A nurse is preparing to administer a weakly acidic medication to a client with an elevated gastric pH due to antacid use. What should the nurse consider?

The medication will have increased absorption in an alkaline environment.

The medication will have decreased absorption in an alkaline environment.

The antacid will have no effect on absorption of the weakly acidic medication.

The antacid will increase excretion of the weakly acidic medication.

Answer and Explanation

The Correct Answer is B

Weakly acidic medications are more readily absorbed in an acidic environment because they are more likely to be in their non-ionized, lipid-soluble form which can easily cross cell membranes and enter systemic circulation. An elevated gastric pH due to antacid use can reduce absorption of weakly acidic medications by increasing ionization and reducing lipid solubility.

a. The medication will have decreased, not increased, absorption in an alkaline environment due to increased ionization.

c. The antacid can affect absorption by altering gastric pH and increasing ionization of weakly acidic medications.

d. The antacid can affect absorption but does not directly affect excretion of weakly acidic medications.

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Correct Answer is B

Explanation

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.

A. Administer the medication as prescribed. B. Hold the medication and notify the provider. C. Administer half the dose of the medication. D. Administer the medication with food or milk.

Correct Answer is B

Explanation

A medication with a narrow therapeutic index has a small margin of safety between its therapeutic and toxic doses. The nurse should hold the medication and notify the provider to ensure that the client’s drug levels are within the therapeutic range and to avoid potential toxicity.

a. Administering the medication as prescribed could result in toxicity if the client’s drug levels are not within the therapeutic range.

c. Administering half the dose of the medication is not appropriate without consulting the provider and monitoring the client’s drug levels.

d. Administering the medication with food or milk may affect its absorption but does not prevent potential toxicity.

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A nurse is preparing to administer a weakly acidic medication to a client with an elevated gastric pH due to antacid use. What should the nurse consider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is B

Explanation

A nurse is preparing to administer a medication that has a narrow therapeutic index. What action should the nurse take?

Correct Answer is B

Explanation

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