Difficulty: Medium
Average Score: 72%
Simulated
Which of the following responses indicate that the nurse understands the first-pass effect?
Correct answer
D
Rationale
The correct answer is D because enteral medications (oral route) are affected by the first-pass effect. This means that when oral medications are absorbed in the gastrointestinal tract, they pass through the liver before reaching systemic circulation, where they may undergo metabolism and lose some of their potency. Therefore, higher doses may be needed to achieve the desired therapeutic effect.
Choice A is incorrect because intravenous, intramuscular, and intradermal routes bypass the liver initially, so they are not affected by the first-pass effect.
Choice B is incorrect because enteric-coated tablets and capsules are designed to bypass the stomach and dissolve in the small intestine to avoid stomach acid degradation, not the first-pass effect.
Choice C is incorrect because the first-pass effect involves metabolism by the liver, not activation of medications.
In summary, the correct understanding of the first-pass effect involves recognizing that oral medications are affected as they pass through the liver before systemic circulation, leading to potential dose adjustments.
Choice A is incorrect because intravenous, intramuscular, and intradermal routes bypass the liver initially, so they are not affected by the first-pass effect.
Choice B is incorrect because enteric-coated tablets and capsules are designed to bypass the stomach and dissolve in the small intestine to avoid stomach acid degradation, not the first-pass effect.
Choice C is incorrect because the first-pass effect involves metabolism by the liver, not activation of medications.
In summary, the correct understanding of the first-pass effect involves recognizing that oral medications are affected as they pass through the liver before systemic circulation, leading to potential dose adjustments.