A certified family nurse practitioner with an msn degree in


1- Which statement regarding general cancer development is true?

Select one:

a . Cancers usually develop in tissues that are missing a nucleus.
b. Most mutations leading to cancer development occur in structural genes.
c. The risk for cancer development increases with age.
d. Children of older mothers have a greater risk for cancer development.

2- Which "schizophrenia fact" is correct? Select one:

a. Copy number variants appear to play the most important role in genetic risk for schizophrenia.
b. Because the phenotype of schizophrenia is so obvious, diagnosis and inheritance risk are the most easily determined of all the psychiatric disorders.
c. When one identical twin is affected with schizophrenia the other most certainly will be affected.
d. When schizophrenia has more genetic influence, its onset begins in very early childhood.

3- Which statement regarding behavioral genetics is accurate?

Select one:

a. The genetic susceptibility or predisposition toward a behavioral disorder requires the trigger of an infectious disease for expression.
b. Genes and gene products have been discovered that directly control behavior.
c. A genetic predisposition toward a specific behavior can be modified by altering environmental influences.
d. The genotypes and phenotypes of behavioral problems or deviations follow Mendelian autosomal recessive inheritance patterns.

4- A patient is 34 years old and concerned about possibly being a carrier for HNPCC because his father died of colon cancer at 39, his father's sister died of colon cancer at age 41, and his brother (aged 37) now has colon cancer. The brother's testing is negative for all the known mutations associated with inherited forms of colon cancer. How should this patient be counseled about his risk for colon cancer?

Select one:

a. Explain that he could benefit from testing even though his brother is negative for these mutations because reduced penetrance might account for his negative status.
b. Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk.
c. Explain that because the brother with cancer is negative for these gene mutations, this cancer is most likely sporadic and his risk is the same as general population risk.
d. Explain that his risk is not related to his brother's diagnosis because he did not inherit any genes from him but that since his father is a first-degree relative, testing should be considered.

5- Sometimes health-care providers with information about family members' genetic risk are confronted by conflicting ethical principles. Which principle is LEAST likely to conflict with the health-care provider's "duty to warn"?

Select one:

a. Beneficence
b. Right to privacy
c. Genetic discrimination
d. Autonomy

6- Why do genetic counseling programs include extensive courses on laboratory methods in genetics?

Select one:

a. To be able to draw blood proficiently and safely
b. To perform standard karyotyping on routine blood specimens
c. To help patients understand testing procedures and results
d. To serve as a backup genetics technician in small laboratories

7- What is the result of a mutation occurring in a suppressor gene?

Select one:

a. Increased "error-prone" DNA repair
b. Increased unequal "crossing over" during meiosis I
c. Gain of a new function
d. Loss of an existing function

8- What is the best description of the genetic contribution to onset of autism?

Select one:

a. Exposure to a teratogen can be a cause of autism spectrum in many cases.
b. Autism spectrum is caused by a single gene mutation in most, but not all, cases.
c. Known causes of autism spectrum include copy number variants and chromosomal problems.
d. Autism spectrum disorders have a much stronger environmental input than genetic input to expression of the phenotype.

9- What is the heritability estimate for addiction to alcohol in both males and females?

Select one:

a. 60% to 80%
b. 50% to 60%
c. 20% to 40%
d. 10% to 20%

10- An 85-year-old patient states that she does not perform breast self-exam because there is no history of breast cancer in her family. What is the best response?

Select one:

a. "Because your breasts are no longer as dense as they were when you were younger, your risk for breast cancer is now decreased."
b. "Breast cancer can be found more frequently in some families; however, the risk for general, nonfamilial breast cancer increases with age."
c. "Examining your breasts once per year when you have your mammogram is sufficient screening for someone with your history."
d. "You are correct. Breast cancer is an inherited type of malignancy and your family history indicates a low risk for you."

11- How are malignant tumors different from benign tumors?

Select one:

a. Benign tumors have totally normal features, and malignant tumors have totally abnormal features.
b. Malignant tumors lose plasma membranes, and benign tumors continue to produce them.
c. Malignant tumors grow by expansion, and benign tumors grow by invasion.
d. Benign tumors retain parental cell functions, and malignant tumors lose parental cell functions.

12- Why is determining the genetic contribution important to assess in stroke patients?

Select one:

a. Comorbidities mask the symptoms and delay the diagnosis.
b. Often the person with a stroke cannot provide accurate family information.
c. Stroke classification and phenotype remain heterogeneous.
d. Environmental risk factors have equal contribution to the problem.

13- 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. Yes, he is a clinician employed in a setting specializing in patients with genetic-based health problems
b. No, a clinical geneticist is a physician who has completed a fellowship in clinical genetics.
c. No, a clinical geneticist must be certified as a genetic counselor.
d. Yes, he is an advanced practice nurse.

14- What is the most accurate classification of the common forms of coronary artery disease and hypertension?

Select one:

a. Sequential genetic disorders related to age, ethnicity, and gender
b. Complex disorders resulting from gene-environment interactions
c. Secondary disorders caused by lifestyle choices
d. Primary disorders with an autosomal dominant pattern of inheritance

15- A woman whose sister tested positive for a specific mutation in the BRCA1 gene, which increases the risk for breast and ovarian cancer, is found not to have that mutation but does have a mutation of unknown significance near the known mutation site. How should this woman be counseled?

Select one:

a. She should be informed that because she does not have the mutation, her risk for breast cancer is not greater than that of the general population.
b. She should be informed of her gene mutation status and be presented with all the available prophylaxis options and reconstruction options.
c. She should be informed that she does not have the specific mutation but that because another mutation is present she should be vigilant about screening
d. She should be informed that her risk for breast cancer is greater than the general population but not as great as her sister's risk.

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