Deck 18: Pain Management

Question 1

When it comes to pain management in infants and children, the majority of health care professionals are still under the impression that infants and children:

A) need one-half the pain medication that adults need
B) need about the same amount of pain medication as adults, adjusted for their body weight
C) do not have pain or suffer less pain than adults
D) have a lot more pain than adults

Answer 1

do not have pain or suffer less pain than adults

Question 2

Which of the following statements best describes acute pain?

A) discomfort lasting 3 to 5 days and due to a specific cause such as surgery or injury
B) discomfort that comes on suddenly and lasts less than 8 hours
C) a sharp hurting in a specific location that comes and goes suddenly
D) any hurting that is not considered long-lasting by the individual experiencing it

Answer 2

discomfort lasting 3 to 5 days and due to a specific cause such as surgery or injury

Question 3

A mother tells the nurse that her child has experienced pain lasting for long periods of time with the pain coming and going. The nurse would describe this pain in her assessment as which of the following kinds of pain?

A) acute pain
B) moderate pain
C) strange pain
D) chronic pain

Answer 3

chronic pain

Question 4

Nociceptors are best described as nerve receptors specific to which of the following?

A) inflammation
B) pain
C) pressure
D) sprain

Question 5

Which of the following factors has the most influence on how long pain lasts and how intense it is?

A) the person's past experience with pain
B) how much pain medication the person takes at one time
C) the release of chemical mediators such as substance P
D) the person's history of pain medication use and tolerance to medications

Question 6

Which of the following theories is currently in use to explain how pain impulses travel and are interpreted in the body?

A) classic gate control theory
B) sodium ion theory
C) electrical impulse theory
D) hormonal rise theory

Question 7

A number of research studies have shown that there is an improvement in postoperative morbidity and mortality then:

A) alpha stimulation is applied for at least 30 minutes before and after surgery
B) infants and children receive general anesthesia and postoperative pain management
C) vitamin C is given to infants and children for a week before and a week after surgery
D) fathers hold and touch their infants before and after surgery

Question 8

As a nurse you must explore your beliefs about medication for infants and children because research has shown which of the following?

A) Nurses are likely to over\-medicate and undermedicate children under their care.
B) Nurses tend to believe that medication will harm children more than help them.
C) It takes a lot of exploration of beliefs before a nurse can be consistent in the administration of pain medication regardless of race, gender, religion, or social status.
D) Educational level, personal pain experience, and number of years in practice influence the nurse in the decision to medicate or not medicate a child in pain.

Question 9

A general rule that nurses can use in deciding whether an intervention or procedure would hurt a child is to ask which of the following questions?

A) "Would this hurt an adult?" If the answer is yes, then it would hurt a child.
B) Ask the child: "Do you think this will hurt a lot, some, or not at all?"
C) Ask the mother: "Do you think this procedure or intervention will hurt your child?"
D) "Has this child had this procedure or intervention in the past? If so, what was the pain history?"

Question 10

Which of the following statements best describes the term tolerance?

A) the ability to take a particular medication without feeling worse after taking it
B) being able to take a medication even if it does have adverse side effects
C) the need to use increasing doses of a medication over time to achieve the desired result
D) putting up with taking various medications even then you do not feel they are necessary

Question 11

When children experience pain it is:

A) character building
B) likely to interrupt sleep, appetite, and play
C) only because they are not focusing on something else
D) going to be of lesser duration and intensity than adults experience

Question 12

The nurse working with infants knows that infants have a unique response to pain, which is to exhibit which of the following behaviors?

A) yawn several times over a couple of minutes
B) claw at the air with their hands
C) utter piercing cries and arch the back in an extreme way
D) withdraw, cry, and have a furrowed brow and a taut tongue

Question 13

When the preschooler is sitting still or lying still for a long time and not engaging in physical activity, the nurse will most suspect and assess for which of the following conditions?

A) pain
B) nausea
C) dizziness
D) boredom

Question 14

The nurse working with school-aged children realizes that children of this age have many body image concerns. Which of the following fears would most likely be a fear of hospitalized school-age children undergoing surgery?

A) The medication will not be strong enough to take away pain.
B) The nurse will spend too much time with them.
C) Their insides will leak out after injections or surgery.
D) Their classmates will get to have more fun and play more.

Question 15

When giving the school-aged child an intramuscular injection, the nurse knows that it is most important to:

A) kiss the area of the hurt
B) apply a self-adhesive bandage
C) say you are sorry for any hurt
D) give the child a hug

Question 16

The nurse is preparing to give the school-aged child an injection. If there are no contraindications, the nurse's best course of action is to do which of the following?

A) Ask a parent which site is preferred.
B) Offer the child a choice of sites.
C) Select a site without consulting anyone.
D) Ask the outgoing shift nurse what site would be best.

Question 17

The nurse working with hospitalized adolescents realizes that frequent assessment of the adolescent's pain level is necessary because adolescents tend to:

A) complain a lot and overrate their pain
B) deny their pain and hide it from caregivers
C) get busy and forget they have pain
D) not want to talk to the nurse about anything

Question 18

The nurse knows that then hospitalized adolescents underrate their pain and hide it, the adolescent is most likely denying pain to:

A) show strength or get out of the hospital earlier
B) get the nursing staff in trouble with the doctor
C) keep from getting cut off from phoning friends
D) avoid having to take pain medication of any type

Question 19

As part of the pain assessment of an adolescent, the nurse will most likely ask which of the following questions?

A) "Have you ever faked pain to get attention from the nurses or your parents?"
B) "What is your favorite street drug for dealing with psychological or physical pain?"
C) "Do you think your parents or caregivers take too much medication for pain?"
D) "What kind of pain have you had in the past and what helped make it decrease or stop?"

