The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug?

Unpredictably

Rapidly

Slowly

Using osmosis

Answer and Explanation

The Correct Answer is B

Choice A reason: Lipid-soluble drugs cross cell membranes quickly due to their affinity for lipid bilayers, leading to predictable, rapid absorption. Their onset is not unpredictable but typically faster than water-soluble drugs, especially via routes like intravenous or transdermal, making this choice incorrect for lipid-soluble drugs.

Choice B reason: Lipid-soluble drugs, like fentanyl, rapidly cross lipid-rich cell membranes, including the blood-brain barrier, leading to quick onset of action. This is due to their high partition coefficient, allowing fast diffusion into tissues, making rapid effect onset the correct expectation for the nurse.

Choice C reason: Lipid-soluble drugs have faster onset than water-soluble drugs due to easier membrane penetration. Slow effects are more typical of water-soluble or poorly absorbed drugs. Lipid solubility enhances rapid distribution and action, making this choice incorrect for the expected effect timeline.

Choice D reason: Osmosis refers to water movement across membranes, not drug absorption. Lipid-soluble drugs diffuse through lipid bilayers, not via osmosis, which is irrelevant to their pharmacokinetics. This choice is scientifically inaccurate for describing the onset of lipid-soluble drug effects.

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Correct Answer is A

Explanation

Choice A reason: ACE inhibitors cause dry cough by inhibiting bradykinin breakdown, which accumulates and irritates the airways. ARBs block angiotensin II receptors without affecting bradykinin, eliminating this side effect. This makes ARBs a suitable alternative for patients experiencing cough, confirming this as the correct choice.

Choice B reason: Hyperkalemia occurs with both ACE inhibitors and ARBs due to reduced aldosterone production, which decreases potassium excretion. Both drug classes affect the renin-angiotensin-aldosterone system similarly, so switching to an ARB does not eliminate this risk, making this choice incorrect for the question.

Choice C reason: Hypotension is a shared side effect of ACE inhibitors and ARBs, as both reduce blood pressure by inhibiting the renin-angiotensin system. ARBs block angiotensin II receptors, causing vasodilation similar to ACE inhibitors, so this side effect persists, making this choice incorrect.

Choice D reason: Angioedema, though rare, can occur with both ACE inhibitors and ARBs. While less common with ARBs, it’s not eliminated, as it may result from mechanisms beyond bradykinin accumulation. Switching to an ARB doesn’t guarantee avoidance of angioedema, making this choice incorrect.

A. Pentazocine (Talwin) PO B. Hydrocodone (Vicodin) PO C. Fentanyl (Duragesic) transdermal patch D. Meperidine (Demerol) PO

Correct Answer is C

Explanation

Choice A reason: Pentazocine is less effective for severe, chronic pain and has mixed agonist-antagonist effects. Fentanyl is stronger for opioid-tolerant patients, so this is incorrect.

Choice B reason: Hydrocodone is weaker than oxycodone and inadequate for severe, resistant pain. Fentanyl’s potency suits chronic cancer pain, so this is incorrect.

Choice C reason: Fentanyl transdermal is potent, long-acting, and ideal for severe, chronic cancer pain in opioid-tolerant patients. It’s appropriate here, making it the correct choice.

Choice D reason: Meperidine is not recommended for chronic pain due to neurotoxic metabolites. Fentanyl is safer and more effective, so this is incorrect.

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The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Correct Answer is A

Explanation

A cancer patient asks the nurse what can be given to alleviate severe, chronic pain of several months’ duration. The patient has been taking oxycodone (OxyContin) and states it is no longer effective. The nurse will suggest discussing which medication with the provider?

Correct Answer is C

Explanation

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The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug?