Question 1

The nurse is planning care for a school-age patient experiencing undiagnosed limb pain. Which nursing diagnoses regarding pain should the nurse consider when designing this patient's plan of care? (Select all that apply.)

A) Pain related to an invasive procedure
B) Disturbed sleep pattern related to chronic pain
C) Fear related to anticipation of painful procedure
D) Anxiety related to dressing changes that cause pain
E) Health-seeking behaviors related to the cause of pain

Pain related to an invasive procedure
Disturbed sleep pattern related to chronic pain
Fear related to anticipation of painful procedure

Accepted Answer

Nursing diagnoses for children with pain focus not only on the pain but also on the stress, fear, or anxiety that pain produces. Nursing diagnoses appropriate for the child experiencing undiagnosed limb pain include pain related to an invasive procedure, disturbed sleep pattern related to chronic pain, and fear related to anticipation of painful procedure. It is unknown if the child has a dressing on the limb. The child is demonstrating health-seeking behaviors related to the cause of the pain.

Question 2

The community nurse is planning a program that focuses on the 2020 National Health Goals to alleviate pain. Which information should the nurse include that focuses on pain control in children? (Select all that apply.)

A) Encourage all episodes of pain to be treated with narcotics.
B) Instruct on avoiding unintentional injuries by using safety belts and helmets.
C) Explain that pain can be managed with medicine or nonmedication measures.
D) Remind that the use of over-the-counter analgesics like aspirin are recommended.
E) Recommend that the use of alternative pain medications on the market be used for pain.

Instruct on avoiding unintentional injuries by using safety belts and helmets.
Explain that pain can be managed with medicine or nonmedication measures.

Accepted Answer

Nurses can help the nation reduce pain among children by active management of pain as well as teaching children about the importance of avoiding painful unintentional injures by the use of safety belts and bicycle helmets. One 2020 National Health Goals is to reduce the number of non-FDA-approved pain medications on the market. Another 2020 National Health Goal is to reduce the incidence of injuries caused by pain medication. Over-the-counter analgesics like aspirin are not recommended for all episodes of pain.

Question 3

Prior to conducting a blood-drawing procedure, the nurse teaches a child to imagine swimming in a cool, shady park with friends and family. Which technique did the nurse use with this patient?&#10;A) Imagery&#10;B) Park therapy&#10;C) Thought stopping&#10;D) Nerve stimulation

Accepted Answer

Substitution of meaning or guided imagery is a distraction technique to help a child place a nonpainful meaning onto a painful procedure. Children are often more adept at imagery than adults because their imagination is less inhibited. This technique works well with quick, simple procedures such as venipunctures or chronic pain. Park therapy is not a pain management technique. This technique is not thought stopping or nerve stimulation.

Question 4

The nurse is preparing to provide a preschool-age child with an injection. Which technique should the nurse use when applying EMLA cream to the injection site?&#10;A) Apply it at least 1 hour before the procedure.&#10;B) Wipe it off at least 15 minutes before the procedure.&#10;C) Apply it immediately prior to the painful procedure.&#10;D) Do not cover it after application to prevent it from discoloring.

Accepted Answer

EMLA is a topical anesthetic cream containing lidocaine and prilocaine. The nurse should apply a dollop of the cream on the intended site at least 1 hour before the injection. The cream should be removed immediately before the injection. The cream needs time to work so applying immediately before the injection will not help reduce pain. The cream is covered to keep it secure over the intended area. The cream will not discolor when covered.

Question 5

The nurse is preparing discharge teaching for the parents of a school-age child who was recently receiving patient-controlled analgesia. What should the nurse include when teaching the parents about pain management for this patient? (Select all that apply.)

A) Dosing of pain medication
B) Frequency of pain medication
C) Expected level of pain relief
D) Contact number to call with questions
E) Technique to insert an intravenous line

Accepted Answer

For ongoing care, the nurse should ensure that children and parents are provided with support and follow-up to the extent necessary to continue adequate pain management in the home. Parents should be given instructions on dosing, administration, frequency, expected outcomes, and expected level of relief. Provide them with the name and telephone number of a health care professional whom they can call if they have questions about pain management. The parents are not responsible for inserting an intravenous line.

Question 6

The nurse is assessing for pain in a 2-month-old infant. Which behavior indicates that this baby is experiencing pain?&#10;A) Sleeping longer during naps&#10;B) Crying when put on abdomen&#10;C) Decreased intake with each feeding&#10;D) Continued crying after diaper change and being fed

Accepted Answer

The chief indication of pain in infants is the inability to be comforted when pain is present. Typical comfort measures such as diaper changing and feeding are not soothing to the child. Sleeping, crying when placed on the abdomen, and a decreased intake do not indicate that the child is experiencing pain.

