Nokea
The nurse has provided medication instructions to a client who has been prescribed a fentanyl transdermal patch. Which of the following statements, if made by the client, would indicate a correct understanding of the instructions? Select all that apply.
- A. I may still need pain medication while this patch is applied.
- B. If the patch comes loose, I may reinforce it with a piece of tape.
- C. I can apply heat to the patch site to increase the pain relief.
- D. I should remove this patch while I am sleeping.
- E. The patch will need to be changed every 72 hours.
Correct Answer: A,B,E
Rationale: A: Breakthrough pain may require additional medication. B: Taping a loose patch is acceptable. E: Fentanyl patches are typically changed every 72 hours. C is incorrect because heat can increase absorption and risk toxicity. D is incorrect as patches are not removed during sleep.
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A nurse is providing education in a community setting about general measures to avoid excessive sun exposure. Which of the following recommendations is appropriate?
- A. Apply sunscreen only after going into the water.
- B. Avoid peak exposure hours from 9 a.m. to 1 p.m.
- C. Wear loosely woven clothing for added ventilation.
- D. Apply sunscreen with a sun protection factor (SPF) of 15 or more before sun exposure.
Correct Answer: D
Rationale: Applying sunscreen with SPF 15 or higher before sun exposure is a key measure to prevent UV damage. Sunscreen should be applied before water exposure, peak hours are 10 a.m. to 4 p.m., and tightly woven clothing is better for protection.
A client with a total hip replacement asks about resuming sexual activity. Which response by the nurse is most appropriate?
- A. Wait at least 3 months post-surgery.'
- B. Avoid positions that flex the hip beyond 90 degrees.'
- C. Resume when you feel no pain.'
- D. Use a soft mattress for comfort.'
Correct Answer: B
Rationale: Avoiding excessive hip flexion prevents dislocation during sexual activity post-hip replacement.
Bethanechol (Urecholine) has been ordered for a client with gastroesophageal reflux disease (GERD). The nurse should assess the client for which of the following adverse effects?
- A. Constipation.
- B. Urinary urgency.
- C. Hypertension.
- D. Dry oral mucosa.
Correct Answer: B
Rationale: Bethanechol, a cholinergic agent, can cause urinary urgency as an adverse effect due to its stimulation of smooth muscle contraction, including in the bladder.
The nurse is preparing to administer an intradermal injection. Which of the following would be appropriate action by the nurse?
- A. Displace the skin to the side and inject at a 15 degree angle
- B. Position the needle bevel up at 15 degrees
- C. Position the needle bevel up at 45 degrees
- D. Position the needle bevel up at 90 degrees with a dart-like motion
Correct Answer: B
Rationale: Intradermal injections require a 15-degree angle with the bevel up to ensure shallow administration.
Which intervention is appropriate for a client on hemodialysis?
- A. Check fistula for a thrill.
- B. Restrict all fluids.
- C. Administer heparin post-dialysis.
- D. Encourage high-protein diet.
Correct Answer: A
Rationale: Checking for a thrill ensures fistula patency for dialysis.