A client with hemolytic anemia asks, "How is bilirubin processed in my body?" Which response by the nurse is accurate?
"Bilirubin is primarily excreted through the kidneys.”
"Bilirubin is stored in the liver as hemosiderin.”
"Bilirubin is recycled into iron and biliverdin.”
"Bilirubin is conjugated in the liver and excreted in bile.”
The Correct Answer is D
"Bilirubin is primarily excreted through the kidneys." This statement is not accurate.
While some bilirubin is excreted through the kidneys, the primary route of bilirubin excretion is through the liver and bile.
Bilirubin is converted to conjugated bilirubin in the liver, which is then excreted in bile.
Choice B rationale:
"Bilirubin is stored in the liver as hemosiderin." This statement is incorrect.
Hemosiderin is not a form of bilirubin but rather a storage form of iron in the liver and other tissues.
Choice C rationale:
"Bilirubin is recycled into iron and biliverdin." This statement is not accurate.
Bilirubin is primarily metabolized in the liver and conjugated before being excreted in bile.
It does not get recycled into iron and biliverdin.
Choice D rationale:
"Bilirubin is conjugated in the liver and excreted in bile." This is the correct answer.
Bilirubin is produced from the breakdown of heme in red blood cells and is then processed in the liver, where it is conjugated (combined with glucuronic acid) to form conjugated bilirubin.
Conjugated bilirubin is excreted in bile and eventually eliminated from the body in feces.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
Hereditary spherocytosis.
C. Sickle cell anemia.
D. Thalassemia intermedia.
E. Immune-mediated hemolytic anemia.
Choice A rationale:
Hereditary spherocytosis is a genetic disorder characterized by abnormal red blood cell membrane proteins, leading to a spherical shape instead of the normal biconcave disc shape.
Choice C rationale:
Sickle cell anemia is caused by a mutation in the hemoglobin gene, leading to the formation of abnormal hemoglobin (hemoglobin S) that causes red blood cells to take on a sickle shape when oxygen levels are low.
Choice D rationale:
Thalassemia intermedia is a form of thalassemia characterized by the production of abnormal hemoglobin molecules, leading to the destruction of red blood cells and potential changes in their structure.
Choice E rationale:
Immune-mediated hemolytic anemia can result in the production of autoantibodies that attack red blood cells, leading to changes in their structure and function.
Choice B rationale:
G6PD deficiency is not associated with abnormalities in the shape or structure of red blood cells.
Instead, it is characterized by red blood cell destruction due to a lack of the enzyme glucose-6-phosphate dehydrogenase.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale:
Increased risk of thrombosis is a potential complication of hemolytic anemia.
When red blood cells are destroyed, they release substances that can promote blood clot formation, increasing the risk of thrombosis.
This choice is correct.
Choice B rationale:
Decreased iron utilization is not a typical complication of hemolytic anemia.
Hemolysis can release iron into the bloodstream, but it does not lead to decreased iron utilization.
This choice is incorrect.
Choice C rationale:
Impaired erythropoiesis can be a complication of hemolytic anemia.
When red blood cells are rapidly destroyed, the bone marrow may struggle to keep up with the demand for new red blood cell production, leading to impaired erythropoiesis.
This choice is correct.
Choice D rationale:
Elevated haptoglobin levels are not typically seen in hemolytic anemia.
Haptoglobin levels may decrease in response to increased hemolysis, as haptoglobin binds to free hemoglobin released from ruptured red blood cells.
This choice is incorrect.
Choice E rationale:
Higher susceptibility to infections is a potential complication of hemolytic anemia.
The destruction of red blood cells can weaken the immune system and make the individual more susceptible to infections.
This choice is correct.
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