A patient with chronic pain is prescribed a fentanyl patch. What is the most important instruction for the nurse to provide?

Correct Answer: B

Rationale: The correct answer is B: Change the patch every 72 hours. Fentanyl patches are typically designed to be worn for 72 hours before being replaced to maintain consistent pain relief. Changing the patch on time helps prevent withdrawal symptoms and ensures the effectiveness of the medication. A: Applying the patch to a different site each time is important to prevent skin irritation but is not the most crucial instruction. C: Avoiding heating pads over the patch is important to prevent overheating and excessive absorption of the medication, but changing the patch timely is more critical. D: Removing the patch before showering is not necessary as fentanyl patches are designed to be water-resistant.

Correct Answer: B

Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival overgrowth as a side effect. This is due to its effect on fibroblasts in the gums, leading to increased connective tissue production. Hypotension (A), bradycardia (C), and hyperkalemia (D) are not common side effects of phenytoin. Monitoring for gingival hyperplasia is crucial to prevent complications such as difficulty in eating, speaking, and maintaining oral hygiene.

Correct Answer: B

Rationale: The primary purpose of prescribing salmeterol is to prevent asthma attacks. Salmeterol is a long-acting beta agonist that helps to relax the muscles of the airways over an extended period, reducing the likelihood of bronchospasms and asthma exacerbations. It is not used for relieving acute bronchospasm (choice A), suppressing cough (choice C), or thinning respiratory secretions (choice D) as these are not the main therapeutic effects of salmeterol in asthma management.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Dabigatran is an anticoagulant medication that comes in capsules, which should not be crushed or chewed to maintain its extended-release formulation. 2. Crushing or chewing the capsules can lead to an increased risk of bleeding due to rapid release of the medication. 3. Therefore, advising the patient not to crush or chew the capsules is crucial to ensure the safety and efficacy of dabigatran therapy. Summary: A: Taking with food is not necessary for dabigatran absorption. C: Green leafy vegetables are high in vitamin K, which can interfere with anticoagulant therapy. D: There is no need to avoid all dairy products while taking dabigatran.

Correct Answer: B

Rationale: The correct answer is B: Relieve bronchospasm. Ipratropium is an anticholinergic bronchodilator that works by relaxing the muscles in the airways, leading to bronchodilation and improved airflow. This helps to relieve bronchospasm, a common symptom in COPD. Choice A is incorrect because ipratropium does not have significant anti-inflammatory effects. Choice C is incorrect as ipratropium does not directly suppress cough. Choice D is incorrect as ipratropium does not specifically target respiratory secretions.