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Chamberlain College of Nursing -NR305 Health Assessment
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NOTE: Please do NOT remove any of the text on this form. Fill it in and submit in its entirety to aid in its grading. Failing to complete this assignment using an adult participant other than yourself will result in a 20% penalty deduction being applied. Thank you. Your...Description
NOTE: Please do NOT remove any of the text on this form. Fill it in and submit in its entirety to aid in its
grading. Failing to complete this assignment using an adult participant other than yourself will result in a
20% penalty deduction being applied. Thank you.
Your Name: Date: 10/31/2017
Your Instructor’s Name: Professor Brenda Trigg
Purpose: This assignment is to help you gain insight regarding the influence of genetics on an individual’s
health and risk for disease. You are to obtain a family genetic history on a willing, nonrelated, adult
participant.
Disclaimer: When taking a family genetic history on an actual client, it is essential that the information is
accurate. Please inform the person you are interviewing that they do NOT need to disclose information
that they wish to keep confidential. If the adult participant decides not to share information, please
write, “Does not want to disclose.” If you find that the client is unwilling to answer several questions, you
will need to find another client who can provide more information.
Directions: Refer to the Family Genetic History guidelines and grading rubric found in Course Resources
to complete the information below. This assignment is worth 150 points.
Type your answers on this form. Click Save as and save the file with the assignment name and your last
name, e.g., “NR305_Family_Genetic_History_Form_Smith”. When you are finished, submit the form to
the Family Genetic History Dropbox by the deadline indicated in your guidelines. Post questions in the Q
& A Forum or contact your instructor if you have questions about this assignment.
1: Family Genetic History (60 points):
Develop a family genetic history that includes, at a minimum, three generations of your chosen
adult’s family, including grandparents, parents, and the adult’s generation. If the adult has any
children, include them as the fourth generation. **PLEASE NOTE: This assignment is to reveal the
potential impact of the family’s health on the adult participant. You do not need to identify anyone
who is not biologically related to the adult except for a spouse or significant other.
You do not need to use symbols, but instead write brief descriptions for each person. Each
description should include the following information: first name, birthdate, death date, occupation,
education, primary language, and a health summary, including any medical diagnoses. An example is
below.
Family Memb