Answer to Question 1
Correct Answer: 2
Rationale 1: When a patient is given bad news, the grieving process begins. The family is grieving the loss of a normal child. This family is most likely in the shock/disbelief stage of grief.
Rationale 2: This response uses therapeutic communication techniques and portrays a caring attitude towards the family. Asking if the family has questions further facilitates communication.
Rationale 3: Although it is good to have supportive family members or a clergy person called if the family desires, it is better for the nurse to take the initiative and establish therapeutic communication and to portray caring.
Rationale 4: It is not therapeutic to ask why questions. In addition, although cystic fibrosis is diagnosable prenatally, a patient opposed to abortion often will not seek prenatal diagnosis, because the pregnancy would not be terminated if the child were affected by a chromosomal abnormality.
Answer to Question 2
Correct Answer: 4
Rationale 1: The nurse should act as a liaison between the family and genetic counselor.
Rationale 2: After a follow-up visit, the family may return to the genetic counselor to ask questions and express concerns, especially if the couple is considering having more children, or if siblings want information about their affected brother or sister.
Rationale 3: Upon completion of genetic counseling, the genetic counselor sends the parent(s) and their certified nursemidwife or physician a letter detailing the contents of the sessions.
Rationale 4: After the initial genetic counseling session, a follow-up visit is scheduled in order for the genetic counselor to provide the parents with all available information and offer additional counseling.