A client who tests positive for a mutation in the BRCA1 gene ...

[vicky]

A client who tests positive for a mutation in the BRCA1 gene allele asks a nurse to be present when she discloses this information to her adult daughter. How should the nurse respond?
 
  a. I will request a genetic counselor who is more qualified to be present for this conversation.
  b. The test results can be confusing; I will help you interpret them for your daughter.
  c. Are you sure you want to share this information with your daughter, who may not test positive for this gene mutation?
  d. This conversation may be difficult for both of you; I will be there to provide support.

Question 2

A nurse consults a genetic counselor for a client whose mother has Huntington disease and is considering genetic testing. The client states, I know I want this test. Why do I need to see a counselor? How should the nurse respond?
 
  a. The advanced practice nurse will advise you on whether you should have children or adopt.
  b. Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process.
  c. There is no cure for this disease. The counselor will determine if there is any benefit to genetic testing.
  d. Genetic testing is expensive. The counselor will advocate for you and help you obtain financial support.

[owenfalvey]

Answer to Question 1

ANS: D
A nurse should provide emotional support while the client tells her daughter the information she has learned about the test results. The nurse should not interpret the results or counsel the client or her daughter. The nurse should refer the client for counseling or support, if necessary.

Answer to Question 2

ANS: B
Genetic testing is a stressful experience, and clients should be provided with support, education, and assistance with coping. Genetic testing should be performed only after genetic counseling has occurred. The client has the right to decide whether to have children or to participate in genetic testing. Nursing staff should provide both benefits and risks to genetic testing so that the client can make an informed decision. Financial support is not part of genetic counseling.