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NBME 2- block 4- terminal care - pranav
#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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#2
b.............
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#3
B.
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#4
C.?????????
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#5
BB
Reply
#6
C
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#7
totally confused.
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#8
hey, one of the important concepts of terminal care is to relieve pain, even if its going to bring the patient closer to death. giving stimulants is only going to prolong his agony. here we are not doing anything to actively kill the patient.
sounds a little warped, right?
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