Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 1: Genetics and Genomics: Definitions and Trends
Case Study Questions
Genetic Biomarker (GB) testing is becoming more popular as the cost and relevancy of
pharmacogenomics testing becomes better known and easily applicable to clinical practice. A site
referencing required, recommended, or for information only testing is available on the FDA website
at www.fda.gov/Drugs/ScienceResearch/ResearchAreas/Pharmacogenetics/ucm083378.htm. This
will assist in answering the following questions:
A registered nurse is assigned to care for three patients who are receiving medications that are
known to be associated with genetic traits or GB(s) that could alter the effect of the drug. Identify if
the GB has required, recommended, or for information only status for testing.
This activity contains 3 questions.
1. L.L. is a 52-year-old Caucasian female being treated with Herceptin for her recently diagnosed
her2/neu positive breast cancer.
Answer: Required. The breast cancer tumor must be tested for the presence of the her2/neu
receptor in order to receive Herceptin.
2. R.N. is a 62-year-old male with a new diagnosis of rheumatoid arthritis and has been
prescribed Celebrex 200mg b.i.d.
Answers: Recommended if PM status suspected. Poor metabolizers (PM) of Celebrex should have
dosage reduced by 50%. If this patient is a PM the dose should be reduced to 100mg b.i.d. and
monitored for side effects.
www.accessdata.fda.gov/drugsatfda_docs/label/2011/020998s033,021156s003lbl.pdf
3. M.G. is a 26-year-old Ethiopian new mom who delivered her first child by a caesarean section.
She was prescribed codeine 30mg p.o. and is breastfeeding her newborn.
Answers: Because of her Ethiopian ancestry, M.G. could be an Ultra-rapid metabolizer and should
receive a non-codeine analgesic.
www.accessdata.fda.gov/drugsatfda_docs/label/2012/022402s003lbl.pdf

Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 1: Genetics and Genomics: Definitions and Trends
Case Study Questions
Genetic Biomarker (GB) testing is becoming more popular as the cost and relevancy of
pharmacogenomics testing becomes better known and easily applicable to clinical practice. A site
referencing required, recommended, or for information only testing is available on the FDA website
at www.fda.gov/Drugs/ScienceResearch/ResearchAreas/Pharmacogenetics/ucm083378.htm. This
will assist in answering the following questions:
A registered nurse is assigned to care for three patients who are receiving medications that are
known to be associated with genetic traits or GB(s) that could alter the effect of the drug. Identify if
the GB has required, recommended, or for information only status for testing.
This activity contains 3 questions.
1. L.L. is a 52-year-old Caucasian female being treated with Herceptin for her recently diagnosed
her2/neu positive breast cancer.
2. R.N. is a 62-year-old male with a new diagnosis of rheumatoid arthritis and has been
prescribed Celebrex 200mg b.i.d.
3. M.G. is a 26-year-old Ethiopian new mom who delivered her first child by a caesarean section.
She was prescribed codeine 30mg p.o. and is breastfeeding her newborn.

Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 1: Genetics and Genomics: Definitions and Trends
NCLEX Review Questions
This activity contains 8 questions.
1. How would the nurse know that the new graduate has attained the required information in
the field of genetics to care for a client population? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Answers: The nurse is familiar with the specialized information needed to practice in the neonatal
unit, where the nurse is assigned.
The nurse knows the basic concepts for practicing in a general medical-surgical unit.
2. The nurse is assigned a group of clients new to the health clinic for their first prenatal visit. For
which client would the nurse recommend a consultation for genetic testing? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Answers: The client has a sibling with known hereditary defect.
A client four months pregnant whose spouse has a hereditary condition
The client has a known genetic disorder and is already under care.
3. What question is best for a nurse to ask to solicit information regarding genetic screening or
testing?
Answer: “Have you ever been tested for a genetic or hereditary condition?”
4. While the nurse is teaching a group of clients about their genetic condition, one client
reports having an illness due to environmental causes. What would be the best approach in dealing
with this situation at this time?
Answer: Inform the clients that some genetic illnesses can be affected by the environment.
5. The quality assurance personnel conducted a review of actions by the nurses on a general
medical unit. Which documented action indicates that educational intervention on genetics and
genomics is required?
Answer: All of the clients were referred for genetic screening.
6. Why is specific genetic and genomics knowledge considered a core competency for nurses?

Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 1: Genetics and Genomics: Definitions and Trends
NCLEX Review Questions
This activity contains 8 questions.
1. How would the nurse know that the new graduate has attained the required information in
the field of genetics to care for a client population? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
• The nurse knows the basic concepts for practicing in a general medical-surgical unit.
• The nurse knows the list of genetic tests that can be afforded by the poor.
• The nurse is familiar with the specialized information needed to practice in the neonatal
unit, where the nurse is assigned.
• The nurse can list the test that will be reimbursed by health insurance coverage.
• The nurse is familiar with the governmental policies for genetic screening of individuals.
2. The nurse is assigned a group of clients new to the health clinic for their first prenatal visit. For
which client would the nurse recommend a consultation for genetic testing? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
• A client four months pregnant whose spouse has a hereditary condition
• The client has occasionally taken a nonprescribed medication during the early pregnancy.
• The client has a sibling with known hereditary defect.
• The client has a known genetic disorder and is already under care.
• The client requests genetic screening without known risk by assessment.
3. What question is best for a nurse to ask to solicit information regarding genetic screening or
testing?
• “Have you ever had special testing done?”
• “Has anyone ever discussed genetic testing with you?”
• “Have your parents been genetically screened?”
• “Have you ever been tested for a genetic or hereditary condition?”

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
4. While the nurse is teaching a group of clients about their genetic condition, one client
reports having an illness due to environmental causes. What would be the best approach in dealing
with this situation at this time?
• Ask that the client not be a part of the group, as the client’s condition differs.
• Inform the clients that some genetic illnesses can be affected by the environment.
• Arrange for a team meeting to discuss this client’s issues.
• Recommend that the client have a conversation with the doctor.
5. The quality assurance personnel conducted a review of actions by the nurses on a general
medical unit. Which documented action indicates that educational intervention on genetics and
genomics is required?
• Clients with visible physical defects suspected of a hereditary condition were referred for
testing.
• All of the clients were referred for genetic screening.
• The nurse documented the pedigree chart on all admitted clients.
• None of the clients was referred for genetic testing.
6. Why is specific genetic and genomics knowledge considered a core competency for nurses?
• It can determine which clients should be screened for cancer.
• It can help to isolate families that have a genetic condition.
• It can help in planning care regarding a client’s health and illness.
• It is important across all generations of clients.
7. When was mapping completed in the Human Genome Project?
• In 1990
• In 1953
• In 2003
• In 1805

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 2: Why Basic Concepts in Genetics and Genomics Are Part of Every
Type of Nursing Practice
Case Study Questions
Jim is a 67-year-old African-American man who has arrived for his annual physical. Jim is in
seemingly good health for his age. While you are taking his family medical history, Jim mentions that
he is having tremors in his hands and it is becoming increasingly annoying to him when he tries to
write or drink coffee. When asked if there is a family history of Parkinson’s disease, Jim says he
doesn’t know. Jim wants to know how he will know if he has Parkinson’s and what types of
treatment are available.
This activity contains 3 questions.
1. Ask Jim some questions to further evaluate the tremors that he is having.
Suggested Answer: Examples of questions to ask are:
Do you have tremors in your hands when you are resting?
Have you or your family noticed changes in the way you move, walk?
Have you had changes in your bowel movements, such as diarrhea or constipation?
2. Please let Jim know what types of testing are available for Parkinson’s and what types of
treatment are recommended.
Suggested Answer: There are no diagnostic tests that specifically identify Parkinson’s disease. Jim
will be referred to a neurologist for further evaluation. There is no cure for Parkinson’s disease, but
the progression of symptoms can be delayed based on individual response. Some of the common
treatments are Carbidopa/Levodopa therapy, Dopamine agonists, Anticholinergics, or MAO-B
inhibitors.
After further evaluation, Jim returns for a follow-up appointment. His neurologist has sent over
notes that suggest that he does have Parkinsonian symptoms. Jim realizes that this is a progressive
disease and expresses that he is an advocate for scientific research and wants to know if any clinical
trials are available that he could participate in. Jim is a talkative man and also indicates that he is an
organ donor and begins wondering if there are any organ donation programs specific for people with
Parkinson’s disease, so that he can make preparations for his family.

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
3. Please share with Jim information about a clinical trial and whom he should contact, and find
out if there is an organ donation program or brain bank that Jim could apply for. (You may find the
following websites helpful: www.clinicaltrials.gov or www.intbbn.org/registry-of-brain-banks.aspx).
Suggested Answer: The answer should include a clinical trial either at a local facility or from the
website provided and the listing of an organ donation program or brain bank.

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 2: Why Basic Concepts in Genetics and Genomics Are Part of Every
Type of Nursing Practice
Case Study Questions
Jim is a 67-year-old African-American man who has arrived for his annual physical. Jim is in
seemingly good health for his age. While you are taking his family medical history, Jim mentions that
he is having tremors in his hands and it is becoming increasingly annoying to him when he tries to
write or drink coffee. When asked if there is a family history of Parkinson’s disease, Jim says he
doesn’t know. Jim wants to know how he will know if he has Parkinson’s and what types of
treatment are available.
This activity contains 3 questions.
1. Ask Jim some questions to further evaluate the tremors that he is having.
2. Please let Jim know what types of testing are available for Parkinson’s and what types of
treatment are recommended.
3. Please share with Jim information about a clinical trial and whom he should contact, and find
out if there is an organ donation program or brain bank that Jim could apply for. (You may find the
following websites helpful: www.clinicaltrials.gov or www.intbbn.org/registry-of-brain-banks.aspx).

