Advanced Nursing Practice
Final Exam
Course Introduction
Advanced Nursing Practice explores the expanded roles and responsibilities of nurses in diverse healthcare settings, emphasizing evidence-based practice, clinical decision-making, and leadership. The course covers advanced assessment techniques, diagnostic reasoning, and the formulation of individualized care plans for patients across the lifespan. Students engage with current issues in healthcare policy, interprofessional collaboration, and the ethical dimensions of advanced practice nursing. Through case studies, simulations, and critical analysis, participants develop the competencies required for advanced clinical practice, advocacy, and effective patient care management in both primary and specialized healthcare environments.
Recommended Textbook
Genetics and Genomics in Nursing and Health Care 2nd Edition by Theresa A. Beery
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20 Chapters
432 Verified Questions
432 Flashcards
Source URL: https://quizplus.com/study-set/201 Page 2
Chapter 1: DNA Structure and Function
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/2914
Sample Questions
Q1) Which chromosome number represents the euploid state for normal human somatic cells?
A)44
B)46
C)47
D)48
Answer: B
Q2) Under what normal condition are genotype and phenotype always the same?
A)Euploidy of alleles
B)Aneuploidy of alleles
C)Homozygosity of alleles
D)Heterozygosity of alleles
Answer: C
Q3) Which of these complementary base pairs form the strongest or "tightest" association?
A)Adenine and thymine
B)Cytosine and guanine
C)Guanine and thymine
D)Cytosine and adenine
Answer: B
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Chapter 2: Protein Synthesis
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) Which process occurs outside of the nucleus?
A)DNA transcription
B)RNA transcription
C)Splicing out of introns
D)Translation of mRNA
Answer: D
Q2) How does the process of polyadenylation affect protein synthesis?
A)Binding to the antisense DNA strand to prevent inappropriate transcription
B)Promoting attachment of ribosomes to the correct end of messenger RNA
C)Linking the exons into the mature messenger RNA
D)Signaling the termination of mRNA translation
Answer: D
Q3) What is the best meaning for the term gene expression?
A)The location of a specific gene allele on a specific autosomal chromosome
B)The specific trait or protein coded for by a single gene is actually present
C)The ability of a single gene to code for more than one trait or characteristic
D)The loss of a trait or characteristic from one family generation to the next generation
Answer: B
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Chapter 3: Genetic Influence on Cell Division, Differentiation,
and
Gametogenesis
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32 Verified Questions
32 Flashcards
Source URL: https://quizplus.com/quiz/2916
Sample Questions
Q1) Which process is unique to spermatogenesis?
A)Synapsis during the zygotene stage
B)Equal distribution of cytoplasm during meiosis I
C)Elongation of chromatids during the diplotene stage
D)Degeneration of germ cells between fetal life and the onset of puberty
Answer: B
Q2) Which normal cell characteristic is represented by the production of insulin in the beta cells of the pancreas?
A)Performance of a differentiated function
B)Ability to undergo apoptosis on schedule
C)Tight regulation of cell division
D)Conservation of energy
Answer: A
Q3) What is the function of a suppressor gene product?
A)To ensure cell division occurs only when it is needed
B)To suppress the loss of differentiated functions with aging
C)To ensure the precise delivery of chromosomes to each new daughter cell
D)To prevent the formation of a large nuclear-to-cytoplasmic ratio during the G<sub>0</sub> state
Answer: A
Page 5
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Chapter 4: Patterns of Inheritance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/2917
Sample Questions
Q1) If there are 10 possible alleles for the single-gene trait of nose shape, how many alleles can a person with euploid chromosomes inherit from his or her biological parents?
A)1
B)2
C)4
D)5
Q2) Which genetic disorder has both an autosomal-dominant and an autosomal-recessive form?
A)Syndactyly
B)Phenylketonuria
C)Long QT syndrome
D)Retinitis pigmentosa
Q3) Which factor allows inheritance patterns for a specific trait or health problem to be traced from one family generation to another?
A)Pleiotropy
B)Allele segregation
C)Regression to the mean
D)Gene-environment interaction
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Page 6
Chapter 5: Epigenetic Influences on Gene Expression
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) How is eating a diet high in broccoli thought to reduce cancer risk?
