The healthcare provider decreased the ordered dose of fentanyl to 25 mcg/hr transdermal patch. The pharmacy delivers a 50 mcg/hr patch to the nurse when the next dose is scheduled. What is the best action by the nurse?

Cut the 50 mcg/hr patch in half to obtain 25 mcg/hr dosing

Ask pharmacy to send a 25 mcg/hr transdermal patch

Contact the healthcare provider and request to increase the dose to 50 mcg/hr

Remove the previous patch and apply the 50 mcg/hr patch in a different location

Answer and Explanation

The Correct Answer is B

A) Cut the 50 mcg/hr patch in half to obtain 25 mcg/hr dosing: Cutting a fentanyl patch in half is not recommended because it can lead to inconsistent dosing. The patches are designed to release medication at a controlled rate, and cutting them could cause the medication to be released too quickly or unevenly, which could result in overdose or insufficient relief of pain. It’s essential to follow the manufacturer's guidelines and avoid altering the patch.

B) Ask pharmacy to send a 25 mcg/hr transdermal patch: The best course of action is to ask the pharmacy to send the correct 25 mcg/hr transdermal patch. This ensures that the patient receives the prescribed dose in the most accurate and safe manner. The 25 mcg/hr patch is formulated to deliver the correct amount of medication, and it will avoid any risk associated with altering the patch.

C) Contact the healthcare provider and request to increase the dose to 50 mcg/hr: Requesting an increase in the dose is premature without a clear justification from the healthcare provider. The healthcare provider decreased the dose to 25 mcg/hr for a reason, possibly due to side effects, effectiveness, or other clinical factors. Altering the prescribed dose without a proper review would be inappropriate. The nurse should follow the current prescribed dose and resolve the issue by requesting the correct patch from the pharmacy.

D) Remove the previous patch and apply the 50 mcg/hr patch in a different location: Switching to the 50 mcg/hr patch without approval could lead to administering an incorrect dose of fentanyl, which can increase the risk of overdose or severe side effects like respiratory depression. The nurse should adhere to the prescribed 25 mcg/hr dose and request the correct patch from the pharmacy rather than substituting with a higher dose patch.

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Correct Answer is C

Explanation

A) Lying flat on the back: Positioning the client flat on their back is not the most effective position for administering a rectal suppository. The correct position allows for easier insertion and proper absorption of the medication. Lying flat on the back may make it difficult for the nurse to administer the suppository in the correct manner.

B) Lying flat on the stomach: Lying flat on the stomach is not recommended for the administration of a rectal suppository, as it can be uncomfortable for the client and can impede the ability to access the rectal area. The side-lying position is more effective for both client comfort and proper placement of the suppository.

C) Left side-lying: The left side-lying position, often referred to as the Sims' position, is the most appropriate for administering a rectal suppository. This position helps to expose the rectal area, allows for easier insertion, and promotes the suppository’s absorption, as gravity can assist in its positioning within the rectum.

D) Right side-lying: The right side-lying position is not as effective as the left side-lying position for the administration of a rectal suppository. The left-side position helps to ensure the smooth placement of the suppository and promotes its absorption. Therefore, the right side is not the optimal choice.

Correct Answer is ["4"]

Explanation

Identify the desired dose: The doctor has ordered 40 mg of atorvastatin.

Identify the available tablet strength: Each tablet contains 10 mg of atorvastatin.

Set up the calculation: We need to find out how many tablets are needed to administer 40 mg of the medication.

We can use the following formula:

(Desired dose) / (Tablet strength) = Number of tablets

Plug in the values and calculate:

(40 mg) / (10 mg/tablet) = 4 tablets

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The healthcare provider decreased the ordered dose of fentanyl to 25 mcg/hr transdermal patch. The pharmacy delivers a 50 mcg/hr patch to the nurse when the next dose is scheduled. What is the best action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is ordered to receive a laxative by rectal suppository. How should the nurse position the client during the administration of the suppository?

Correct Answer is C

Explanation

The client is ordered to receive 40 mg of atorvastatin PO daily. In the medication cabinet, you find 10 mg tablets. How many tablets will you administer to the client? (Enter a numerical value only)

Correct Answer is ["4"]

Explanation

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