A nurse is providing teaching to a client about proper administration of a medication regarding meals.
The nurse should instruct the client that the presence of food will alter the rate of which of the following pharmacokinetic processes?
Distribution.
Metabolism.
Excretion.
Absorption.
The Correct Answer is D
Choice A rationale
Distribution refers to the reversible movement of a drug from the systemic circulation to the body's tissues. While food can indirectly influence distribution by altering blood flow or protein binding, its primary and most direct impact on drug pharmacokinetics is not typically on the distribution phase itself.
Choice B rationale
Metabolism, primarily occurring in the liver, involves the biochemical modification of drugs. While some foods can induce or inhibit metabolic enzymes, the direct and immediate effect of the presence of food at the time of administration is typically not on the rate of drug metabolism but rather on the initial entry into the systemic circulation.
Choice C rationale
Excretion is the elimination of drugs from the body, mainly through the kidneys. Food generally does not directly influence the rate of drug excretion, which is primarily dependent on renal function, glomerular filtration, tubular secretion, and reabsorption processes.
Choice D rationale
Absorption is the process by which a drug moves from its site of administration into the bloodstream. The presence of food in the gastrointestinal tract can significantly alter the rate and extent of oral drug absorption by affecting gastric emptying time, pH, drug solubility, and interaction with food components.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Alendronate is a bisphosphonate medication used to treat osteoporosis. It is known to be highly irritating to the esophageal mucosa, and if it lodges in the esophagus, it can cause severe esophagitis, ulceration, or erosion. Assessing the client's ability to swallow ensures safe passage of the medication and minimizes the risk of esophageal injury, highlighting a critical safety measure.
Choice B rationale
Alendronate should not be administered before bed. For optimal absorption and to minimize the risk of esophageal irritation, alendronate must be taken in the morning upon waking, at least 30 minutes before the first food, beverage, or medication. Taking it before bed increases the likelihood of the pill lingering in the esophagus, leading to irritation and potential injury.
Choice C rationale
Alendronate should not be administered with orange juice. The absorption of alendronate is significantly impaired by food, beverages other than plain water, and certain minerals like calcium. Orange juice contains calcium and can decrease the bioavailability of the medication, thereby reducing its therapeutic effectiveness. It must be taken with plain water only.
Choice D rationale
Informing the client to remain supine after taking the medication is incorrect. To facilitate rapid transit to the stomach and minimize esophageal contact, clients must remain upright (sitting or standing) for at least 30 minutes after taking alendronate, and until after their first food of the day. Lying down increases the risk of esophageal reflux and irritation.
Correct Answer is B
Explanation
Choice A rationale
Jaundice is a serious indicator of hepatotoxicity, a known and potentially severe adverse effect of rifampin. It signifies liver dysfunction and requires immediate medical attention. Therefore, stating that jaundice is harmless demonstrates a critical misunderstanding of the medication's potential risks and the need for prompt reporting to the healthcare provider.
Choice B rationale
Rifampin is known to cause discoloration of body fluids, including urine, sweat, tears, and saliva, due to its reddish-orange pigment. This discoloration can permanently stain soft contact lenses. Therefore, a client's statement about not wearing soft contact lenses indicates an understanding of this specific and important adverse effect.
Choice C rationale
Rifampin absorption is reduced when taken with food. To maximize its bioavailability and effectiveness, rifampin should be taken on an empty stomach, typically one hour before or two hours after a meal. Taking it when the stomach is full would decrease its therapeutic efficacy, indicating a misunderstanding of the teaching.
Choice D rationale
Rifampin is metabolized by the liver, and alcohol consumption also places a significant metabolic burden on the liver. Concurrent use of rifampin and alcohol significantly increases the risk of hepatotoxicity, which can lead to severe liver damage. Therefore, drinking alcohol while on rifampin is strongly contraindicated and shows a lack of understanding. .
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