Assessing Pain: Texts

Text A

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 Text B

Pain Assessment Tools

Tools used for pain assessment have been selected on their validity, reliability and usability and are
recognised by pain specialists to be clinically effective in assessing acute pain. All values are documented on
the clinical observation chart as the 5th vital sign.

Three ways of measuring pain:

• Self report – what the child says (the gold standard)

• Behavioural – how the child behaves
• Physiological – clinical observations

Physiological indicators
Physiological indicators in isolation cannot be used as a measurement for pain. A tool that incorporates
physical, behavioural and self report is preferred when possible. However, in certain circumstance (for
example, the ventilated and sedated child) physiological indicators of pain can be helpful to determine a
patient’s experience of pain.

These include:
• heart rate may increase
• respiratory rate and pattern may shift from normal ie: increase, decrease or change pattern
• blood pressure may increase
• oxygen saturation may decrease

Text C

Wong-Baker faces pain scale

The Wong-Baker faces pain scale uses self report of pain to assess a patient’s experience of pain. It can be used
in children aged between 3 and 18 years of age, depending upon their cognitive ability.

Explain to the patient that each face helps us understand how much pain they have, and how this makes
them feel. Face 0 is very happy because he doesn't hurt at all (i.e has no pain). Face 2 hurts just a little bit.
Face 4 hurts a little more. Face 6 hurts even more. Face 8 hurts a whole lot. Face 10 hurts as much as you can
imagine, although you don't have to be crying to feel this bad. Ask the person to choose the face that best
describes how he is feeling.

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 Text D

FLACC: Face, Legs, Activity, Cry and Consolability

The FLACC is a pain assessment tool that uses that patient’s behaviour to
assess their pain experience. It can be used for children aged between
2 months and 18 years of age, and up to 18 years of age in children with
cognitive impairment and/or developmental disability.

Each category (Face, Legs etc) is scored on a 0-2 scale, which results in
a total pain score between 0 and 10. The person assessing the child should
observe them briefly and then score each category according to the
description supplied.

END OF PART A

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OET ONLINE – READING
TEST 1

A1

INSTRUCTIONS
Type all your *s in the * box provided.
One mark will be granted for each correct *.
* ALL questions. Marks are NOT deducted for incorrect *s.

Part A
TIME: 15 minutes
Look at the four texts, A-D, in the separate Reading Part A: Text Booklet.
For each question, 1-20, look through the texts A-D, to find the relevant information.
Type your *s in the * box provided.
* all the questions within the 15-minute time limit.
Your *s should be spelled correctly.
Information text
For each of the questions, 1 – 7, decide which text (A, B, C or D) the information comes from. You may use any letter
more than once.

In which text can you find information

1. regarding necessary considerations when assessing a child’s pain level?_ _________

2. the methods used to measure pain? ___________

3. specific factors to note when assessing a child’s pain? __________

4. a tool that uses behavioural responses to assess pain level. __________

5. the rating scale to use for self report when assessing pain? _________

6. how to assess a patient’s pain level via their facial expression?________

7. signs of pain to be aware of in a patient who is under sedation? _______

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each of the questions, 8-13, with a word or short phrase from one of the texts. Each * may include words, numbers or
both.
Rules of Use:
Spell all words correctly.
Use correct spacing between words.
Use correct punctuation.
Note: This is an automated system with a range of predetermined *s. As a result, sometimes a correct * choice may
be marked incorrect. Therefore, please refer to the * key to determine if your * is correct.
*
8- Which pain assessment tools should be used in children who are developmentally disabled or too young to speak?
_______________________________________________________

9- What is the maximum age for behavioural assessment of pain in an intellectually disabled patient?
_______________________________________________________

10 - What risk should you be aware of when assessing pain in children with disabilities?
_______________________________________________________

11- Who can help provide better assessment of pain in disabled children?
_______________________________________________________

12- Where should pain values be documented?

_______________________________________________________

13- How often should all children have their pain scores recorded?
_______________________________________________________

Questions 14 - 20
Complete the sentences, in questions 15-20, with a word or short phrase from one of the texts. Each * may include
words, numbers or both. Your *s should be spelled correctly.

14- Self reporting is considered to be _______________when measure pain in children.

15- You should avoid using__________________ observations on their own as a way of measuring pain.

16- You should ensure the patient understands they need to choose the__________________that most accurately
represents their mood when self reporting.

17- Don’t have patients self report if they lack the required __________________ability

18- Make sure to allocate a score of between__________________for each sub-group when evaluating the behavioural
responses of a child.

19- The maximum possible pain score should be given to a patient if you notice it is hard to __________________them

20- Pain should be assessed and recorded __________________analgesia.

