Which of the following responses indicate that the nurse understands the first-pass effect?

Choice A rationaleIntravenous, intramuscular, and intradermal routes bypass the first-pass effect as they do not pass through the liver first.Choice B rationaleEnteric-coated tablets and capsules are designed to bypass the stomach and dissolve in the intestines, reducing the first-pass effect.Choice C rationaleThe first-pass effect involves the liver metabolizing and inactivating a portion of the medication on its first pass through the liver.Choice D rationaleEnteral medications, which pass through the digestive system, may require higher doses due to the first-pass effect where the liver metabolizes the medication before it reaches systemic circulation. .