Western Governors University; NURSC475/ NURS C475_ Quiz 2 Answered Complete answers/feedback

NURS C475 Quiz 2 Answered 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. Discuss Julia’s responsibility to inform all the other female members of her family about her BRCA1 status and cancer risk c. Clarify that a BRCA1 mutation does not preferentially express ovarian cancer over breast cancer in any given family. d. Encourage her to consider a bilateral mastectomy. Question 2 Correct 1 points out of 1 Flag question Question text Which lethal cardiac arrhythmia can occur as a complication of long QT syndrome? Select one: a. Mitral valve prolapse b. Atrial node reentry tachycardia c. Torsade de Pointes d. Prolonged atrial fibrillation Question 3 Correct 1 points out of 1 Flag question Question text 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. Question 4 Correct 1 points out of 1 Flag question Question text Which type of body tissue has the highest risk for cancer development? Select one: a. Any tissue that retains the ability to divide b. Bone tissue because its absorption of radiation is cumulative c. Connective tissue that remains functional throughout life d. Brain tissue because it does not respond well to injury Question 5 Correct 1 points out of 1 Flag question Question text Which condition or behavior suggests attention deficit hyperactivity disorder (ADHD)? Select one: a. A 10-year-old who prefers to play basketball rather than chess. b. An 8-year-old who can hop on one foot but cannot ride a bicycle without training wheels. c. A 5-year-old who does not want to go to bed at 8:00 p.m. and begs to be allowed to stay up later. d. A 9-year-old who does not focus on a favorite story or game for longer than 3 minutes. Question 6 Correct 1 points out of 1 Flag question Question text 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 decreased because the drug will exert its actions at lower concentrations. b. Insulin dosages should be increased because cells will be less sensitive to the presence of active insulin c. Insulin dosages should be given more frequently because the drug will be eliminated at a faster rate. d. Insulin dosages should be given less frequently because the drug will remain bound to receptors longer. Question 7 Incorrect 0 points out of 1 Flag question Question text 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. Question 8 Correct 1 points out of 1 Flag question Question text What term is used to describe the gene-to-gene interaction in which the action of one gene modifies the expression of a different gene? Select one: a. Heterogeneity b. Epistasis c. Epigenetic penetrance d. Genomic imprinting Question 9 Correct 1 points out of 1 Flag question Question text 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. No, a clinical geneticist is a physician who has completed a fellowship in clinical genetics. b. Yes, he is an advanced practice nurse. c. Yes, he is a clinician employed in a setting specializing in patients with genetic-based health problems d. No, a clinical geneticist must be certified as a genetic counselor. Question 10 Incorrect 0 points out of 1 Flag question Question text A 40 year-old man who has a mother who was diagnosed with breast cancer at age 45, a father who was diagnosed with smoking-related lung cancer at age 55, a 33-year-old sister with breast cancer, and a 38-year-old sister with ovarian cancer, asks if he should be concerned for his cancer risk. What is the best response? Select one: a. “Your risk is not affected by this family history because most of the cancers arose in female sex-associated tissues.” b. “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.” c. “Your risk for breast cancer may be increased and requires more investigation; however, your risk for lung cancer is not affected by this history.” d. You have two first-degree relatives and two second-degree relatives with cancer, which increases your general risk for cancer.” Question 11 Correct 1 points out of 1 Flag question Question text 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. Psychiatric medications may be effective in only a small group of patients. c. Psychotropic medications have few side effects. d. Most psychiatric illnesses are single gene disorders with predictable drug responses. Question 12 Correct 1 points out of 1 Flag question Question text 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. “Your family history indicates a high risk and you should definitely have genetic testing.” 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. “Because no men in your family are affected, it is not inherited cancer so you don’t need mammograms or any special screening practices.” 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.” Question 13 Correct 1 points out of 1 Flag question Question text 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. You are probably anemic, which would reduce your ability to form blood clots, so your doses can be lower.” c. Many Asian Americans do not break down warfarin as fast as Caucasians, so the drug is more effective at lower dosages d. “Caucasians have higher levels of the enzyme that breaks down warfarin, requiring higher dosages for the same effect on INR.” Question 14 Correct 1 points out of 1 Flag question Question text Why are people who have poor DNA repair mechanisms at greater risk for cancer development? Select one: a. They have greater exposure to environmental carcinogens. b. They have sustained the initial “hit” in all cells and tissues. c. Their somatic mutations are more likely to be permanent. d. Their cancers are usually resistant to chemotherapy. Question 15 Incorrect 0 points out of 1 Flag question Question text Which tissue is most likely to provide an adequate DNA sample for genetic testing? Select one: a. Mature red blood cells b. A mummy’s tooth c. Nasal epithelial cells d. Distal ends of hair shafts