A client with cancer is taking the prescribed dose of morphine sulfate, and a family member informs the nurse that the client is extremely sedated. What finding by the nurse would indicate the causative factor for the increased sedation experienced by the client?

Correct Answer: A

Rationale: The correct answer is A: The client is taking St. John’s wort for depression. St. John’s wort is known to interact with morphine sulfate, potentiating its sedative effects due to its impact on liver enzymes. This interaction can lead to increased sedation in the client. Incorrect choices: B: The client has a glass of ginger ale by the bedside. Ginger ale does not interact with morphine sulfate to cause increased sedation. C: A family member has a naloxone pen by the bedside. Naloxone is an opioid antagonist used to reverse opioid overdose, not a causative factor for increased sedation. D: The client is taking metoprolol for hypertension. Metoprolol is a beta-blocker and does not interact with morphine sulfate to cause increased sedation.

Correct Answer: A

Rationale: The correct answer is A because a loading dose allows for a rapid achievement of drug levels in the therapeutic range on the first day. By administering a higher initial dose, the drug concentration quickly reaches the desired level. Choice B is incorrect because a loading dose does not necessarily require multiple half-lives to attain. Choice C is incorrect as renal function typically influences maintenance doses rather than loading doses. Choice D is incorrect because a loading dose is primarily focused on achieving therapeutic levels in the bloodstream, not specifically targeting tissues.

Correct Answer: B

Rationale: The correct answer is B because when the peak level for a drug is above the minimum toxic concentration, it indicates that the concentration will produce an adverse response. This is because high drug levels can lead to toxicity and harmful effects on the body. The other choices are incorrect because: A: Concentration will produce therapeutic effects - This is incorrect because being above the minimum toxic concentration means the drug level is too high for therapeutic effects. C: Time between doses must be shortened - This is incorrect as adjusting the time between doses does not address the issue of drug toxicity. D: Duration of action of the drug is too long - This is incorrect because the duration of action does not directly relate to drug toxicity; it is the concentration level that determines toxicity.

Correct Answer: C

Rationale: The correct answer is C: Lipid solubility of the drug. This affects gastric drug absorption because lipid-soluble drugs can easily pass through the lipid bilayer of the cell membrane in the stomach. This allows for faster and more efficient absorption into the bloodstream. Liver enzyme activity (choice A) primarily affects drug metabolism, not absorption. Protein-binding properties (choice B) influence distribution within the body but not absorption. Ability to chew and swallow (choice D) relates to drug administration rather than absorption in the stomach.

Correct Answer: A

Rationale: The correct answer is A because bioavailability is crucial for drugs with narrow therapeutic ranges or sustained release mechanisms as it determines the amount of the drug that reaches the systemic circulation. Choice B is incorrect because different brands of a drug can have varying bioavailability due to differences in formulations. Choice C is incorrect because the frequency of drug administration does not necessarily correlate with bioavailability. Choice D is incorrect as combining an active drug with an inert substance can affect bioavailability, such as altering absorption rates.