The patient is taking low-dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?

Distribution

First-pass effect

Reduced absorption

Gastrointestinal circulation

Answer and Explanation

The Correct Answer is B

A. Distribution refers to the movement of the drug from the bloodstream into tissues and organs, but it does not explain why only a portion of the medication reaches the tissues.

B. The first-pass effect occurs when an orally administered drug is metabolized by the liver before reaching systemic circulation. Aspirin, when taken orally, undergoes significant metabolism in the liver, reducing the amount of active drug available to exert its therapeutic effect. This explains why only a portion of the drug reaches the tissues.

C. Reduced absorption can limit drug availability, but aspirin is generally well absorbed in the gastrointestinal tract. The primary reason for reduced drug availability in this case is metabolism by the liver, not poor absorption.

D. Gastrointestinal circulation involves the enterohepatic recycling of some drugs, but it does not explain why only a portion of aspirin reaches systemic circulation. The first-pass effect is the primary factor.

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Correct Answer is C

Explanation

A. Complete blood count (CBC) and serum glucose levels are important for overall health monitoring but do not specifically assess drug metabolism or excretion, which are key factors in drug toxicity.

B. Pancreatic enzymes and urinalysis are useful for detecting pancreatic disorders and infections but are not primary indicators of drug toxicity.

C. Serum creatinine and liver function tests (LFTs) are critical for monitoring drug toxicity, especially in older adults. The kidneys and liver are responsible for drug metabolism and excretion. Impaired kidney function, indicated by elevated serum creatinine, can lead to drug accumulation and toxicity. Abnormal LFTs suggest liver dysfunction, which can affect drug metabolism and increase toxicity risk.

D. Serum lipids and electrolytes are important for cardiovascular and metabolic health but do not directly assess drug metabolism or toxicity risk.

A. None B. 50 mg C. 100 mg D. 200 mg

Correct Answer is C

Explanation

A. The statement that no drug remains is incorrect. A drug with a half-life of 8 hours will not be completely eliminated in 24 hours, as it follows a predictable pattern of reduction.

B. A reduction to 50 mg would require additional half-life intervals beyond 24 hours. The drug concentration decreases by half every 8 hours, meaning it would take more than 24 hours to reach this level.

C. The correct calculation follows the half-life principle:

- At 8 hours: 800 mg → 400 mg

- At 16 hours: 400 mg → 200 mg

- At 24 hours: 200 mg → 100 mg

Therefore, 100 mg of the drug remains after 24 hours.

D. While 200 mg is a step in the process, it represents the amount remaining after only 16 hours, not the full 24-hour period.

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The patient is taking low-dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?

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Naxlex Comprehensive Predictor Exams

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