Neonatal Nurse Practitioner Practice Exam

Excess bilirubin load to the liver in neonates can lead to what condition?

1. Physiologic jaundice

2. Hemolytic disease

3. Cholecystitis

4. Hepatitis

The correct answer is: Physiologic jaundice

Excess bilirubin load to the liver in neonates is primarily associated with physiologic jaundice. This condition arises when there is an increased production of bilirubin due to the breakdown of red blood cells, which is common in newborns. Neonates have a higher rate of hemolysis compared to older children and adults because of the transition from fetal to adult hemoglobin and the normal adaptation to extrauterine life. Physiologic jaundice typically presents itself between the second and seventh day of life as liver maturity develops and the neonate's ability to conjugate bilirubin improves. Although other conditions may involve increased bilirubin levels, physiologic jaundice is characterized by its development in healthy newborns and resolves spontaneously as the liver matures and bilirubin clearance increases. In understanding the context of the other options, hemolytic disease can indeed lead to an excess bilirubin load, but it is a pathological condition requiring specific treatment, unlike the more benign and common physiologic jaundice. Cholecystitis and hepatitis, while they can involve bilirubin metabolism, are not direct consequences of excess bilirubin load specifically in neonates, thus making them less relevant in this context. Therefore, physiologic jaundice is the most appropriate