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 A
Explanation
Choice A rationale
The latent phase of labor is the longest and often the least intense phase, characterized by mild, infrequent contractions and gradual cervical dilation (0-3 cm). During this time, the woman is typically more receptive to learning and can concentrate better, making it the ideal phase to teach non-pharmacologic pain control methods such as breathing techniques, relaxation exercises, and positioning.
Choice B rationale
The active phase of labor (4-7 cm dilation) is characterized by more frequent and intense contractions, making it harder for the laboring woman to concentrate and learn new pain management techniques. Reinforcement of previously learned techniques is more appropriate at this stage.
Choice C rationale
The transition phase (8-10 cm dilation) is the most intense and shortest phase of the first stage of labor. The woman is likely experiencing significant discomfort and may have difficulty focusing on learning new pain control methods.
Choice D rationale
The second stage of labor begins with complete cervical dilation (10 cm) and ends with the birth of the baby. The focus during this stage is on pushing and delivering the baby, making it an inappropriate time to teach non-pharmacologic pain control methods for labor.
Correct Answer is B
Explanation
Choice A rationale
Caput succedaneum is swelling of the soft tissues of the newborn's scalp, often caused by pressure during vaginal delivery. It is a separate condition from cephalohematoma, which involves bleeding between the periosteum and the skull bone. Therefore, cephalohematoma does not increase the risk for caput succedaneum.
Choice B rationale
Jaundice, or hyperbilirubinemia, is a common condition in newborns due to the breakdown of fetal red blood cells and the immature liver's inability to efficiently process bilirubin. Cephalohematomas involve the rupture of blood vessels, leading to an increased breakdown of red blood cells. This releases more bilirubin into the bloodstream, thus elevating the risk of jaundice in infants with cephalohematomas. Normal total bilirubin levels in newborns range from 1 to 12 mg/dL, varying with age in days.
Choice C rationale
Infection is a risk associated with any break in the skin or invasive procedure, but a cephalohematoma itself is a collection of blood beneath the periosteum and does not inherently create an open wound or direct pathway for infection. While infection of a cephalohematoma is possible, it is not a primary increased risk associated with its development.
Choice D rationale
Erythema toxicum is a common, benign skin rash seen in newborns, characterized by small, yellow-white papules or pustules surrounded by red skin. Its etiology is unknown but it is thought to be an inflammatory reaction of the hair follicles. It is not related to the presence or development of a cephalohematoma.
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