Deck 39: Pain Management for Children

Question 1

The nurse is discussing various non-pharmacologic pain-relief techniques with the father of an 8-year-old boy.They agree on a plan to use a modality where the child is encouraged to remember or imagine the sights and sounds of an enjoyable experience such as his birthday.This is known as ________________ .

Answer 1

guided imagery
The facilitator (nurse or child-life specialist)talks in a calm voice while guiding the child's imagination.Studies have shown a reduction in pain from all causes using this technique.

Question 2

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

Answer 2

Preschool stage

Question 3

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.

Answer 3

Only a specified number of chips can be used.

Question 4

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 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 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.The most appropriate management of this child is for the nurse to

A) Administer naloxone (Narcan).
B) Discontinue IV infusion.
C) Discontinue morphine until child is fully awake.
D) Stimulate child by calling name, shaking gently, and asking to breathe deeply.

Question 7

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 8

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 9

Skin to skin holding of infants dressed only in a diaper,next to their mother's or father's chest is commonly known as __________ care.

Question 10

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 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

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 13

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 14

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 15

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

Question 16

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 vital signs over the past 4 hours.
C) The child becomes quiet when held and cuddled.
D) The child has just returned from the recovery room.

Question 17

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 18

The nurse is preparing a 4-year-old with a fractured humerus for an MRI.While the nurse is explaining the procedure to the child's parents,she understands that procedural sedation is a medically controlled state of depressed consciousness that will allow the child to be able to respond appropriately and to maintain her airway control.Is this statement true or false?

Question 19

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

Question 20

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

A) Morphine
B) Acetaminophen (Tylenol)
C) Ibuprofen (Advil)
D) Ketorolac (Toradol)
E) Aspirin