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 2: Why Basic Concepts in Genetics and Genomics Are Part of Every
Type of Nursing Practice
NCLEX Review Questions
This activity contains 8 questions.
1. A nurse manager is evaluating a staff nurse’s demonstration of essential competencies in
genetics. Which situations would the manager recognize as meeting one of these competencies?
Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Answers: The nurse constructed a three-generation family health history on a newly admitted client.
The nurse asked to be transferred off a case in which a client requested to abort a pregnancy after
genetic testing.
The nurse asked to attend a conference on diversity.
The nurse advocated for transfer to a specialized genetic service for a client with complex needs.
2. How would the nurse determine that the family needed care related to genetic counseling?
Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Answers: A family member has been told he has a genetic illness.
The client has agreed to undergo genetic testing.
3. Who developed the monograph related to genetics and genomics competencies for nursing?
Answer: Group of nurse clinicians, leaders, educators, and researchers
4. What is the best inference that can be made if the nurse included the pharmacist in the
discussion of care for a client who is being treated for a genetic condition?
Answer: There are possible pharmacogenetic implications to the treatment.
5. What step would the nurse take first when prioritizing care for the family that refuses for their
child with mental retardation to be genetically tested?
Answer: Discuss the pros and cons of genetic testing.

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
6. What is the minimum familial generation history needed to be collected on a client who was
adopted in order to determine whether appropriate genetic and genomic assessment of the client
was completed?
Answer: Three generations of family history
7. Which activity is consistent with the role of the registered nurse who is participating in genetic
and genomic primary preventative care?
Answer: The nurse teaches pregnant mothers over age 40 years about common birth defects.
8. What is the role of genetic/genomic bio-banking in delivering health care to clients at high risk
for genetic disease?
Answer: The stored genetic material can help determine which illnesses are in the client’s gene pool.

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
Chapter 2: Why Basic Concepts in Genetics and Genomics Are Part of Every
Type of Nursing Practice
NCLEX Review Questions
This activity contains 8 questions.
1. A nurse manager is evaluating a staff nurse’s demonstration of essential competencies in
genetics. Which situations would the manager recognize as meeting one of these competencies?
Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
• The nurse advocated for transfer to a specialized genetic service for a client with complex
needs.
• The nurse asked to attend a conference on diversity.
• The nurse constructed a three-generation family health history on a newly admitted client.
• The nurse asked to be transferred off a case in which a client requested to abort a pregnancy
after genetic testing.
• The nurse’s care plans seldom mention genetic or genomic assessment.
2. How would the nurse determine that the family needed care related to genetic counseling?
Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
• The breadwinner of the family was diagnosed with a genetic illness.
• More than one member of the family is affected by the genetic condition.
• The client has agreed to undergo genetic testing.
• The newborn infant was diagnosed with a genetic condition.
• A family member has been told he has a genetic illness.
3. Who developed the monograph related to genetics and genomics competencies for nursing?
• Group of geneticists from the United States and Canada
• Members of the American Medical Association

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
• Group of nurse clinicians, leaders, educators, and researchers
• Members of the American Association of Colleges of Nursing
4. What is the best inference that can be made if the nurse included the pharmacist in the
discussion of care for a client who is being treated for a genetic condition?
• The nurse is involving interdisciplinary team members.
• The client is unfamiliar with the medication being administered.
• The nurse is breaking the laws of confidentiality.
• There are possible pharmacogenetic implications to the treatment.
5. What step would the nurse take first when prioritizing care for the family that refuses for their
child with mental retardation to be genetically tested?
• Complete a detailed assessment of the psychological impairment of the child.
• Discuss the pros and cons of genetic testing.
• Encourage the family to seek care for the sorrow they are experiencing.
• Inform the family that there are environmental causes of mental retardation.
6. What is the minimum familial generation history needed to be collected on a client who was
adopted in order to determine whether appropriate genetic and genomic assessment of the client
was completed?
• One generation of family health history
• No familial history, as the client is adopted
• Three generations of family history
• Two generations of family health history
7. Which activity is consistent with the role of the registered nurse who is participating in genetic
and genomic primary preventative care?
• The nurse teaches pregnant mothers over age 40 years about common birth defects.
• The nurse participates in post-test genetic counseling of families with a positive result on a
confirmatory test.

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Kenner/Lewis: Genetics and Genomics for Nursing, 1e
• The nurse teaches the client with a genetic condition how to minimize disability.
• The nurse discusses financial assistance with the family to minimize the burden of health
care.
8. What is the role of genetic/genomic bio-banking in delivering health care to clients at high risk
for genetic disease?
• To collect and store genes from every organ in the human body
• Results from the stored samples can help determine the length of time the client will live
with her condition.
• The information from material stored can help only the family from which it was collected.
• The stored genetic material can help determine which illnesses are in the client’s gene pool.

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Solution Manual for Genetics and Genomics for Nursing

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