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, 3. The nurse is teaching a patient who will be discharged home with a prescription for an enteric-
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st coated tablet. Which statement by the patient indicates understanding of the teaching?
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a. Imay crush the tablet and put it in applesauce to improve absorption.
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b. I should consume acidic foods to enhance absorption of this medication.
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c. I should expect a delay in onset of the drugs effects after taking the tablet.
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d. I should take this medication with high-
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fat foods to improve its action. ANS: C
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Enteric-
coated tablets resist disintegration in the acidic environment of the stomach and disintegrate whe
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n they reach the small intestine. There is usually some delay in onset of actions after taking these m
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edications. Enteric- st



coated tablets should not be crushed or chewed, which would alter the time and location of absorpt
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ion. Acidic foods will not enhance the absorption of the medication. The patient should not to eat
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high-fat food before ingesting an enteric-coated tablet, because high-
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fat foods decrease the absorption rate.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 3 TO
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P: NURSING PROCESS: Nursing Intervention
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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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4. A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be giv
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en by subcutaneous injection instead of by mouth. The nurse will explain that this is because
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a. absorption is diminished by the first-pass effects in the liver. st st st st st st st st st



b. absorption is faster when insulin is given subcutaneously. st st st st st st st



c. digestive enzymes in the gastrointestinal tract prevent absorption. st st st st st st st



d. the oral formis less predictable with more adverse effects.
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ANS: C st



Insulin, growth hormones, and other protein- st st st st st



based drugs are destroyed in the small intestine by digestive enzymes and must be given parentera
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lly. Because insulin is destroyed by digestive enzymes, it would not make it to the liver for metabo
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lism with a first- st st st



pass effect. Subcutaneous tissue has fewer blood vessels, so absorption is slower in such tissue. In
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sulin is given subcutaneously because it is desirable to have it absorb slowly.
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DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3 TOP:
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NURSING PROCESS: Nursing Intervention: Patient Teaching
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