The nurse is providing education to a patient who has been prescribed both an antacid and ranitidine (an H2 receptor blocker). Which instruction should the nurse give the patient about taking the medications?
Take the antacid 1 hour after the ranitidine.
The antacid and ranitidine should be taken at the same time for better effect.
Take both medications at the same time before meals.
Patient can't take both of these medications and needs to be on one of these medications only.
The Correct Answer is A
Choice A reason:
Taking an antacid one hour after ranitidine is recommended because antacids can affect the absorption of H2 receptor blockers like ranitidine. Ranitidine works by reducing stomach acid production, whereas antacids neutralize existing acid. Taking the antacid too close to the ranitidine can reduce the effectiveness of the ranitidine by altering the stomach's pH balance and affecting its absorption.
Choice B reason:
Taking an antacid and ranitidine at the same time does not enhance their effect. In fact, this can interfere with the absorption and effectiveness of ranitidine. Antacids can increase the pH of the stomach, which may reduce the absorption of ranitidine, thus diminishing its acid-reducing effects.
Choice C reason:
Taking both medications at the same time before meals is not advisable for the same reason as above. The simultaneous administration can reduce the effectiveness of ranitidine, as the increased pH caused by the antacid can interfere with the absorption of the H2 receptor blocker, thereby not providing the intended therapeutic effect.
Choice D reason:
The patient can take both medications, but they should be timed correctly to ensure optimal effectiveness. Saying that the patient needs to be on one medication only is incorrect. Both medications can be used together, but the antacid should be taken after ranitidine to avoid any interaction that might impair the effectiveness of ranitidine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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.
Correct Answer is B
Explanation
Choice A reason:
Metoprolol is a beta-blocker that primarily affects the heart by reducing heart rate and contractility. It does not specifically block the efflux of potassium. Beta-blockers are used to manage high blood pressure, angina, and certain arrhythmias, but they do not target potassium channels directly.
Choice B reason:
Amiodarone is an antiarrhythmic medication that blocks the efflux of potassium from cardiac cells. It prolongs the repolarization phase of the cardiac action potential by inhibiting potassium channels, which helps to stabilize cardiac rhythms and prevent arrhythmias. This mechanism makes amiodarone effective in treating various types of arrhythmias.
Choice C reason:
Lidocaine is a class IB antiarrhythmic that primarily blocks sodium channels in the heart. It is used to treat acute ventricular arrhythmias, especially after a myocardial infarction. While it affects the electrical activity of the heart, it does not specifically block potassium efflux.
Choice D reason:
Verapamil is a calcium channel blocker that primarily affects the influx of calcium into cardiac and smooth muscle cells. It is used to treat hypertension, angina, and certain arrhythmias, but it does not block potassium efflux.
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