Deck 15: Pain Assessment and Management in Children

Question 1

The adolescent is 6-hours postappendectomy and refuses pain medications. The nurse would like to walk the child in the hall but is concerned that the child has unrelieved pain. The nurse knows that unrelieved pain causes physiologic consequences such as (Select all that apply.)
1) Atelectasis
2) Pneumonia
3) Ileus
4) Lethargy
5) Hypoactive bowel sounds

Answer 1

1, 2, 3

Question 2

The nurse is caring for a toddler client in the postoperative period. Which pain assessment tool is most appropriate for this client?
1) FLACC Behavioral Pain Assessment Scale
2) FACES pain scale
3) Oucher scale
4) Poker-chip tool

Answer 2

1

Question 3

A school-age client has been receiving morphine every two hours for postoperative pain as ordered. The medication relieves the pain for approximately 90 minutes, and then the pain returns. Which action by the nurse is the most appropriate?
1) Tell the child that pain medication cannot be administered more frequently than every two hours.
2) Reposition the child and quietly leave the room.
3) Inform the parents that the child is dependent on the medication.
4) Call the healthcare provider to see if the child's orders for pain medication can be changed.

Answer 3

4

Question 4

As an advocate for the child undergoing bone-marrow aspiration, which intervention would the nurse suggest to decrease the pain experienced due to the procedure?
1) General anesthesia
2) Conscious sedation
3) Intravenous narcotics ten minutes before the procedure
4) Oral pain medication for discomfort after the procedure

Question 5

A preschool-age client is hospitalized following surgery for a ruptured appendix. During assessment of the child, the nurse notes that the child is sleeping. Vital signs are as follows: temperature 97.8 degrees F axillary, pulse 90, respirations 12, and blood pressure 100/60. Which conclusion by the nurse is appropriate based on the assessment findings?
1) The client is comfortable and the pain is controlled.
2) The client is in shock secondary to blood loss during surgery.
3) The client is experiencing respiratory depression secondary to opioid administration for postoperative pain.
4) The client is sleeping to avoid pain associated with surgery.

Question 6

During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of
1) Administer prescribed analgesic.
10) The child is lying quietly in bed watching television. Which action by the nurse is most appropriate?
2) Ask the child's parents if they think the child is hurting.
3) Reassess the child in 15 minutes to see if the pain rating has changed.
4) Do nothing, since the child appears to be resting.

Question 7

The preschool-age child has been back from surgery for removal of a Wilm's tumor for 6 hours, the nurse anticipates the preschooler will need pain medication very soon. The nurse is aware that the preschool-age child may not complain of pain because Select all that apply.
1) The preschooler cannot give a description of his pain.
2) The preschooler may assume the nurse knows he has pain.
3) The preschooler may be afraid it may hurt more to have the pain treated.
4) The preschooler believes he must be brave.
5) The preschooler uses sleeping to deal with pain.

Question 8

The nurse is working with a preschool-age client in Bryant traction for a fractured femur. Why is the Oucher Scale useful to the nurse caring for this child?
1) It provides continuity and consistency in assessing and monitoring the child's pain.
2) It decreases anxiety in the child.
3) It increases the child's comfort level.
4) It reduces the child's fear of painful procedures.

Question 9

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. Which intervention would the nurse implement- based on the parent's concern?
1) Intravenous sedation 15 minutes prior to the procedure
2) EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure
3) Use of guided imagery during the procedure
4) Use of muscle-relaxation techniques

Question 10

The nurse is working in a pediatric surgical unit. In discussing patient-controlled analgesia (PCA) in a preoperative parental meeting, which client would be a candidate for PCA?
1) Developmentally delayed 16-year-old, postoperative bone surgery
2) A 5-year-old, postoperative tonsillectomy
3) A 10-year-old who has a fractured femur and concussion from a bike accident
4) A 12-year-old, postoperative spinal fusion for scoliosis

Question 11

A school-age client is being discharged from the outpatient surgical center. Which statement by the parent would indicate the need for further teaching?
1) "I can expect my child to have some pain for the next few days."
2) "I will plan to give my child pain medicine around the clock for the next day or so."
3) "Since my child just had surgery today, I can expect the pain level to be higher tomorrow."
4) "I will call the office tomorrow if the pain medicine is not relieving the pain."

Question 12

The nurse is caring for a child who has a long leg cast. The child complains of increasing pain in the toes of the casted foot. Which initial action by the nurse is the most appropriate?
1) Call the healthcare provider to report increasing pain
2) Administer pain medication
3) Reposition the child in bed
4) Check to see if the cast is too tight

Question 13

A toddler is hospitalized with a fractured femur. In addition to pain medication, which will best provide pain relief for this child?
1) Parents' presence at the bedside
2) Age-appropriate toys
3) Deep-breathing exercises
4) Videos for the child to watch

Question 14

The nurse is admitting a school-age Vietnamese client 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. Which nursing actions are most appropriate in this situation? Select all that apply.
1) Use the FLACC scale to determine the child's pain level.
2) Tell the child to ring the call bell if the leg starts hurting.
3) Administer pain medication now and continue on a regular basis.
4) Ask the child's parents to notify the nurse if the child complains of pain.
5) Use the NIPS scale to determine the child's pain level.

Question 15

A hospitalized toddler-age client needs to have an IV restarted. The child begins to cry when carried into the treatment room by the mother. Which nursing diagnosis is most appropriate?
1) Ineffective Individual Coping Related to an Invasive Procedure
2) Anxiety Related to Anticipated Painful Procedure
3) Fear Related to the Unfamiliar Environment
4) Knowledge Deficit of the Procedure

Question 16

The nurse is caring for a child who has been sedated for a painful procedure. Which nursing activity is the priority for this child?
1) Allow parents to stay with the child.
2) Monitor pulse oximetry.
3) Assess the child's respiratory effort.
4) Place the child on a cardiac monitor.

Question 17

A young school-age client is hospitalized with a fractured femur. Which assessment tools are appropriate for this client? Select all that apply.
1) FACES pain scale
2) Oucher scale
3) Visual Analog Scale
4) CRIES Scale
5) Poker-chip tool

Question 18

The nurse is preparing to perform a heel stick on a neonate. Which complementary therapy is appropriate for the nurse to use decrease pain during this quick but painful procedure?
1) Swaddling
2) Sucrose pacifier
3) Massage
4) Holding the infant