Which statement made by the nurse is evidence of therapeutic ...

[Yi-Chen]

Which statement made by the nurse is evidence of therapeutic communication for a couple who is undergoing genetic counseling and very concerned about the possibility of having a child with a birth defect as a result of a strong family history on both side
 
  of the family?
 
  a. It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history.
  b. Given what you have told me, there is little that anyone can do to improve outcomes.
  c. Although you may feel that you have no options, I can't really discuss these matters as only the physician can provide you with information.
  d. Do you have all your forms filled out correctly? This will make the review easier to accomplish.

Question 2

During the course of obtaining a genetic history from a female client, you note that there is a family history of a genetic disease on the maternal side but no evidence of symptomatology in the client or the client's children, two girls.
 
  Which observation can you make related to genetic expression?
 
  a. Autosomal dominant expression is observed.
  b. X-linked dominant trait is observed.
  c. More information is needed to determine the answer.
  d. Autosomal recessive expression is observed and both the children will be carriers of the disease process.

[lorealeza]

Answer to Question 1

ANS: A
Having as much information as possible will help analyze potential health patterns. It also shows that the nurse is taking the clients' concerns seriously. Telling the clients that there is little anyone can do does not provide any comfort or hope and is therefore self-defeating. Although the clients may have limited options based on their genetic and medical history, it is important to provide support and not defer all communication to the physician. The nurse must be able to provide support and counseling to clients. It is important to have completed forms, but asking clients about them does not address their psychological concerns.

Answer to Question 2

ANS: C
Because we have no information about the father and/or paternal side, the other stated options do not apply. If an autosomal dominant expression were present in the family history, the client would be symptomatic. It is more likely to see X-linked recessive traits than X-linked dominant traits and, again, the client and children are not symptomatic. Although an autosomal recessive expression may be present, we cannot predict that the children will be carriers. There is a 25 chance of being affected.

[Yi-Chen]

Excellent

[patma1981]

TYSM