A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

Check for correct placement of the patch behind the client's ear.

Explain that the medication is not given to prevent pain.

Advise the client that the effects of the medication have worn off.

Offer to apply a new transdermal patch to relieve the pain.

Answer and Explanation

The Correct Answer is B

A) Check for correct placement of the patch behind the client's ear: While ensuring correct placement is important for the effectiveness of transdermal patches, the scopolamine patch is primarily used for motion sickness and nausea, not for pain relief. Checking placement does not address the client's pain, which is not the intended use of the medication.

B) Explain that the medication is not given to prevent pain: Scopolamine is used to prevent nausea and motion sickness, not to manage pain. The client’s pain is unrelated to the patch’s intended purpose. Educating the client about the medication's purpose and recommending appropriate pain management would address the issue effectively.

C) Advise the client that the effects of the medication have worn off: The scopolamine patch's effects for nausea or motion sickness would not typically wear off within four hours. The medication was not intended to address pain, so advising the client about its effectiveness for nausea rather than pain would be more appropriate.

D) Offer to apply a new transdermal patch to relieve the pain: Applying a new patch would not be effective for pain management, as scopolamine is not designed for pain relief. Instead, the focus should be on addressing the client's pain with suitable analgesics and explaining the purpose of the scopolamine patch.

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Correct Answer is C

Explanation

A) Diarrhea: Diarrhea is a common side effect of many medications, including those used for nausea and vomiting. While it can be uncomfortable and may require management, it is generally less severe compared to neurological symptoms. Persistent diarrhea should be monitored and managed, but it does not typically indicate a serious underlying issue with metoclopramide.

B) Unusual irritability: Irritability can occur as a side effect of many medications and might be a sign of a mild central nervous system effect or a response to the stress of illness. While it is important to assess and address any changes in mood, unusual irritability is generally less urgent compared to neurological symptoms that could suggest more serious adverse effects.

C) Involuntary movements: Involuntary movements, such as tremors or muscle spasms, are significant concerns when a patient is on metoclopramide. These symptoms can indicate extrapyramidal side effects, which include tardive dyskinesia or other severe movement disorders. These conditions can be serious and potentially irreversible if not addressed promptly, making it crucial to report such symptoms immediately to the healthcare provider for further evaluation and intervention.

D) Nausea: Nausea is the primary symptom that metoclopramide is intended to treat, so its presence is expected and does not usually signal an adverse reaction to the medication. If nausea persists despite treatment, it might suggest the need for dose adjustment or an alternative treatment, but it is not an urgent adverse effect that requires immediate reporting compared to neurological symptoms.

A. Provide a PRN NSAID for gum B. Complete a medication variance report. C. Review most recent coagulation lab values. D. Report findings to healthcare provider. E. Obtain a soft bristle toothbrush for client.

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

Explanation

A) Provide a PRN NSAID for gum pain: Administering NSAIDs is not recommended as they can exacerbate bleeding risks in clients on anticoagulants. NSAIDs can interfere with platelet function and increase bleeding tendencies.

B) Complete a medication variance report: Documenting adverse effects and any discrepancies in medication administration is crucial for patient safety and quality control. A variance report helps track and address issues related to medication effects.

C) Review most recent coagulation lab values: Evaluating recent lab results is essential to determine if the anticoagulant dosage is appropriate and if there is an increased risk of bleeding. This information guides decisions about further interventions or adjustments to the medication regimen.

D) Report findings to healthcare provider: Immediate communication with the healthcare provider is necessary to address the client’s symptoms of bleeding and bruising. The provider can then evaluate the need for treatment modification or additional measures to manage bleeding risks.

E) Obtain a soft bristle toothbrush for client: A soft bristle toothbrush helps minimize gum irritation and bleeding, which is important for clients on anticoagulants to reduce the risk of oral bleeding and maintain oral health.

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A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?

Correct Answer is C

Explanation

After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which actions should the nurse implement? Select all that apply.

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

Explanation

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