A)Increasing the excretion rate of foods known to be methyl donors
B)Increasing histone acetylation, turning on anticancer genes
C)Decreasing the rate of microDNA synthesis and activity
D)Decreasing the exposure of carcinogens to nuclear DNA
Q2) How does histone modification alter gene expression?
A)Modified histones result in increased DNA methylation, which increases the transcription of genes in that area.
B)In areas where histones are modified, the DNA is more tightly wound, and genes are not transcribed.
C)Histone modification results in an increase in microRNA production, which inhibits gene expression by preventing translation.
D)Histone modification results in an increase in microRNA production, which promotes gene expression by enhancing translation.
Q3) What part of a chromosome's DNA is altered by histone modification?
A)Complementary base pairing
B)Attachment of phosphate groups
C)Development of telomeric "caps"
D)The degree of tension in helical tightness
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Page 7
Chapter 6: Autosomal Inheritance and Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which reproductive consequence is possible for a man who has a 13;15 Robertsonian translocation when his wife has a normal karyotype?
A)He is unlikely to ever impregnate his wife.
B)Because his wife has a normal karyotype, there are no reproductive consequences.
C)He has an increased risk for having a child born with either trisomy 13 or trisomy 15.
D)He has an increased risk for having a child born with either monosomy 13 or monosomy 15.
Q2) What is the risk for a man who has Down syndrome to produce a child with Down syndrome with a woman who has a normal karyotype?
A)100%
B)50%
C)5%
D)0%
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Chapter 7: Sex Chromosome and Mitochondrial Inheritance and Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) What is the risk for a man with a 47,XYY karyotype to produce a child with a 47,XYY karyotype?
A)100%
B)50%
C)25%
D)0%
Q2) Which feature is common among people who have Klinefelter syndrome (47,XXY) or a karyotype with 47,XXX but not among people who have Down syndrome or Edward syndrome?
A)Severely reduced cognition
B)Cleft palate
C)Tall stature
D)Infertility
Q3) Which type of problem results from mutations in mitochondrial DNA (mtDNA)?
A)Reduced cellular energy
B)Balanced translocations
C)Excessive "crossing over"
D)Single-nucleotide polymorphisms
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Chapter 8: Family History and Pedigree Construction
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Marjory tells a nurse that she has three aunts with cancer. The two on her father's side were diagnosed with breast and ovarian cancers at ages 42 and 36. Shealsohasone aunt on her mother's side who was diagnosed with breast cancer at age 70. Marjory asks if she should have genetic testing. What should the nurse tell her?
A)"Your family history indicates a high risk, and you should definitely have genetic testing."
B)"Because no men in your family are affected, it is not inherited cancer, so you don't need mammograms or any special screening practices."
C)"Because your aunts were older when they got breast cancer, it was probably sporadic, and you should just have regular mammograms like everyone else."
D)"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."
Q2) Why is a pedigree considered an "unstable" product?
A)The person collecting the information may not be a genetics professional.
B)Some family members may have lied about their reproductive history.
C)The memories of older family members may be inaccurate.
D)The health of living family members continues to evolve.
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Chapter 9: Congenital Anomalies, Basic Dysmorphology, and
Genetic Assessment
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/2922
Sample Questions
Q1) Which condition in a newborn should be described as a deformation if it is the only abnormal finding?
A)A unilateral clubfoot
B)A sealed (imperforate) anus
C)The absence of a thyroid gland
D)The presence of six toes on each foot
Q2) How does genetic assessment differ from routine physical assessment?
A)Routine physical assessment relies on personal history, and genetic assessment relies on the recorded family history.
B)Genetic assessment requires only inspection, and routine physical assessment involves inspection, palpation, and auscultation.
C)Genetic assessment encompasses routine physical assessment and always adds the consideration of genetic causes for findings.
D)Routine physical assessment is performed by all health-care professionals, and genetic assessment is performed only by genetic professionals.
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11
Chapter 10: Enzyme and Collagen Disorders
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Which health problem could be expected as a result of a gene mutation that affects the correct production and function of type 1 collagen?
A)Failure of blood to clot after minor trauma
B)Increased incidence of arterial and venous aneurysms
C)Increased incidence of hearing loss among children and adults
D)Restrictive lung disease from excessive stiffening of alveolar walls
Q2) Which therapeutic option has been found beneficial for patients with Gaucher type 1 disease?
