Clinical context A pain service is comparing four clients for a fentanyl transdermal system; all histories include opioid exposure, pain pattern, respiratory status, and need for sustained analgesia. Which client is an appropriate candidate for a fentanyl transdermal system?

1 An opioid-tolerant client with severe persistent pain requiring continuous around-the-clock opioid therapy ✓ Correct answer
2 An opioid-tolerant client with severe pain expected to resolve within 3 days after a procedure
3 An opioid-tolerant client whose intermittent pain is controlled with as-needed oral opioid doses
4 An opioid-tolerant client with persistent pain who currently has acute respiratory depression and a rate of 7/min

Explanation

Transdermal fentanyl is reserved for opioid-tolerant clients with severe persistent pain requiring continuous therapy. It is not for acute, postoperative, intermittent, or opioid-naive use, and external heat can increase absorption.

Next question on this topicA client is admitted to the emergency department after ingesting an unknown amount of acet…From this question bankL4-4. Pharmacology Safety TrainerKRW 18,000 · Free trial

In-depth explanation

Quick answer
Require opioid tolerance, persistent pain, and no heat exposure.

Why this is correct
Patch delivery continues for days and cannot be titrated like a short-acting rescue dose.

Easy analogy or mental picture
Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.

References

1DailyMed: Fentanyl Transdermal SystemOpioid-tolerant indication and fatal heat-related absorption risk

Clinical scenario

Clinical context
A pain service is comparing four clients for a fentanyl transdermal system; all histories include opioid exposure, pain pattern, respiratory status, and need for sustained analgesia.

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For study reference only. Always follow current clinical guidelines and your institution’s protocols.

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Clinical context A pain service is comparing four clients for a fentanyl transdermal system; all histories include opioid exposure, pain pattern, respiratory status, and need for sustained analgesia. Which client is an appropriate candidate for a fentanyl transdermal system?

In-depth explanation

Clinical scenario

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