Deck 23: Pediatric Pain Management

Question 1

The primary care pediatric nurse practitioner is preparing to perform a painful
procedure on a 4­month­old infant. Besides providing local anesthesia, what other pain control method provides analgesic effects?
A. Providing toys
B. Singing or music
C. Sucrose solution
D. Swaddling or cuddling

Answer 1

Sucrose solution

Question 2

What is the most important dose­limiting factor when prescribing acetaminophen with hydrocodone?
A. Acetaminophen dose
B. Gastrointestinal side effects
C. Pruritis symptoms
D. Urinary retention

Answer 2

Acetaminophen dose

Question 3

An adolescent female reports moderate dysmenorrhea with periods and tells
the primary care pediatric nurse practitioner that 400 mg ibuprofen every 6 to 8 hours doesn't completely control her pain. What will the nurse practitioner recommend?
A. Increasing the ibuprofen dose to 600 to 800 mg every 6 to 8 hours
B. Taking extra­strength acetaminophen 1000 mg every 4 to 6 hours
C. Taking naproxen 500 mg initially and then 250 mg every 6 to 8 hours
D. Using extended­release naproxen 500 mg every 12 hours

Answer 3

Taking naproxen 500 mg initially and then 250 mg every 6 to 8 hours

Question 4

The parent of a school­age child with a chronic pain condition tells the
primary care pediatric nurse practitioner that the child has requested to stay home from school more often in the past few months. The child's exam does not reveal any significant change in pathology, and a review of the child's medications indicates appropriate dosing of analgesic medications. What will the nurse practitioner recommend?
A. Assessing the child's pain every day to determine changes
B. Ensuring the child stays quiet in bed with videos when having pain
C. Having the child do homework when staying home from school
D. Requiring the child to go to school even during pain episodes

Question 5

A 4­year­old child has just been released from the hospital after orthopedic
surgery on one leg following a bicycle accident. The child is sitting quietly on the exam table. When asked to rate pain, the child points to the "1" on a faces rating pain scale. What will the primary care pediatric nurse practitioner do next?
A. Assess the child's vital signs and ability to walk without pain.
B. Refill the prescription for a narcotic analgesic medication.
C. Suggest that the parents give acetaminophen for mild pain.
D. Teach the parent to give analgesics based on the child's report of pain.

Question 6

An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant
(TCA) to treat phantom limb pain and reports that the medications are no longer effective. What will the primary care pediatric nurse practitioner do?
A. Change the TCA to a selective serotonin reuptake inhibitor.
B. Evaluate the adolescent for drug­seeking behavior.
C. Increase the TCA dose and reevaluate in 2 to 3 weeks.
D. Refer the adolescent to a pain management specialist.

Question 7

A 3­year­old child is recovering from injuries sustained in a motor vehicle
accident. How will the primary care pediatric nurse practitioner evaluate this child's pain?
A. Ask the child to rate pain intensity on a 4­ to 5­item pain discrimination scale.
B. Have the child describe any pain as "no pain, a little pain, or a lot of pain."
C. Question the child about the intensity and specific location of any pain.
D. Rely on nonverbal responses such as facial expressions and limb movements.

Question 8

A developmentally and cognitively disabled 10­year­old child who is unable to
communicate must undergo a series of surgeries, and the child's parent asks how to know if the child is in pain and when to give pain medication. What will the primary care pediatric nurse practitioner teach this parent to use to assess this child's pain?
A. Comfort scale
B. FLACC scale
C. NCCPC­R
D. Non­verbal observations

Question 9

The primary care pediatric nurse practitioner is evaluating a 10­year­old child
who is describing shooting pain in both legs associated with aching, tingling, and burning. The child is unable to pinpoint specific locations for this pain. Which type of pain does the nurse practitioner suspect?
A. Chronic pain
B. Neuropathic pain
C. Somatic pain
D. Visceral pain