable disease
C)When harm is likely to occur if disclosure is not made
D)If the family member at risk can be determined by the information given
E)When there is no stigma related to the disorder

Answer 3

When harm is likely to occur if disclosure is not made
If the family member at risk can be determined by the information given

Question 4

A client states,"I asked my aunt if she had any history of miscarriage,but she wouldn't tell me." What should the nurse consider when responding to this statement?

A)Most family members are willing to divulge important health information.
B)The client must not have a good relationship with the aunt.
C)The aunt has a right to keep her health history private.
D)The aunt probably has had miscarriages that she is still mourning.

Question 5

The nurse is reviewing a female client's genetic pedigree and sees a set of two squares with a triangle inside each square.How should the nurse interpret this symbol?

A)The client has brothers who are identical twins.
B)The client had two brothers,but one is deceased.
C)This couple consists of gay men.
D)The client's mother spontaneously aborted a male fetus.

Question 6

A client says,"My mom had Alzheimer disease and I am so afraid I am going to get it." Which nurse,if any,could best determine this client's risk and provide direction for care?

A)Any professional nurse
B)A nurse who has worked in an Alzheimer unit
C)A genetic clinical nurse
D)Nurses do not have the skills for this level of intervention.

Question 7

A nurse is constructing a pedigree for a client who was raised as a boy but is now transgendered.The client is affected by sleepwalking.How would the nurse indicate this individual on the pedigree?

A)With a circle that has a slash through it
B)With a square that intersects with a circle
C)With a diamond
D)By shading in the symbol used to designate the client
E)By drawing a horizontal line under the symbol used to designate the client

Question 8

The nurse is planning to construct a three-generation pedigree for a client with a heritable disorder.Which step should be the nurse's first priority?

A)Determine if any persons in the client's immediate family are affected by the disorder.
B)Discuss the cost of this work with the client.
C)Obtain informed consent from living family members.
D)Have the client complete a questionnaire detailing as much family history as is currently known.

Question 9

The providers at a clinic are interested in improving the amount of family history collected on each client but do not wish to extend visit times.Which statement by the nurse is most helpful?

A)"We could have the office manager ask some questions while the clients are in the waiting area."
B)"We could have new clients come in 30 minutes before their appointment time to complete a questionnaire."
C)"We could hire a secretary to complete these histories on new clients."
D)"We could ask a few questions at every visit."

Question 10

A child is accompanied to the clinic by the grandmother rather than by the parents.The grandmother says,"I am substituting for my daughter today because she is ill." The nurse would like to add information to the child's health history.How should the nurse proceed?

A)Wait until the parents bring the child to an appointment.
B)Understand that a grandmother is an authority on the child's life.
C)Plan to validate any information with the parents at the next visit.
D)Check the grandmother's accuracy by validating some data with the medical record.

Question 11

The nurse and a client have been working together to construct the client's pedigree.When the pedigree is complete,the client says,"I'd love to have a copy of this to frame for my living room wall." How should the nurse respond?

A)"A pedigree is like a beautiful work of art."
B)"Some of your family may not want their information displayed."
C)"No one would understand what it means."
D)"The information is not identifiable,so I don't see a problem."

Question 12

The policy of an adult health clinic is to collect a family history of three generations on every new client.The nurse orienting a newly hired nurse explains this policy in which way?

A)"Family history is a critical component of the way we educate clients about their health."
B)"You will not find this depth of family history collected in most practices."
C)"We are working to change this policy as it is very time consuming."
D)"Most of this information is never reviewed by providers."
E)"We review this information with clients at every visit and update the information as necessary."

Question 13

The nurse is interviewing a client in regard to his history of benign prostatic hypertrophy (BPH).Which question should the nurse ask first?

A)"How long have you had BPH?"
B)"Does your condition interfere with your sex life?"
C)"How are you feeling today?"
D)"This is a frustrating condition,isn't it?"

Question 14

The nurse constructing a genetic pedigree would use an arrow to indicate which situation?

A)This is the client for whom the pedigree is being created.
B)This is the person who relayed the majority of information for the pedigree.
C)This is the person who is seeking genetic counseling.
D)The person who is furthest in time from the client requesting the pedigree.
E)The point at which there is an interruption in knowledge about the client's ancestors.