Answer to Question 1
B
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A Incorrect. The nurse can rely on the patient's report to determine the need for pain medication. As long as the timing is suitable and the patient is stable, the nurse should administer the medication. However, the nurse should use assess-ment data to support withholding of pain medication in the presence of over-sedation or another assessment that would potentially be aggravated by pain medication administration.
B Correct. The nurse should administer the opioid pain medication as prescribed because the patient requested pain medication within the prescription's time limit. Most institutions allow the nurse to administer opioid medications 15 to 30 minutes before the designated time on the prescription, so the patient is not asking for the medication too early. In addition, the nurse has an obligation to the patient to administer the pain medication; not doing so violates the patient's rights.
C Incorrect. The nurse violates the patient's rights by stating that it is too soon for the medication and ignores the possibility that the patient's pain is real. Al-though the nurse may believe the patient is not having pain and is exhibiting drug-seeking behavior, the nurse must administer the medication. Since the pa-tient knows the timing of his pain medication, the nurse could be subject to legal and ethical ramifications of this statement.
D Incorrect. The nurse must administer the pain medication as requested and can use comfort measures to enhance the therapeutic effect of the medication.
Answer to Question 2
B
The practices of advanced practice nurses, who base their practice on nursing research, have re-sulted in positive older adult outcomes and cost effectiveness. The scientific community widely accepts the research. Advanced practice nurses generate positive outcomes and are cost effective in many settings. Mezey and Fulmer believe the goal of gerontological nursing is to disseminate the knowledge from gerontological nursing research to all nurses and to have the knowledge ap-plied to their practices.