Question 20

Who is the best person to provide the most accurate measurement of a child's pain?

A) the child him- or herself
B) the mother of the child
C) the father or a caregiver other than the mother
D) the primary nurse

Question 21

The PQRST pain assessment measures:

A) past quick responses to stimulation of tough pain
B) presence, quality, radiation or location, severity, and timing of pain
C) the type of pain: pinlike, quiet or dull, radiant, stinging, and tolerable
D) client's quality rating of strength and tolerability of pain level

Question 22

The Wong-Baker method for assessing pain in children uses:

A) a system of six different colors for ranking pain from red hot to none in cool shades of blue on a rating scale of 5 to 0
B) six different faces ranging from smiling to very distressed with downturned mouth and severe frown on a rating scale of 0 to 5
C) pictures of children in various activities from playing happily to crying over a scraped knee
D) a play kit with dolls who show various expressions including three who have expressions of mild, moderate, and severe pain

Question 23

The Oucher pain assessment tool is for use with children of ages:

A) 1 to 2 years
B) 3 to 12 years
C) 12 to 14 years
D) 15 to 18 years

Question 24

The Oucher pain assessment tool uses a numeric scale ranking pain from:

A) 0 to 100
B) 1 to 5
C) 1 to 10
D) 0 to 20

Question 25

The nurse has asked a child to rate her pain on a scale of 0 to 10. The child ranks the pain at a 5. The nurse will chart this in which of the following ways?

A) ranks pain at a 5
B) states pain is at a 5 on a 10-point scale
C) admits to a moderate level of pain
D) midpoint of scale in terms of pain

Question 26

In studies of nurses' and children's perceptions of pain, findings indicate that:

A) children and nurses agreed on pain levels
B) children ranked their pain lower than nurses did
C) nurses could not even come close to the amount of pain the children experienced
D) children ranked their pain higher than nurses did

Question 27

The pediatric nurse is aware that the best approach to pain treatment for children is:

A) early medication for pain
B) heavy medication up front with smaller follow-up doses
C) to work to prevent pain
D) to withhold medication

Question 28

When discussing pain management with a child and the parents, the nurse needs to:

A) assure the child and parents that the child can be kept pain free with good communication
B) tell them that pain medication and management will improve or relieve the pain, but it has its limitations
C) teach the child and parents about the possibility of addiction to pain medication
D) let them know that they need to talk to the physician if the pain medication does not help

Question 29

Which of the following goals is most associated with good pain management?

A) Maximize function (eating, walking, and participating in the recovery process).
B) Minimize the amount of pain medication required by smaller dosing.
C) Make the child feel good at least 90% of the time.
D) Reduce requests for pain medication to one per shift by time of discharge.

Question 30

A child continues to complain of pain after being given all the medication that is safe to administer. Which of the following actions should the nurse take?

A) Provide cutaneous stimulation such as massage, rubbing, holding, and applying heat or cold as indicated.
B) Distract the child as much as possible, and give the next pain medication a little early.
C) Ask the mother to tell the child that she can't have any more medication.
D) Tell the child she will have to wait for more pain medication, and let the child know then she can have more.

Question 31

The pediatrician orders an opioid as a pain reliever for a child. The nurse is aware that research has shown that:

A) children do not tolerate opioid medications well
B) opioids tend to potentiate other medications to a dangerous level in children
C) opioids are not a good choice for children over 10 as these children are more prone to addiction than younger children
D) use of opioids for pain relief in children is unlikely to result in addiction even if used for the long-term

Question 32

When the nurse administers an opioid to a child, the nurse realizes that the dose to be given is most often obtained by:

A) a given amount per kilogram or pound of weight
B) instructions on the container the opioid is packaged in
C) an educated guess based on past experience of the physician
D) starting with a low dose and building until relief is obtained

Question 33

The nurse has given a child an opioid for pain relief. Which of the following signs or symptoms would the nurse most likely find on assessment if the child has side effects from the opioid?

A) dizziness, drowsiness, and lethargy
B) irregular pulse and stomach cramps
C) rapid breathing and rapid pulse
D) nausea, vomiting, and itching

Question 34

The physician orders an adult dose of morphine for a 14-year-old who weighs 55 kilograms. The nurse administering opioid pain medication to children is aware then checking the physician's orders that it is safe to give an adult dose to children who weigh more than how many kilograms?

A) 35
B) 40
C) 45
D) 50

Question 35

A pediatric client who has a terminal illness and is in a lot of pain is given an opioid analgesic, which is titrated. The nurse receiving report on this client hears the word titrated and knows this means:

A) to pass through a special fine-mesh micron filter to remove any impurities
B) to deliver small, frequent doses of the medication prescribed to the child until the desired effect (pain management) is observed
C) to give a bolus and follow up the bolus with several small doses if there is breakthrough pain
D) to mix with a special titration solution, which will better dissolve the opiate because this medication is difficult to dissolve fully

Question 36

Opioids have a unique characteristic in that they have:

A) no addicting qualities
B) only beneficial side effects
C) no ceiling dose
D) a preconscious effect

Question 37

For children who have the most severe pain, the nurse is aware that opioid analgesics can be given in which of the following ways?

A) titrated to extremely high doses
B) up to one and a halftimes the usual dose
C) bolused with three-fourths of the daily dose
D) rectally and orally at the same time

Question 38

Pain management in babies and children has been found in studies to do which of the following? Select all that apply.

A) to be unnecessary
B) to promote wound healing
C) to decrease hospital stays
D) to cause children to be predisposed to drug addiction

Question 39

Which type of pain is transmitted by C-nerve fibers? Select all that apply.

A) diffuse and dull
B) burning and chronic
C) pain that comes and goes unexpectedly
D) unremitting and unbearable pain