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nbme 1 4 10 - lilyvalley
#1
10. A mentally competent 76-year-old man is in the
terminal stage of
multiple myeloma. He is unable to move and requires
24-hour nursing
care. Increasing doses of narcotics are needed to
control severe pain.
As a result, when he is pain-free, respiratory
function is impaired and
consciousness is clouded. The patient says he cannot
live with this
degree of pain and asks to be given a lethal injection
of pain
medication. Which of the following is the most
appropriate step regarding the
pain medication?

A
) Reduce the dosage so as not to impair respiration

B
) Administer the dosage necessary to control pain
despite
respiratory impairment

C
) Administer the dosage necessary to control pain
and add a
centrally acting stimulant

D
) Appeal to the family to convince the patient to
tolerate a bit
more pain
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