CBRN Patient Education & Psychosocial Support 3 — Questions and Answers
Question 1: A pediatric burn patient (age 8) is refusing dressing changes despite adequate analgesia. Which psychosocial strategy is MOST effective?
- Restrain the child to complete the dressing change efficiently
- Use distraction techniques such as virtual reality or tablet games during the procedure (Correct answer)
- Postpone the dressing change until the child agrees
- Increase sedation for all future dressing changes
Correct answer: Use distraction techniques such as virtual reality or tablet games during the procedure
Non-pharmacological distraction (e.g., VR, interactive games) is evidence-based for reducing procedural pain and anxiety in pediatric burn patients.
Question 2: Which behavior in a burn patient MOST warrants immediate psychiatric consultation?
- Tearfulness when viewing their scars for the first time
- Expressing hopelessness and a wish not to survive (Correct answer)
- Requesting more frequent pain medication
- Asking detailed questions about the burn mechanism
Correct answer: Expressing hopelessness and a wish not to survive
Hopelessness and passive suicidal ideation require urgent psychiatric evaluation to ensure patient safety.
Question 3: Patient education about sun protection for healed burn scars should emphasize which key point?
- Scars need sunscreen only during summer months
- Healed scars lack melanocytes and are highly susceptible to UV damage and hyperpigmentation (Correct answer)
- SPF 15 provides adequate protection for mature scars
- Compression garments provide sufficient UV protection outdoors
Correct answer: Healed scars lack melanocytes and are highly susceptible to UV damage and hyperpigmentation
Burn scars are deficient in melanocytes, making them unable to tan and extremely vulnerable to UV-induced damage and discoloration.
Question 4: A burn survivor reports flashbacks and nightmares 6 weeks post-injury. The nurse should:
- Reassure the patient this is normal and will resolve without intervention
- Screen formally for PTSD and refer to psychology if criteria are met (Correct answer)
- Prescribe benzodiazepines for sleep
- Advise the patient to avoid thinking about the injury
Correct answer: Screen formally for PTSD and refer to psychology if criteria are met
Persistent re-experiencing symptoms at 6 weeks warrant formal PTSD screening and referral to mental health services for evidence-based treatment.
Question 5: Which statement best explains why body image disturbance is common after burn injury?
- Burns always cause permanent cognitive impairment affecting self-perception
- Visible scarring and functional changes disrupt the patient's pre-injury sense of physical self (Correct answer)
- Pain medications alter perception of body boundaries
- Isolation during hospitalization causes depersonalization
Correct answer: Visible scarring and functional changes disrupt the patient's pre-injury sense of physical self
Burn scarring permanently alters appearance and function, disrupting the patient's pre-injury body schema and requiring psychological adaptation.
Question 6: When teaching a patient to apply moisturizer to healed burn scars, the nurse should instruct them to:
- Apply moisturizer once daily after compression garment removal
- Apply non-scented, lanolin-free moisturizer 2–4 times daily with gentle circular massage (Correct answer)
- Use petroleum jelly exclusively as it is the most effective moisturizer
- Avoid moisturizer if the scar is still pink or raised
Correct answer: Apply non-scented, lanolin-free moisturizer 2–4 times daily with gentle circular massage
Frequent application of appropriate non-irritating moisturizers with massage improves scar pliability and prevents skin breakdown from dryness.
Question 7: A parent of a burned toddler states, 'I feel guilty — I should have been watching more carefully.' The nurse's BEST therapeutic response is:
- 'Try not to blame yourself; accidents happen.'
- 'I understand you're feeling guilty. Would you like to talk about what you're experiencing?' (Correct answer)
- 'Focus on your child's recovery rather than what happened.'
- 'Many parents feel this way but usually get over it quickly.'
Correct answer: 'I understand you're feeling guilty. Would you like to talk about what you're experiencing?'
Inviting the parent to express feelings without minimizing or redirecting opens therapeutic communication and validates their emotional experience.
CBRN Patient Education & Psychosocial Support 3
A pediatric burn patient (age 8) is refusing dressing changes despite adequate analgesia.
Which psychosocial strategy is MOST effective?