What does the term 'first pass effect' refer to?
The initial phase of drug distribution
The rapid absorption of a drug in the intestine
The initial rapid excretion of a drug through the urinary system
The metabolism of a drug before it reaches the systemic circulation
The Correct Answer is D
Choice A reason: The initial phase of drug distribution is not the correct definition of the term 'first pass effect'. Drug distribution is the process by which a drug moves from the bloodstream to the tissues and organs of the body. The initial phase of drug distribution is influenced by factors such as blood flow, tissue permeability, plasma protein binding, and tissue binding. The first pass effect is not related to drug distribution, but to drug metabolism, which is the chemical transformation of a drug in the body.
Choice B reason: The rapid absorption of a drug in the intestine is not the correct definition of the term 'first pass effect'. Drug absorption is the process by which a drug enters the bloodstream from the site of administration. The rapid absorption of a drug in the intestine depends on factors such as the drug formulation, the pH of the gastrointestinal tract, the presence of food or other drugs, and the surface area and motility of the intestine. The first pass effect is not related to drug absorption, but to drug metabolism, which is the chemical transformation of a drug in the body.
Choice C reason: The initial rapid excretion of a drug through the urinary system is not the correct definition of the term 'first pass effect'. Drug excretion is the process by which a drug or its metabolites are eliminated from the body. The initial rapid excretion of a drug through the urinary system is influenced by factors such as the renal blood flow, the glomerular filtration rate, the tubular secretion and reabsorption, and the urine pH. The first pass effect is not related to drug excretion, but to drug metabolism, which is the chemical transformation of a drug in the body.
Choice D reason: The metabolism of a drug before it reaches the systemic circulation is the correct definition of the term 'first pass effect'. Drug metabolism is the process by which a drug is chemically transformed in the body, usually by enzymes in the liver or other tissues. The first pass effect is a phenomenon of drug metabolism that occurs when a drug is administered orally and passes through the gastrointestinal tract and the liver before reaching the systemic circulation. The first pass effect can reduce the bioavailability and the effectiveness of the drug, as some or most of the drug may be metabolized and inactivated before reaching the site of action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Increased respiratory rate is not a sign of adverse reaction to metoprolol, but rather a normal response to hypoxia or distress. Metoprolol is a betablocker that can lower the heart rate and blood pressure, but it does not affect the respiratory rate directly.
Choice B reason: Bronchodilation is not a sign of adverse reaction to metoprolol, but rather a desired effect of asthma medications such as betaagonists or anticholinergics. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can cause bronchoconstriction or narrowing of the airways. This is why metoprolol is contraindicated or used with caution in clients with asthma.
Choice C reason: Decreased sputum production is not a sign of adverse reaction to metoprolol, but rather a result of effective asthma management. Metoprolol is a betablocker that does not have any direct effect on the mucus secretion or inflammation in the lungs.
Choice D reason: Wheezing is a sign of adverse reaction to metoprolol, as it indicates bronchoconstriction or narrowing of the airways. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can reduce the bronchodilation effect of beta agonists or other asthma medications. This can worsen the asthma symptoms and cause wheezing, coughing, dyspnea, or chest tightness. The nurse should monitor the client for these signs and report them to the prescriber immediately.
Correct Answer is A
Explanation
Choice A reason: This is correct. Hypertension is a contraindication for taking pseudoephedrine. Pseudoephedrine is a decongestant that shrinks the blood vessels in the nasal passages and relieves congestion. However, it can also increase the blood pressure and the heart rate, which can worsen hypertension and increase the risk of stroke, heart attack, or kidney damage. The nurse should advise the client to avoid pseudoephedrine and use other methods to relieve sinus congestion, such as saline nasal spray, steam inhalation, or humidifier.
Choice B reason: This is incorrect. Diverticulitis is not a contraindication for taking pseudoephedrine. Diverticulitis is a condition where small pouches in the colon become inflamed and infected. It can cause symptoms such as abdominal pain, fever, nausea, or constipation. Pseudoephedrine does not affect the colon or the inflammation directly, but it can cause dehydration, which can worsen constipation and diverticulitis. The nurse should advise the client to drink plenty of fluids and eat a highfiber diet to prevent constipation and diverticulitis.
Choice C reason: This is incorrect. Migraines are not a contraindication for taking pseudoephedrine. Migraines are severe headaches that are often accompanied by nausea, vomiting, or sensitivity to light and sound. They can be triggered by various factors, such as stress, hormones, or food. Pseudoephedrine does not cause migraines directly, but it can interact with some migraine medications, such as triptans, which are used to treat acute migraine attacks. The combination of pseudoephedrine and triptans can increase the blood pressure and the risk of serotonin syndrome, a serious condition that causes agitation, confusion, tremors, or seizures. The nurse should advise the client to check with their doctor before taking pseudoephedrine and triptans together.
Choice D reason: This is incorrect. Eczema is not a contraindication for taking pseudoephedrine. Eczema is a skin condition that causes dry, itchy, and inflamed skin. It can be caused by various factors, such as allergies, irritants, or genetics. Pseudoephedrine does not affect the skin or the inflammation directly, but it can cause dryness of the mucous membranes, such as the mouth, nose, or eyes. The nurse should advise the client to use a moisturizer, a lip balm, and artificial tears to prevent dryness and irritation of the skin and the mucous membranes.
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