Difficulty: Medium
Average Score: 92%
Simulated
The nurse is administering medications to a client who has severe liver damage. Which medications, as ordered below, will avoid the first pass effect?
Correct answer
B,D,E
Rationale
Dulcolax suppository (B), fentanyl transdermal patch (D), and morphine IV (E) avoid the first pass effect as they are administered rectally, transdermally, and intravenously, respectively, bypassing the liver's initial metabolism. Oral medications like acetaminophen (A) and aspirin (C) undergo first pass metabolism in the liver, reducing their bioavailability.