The nurse is providing education to a patient who has been prescribed both an antacid and ranitidine (an H2 receptor blocker). Which instruction should the nurse give the patient about taking the medications?

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.

Choice A reason:
Viruses are known for their unique replication process. They cannot replicate independently and must hijack a host cell's machinery to reproduce. This characteristic is fundamental to understanding viruses and is a key concept in virology. By replicating their genetic material inside host cells, viruses ensure their propagation and survival. This answer is correct because it highlights this crucial aspect of viral biology.
Choice B reason:
This choice is incorrect because viruses are not easily killed by antimicrobials. Antimicrobials, such as antibiotics, are typically effective against bacteria, not viruses. Viruses have different structures and replication mechanisms that make them resistant to these treatments. Instead, antiviral medications are needed to target viruses specifically.
Choice C reason:
This choice is also incorrect. Viruses do contain either DNA or RNA as their genetic material. This genetic material is essential for their replication and propagation. Some viruses have DNA, while others have RNA, and this distinction is one of the primary ways viruses are classified.
Choice D reason:
Viruses are not capable of independent reproduction. They rely entirely on infecting host cells to replicate. This dependence on host cells distinguishes them from other microorganisms like bacteria, which can reproduce on their own. Thus, this choice is incorrect as it does not accurately reflect the nature of viruses.