Neonatal Nurse Practitioner Practice Exam

Which of the following is a true statement regarding neonatal hyperbilirubinemia?

1. Conjugated bilirubin is reabsorbed in the intestine

2. Newborn infants produce more bilirubin per day than adults

3. In VLBW infants, albumin has an increased affinity for bilirubin

4. Newborns have a lower bilirubin production than adults

The correct answer is: Newborn infants produce more bilirubin per day than adults

Newborn infants produce more bilirubin per day than adults due to several physiological factors. One of the primary reasons is the higher turnover of red blood cells in newborns, particularly in the first few days of life. This increased hemolysis leads to greater amounts of unconjugated bilirubin being formed as the liver processes heme from the breakdown of these red cells. Additionally, the neonatal liver is often immature and less efficient at conjugating bilirubin, which results in higher levels of unconjugated bilirubin in the blood. This is particularly common in the first week of life, contributing to the condition known as physiological jaundice. In contrast, adults have a more stable hemoglobin turnover and a fully developed hepatic system capable of processing bilirubin more effectively, resulting in lower daily production. The other options do not accurately describe the mechanisms or characteristics of neonatal hyperbilirubinemia, which is why they do not align with the established understanding of bilirubin metabolism in newborns.