medium · NCLEX-RN Health Promotion and Maintenance

A 26-year-old client (G1P0) at 10 weeks gestation has just received results indicating she is a carrier for the cystic fibrosis F508del mutation. Her partner's carrier status is unknown. The client is crying and asks the prenatal clinic nurse, 'Does this mean my baby is definitely going to have this terrible disease? What should I do?' Which response by the nurse is the most appropriate first action?

  1. Explain that cystic fibrosis is an autosomal recessive condition requiring mutations from both parents, offer to facilitate carrier testing for her partner, and explore her personal values regarding prenatal diagnostics.
  2. Instruct the client to wait until her third trimester to obtain a diagnostic amniocentesis before making any decisions about the pregnancy, as the next nursing response, for this client at this point in the plan of care.
  3. Advise the client to immediately schedule a termination of the pregnancy since carrying the gene poses an unacceptable risk to her future children, at this point in care, for this client at this point in the plan of care.
  4. Reassure the client that because she is only a carrier, her baby is safe and she does not need to worry or pursue further screening.

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