A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?

More constant drug levels for analgesia

Less constipation and minimal dry mouth

Less drowsiness than with oral opioids

Lower dependency potential and no major adverse effects

Answer and Explanation

The Correct Answer is A

Transdermal fentanyl patches are a common choice for patients with chronic cancer-related pain because they provide continuous systemic absorption of the drug. This allows for stable plasma concentrations and sustained pain relief, reducing the peaks and troughs that occur with oral or injectable opioids. The patches are not free of adverse effects, but their main advantage is consistent analgesia.

Rationale for correct answer:

A. More constant drug levels for analgesia:
The patch delivers fentanyl steadily over 72 hours, ensuring stable pain control without the fluctuations seen with short-acting opioids. This makes it particularly useful for persistent cancer pain.

Rationale for incorrect answers:

B. Less constipation and minimal dry mouth:
Constipation and dry mouth are common opioid side effects regardless of the route. Fentanyl patches do not eliminate these adverse effects, so laxatives and oral care are still necessary.

C. Less drowsiness than with oral opioids:
Fentanyl can still cause CNS depression and drowsiness. The patch does not prevent this effect—it mainly changes how the drug is delivered.

D. Lower dependency potential and no major adverse effects:
Fentanyl is a potent opioid with the same risks of tolerance, dependence, and adverse effects as other opioids. It must be carefully monitored.

Take-home points:

Transdermal fentanyl provides stable and continuous analgesia, which is ideal for chronic cancer pain.
Side effects such as constipation, sedation, and dependency risks remain and require monitoring.
The main advantage is avoiding peaks and troughs in pain relief, improving patient comfort and quality of life.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","E"]

Explanation

Nalbuphine (Nubain) is an opioid agonist-antagonist used for moderate to severe pain. While effective, it carries opioid-related risks such as respiratory depression and CNS effects, requiring close nursing monitoring and thorough patient teaching.

Rationale for correct answers:
A. Monitor any changes in respirations:
As with other opioids, nalbuphine can depress the respiratory center. Monitoring rate, depth, and pattern is critical, especially after IV administration.

B. Instruct the patient to report bradycardia:
Nalbuphine can slow heart rate. Patients must promptly report dizziness, faintness, or slow pulse to prevent complications.

C. Administer IV nalbuphine undiluted:
This drug may be given undiluted IV, usually slowly over 2 minutes, to reduce adverse effects like hypotension or respiratory depression.

E. Instruct the patient to avoid alcohol when taking nalbuphine to avoid respiratory depression:
Alcohol potentiates CNS and respiratory depression from opioids, so complete avoidance is essential.

Rationale for incorrect answer:
D. Explain to the patient to expect an excessive amount of urine output:
This is false. Nalbuphine does not increase urine output; instead, opioids may cause urinary retention.

Take-home points:

Always monitor respiratory status and heart rate with nalbuphine.
Give IV doses undiluted, administered slowly.
Warn patients about alcohol and CNS depressant interactions.

A. Renal insufficiency B. Severe asthma C. Sleep apnea D. Severe head injury E. Liver disease

Correct Answer is ["B","C","D"]

Explanation

Opioid analgesics are effective for moderate to severe pain but have significant central nervous system and respiratory depressant effects. Nurses must assess for conditions that increase the risk of respiratory compromise or intracranial pressure before administration.

Rationale for correct answers:

B. Severe asthma:
Opioids can depress respiratory drive and reduce the body’s response to hypoxia and hypercapnia. In patients with severe asthma, this can precipitate life-threatening respiratory compromise.

C. Sleep apnea:
Patients with sleep apnea already have intermittent airway obstruction during sleep. Opioids can worsen hypoventilation and apnea episodes, increasing the risk of severe hypoxia.

D. Severe head injury:
Opioids can increase intracranial pressure and mask changes in neurological status, making monitoring of head injury patients more difficult and potentially dangerous.

Rationale for incorrect answers:

A. Renal insufficiency:
Opioids can be used with caution in renal impairment, adjusting doses if necessary. They are not strictly contraindicated.

E. Liver disease:
Most opioids are metabolized by the liver, so caution and dose adjustment may be needed, but they are not absolute contraindications unless there is severe hepatic failure.

Take-home points:

Opioids can depress respiration, so avoid in severe asthma, sleep apnea, and head injury.
Dose adjustments may be necessary for renal or hepatic impairment, but these conditions are not absolute contraindications.
Always monitor for signs of respiratory depression and CNS changes in high-risk patients.

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A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

For the patient who is taking nalbuphine (Nubain), what should the nurse do? Select all that apply

Correct Answer is ["A","B","C","E"]

Explanation

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder? Select all that apply

Correct Answer is ["B","C","D"]

Explanation

The nurse is teaching a patient about taking aspirin. Which are important points for the nurse to include? Select all that apply

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A patient is taking aspirin for arthritis. Which adverse reaction should the nurse teach the patient to report to the health care provider?

A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?

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