A 13-year-old with juvenile arthritis has been experiencing persistent joint pain for the past 4 months. Which statement BEST defines this type of pain?
Referred pain
Procedural pain
Chronic pain
Acute pain
The Correct Answer is C
A. Referred pain occurs when pain is perceived in an area different from the site of the actual tissue damage (e.g., shoulder pain from gallbladder disease). In this scenario, the pain is localized to the joints, not referred, so this is incorrect.
B. Procedural pain is short-term pain associated with medical procedures such as injections, IV insertions, or surgeries. Persistent joint pain lasting 4 months is not related to a procedure, so this is incorrect.
C. Chronic pain is defined as pain that persists longer than 3 months or beyond the expected period of healing. This 13-year-old has had joint pain for 4 months, meeting the criteria for chronic pain. Chronic pain in juvenile arthritis can affect physical activity, school performance, and psychosocial well-being, and requires long-term management strategies.
D. Acute pain is short-term, sudden in onset, and usually associated with tissue injury or inflammation, typically resolving within days to weeks. Pain lasting 4 months exceeds the acute timeframe, so this is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Macrosomia, defined as a birth weight greater than 4,000–4,500 grams, is the most common fetal complication associated with gestational diabetes. Hyperglycemia in the mother leads to increased glucose transfer across the placenta, stimulating fetal pancreatic insulin production. Fetal hyperinsulinemia acts as a growth-promoting hormone, resulting in excessive fat and muscle deposition and ultimately large-for-gestational-age infants. Macrosomia increases the risk of birth injuries such as shoulder dystocia, clavicle fractures, and the need for cesarean delivery.
B. Preterm birth is not the primary risk associated with GDM. While poorly controlled diabetes can contribute to preterm labor, it is less common than macrosomia. The main concern in GDM is excessive fetal growth, not premature delivery.
C. Low birth weight is not typically associated with gestational diabetes. In fact, infants of mothers with poorly controlled GDM are often larger than average, not smaller, due to fetal hyperinsulinemia and increased nutrient availability.
D. Congenital anomalies, particularly neural tube defects or central nervous system defects, are primarily associated with pregestational diabetes rather than GDM. Gestational diabetes develops later in pregnancy (usually after 24 weeks) when organogenesis has largely occurred, so the risk for major congenital anomalies is minimal.
Correct Answer is A
Explanation
A. EMLA cream (a eutectic mixture of local anesthetics) applied 30–60 minutes before a procedure under an occlusive dressing provides effective topical anesthesia, reducing pain at the venipuncture site. This is evidence-based practice for minimizing procedural pain in children and is particularly effective for needle insertions.
B. Administering a sugar solution (sucrose) is effective primarily for infants under 12 months and is most beneficial when given before or during painful procedures, not after. In a 5-year-old, it has minimal analgesic effect.
C. Applying a cold pack can provide some temporary numbing, but it is less effective than topical anesthetic creams for reducing pain during venipuncture. Additionally, short-duration cold application may not penetrate deep enough to anesthetize the vein adequately.
D. Distraction with toys can reduce anxiety and perceived pain but does not directly numb the insertion site. While helpful as a complementary measure, it is not as effective as topical anesthesia in reducing procedural pain.
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