A nurse is preparing to administer a medication that undergoes extensive first-pass metabolism. What route of administration should be used?

Oral

Intravenous

Subcutaneous

Intramuscular

Answer and Explanation

The Correct Answer is B

First-pass metabolism refers to the metabolism of a drug by the liver before it reaches systemic circulation. Drugs that undergo extensive first-pass metabolism have a lower bioavailability when administered orally because a significant portion of the drug is metabolized before it reaches systemic circulation. Intravenous administration bypasses first-pass metabolism and delivers the drug directly into systemic circulation.

a. Oral administration would result in lower bioavailability due to first-pass metabolism.

c. Subcutaneous administration may also be subject to first-pass metabolism.

d. Intramuscular administration may also be subject to first-pass metabolism.

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Correct Answer is B

Explanation

Medications that are primarily excreted by the kidneys can accumulate in clients with renal impairment, potentially leading to toxicity.A client with renal impairment may require a lower dose of a medication that is primarily excreted by the kidneys to avoid accumulation and toxicity.

a.The client may require a lower, not higher, dose of the medication due to reduced renal excretion.

c.More frequent dosing may not be necessary if an appropriate dose is administered.

d.The client’s renal function can affect pharmacokinetics by altering excretion of medications that are primarily eliminated by the kidneys.

A. The client may require a higher dose of the medication. B. The client may require a lower dose of the medication. C. The client may require more frequent dosing of the medication. D. The client’s body fat percentage does not affect pharmacokinetics.

Correct Answer is A

Explanation

Lipophilic medications are soluble in fat and can accumulate in adipose tissue, reducing their concentration in plasma and potentially reducing their therapeutic effect. A client with a high body fat percentage may require a higher dose of a lipophilic medication to achieve therapeutic levels.

b. The client may require a higher, not lower, dose of the medication due to accumulation in adipose tissue.

c. More frequent dosing may not be necessary if an appropriate dose is administered.

d. The client’s body fat percentage can affect pharmacokinetics by altering distribution of lipophilic medications.

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A nurse is preparing to administer a medication that undergoes extensive first-pass metabolism. What route of administration should be used?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a medication that is primarily excreted by the kidneys.What should be considered when administering this drug to a client with renal impairment?

Correct Answer is B

Explanation

A nurse is preparing to administer a lipophilic medication to a client with a high body fat percentage. What should the nurse consider?

Correct Answer is A

Explanation

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