The nurse is caring for a 4-year-old child who is demonstrating signs of pain. Which technique will the nurse use to best assess pain in this child?

Choice A reason: Asking if the patient is reliving trauma targets a core PTSD symptom—intrusive memories or flashbacks—critical for diagnosis per DSM-5 criteria. This question helps identify PTSD’s psychological impact, guiding interventions like cognitive behavioral therapy or SSRIs. Prioritizing this ensures timely recognition of PTSD, addressing the patient’s sleep disturbances and trauma-related distress effectively.

Choice B reason: Asking when the patient wakes up provides limited insight into PTSD. While sleep timing may indicate disturbances, it doesn’t address specific PTSD symptoms like intrusive memories or hyperarousal. This question is less urgent, risking delayed identification of PTSD, which requires targeted psychological assessment to guide therapy and medication for trauma-related nightmares.

Choice C reason: Describing phobias is irrelevant to PTSD assessment, as phobias are distinct anxiety disorders. PTSD involves trauma-specific symptoms like flashbacks, not generalized fears. This question misdirects focus from trauma-related sleep issues, potentially delaying PTSD diagnosis and appropriate interventions like trauma-focused therapy, leaving the patient’s nightmares and distress unaddressed.

Choice D reason: Asking about chest pain assesses physical symptoms unrelated to PTSD’s psychological profile, which includes nightmares and intrusive thoughts. While chest pain could indicate anxiety or cardiac issues, it’s not a priority for suspected PTSD. This question risks overlooking trauma-related symptoms, delaying psychological evaluation and support critical for the patient’s mental health recovery.

Choice A reason: Family relocation can cause stress or adjustment issues but is not a primary driver of developmental problems. It may temporarily affect social or academic progress, but its impact is less consistent than prolonged poverty, which has broader, long-term effects on development, making this an incorrect choice.

Choice B reason: Prolonged poverty is strongly linked to developmental problems, as it limits access to nutrition, healthcare, and education, impacting cognitive, physical, and emotional growth. Chronic socioeconomic stress can lead to developmental delays or behavioral issues, making this a critical sociocultural finding for the nurse to assess.

Choice C reason: Childhood obesity may indicate health issues like poor diet or inactivity, but its link to developmental problems is less direct than poverty. It can affect self-esteem or physical mobility but is not a primary sociocultural driver of broad developmental delays, making this a less critical finding.

Choice D reason: Loss of stamina is a vague symptom, often age-related or due to medical conditions, not a sociocultural factor. It does not directly indicate developmental problems, especially Dalin children, where poverty has a stronger impact on growth and milestones, making this an incorrect choice.