A nurse reads in a drug information guide that PO (oral) morphine has a high first-pass effect. Which of the following statements would demonstrate the nurse's understanding of the first-pass effect?
The drug will be most effective when given orally.
The drug will be more effective when given in a non-enteral route (IV, SQ).
The drug whether given oral or IV will have the same effect.
The drug is excreted by the lungs at a slower rate than most medications.
The Correct Answer is B
Choice A reason:
Morphine is not most effective when given orally due to the high first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver immediately after it enters the bloodstream from the gastrointestinal tract, significantly reducing the amount of active drug that reaches systemic circulation. Therefore, oral administration of morphine is not the most effective route because much of it is metabolized before it can exert its effect.
Choice B reason:
Morphine will be more effective when given via a non-enteral route such as intravenous (IV) or subcutaneous (SQ) because these routes bypass the liver, thereby avoiding the first-pass metabolism. This allows a higher concentration of the active drug to reach the systemic circulation, providing a more potent and effective pain relief.
Choice C reason:
Oral and IV administration of morphine do not have the same effect due to the first-pass metabolism. When morphine is administered orally, a significant amount is metabolized by the liver before it reaches the systemic circulation, whereas IV administration delivers the drug directly into the bloodstream, bypassing the liver and allowing a higher active concentration.
Choice D reason:
Morphine is not primarily excreted by the lungs; it is mainly metabolized by the liver and excreted by the kidneys. This statement does not accurately demonstrate an understanding of the first-pass effect or the pharmacokinetics of morphine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Lactulose is the medication of choice for treating elevated ammonia levels, commonly seen in hepatic encephalopathy associated with cirrhosis. It works by reducing the absorption of ammonia from the intestines, converting ammonia to ammonium, which is then excreted. Administering lactulose helps in lowering blood ammonia levels and improving mental status in affected patients.
Choice B reason:
Polyethylene glycol (MiraLax) is a laxative used to treat constipation. It does not have any role in reducing ammonia levels or treating hepatic encephalopathy. Therefore, it is not appropriate for this patient's elevated ammonia condition.
Choice C reason:
0.9% NS (normal saline) is primarily used for fluid resuscitation and electrolyte balance. While essential in managing cirrhotic patients with fluid imbalances, it does not address the elevated ammonia levels directly. Therefore, it is not the treatment of choice for this specific situation.
Choice D reason:
Docusate sodium (Colace) is a stool softener used to treat constipation. It does not have any effect on ammonia levels or the treatment of hepatic encephalopathy. Thus, it is not appropriate for managing elevated ammonia in this patient.
Correct Answer is A
Explanation
Choice A reason:
True is the correct answer. Cardiac cells can endure ischemic conditions for approximately 20 minutes before irreversible injury occurs. Beyond this period, the lack of oxygen and nutrients leads to cell death and permanent damage to the heart tissue. This understanding is crucial in acute cardiac care, where timely intervention can prevent irreversible damage.
Choice B reason:
False is incorrect because it does not align with the known tolerance period of cardiac cells to ischemic conditions. The 20-minute window is critical for initiating interventions that can save heart tissue from permanent damage.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.