Question 7

A school-age child with a fractured leg is crying. The child will not move the extremity, lies very still, and denies the presence of pain. What should the nurse recognize as the possible reason for this child's behavior?

A) The child is scared.
B) The child is afraid of the hospital and personnel.
C) An injection was given for pain in the emergency room.
D) The child is anticipating punishment for breaking the leg.

Accepted Answer

If a child is reluctant to admit the presence of pain because of the fear of receiving an injection, another form of analgesia needs to be determined. The child's behavior indicates pain. This behavior is not consistent with being scared or afraid of the hospital. There is no information to support that the child is awaiting punishment for breaking the leg.

Question 8

The nurse is preparing to conduct a health history with the parents of a preschool-age child admitted for an appendectomy. Which questions should the nurse plan to use to learn more about the child's ability to manage pain? (Select all that apply.)

A) "How does your child usually react to pain?"
B) "How do you know when your child is in pain?"
C) "Does your child use pain as a control mechanism?"
D) "Are you concerned about addiction to pain medication?"
E) "What do you do for your child when your child is hurting?"

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Accepted Answer

When conducting a pain experience inventory with parents, the nurse should ask how the child usually reacts to pain, how the parents know that the child is in pain, and what the parents do when the child is in pain. Questions not appropriate for this inventory include asking if the child uses pain as a control mechanism and if the parents are concerned about addiction to pain medication.

Question 9

The nurse is using a postoperative pain management scale to determine if a newborn recovering from emergency surgery is experiencing pain. Which observations indicate that the child is experiencing level 3 pain this time? (Select all that apply.)

A) High-pitched cry
B) Baby is grimacing
C) Baby has not fallen asleep
D) Heart rate elevated to greater than 20% over the baseline
E) Baby falls asleep for short periods and then wakes up crying

Accepted Answer

Observations that the infant is experiencing pain at a level 3 include a high-pitched cry, not sleeping, and a heart rate elevated to greater than 20% over the baby's baseline.
Grimacing and falling asleep for short periods indicate pain at a level 2.

Question 10

An adolescent is being evaluated for appendicitis. When assessed for pain, the patient points to the lower left abdominal region. What type of pain should the nurse document that this patient is experiencing?

A) Somatic pain
B) Chronic pain
C) Referred pain
D) Cutaneous pain

Accepted Answer

Referred pain is pain that is perceived at a site distant from its point of origin. Somatic pain is pain that originates from deep body structures such as muscles or bones. Chronic pain is pain that lasts for a prolonged period or beyond the time span anticipated for healing. Cutaneous pain is pain that arises from superficial structures such as the skin and mucous membrane.

Question 11

During a home visit, the mother of a child with chronic pain is distraught because the child always seems to be uncomfortable despite receiving pain medication as prescribed. What should the nurse instruct the mother to do to help this child's pain? (Select all that apply.)

A) Offer a back rub or other comfort measures.
B) Stay with the child and offer love and support.
C) Suggest the child learn to deal with the pain and grow up.
D) Provide pain medication with a positive expectation that it will take the pain away.
E) Ask the child what might help relieve the pain, such as extra pillows or a warm drink.

Accepted Answer

The answer of During a home visit, the mother of...

Question 12

The nurse is planning to assess the amount of pain that a 15-year-old child is experiencing after a motor vehicle crash. Which pain scale should the nurse use to measure this patient's pain?&#10;A) CRIES&#10;B) FACES&#10;C) Adolescent Pediatric Pain Tool&#10;D) The COMFORT Behavior Scale

Accepted Answer

The answer of The nurse is planning to assess the...

Question 13

The nurse wants to assess the amount of pain a preadolescent with scoliosis experiences throughout the day. Which tool should the nurse use to make this assessment?&#10;A) Logs and diaries&#10;B) FACES Pain Rating Scale&#10;C) Adolescent Pediatric Pain Tool&#10;D) Numerical or Visual Analog Scale

Accepted Answer

The answer of The nurse wants to assess the amount...

Question 14

While the phlebotomist draws blood from a toddler's right arm, the nurse is having the child blow bubbles with the left hand. Which pain management technique is the nurse using with the child?&#10;A) Imagery&#10;B) Hypnosis&#10;C) Distraction&#10;D) Thought stopping

Accepted Answer

The answer of While the phlebotomist draws blood from a...

Question 15

The nurse teaches a mother pain management techniques to use for a toddler with otitis media. Which statement indicates that the mother needs additional teaching?&#10;A) &#34;I should give my toddler one baby aspirin.&#34;&#10;B) &#34;Use of infant Tylenol is good for my toddler.&#34;&#10;C) &#34;I don't have to give my child pain medication unless it is needed.&#34;&#10;D) &#34;Ibuprofen can be purchased over the counter to use if my toddler needs it.&#34;

Accepted Answer

The answer of The nurse teaches a mother pain management...

Deck 39: Pain Management in Children