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.

Answer and Explanation

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

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Correct Answer is D

Explanation

Choice A reason: Zolpidem is primarily prescribed for the short-term treatment of insomnia. It works by enhancing the activity of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, which helps to induce sleep. While improved sleep can indirectly affect other conditions, such as incontinence, decreased episodes of incontinence are not a direct outcome of zolpidem administration.

Choice B reason: Improved ability to concentrate is not a primary outcome of zolpidem treatment. Zolpidem is a sedative-hypnotic medication used to treat insomnia by helping patients fall asleep faster and stay asleep longer. While better sleep can improve overall cognitive function, the primary goal of zolpidem is to improve sleep quality, not directly enhance concentration.

Choice C reason: Exhibiting fewer emotional outbursts is not a direct effect of zolpidem. The medication is designed to treat insomnia and does not have a significant impact on emotional regulation. Emotional outbursts may be related to other underlying conditions that zolpidem does not address.

Choice D reason: The primary desired outcome of zolpidem administration is to help the patient sleep soundly through the night. Zolpidem is effective in reducing sleep latency and increasing the duration of sleep, which is particularly beneficial for older adults who may have difficulty maintaining sleep. Achieving a full night’s rest is the main indicator that zolpidem is working as intended.

A. Document the client’s refusal of the medication at this time. B. Explain the need to take the medication at least 1 hour before meals. C. Allow the client to take the medication up to 1 hour after breakfast. D. Instruct the client to take it when the meal tray is delivered.

Correct Answer is B

Explanation

Choice A reason:

Documenting the client’s refusal of the medication at this time is not the best response. While it is important to document any refusal of medication, the nurse should first educate the client on the proper administration of sucralfate. Sucralfate works by forming a protective barrier over ulcers, and it is most effective when taken on an empty stomach, at least 1 hour before meals.

Choice B reason:

Explaining the need to take the medication at least 1 hour before meals is the correct response. Sucralfate should be taken on an empty stomach to ensure it can effectively coat the stomach lining and protect it from acid. Taking it before meals maximizes its efficacy in treating and preventing ulcers.

Choice C reason:

Allowing the client to take the medication up to 1 hour after breakfast is not appropriate. Sucralfate needs to be taken on an empty stomach to form a protective barrier over the ulcer. Taking it after a meal would reduce its effectiveness, as the presence of food can interfere with its action.

Choice D reason:

Instructing the client to take it when the meal tray is delivered is incorrect. Sucralfate should be taken on an empty stomach, at least 1 hour before meals, to ensure it can properly coat the stomach lining and provide the necessary protection against stomach acid

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Correct Answer is D

Explanation

The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Correct Answer is B

Explanation

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