Practice Question
A nurse is teaching a newly licensed nurse about the use of a fentanyl transdermal patch. Which of the following instructions should the nurse include in the teaching?
Answer Choices:
Correct Answer:
"Inform the client that the patch will absorb slowly to provide pain relief."
Rationale:
🩹 Fentanyl transdermal patches are designed to provide slow, continuous absorption of medication through the skin over 48–72 hours.
🩹 This means the client should be taught that pain relief is not immediate and that it can take several hours to reach a therapeutic level.
🩹 Understanding the slow onset helps prevent the client from expecting rapid relief and requesting unsafe additional opioids too soon.
🩹 The patch is intended for chronic, stable pain control, not sudden or breakthrough pain.
🩹 Therefore, teaching that the patch absorbs slowly to provide ongoing pain relief is accurate and essential.
"Cut the transdermal patch in half prior to application."
🩹 Transdermal patches should never be cut, because doing so disrupts the controlled-release mechanism and can cause unpredictable dosing.
🩹 Cutting the patch may lead to a rapid release of fentanyl, increasing the risk of overdose and respiratory depression.
🩹 Manufacturers design patches to deliver medication at a specific rate, which is only safe when the patch is kept intact.
🩹 If a lower dose is needed, the provider should prescribe a different patch strength, not have the nurse cut the patch.
🩹 Therefore, instructing the nurse to cut the patch in half is unsafe and incorrect.
"Record the date directly on the patch."
🩹 While some facilities allow labeling directly on the patch, many safety standards discourage writing on the patch itself because ink or pressure might damage the drug matrix.
🩹 Best practice is usually to document the date, time, and location in the medical record and sometimes on tape next to the patch, not on the patch surface.
🩹 Writing on the patch can potentially compromise the integrity of the delivery system.
🩹 NCLEX-style questions typically look for the safest, most conservative practice, which is to avoid altering the patch in any way.
🩹 So this is not the best instruction to include in general teaching.
"Keep the previous patch in place along with each new patch."
🩹 Leaving the old fentanyl patch in place while applying a new one would lead to double dosing, significantly increasing the risk of fentanyl toxicity and respiratory depression.
🩹 The old patch still contains residual medication, so it must be removed, folded, and discarded properly before a new patch is applied.
🩹 Safe practice requires only one fentanyl patch to be active on the body at a time, unless specifically ordered and carefully managed by a specialist (which is rare and not implied here).
🩹 This teaching would lead to serious medication errors and harm.
🩹 Therefore, it is clearly incorrect and unsafe.
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This question is from RN Fundamentals 2023 EXAM 7 which contains 69 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Fundamentals of Nursing
- Answer Choices: 4