A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?

The drug will be more effective when given in a nonenteral route.

The drug will be most effective when given orally

The drug is excreted by the kidneys at a slower rate than most medications

The kidney will metabolize some of the drug before it reaches the blood stream

Answer and Explanation

The Correct Answer is A

A. The drug will be more effective when given in a nonenteral route:
Morphine has a high first-pass effect when taken orally, meaning that a significant amount of the drug is metabolized in the liver before it reaches systemic circulation. This reduces the amount of active drug available in the bloodstream. To avoid this extensive metabolism, morphine is often administered through nonenteral routes, such as intravenous or subcutaneous, where it bypasses the digestive system and liver first-pass metabolism, resulting in higher systemic bioavailability and effectiveness.

B. The drug will be most effective when given orally:
Due to the high first-pass effect of oral morphine, a significant portion of the drug is metabolized by the liver before it reaches systemic circulation. This means that oral morphine is often less effective compared to other routes of administration, such as intravenous, because the bioavailability of the drug is reduced.

C. The drug is excreted by the kidneys at a slower rate than most medications:
The high first-pass effect primarily affects the drug's absorption and systemic availability rather than its excretion rate. The rate at which a drug is excreted by the kidneys is generally unrelated to its first-pass effect. Morphine’s excretion is influenced by its metabolism and clearance, but not directly by the first-pass effect.

D. The kidney will metabolize some of the drug before it reaches the bloodstream:
The first-pass effect occurs primarily in the liver, not the kidneys. It involves the metabolism of the drug by the liver before it reaches systemic circulation. Therefore, this option incorrectly attributes the first-pass effect to kidney metabolism.

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Free Nursing Study Resources

Correct Answer is ["13.3"]

Explanation

Let's calculate the dosage step-by-step:

1. Determine the total daily dosage:
20 mg/dose x 4 doses/day = 80 mg/day

2. Calculate the volume needed for one dose:
20 mg / 1.5 mg/mL = 13.33 mL

3. Round to the nearest tenth:
13.33 L ≈ 13.3 mL

A. Inject a volume of less than 2 mL. B. Inject the medication at a 90 degree angle. C. Inject the medication 12.7 cm (5 in) below the client's acromion process. D. Use a 21-gauge needle for the injection.

Correct Answer is B

Explanation

A) Inject a volume of less than 2 mL: While it is generally recommended to inject a volume of less than 2 mL into the deltoid muscle to avoid discomfort and ensure proper absorption, this is not the primary action to focus on when planning the injection.

B) Inject the medication at a 90 degree angle: This is the correct action. Administering an intramuscular (IM) injection at a 90-degree angle ensures that the medication is delivered deep into the muscle tissue, which is necessary for proper absorption and effectiveness.

C) Inject the medication 12.7 cm (5 in) below the client’s acromion process: The correct injection site for the deltoid muscle is typically 2-3 finger widths (approximately 2.5-5 cm) below the acromion process, not 12.7 cm. Injecting too far below the acromion process could result in an incorrect injection site.

D) Use a 21-gauge needle for the injection: While a 21-gauge needle can be used for IM injections, the gauge of the needle is not the primary focus in this context. The angle of injection is more critical to ensure proper delivery of the medication.

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A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?

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Naxlex Comprehensive Predictor Exams

The healthcare provider orders Ceftriaxone 20 mg IV every 6 hours. The instructions say to reconstitute 10 mg of Ceftriaxone with 6.5 ml of normal saline for a final concentration of 5 mg/ml. How many mL would the nurse administer? (Round to the nearest tenth)

Correct Answer is ["13.3"]

Explanation

A nurse is planning to administer an IM injection into a client's deltoid muscle. Which action should the nurse take?

Correct Answer is B

Explanation

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