Editing Fundamentals of Nursing – RN Practice Questions (section)

==Question 5==
The nurse enters the room of a patient using intravenous patient controlled analgesia and finds the patient's spouse pressing the dose button while the patient sleeps. What is the nurse's best initial response?
# Document the finding and continue monitoring the patient.
# Explain that only the patient may press the button and assess the patient's sedation and respiratory status.
# Remove the patient controlled analgesia device and notify the provider.
# Reassure the spouse that this is acceptable if the patient is in pain.

'''Answer:''' 2. Explain that only the patient may press the button and assess the patient's sedation and respiratory status.

''Rationale:'' Patient controlled analgesia is safe because a sedated patient cannot press the button, so the patient's own level of consciousness limits the dose. Proxy dosing by family or staff removes that safeguard and can cause oversedation and respiratory depression. The nurse must both stop the unsafe behavior with education and immediately evaluate the patient for sedation, which precedes respiratory depression. Option 1 fails to correct the hazard. Option 3 is excessive as an initial action and would leave the patient without analgesia. Option 4 is unsafe and factually wrong.