A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

"Remove the patch for 8 hours every day to reduce the risk of tolerance."

"Avoid hot tubs while wearing the patch."

"Avoid high-fiber foods while taking this medication."

"Apply the patch to your forearm."

Answer and Explanation

The Correct Answer is B

A. "Remove the patch for 8 hours every day to reduce the risk of tolerance.": This is incorrect. The fentanyl patch should be left in place continuously for the prescribed duration to maintain consistent pain relief and should not be removed unless instructed by a healthcare provider.

B. "Avoid hot tubs while wearing the patch.": This is an important instruction. Heat can increase the absorption of fentanyl from the patch, potentially leading to overdose. Therefore, avoiding hot tubs and other heat sources is crucial while using the patch.

C. "Avoid high-fiber foods while taking this medication.": This statement is not accurate. In fact, opioid medications like fentanyl often cause constipation, so high-fiber foods can be beneficial to help prevent this side effect.

D. "Apply the patch to your forearm.": This is not typically the recommended application site for fentanyl patches. They are usually applied to hairless areas of the upper body or upper outer arm, where they can adhere properly and be effective.

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Correct Answer is A

Explanation

A) The anterior fontanel is open: This is an expected finding in an 8-month-old infant. The anterior fontanel typically remains open until around 12 to 18 months of age, allowing for brain growth.

B) Both fontanels show molding: Molding is usually a temporary shape change of the skull that occurs during birth, particularly in relation to the birth canal. By 8 months, the fontanels should not show molding.

C) Both fontanels are the same size: The anterior fontanel is generally larger than the posterior fontanel. The posterior fontanel typically closes by 2 to 3 months of age and is much smaller.

D) The posterior fontanel is open: This finding is not expected, as the posterior fontanel should have closed by 2 to 3 months of age. An open posterior fontanel at 8 months could indicate a developmental concern.

A. A history of gastroesophageal reflux disease. B. A residual of 65 mL. 1 hr postprandial. C. Sitting in high-Fowler's position during the feeding D. Receiving a high-osmolarity formula.

Correct Answer is A

Explanation

A. A history of gastroesophageal reflux disease: This factor places the client at a higher risk for aspiration. Patients with gastroesophageal reflux disease (GERD) may experience backflow of stomach contents, which can lead to aspiration, especially when receiving enteral feedings.

B. A residual of 65 mL, 1 hr postprandial: While monitoring residual volumes is important to assess tolerance to feeding, a residual of 65 mL alone does not inherently indicate a high risk for aspiration. It may suggest that the feeding rate needs adjustment but isn't a direct risk factor.

C. Sitting in high-Fowler's position during the feeding: This position is actually protective against aspiration, as it promotes better gastric emptying and reduces the likelihood of reflux.

D. Receiving a high-osmolarity formula: While high-osmolarity formulas can sometimes lead to gastrointestinal discomfort or diarrhea, they do not directly increase the risk of aspiration. Proper management of feeding administration is key.

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A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing the fontanels of an 8-month-old infant. Which of the following findings should the nurse recognize as an expected finding?

Correct Answer is A

Explanation

A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

Correct Answer is A

Explanation

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