A client has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

Correct Answer: C

Rationale: The correct answer is option C: "I will apply the patch to an area of skin with no hair." This statement indicates that the client understands the instructions for applying transdermal patches correctly. This is the correct answer because applying the patch to an area of skin without hair helps ensure proper adhesion and absorption of the medication. Hair can interfere with the patch's ability to adhere securely to the skin and deliver the medication effectively. Option A is incorrect because cleaning the site with an alcohol swab before applying the patch is a good practice, but it is not the best indicator of understanding the instructions. Option B is incorrect because rotating the application sites weekly is important to prevent skin irritation and ensure consistent drug absorption, but it does not specifically demonstrate understanding of the instructions. Option D is incorrect because placing the new patch where the old patch was is not recommended as it can lead to skin irritation and uneven absorption of the medication. In an educational context, it is essential for nurses to educate clients on the proper administration of transdermal patches to ensure optimal therapeutic outcomes and minimize potential adverse effects. Proper site selection, preparation, and rotation are crucial aspects of transdermal patch administration that nurses should emphasize to clients.

Correct Answer: A

Rationale: In this pharmacology question, the correct answer is A) 0.8 mL. To determine this, the healthcare professional needs to calculate the volume of heparin needed to administer 15,000 units, knowing that the concentration is 20,000 units/mL. The correct calculation is: 15,000 units ÷ 20,000 units/mL = 0.75 mL However, since the available concentration is 20,000 units/mL, the healthcare professional needs to round up to the nearest available volume increment, which is 0.8 mL in this case. Option B) 0.75 mL is the calculated exact volume needed, but in practice, it should be rounded up to ensure the full dose is administered. Option C) 0.5 mL is too low and would not provide the required dose. Option D) 1 mL is too high and would result in administering more heparin than necessary, potentially leading to adverse effects. Understanding dosage calculations is crucial in pharmacology to ensure accurate medication administration and patient safety. Healthcare professionals must be proficient in these calculations to provide effective care to patients.

Correct Answer: B

Rationale: The nurse should withhold the medication and inform the provider of the client's previous rash after taking penicillin. This history suggests a potential allergic reaction to penicillin, which can range from mild to severe anaphylaxis. Notifying the provider allows for an alternative antibiotic to be prescribed, considering the client's allergy to penicillin. It is crucial to avoid administering a medication that could potentially lead to a severe allergic reaction in the client.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Reduced hepatic function. The drowsiness experienced by the older adult client can be attributed to reduced hepatic function, which leads to decreased metabolism and clearance of medications from the body. Hypnotic medications, such as sedatives and sleep aids, are metabolized in the liver, and in individuals with reduced hepatic function, these drugs can accumulate in the body, leading to prolonged sedative effects. Option A) Reduced cardiac function is not directly related to the drowsiness caused by the hypnotic medication. Cardiac function primarily affects blood circulation, not the metabolism of drugs. Option B) First-pass effect refers to the initial metabolism of a drug in the liver before it reaches systemic circulation. While it is a relevant pharmacokinetic concept, it is not the primary reason for the client's drowsiness in this case. Option D) Increased gastric motility would not typically result in drowsiness. Gastric motility relates to the movement of food through the digestive system and is not directly linked to the sedative effects of hypnotic medications. Educationally, this question highlights the importance of considering age-related changes in pharmacokinetics, particularly hepatic function, when administering medications to older adults. It underscores the need for nurses to be aware of how age-related physiological changes can impact medication responses and side effects in this population.

Correct Answer: A

Rationale: Orthostatic hypotension is a known adverse effect of Phenelzine, a monoamine oxidase inhibitor (MAOI) used for depression. It is caused by a sudden drop in blood pressure when changing positions, leading to symptoms like dizziness or fainting. Monitoring for orthostatic hypotension is crucial during Phenelzine therapy to prevent complications.