ANSWERS GRADED A+ LATEST UPDATE.
1. A nurse is teaching a client who will start using transdermal fentanyl. Which
of the following statements should the nurse identify as an indication that the
client understands the teaching
A. "I can use an electric blanket while in bed"
B. "I will replace the patch every day"
C. "I should apply the patch to my upper thigh"
D. "I can take an oral analgesic for breakthrough pain": D
,Fentanyl is a transdermal opioid agonist for managing persistent, moderate to severe
chronic pain. It takes up to 24 hr after the client applies the patch for medication
levels to reach their peak. Use short acting analgesics to treat acute or breakthrough
pain
--
A, heat causes an increase in the release of the medication from the patch, as well
as vasodilation, which can increase the absorption of the medication
B, the patch releases the med steadily over 72 hrs, but some times they can change
it every 48 hr
C, apply the patch to the skin of the upper torso for optimal absorption
2. A nurse is teaching a client who has a new prescription for levodopa-
carbidopa. Which of the following instructions should the nurse include in the
teaching
A. Report muscle twitching to your provider
B. Reduce your daily fluid intake
C. Take the medication with a high protein meal
D. Discontinue the medication if your urine turns a dark color: A
Levodopa carbidopa can cause dyskinesias with toxicity and to report muscle
twitching, tremors, and spastic winking
--
B, reducing fluid intake can increase risk of orthostatic hypotension. Drink at least
2-3 L of fluid daily
,C, protein reduces the absorption of levodopa carbidopa
D, urine and sweat can become dark in color, but this is harmless
, 3. A nurse is caring for a client who has primary hypothyroidism and has been
taking levothyroxine for 8 weeks. The current thyroid stimulating hormone
(TSH) level is 5.2 microunits/mL. The nurse should expect which of the follow-
ing prescriptions regarding the client's medication?
A. Decrease in the dosage
B. Discontinue the medication
C. Increase in the dosage
D. Maintain the current dosage: C
A TSH of 5.2 is above the expected reference range, which indicates the thyroid
hormone level is not adequate (so the TSH is trying to increase to compensate and
release more thyroid hormone). Increase the dosage to achieve a therapeutic TSH,
undergo lab testing in 6-8 weeks after dosage increase to reassess the TSH level
4. A nurse is assessing a client who has chronic pain disorder and is request-
ing pain medication. Which of the following findings should the nurse identify
as the most reliable indicator of the client's pain
A. The client's behavior
B. Changes in the client's vital signs
C. The client's facial expression
D. The client's verbal report: D