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:
Metoprolol is a beta-blocker that primarily affects the heart by reducing heart rate and contractility. It does not specifically block the efflux of potassium. Beta-blockers are used to manage high blood pressure, angina, and certain arrhythmias, but they do not target potassium channels directly.

Choice B reason:
Amiodarone is an antiarrhythmic medication that blocks the efflux of potassium from cardiac cells. It prolongs the repolarization phase of the cardiac action potential by inhibiting potassium channels, which helps to stabilize cardiac rhythms and prevent arrhythmias. This mechanism makes amiodarone effective in treating various types of arrhythmias.

Choice C reason:
Lidocaine is a class IB antiarrhythmic that primarily blocks sodium channels in the heart. It is used to treat acute ventricular arrhythmias, especially after a myocardial infarction. While it affects the electrical activity of the heart, it does not specifically block potassium efflux.

Choice D reason:
Verapamil is a calcium channel blocker that primarily affects the influx of calcium into cardiac and smooth muscle cells. It is used to treat hypertension, angina, and certain arrhythmias, but it does not block potassium efflux.

A. There is an infusion reaction to Amphotericin B B. Infusions of Amphotericin B should be administered rapidly C. The IV site should be rotated frequently to reduce the risk of phlebitis or use bigger vein for the treatment like central line D. Amphotericin B is for treatment of fungal infection

Correct Answer is B

Explanation

Choice A reason:
Amphotericin B is known to cause infusion reactions, including fever, chills, and rigors. These reactions are common and expected when administering this medication. Therefore, the statement that there is an infusion reaction to Amphotericin B is correct and does not indicate a need for further teaching.
Choice B reason:
This choice is incorrect because infusions of Amphotericin B should not be administered rapidly. Rapid infusion can increase the risk of severe side effects and adverse reactions. The drug should be administered slowly to minimize these risks. Thus, this statement indicates a need for further teaching.
Choice C reason:
Rotating the IV site frequently or using a larger vein, such as a central line, is a standard practice to reduce the risk of phlebitis, a common complication of Amphotericin B treatment. This statement is correct and does not indicate a need for further teaching.
Choice D reason:
Amphotericin B is indeed used for the treatment of systemic fungal infections. This statement is factually accurate and does not suggest any misunderstanding on the part of the nursing student. Therefore, it does not indicate a need for further teaching.

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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

Which medication blocks the efflux (outflow) of potassium at the heart muscle?

Correct Answer is B

Explanation

Anurse 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

A patient has begun taking an HMG-COA reductase inhibitor (statins). Which statement about this class of drugs made by the nurse during patient education would be inappropriate?

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