A nurse should instruct a client who has been taking fentanyl (Duragesic) for several weeks to

• A. Increase the dosage when pain persists for several hours
• B. Taper this medication slowly when discontinuing its use
• C. Limit physical activity while on this medication
• D. Vigorously rub medication into skin

Answer: (B)

Long-term fentanyl use can cause physical dependence, so stopping abruptly can trigger withdrawal and destabilize pain control. Because the patch delivers a steady amount of drug over several days, the appropriate approach when discontinuing is to taper the dose slowly under supervision, gradually reducing exposure to the medication and minimizing withdrawal symptoms while maintaining analgesia. If breakthrough pain occurs, it should be managed with short-acting analgesics rather than increasing the patch dose. Other options aren’t correct: abruptly increasing the patch for hours of pain isn’t safe or effective, limiting physical activity isn’t required, and the patch should be applied to clean, dry skin without vigorous rubbing.