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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A reason:
As mentioned earlier, infusion reactions are common with Amphotericin B, including symptoms like fever and chills. Therefore, recognizing that these reactions occur is correct and indicates a proper understanding of the medication's effects.
Choice B reason:
Rapid administration of Amphotericin B is incorrect because it increases the risk of severe side effects. The infusion should be slow to ensure patient safety, indicating that the student needs further teaching on this point. Thus, this choice is incorrect and suggests a misunderstanding.
Choice C reason:
Frequent rotation of the IV site or the use of a central line is standard practice to minimize the risk of phlebitis. This practice is correct and shows that the student understands how to manage the complications associated with Amphotericin B infusion.
Choice D reason:
Amphotericin B's primary use is to treat systemic fungal infections. This is a correct statement, reflecting an accurate understanding of the drug's purpose and does not require further teaching.

A. Stenosis B. Regurgitation C. Insufficiency D. Incompetence

Correct Answer is A

Explanation

Choice A reason:
Stenosis is characterized by the constriction and narrowing of the valve opening, which causes the valve leaflets to fail to open completely. This condition restricts blood flow through the valve, leading to increased pressure in the heart and reduced blood flow to the body or lungs, depending on which valve is affected.

Choice B reason:
Regurgitation refers to the condition where the valve does not close properly, allowing blood to flow backward. This is different from stenosis, where the valve opening is narrowed and does not allow sufficient blood flow forward.

Choice C reason:
Insufficiency is another term for regurgitation and involves the backward flow of blood due to improper closure of the valve. It does not describe the condition where the valve opening is narrowed and restricts forward blood flow.

Choice D reason:
Incompetence also refers to the inability of the valve to close properly, leading to regurgitation. It is not used to describe the narrowing of the valve opening, which is the defining characteristic of stenosis.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discussing intravenous Amphotericin B treatment with a nursing student who is about to care for a patient with a systemic fungal infection. Which statement by the student indicates a need for further teaching?

Correct Answer is B

Explanation

Which valvular condition is characterized by the valve opening being constricted and narrowed, causing the valve leaflets, or cusps, to fail to open completely?

Correct Answer is A

Explanation

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