NURS C475 Care of the older adult AMNH Questions and Answers | 100% Guaranteed Pass | Western Governors University

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NURS C475 Care of the older adult AMNH Questions and Answers | 100% Guaranteed Pass Which condition provides the greatest support for a strong genetic contribution to autism spectrum disorders (ASD... s)? Select one: a. ASDs are more likely to occur in children of parents who are over 35 at time of conception. b. Concordance among dizygotic twins is 10%. c. People with some neurologic disorders also have features of ASDs. d. Males are affected four times more frequently than females. Feedback The correct answer is: Concordance among dizygotic twins is 10%. Question 2 Juliet tells a nurse that she has three aunts (two on her father’s side, ages 42 and 56, and one on her mother’s side, age 62) who were diagnosed with breast cancer. She asks if she should have genetic testing. What should the nurse tell her? Select one: a. “Because no men in your family are affected, it is not inherited cancer so you don’t need mammograms or any special screening practices.” b. “Your family history indicates a high risk and you should definitely have genetic testing.” c. “Because your aunts were older when they got breast cancer, it was probably sporadic and you should just have regular mammograms like everyone else.” d. “Your family history may indicate an increased risk for breast cancer and a genetic counselor could help determine whether you could benefit from genetic testing.” Feedback The correct answer is: “Your family history may indicate an increased risk for breast cancer and a genetic counselor could help determine whether you could benefit from genetic testing.” Question 3 How are malignant tumors different from benign tumors? Select one: a. Benign tumors have totally normal features, and malignant tumors have totally abnormal features. b. Malignant tumors grow by expansion, and benign tumors grow by invasion. c. Malignant tumors lose plasma membranes, and benign tumors continue to produce them. d. Benign tumors retain parental cell functions, and malignant tumors lose parental cell functions. Feedback The correct answer is: Benign tumors have totally normal features, and malignant tumors have totally abnormal features. Question 4 A patient has a very high concentration of insulin receptors on cells that require insulin for glucose to enter. How should insulin dosages be adjusted for this patient to have blood glucose levels within the normal range? Select one: a. Insulin dosages should be given more frequently because the drug will be eliminated at a faster rate. b. Insulin dosages should be increased because cells will be less sensitive to the presence of active insulin c. Insulin dosages should be decreased because the drug will exert its actions at lower concentrations. d. Insulin dosages should be given less frequently because the drug will remain bound to receptors longer. Feedback The correct answer is: Insulin dosages should be decreased because the drug will exert its actions at lower concentrations. Question 5 What is the result of a mutation occurring in a suppressor gene? Select one: a. Gain of a new function b. Increased “error­prone” DNA repair c. Loss of an existing function d. Increased unequal “crossing over” during meiosis I Feedback The correct answer is: Loss of an existing function Question 6 Which statement regarding the biology of cancer is always true? Select one: a. Testicular cancer is strongly associated with excessive masturbation. b. The biggest risk factor for cancer development is having a first­degree relative with cancer. c. Cancer cells arise from normal cells. d. When cancer cells are exposed to air, their growth rate becomes uncontrolled. Feedback The correct answer is: Cancer cells arise from normal cells. Question 7 What is the best description of the genetic contribution to onset of autism? Select one: a. Autism spectrum disorders have a much stronger environmental input than genetic input to expression of the phenotype. b. Exposure to a teratogen can be a cause of autism spectrum in many cases. c. Known causes of autism spectrum include copy number variants and chromosomal problems. d. Autism spectrum is caused by a single gene mutation in most, but not all, cases. Feedback The correct answer is: Known causes of autism spectrum include copy number variants and chromosomal problems. Question 8 What would be the patient’s response to a normal drug dose that because of a genetic variation in an enzyme that prepares the drug for elimination results in a blood drug level that is below the minimum effective concentration (MEC)? Select one: a. The drug’s duration of action is longer than expected. b. Drug entry exceeds drug elimination c. The intended response fails to be produced. d. The risk for toxic side effects is increased. Feedback The correct answer is: The intended response fails to be produced. Question 9 Julia (aged 32) is BRCA1 positive, which is known to greatly increase the risk for breast and ovarian cancer. She was tested because her mother, who had ovarian cancer, was BRCA1 positive. Julia has decided to have both of her ovaries removed because she believes that, in her family, being BRCA1 positive increases the risk for ovarian cancer only. How should a genetic counselor respond to Julia’s statement? Select one: a. Accept Julia’s explanation as a manifestation of her autonomy and remain nondirective in the interactions with her. b. Clarify that a BRCA1 mutation does not preferentially express ovarian cancer over breast cancer in any given family. c. Discuss Julia’s responsibility to inform all the other female members of her family about her BRCA1 status and cancer risk d. Encourage her to consider a bilateral mastectomy. Feedback The correct answer is: Clarify that a BRCA1 mutation does not preferentially express ovarian cancer over breast cancer in any given family. Question 10 What is the heritability estimate for addiction to alcohol in both males and females? Select one: a. 20% to 40% b. 60% to 80% c. 10% to 20% d. 50% to 60% Feedback The correct answer is: 50% to 60% Question 11 A patient with a fractured elbow in the emergency department states that he needs morphine for pain rather than codeine because the last time he had a painful injury, codeine was not effective in managing his pain. What is the nurse’s best response or action? Select one: a. Reassure the patient that he will receive progressively higher dosages of codeine until his pain is controlled. b. Communicate this information to the admitting physician. c. Alert the health­care provider that this patient is “drug­seeking.” d. Ask the patient how much alcohol he ingests daily. Feedback The correct answer is: Communicate this information to the admitting physician. Question 12 Which type of genetic testing is the most sensitive method for detecting any mutation in a specific gene? Select one: a. Immunohistochemistry b. Direct DNA sequencing c. Banded chromosomal analysis d. Fluorescence in situ hybridization Feedback The correct answer is: Direct DNA sequencing Question 13 Which normal cell characteristic is represented by the production of insulin in the beta cells of the pancreas? Select one: a. Performance of a differentiated function