The nurse provides counseling to a family of a patient with Duchenne muscular dystrophy with the knowledge that
Only males can pass the gene to their offspring
Patients are usually female
Genetic testing can help determine treatment
All daughters of a carrier will be carriers
The Correct Answer is C
Choice A reason: Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder. Males (XY) pass their Y chromosome to sons and X to daughters, not the DMD gene. Females (XX) can pass the mutated X to offspring. This statement is incorrect, as males cannot pass the DMD gene to their children.
Choice B reason: DMD primarily affects males, as it is X-linked recessive, and males lack a second X chromosome to mask the mutation. Females are rarely affected, typically as carriers or in rare cases with skewed X-inactivation. This statement is incorrect, as patients are predominantly male, not female.
Choice C reason: Genetic testing identifies DMD gene mutations, confirming diagnosis and guiding treatment, such as corticosteroids to slow muscle degeneration or emerging gene therapies. It informs prognosis, carrier status, and family planning, making it critical for tailoring interventions and counseling families about the disease’s progression and management.
Choice D reason: Not all daughters of a carrier female will be carriers. A carrier mother has a 50% chance of passing the mutated X chromosome to each daughter, making half likely carriers. This statement is incorrect, as it overstates the genetic transmission probability for female offspring.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Ankylosis, fusion of spinal joints, is associated with ankylosing spondylitis, not osteoporosis. Osteoporosis causes bone density loss, leading to fractures and deformities like kyphosis, not joint fusion. Expecting ankylosis misaligns assessment, potentially overlooking osteoporosis-related vertebral compression fractures critical for managing mobility and pain in older adults.
Choice B reason: Kyphosis, an exaggerated thoracic spine curvature, is common in osteoporosis due to vertebral compression fractures from weakened bones. These fractures collapse anteriorly, causing a hunchback appearance, affecting posture and balance. Recognizing kyphosis guides interventions like bracing or bisphosphonates to prevent further fractures and improve quality of life.
Choice C reason: Scoliosis, lateral spine curvature, is typically congenital or idiopathic, not directly caused by osteoporosis. While osteoporosis may exacerbate existing scoliosis through fractures, it’s not a primary deformity. Expecting scoliosis risks misdiagnosis, diverting focus from osteoporosis-related kyphosis and its management, like calcium supplementation or physical therapy.
Choice D reason: Lordosis, exaggerated lumbar curvature, is not typical in osteoporosis. Osteoporosis primarily affects thoracic vertebrae, causing kyphosis from compression fractures. Lordosis may occur in other conditions like muscular imbalances, but expecting it in osteoporosis misguides assessment, delaying interventions for fracture prevention and spinal stability in older adults.
Correct Answer is A
Explanation
Choice A reason: Morning stiffness lasting 60 minutes or more is a hallmark of rheumatoid arthritis (RA) due to synovial inflammation in affected joints. This prolonged stiffness, worse after inactivity, reflects autoimmune-mediated synovitis, distinguishing RA from osteoarthritis. Recognizing this guides diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs) to reduce joint damage.
Choice B reason: Bamboo-shaped fingers are characteristic of psoriatic arthritis, not RA. RA causes joint deformities like swan-neck or boutonnière due to synovial destruction, not a bamboo appearance. Expecting this finding risks misdiagnosis, delaying RA-specific therapies like methotrexate, which target inflammation and prevent progressive joint erosion.
Choice C reason: Asymmetric small joint involvement is typical of osteoarthritis or psoriatic arthritis, not RA. RA features symmetric involvement of small joints, like metacarpophalangeal joints, due to systemic autoimmune inflammation. Assuming asymmetry misguides assessment, potentially overlooking RA’s bilateral pattern critical for early diagnosis and effective immunosuppressive treatment.
Choice D reason: Noninflammatory pain in large joints is not typical of RA, which involves inflammatory pain in small joints due to synovitis. Large joint pain may occur in osteoarthritis or gout. Expecting noninflammatory pain misdirects RA diagnosis, delaying interventions like corticosteroids or biologics to manage inflammation and joint destruction.
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