A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?

The drug will be more effective when given in a nonenteral route.

The drug will be most effective when given orally

The drug is excreted by the kidneys at a slower rate than most medications

The kidney will metabolize some of the drug before it reaches the blood stream

Answer and Explanation

The Correct Answer is A

A. The drug will be more effective when given in a nonenteral route:
Morphine has a high first-pass effect when taken orally, meaning that a significant amount of the drug is metabolized in the liver before it reaches systemic circulation. This reduces the amount of active drug available in the bloodstream. To avoid this extensive metabolism, morphine is often administered through nonenteral routes, such as intravenous or subcutaneous, where it bypasses the digestive system and liver first-pass metabolism, resulting in higher systemic bioavailability and effectiveness.

B. The drug will be most effective when given orally:
Due to the high first-pass effect of oral morphine, a significant portion of the drug is metabolized by the liver before it reaches systemic circulation. This means that oral morphine is often less effective compared to other routes of administration, such as intravenous, because the bioavailability of the drug is reduced.

C. The drug is excreted by the kidneys at a slower rate than most medications:
The high first-pass effect primarily affects the drug's absorption and systemic availability rather than its excretion rate. The rate at which a drug is excreted by the kidneys is generally unrelated to its first-pass effect. Morphine’s excretion is influenced by its metabolism and clearance, but not directly by the first-pass effect.

D. The kidney will metabolize some of the drug before it reaches the bloodstream:
The first-pass effect occurs primarily in the liver, not the kidneys. It involves the metabolism of the drug by the liver before it reaches systemic circulation. Therefore, this option incorrectly attributes the first-pass effect to kidney metabolism.

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Correct Answer is D

Explanation

A. Chemical name:
The chemical name of a drug refers to its molecular structure and is often complex and technical, such as "2-(4-isobutylphenyl)propionic acid" for ibuprofen. This name is used primarily by chemists and is not typically used in clinical settings.

B. Generic name:
The generic name of a drug is its non-proprietary name, which is often simpler than the chemical name and is used universally to identify the drug regardless of the brand. For ibuprofen, the generic name is "ibuprofen." It is distinct from the brand name, which is a trademarked name used by manufacturers.

C. Nonproprietary name:
The term "nonproprietary name" is synonymous with the generic name. It refers to the drug's official, universally accepted name that is not associated with any specific brand. In this case, "ibuprofen" is the nonproprietary or generic name.

D. Brand name:
The brand name, also known as the trade name, is the name given by the manufacturer and is protected by trademark. "Motrin" is the brand name for ibuprofen. It is used in marketing and prescribing to differentiate it from other brands or generic forms of the same medication.

A. This hospital might use a different manufacturer, but the medication is the same." B. "What does your usual pill look like?" C. This is the medication prescribed by your provider." D. "This pill is probably from a different lot number than yours at home."

Correct Answer is B

Explanation

A. This hospital might use a different manufacturer, but the medication is the same:
While it is possible that different manufacturers might produce pills of varying appearances, this response does not directly address the client's concern or involve them in verifying the medication. It's important for the nurse to first understand what the client is accustomed to before providing reassurance about the medication.

B. What does your usual pill look like?:
Asking the client to describe their usual pill is the best response. This approach allows the nurse to verify the medication in question by comparing it to the client’s known medication. It also reassures the client that their concerns are being taken seriously and provides an opportunity for the nurse to check if there has been an error or if the medication is indeed correct.

C. This is the medication prescribed by your provider:
While this statement is factual, it does not directly address the client’s concern about the appearance of the medication. It's important to involve the client in verifying the medication to ensure they are receiving the correct drug and to maintain their trust.

D. This pill is probably from a different lot number than yours at home:
This response assumes the issue is related to the lot number, which may not be the case. It does not involve the client in the verification process or address their specific concern about the appearance of the medication. Providing a more thorough and engaging response would be more appropriate.

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A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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