b. Conservation of energy c. Tight regulation of cell division d. Ability to undergo apoptosis on schedule Feedback The correct answer is: Performance of a differentiated function Question 14 An 85­year­old patient states that she does not perform breast self­exam because there is no history of breast cancer in her family. What is the best response? Select one: a. “Because your breasts are no longer as dense as they were when you were younger, your risk for breast cancer is now decreased.” b. “Examining your breasts once per year when you have your mammogram is sufficient screening for someone with your history.” c. “You are correct. Breast cancer is an inherited type of malignancy and your family history indicates a low risk for you.” d. “Breast cancer can be found more frequently in some families; however, the risk for general, nonfamilial breast cancer increases with age.” Feedback The correct answer is: “Breast cancer can be found more frequently in some families; however, the risk for general, nonfamilial breast cancer increases with age.” Question 15 What is the genetic contribution to the development of the most common forms of atherosclerosis? Select one: a. Single gene mutation following autosomal dominant inheritance b. Disordered mitochondrial function reducing energy production c. Genetic predisposition expressed after exposure to a viral trigger d. Variation in a variety of genes each exerting a small effect Question1: Sometimes health­care providers with information about family members’ genetic risk are confronted by conflicting ethical principles. Which principle is LEAST likely to conflict with the health­care provider’s “duty to warn”? Select one: a. Beneficence b. Autonomy c. Genetic discrimination d. Right to privacy Feedback The correct answer is: Genetic discrimination Question 2 What is the heritability estimate for schizophrenia in the general population? Select one: a. 40% b. 80% c. 60% d. 100% Feedback The correct answer is: 80% Question 3 What type of genetic test provides information about an asymptomatic person’s risk for having a child with a specific autosomal recessive disorder in the future? Select one: a. Predictive test b. Diagnostic test c. Newborn screening d. Carrier test Feedback The correct answer is: Carrier test Question 4 Which action reflects promotion of genomic care as part of comprehensive health care? Select one: a. Ensuring that genomic issues potentially influencing a person’s health are incorporated into routine care b. Calculating the odds ratios and recurrence risks of common complex health problems for all people c. Encouraging all people to undergo genetic testing as part of a proactive health screening and prevention program d. Instructing patients who undergo genetic testing about their obligation to inform family members regarding test results Feedback The correct answer is: Ensuring that genomic issues potentially influencing a person’s health are incorporated into routine care Question 5 Which statement best describes the role of tumor suppressor genes in cancer development? Select one: a. Tumor suppressor genes reduce/suppress immune function, increasing the risk for cancer development. b. The presence of tumor suppressor genes increases the risk for gene damage by environmental carcinogens. c. Tumor suppressor genes control or modify the activity of oncogenes, reducing the risk for cancer development. d. Tumor suppressor genes are a type of oncogene that is only active in germ line cells and tissues. Feedback The correct answer is: Tumor suppressor genes control or modify the activity of oncogenes, reducing the risk for cancer development. Question 6 Which “schizophrenia fact” is correct? Select one: a. Because the phenotype of schizophrenia is so obvious, diagnosis and inheritance risk are the most easily determined of all the psychiatric disorders. b. Copy number variants appear to play the most important role in genetic risk for schizophrenia. c. When schizophrenia has more genetic influence, its onset begins in very early childhood. d. When one identical twin is affected with schizophrenia the other most certainly will be affected. Feedback The correct answer is: Copy number variants appear to play the most important role in genetic risk for schizophrenia. Question 7 Your patient, Maggie, insists that her mother have genetic testing to determine if her breast cancer is connected to a mutation in the BRCA1/2 genes. Maggie is concerned about her own risk for getting breast cancer and that of her children, but Maggie’s mom does not want to be tested. What ethical principle is one of several that must be considered in evaluating this case? Select one: a. Maggie’s “autonomy” b. Maggie’s mother’s “right to know” c. Maggie’s mother’s “right to privacy” d. The nurse’s “duty to warn” Feedback The correct answer is: Maggie’s mother’s “right to privacy” Question 8 A patient states that she has heard that the origin of most cancers is “genetic.” What is the best response? Select one: a. “The development of most cancers is predetermined and not affected by environmental factors.” b. Cancers arise in cells that have alterations in the genes.” c. “Cancer is more common among males than females.” d. The majority of cancers are inherited.” Feedback The correct answer is: Cancers arise in cells that have alterations in the genes.” Question 9 Which statement regarding general cancer development is true? Select one: a. Most mutations leading to cancer development occur in structural genes. b. The risk for cancer development increases with age. c. Cancers usually develop in tissues that are missing a nucleus. d. Children of older mothers have a greater risk for cancer development. Feedback The correct answer is: The risk for cancer development increases with age. Question 10 A woman whose family history for breast cancer includes two paternal aunts who developed breast cancer before age 45. Which genetics professional would be most appropriate for assistance in helping this patient understand the health risk posed by this family history? Select one: a. Genetic counselor b. Clinical laboratory geneticist c. Clinical geneticist d. Medical geneticist Feedback The correct answer is: Genetic counselor Question 11 What should be told to the patient who has been found to have a genetic mutation that increases the risk for colon cancer and says he does not want any of his family to know about this result? Select one: a. “It is required by law that you inform your siblings and your children about this result so that they also can be tested and monitored for colon cancer.” b. “It is not necessary to tell your siblings because they are adults, but you should tell your children so they can be tested before they decide to have children of their own.” c. “It is your decision to determine with whom, if anyone, you share this test result; however, if you do not tell any of your family members and they get colon cancer, you would be responsible for their developing the disease.” d. “It is not required that you tell anyone about this result; however, because your siblings and children may also be at risk for colon cancer, you should think about how this information might help them.” Feedback The correct answer is: “It is not required that you tell anyone about this result; however, because your siblings and children may also be at risk for colon cancer, you should think about how this information might help them.” Question 12 A patient is 34 years old and concerned about possibly being a carrier for HNPCC because his father died of colon cancer at 39, his father’s sister died of colon cancer at age 41, and his brother (aged 37) now has colon cancer. The brother’s testing is negative for all the known mutations associated with inherited forms of colon cancer. How should this patient be counseled about his risk for colon cancer? Select one: a. Explain that because the brother with cancer is negative for these gene mutations, this cancer is most likely sporadic and his risk is the same as general population risk. b. Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. c. Explain that his risk is not related to his brother’s diagnosis because he did not inherit any genes from him but that since his father is a first­degree relative, testing should be considered. d. Explain that he could benefit from testing even though his brother is negative for these mutations because reduced penetrance might account for his negative status. Feedback The correct answer is: Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. Question 13 What is the relationship among genes, DNA, and proteins? Select one: a. DNA is composed of a series of amino acids that provide the directions for synthesizing proteins. b. A gene is a section of DNA that provides the directions for synthesizing a specific protein. c. Protein is composed of DNA that is organized into specific gene sequences called amino acids. d. Proteins are the nitrogenous bases that form double strands of DNA in its helical shape. Feedback The correct answer is: A gene is a section of DNA that provides the directions for synthesizing a specific protein. Question 14 A patient whose mother has Huntington’s disease is considering genetic testing but is not sure whether she really wants to know if she has the mutation. She asks you what you would do if your mother had the disease. What is your best response? Select one: a. “I can only tell you the benefits and the risks of testing, you must make this decision yourself.” b. “You need to check with your brothers and sisters to determine whether testing for this disease would be appropriate for you.” c. “I would have the test so I could decide whether to have children or to use adoption.” d. “Because there is no cure for this disease and testing would not be beneficial, I would not have the test.” Feedback The correct answer is: “I can only tell you the benefits and the risks of testing, you must make this decision yourself.” Question 15 An Asian American man and his Caucasian wife are both taking warfarin (Coumadin) daily because of atrial fibrillation. The husband asks why he is prescribed a much smaller than average dose of the drug to keep his international normalized ratio (INR) at 2.0 and his wife takes the average dose even though he is taller and heavier than she is. What is the nurse’s best response? Select one: a. “Body size is not important for warfarin but gender differences are because testosterone improves its action.” b. Many Asian Americans do not break down warfarin as fast as Caucasians, so the drug is more effective at lower dosages c. “Caucasians have higher levels of the enzyme that breaks down warfarin, requiring higher dosages for the same effect on INR.” d. You are probably anemic, which would reduce your ability to form blood clots, so your doses can be lower.” Feedback The correct answer is: Many Asian Americans do not break down warfarin as fast as Caucasians, so the drug is more effective at lower dosages Question 1: Which normal cell characteristic is represented by the production of insulin in the beta cells of the pancreas? Select one: a. Conservation of energy b. Tight regulation of cell division c. Ability to undergo apoptosis on schedule d. Performance of a differentiated function Feedback The correct answer is: Performance of a differentiated function Question 2 How do genetic/genomic issues influence individual variation of the response to a specific drug? Select one: a. Age­related loss of alleles within the cells lining the intestinal tract b. Polymorphisms of genes encoding metabolizing enzymes c. Genetic­based behavior problems that promote poor adherence to prescribed drug regimens d. Single gene disorders that reduce the function of the kidneys or the liver Feedback The correct answer is: Polymorphisms of genes encoding metabolizing enzymes Question 3 Which lethal cardiac arrhythmia can occur as a complication of long QT syndrome? Select one: a. Mitral valve prolapse b. Torsade de Pointes c. Atrial node reentry tachycardia d. Prolonged atrial fibrillation Feedback The correct answer is: Torsade de Pointes Question 4 Which condition or behavior suggests attention deficit hyperactivity disorder (ADHD)? Select one: a. A 10­year­old who prefers to play basketball rather than chess. b. A 5­year­old who does not want to go to bed at 8:00 p.m. and begs to be allowed to stay up later. c. An 8­year­old who can hop on one foot but cannot ride a bicycle without training wheels. d. A 9­year­old who does not focus on a favorite story or game for longer than 3 minutes. Feedback The correct answer is: A 9­year­old who does not focus on a favorite story or game for longer than 3 minutes. Question 5 What would be the expected response to a skin injury if the involved tissue had lost the normal cell characteristic of contact inhibition? Select one: a. Excessive growth of replacement tissue b. Displacement of skin cells into other body tissues c. Failure of the wound to close d. Replacement with scar tissue rather than skin Feedback The correct answer is: Excessive growth of replacement tissue Question 6 In which body or cell area are most genes in humans located? Select one: a. Nucleus b. Cytoplasm c. Plasma Membrane d. Mitochondrion Feedback The correct answer is: Nucleus Question 7 How do genetic counselors provide genetic/genomic information to patients and families in a nondirective manner? Select one: a. Providing only the information the patient or family specifically requests b. Filtering management options and focusing on the information that will support the decision they believe is right for the individual patient/family c. Presenting all facts and available options in a manner that neither promotes nor excludes any legally permitted decision or action d. Skillfully directing the patient and family toward the best choice that is supported by appropriate research Feedback The correct answer is: Presenting all facts and available options in a manner that neither promotes nor excludes any legally permitted decision or action Question 8 Which variable in a person with coronary artery disease increases the likelihood of a strong genetic influence in its expression? Select one: a. The problem is severe before age 50 years. b. The disorder is not present in the person’s dizygotic twin. c. The disorder is present in about 5% of the person’s maternal older male family members. d. The affected person has eaten a vegetarian diet for the past 5 years. Feedback The correct answer is: The problem is severe before age 50 years. Question 9 What is the relationship among genes, DNA, and proteins? Select one: a. DNA is