When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Place the patch on the client’s shoulder and leave both patches in place for 12 hours.

Remove the patch and consult with the healthcare provider about the client’s pain resolution.

Apply the new patch in a different location after removing the original patch.

Administer an oral analgesic and evaluate its effectiveness before applying the new patch.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Placing the new patch on the client’s shoulder and leaving both patches in place for 12 hours is not recommended. Fentanyl patches are designed to be used one at a time, and overlapping patches can lead to an overdose due to excessive absorption of the medication1. The standard practice is to remove the old patch before applying a new one.

Choice B reason:

Removing the patch and consulting with the healthcare provider about the client’s pain resolution is a cautious approach. However, it is not necessary to consult the healthcare provider if the client denies pain and the patch is due for replacement. The nurse should follow the standard protocol for patch replacement.

Choice C reason:

Applying the new patch in a different location after removing the original patch is the correct action. This ensures that the medication is delivered effectively while preventing skin irritation and potential overdose. The new patch should be placed on a different area of intact skin to allow the previous site to recover.

Choice D reason:

Administering an oral analgesic and evaluating its effectiveness before applying the new patch is not appropriate in this scenario. The client is already receiving pain management through the transdermal patch, and additional oral analgesics are not necessary unless there is breakthrough pain. The focus should be on proper patch replacement

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Correct Answer is D

Explanation

Choice A reason:

Resuming a diet that consists of milk, cream, and bland foods is not the most critical instruction for a client taking esomeprazole. While bland foods can help reduce gastric irritation, they do not address the primary concern of monitoring for serious side effects. Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid, and dietary changes alone are not sufficient to manage potential complications.

Choice B reason:

Calling the clinic if diarrhea or headache occurs when taking esomeprazole is important, but it is not the most critical instruction. Diarrhea and headache are common side effects of esomeprazole, but they are usually not severe. The client should be aware of these potential side effects, but the primary concern is monitoring for signs of gastrointestinal bleeding.

Choice C reason:

Once pain subsides, NSAID therapy should not be resumed without consulting the healthcare provider. NSAIDs can cause significant gastrointestinal issues, including ulcers and bleeding. The client should be advised to avoid NSAIDs unless specifically directed by their healthcare provider.

Choice D reason:

Notifying the healthcare provider of the passage of black stools is the most critical instruction. Black stools can indicate gastrointestinal bleeding, which is a serious side effect of both NSAIDs and esomeprazole. Immediate medical attention is necessary if this occurs to prevent further complications.

A. I should take this medication only when I am having an asthma attack. B. I will not need to use my inhalers twice a day when I start this medicine. C. I will take the tablet every evening to control my asthma. D. This medication will stop an asthma attack immediately.

Correct Answer is C

Explanation

Choice A Reason:

I should take this medication only when I am having an asthma attack: This statement is incorrect because montelukast is not a rescue medication. It is a maintenance medication designed to be taken regularly to prevent asthma symptoms and attacks. Using it only during an asthma attack would not provide the intended preventive benefits.

Choice B Reason:

I will not need to use my inhalers twice a day when I start this medicine: This statement is also incorrect. Montelukast is often used as an adjunct therapy and does not replace the need for inhalers, especially for those with moderate to severe asthma. Inhalers, particularly corticosteroids, remain a critical part of asthma management.

Choice C Reason:

I will take the tablet every evening to control my asthma: This statement is correct. Montelukast is typically prescribed to be taken once daily in the evening. This helps to control asthma symptoms and prevent attacks by reducing inflammation and constriction in the airways.

Choice D Reason:

This medication will stop an asthma attack immediately: This statement is incorrect. Montelukast is not a fast-acting medication and will not provide immediate relief during an asthma attack. Fast-acting bronchodilators, such as albuterol, are used for immediate relief.

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When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?

Correct Answer is D

Explanation

A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

Correct Answer is C

Explanation

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When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

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