NURSING > EXAM > MED SURG 201 FINAL EXAM FINAL EXAM QUESTIONS, ANSWERS (EXPLAINED) (All)

MED SURG 201 FINAL EXAM FINAL EXAM QUESTIONS, ANSWERS (EXPLAINED)

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1. The sister of a patient diagnosed with BRCA gene–related breast cancer asks the nurse, “Do you think I should be tested for the gene?” Which response by the nurse is most appropriate? • “In most cases, breast cancer is not caused by the BRCA gene.” • “It depends on how you will feel if the test is positive for the BRCA gene.” • “There are many things to consider before deciding to have genetic testing.” • “You should decide first whether you are willing to have a bilateral mastectomy.” ANS: C Although presymptomatic testing for genetic disorders allows patients to take action (such as mastectomy) to prevent the development of some genetically caused disorders, patients also need to consider that test results in their medical record may affect insurance, employability, etc. Telling a patient that a decision about mastectomy should be made before testing implies that the nurse has made a judgment about what the patient should do if the test is positive. Although the patient may need to think about her reaction if the test is positive, other issues (e.g., insurance) also should be considered. Although most breast cancers are not related to BRCA gene mutations, the patient with a BRCA gene mutation has a markedly increased risk for breast cancer. 7. The nurse in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing? • 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96 • 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy • 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease • 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea ANS: C The adult form of polycystic kidney disease is an autosomal dominant disorder and frequently it is asymptomatic until the patient is older. Presymptomatic testing will give the patient information that will be useful in guiding lifestyle and childbearing choices. The other patients do not have any indication of genetic disorders or need for genetic testing. • An adolescent patient seeks care in the emergency department after sharing needles forheroin injection with a friend who has hepatitis B. To provide immediate protection from infection, what medication will the nurse

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