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.
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
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.
Choice B reason:
Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.
Choice C reason:
Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.
Choice D reason:
Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.

Correct Answer is A
Explanation
Choice A reason: Baclofen is a muscle relaxant that can cause side effects such as dizziness and fatigue, especially when starting the medication or adjusting the dose1. These symptoms are usually temporary and may subside as the body adjusts to the medication. Advising the client to avoid hazardous activities, such as driving or operating heavy machinery, helps prevent accidents and ensures safety while the body adapts to the new medication.
Choice B reason: Increasing the intake of fluids and high-protein foods is generally good advice for overall health but is not specifically related to managing the side effects of baclofen. While staying hydrated and maintaining a balanced diet can support overall well-being, it does not directly address the dizziness and fatigue caused by baclofen.
Choice C reason: Stopping the medication immediately is not recommended without consulting a healthcare provider. Abruptly discontinuing baclofen can lead to withdrawal symptoms, including hallucinations and seizures4. It is important to follow a healthcare provider’s guidance when adjusting or stopping any medication.
Choice D reason: Obtaining transportation to the emergency department is not necessary unless the symptoms are severe or accompanied by other concerning signs, such as difficulty breathing or chest pain. Mild to moderate dizziness and fatigue are common side effects of baclofen and can typically be managed with caution and monitoring.
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