A client who is gravida 2 and 16 weeks of gestation comes in for her prenatal appointment. Her 2-year-old daughter is with her and is wearing a sleeveless top. While interacting with her daughter, you note axillary freckling and several café-au-lait spots (>2 cm). In reviewing her chart, the nurse should assess for documentation of which genetic disease?

Correct Answer: C

Rationale: Clinical manifestations of NF may include axillary freckling and café-au-lait spots. Tay-Sachs disease is an incurable lipid-storage disorder and is not associated with café-au-lait spots. Galactosemia is an inborn error of metabolism and is also not associated with café-au-lait spots. PKU is not associated with café-au-lait spots. A child with PKU would have difficulty manufacturing the liver enzyme phenylalanine.

Correct Answer: A

Rationale: The genotype comprises all the genes the individual can pass on to a future generation. The phenotype is the observable expression of an individual's genotype. The karyotype is a pictorial analysis of the number, form, and size of an individual's chromosomes. Genotype refers to an individual's genetic makeup.

Correct Answer: C

Rationale: Perhaps the most important of all nursing functions is the ability to provide emotional support. Nurses should be prepared to help with various stress reactions from a couple facing the possibility of a genetic disorder. Although anyone may have a genetic disorder, certain disorders appear more often in certain ethnic and racial groups. Genetic health care is highly individualized because treatments are based on the phenotypic responses of the individual. Individual nurses at any facility can take a genetic history, although larger facilities may have better support services.

Correct Answer: A

Rationale: The correct answer is A) Between 5 and 7 days after menses ceases. This timing is crucial because during this phase of the menstrual cycle, the breast tissue is least affected by hormonal changes. This makes it easier to detect any abnormalities or changes during a breast self-examination (BSE). Option B) Day 1 of the endometrial cycle is incorrect because it does not coincide with the optimal time when hormonal fluctuations have the least impact on breast tissue. Option C) Midmenstrual cycle is also incorrect as hormonal changes during this time can affect breast tissue, making it less suitable for an accurate BSE. Option D) Any time during a shower or bath is incorrect because it does not take into account the hormonal changes in the menstrual cycle that can impact the sensitivity and texture of breast tissue, potentially leading to missed abnormalities. In an educational context, understanding the best time for BSE in relation to the menstrual cycle is crucial for women's health. Educating individuals on the importance of timing BSE correctly can empower them to take charge of their breast health and detect any potential issues early, leading to better outcomes in terms of breast cancer detection and treatment.

Correct Answer: C

Rationale: The most appropriate response from the nurse in this scenario is option C: "Tell me about your undergarments. I'll explain the examination procedure, and then we can discuss how you can comfortably have your examination." This response demonstrates respect for the woman's beliefs and cultural considerations. It acknowledges her concerns and opens the door for a collaborative discussion to find a solution that respects her religious beliefs while ensuring proper medical care. Option A is incorrect as it dismisses the woman's religious beliefs and fails to consider alternative accommodations. Option B is not as strong as option C because it immediately suggests involving the physician without first attempting to understand and address the patient's needs directly. Option D is also inappropriate as it shows a lack of empathy and willingness to work with the patient to find a solution. From an educational perspective, this scenario highlights the importance of cultural competence and patient-centered care in nursing practice. Nurses must be sensitive to the diverse beliefs and practices of their patients and be prepared to adapt care plans to respect individual preferences. Effective communication and collaboration with patients are essential in providing ethical and respectful care.