A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?

Rationale: A. With long-term opioid therapy, the body becomes accustomed to the medication, and higher doses are required to achieve the same level of pain relief. This is expected in palliative and hospice care. B. Addiction involves psychological dependence, compulsive use, and loss of control. In hospice care, the focus is on comfort, and increasing doses due to tolerance does not indicate addiction. C. Confusion is a possible side effect of opioids, but it does not explain the client’s need to increase the dose for pain relief. D. Nonadherence might cause pain, but the client specifically reports increasing the dose to maintain relief, which is characteristic of tolerance, not improper use.