Deck 39: Pain Management for Children

Question 1

A nurse is administering an opioid medication to a child.Which side effects should the nurse watch for with this classification of medication? (Select all that apply.)

A) Respiratory depression
B) Hepatic damage
C) Constipation
D) Pruritus
E) Gastrointestinal bleeding

Answer 1

Respiratory depression
Constipation
Pruritus

Question 2

The nurse is caring for a child receiving intravenous (IV)morphine for severe postoperative pain.The nurse observes a slower respiratory rate,and the child cannot be aroused.What action by the nurse takes priority?

A) Administer naloxone (Narcan) immediately.
B) Notify the provider immediately.
C) Discontinue morphine until the child is fully awake.
D) Stimulate the child by calling his or her name and shaking gently.

Answer 2

Administer naloxone (Narcan) immediately.

Question 3

The nurse caring for the child in pain knows that distraction

A) can give total pain relief to the child.
B) is effective when the child is in severe pain.
C) is the best method for pain relief.
D) must be developmentally appropriate to refocus attention.

Answer 3

must be developmentally appropriate to refocus attention.

Question 4

Which statement indicates the nurse's lack of understanding about the use of patient-controlled analgesia (PCA)therapy?

A) Children as young as 3 years old can effectively and successfully use a PCA pump.
B) Two registered nurses (RNs) are required to double-check the dosage and programmed administration of opioids.
C) The child should be carefully monitored for signs and symptoms of overmedication with opioids.
D) Naloxone (Narcan) should be readily available.

Question 5

What medication is the most effective choice for treating pain associated with sickle cell crisis in a newly admitted 5-year-old child?

A) Morphine
B) Acetaminophen
C) Ibuprofen
D) Midazolam

Question 6

The nurse knows that physiologic changes associated with pain in the neonate include

A) increased blood pressure and decreased arterial saturation.
B) decreased blood pressure and increased arterial saturation.
C) increased urine output and increased heart rate.
D) decreased urine output and increased blood pressure.

Question 7

A student nurse is preparing to administer fentanyl 2-mcg/kg IV push to a child who weighs 26.4 pounds.The pharmacy delivers a vial with 50 mcg/10 mL.How much fentanyl does the student draw up?

Question 8

The appropriate tool(s)to assess pain in a 3-year-old child is the (Select all that apply.)

A) Visual Analogue Scale (VAS)
B) adolescent and pediatric pain tool
C) Oucher tool
D) poker chip tool
E) FACES pain rating scale

Question 9

A nurse uses the CRIES tool to assess pain in neonates.What categories does the nurse assess? (Select all that apply.)

A) Crying
B) Requires O₂
C) Increased respiratory rate
D) Expression
E) Sleepiness

Question 10

The nurse is caring for a 6-year-old girl who had surgery 12 hours ago.The child tells the nurse that she does not have pain,but a few minutes later tells her parent that she does.What should the nurse consider when interpreting this?

A) Truthful reporting of pain should occur by this age.
B) Inconsistency in pain reporting suggests that pain is not present.
C) Children use pain experiences to manipulate their parents.
D) Children may be experiencing pain even though they deny it to the nurse.

Question 11

What myth may interfere with the treatment of pain in infants and children?

A) Infants may have sleep difficulties after a painful event.
B) Children and infants are more susceptible to respiratory depression from narcotics.
C) Pain in children is multidimensional and subjective.
D) A child's cognitive level does not influence the pain experience.

Question 12

Which medications are the most effective choices for treating pain associated with inflammation in children? (Select all that apply.)

A) Morphine
B) Acetaminophen
C) Ibuprofen
D) Ketorolac
E) Aspirin

Question 13

When assessing a child for pain,the nurse is aware that

A) neonates do not feel pain.
B) pain is an individualized experience.
C) children do not remember pain.
D) a child must cry to express pain.

Question 14

When using the poker chip tool,it is important for the nurse to know that

A) any number of chips can be used.
B) only a specified number of chips can be used.
C) the assessment tool is used with adolescents.
D) the assessment tool is most effectively used with 2-year-old children.

Question 15

Which assessment indicates to a nurse that a 2-year-old child is in need of pain medication?

A) The child is lying rigidly in bed and not moving.
B) The child's current vital signs are consistent with previous vital signs.
C) The child becomes quiet when held and cuddled.
D) The child has just returned from the recovery room.

Question 16

When assessing pain in any child,the nurse should consider that

A) any pain assessment tool can be used to assess pain in children.
B) children as young as 1 year old use words to express pain.
C) the child's behavioral, physiologic, and verbal responses are valuable when assessing pain.
D) pain assessment tools are minimally effective for communicating about pain.

Question 17

Which drug is usually the best choice for PCA for a child in the immediate postoperative period?

A) Codeine
B) Morphine
C) Methadone
D) Meperidine

Question 18

In which developmental stage is the child first able to localize pain and describe both the amount and the intensity of the pain felt?

A) Toddler stage
B) Preschool stage
C) School-age stage
D) Adolescent stage

Question 19

When pain is assessed in an infant,it is inappropriate to assess for

A) facial expressions of pain.
B) localization of pain.
C) crying.
D) thrashing of extremities.

Question 20

A nurse in the pediatric critical care unit assesses a child for pain using the COMFORT behavior scale.The child scores a 25.What action by the nurse is most appropriate?

A) Ask a parent if the child is in pain.
B) Medicate the patient for pain.
C) Document and reassess in 4 hours.
D) Notify the provider.