Nokea
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
- A. Parenteral drugs bypass the first-pass effect.
- B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
- C. Absorption of parenteral drugs is faster when the stomach is empty.
- D. Parenteral drugs exert their effects while circulating in the bloodstream.
Correct Answer: A
Rationale: Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in the bloodstream.
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The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?
- A. Absorption
- B. Distribution
- C. Metabolism
- D. Excretion
Correct Answer: D
Rationale: The kidneys are the organs that are most responsible for drug excretion. Renal function does not affect the absorption and distribution of a drug. Renal function may affect metabolism of drugs to a small extent.
When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?
- A. The time it takes for a drug to elicit a therapeutic response
- B. The amount of time needed to remove a drug from circulation
- C. The time it takes for a drug to achieve its maximum therapeutic response
- D. The time period at which a drug's concentration is sufficient to cause a therapeutic response
Correct Answer: D
Rationale: Duration of action is the time during which drug's concentration is sufficient to elicit a therapeutic response. The other options do not define duration of action. A drug's onset of action is the time it takes for the drug to elicit a therapeutic response. A drug's peak effect is the time it takes for the drug to reach its maximum therapeutic response. Elimination is the length of time it takes to remove a drug from circulation.
The patient is experiencing chest pain and needs to take a buccal form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
- A. Under the tongue
- B. On top of the tongue
- C. At the back of the throat
- D. In the space between the cheek and the gum
Correct Answer: D
Rationale: Drugs administered via the buccal route are placed in the space between the cheek and the gum. Drugs administered via the sublingual route are placed under the tongue. The other options are incorrect.
When given an intravenous medication, the patient says to the nurse, -I usually take pills. Why does this medication have to be given in the arm? What is the nurse's best answer?
- A. The medication will cause fewer adverse effects when given intravenously.
- B. The intravenous medication will have delayed absorption into the body's tissues.
- C. The action of the medication will begin sooner when given intravenously.
- D. There is a lower chance of allergic reactions when drugs are given intravenously.
Correct Answer: C
Rationale: An intravenous (IV) injection provides the fastest route of absorption. The IV route does not affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in faster absorption). The IV route does not affect the number of allergic reactions.
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?
- A. Renal excretion will be faster.
- B. The drug will be metabolized quickly.
- C. The duration of action of the medication will be shorter.
- D. The duration of action of the medication will be longer.
Correct Answer: D
Rationale: Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein binding does not make renal excretion faster, does not speed up drug metabolism, and does not cause the duration of action to be shorter.