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-naive client with acute postoperative pain
3 A client with intermittent mild pain who wants as-needed dosing
4 A febrile opioid-naive client using a heating pad over the application site

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.

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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

Medication-safety review
Verify indication, current assessment, dose and route, organ function, interactions, urgent toxicity cues, authorized action, and measurable follow-up.

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

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Which client is an appropriate candidate for a fentanyl transdermal system?

In-depth explanation

Clinical scenario

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