PHYSICAL EXAMINATION AND HEALTH
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1)
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 28-year-old pregnant patient at 10 weeks presents for her
first prenatal visit. She reports a family history of cystic fibrosis
(father is a known carrier). She is asymptomatic and requests
guidance about genetic risk. Which action best aligns with
Page 1 of 986
,evidence-based genetic assessment and immediate safe
practice?
A. Reassure the patient; order no testing because she is
asymptomatic.
B. Offer maternal carrier testing now and, if positive, offer
paternal testing and genetic counseling.
C. Recommend chorionic villus sampling (CVS) immediately to
test the fetus.
D. Schedule amniocentesis in the third trimester to avoid early
fetal risk.
Correct answer: B
Rationale — Correct (B)
Jarvis emphasizes family history and targeted carrier testing
when a known familial mutation or carrier exists. Maternal
carrier testing first is noninvasive and informs whether
paternal testing/genetic counseling is needed. This approach
prioritizes informed decision-making and avoids unnecessary
invasive fetal procedures. It aligns with safety and stepwise
assessment.
Rationale — Incorrect
A: Reassurance alone ignores actionable family history and
misses opportunity to identify carrier risk.
C: CVS is invasive and indicated only after parental carrier
status or clear indications; not first step.
D: Amniocentesis is invasive and typically performed later; not
appropriate as initial test.
Page 2 of 986
,Teaching point:
Start with parental carrier testing and counseling before
invasive fetal testing.
Citation:
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
2)
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 45-year-old woman reports two first-degree relatives with
early-onset breast cancer (ages 42 and 46). She asks whether
she should be tested for BRCA mutations. What is the nurse-
clinician’s best next step in managing her genetic risk?
A. Order immediate BRCA1/2 testing on the patient without
family testing.
B. Construct a three-generation pedigree and refer for genetic
counseling prior to testing.
C. Begin annual mammography only, since imaging will detect
cancer early.
D. Suggest prophylactic bilateral mastectomy immediately due
to family history.
Correct answer: B
Page 3 of 986
, Rationale — Correct (B)
Jarvis stresses constructing pedigrees for risk assessment and
referral to genetic counseling when familial patterns suggest
hereditary cancer. A three-generation family history refines
pretest probability and informs appropriate testing strategies
and informed consent. This preserves safety and shared
decision-making.
Rationale — Incorrect
A: Direct testing without pedigree/counseling risks
misinterpretation and misses targeted family mutation
identification.
C: Imaging is important but incomplete; genetic
counseling/testing informs surveillance and prevention
choices.
D: Prophylactic surgery is an extreme step requiring
counseling and confirmed high genetic risk.
Teaching point:
Always build a pedigree and refer to genetic counseling before
targeted mutation testing.
Citation:
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3)
Page 4 of 986
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1)
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 28-year-old pregnant patient at 10 weeks presents for her
first prenatal visit. She reports a family history of cystic fibrosis
(father is a known carrier). She is asymptomatic and requests
guidance about genetic risk. Which action best aligns with
Page 1 of 986
,evidence-based genetic assessment and immediate safe
practice?
A. Reassure the patient; order no testing because she is
asymptomatic.
B. Offer maternal carrier testing now and, if positive, offer
paternal testing and genetic counseling.
C. Recommend chorionic villus sampling (CVS) immediately to
test the fetus.
D. Schedule amniocentesis in the third trimester to avoid early
fetal risk.
Correct answer: B
Rationale — Correct (B)
Jarvis emphasizes family history and targeted carrier testing
when a known familial mutation or carrier exists. Maternal
carrier testing first is noninvasive and informs whether
paternal testing/genetic counseling is needed. This approach
prioritizes informed decision-making and avoids unnecessary
invasive fetal procedures. It aligns with safety and stepwise
assessment.
Rationale — Incorrect
A: Reassurance alone ignores actionable family history and
misses opportunity to identify carrier risk.
C: CVS is invasive and indicated only after parental carrier
status or clear indications; not first step.
D: Amniocentesis is invasive and typically performed later; not
appropriate as initial test.
Page 2 of 986
,Teaching point:
Start with parental carrier testing and counseling before
invasive fetal testing.
Citation:
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
2)
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 45-year-old woman reports two first-degree relatives with
early-onset breast cancer (ages 42 and 46). She asks whether
she should be tested for BRCA mutations. What is the nurse-
clinician’s best next step in managing her genetic risk?
A. Order immediate BRCA1/2 testing on the patient without
family testing.
B. Construct a three-generation pedigree and refer for genetic
counseling prior to testing.
C. Begin annual mammography only, since imaging will detect
cancer early.
D. Suggest prophylactic bilateral mastectomy immediately due
to family history.
Correct answer: B
Page 3 of 986
, Rationale — Correct (B)
Jarvis stresses constructing pedigrees for risk assessment and
referral to genetic counseling when familial patterns suggest
hereditary cancer. A three-generation family history refines
pretest probability and informs appropriate testing strategies
and informed consent. This preserves safety and shared
decision-making.
Rationale — Incorrect
A: Direct testing without pedigree/counseling risks
misinterpretation and misses targeted family mutation
identification.
C: Imaging is important but incomplete; genetic
counseling/testing informs surveillance and prevention
choices.
D: Prophylactic surgery is an extreme step requiring
counseling and confirmed high genetic risk.
Teaching point:
Always build a pedigree and refer to genetic counseling before
targeted mutation testing.
Citation:
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3)
Page 4 of 986
