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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Correct Answer is D

Explanation

A) The nurse reports the error to the physician and the charge nurse but does not document the error due to possible legal action: Ethical reporting includes thorough documentation of the error, regardless of potential legal implications. Failing to document the error could compromise patient safety and the quality of care, and it does not fulfill the requirement for transparent and comprehensive reporting.

B) The nurse does not report or document the error, since the error did not result in any harm to the patient: Ethical reporting of medication errors involves documenting and reporting all errors, regardless of whether harm occurred. This helps in preventing future errors and maintaining a culture of safety and accountability.

C) The nurse does not report the error, because the error was caught and corrected prior to drug administration: Even if the error was corrected before administration, it is crucial to report and document the incident. This practice helps identify potential systemic issues and improve safety protocols.

D) The nurse informs the patient, documents the error as per hospital policy, and notifies the physician: This action demonstrates ethical reporting as it includes informing the patient about the error, thoroughly documenting it according to hospital policy, and notifying the physician. This comprehensive approach ensures transparency, patient safety, and adherence to institutional guidelines.

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

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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

Which situation demonstrates ethical reporting of a medication error?

Correct Answer is D

Explanation

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

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