Counseling Sample Problems
A 26-year-old woman comes for genetic counseling for presymptomatic testing for HD.
Her psychiatrist has told the genetic counselor that the woman has an unstable living
situation and is showing signs of depression. The woman told the psychiatrist that "she
has no one." The woman is very emotional when she arrives at the counselor's office
and demands HD testing. What is the best way to proceed with the session? - answer
Acknowledge the patient's situation, and refer her for psychological services before
proceeding
A 15-year-old girl at 21 weeks gestation comes with her mother to the genetic counselor
because the fetus has gastroschisis. The patient's mother insists that the birth defect is
incompatible with life and that she should terminate the pregnancy, but the patient says
she wants to keep the baby. However, the patient says that she might terminate the
pregnancy if the counselor says the chances of the fetus surviving are poor. The
patient's mother becomes agitated when the counselor states that the birth defect is
often compatible with life. She accuses the counselor of undermining her authority as
the mother. What is the BEST response by the counselor? - answerAcknowledge the
mother's concerns, but inform her that the counselor is obligated to provide
accurate information
A 2-year-old child with developmental delay is newly diagnosed as having Rubinstein-
Taybi syndrome. The mother continues to keep the child's medical appointments but
tells the genetic counselor that she does not believe the diagnosis. What is the BEST
strategy for the counselor to pursue? - answerAllow the mother time to come to terms
with the diagnosis at her
own rate
A couple comes for genetic counseling because of advanced maternal age. The
counselor notes that the father has a large vertical scar on his upper lip. While taking
the family history, the counselor asks both individuals if either has a history of birth
defects, and they deny any such history. What is the BEST next step for the counselor
to take? - answerAsk the father about the scar
on his lip, explaining that this information is essential for risk assessment
A couple comes for preconception genetic counseling because the woman had bilateral
retinoblastoma. The husband asks about his wife's risks for developing the non-ocular
cancers associated with this disease. The genetic counselor invites the woman to
answer in an attempt to assess her level of understanding and perception of risk. She
responds in anger, "Do you mind not talking about this?!" What is the MOST appropriate
response by the counselor? - answerAcknowledge her anger and ask her to elaborate
on her reaction
A 26-year-old woman comes for genetic counseling for presymptomatic testing for HD.
Her psychiatrist has told the genetic counselor that the woman has an unstable living
situation and is showing signs of depression. The woman told the psychiatrist that "she
has no one." The woman is very emotional when she arrives at the counselor's office
and demands HD testing. What is the best way to proceed with the session? - answer
Acknowledge the patient's situation, and refer her for psychological services before
proceeding
A 15-year-old girl at 21 weeks gestation comes with her mother to the genetic counselor
because the fetus has gastroschisis. The patient's mother insists that the birth defect is
incompatible with life and that she should terminate the pregnancy, but the patient says
she wants to keep the baby. However, the patient says that she might terminate the
pregnancy if the counselor says the chances of the fetus surviving are poor. The
patient's mother becomes agitated when the counselor states that the birth defect is
often compatible with life. She accuses the counselor of undermining her authority as
the mother. What is the BEST response by the counselor? - answerAcknowledge the
mother's concerns, but inform her that the counselor is obligated to provide
accurate information
A 2-year-old child with developmental delay is newly diagnosed as having Rubinstein-
Taybi syndrome. The mother continues to keep the child's medical appointments but
tells the genetic counselor that she does not believe the diagnosis. What is the BEST
strategy for the counselor to pursue? - answerAllow the mother time to come to terms
with the diagnosis at her
own rate
A couple comes for genetic counseling because of advanced maternal age. The
counselor notes that the father has a large vertical scar on his upper lip. While taking
the family history, the counselor asks both individuals if either has a history of birth
defects, and they deny any such history. What is the BEST next step for the counselor
to take? - answerAsk the father about the scar
on his lip, explaining that this information is essential for risk assessment
A couple comes for preconception genetic counseling because the woman had bilateral
retinoblastoma. The husband asks about his wife's risks for developing the non-ocular
cancers associated with this disease. The genetic counselor invites the woman to
answer in an attempt to assess her level of understanding and perception of risk. She
responds in anger, "Do you mind not talking about this?!" What is the MOST appropriate
response by the counselor? - answerAcknowledge her anger and ask her to elaborate
on her reaction
