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 A
Explanation
A. Following the insertion of the Nexplanon rod, it is important to inform the client that backup contraception methods are needed for the first 24 hours to ensure pregnancy prevention while the implant becomes effective.
B. While smoking cessation is advised due to the increased risk of thrombotic events with hormonal contraceptives, it is not the priority instruction immediately following the insertion of Nexplanon.
C. The statement regarding weight loss is incorrect; Nexplanon is more commonly associated with weight gain rather than loss, so advising clients on calorie consumption is misleading.
D. Although Nexplanon has a high efficacy rate in preventing pregnancy, stating a prevention rate of 100% is inaccurate and misleading, as no contraceptive method is completely foolproof.
Correct Answer is D
Explanation
A. Hair loss is not a recognized long-term side effect of phenytoin.
B. Phenytoin is used to prevent seizures, not cause them; a reoccurrence of seizures may indicate ineffective control or medication issues, but it is not a side effect.
C. Hypertension is not typically associated with phenytoin use.
D. Gingival hyperplasia, or overgrowth of gum tissue, is a common long-term side effect of phenytoin and requires regular dental hygiene and monitoring.