A Guide to Genetic Counseling "the green book questions"

7. 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 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. Which of the following is the BEST response? a. Acknowledge the mother's concern, but inform her it is the counselor's obligation to provide accurate information. b. Ask the mother to leave so the counselor can speak with the daughter alone. c. Call the daughter after the session at a time when the mother is not at home. - a. Acknowledge the mother's concern, but inform her it is the counselor's obligation to provide accurate information. 11. A pregnant woman is undecided about pursuing invasive testing. She asks, "If I were your wife, what would you tell me to do?" The counselor replies, "I don't know what I would do, but I do know what concerns I would think about." Which of the following techniques BEST describes this response? a. Advice giving b. Directive guidance c. Nondirective counseling d. Nonjudgmental reflection - c. Nondirective counseling 17. A 2-year-old with developmental delay is newly diagnosed as having RubinsteinTaybi syndrome. The mother continues to keep the child's medical appointments but tells the genetic counselor that she does not believe the diagnosis. Which of the following is the BEST strategy for the counselor to pursue? a. Refer the mother to a support group to meet with other families. b. Emphasize positive aspects of the diagnosis with the mother c. Review the medical findings to convince the mother of the diagnosis d. Allow the mother time to come to terms with the diagnosis at her own rate - d. Allow the mother time to come to terms with the diagnosis at her own rate 24. A couple comes for genetic counseling because of advanced maternal age. The counselor notes that the father of the pregnancy 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. Which of the following is the BEST next step for the counselor to take? a. Inquire again about the history of birth defects on both sides of the family, using cleft lip as an example