A)Daily ingestion of oral sapropterin hydrochloride (Kuvan)
B)Intravenous enzyme replacement with alpha-L iduronidase
C)Weekly phlebotomy with removal of excess red blood cells
D)Intravenous enzyme replacement with imiglucerase (Cerezyme)
Q3) Which substance fails to form normally in individuals with Marfan syndrome?
A)Elastin
B)Glycogen
C)Collagen
D)Fibrillin
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12
Chapter 11: Common Childhood-Onset Genetic Disorders
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) A 12-year-old girl was diagnosed with von Willebrand disease (VWD) when she developed profound anemia from very heavy menstrual periods. Her levels of von Willebrand (vWf) factor are normal. What specific type of von Willebrand disease is she most likely to have?
A)Type 1 VWD
B)Type 2 VWD
C)Type 3 VWD
D)Type 4 VWD
Q2) Which ethnic group has the highest incidence of sickle cell disease (SCD)?
A)Ashkenazi Jews
B)Asian Americans
C)African Americans
D)French Canadians from Quebec
Q3) Which type of testing is most commonly used to diagnose classic hemophilia?
A)Hematocrit and hemoglobin levels
B)X-chromosome inactivation
C)Genetic mutation analysis
D)Factor VIII levels
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13
Chapter 12: Common Adult-Onset Disorders
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A 31-year-old man has been diagnosed with chronic obstructive pulmonary disease (COPD) as a result of being homozygous for the ZZ mutation of the -1 antitrypsin (AAT)gene alleles. His wife has been tested and has the MM genotype on her AAT gene alleles. The man is worried that his three children may eventually develop COPD. What is your best response?
A)"Because your wife does not have the mutation, and neither of your parents has the disease, your children will not be affected."
B)"Because your wife is not affected and is not a carrier, your children will have normal levels of AAT, and their risk is the same as for the general population."
C)"Because you have the mutations, and your wife does not, your son will be at an increased risk for developing COPD, but your daughter will only be a carrier."
D)"Because your children will each have only one mutated gene allele, their risk for COPD is primarily dependent on chronic environmental exposure to inhalation irritants."
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Chapter 13: Cardiovascular Disorders
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) The process in which gene variants interact with other gene variants to cause disease can be described by what word/phrase?
A)Phenotype variation
B)Reduced penetrance
C)Epistasis
D)Variable expressivity
Q2) Why is factor V Leiden disorder considered a form of thrombophilia?
A)Platelet activity is impaired.
B)Blood clots form more easily.
C)Atherosclerosis development is accelerated.
D)Excessive bleeding episodes occur in response to minor trauma.
Q3) Which health problem is the most frequent cause of sudden cardiac death among young athletes?
A)Atrial fibrillation
B)Hypertrophic cardiomyopathy
C)Familial hypercholesterolemia type 1
D)Romano-Ward form of long QT syndrome
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Chapter 14: The Genetics of Cancer
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/2927
Sample Questions
Q1) What event occurring during the latency period of carcinogenesis is most likely to contribute to cancer development?
A)Cellular apoptosis
B)Error-free DNA repair
C)Exposure to promoters
D)Oncogene inactivation
Q2) Mutations in which of the following genes are now known to greatly increase the risk for developing breast cancer? Select all that apply.
A)APC
B)CDH1
C)CHEK2
D)DCC
E) PALB2
F) PTEN
Q3) Which cancer type is associated with a 9;22 translocation t(9;22)?
A)Acute promyelocytic leukemia
B)Acute lymphocytic leukemia
C)Chronic lymphocytic leukemia
D)Chronic myelogenous leukemia
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Page 16
Chapter 15: Genetic Contributions to Psychiatric and Behavioral Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Why is pharmacogenetics/pharmacogenomics of particular interest in treating patients with psychiatric/mental health problems?
A)Psychiatric medications may be effective in only a small group of patients.
B)Genetics restricts patients to only one drug in each classification.
C)Most psychiatric illnesses are single-gene disorders with predictable drug responses.
D)Psychotropic medications have few side effects.
Q2) Which condition or behavior suggests attention deficit hyperactivity disorder (ADHD)?
