A nurse is caring for a patient who has been prescribed fentanyl patches for chronic cancer pain management at home. Which statement by the patient indicates that he understands how to use this medication safely?
“I will change the patch every other day.”
“I will apply the patch to a hairy area for better adhesion.”
“I will remove the old patch before applying a new one.”
“I will cut the patch in half if I need a lower dose.”.
The Correct Answer is C
The correct answer is choice C. The patient should remove the old patch before applying a new one to avoid overdose and adverse effects of fentanyl. Fentanyl patches are designed to deliver a constant amount of opioid analgesic over a period of time, usually 72 hours.
Therefore, changing the patch every other day (choice A) would result in inadequate pain relief and withdrawal symptoms.
Applying the patch to a hairy area (choice B) would interfere with the absorption of the drug and reduce its effectiveness.
Cutting the patch in half (choice D) would damage the integrity of the patch and cause erratic or rapid release of the drug, which could be fatal. Fentanyl patches should be applied to a clean, dry, hairless area of intact skin on the upper torso or upper arm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
The correct answer is choice A, B, and C. These are all liver enzymes that can indicate hepatotoxicity (liver damage) from acetaminophen overdose.
The normal ranges for these enzymes are:
• AST: 10 to 40 U/L
• ALT: 7 to 56 U/L
• ALP: 45 to 115 U/L
Choice D and E are wrong because they are indicators of renal function, not liver function.
The normal ranges for these values are:
• BUN: 7 to 20 mg/dL
• Creatinine: 0.6 to 1.2 mg/dL
Correct Answer is A
Explanation
The correct answer is choice A. Hepatic necrosis.Acetaminophen (APAP) is a common cause of drug-induced liver injury and can lead to hepatic necrosis, especially in patients who have chronic hepatitis C.APAP is metabolized by the liver and produces a toxic intermediate called N-acetyl-p-benzoquinone imine (NAPQI), which can deplete glutathione and damage hepatocytes.Patients who have chronic hepatitis C may have reduced glutathione levels and increased oxidative stress, making them more susceptible to APAP toxicity.
Choice B. Pulmonary fibrosis is wrong because APAP does not cause pulmonary fibrosis.
Pulmonary fibrosis is a chronic lung disease that involves scarring of the lung tissue and impaired gas exchange.Some drugs that can cause pulmonary fibrosis are amiodarone, bleomycin, methotrexate and nitrofurantoin.
Choice C. Pancreatitis is wrong because APAP does not cause pancreatitis.
Pancreatitis is an inflammation of the pancreas that can result from gallstones, alcohol abuse, hypertriglyceridemia, hypercalcemia, infections, trauma or certain medications.
Some drugs that can cause pancreatitis are azathioprine, valproic acid, didanosine and pentamidine.
Choice D. Cardiac dysrhythmias is wrong because APAP does not cause cardiac dysrhythmias.
Cardiac dysrhythmias are abnormal heart rhythms that can result from electrolyte imbalances, ischemia, myocardial infarction, heart failure, congenital defects or certain medications.
Some drugs that can cause cardiac dysrhythmias are digoxin, quinidine, sotalol and erythromycin.
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