During the initial prenatal visit, the nurse completes a history for a 25-year-old G1PO client.
During the interview, the client states her mother has been diagnosed with Huntington’s Disease.
Which of the following is a correct statement by the nurse about this autosomal dominant disorder?
“Huntington’s disease is diagnosed in childhood.”
“If you are a carrier, there is a 25% chance your child will inherit the gene.”
“Only one copy of the variant gene is needed for expression of the disease.”
“You only need to be referred to a genetic counselor if you are a carrier.”
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
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.
Correct Answer is A
Explanation
Choice A rationale:
Fetal position during the first trimester is not definitively determined through ultrasound. While the gestational sac and fetal pole can be visualized, the fetus is still quite small and has ample space to move within the amniotic sac. This makes it challenging to accurately ascertain its position.
Reliable assessment of fetal position typically occurs later in pregnancy, usually between 34 and 36 weeks gestation. At this point, the fetus is larger and less mobile, allowing for a clearer assessment of its position through ultrasound.
The early determination of fetal position in the first trimester is not a primary goal of ultrasound. It is more focused on establishing pregnancy viability, gestational age, and detecting any potential abnormalities.
Choice B rationale:
Ultrasound in the first trimester can reliably detect multiple gestations. It can visualize the presence of multiple gestational sacs or fetal poles, clearly indicating whether a woman is carrying twins, triplets, or more.
Early identification of multiple gestations is crucial for optimal pregnancy management. It allows healthcare providers to tailor prenatal care, monitor for potential complications associated with multiple pregnancies, and plan for appropriate delivery. Choice C rationale:
Ultrasound in the first trimester can assist in detecting certain maternal abnormalities that could impact pregnancy. These may include:
Uterine abnormalities, such as fibroids or structural defects
Ovarian cysts
Ectopic pregnancies (where the embryo implants outside the uterus)
Gestational trophoblastic disease (abnormal growth of tissue inside the uterus)
Early identification of these maternal abnormalities allows for timely intervention and management, ensuring the best possible outcomes for both mother and fetus.
Choice D rationale:
Confirming pregnancy is a primary reason for ultrasound in the first trimester. It can visualize the gestational sac, which contains the developing embryo and confirms the presence of a pregnancy.
Ultrasound can also detect the fetal heartbeat, which typically becomes visible between 6 and 8 weeks gestation. This provides further confirmation of a viable pregnancy.
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