 Nurse Practitioners. How can nurse practitioners be prepared to respond when patients share DTC results? Consumers who have undergone some type of direct-to-consumer genetic test or DTC testing is expected to surpass 100 million very soon. DTC genetic tests are readily available, often marketed as gifts for family or friends, and can be purchased quickly online. Patients bringing DTC genetic test results to primary care providers, such as nurse practitioners, has and will become more frequent. Nurse practitioners should be aware of what these results mean, where to go for assistance, and recommendations for next steps. Patients trust their healthcare team and are counting on you for the most sound and educated advice. In these cases, it's up to you to remain knowledgeable about how to interpret these results, as well as keeping an updated list of genetic specialists who may be able to help you. There are nurse practitioners with clinical genomics nurse credentials, or those who may be working in a genetics clinic. Additionally, there are physicians who work as clinical geneticists, as well as genetic counselors, to name a few. While DTC genetic tests can provide details about ancestry, traits, and some health risks, they do not test for all known variants that can be disease-causing. This means they should not be used to rule out or screen for a particular condition. Even if the DTC genetic test results show an abnormality that may be clinical actionable, these results typically need to be confirmed with a clinical genetic test. While DTC tests look at some genomic information, clinical genetic tests are more comprehensive and are based upon current genomic information known for a certain disorder. Due to this, DTC genetic test results should not be used for clinical decision-making. It is important to communicate with patients about the risks of a false sense of security if their results in fact come back normal. As mentioned, all known variants are typically not tested, which means that the patient may still be at risk and patients should really understand this. For instance, if a DTC genetic test result identifies a single gene high-risk variant, such as those we see with the BRCA gene variants for breast cancer, clinical genetic testing should be initiated and or a referral or further discussion with a genetic specialist should occur. In the meantime, it's your duty as a nurse practitioner to maintain and update a thorough family history. And then depending on the results of the clinical test, patients, family members, and close relatives should be educated about their risk and offered any screenings, treatments, or other interventions as indicated. For patients with a low-risk variant or one considered to be multifactorial, involving genetics plus the environment, such as with type 2 diabetes, providers should be prepared to explain that this may indicate increased risk for condition, but does not mean that they have or will even get the condition. Patient education in this case should focus on lifestyle management as well as ongoing screenings. However, DTC genetic testing has been approved for a few variants for medication management via pharmacogenomics. Tests that are FDA approved do not need to be confirmed with a clinical genetic test. Currently, there are just a few medications for which this is approved. However, one caveat here again is that patients may not be tested for all known genetic information and may only get results for a handful of the variants that are known. For drug metabolism specifically, you always want to remember your chemist, also known as your pharmacist, as someone to seek professional guidance from as well. With the increase in DTC genetic test access as well as the increased use, interpretation of these results will fall on nurse practitioners or other healthcare providers who are trusted to provide the most sound advice. In order to do this, nurse practitioners are expected to remain knowledgeable and up-to-date just as they would with any other clinical practice update in order to provide the best evidence-paced care for every patient.