A nurse reads in a drug information guide that PO (oral) morphine has a high first-pass effect. Which of the following statements would demonstrate the nurse's understanding of the first-pass effect?
The drug will be most effective when given orally.
The drug will be more effective when given in a non-enteral route (IV, SQ).
The drug whether given oral or IV will have the same effect.
The drug is excreted by the lungs at a slower rate than most medications.
The Correct Answer is B
Choice A reason:
Morphine is not most effective when given orally due to the high first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver immediately after it enters the bloodstream from the gastrointestinal tract, significantly reducing the amount of active drug that reaches systemic circulation. Therefore, oral administration of morphine is not the most effective route because much of it is metabolized before it can exert its effect.
Choice B reason:
Morphine will be more effective when given via a non-enteral route such as intravenous (IV) or subcutaneous (SQ) because these routes bypass the liver, thereby avoiding the first-pass metabolism. This allows a higher concentration of the active drug to reach the systemic circulation, providing a more potent and effective pain relief.
Choice C reason:
Oral and IV administration of morphine do not have the same effect due to the first-pass metabolism. When morphine is administered orally, a significant amount is metabolized by the liver before it reaches the systemic circulation, whereas IV administration delivers the drug directly into the bloodstream, bypassing the liver and allowing a higher active concentration.
Choice D reason:
Morphine is not primarily excreted by the lungs; it is mainly metabolized by the liver and excreted by the kidneys. This statement does not accurately demonstrate an understanding of the first-pass effect or the pharmacokinetics of morphine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
The onset of warfarin is delayed, meaning it takes longer to achieve a therapeutic effect. Warfarin requires several days to adjust to effective anticoagulation levels because it works by inhibiting the synthesis of clotting factors that are already present and active in the bloodstream. In contrast, heparin has an immediate anticoagulant effect when administered, which is crucial for patients with acute conditions like deep vein thrombosis.
Choice B reason:
Warfarin does not prevent platelet aggregation. Instead, it works by inhibiting vitamin K-dependent clotting factors, which are essential for blood coagulation. Platelet aggregation is primarily inhibited by antiplatelet drugs like aspirin or clopidogrel, not anticoagulants like warfarin.
Choice C reason:
Heparin does not necessarily have fewer adverse effects compared to warfarin. Both anticoagulants have their specific risks and side effects. Heparin is preferred in acute settings due to its rapid onset of action, but it can cause complications like heparin-induced thrombocytopenia (HIT), which requires careful monitoring.
Choice D reason:
Heparin does not have a longer half-life than warfarin. In fact, heparin's half-life is relatively short, which is why it is often administered via continuous infusion or frequent subcutaneous injections. Warfarin has a longer half-life, but its delayed onset of action makes it less suitable for immediate anticoagulation needs.
Correct Answer is A
Explanation
Choice A reason:
Stenosis is characterized by the constriction and narrowing of the valve opening, which causes the valve leaflets to fail to open completely. This condition restricts blood flow through the valve, leading to increased pressure in the heart and reduced blood flow to the body or lungs, depending on which valve is affected.
Choice B reason:
Regurgitation refers to the condition where the valve does not close properly, allowing blood to flow backward. This is different from stenosis, where the valve opening is narrowed and does not allow sufficient blood flow forward.
Choice C reason:
Insufficiency is another term for regurgitation and involves the backward flow of blood due to improper closure of the valve. It does not describe the condition where the valve opening is narrowed and restricts forward blood flow.
Choice D reason:
Incompetence also refers to the inability of the valve to close properly, leading to regurgitation. It is not used to describe the narrowing of the valve opening, which is the defining characteristic of stenosis.
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