A 79-year-old patient reports a pain level of 3 out of 10 and states, “Don’t worry, this is just part of getting old.” What is the best response?

Choice A rationale:

While explaining the importance and rationale of the new policy can be helpful, it may not address the underlying reasons for the nurse's resistance.

If the nurse does not understand or agree with the rationale, they may still be resistant to change.

Additionally, simply providing information may not create an open and trusting environment where the nurse feels comfortable expressing their concerns.

Choice B rationale:

Encouraging the nurse to verbalize their concerns allows the nurse manager to understand the specific reasons for the resistance.

This can help to identify any misconceptions or concerns that can be addressed directly.

It also gives the nurse an opportunity to feel heard and understood, which can help to build trust and rapport. When nurses feel that their concerns are being taken seriously, they are more likely to be open to change.

Choice C rationale:

Threatening disciplinary action is likely to create resentment and further resistance. It may also damage the relationship between the nurse manager and the nurse.

This approach should only be used as a last resort, after other attempts to address the resistance have failed.

Choice D rationale:

Ignoring the resistance is not an effective strategy.

It is likely to lead to continued noncompliance with the new policy,

It may also send the message that the nurse manager does not care about the nurse's concerns.

Peer pressure can sometimes be helpful in facilitating change, but it should not be relied upon as the sole strategy.

Choice A rationale:

Awaiting biopsy results can certainly cause anxiety and stress, but it doesn't directly impact the physiological mechanisms that modulate pain perception.

While a patient awaiting biopsy results may be more attentive to their bodily sensations, including pain, the anxiety itself is not the primary driver of a lowered pain threshold.

It's important to address the patient's concerns and provide emotional support, but this alone may not be sufficient to manage pain effectively if anxiety is not the primary factor.

Choice B rationale:

Anxiety activates the sympathetic nervous system, which triggers the "fight-or-flight" response. This cascade of physiological changes includes:

Increased heart rate and blood pressure Muscle tension

Dilated pupils

Heightened awareness of bodily sensations

These physiological changes can amplify pain signals and lower the pain threshold, meaning that a person who is anxious may perceive pain more intensely than someone who is calm and relaxed.

This is because anxiety can reduce the effectiveness of the body's natural pain-inhibiting mechanisms, such as the release of endorphins and serotonin.

Choice C rationale:

Difficulty sleeping can also contribute to pain, but its effect on pain threshold is less direct than that of anxiety. Sleep deprivation can lead to:

Increased irritability Decreased pain tolerance Impaired cognitive function

These factors can make it more difficult to cope with pain, but they don't directly lower the threshold at which pain signals are perceived.

Choice D rationale:

Pain threshold varies among individuals due to a variety of factors, including: Genetics

Past experiences with pain Psychological factors Cultural beliefs

Coping mechanisms

It is incorrect to assume that all patients who have had surgery will have the same pain threshold.