A nurse completes pedigree charts for clients at a community ...

[MGLQZ]

A nurse completes pedigree charts for clients at a community health center. Which diagnosis should the nurse refer for carrier genetic testing? (Select all that apply.)
 
  a. Huntington disease
  b. Breast cancer
  c. Hemophilia
  d. Colorectal cancer
  e. Sickle cell disease
  f.
  Cystic fibrosis

Question 2

A nurse cares for a client who recently completed genetic testing that revealed that she has a BRCA1 gene mutation. Which actions should the nurse take next? (Select all that apply.)
 
  a. Discuss potential risks for other members of her family.
  b. Assist the client to make a plan for prevention and risk reduction.
  c. Disclose the information to the medical insurance company.
  d. Recommend the client complete weekly breast self-examinations.
  e. Assess the client's response to the test results.
  f.
  Encourage support by sharing the results with family members.

[Briannahope]

Answer to Question 1

ANS: C, E, F
Of the disease processes listed, the ones that would make the client a candidate for carrier genetic testing would be hemophilia, sickle cell disease, and cystic fibrosis. Although Huntington disease, breast cancer, and colorectal cancer all have genetic components, there is no evidence that carrier genetic testing would be beneficial in diseases such as these.

Answer to Question 2

ANS: A, B, E
The medical-surgical nurse can assess the client's response to the test results, discuss potential risks for other family members, encourage genetic counseling, and assist the client to make a plan for prevention, risk reduction, and early detection. For some positive genetic test results, such as having a BRCA1 gene mutation, the risk for developing breast cancer is high but is not a certainty. Because the risk is high, the client should have a plan for prevention and risk reduction. One form of prevention is early detection. Breast self-examinations may be helpful when performed monthly, but those performed every week may not be useful, especially around the time of menses. A client who tests positive for a BRCA1 mutation should have at least yearly mammograms and ovarian ultrasounds to detect cancer at an early stage, when it is more easily cured. Owing to confidentiality, the nurse would never reveal any information about a client to an insurance company or family members without the client's permission.