composed of a series of amino acids that provide the directions for synthesizing proteins. b. Proteins are the nitrogenous bases that form double strands of DNA in its helical shape. c. A gene is a section of DNA that provides the directions for synthesizing a specific protein. d. Protein is composed of DNA that is organized into specific gene sequences called amino acids. Feedback The correct answer is: A gene is a section of DNA that provides the directions for synthesizing a specific protein. Question 10 What is the most accurate classification of the common forms of coronary artery disease and hypertension? Select one: a. Secondary disorders caused by lifestyle choices b. Sequential genetic disorders related to age, ethnicity, and gender c. Complex disorders resulting from gene–environment interactions d. Primary disorders with an autosomal dominant pattern of inheritance Feedback The correct answer is: Complex disorders resulting from gene–environment interactions Question 11 Sometimes health­care providers with information about family members’ genetic risk are confronted by conflicting ethical principles. Which principle is LEAST likely to conflict with the health­care provider’s “duty to warn”? Select one: a. Autonomy b. Beneficence c. Right to privacy d. Genetic discrimination Feedback The correct answer is: Genetic discrimination Question 12 Which statement regarding behavioral genetics is accurate? Select one: a. The genetic susceptibility or predisposition toward a behavioral disorder requires the trigger of an infectious disease for expression. b. Genes and gene products have been discovered that directly control behavior. c. The genotypes and phenotypes of behavioral problems or deviations follow Mendelian autosomal recessive inheritance patterns. d. A genetic predisposition toward a specific behavior can be modified by altering environmental influences. Feedback The correct answer is: A genetic predisposition toward a specific behavior can be modified by altering environmental influences. Question 13 What term is used to describe the gene­to­gene interaction in which the action of one gene modifies the expression of a different gene? Select one: a. Epigenetic penetrance b. Heterogeneity c. Genomic imprinting d. Epistasis Feedback The correct answer is: Epistasis Question 14 Which condition provides the greatest support for a strong genetic contribution to autism spectrum disorders (ASDs)? Select one: a. ASDs are more likely to occur in children of parents who are over 35 at time of conception. b. People with some neurologic disorders also have features of ASDs. c. Concordance among dizygotic twins is 10%. d. Males are affected four times more frequently than females. Feedback The correct answer is: Concordance among dizygotic twins is 10%. Question 15 Which statement regarding general cancer development is true? Select one: a. Cancers usually develop in tissues that are missing a nucleus. b. The risk for cancer development increases with age. c. Children of older mothers have a greater risk for cancer development. d. Most mutations leading to cancer development occur in structural genes. Feedback The correct answer is: The risk for cancer development increases with age. Question 1: A woman whose family history for breast cancer includes two paternal aunts who developed breast cancer before age 45. Which genetics professional would be most appropriate for assistance in helping this patient understand the health risk posed by this family history? Select one: a. Genetic counselor b. Clinical geneticist c. Medical geneticist d. Clinical laboratory geneticist Feedback The correct answer is: Genetic counselor Question 2 How are malignant tumors different from benign tumors? Select one: a. Malignant tumors lose plasma membranes, and benign tumors continue to produce them. b. Benign tumors retain parental cell functions, and malignant tumors lose parental cell functions. c. Malignant tumors grow by expansion, and benign tumors grow by invasion. d. Benign tumors have totally normal features, and malignant tumors have totally abnormal features. Feedback The correct answer is: Benign tumors have totally normal features, and malignant tumors have totally abnormal features. Question 3 An 85­year­old patient states that she does not perform breast self­exam because there is no history of breast cancer in her family. What is the best response? Select one: a. “Breast cancer can be found more frequently in some families; however, the risk for general, nonfamilial breast cancer increases with age.” b. “You are correct. Breast cancer is an inherited type of malignancy and your family history indicates a low risk for you.” c. “Because your breasts are no longer as dense as they were when you were younger, your risk for breast cancer is now decreased.” d. “Examining your breasts once per year when you have your mammogram is sufficient screening for someone with your history.” Feedback The correct answer is: “Breast cancer can be found more frequently in some families; however, the risk for general, nonfamilial breast cancer increases with age.” Question 4 What would be the expected response to a skin injury if the involved tissue had lost the normal cell characteristic of contact inhibition? Select one: a. Displacement of skin cells into other body tissues b. Failure of the wound to close c. Replacement with scar tissue rather than skin d. Excessive growth of replacement tissue Feedback The correct answer is: Excessive growth of replacement tissue Question 5 Which lethal cardiac arrhythmia can occur as a complication of long QT syndrome? Select one: a. Atrial node reentry tachycardia b. Mitral valve prolapse c. Prolonged atrial fibrillation d. Torsade de Pointes Feedback The correct answer is: Torsade de Pointes Question 6 What is the heritability estimate for addiction to alcohol in both males and females? Select one: a. 60% to 80% b. 20% to 40% c. 50% to 60% d. 10% to 20% Feedback The correct answer is: 50% to 60% Question 7 A certified family nurse practitioner with an MSN degree in family practice who works in a clinic serving patients who have connective tissue disorders refers to himself as a clinical geneticist. Is this title appropriate? Select one: a. Yes, he is an advanced practice nurse. b. No, a clinical geneticist is a physician who has completed a fellowship in clinical genetics. c. No, a clinical geneticist must be certified as a genetic counselor. d. Yes, he is a clinician employed in a setting specializing in patients with genetic­based health problems Feedback The correct answer is: No, a clinical geneticist is a physician who has completed a fellowship in clinical genetics. Question 8 Under which condition(s) would genetic testing for predisposition to an inherited disorder in a minor child be considered reasonable? Select one: a. When the risk is high and prophylaxis to reduce disorder severity is available b. When the mutation within a family is known and is specific c. When penetrance is high and the expected onset is middle adulthood d. When the family pedigree indicates an autosomal dominant pattern of inheritance Feedback The correct answer is: When the risk is high and prophylaxis to reduce disorder severity is available Question 9 In which body or cell area are most genes in humans located? Select