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 C
Explanation
Choice A rationale
Encouraging a hands-and-knees position can help rotate a fetus in an occiput posterior position or relieve back pain during labor. However, in hypotonic uterine dysfunction where contractions are weak and ineffective, this positional change alone is unlikely to augment labor significantly.
Choice B rationale
Providing a comfortable environment with dim lighting can reduce anxiety and promote relaxation, which might indirectly support labor progress. However, it does not directly address the issue of weak and ineffective uterine contractions characteristic of hypotonic dysfunction.
Choice C rationale
Administering oxytocin is the typical intervention for hypotonic uterine dysfunction after ruling out fetopelvic disproportion. Oxytocin is a synthetic hormone that stimulates uterine contractions, increasing their frequency, duration, and intensity to facilitate labor progress. It acts on the oxytocin receptors in the uterus, leading to smooth muscle contraction.
Choice D rationale
Preparing for an amniotomy (artificial rupture of membranes) might be considered to augment labor if the membranes are intact. However, since the woman's membranes have already ruptured, this intervention is not applicable in this situation. Amniotomy can sometimes stimulate or augment labor by releasing prostaglandins.
Correct Answer is D
Explanation
Choice A rationale
Rapid plasma regain is not a standard laboratory test associated with hyperemesis gravidarum. Hyperemesis gravidarum is characterized by severe nausea and vomiting leading to dehydration and electrolyte imbalances.
Choice B rationale
A urine culture is used to detect urinary tract infections, which are not a primary concern in hyperemesis gravidarum unless specifically indicated by symptoms of a UTI.
Choice C rationale
Prothrombin time (PT) and other coagulation studies assess blood clotting. While severe dehydration and malnutrition from hyperemesis gravidarum could theoretically affect coagulation, it is not a routine initial test to anticipate.
Choice D rationale
Urine ketones are a key laboratory finding in hyperemesis gravidarum. Due to persistent vomiting and inadequate oral intake, the body starts to break down fat for energy, leading to ketonuria. The presence of ketones in the urine indicates starvation and the need for intravenous fluids and nutritional support.
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