A nurse is caring for a client is receiving hydromorphone HCL via PCA pump and reports continuous pain of 5 on a scale from 0 to 10. Which of the following actions should the nurse take first?

Rationale: A. While additional medication may be needed, the nurse must first assess the PCA pump to ensure it is functioning properly. B. The priority action is to assess the PCA pump settings and usage. The display will show how often the patient has attempted doses, how many were delivered, and whether the pump is functioning correctly. This helps determine the cause of inadequate pain control. C. The nurse should not independently administer a bolus without first assessing the PCA function and obtaining provider orders. D. Encouraging the patient to push the button may not be effective if the pump is malfunctioning or if the lockout interval is preventing delivery. Assessment comes first.