A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

"Remove the patch for 8 hours every day to reduce the risk of tolerance."

"Avoid hot tubs while wearing the patch."

"Avoid high-fiber foods while taking this medication."

"Apply the patch to your forearm."

Answer and Explanation

The Correct Answer is B

A. "Remove the patch for 8 hours every day to reduce the risk of tolerance.": This is incorrect. The fentanyl patch should be left in place continuously for the prescribed duration to maintain consistent pain relief and should not be removed unless instructed by a healthcare provider.

B. "Avoid hot tubs while wearing the patch.": This is an important instruction. Heat can increase the absorption of fentanyl from the patch, potentially leading to overdose. Therefore, avoiding hot tubs and other heat sources is crucial while using the patch.

C. "Avoid high-fiber foods while taking this medication.": This statement is not accurate. In fact, opioid medications like fentanyl often cause constipation, so high-fiber foods can be beneficial to help prevent this side effect.

D. "Apply the patch to your forearm.": This is not typically the recommended application site for fentanyl patches. They are usually applied to hairless areas of the upper body or upper outer arm, where they can adhere properly and be effective.

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Correct Answer is B

Explanation

A. Insert an 18-gauge IV catheter: While establishing IV access is important for fluid resuscitation and medication administration, it is not the immediate priority in this scenario.

B. Apply 100% humidified oxygen: This action is critical as the client is showing signs of potential airway compromise (drooling and hoarseness), which may indicate edema or inhalation injury. Providing humidified oxygen can help maintain airway patency and support respiratory function, making it the top priority.

C. Obtain a baseline ECG: While cardiac monitoring is important in many emergency situations, it is not the immediate concern in this case, where airway issues are evident.

D. Obtain a blood specimen for ABG analysis: Although assessing arterial blood gases can provide useful information about the client's respiratory status, it is not the first priority when there are clear signs of airway compromise. Addressing the airway issue is critical to prevent respiratory failure.

A. Bradypnea B. Jugular vein distention C. Weight gain D. Frothy, pink sputum

Correct Answer is D

Explanation

A. Bradypnea: This refers to a slower than normal respiratory rate, which is not a typical manifestation of pulmonary congestion. In fact, pulmonary congestion often leads to tachypnea (increased respiratory rate).

B. Jugular vein distention: This is more indicative of right-sided heart failure or fluid overload rather than left-sided heart failure, where the primary issue is related to pulmonary congestion.

C. Weight gain: While weight gain can occur due to fluid retention in heart failure, it is not specific to pulmonary congestion and can be seen in both left-sided and right-sided heart failure.

D. Frothy, pink sputum: This is a classic manifestation of pulmonary congestion and indicates the presence of fluid in the lungs, often seen in left-sided heart failure. The pink color is due to the presence of blood, which may leak into the alveoli due to increased pressure. This finding is critical and should be closely monitored.

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A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is D

Explanation

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