Quiz 8: Pain management

Choose the one, most correct answer to each question or statement.

1. Pain is:
   • What the patient says hurts (subjective)
   • What another person observes (objective)
   • Any unpleasant emotional experience
   • Not felt as intensely by babies
2. Which of the following statements is correct?
   • Children do not feel pain
   • Children will always tell you when they are in pain
   • Children exposed to repeated investigations and procedures will not get used to pain
   • Accurate pain assessment is possible in all children
3. What causes nociceptive pain?
   • Damage to peripheral nerves
   • Damage to sympathetic nerves
   • A response to grief or loss
   • Stimulation of the pain receptors when tissues are damaged
4. Neuropathic pain can be described as:
   • A burning, stabbing, stinging pain or pins and needles
   • A squeezing or cramping pain
   • An aching or throbbing pain
   • A tightening or cramping pain
5. What is total pain?
   • Physical, psychosocial, spiritual and cultural pain
   • All the pain that the child experiences in a day
   • The score on a pain rating tool
   • Both a verbal and non-verbal expression of pain
6. How do children express their pain?
   • They will always cry when they are in pain
   • They will always stop eating when they are in pain
   • They will express their pain in a manner according to their developmental stage
   • If they can talk, they will always say when they are in pain
7. An assessment of a child’s pain:
   • Is a once off process
   • Is an ongoing process
   • Can only be done by using pain rating scales
   • Is only necessary if the family ask for it
8. When assessing pain in children it is necessary to:
   • Only question the family about their child’s pain
   • Question both the child and the parents and try and assess the pain for yourself
   • Assess the pain for yourself without involving the child or family
   • Only question the child about their pain
9. Using the QUESTT approach to pain assessment is:
   • A recommended approach to pain assessment in children
   • Not a reliable method of assessing pain
   • Only suitable for adults
   • Too expensive to use in many countries
10. Pain rating scales are useful for:
    • Parents to decide the severity of the child’s pain
    • Weighing children to calculate medicine dosages
    • Deciding on the smallest dose of pain medicine for a child
    • Guiding treatment and monitoring the response to the treatment and interventions
11. The FLACC scale is a pain rating scale that is used to assess pain in:
    • Adolescents
    • Children between 5 and 6 years
    • Children between 3 and 5 years
    • Infants and children under 3 years
12. Which pain rating scales can be used to assess pain in children over the age of 7 years?
    • Numerical rating scale
    • NIPS
    • Revised faces pain scale
    • Ten finger pain scale
13. The main aim of pain management is to:
    • Decrease the time the child spends away from school
    • Make the child easier to manage in hospital
    • Prevent the parents complaining to the hospital management
    • Improve the quality of life for both the child and the family by relieving their pain
14. What measures must you use to manage a child’s pain?
    • Non-pharmacological measures only
    • Pharmacological measures only
    • Only distraction measures like reading story’s and blowing bubbles
    • Both non-pharmacological and pharmacological measures
15. According to the World Health Organization (WHO) the broad principles of analgesic use are to:
    • Give analgesia according to a fixed dose and schedule
    • Give analgesia according to the wishes of the parents
    • Give analgesia by the appropriate route, by the clock, by the individual child and by the ladder
    • Give analgesia only when the caregiver thinks that the child is in pain
16. On step three of the WHO pain ladder which of the following is used for severe pain?
    • A strong opioid (morphine)
    • A weak opioid (Valoron)
    • A non-opioid (paracetamol)
    • A co-analgesic (Brufen)
17. Which of the following statements is true about morphine?
    • If morphine is given it means the child is nearing the end of their life
    • Children will develop an addiction to morphine if it is used for extended periods
    • Morphine is dangerous as it will suppress respiration
    • Morphine is a versatile drug with no ceiling dose
18. What is the correct dose when starting morphine?
    • 0.1 mg/kg hourly
    • 0.1 mg/kg 2 hourly
    • 0.2 mg/kg 4 hourly
    • 0.2 mg/kg 8 hourly
19. Why is it important to treat procedural pain in children?
    • It is a major cause of anxiety and fear in the child and may have long term effects on how they cope and tolerate pain in the future
    • So that the child will not cry and upset the other patients
    • To make it easier for the healthcare worker to hold the child during the procedure
    • Parents do not like to see their child suffering
20. Which of the following techniques is the best way to manage procedural pain in a newborn baby?
    • Non-nutritive sucking
    • Swaddling
    • Sedating the baby
    • Giving analgesia, e.g. paracetamol