A client recently underwent genetic testing that revealed that she has a BRCA1 gene mutation for breast cancer. What are the best actions of the nurse? (Select all that apply.)
a. Encourage genetic counseling for self and family.
b. Disclose the information to the medical insurance company.
c. Recommend self–breast examination every week.
d. Assess the client's response to the test re-sults.
e. Aid in making a plan for prevention and risk reduction.
A, D, E
The medical-surgical nurse can assess the client's response to the test results and encourage ge-netic counseling for self and family. For some positive genetic test results, such as having a BRCA1 gene mutation, the risk for developing breast cancer is high but is not a certainty. Be-cause the risk is high, the client should have a plan for prevention and risk reduction. One form of prevention is early detection. Self–breast examinations are helpful when performed monthly, but those performed every week may not be useful, especially around the time of menses. A client who tests positive for a BRCA1 mutation should have at least yearly mammograms and ovarian ultrasounds to detect cancer at an early stage, when it is more easily cured. Owing to confidentiality, the nurse would never reveal any information about a client to an insurance company without the client's permission.
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The nurse is caring for a patient who has a history of congestive heart failure. The nurse includes the diagnosis fluid volume excess in the patient's care plan. Which goal statement has the highest priority for the patient and nurse?
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A. Adverse effects that can be expected B. Which adverse effect to report to the healthcare provider C. The drug's therapeutic action D. Chemical composition of the drug E. Name of the drug manufacturer