Deck 11: Newborn Screening and Genetic Testing: Ethical Considerations

Question 1

A newborn's screening tests indicate the presence of a hemoglobin disorder.Which assessment findings would the nurse expect in this newborn?

A)Normal assessment
B)Seizure
C)Listlessness and inability to maintain thermal control
D)Urine that smells like burnt sugar

Answer 1

Normal assessment

Question 2

A state legislature is considering the expansion of funding for newborn screening to assure availability to all newborns in the state.What ethical principle is being upheld by this group?

A)Distributive justice
B)Nonmaleficence
C)Justice
D)Self-determination

Answer 2

Distributive justice

Question 3

A public health nurse is addressing legislators on the topic of funding for newborn screening.Which topic should be this nurse's priority?

A)Increasing the number of diseases on the state's standard screen
B)Including screening for hearing loss in the state's standard screen
C)Legislation mandating that screenings not paid for by insurance are paid for with state money
D)Ensuring that all parents are offered the opportunity to have their baby screened

Answer 3

Ensuring that all parents are offered the opportunity to have their baby screened

Question 4

One of a client's treatment options involves an autologous stem cell transplant from cord blood.What is the best source of this blood?

A)Stored cord blood from a sibling who is a transfusion match
B)Stored cord blood from any relative who is a transfusion match
C)Stored cord blood from any donor who is a transfusion match
D)Stored cord blood from any donor of the same gender who is a transfusion match

Question 5

A research study is conducted using newborn screening samples analyzed and stored over two years at a state health department.Study results are inconsistent and erratic.What are the likely reasons for this variability?

A)Differences in the way samples were originally collected
B)Degradation of the samples over time
C)Contamination from the original analysis
D)Inexperience using newborn screening samples
E)High numbers of conditions screened in these samples

Question 6

A nurse researcher has proposed a study that would require the analysis of thousands of newborn screening samples.Which ethical principle is this study most likely to violate?

A)Beneficence
B)Autonomy
C)Fidelity
D)Nonmaleficence

Question 7

How would the nurse explain the process of newborn screening to new parents?

A)"Your infant will be screened for 10 diseases in our lab and the rest of the samples will be sent to the state laboratory."
B)"We will collect two urine samples from your child for this screening."
C)"The screening will only require one blood sample."
D)"The screening sample will be drawn at your baby's six-week check-up."

Question 8

The mother of a newborn states,"I am surprised that my baby is only being tested for 30 genetic diseases.When my son was born in another state he was tested for several dozen." How should the nurse respond?

A)"Each state controls how its newborn screening program works."
B)"Some states are more advanced than this one."
C)"Fewer tests are done now,but more diseases are included in those tests."
D)"The federal government has decided that not as many tests are needed now."

Question 9

Which statements regarding newborn screening programs would the nurse recognize as supporting the ethical principle of autonomy?

A)Mandatory newborn screening programs should be standardized across all states.
B)Parents should have the right to decide if their infant will undergo newborn screening.
C)Newborn screening identifies some treatable conditions and serves to improve the life of the child.
D)Newborn screening identifies some treatable conditions and serves to improve the health of the nation.
E)Ideally the parents would decide which newborn screens are performed.

Question 10

A couple took their newborn home from the hospital yesterday.The pediatrician's office was notified this morning that the infant's newborn screen was positive.What information should the nurse provide to the parents?

A)"You need to take your baby back to the hospital for examination."
B)"We don't see many false positive screens,so we should take action quickly."
C)"I would like to schedule an appointment so that we can talk with you about this screen."
D)"We may want to schedule an appointment with a specialist."
E)"A second screening may be indicated."

Question 11

Which newborn sample would be best to screen for prenatal drug,alcohol,and nicotine exposure?

A)Mother's blood
B)Meconium stool
C)Hair
D)Skin cells

Question 12

The parents refuse newborn screening for their infant,who was born this morning.What nursing action is indicated?

A)Draw a sample for screening in case they change their minds.
B)Discuss the purposes of the screen with the parents.
C)Obtain a court order for the screening.
D)Warn the parents that the pediatrician may refuse to care for the infant if screening is not performed.

Question 13

Members of an obstetrical practice group have decided to screen all pregnant women for drugs,alcohol,and nicotine.What is the most important aspect of planning for this screen?

A)Preparing a detailed informed consent form
B)Identifying which insurance carriers will pay for this testing
C)Publicizing the intention to do this screening
D)Securing the most accurate testing available

Question 14

A state health department is planning to redesign its newborn screening program.The nurse charged with heading this initiative would identify which concerns about using the Wilson and Jungner Classic Screening Criteria to guide this work?

A)Interpretation of what is an "important health problem" is individual and therefore variable.
B)The acceptability of tests to the population is variable.
C)The issue of cost containment is not as important as it was when these criteria were developed.
D)Today's testing may have widespread implications.
E)Screening tests are developing very rapidly.