A client who is receiving morphine sulfate for severe pain reports feeling nauseated and vomits. The nurse should recognize that this is an adverse effect of which of the following classifications of controlled substances?

Correct answer: a, b, c, e

Rationale: Methadone is a Schedule II controlled substance that requires strict regulation and documentation. The nurse should verify the client's identity, document the dose and time of administration, count the remaining tablets with another nurse, and assess the client for adverse effects. Disposing of unused or expired methadone tablets in a sharps container is not appropriate as it poses a risk of needlestick injury and environmental contamination.

Incorrect choices:
d) Dispose of any unused or expired methadone tablets in a sharps container.: This is incorrect as it poses a risk of needlestick injury and environmental contamination.

Correct answer: A, D, E

Rationale: Fentanyl patches are transdermal delivery systems that provide continuous opioid analgesia for up to 72 hours. The nurse should instruct the client to apply the patch to a dry, hairless area of intact skin; avoid exposing the patch to heat sources that can increase absorption and cause overdose; and report any signs of opioid toxicity such as confusion, drowsiness, or difficulty breathing.

Incorrect choices:
b) Change the patch every 24 hours or as needed for pain relief.: This is incorrect as changing the patch more frequently than every 72 hours can cause overdose and dependence.

c) Dispose of the used patch by flushing it down the toilet.: This is incorrect as flushing the patch down the toilet can contaminate the water supply and pose a risk of accidental ingestion by children or pets. The nurse should instruct the client to fold the patch in half with the sticky sides together and dispose of it in a secure trash container.