A client received oxycodone (Oxycontin) 5 mg po for pain at 0830. The half-life of the drug is 2.5 hours. When will 75% of this dosage of this medication be removed from the body?
1100
1200
1330
1600
The Correct Answer is C
A. 1100. This time represents the passage of 2.5 hours, which is exactly one half-life of the medication. At this interval, only 50% of the initial 5 mg dose has been eliminated from the plasma. To reach 75% elimination, the drug must undergo a second half-life cycle to clear half of the remaining amount.
B. 1200. This interval is only 3.5 hours post-administration, which does not align with the completion of the required metabolic cycles. The drug concentration would still be significantly above the 25% retention threshold at this point. Pharmacokinetic clearance follows specific exponential decay intervals based on the established 2.5-hour half-life of Oxycodone.
C. 1330. After two half-lives, totaling 5 hours (2.5 plus 2.5), 75% of the drug is cleared from the systemic circulation. The first cycle reduces the dose to 50%, and the second cycle reduces that remaining half by another 50%. Starting from 0830, the addition of 5 hours correctly reaches the time of 1330.
D. 1600. This represents 7.5 hours since administration, which corresponds to the passage of three full half-lives. At this stage, approximately 87.5% of the drug would be eliminated, leaving only 12.5% in the body. This exceeds the 75% clearance threshold specified in the question regarding the metabolic rate of the dose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "The ibuprofen works faster.": Onset of action for both oral acetaminophen and ibuprofen is approximately 30 to 60 minutes. There is no significant clinical evidence to suggest that ibuprofen provides faster systemic relief for an acute injury. Speed of onset is not the primary rationale for this specific drug selection.
B. "Ibuprofen works better than acetaminophen with muscle and bone injuries.": This statement is generalized and does not explain the underlying pharmacological mechanism to the client. While true in a practical sense, it lacks the scientific depth required for professional patient education. It does not address the specific pathology of a sprain.
C. "The healthcare provider can prescribe a high dose of the ibuprofen so it will relieve the pain better.": High doses can also be prescribed for acetaminophen, but dosage size does not change the drug's therapeutic class. The efficacy of ibuprofen in this scenario is due to its mechanism of action, not simply the amount administered. This response misleads the client.
D. "The ibuprofen will also reduce the inflammation that is causing swelling, which contributes to pain.": An ankle sprain involves soft tissue trauma that triggers the arachidonic acid cascade and prostaglandin production. Ibuprofen is a non-steroidal anti-inflammatory drug that inhibits cyclooxygenase enzymes to reduce localized edema. Acetaminophen lacks these significant peripheral anti-inflammatory properties needed for this injury.
Correct Answer is B
Explanation
A. Wound debridement: Debriding dry, stable eschar on a distal extremity with poor vascularity can expose underlying tissue to infection without sufficient blood flow to heal. In patients with diabetes and peripheral arterial disease, aggressive debridement of stable eschar is often contraindicated.
B. Maintenance and protection of the intact eschar: For stable, dry, and intact eschar on ischemic limbs or digits, the clinical goal is to keep the area dry and protected. This "natural cover" prevents the entry of pathogens into deeper tissues while avoiding the risks of surgical or chemical intervention.
C. Use of a topical antimicrobial agent to prevent infection: Topical agents often introduce moisture, which can soften the eschar and promote bacterial proliferation. If the eschar is dry and intact without signs of infection, the priority is maintaining that dryness rather than applying creams or ointments.
D. Removal of eschar to create a moist environment for healing: Creating a moist environment is beneficial for many wounds but dangerous for ischemic, stable eschar. Softening this tissue can lead to "wet gangrene," which spreads rapidly and significantly increases the risk of limb amputation in diabetic patients.
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