A prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to order?

A Increase the frequency of medication dosing.

B Order a dose that is higher than an adult dose.

Discontinue the drug after one or two treatments.

D Order a dose that is lower than an adult dose.

Answer and Explanation

The Correct Answer is D

a) Increasing the frequency of medication dosing may lead to higher overall exposure and is not necessarily related to hepatic metabolism.

b) Ordering a dose that is higher than an adult dose could result in excessive drug levels, especially in a newborn with immature hepatic function.

c) Discontinuing the drug after one or two treatments may not be necessary if the dose is appropriately adjusted based on hepatic metabolism.

d) Ordering a lower dose is appropriate because hepatic metabolism in newborns is often immature, and lower doses are required to avoid toxicity.

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Correct Answer is D

Explanation

a) While the negative feedback loop plays a role in the body's natural regulation of corticosteroids, it does not eliminate the potential for side effects when exogenous glucocorticoids are administered.

b) Taking the drug as prescribed does not guarantee the absence of side effects. Side effects are inherent to glucocorticoid therapy and can occur even with appropriate use.

c) Interrupting the inflammatory process does not directly inhibit side effects. The anti inflammatory action is the therapeutic effect, but it does not eliminate the potential for side effects.

d) Glucocorticoids, even those produced naturally by the body, can cause side effects, and the likelihood and severity of these side effects depend on the dose and duration of treatment. Regular monitoring and appropriate management are essential.

A. Increasing the excretion of morphine sulfate by altering serum pH. B. Preventing activation of opioid receptors through antagonist actions. C. Regulating the sensitivity of opioid receptors by neurochemical alterations. D. Countering the effects of morphine sulfate by agonist actions.

Correct Answer is B

Explanation

a) Naloxone does not increase the excretion of opioids by altering serum pH; its primary action is at the receptor level.

b) Naloxone is an opioid receptor antagonist, meaning it blocks or prevents the activation of opioid receptors. This is how it counteracts the effects of opioids like morphine.

c) Naloxone does not regulate the sensitivity of opioid receptors by neurochemical alterations. Its action is more direct as an antagonist.

d) Naloxone is not an agonist; it does not produce opioid-like effects. Instead, it competes with opioids for receptor binding and blocks their effects.

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A prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse tells a nursing student that glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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