A nurse is providing teaching about the use of transdermal fentanyl patches to a client. Which of the following statements by the client indicates an understanding of the teaching?

"I should fold the patch in half with the medication side touching before disposal."

"I should cut the patch in half before application."

"I should apply a heating pad to the patch when I have joint pain.”

"I will rotate the patch to a different extremity each day."

Answer and Explanation

The Correct Answer is A

Choice A reason: Folding the patch in half with the medication side touching before disposal is correct because it prevents accidental exposure to residual medication. Fentanyl patches contain potent opioids, and improper disposal can lead to accidental ingestion or misuse. This practice ensures safety for both the client and others in the household.

Choice B reason: Cutting the patch in half is unsafe. Transdermal patches are designed to deliver medication at a controlled rate. Cutting them compromises the integrity of the delivery system, leading to unpredictable dosing and risk of overdose.

Choice C reason: Applying a heating pad to the patch is contraindicated. Heat increases absorption of fentanyl through the skin, which can result in toxic levels and respiratory depression. Clients should avoid external heat sources on or near the patch.

Choice D reason: Rotating the patch to a different extremity each day is incorrect. Patches should be applied to intact, non-irritated skin on the upper torso or upper arm, not rotated daily to extremities. Rotation is important, but it should be between recommended sites every 72 hours, not daily.

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Correct Answer is A

Explanation

Choice A reason: Tachycardia is a classic sign of dehydration. When fluid volume decreases, cardiac output drops, and the body compensates by increasing heart rate to maintain perfusion. This makes tachycardia a reliable indicator of dehydration in a client with prolonged vomiting.

Choice B reason: A urine output of 850 mL per day is within normal limits (normal adult urine output is 800–2000 mL/day). Dehydration would typically present with oliguria, defined as less than 400 mL/day. Therefore, this finding does not indicate dehydration.

Choice C reason: A serum sodium level of 130 mEq/L indicates hyponatremia, which can occur with excessive vomiting and fluid loss. However, hyponatremia is not a direct indicator of dehydration; it reflects electrolyte imbalance. Dehydration is more directly identified by clinical signs such as tachycardia, hypotension, and dry mucous membranes.

Choice D reason: Distended neck veins suggest fluid overload, not dehydration. In dehydration, neck veins are typically flat or collapsed due to reduced circulating volume. This finding is inconsistent with dehydration.

A. Hospice care improves quality of life through palliative care. B. Hospice care provides 24-hr, in-home care. C. Hospice care is intended to postpone death. D. Hospice care encourages the family to coordinate health care services.

Correct Answer is A

Explanation

Choice A reason: Hospice care focuses on improving quality of life through palliative care, emphasizing comfort, dignity, and symptom management rather than curative treatment. This is the central philosophy of hospice.

Choice B reason: Hospice care does not guarantee 24-hour in-home care. Services are provided intermittently, with family and caregivers playing a major role.

Choice C reason: Hospice care is not intended to postpone death. It acknowledges the natural process of dying and provides support during this stage.

Choice D reason: Hospice care coordinates services through the hospice team, not solely through the family. Families are supported, but professional coordination is central.

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A nurse is providing teaching about the use of transdermal fentanyl patches to a client. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

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