A nurse is preparing to replace a client's transdermal fentanyl patch after 72 hr of use. After the nurse opens the packet containing the new pouch, the client declines to accept it. Which of the following actions should the nurse take?

Withhold pain medications for 24 hr after the old patch is removed

Ask another nurse to witness the disposal of the new patch

Seal the patches in a plastic bag and place in the client's trash basket

Stick the two patches to each other and place them in the sharps bin

Answer and Explanation

The Correct Answer is B

A. Incorrect. Withholding pain medications for 24 hr after the old patch is removed is a harmful action that could cause severe withdrawal symptoms and uncontrolled pain for the client. The nurse should respect the client's right to refuse treatment and explore the reasons for their decision.
B. Correct. Asking another nurse to witness the disposal of the new patch is a safe and legal action that follows the policies and procedures for handling controlled substances. The nurse should document the disposal of the new patch and report it to the appropriate authority.
C. Incorrect. Sealing the patches in a plastic bag and placing them in the client's trash basket is an unsafe and illegal action that could lead to diversion, misuse, or accidental exposure of fentanyl to others. The nurse should dispose of the patches in a secure and designated container that prevents access by unauthorized persons.
D. Incorrect. Sticking the two patches to each other and placing them in the sharps bin is an unsafe and improper action that could cause contamination, injury, or infection to others who handle or dispose of sharps waste. The nurse should dispose of the patches separately and carefully, avoiding contact with their adhesive surfaces.

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Correct Answer is C

Explanation

A. Constipation is not a common complication of vacuum-assisted birth. It may be related to other factors such as dehydration, opioid use, or decreased mobility.
B. Urinary urgency is not a common complication of vacuum-assisted birth. It may be related to other factors such as bladder trauma, infection, or diuretic use.
C. Cervical laceration is a common complication of vacuum-assisted birth. It occurs when the vacuum cup causes damage to the cervix during delivery. It can lead to bleeding, infection, or cervical incompetence in future pregnancies.
D. Retained placenta is not a common complication of vacuum-assisted birth. It may be related to other factors such as placenta accreta, uterine atony, or manual removal of the placenta.

A. Hyperthyroidism. B. Asthma. C. High blood pressure. D. Active liver disease.

Correct Answer is D

Explanation

Choice A rationale:

Hyperthyroidism is not a contraindication for niacin use. Niacin is used to lower LDL cholesterol levels and has no specific contraindications related to thyroid disorders.

Choice B rationale:

Asthma is not a contraindication for niacin use. Niacin does not interact with asthma medications or worsen asthma symptoms, so it is not contraindicated in individuals with asthma.

Choice C rationale:

High blood pressure is not a contraindication for niacin use. In fact, niacin can help lower blood pressure and improve overall cardiovascular health. It is often prescribed to individuals with high blood pressure and elevated cholesterol levels.

Choice D rationale:

Active liver disease is a contraindication for niacin use. Niacin can cause liver damage, and individuals with active liver disease should avoid niacin therapy to prevent further harm to the liver. Monitoring liver function tests is crucial in patients taking niacin to ensure their liver health.

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A nurse is preparing to replace a client's transdermal fentanyl patch after 72 hr of use. After the nurse opens the packet containing the new pouch, the client declines to accept it. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client following a vacuum-assisted birth. The nurse should monitor the client for which of the following complications related to vacuum-assisted birth?

Correct Answer is C

Explanation

A nurse is teaching a class about using niacin to reduce LDL cholesterol.The nurse should include in the teaching that which of the following conditions is a contraindication for receiving this medication?

Correct Answer is D

Explanation

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