The healthcare provider orders azithromycin (Zithromax) 1000mg to be given as a loading dose. The nurse understands that the purpose of this loading dose is to:

Increase the duration of action of the medication

Decrease the frequency of subsequent doses.

Achieve therapeutic drug levels more rapidly

Minimize the risk of adverse effects

Answer and Explanation

The Correct Answer is C

A. Increase the duration of action of the medication:
A loading dose is not intended to increase the duration of action of a medication. Instead, it aims to rapidly achieve therapeutic levels in the bloodstream. The duration of action is primarily influenced by the drug's half-life and how it's metabolized and excreted, rather than the initial dose.

B. Decrease the frequency of subsequent doses:
The primary goal of a loading dose is to reach therapeutic levels quickly, not necessarily to alter the frequency of future doses. While a loading dose can help achieve therapeutic levels faster, the dosing schedule is determined by the drug's pharmacokinetics and the condition being treated.

C. Achieve therapeutic drug levels more rapidly:
The main purpose of a loading dose is to quickly achieve a concentration of the medication in the blood that is sufficient to be therapeutic. By giving a larger initial dose, the medication reaches effective levels faster compared to gradually reaching those levels with smaller, incremental doses.

D. Minimize the risk of adverse effects:
Minimizing adverse effects is not the primary aim of a loading dose. While achieving therapeutic levels quickly may indirectly help in reducing symptoms and improving outcomes, the main purpose of a loading dose is to reach effective drug levels promptly, not specifically to reduce adverse effects.

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Correct Answer is A

Explanation

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.

A. Does not have an effect B. Increases C. Decreases D. Enhances

Correct Answer is C

Explanation

A) Does not have an effect: Food can significantly affect drug dissolution and absorption, so it is not accurate to say it has no effect. The presence of food in the gastrointestinal tract can alter how drugs are absorbed.

B) Increases: While food can sometimes increase the absorption of certain medications by stimulating digestive processes, it generally does not increase drug absorption for all medications. In many cases, food can delay or decrease the rate of drug absorption.

C) Decreases: Food commonly decreases the rate and extent of drug absorption. This can occur because food may bind to the drug, alter the pH of the stomach, or affect gastric emptying, leading to reduced drug dissolution and absorption.

D) Enhances: Food generally does not enhance drug dissolution and absorption for most medications. While some medications are better absorbed with food, in many cases, food can reduce the rate at which a drug is absorbed, leading to decreased efficacy.

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The healthcare provider orders azithromycin (Zithromax) 1000mg to be given as a loading dose. The nurse understands that the purpose of this loading dose is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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