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A
Ignoring the pain
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B
Cognitive-behavioral therapy (CBT) for pain — along with other evidence-based approaches including heat/cold therapy, TENS, massage, mindfulness-based stress reduction, and physical therapy/exercise therapy; multimodal pain management is the standard of care
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C
Prescribing maximum opioid doses immediately
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D
Telling the client pain is not real
Why this is the answer
CHRONIC PAIN management has evolved significantly with recognition that pain is complex — involving biological, psychological, and social factors (the biopsychosocial model). EVIDENCE-BASED NON-PHARMACOLOGICAL APPROACHES: COGNITIVE-BEHAVIORAL THERAPY (CBT) for pain: most evidence-based psychological approach; addresses catastrophizing, maladaptive thoughts, pain behaviors; improves functioning and quality of life even when pain intensity doesn't fully resolve; MINDFULNESS-BASED STRESS REDUCTION (MBSR): meditation-based approach; reduces pain-related distress; PHYSICAL THERAPY AND EXERCISE: counterintuitive but movement is generally beneficial for most chronic pain (including low back pain); reduces deconditioning and muscle atrophy; HEAT THERAPY: increases blood flow, relaxes muscles; for chronic muscle pain; not for acute inflammation; COLD THERAPY (CRYOTHERAPY): reduces inflammation and acute pain; numbs area; for acute injuries or inflammatory conditions; TENS (Transcutaneous Electrical Nerve Stimulation): low-level electrical current modulates pain signals; evidence moderate; useful adjunct; MASSAGE: reduces muscle tension; improves mood; evidence for some chronic pain types; BIOFEEDBACK: teaches physiological self-regulation; ACUPUNCTURE: evidence for some pain conditions (low back pain, osteoarthritis, headache); DISTRACTION: music therapy, guided imagery, virtual reality (newer, emerging evidence); POSITIONING AND ASSISTIVE DEVICES: proper positioning, orthotic devices for joint pain. MULTIMODAL ANALGESIA: the current standard of care combines multiple approaches (pharmacological and non-pharmacological) at lower doses to achieve pain control while minimizing side effects of any single approach. PN ROLE: teach and implement non-pharmacological measures; assess pain with validated tools (0-10 numeric, FACES, FLACC for children); document pain assessment and response to interventions; advocate for adequate pain management; avoid stigmatizing chronic pain patients.
Source: NCLEX-PN Test Plan: Physiological — Basic Care, Chronic Pain Management