The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse. While performing a head to toe assessment, the nurse discovers four patches on the client's body. Which action should the nurse take first?

Choice A reason: This is not the first action for the nurse to take. Applying oxygen face mask may help the client with shortness of breath, but it does not address the underlying cause of the respiratory depression, which is the overdose of morphine. The nurse should first remove the source of the excess morphine and then provide oxygen therapy as needed.Choice B reason: This is the first action for the nurse to take. Removing the morphine patches is the most urgent and effective way to stop the further absorption of the drug and reduce the risk of life-threatening complications, such as respiratory arrest, coma, or death. The nurse should remove all the patches from the client's body and dispose of them safely. The nurse should also notify the healthcare provider and prepare to administer a narcotic reversal drug, such as naloxone, if indicated.Choice C reason: This is not the first action for the nurse to take. Administering a narcotic reversal drug may be necessary to reverse the effects of the morphine overdose, but it is not the most immediate intervention. The nurse should first remove the morphine patches to prevent further exposure and then assess the client's level of consciousness, respiratory rate, and oxygen saturation. The nurse should follow the healthcare provider's orders and the facility's protocol for administering a narcotic reversal drug.Choice D reason: This is not the first action for the nurse to take. Monitoring blood pressure may be important to assess the client's hemodynamic status, but it is not the most critical intervention. The nurse should first remove the morphine patches to prevent further deterioration and then monitor the client's vital signs, including blood pressure, pulse, and temperature. The nurse should also watch for signs of hypotension, shock, or cardiac arrest.