The nurse is administering medications to a client who has severe liver damage. Which medications, as ordered below, will avoid the first pass effect? (SELECT ALL THAT APPLY)

Acetaminophen 500 mg PO q4h PRN headache

Dulcolax suppository one per rectum PRN

Aspirin 10 mg PO crush and put in apple sauce

Fentanyl 25 mcg/h via transdermal patch daily

Morphine 0:4 mg IV q4h PRN severe pain

Answer and Explanation

Correct Answer : B,D,E

Choice A rationale: Acetaminophen 500 mg PO is subject to the first pass effect as it is absorbed through the gastrointestinal system.

Choice B rationale: Dulcolax suppository is not subject to the first pass effect as it is administered rectally.

Choice C rationale: Aspirin 10 mg PO is subject to the first pass effect as it is absorbed through the gastrointestinal system.

Choice D rationale: Fentanyl 25 mcg/h via transdermal patch avoids the first pass effect as it is absorbed through the skin.

Choice E rationale: Morphine 0.4 mg IV avoids the first pass effect as it is administered intravenously.

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Correct Answer is B

Explanation

Choice A rationale: Applying an ice pack after a topical agent is not primarily for decreasing discomfort but rather to achieve a specific therapeutic effect.

Choice B rationale: Applying an ice pack can slow the absorption of the topical drug, allowing for prolonged local action.

Choice C rationale: Enhancing drug excretion is not typically achieved by applying an ice pack.

Choice D rationale: Maximizing drug distribution is not the primary purpose of applying an ice pack after a topical agent.

A. Inflammatory B. Proliferation C. Remodeling D. Infection

Correct Answer is A

Explanation

Choice A rationale: An inflammatory response, including mild fever and malaise, is common during the inflammatory phase of healing, which occurs in the initial postoperative period.

Choice B rationale: Proliferation is the phase of healing characterized by tissue repair and regeneration, not by fever and malaise.

Choice C rationale: Remodeling is the final phase of healing involving tissue maturation and strengthening, not associated with generalized body responses.

Choice D rationale: Infection is a separate complication and may present with more severe symptoms than mild fever and malaise.

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The nurse is administering medications to a client who has severe liver damage. Which medications, as ordered below, will avoid the first pass effect? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has applied a topical agent to the client's skin, and then applies an ice pack to the area. This is done to:

Correct Answer is B

Explanation

A client has had an uncomplicated repair of an inguinal hernia. On the second post- operative day, the client has mildly elevated temperature and general malaise. The nurse recognizes that this is a generalized body response which is common to which phase of healing?

Correct Answer is A

Explanation

The best way for the nurse to assess a client's level of dyspnea is to:

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