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 B1

The spicial access scheme should be used when :

A. the patient requires specialised treatment.

B. all other possibilities have been exhausted.
C. the standard of the product has been verified.
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What needs to be considered when recommending the use of cough and cold medicines in children?
Select one:
A. The possible dangers.
B. The low success rate.
C. The age of the child.

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\

The memo tells us that the new form

Select one:
A. replaces all previous airway forms.
B. is designed to reduce airway incidences.
C. can be used in a variety of airway situations.
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The guidelines inform us that pregnancy testing

Select one:
A. is compulsory for any woman who suspects she may be pregnant.
B. may result in scheduled treatment being postponed or cancelled.
C. should be conducted in accordance with established procedures.

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The policy recommends that vitamin K be given to infants
A. by a trained health professional.
B. within the first month of birth.
C. only if they are healthy.
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The update on cosmetic and discretionary surgery informs us

A. who is eligible to provide surgery.
B. when surgery should be performed.
C. the process for approval of surgery.

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 C1.1
Text: Healthy Ageing

The writer says the INTERHEART study found that stress

A. is conditional on how much money a person earns.

B. can be affected by a person’s level of social integration.

C. affects people from some nations more than others.

D. is worse in people who already have health concerns.

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In the second paragraph, the writer cites several studies to suggest:

A. the quality of a person’s relationships is integral to their health.

B. being on your own as you age may lead to premature death.

C. some diseases are more affected by loneliness than others

D. there are many contributing factors that lead to poor health.

What does the phrase ‘the effect’ refer to?

A. Other issues that reduce mortality rates.

B. A person’s chance of staying healthy.

C. The influence of being on your own.

D. Having enough people in your life.

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What point does the writer make in the third paragraph?
Select one:
A. The causes of social isolation differ between the US and Europe.
B. More research has been done into social isolation than social integration.
C. Social integration assists in minimising heart disease by altering nerve impulses.
D. Social isolation affects women while social integration has a greater effect on men.
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The writer suggests the ‘package’ developed by the WHO

Select one:
A. has a strong focus on saving money.
B. encourages elderly people to take responsibility for their lives.
C. fails to acknowledge dangers beyond lifestyle choices and eating habits.
D. carefully balances a range of issues that impact on an individual’s well-being.

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The phrase ‘in the shadows’ suggests that social participation

A. is difficult to understand.

B. has become hidden.

C. is largely unknown.

D. has been ignored.

In the fifth paragraph, the writer expresses the view that

A. the approach by the WHO is too simplistic.

B. people in low-income areas have worse health.

C. lifestyle factors are not the only cause of illness.

D. irresponsible behaviour causes most health problems.

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The writer suggests that social participation is not encouraged in the WHO package because

A. studies of this kind would be challenging to complete.

B. it is a new area of research with limited data to support it.
C. they have an obligation to focus on areas that promote profits.
D. there is no indication it would make any difference to a person’s health.

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 C1.2
Text: No Scientific Proof That Multivitamins Promote Heart Health
For questions 1 to 8, choose the answer (A, B, C or D) which you think fits best according to the text.

DrJoonseok Kim uses the expression ‘settle the controversy’ to suggest there is
Select one:

A. a lack of agreement about the efficacy of MVM supplement use.

B. confusion over the terms used to define cardiovascular disease.
C. a dispute over the findings from his latest published research.
D. misunderstanding about the methods used during his study.

What are Dr JoAnn Manson’s views on multivitamins?

A. Far too many people take them.

B. They help fight certain illnesses.
C. We still don't know enough about them.
D. They shouldn't replace a nutritional diet.

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The writer explains the systematic review and meta-analysis of the studies reviewed by Dr Kim to highlight

A. the amount of categories it covered.

B. how many people it included.

C. the age of the participants.

D. its global scope.

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What does the word ‘they’ in the fourth paragraph refer to?

A. Multivitamins.

B. Some vitamins.

C. Health and well-being.

D. Cardiovascular events.

How do Dr Haslam and Dr Prasad feel about multivitamin use for cardiovascular disease

A. They are positive about their future application.

B. They believe that some help and some don’t.

C. Although they appear to be promising, ultimately they don’t work.

D. Scientifically speaking they are still one of the best options available.

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What particularly concerns Dr Manson?

A. The way some people take multivitamins instead of their prescribed medication.

B. The lack of understanding about the prolonged use of multivitamins.

C. The ineffectiveness of multivitamins in many patients.

D. The belief that multivitamins do no harm.

In the fifth paragraph, Dr Manson explains that supplements

A. should be regulated for use with particular diseases.

B. do have their place as a method of treatment.

C. work better in some people than others.

D. are helpful for vegetarians.

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The writer mentions the Physicians’ Health Study II to highlight that supplements

A. are ineffective in most situations.

B. may work better depending on a person’s gender.

C. may work best when combined with other vitamins.

D. are still being investigated as a way of treating serious illness.

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