Deck 41: Pain Assessment and Management in Children

Question 1

In responding to the needs of pediatric patients in pain, the nurse has numerous nonpharmacologic interventions available. These interventions include:

A)Regional nerve block.
B)Cutaneous stimulation.
C)Application of heat.
D)Electroanalgesia.
E)Use of EMLA cream.

Answer 1

Cutaneous stimulation.
Application of heat.
Electroanalgesia.

Question 2

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

A)Place the child on a cardiac monitor.
B)Allow parents to stay with the child.
C)Monitor pulse oximetry.
D)Assess the child's respiratory effort.

Answer 2

Assess the child's respiratory effort.

Question 3

During shift report, the night nurse reports that the child who is terminally ill has developed tolerance to the morphine that the child has been receiving. The oncoming nurse realizes that the child:

A)Is physically dependent on morphine.
B)Is addicted to morphine.
C)Is showing physical signs of withdrawal.
D)Will need more medication to achieve the same effect.

Answer 3

Will need more medication to achieve the same effect.

Question 4

The nurse is taking care of a seven-year-old child who is postoperative. The child's mother requests that the child not receive narcotics in the postoperative period because she is afraid the child will become addicted. The nurse would explain to the mother that children who do not receive adequate pain control will be at risk for:

A)Respiratory complications.
B)Urinary complications.
C)Cardiac complications.
D)Bowel complications.

Question 5

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

A)Poker Chip Tool.
B)Oucher Scale.
C)Faces Pain Rating Scale.
D)FLACC Behavioral Pain Assessment Scale.

Question 6

A six-year-old postoperative patient IV has infiltrated and has to be restarted immediately for medication. There is no time for placing local anesthetic cream on the skin. What other complementary therapies would be most helpful when placing this IV?

A)Restraints
B)Moderate sedation
C)Anesthesia
D)Distraction

Question 7

The nurse administered morphine intravenously to a four-year-old postoperative patient. Thirty minutes later, the nurse assesses the child. Which assessment finding requires further evaluation?

A)Pulse decreased from 136 to 104
B)Blood pressure dropped from 110/72 to 90/55
C)Respiratory rate went from 42 to 16
D)Child pulls away from nurse who wants to assess surgical site

Question 8

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

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

Question 9

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

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

Question 10

A five-year-old is hospitalized with a fractured femur. Which assessment tool is appropriate for this child?

A)CRIES Scale
B)Faces Pain Rating Scale
C)SUN Scale
D)PIPP Scale

Question 11

The nurse is caring for a four-year-old child who is intellectually disabled and is scheduled for surgery tomorrow. The nurse wants to plan postoperative care and pain relief. The nurse will determine the best pain assessment tool by observing the child's:

A)Language skills.
B)Understanding of the concept of more and less or otherwise has the ability to quantify pain.
C)Ability to sit for a ten minute evaluation.
D)Ability to perceive pain.
E)Ability to understand pain.

Question 12

An analgesic is ordered for a post-surgical patient to be given every three to four hours. The nurse knows that a delay in giving the medication will cause a(n):

A)Decrease in the chance of withdrawal symptoms.
B)Decrease in the chance of addiction.
C)Increase in the chance of breakthrough pain.
D)Increase in the child's pain tolerance.

Question 13

The clinical nurse specialist is concerned about children's reactions to painful invasive procedures such as intravenous starts. The nurse has decided to use distraction as a means to comfort the school-age child. Depending on the age of the school-age child, which technique might the nurse use to distract the child?

A)Blowing bubbles
B)Music therapy
C)Guided imagery
D)Hypnosis
E)Sucrose solution

Question 14

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

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

Question 15

A nurse is taking care of a patient in the ICU who has been on opioids for an extended period of time. The nurse understands that the child has to slowly wean from the medication over a period of time. While weaning, the nurse will observe the child for symptoms of too rapid withdrawal, including:

A)Hyperactive deep tendon reflexes, vomiting, and abdominal cramps.
B)Bradycardia and pallor.
C)Decreased blood pressure and drowsiness.
D)Voracious appetite and hypotonicity.

Question 16

During the nurse's initial assessment of a school-age 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)Reassess the child in 15 minutes to see if the pain rating has changed.
B)Administer the prescribed analgesic.
C)Do nothing, since the child appears to be resting.
D)Ask the child's parents if they think the child is hurting.

Question 17

The nurse is working in a pediatric surgical unit. The nurse would expect that patient-controlled analgesia would be most appropriate for which patient?

A)Twelve-year-old who is postoperative for spinal fusion for scoliosis
B)Ten-year-old who has a fractured femur and concussion from a bike accident
C)Five-year-old who is postoperative for tonsillectomy
D)Developmentally delayed 16-year-old who is postoperative for bone surgery.

Question 18

The postoperative unit of the pediatric hospital has several children who had surgery this morning. While making rounds, the nurse observes all of the following behaviors. Which child should be further evaluated as to postoperative pain?

A)The six-month-old in deep sleep
B)The two-year-old who is cooperative when the nurse takes his vital signs
C)The four-year-old who is actively watching cartoons
D)The 14-month-old who is thrashing his arms and legs