Answer to Question 1
Correct Answer: 3
Rationale 1: Not everyone with anxiety develops irritable bowel syndrome.
Rationale 2: Mental health conditions can affect appetite and digestive processes.
Rationale 3: Mental health conditions such as depression, anxiety, excessive stress, or bipolar disorder can affect appetite and digestive processes.
Rationale 4: The nurse may discuss this topic with the client.
Global Rationale: Mental health conditions such as depression, anxiety, excessive stress, or bipolar disorder can affect the appetite and digestive processes. Not everyone with anxiety develops irritable bowel syndrome. The nurse should be prepared to discuss this topic with the patient.
Answer to Question 2
Correct Answer: 2,3,4
Rationale 1: Medications that are given topically do not bypass the first-pass effect of the liver.
Rationale 2: Medications that are given sublingually bypass the first-pass effect on the liver.
Rationale 3: Medications that are given rectally bypass the first-pass effect of the liver.
Rationale 4: Medications that are given buccally bypass the first-pass effect on the liver.
Rationale 5: Medications that are given intravenously do not bypass the first-pass effect of the liver.
Global Rationale: The venous systems serving the head and the lower rectum are not parts of the hepatic portal system. Thus, drugs that are given by the buccal, sublingual, or rectal routes bypass the first-pass effect of the liver. Although a drug will still eventually reach the liver by the IM, IV and subcutaneous routes, it will have an opportunity to also reach its target tissue.