A nurse cares for a client who tests positive for alpha-antitrypsin (AAT) deficiency.
The client asks, "What does this mean?" How would the nurse respond?
Your children will be at high risk for chronic obstructive pulmonary disease.
I will contact a genetic counselor to discuss your condition.
Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke.
This is a recessive gene and would have no impact on your health.
The Correct Answer is C
Choice A rationale
Alpha-1 antitrypsin (AAT) deficiency is an autosomal co-dominant genetic disorder, not strictly recessive. While individuals with two deficient alleles (PiZZ) are at highest risk, heterozygous carriers (PiMZ) also have an increased risk for developing COPD, particularly with environmental exposures like smoking. Therefore, stating children will be at high risk is an oversimplification and potentially inaccurate regarding the genetic transmission pattern.
Choice B rationale
While genetic counseling is an appropriate recommendation for individuals with AAT deficiency to understand inheritance patterns and reproductive risks, it is not the most immediate and direct response regarding the client's personal health implications. The client's question focuses on what the diagnosis means for *them*, not their offspring initially.
Choice C rationale
AAT deficiency significantly increases the risk for developing emphysema, a form of COPD, especially when compounded by environmental factors such as smoking. AAT normally protects lung tissue from elastase, and its deficiency leads to unchecked protease activity and subsequent lung destruction. This response directly addresses the client's personal health risk and a major modifiable factor.
Choice D rationale
This statement is inaccurate. AAT deficiency is not a recessive gene in a simple Mendelian sense where only homozygous recessive individuals are affected. It's an autosomal co-dominant condition where both alleles contribute to AAT levels, and even heterozygous carriers (PiMZ) can have lower AAT levels and increased risk for COPD, especially with smoking. Thus, it certainly impacts health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A 30-pack-year smoking history indicates significant cumulative exposure to respiratory irritants, predisposing the client to COPD development. However, this historical factor does not indicate acute respiratory distress requiring immediate intervention. While a strong risk factor, it doesn't present as an emergent physiological alteration demanding first assessment in this scenario. Current physiological stability takes precedence over historical risk.
Choice B rationale
A client in a tripod position utilizing accessory muscles to breathe indicates significant respiratory distress and increased work of breathing. This compensatory mechanism suggests impending respiratory failure or severe hypoxemia. This is an acute, life-threatening physiological manifestation demanding immediate nursing assessment and intervention to prevent respiratory arrest and optimize oxygenation.
Choice C rationale
Dependent edema and clubbed fingers are chronic manifestations of long-standing respiratory and/or cardiovascular compromise, often seen in advanced COPD or cor pulmonale. While indicative of significant disease progression, they do not represent an acute, life-threatening emergency demanding immediate assessment over active respiratory distress. These are chronic adaptations, not acute decompensation.
Choice D rationale
A chronic cough with thick, tenacious secretions is a common symptom in COPD, indicating impaired mucociliary clearance and chronic inflammation. While these symptoms can exacerbate acute respiratory issues, they do not inherently suggest the acute, life-threatening respiratory distress seen in a client using accessory muscles, thus not requiring the absolute first assessment.
Correct Answer is ["200"]
Explanation
Calculate the milligrams per dose. 600 mg/day ÷ 3 doses/day = 200 mg/dose. The patient will receive 200 mg per dose.
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