A client, who is 39 weeks pregnant, has been admitted to the hospital for induction.
The doctor has prescribed misoprostol (Cytotec). Which statement by the client indicates a need for further education?

The correct answer is C. Only one copy of the variant gene is needed for expression of the disease.

Choice A rationale:

Huntington's disease (HD) is not typically diagnosed in childhood. While symptoms can sometimes manifest in adolescence or early adulthood, the average age of onset is between 30 and 50 years old.

Early-onset HD, which occurs before the age of 20, is much rarer and accounts for only about 5-10% of cases.

It's crucial to convey accurate information about the typical age of onset to avoid unnecessary anxiety and unwarranted testing in children.

Choice B rationale:

The statement "If you are a carrier, there is a 25% chance your child will inherit the gene" is not entirely accurate for autosomal dominant disorders like HD.

If a parent has HD, each child has a 50% chance of inheriting the mutated gene, not 25%. This is because the parent with HD has one mutated copy of the gene and one normal copy.

During conception, each child randomly receives one copy of the gene from each parent. Therefore, there's a 50% chance the child will receive the mutated copy and a 50% chance they'll receive the normal copy.

Choice D rationale:

Referral to a genetic counselor is essential for all individuals with a family history of HD, regardless of their carrier status.

Genetic counselors can provide comprehensive information about HD, including: Inheritance patterns

Risk assessment

Testing options

Reproductive options

Support resources

Psychosocial counseling

They can assist individuals in making informed decisions about testing, family planning, and management of the condition.

Choice C is the correct answer because:

HD is indeed an autosomal dominant disorder, meaning that only one copy of the mutated gene is needed for an individual to develop the disease.

This contrasts with autosomal recessive disorders, which require two copies of the mutated gene (one from each parent) for the disease to manifest.

Understanding the pattern of inheritance is crucial for accurate risk assessment and genetic counseling.

The correct answer is C. The test results are normal.

Choice A rationale:

A biophysical profile (BPP) score of 8 does not necessarily indicate a need for immediate cesarean delivery.

Cesarean delivery is typically reserved for cases where there is a clear and urgent risk to the health of the mother or fetus, such as severe fetal distress or placental abruption.

A score of 8, while not the highest possible score, is still within the normal range and does not, by itself, constitute a reason for immediate surgical intervention.

Choice B rationale:

Additional tests may be considered in certain cases, such as when the BPP score is borderline or when there are other risk factors present.

However, a score of 8 is generally considered reassuring and does not typically warrant further testing.

It's essential to evaluate the BPP score in the context of the overall clinical picture, including the gestational age, maternal health, and fetal history.

Choice D rationale:

While an obstetric specialist may review the BPP results and discuss delivery options with the patient, this is not typically done within a week for a score of 8.

A score of 8 indicates reassuring fetal well-being, and there is usually no need for such urgent consultation or decision-making.

The timing of delivery discussions would depend on the overall clinical situation and the patient's individual preferences.

Choice C rationale:

A BPP score of 8 is considered normal.

It suggests that the fetus is well-oxygenated and has normal heart rate, breathing movements, muscle tone, and amniotic fluid levels.

This score does not raise immediate concerns about fetal well-being and does not typically require any immediate interventions.