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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.)

A.

Morphine 2mg IV (Intravenously)

B.

Diphenhydramine (Benadryl) 25mg Tablet

C.

Famotidine 10mg Tablet

D.

Nitroglycerin 4mg Sublingual Tablet

E.

Nitroglycerin 10mg Sublingual Tablet

F.

Acetaminophen 325mg Capsule

Question Solution

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.


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Correct Answer is B

Explanation

A. Methylprednisolone does not contain soy products and is not contraindicated for clients with a soybean allergy.

B. Ipratropium bromide is often formulated with soy lecithin as a stabilizer, making it contraindicated for individuals allergic to soybeans.

C. Montelukast is a leukotriene receptor antagonist and does not contain soy products, so it is safe for this client.

D. Albuterol does not contain soy products and is generally safe for clients with a soybean allergy.

Correct Answer is A

Explanation

A. Oxytocin is primarily used to induce or augment labor in full-term clients, making this the correct statement regarding its expected outcome.

B. Oxytocin is not used to prevent contractions; it is used to stimulate them, especially during labor.

C. Oxytocin is not a contraceptive; it does not prevent pregnancy but is used in labor management.

D. Oxytocin does not influence egg production; it primarily affects uterine contractions and milk ejection in breastfeeding.

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