one: a. Cytoplasm b. Plasma Membrane c. Nucleus d. Mitochondrion Feedback The correct answer is: Nucleus Question 10 Which statement regarding behavioral genetics is accurate? Select one: a. The genotypes and phenotypes of behavioral problems or deviations follow Mendelian autosomal recessive inheritance patterns. b. A genetic predisposition toward a specific behavior can be modified by altering environmental influences. c. Genes and gene products have been discovered that directly control behavior. d. The genetic susceptibility or predisposition toward a behavioral disorder requires the trigger of an infectious disease for expression. Feedback The correct answer is: A genetic predisposition toward a specific behavior can be modified by altering environmental influences. Question 12 Juliet tells a nurse that she has three aunts (two on her father’s side, ages 42 and 56, and one on her mother’s side, age 62) who were diagnosed with breast cancer. She asks if she should have genetic testing. What should the nurse tell her? Select one: a. “Because no men in your family are affected, it is not inherited cancer so you don’t need mammograms or any special screening practices.” b. “Your family history may indicate an increased risk for breast cancer and a genetic counselor could help determine whether you could benefit from genetic testing.” c. “Your family history indicates a high risk and you should definitely have genetic testing.” d. “Because your aunts were older when they got breast cancer, it was probably sporadic and you should just have regular mammograms like everyone else.” Feedback The correct answer is: “Your family history may indicate an increased risk for breast cancer and a genetic counselor could help determine whether you could benefit from genetic testing.” Question 13 Which “schizophrenia fact” is correct? Select one: a. Copy number variants appear to play the most important role in genetic risk for schizophrenia. b. When one identical twin is affected with schizophrenia the other most certainly will be affected. c. When schizophrenia has more genetic influence, its onset begins in very early childhood. d. Because the phenotype of schizophrenia is so obvious, diagnosis and inheritance risk are the most easily determined of all the psychiatric disorders. Feedback The correct answer is: Copy number variants appear to play the most important role in genetic risk for schizophrenia. Question 14 A woman whose sister tested positive for a specific mutation in the BRCA1 gene, which increases the risk for breast and ovarian cancer, is found not to have that mutation but does have a mutation of unknown significance near the known mutation site. How should this woman be counseled? Select one: a. She should be informed that because she does not have the mutation, her risk for breast cancer is not greater than that of the general population. b. She should be informed that she does not have the specific mutation but that because another mutation is present she should be vigilant about screening c. She should be informed of her gene mutation status and be presented with all the available prophylaxis options and reconstruction options. d. She should be informed that her risk for breast cancer is greater than the general population but not as great as her sister’s risk. Feedback The correct answer is: She should be informed that she does not have the specific mutation but that because another mutation is present she should be vigilant about screening Question 15 What is the most accurate classification of the common forms of coronary artery disease and hypertension? Select one: a. Primary disorders with an autosomal dominant pattern of inheritance b. Sequential genetic disorders related to age, ethnicity, and gender c. Complex disorders resulting from gene–environment interactions d. Secondary disorders caused by lifestyle choices Feedback The correct answer is: Complex disorders resulting from gene–environment interactions Question 1: What is the best description of the genetic contribution to onset of autism? Select one: a. Known causes of autism spectrum include copy number variants and chromosomal problems. b. Autism spectrum is caused by a single gene mutation in most, but not all, cases. c. Autism spectrum disorders have a much stronger environmental input than genetic input to expression of the phenotype. d. Exposure to a teratogen can be a cause of autism spectrum in many cases. Feedback The correct answer is: Known causes of autism spectrum include copy number variants and chromosomal problems. Question 2 A patient has a very high concentration of insulin receptors on cells that require insulin for glucose to enter. How should insulin dosages be adjusted for this patient to have blood glucose levels within the normal range? Select one: a. Insulin dosages should be given less frequently because the drug will remain bound to receptors longer. b. Insulin dosages should be given more frequently because the drug will be eliminated at a faster rate. c. Insulin dosages should be decreased because the drug will exert its actions at lower concentrations. d. Insulin dosages should be increased because cells will be less sensitive to the presence of active insulin Feedback The correct answer is: Insulin dosages should be decreased because the drug will exert its actions at lower concentrations. Question 3 A 40 year­old man who has a mother who was diagnosed with breast cancer at age 45, a father who was diagnosed with smoking­related lung cancer at age 55, a 33­year­old sister with breast cancer, and a 38­year­old sister with ovarian cancer, asks if he should be concerned for his cancer risk. What is the best response? Select one: a. “Your risk for cancer is affected by your parents’ cancer development and you should have genetic counseling on that basis; however, your sisters’ cancers have no bearing on your risk.” b. You have two first­degree relatives and two second­degree relatives with cancer, which increases your general risk for cancer.” c. “Your risk is not affected by this family history because most of the cancers arose in female sex­associated tissues.” d. “Your risk for breast cancer may be increased and requires more investigation; however, your risk for lung cancer is not affected by this history.” Feedback The correct answer is: “Your risk for breast cancer may be increased and requires more investigation; however, your risk for lung cancer is not affected by this history.” Question 4 Which processes of drug response are most subject to genetic variation? Select one: a. Rates of drug movement into and through the gastrointestinal tract b. Drug dissolution in body fluids and drug binding to plasma proteins c. Drug binding with receptors and drug blocking of receptors d. Drug activation or deactivation and duration of drug actions Feedback The correct answer is: Drug activation or deactivation and duration of drug actions Question 5 Which statement about atrial fibrillation is correct? Select one: a. It is the most common genetic cardiac disorder worldwide. b. It is found exclusively in adults over 60 years old. c. When severe, it leads to long QT syndrome. d. A variety of different genes contribute to its expression. Feedback The correct answer is: A variety of different genes contribute to its expression. Question 