The student nurse learns that the process in which bilirubin is changed from a fat-soluble product to a water-soluble product is known as:
Unconjugation of bilirubin.
Albumin binding.
Enterohepatic circuit.
Conjugation of bilirubin.
The Correct Answer is D
Choice A rationale
Unconjugation of bilirubin is the process where bilirubin, initially produced in a water-insoluble form (unconjugated or indirect bilirubin), is not yet processed by the liver. This form cannot be easily excreted by the body.
Choice B rationale
Albumin binding refers to the transport of unconjugated bilirubin in the bloodstream. Because unconjugated bilirubin is fat-soluble and not easily dissolved in water, it binds to albumin, a protein in the blood, which allows it to be transported to the liver.
Choice C rationale
The enterohepatic circuit describes the circulation of bile acids from the liver to the small intestine, where they aid in fat digestion and absorption, and then back to the liver. Bilirubin is a byproduct of heme breakdown and is processed separately in the liver before excretion in bile.
Choice D rationale
Conjugation of bilirubin is the process that occurs in the liver where the enzyme uridine diphosphoglucuronate glucuronosyltransferase (UGT) attaches glucuronic acid molecules to unconjugated bilirubin. This process transforms the fat-soluble unconjugated bilirubin into a water-soluble form called conjugated (or direct) bilirubin, which can then be excreted in bile into the intestines.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Hydralazine is an antihypertensive medication used to manage hypertension, not preterm labor. Administering hydralazine would be inappropriate for a client in preterm labor unless she also has hypertension.
Choice B rationale
Preparing the client for immediate delivery based solely on a lecithin-to-sphingomyelin (L/S) ratio of 1: is premature. An L/S ratio of 2: or greater is generally indicative of fetal lung maturity. A ratio of 1: suggests lung immaturity, and interventions to promote lung maturity are indicated.
Choice C rationale
Infusing a bolus of IV fluids might be considered for hydration in preterm labor, but it does not directly address the issue of fetal lung immaturity indicated by the low L/S ratio. While hydration can help manage preterm contractions in some cases, it is not the primary intervention to improve fetal lung maturity.
Choice D rationale
Administering betamethasone, a corticosteroid, is the appropriate action for a client in preterm labor with a low L/S ratio (1:). Betamethasone crosses the placenta and stimulates the production of surfactant in the fetal lungs, accelerating lung maturity and reducing the risk of respiratory distress syndrome in the preterm infant. The typical dose is 12 mg IM, given in two doses 24 hours apart. .
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
The nurse should anticipate a provider prescription for pyridoxine due to the client’s severe dehydration.
Rationale for correct answers
Pyridoxine (vitamin B6) is recommended for nausea and vomiting in pregnancy (NVP), commonly known as hyperemesis gravidarum (HG), especially in patients with persistent symptoms leading to dehydration. Severe dehydration is confirmed by elevated urine specific gravity (normal: 1.002–1.030), low sodium (normal: 135–145 mEq/L), and positive ketones, indicating excessive vomiting and malnutrition.
Rationale for incorrect Response 1 options
- Antibiotics: There is no evidence of infection; urinalysis and WBC count are within normal limits.
- Magnesium sulfate: Used for eclampsia or preterm labor prevention, not for HG.
- Oxytocin: Stimulates uterine contractions and is contraindicated during early pregnancy unless labor induction is required.
Rationale for incorrect Response 2 options
- Urinary tract infection: No leukocytes or nitrites in urine, and WBC count is normal (4,500–11,000/mm³).
- Preeclampsia: No proteinuria or hypertension (≥140/90 mm Hg).
- Preterm labor: No uterine contractions or cervical changes.
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