A)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
B)An 8-year-old who can hop on one foot but cannot ride a bicycle without training wheels
C)A 9-year-old who does not focus on a favorite story or game for longer than 3 minutes
D)A 10-year-old who prefers to play basketball rather than chess
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Chapter 16: Genetic and Genomic Testing
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Which tissue is most likely to provide an adequate DNA sample for genetic testing?
A)Distal ends of hair shafts
B)Mature red blood cells
C)Nasal epithelial cells
D)A mummy's tooth
Q2) What type of genetic test provides information about an asymptomatic person's risk for having a child with a specific autosomal-recessive disorder in the future?
A)Carrier test
B)Diagnostic test
C)Newborn screening
D)Predictive test
Q3) Genetic testing of an asymptomatic woman whose sister is positive for the mutation that is responsible for an autosomal-dominant disorder that has a 70% penetrance ratewould fall into which testing category?
A)Diagnostic predisposition
B)Diagnostic presymptomatic
C)Predictive predisposition
D)Predictive presymptomatic
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Chapter 17: Assessing Genomic Variation in Drug Response
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) Which condition or factor improves the initial bioavailability of a drug agonist that has extensive first-pass loss as a result of the patient's enhanced liver enzymeactivity?
A)Increasing the patient's fluid intake
B)Co-administering the drug with an antagonist
C)Administering the drug by the intravenous route
D)Crushing the oral form of the drug before administration
Q2) 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 ina blooddrug level that is below the minimum effective concentration (MEC)?
A)Drug entry exceeds drug elimination.
B)The risk for toxic side effects is increased.
C)The intended response fails to be produced.
D)The drug's duration of action is longer than expected.
Q3) Which organ has the greatest concentration of cytochrome P (CYP) 450 enzymes?
A)Stomach
B)Kidney
C)Brain
D)Liver
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Chapter 18: Health Professionals and Genomic Care
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) The patient who has been found to have a mutation in a gene allele that greatly increases her risk for a serious health problem has asked a generalist nurse tobe present when she discloses this information to her family. What is the nurse's role in this situation?
A)Primary health-care provider
B)Genetic counselor
C)Patient advocate
D)Patient support
Q2) How do genetics counselors provide genetic/genomic information to patients and families in a nondirective manner?
A)Providing only the information the patient or family specifically requests
B)Skillfully directing the patient and family toward the best choice that is supported by appropriate research
C)Presenting all facts and available options in a manner that neither promotes nor excludes any legally permitted decision or action
D)Filtering management options and focusing on the information that will support the decision they believe is right for the individual patient/family
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Chapter 19: Financial, Ethical, Legal, and Social
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9 Verified Questions
9 Flashcards
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Sample Questions
Q1) Your patient, Maggie, insists that her mother have genetic testing to determine if her breast cancer is connected to a mutation in the BRCA1/2 genes. Maggie isconcerned about her own risk for getting breast cancer and that of her children, but Maggie's mom does not want to be tested. What ethical principle is one of several that must be considered in evaluating this case?
A)Maggie's "autonomy"
B)Maggie's mother's "right to know"
C)The nurse's "duty to warn"
D)Maggie's mother's "right to privacy"
Q2) Sometimes health-care providers with information about family members' genetic risk are confronted by conflicting ethical principles. Which principle is leastlikelytoconflict with the health-care provider's "duty to warn"?
A)Autonomy
B)Beneficence
C)Right to privacy
D)Genetic discrimination
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Chapter 20: Genetic and Genomic Variation
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Which term refers to a random change in allele frequencies, not based on natural selection?
A)Population bottleneck
B)Genetic drift
C)Founder effect
D)Migration effect
Q2) What is the main purpose of population genetics?
A)Determining the factors that allow allelic frequencies to change over time
B)Determining the geographic origins of specific genetic-based disorders
C)Assessing the effects of assortive mating on natural selection and evolution
D)Assessing the differences between race and ethnicity for susceptibility and resistance to infectious diseases
Q3) What criteria must a population meet in order to stay in Hardy-Weinberg equilibrium?
A)Random mating, no migration, and no mutation
B)Founding commonalities and no haplotype differences
C)Assortative mating, migration, and frequent mutation
D)Limited procreation, no diet change
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