Deck 42: Pain Assessment and Management in Children

Question 1

During the nurse's initial assessment of a school-aged child,the child reports a pain level of 6 out of 10.The child is lying quietly in bed watching television.The nurse should:

A)Administer prescribed analgesic.
B)Ask the child's parents if they think the child is hurting.
C)Reassess the child in 15 minutes to see if the pain rating has changed.
D)Do nothing,since the child appears to be resting.

Answer 1

Administer prescribed analgesic.

Question 2

The nurse is working in a pediatric surgical unit.In discussing patient-controlled analgesia (PCA)in a preop parental meeting,the nurse would explain that PCA is most appropriate for the:

A)Developmentally delayed 16-year-old postop bone surgery.
B)4-year-old postop tonsillectomy.
C)10-year-old who has a fractured femur and concussion from a bike accident.
D)12-year-old postop spinal fusion for scoliosis.

Answer 2

12-year-old postop spinal fusion for scoliosis.

Question 3

A 5-year-old is hospitalized with a fractured femur.Which of the following assessment tools are appropriate for this age child? Select all that apply.

A)Faces pain scale
B)Oucher scale
C)Visual analog scale
D)CRIES scale
E)Poker chip tool

Answer 3

Faces pain scale
Oucher scale
Poker chip tool

Question 4

As an advocate for the child undergoing bone marrow aspiration,the nurse would most appropriately suggest:

A)General anesthesia.
B)Sedation prior to and during the procedure.
C)Intravenous narcotics 10 minutes before the procedure.
D)Oral pain medication for discomfort after the procedure.

Question 5

The nurse is admitting an 8-year-old Vietnamese child who hit a parked car while riding a bike.The child has a fracture of the left radius and femur in addition to a fractured orbit.The child is stoic,and denies pain.The most appropriate initial action by the nurse is to:

A)Use the FLACC scale to determine the child's pain level.
B)Tell the child to ring the call bell if the leg starts hurting.
C)Administer pain medication now and continue on a regular basis.
D)Ask the child's parents to notify the nurse if the child complains of pain.

Question 6

A 3-year-old is hospitalized following surgery for a ruptured appendix.Opioids were administered postoperatively to relieve pain.During assessment of the child,the nurse notes that the child is sleeping.Vital signs are as follows: temperature 97.8 $\degree$ F axillary,pulse 90,respirations 12,and blood pressure 100/60.Based on this assessment,the nurse concludes that the child is:

A)Comfortable,and the pain is controlled.
B)In shock secondary to blood loss during surgery.
C)Experiencing respiratory depression secondary to opioid administration for postoperative pain.
D)Sleeping to avoid pain associated with surgery.

Question 7

The nurse is caring for a child who has a long leg cast.The child complains of increasing pain in the toes of the foot in the cast.The nurse's initial action is to:

A)Call the physician to report increasing pain.
B)Administer pain medication.
C)Reposition the child in bed.
D)Check to see whether the cast is too tight.

Question 8

The nurse is preparing to perform a heel stick on a newborn.The most appropriate complementary therapy for the nurse to plan to use for the newborn to decrease pain during this quick but painful procedure is:

A)Swaddling.
B)Sucrose pacifier.
C)Massage.
D)Holding the infant.

Question 9

A 10-year-old has been receiving morphine every 2 hours for postoperative pain as ordered.The medication relieves the pain for approximately 90 minutes and then the pain returns.The nurse should:

A)Tell the child that pain medication cannot be administered more frequently than every 2 hours.
B)Reposition the child and quietly leave the room.
C)Inform the parents that the child is dependent on the medication.
D)Call the physician to see if the child's orders for pain medication can be changed.

Question 10

A parent asks the nurse if there is anything that can be done to reduce the pain that his 3-year-old experiences each morning when blood is drawn for lab studies.The most appropriate method the nurse can suggest to relieve pain associated with the venipuncture is:

A)Intravenous sedation 15 minutes prior to the procedure.
B)EMLA cream applied to skin at least 1 hour prior to the procedure.
C)Use of guided imagery during the procedure.
D)Use of muscle-relaxation techniques.

Question 11

The nurse is caring for a child who has been sedated for a painful procedure.The priority nursing activity for this child is:

A)Allowing parents to stay with the child.
B)Monitoring pulse oximetry.
C)Assessing the child's respiratory effort.
D)Placing the child on a cardiac monitor.

Question 12

A 2-year-old is hospitalized with a fractured femur.In addition to pain medication,which of the following will best provide pain relief for this child?

A)Parents' presence at the bedside
B)Age-appropriate toys
C)Deep-breathing exercises
D)Providing videos for the child to watch

Question 13

A 5-year-old is being discharged from the outpatient surgical center.Which statement by the parent would indicate the need for further teaching?

A)"I can expect my child to have some pain for the next few days."
B)"I will plan to give my child pain medicine around the clock for the next day or so."
C)"Since my child just had surgery today,I can expect the pain level to be higher tomorrow."
D)"I will call the office tomorrow if the pain medicine is not relieving the pain."

Question 14

The nurse is caring for a 2-year-old child in the postoperative period.The pain assessment tool most appropriate for assessment of pain intensity in a 2-year-old is the:

A)FLACC behavioral pain assessment scale.
B)Faces pain scale.
C)Oucher scale.
D)Poker chip tool.

Question 15

A hospitalized 3-year-old needs to have an IV restarted.The child begins to cry when carried into the treatment room by the mother.The most appropriate nursing diagnosis is:

A)Ineffective individual coping related to an invasive procedure.
B)Anxiety related to anticipated painful procedure.
C)Fear related to the unfamiliar environment.
D)Knowledge deficit of the procedure.