Neonatal Nurse Practitioner Practice Exam

Which of the following is a common clinical feature of hemolysis in newborns?

1. anemia after 2 weeks

2. hyperbilirubinemia

3. normocytic, normochromic anemia at birth

4. persistent fetal circulation

The correct answer is: hyperbilirubinemia

Hyperbilirubinemia is a common clinical feature of hemolysis in newborns. When red blood cells are destroyed at an increased rate, as occurs in hemolytic disease, the breakdown of hemoglobin results in the production of bilirubin. The liver, which is responsible for processing bilirubin, may not be fully mature in newborns, especially preterm ones, leading to the accumulation of bilirubin in the bloodstream. This elevated level of bilirubin can result in jaundice, a noticeable yellowing of the skin and eyes. Anemia after two weeks typically does not indicate acute hemolysis, as hemolysis commonly results in signs of anemia much sooner due to the rapid destruction of red blood cells. Normocytic, normochromic anemia at birth can occur, but it does not specifically indicate hemolysis and can be seen in other conditions as well. Persistent fetal circulation is a pathophysiological condition that occurs when the fetal circulatory patterns do not transition to neonatal patterns, which can be related to respiratory problems rather than hemolysis. Overall, hyperbilirubinemia is a direct consequence of the accelerated breakdown of red blood cells experienced during hemolysis, making it a key feature to recognize in affected neon