A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

Check for correct placement of the patch behind the client's ear.

Explain that the medication is not given to prevent pain.

Advise the client that the effects of the medication have worn off.

Offer to apply a new transdermal patch to relieve the pain.

Answer and Explanation

The Correct Answer is B

A) Check for correct placement of the patch behind the client's ear: While ensuring correct placement is important for the effectiveness of transdermal patches, the scopolamine patch is primarily used for motion sickness and nausea, not for pain relief. Checking placement does not address the client's pain, which is not the intended use of the medication.

B) Explain that the medication is not given to prevent pain: Scopolamine is used to prevent nausea and motion sickness, not to manage pain. The client’s pain is unrelated to the patch’s intended purpose. Educating the client about the medication's purpose and recommending appropriate pain management would address the issue effectively.

C) Advise the client that the effects of the medication have worn off: The scopolamine patch's effects for nausea or motion sickness would not typically wear off within four hours. The medication was not intended to address pain, so advising the client about its effectiveness for nausea rather than pain would be more appropriate.

D) Offer to apply a new transdermal patch to relieve the pain: Applying a new patch would not be effective for pain management, as scopolamine is not designed for pain relief. Instead, the focus should be on addressing the client's pain with suitable analgesics and explaining the purpose of the scopolamine patch.

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Correct Answer is D

Explanation

A) Determine Glasgow Coma Scale score: While assessing the Glasgow Coma Scale (GCS) score is important for evaluating the level of consciousness and neurological status, it does not address the immediate life-threatening issue of severe respiratory depression and hypoxia. The client's critical respiratory status and low oxygen saturation require more urgent intervention.

B) Prepare to assist with chest tube insertion: Preparing for chest tube insertion is not appropriate in this scenario, as the client's symptoms are related to severe respiratory depression rather than a condition that would require chest drainage. Chest tube insertion is indicated for conditions such as pneumothorax or pleural effusion, not for opioid overdose.

C) Initiate cardiopulmonary resuscitation (CPR): CPR would be necessary if the client were in cardiac arrest or if there were no pulse and respiratory effort. However, the immediate issue appears to be severe respiratory depression rather than cardiac arrest, so administering a second dose of naloxone is a more appropriate and immediate action to address the cause of the client's condition.

D) Administer a second dose of naloxone: Given the client’s severe respiratory depression and low oxygen saturation despite the initial dose of naloxone, it is crucial to administer a second dose. Naloxone is used to reverse opioid overdose effects, and its administration should be repeated if symptoms persist, ensuring the client’s safety and potentially reversing the opioid’s effects on the respiratory system.

A. Notify the healthcare provider of lethargy. B. Decrease cigarette use to a pack per day. C. Monitor for any signs of sexual dysfunction. D. Take the medication an hour after antacids.

Correct Answer is B

Explanation

A. Notify the healthcare provider of lethargy:
Cimetidine can cause side effects such as confusion and lethargy, especially in the elderly or those with renal impairment. Reporting these symptoms to the healthcare provider is important for proper management and potential adjustment of treatment.

B. Decrease cigarette use to a pack per day:
This statement indicates a misunderstanding of the impact of smoking on peptic ulcer disease. Smoking can exacerbate ulcer symptoms and interfere with healing. The nurse should instruct the client to ideally quit smoking altogether rather than just reducing the amount.

C. Monitor for any signs of sexual dysfunction:
Cimetidine can cause sexual dysfunction, including decreased libido and erectile dysfunction. The client should be aware of this potential side effect and report any such issues to their healthcare provider for further evaluation and management.

D. Take the medication an hour after antacids:
Cimetidine should not be taken simultaneously with antacids as this can interfere with its absorption. Taking cimetidine an hour after antacids is a correct approach to avoid interaction and ensure effective medication action.

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A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?

Correct Answer is D

Explanation

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

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