The nurse is preparing to administer medications to a 54-year-old client. Which medications taken would be affected by the first-pass effect? (Select All that Apply.)
Morphine 2mg IV (Intravenously)
Diphenhydramine (Benadryl) 25mg Tablet
Famotidine 10mg Tablet
Nitroglycerin 4mg Sublingual Tablet
Nitroglycerin 10mg Sublingual Tablet
Acetaminophen 325mg Capsule
Correct Answer : B,C,F
A. Morphine administered intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect entirely.
B. Diphenhydramine in tablet form is absorbed through the gastrointestinal tract and undergoes significant first-pass metabolism in the liver, affecting its bioavailability.
C. Famotidine in tablet form is also subject to first-pass metabolism, which can reduce its effectiveness.
D. Nitroglycerin sublingual tablets are designed to bypass the first-pass metabolism by being absorbed directly into the bloodstream through the mucous membranes.
E. The same applies to nitroglycerin 10mg sublingual tablets; they also avoid the first-pass effect due to sublingual administration.
F. Acetaminophen is taken orally and undergoes first-pass metabolism in the liver, which can significantly affect its overall bioavailability.
Free Nursing Test Bank
- Free Pharmacology Quiz 1
- Free Medical-Surgical Quiz 2
- Free Fundamentals Quiz 3
- Free Maternal-Newborn Quiz 4
- Free Anatomy and Physiology Quiz 5
- Free Obstetrics and Pediatrics Quiz 6
- Free Fluid and Electrolytes Quiz 7
- Free Community Health Quiz 8
- Free Promoting Health across the Lifespan Quiz 9
- Free Multidimensional Care Quiz 10
View Related questions
Correct Answer is ["B","D","F"]
Explanation
A. Dry mouth is not a cholinergic side effect; cholinergic effects typically increase secretions.
B. Diarrhea is a common cholinergic side effect due to increased gastrointestinal motility.
C. Decreased urination is not expected; cholinergic agents may increase urination.
D. Excessive lacrimation (tearing) is a common cholinergic effect, as these agents stimulate glandular secretions.
E. Tachycardia is not a cholinergic side effect; bradycardia is more likely due to cholinergic effects.
F. Excessive sweating is a cholinergic effect due to increased glandular activity.
Correct Answer is B
Explanation
A. Diarrhea is not a direct risk of stopping TPN abruptly.
B. Abruptly stopping TPN can cause hypoglycemia because the high glucose content in TPN leads to increased insulin production. Without the continuous glucose infusion, blood sugar levels can drop rapidly.
C. Hypovolemia is not a common outcome from stopping TPN suddenly.
D. Erythema at the site is unrelated to the cessation of TPN and more commonly related to local site reactions or infection.