6 Which type of genetic testing is the most sensitive method for detecting any mutation in a specific gene? Select one: a. Fluorescence in situ hybridization b. Direct DNA sequencing c. Immunohistochemistry d. Banded chromosomal analysis Feedback The correct answer is: Direct DNA sequencing Question 7 What is the genetic contribution to the development of the most common forms of atherosclerosis? Select one: a. Variation in a variety of genes each exerting a small effect b. Disordered mitochondrial function reducing energy production c. Genetic predisposition expressed after exposure to a viral trigger d. Single gene mutation following autosomal dominant inheritance Feedback The correct answer is: Variation in a variety of genes each exerting a small effect Question 8 An adult daughter whose mother has bipolar disorder is concerned that she may also have the disorder because she engages in all of the following behaviors. Which behavior should be explored further as a manifestation of bipolar disorder? Select one: a. Having a strong sense of sleepiness daily in the middle of the afternoon b. Making frequent purchases of expensive clothing that she never wears c. Crying whenever she looks at a picture of a close friend who died 3 months ago d. Refusing to allow her husband to participate in general housekeeping chores Feedback The correct answer is: Making frequent purchases of expensive clothing that she never wears Question 9 Which action reflects promotion of genomic care as part of comprehensive health care? Select one: a. Ensuring that genomic issues potentially influencing a person’s health are incorporated into routine care b. Encouraging all people to undergo genetic testing as part of a proactive health screening and prevention program c. Calculating the odds ratios and recurrence risks of common complex health problems for all people d. Instructing patients who undergo genetic testing about their obligation to inform family members regarding test results Feedback The correct answer is: Ensuring that genomic issues potentially influencing a person’s health are incorporated into routine care Question 10 Which variable in a person with coronary artery disease increases the likelihood of a strong genetic influence in its expression? Select one: a. The problem is severe before age 50 years. b. The disorder is not present in the person’s dizygotic twin. c. The disorder is present in about 5% of the person’s maternal older male family members. d. The affected person has eaten a vegetarian diet for the past 5 years. Feedback The correct answer is: The problem is severe before age 50 years. Question 11 Which statement regarding the biology of cancer is always true? Select one: a. When cancer cells are exposed to air, their growth rate becomes uncontrolled. b. Cancer cells arise from normal cells. c. Testicular cancer is strongly associated with excessive masturbation. d. The biggest risk factor for cancer development is having a first­degree relative with cancer. Feedback The correct answer is: Cancer cells arise from normal cells. Question 12 A patient states that she has heard that the origin of most cancers is “genetic.” What is the best response? Select one: a. Cancers arise in cells that have alterations in the genes.” b. “Cancer is more common among males than females.” c. “The development of most cancers is predetermined and not affected by environmental factors.” d. The majority of cancers are inherited.” Feedback The correct answer is: Cancers arise in cells that have alterations in the genes.” Question 13 Julia (aged 32) is BRCA1 positive, which is known to greatly increase the risk for breast and ovarian cancer. She was tested because her mother, who had ovarian cancer, was BRCA1 positive. Julia has decided to have both of her ovaries removed because she believes that, in her family, being BRCA1 positive increases the risk for ovarian cancer only. How should a genetic counselor respond to Julia’s statement? Select one: a. Encourage her to consider a bilateral mastectomy. b. Clarify that a BRCA1 mutation does not preferentially express ovarian cancer over breast cancer in any given family. c. Accept Julia’s explanation as a manifestation of her autonomy and remain nondirective in the interactions with her. d. Discuss Julia’s responsibility to inform all the other female members of her family about her BRCA1 status and cancer risk Feedback The correct answer is: Clarify that a BRCA1 mutation does not preferentially express ovarian cancer over breast cancer in any given family. Question 14 Why are general physicians and surgeons NOT considered to be genetics professionals? Select one: a. The focus of their professional education is the study of medicine rather than genetics. b. These health­care professionals have minimal experience with genetics laboratory techniques. c. The typical patients seen by these health­care providers have acute conditions rather than chronic conditions, and thus genetic influence is irrelevant. d. Most of today’s physicians and surgeons were educated before completion of the human genome research project. Feedback The correct answer is: The focus of their professional education is the study of medicine rather than genetics. Question 15 A patient with a fractured elbow in the emergency department states that he needs morphine for pain rather than codeine because the last time he had a painful injury, codeine was not effective in managing his pain. What is the nurse’s best response or action? Select one: a. Ask the patient how much alcohol he ingests daily. b. Alert the health­care provider that this patient is “drug­seeking.” c. Communicate this information to the admitting physician. d. Reassure the patient that he will receive progressively higher dosages of codeine until his pain is controlled. Feedback The correct answer is: Communicate this information to the admitting physician. Which type of body tissue has the highest risk for cancer development? Select one: a. Brain tissue because it does not respond well to injury b. Bone tissue because its absorption of radiation is cumulative c. Connective tissue that remains functional throughout life d. Any tissue that retains the ability to divide Feedback The correct answer is: Any tissue that retains the ability to divide Question 2 Why is determining the genetic contribution important to assess in stroke patients? Select one: a. Often the person with a stroke cannot provide accurate family information. b. Environmental risk factors have equal contribution to the problem. c. Comorbidities mask the symptoms and delay the diagnosis. d. Stroke classification and phenotype remain heterogeneous. Feedback The correct answer is: Stroke classification and phenotype remain heterogeneous. Question 3 What type of genetic test provides information about an asymptomatic person’s risk for having a child with a specific autosomal recessive disorder in the future? Select one: a. Predictive test b. Carrier test c. Newborn screening d. Diagnostic test Feedback The correct answer is: Carrier test Question 4 A patient is 34 years old and concerned about possibly being a carrier for HNPCC because his father died of colon cancer at 39, his father’s sister died of colon cancer at age 41, and his brother (aged 37) now has colon cancer. The brother’s testing is negative for all the known mutations associated with inherited forms of colon cancer. How should this patient be counseled about his risk for colon cancer? Select one: a. Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. b. Explain that because the brother with cancer is negative for these gene mutations, this cancer is most likely sporadic and his risk is the same as general population risk. c. Explain that his risk is not related to his brother’s diagnosis because he did not inherit any genes from him but that since his father is a first­degree relative, testing should be considered. d. Explain that he could benefit from testing even though his brother is negative for these mutations because reduced penetrance might account for his negative status. Feedback The correct answer is: Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. Question 5 Which condition or behavior suggests attention deficit hyperactivity disorder (ADHD)? Select one: a. A 5­year­old who does not want to go to bed at 8:00 p.m. and begs to be allowed to stay up later. b. A 9­year­old who does not focus on a favorite story or game for longer than 3 minutes. c. An 8­year­old who can hop on one foot but cannot ride a bicycle without training wheels. d. A 10­year­old who prefers to play basketball rather than chess. Feedback The correct answer is: A 9­year­old who does not focus on a favorite story or game for longer than 3 minutes. Question 6 What is the heritability estimate for schizophrenia in the general population? Select one: a. 80% b. 40% c. 100% d. 60% Feedback The correct answer is: 80% Question 7 How do genetic/genomic issues influence individual variation of the response to a specific drug? Select one: a. Polymorphisms of genes encoding metabolizing enzymes b. Age­related loss of alleles within the cells lining the intestinal tract c. Genetic­based behavior problems that promote poor adherence to prescribed drug regimens d. Single gene disorders that reduce the function of the kidneys or the liver Feedback The correct answer is: Polymorphisms of genes encoding metabolizing enzymes Question 8 How do genetic counselors provide genetic/genomic information to patients and families in a nondirective manner? Select one: a. Presenting all facts and available options in a manner that neither promotes nor excludes any legally permitted decision or action b. Skillfully directing the patient and family toward the best choice that is supported by appropriate research c. Filtering management options and focusing on the information that will support the decision they believe is right for the individual patient/family d. Providing only the information the patient or family specifically requests Feedback The correct answer is: Presenting all facts and available options in a manner that neither promotes nor excludes any legally permitted decision or action Question 9 For patients who have familial hypercholesterolemia, what should be the focus of teaching for blood cholesterol reduction? Select one: a. Exercising at least 4 to 5 hours every week b. Taking the lipid­lowering drug as prescribed c. Increasing the amount of fruit in the diet d. Eliminating animal fats from the diet Feedback The correct answer is: Taking the lipid­lowering drug as prescribed Question 10 What should be told to the patient who has been found to have a genetic mutation that increases the risk for colon cancer and says he does not want any of his family to know about this result? Select one: a. “It is not required that you tell anyone about this result; however, because your siblings and children may also be at risk for colon cancer, you should think about how this information might help them.” b. “It is not necessary to tell your siblings because they are adults, but you should tell your children so they can be tested before they decide to have children of their own.” c. “It is required by law that you inform your siblings and your children about this result so that they also can be tested and monitored for colon cancer.” d. “It is your decision to determine with whom, if anyone, you share this test result; however, if you do not tell any of your family members and they get colon cancer, you would be responsible for their developing the disease.” Feedback The correct answer is: “It is not required that you tell anyone about this result; however, because your siblings and children may also be at risk for colon cancer, you should think about how this information might help them.” Question 11 A patient whose mother has Huntington’s disease is considering genetic testing but is not sure whether she really wants to know if she has the mutation. She asks you what you would do if your mother had the disease. What is your best response? Select one: a. “I would have the test so I could decide whether to have children or to use adoption.” b. “Because there is no cure for this disease and testing would not be beneficial, I would not have the test.” c. “You need to check with your brothers and sisters to determine whether testing for this disease would be appropriate for you.” d. “I can only tell you the benefits and the risks of testing, you must make this decision yourself.” Feedback The correct answer is: “I can only tell you the benefits and the risks of testing, you must make this decision yourself.” Question 12 What is the result of a mutation occurring in a suppressor gene? Select one: a. Gain of a new function b. Increased “error­prone” DNA repair c. Loss of an existing function d. Increased unequal “crossing over” during meiosis I Feedback The correct answer is: Loss of an existing function Question 13 Your patient, Maggie, insists that her mother have genetic testing to determine if her breast cancer is connected to a mutation in the BRCA1/2 genes. Maggie is concerned about her own risk for getting breast cancer and that of her children, but Maggie’s mom does not want to be tested. What ethical principle is one of several that must be considered in evaluating this case? Select one: a. Maggie’s mother’s “right to know” b. Maggie’s mother’s “right to privacy” c. The nurse’s “duty to warn” d. Maggie’s “autonomy” Feedback The correct answer is: Maggie’s mother’s “right to privacy” Question 14 Why are people who have poor DNA repair mechanisms at greater risk for cancer development? Select one: a. Their cancers are usually resistant to chemotherapy. b. Their somatic mutations are more likely to be permanent. c. They have sustained the initial “hit” in all cells and tissues. d. They have greater exposure to environmental carcinogens. Feedback The correct answer is: Their somatic mutations are more likely to be permanent. Question 15 Which tissue is most likely to provide an adequate DNA sample for genetic testing? Select one: a. Nasal epithelial cells b. Distal ends of hair shafts c. Mature red blood cells d. A mummy’s tooth Feedback The correct answer is: Nasal epithelial cells Question 1: A patient is 34 years old and concerned about possibly being a carrier for HNPCC because his father died of colon cancer at 39, his father’s sister died of colon cancer at age 41, and his brother (aged 37) now has colon cancer. The brother’s testing is negative for all the known mutations associated with inherited forms of colon cancer. How should this patient be counseled about his risk for colon cancer? Select one: a. Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. b. Explain that his risk is not related to his brother’s diagnosis because he did not inherit any genes from him but that since his father is a first­degree relative, testing should be considered. c. Explain that because the brother with cancer is negative for these gene mutations, this cancer is most likely sporadic and his risk is the same as general population risk. d. Explain that he could benefit from testing even though his brother is negative for these mutations because reduced penetrance might account for his negative status. Feedback The correct answer is: Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. Question 2 Which type of genetic testing is the most sensitive method for detecting any mutation in a specific gene? Select one: a. Direct DNA sequencing b. Immunohistochemistry c. Fluorescence in situ hybridization d. Banded chromosomal analysis Feedback The correct answer is: Direct DNA sequencing Question 3 Which tissue is most likely to provide an adequate DNA sample for genetic testing? Select one: a. A mummy’s tooth b. Nasal epithelial cells c. Mature red blood cells d. Distal ends of hair shafts Feedback The correct answer is: Nasal epithelial cells Question 4 Which lethal cardiac arrhythmia can occur as a complication of long QT syndrome? Select one: a. Atrial node reentry tachycardia b. Prolonged atrial fibrillation c. Torsade de Pointes d. Mitral valve prolapse Feedback The correct answer is: Torsade de Pointes Question 5 What would be the expected response to a skin injury if the involved tissue had lost the normal cell characteristic of contact inhibition? Select one: a. Excessive growth of replacement tissue b. Replacement with scar tissue rather than skin c. Failure of the wound to close d. Displacement of skin cells into other body tissues Feedback The correct answer is: Excessive growth of replacement tissue Question 6 What would be the patient’s response to a normal drug dose that because of a genetic variation in an enzyme that prepares the drug for elimination results in a blood drug level that is below the minimum effective concentration (MEC)? Select one: a. The drug’s duration of action is longer than expected. b. The risk for toxic side effects is increased. c. Drug entry exceeds drug elimination d. The intended response fails to be produced. Feedback The correct answer is: The intended response fails to be produced. Question 7 Which statement best describes the role of tumor suppressor genes in cancer development? Select one: a. Tumor suppressor genes control or modify the activity of oncogenes, reducing the risk for cancer development. b. The presence of tumor suppressor genes increases the risk for gene damage by environmental carcinogens. c. Tumor suppressor genes are a type of oncogene that is only active in germ line cells and tissues. d. Tumor suppressor genes reduce/suppress immune function, increasing the risk for cancer development. Feedback The correct answer is: Tumor suppressor genes control or modify the activity of oncogenes, reducing the risk for cancer development. Question 8 What is the best description of the genetic contribution to onset of autism? Select one: a. Autism spectrum is caused by a single gene mutation in most, but not all, cases. b. Known causes of autism spectrum include copy number variants and chromosomal problems. c. Autism spectrum disorders have a much stronger environmental input than genetic input to expression of the phenotype. d. Exposure to a teratogen can be a cause of autism spectrum in many cases. Feedback The correct answer is: Known causes of autism spectrum include copy number variants and chromosomal problems. Question 9 What should be told to the patient who has been found to have a genetic mutation that increases the risk for colon cancer and says he does not want any of his family to know about this result? Select one: a. “It is not necessary to tell your siblings because they are adults, but you should tell your children so they can be tested before they decide to have children of their own.” b. “It is not required that you tell anyone about this result; however, because your siblings and children may also be at risk for colon cancer, you should think about how this information might help them.” c. “It is your decision to determine with whom, if anyone, you share this test result; however, if you do not tell any of your family members and they get colon cancer, you would be responsible for their developing the disease.” d. “It is required by law that you inform your siblings and your children about this result so that they also can be tested and monitored for colon cancer.” Feedback The correct answer is: “It is not required that you tell anyone about this result; however, because your siblings and children may also be at risk for colon cancer, you should think about how this information might help them.” Question 10 Why do genetic counseling programs include extensive courses on laboratory methods in genetics? Select one: a. To help patients understand testing procedures and results b. To be able to draw blood proficiently and safely c. To perform standard karyotyping on routine blood specimens d. To serve as a backup genetics technician in small laboratories Feedback The correct answer is: To help patients understand testing procedures and results Question 11 In which body or cell area are most genes in humans located? Select one: a. Mitochondrion b. Nucleus c. Plasma Membrane d. Cytoplasm Feedback The correct answer is: Nucleus Question 12 Why is pharmacogenetics/pharmacogenomics of particular interest in treating patients with psychiatric/mental health problems? Select one: a. Genetics restricts patients to only one drug in each classification b. Psychotropic medications have few side effects. c. Most psychiatric illnesses are single gene disorders with predictable drug responses. d. Psychiatric medications may be effective in only a small group of patients. Feedback The correct answer is: Psychiatric medications may be effective in only a small group of patients. Question 13 Which type of body tissue has the highest risk for cancer development? Select one: a. Bone tissue because its absorption of radiation is cumulative b. Connective tissue that remains functional throughout life c. Any tissue that retains the ability to divide d. Brain tissue because it does not respond well to injury Feedback The correct answer is: Any tissue that retains the ability to divide Question 14 What term is used to describe the gene­to­gene interaction in which the action of one gene modifies the expression of a different gene? Select one: a. Epigenetic penetrance b. Genomic imprinting c. Heterogeneity d. Epistasis Feedback The correct answer is: Epistasis Question 15 Which statement regarding the biology of cancer is always true? Select one: a. Cancer cells arise from normal cells. b. Testicular cancer is strongly associated with excessive masturbation. c. When cancer cells are exposed to air, their growth rate becomes uncontrolled. d. The biggest risk factor for cancer development is having a first­degree relative with cancer. Feedback The correct answer is: Cancer cells arise from normal cells. [Show More]

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