Deck 30: Pain Assessment and Management in Children

Question 1

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair.Which pain assessment tool should the nurse use to assess this child for the presence of pain?

A) FACES pain rating tool
B) Numeric scale
C) Oucher scale
D) FLACC tool

Answer 1

FLACC tool

Question 2

A dose of oxycodone (OxyContin)2 mg/kg has been ordered for a child weighing 33 lbs.The nurse should administer ______ mg of OxyContin.(Record your answer as a whole number.)

Answer 2

30
The child's weight is divided by 2.2 to obtain the weight in kilograms.Kilograms in weight are then multiplied by the prescribed 2 mg.
33 lbs/2.2 = 15 kg.
15 kg ´ 2 mg = 30 mg.

Question 3

The pediatric nurse understands that nonpharmacologic strategies for pain management:

A) may reduce pain perception.
B) make pharmacologic strategies unnecessary.
C) usually take too long to implement.
D) trick children into believing they do not have pain.

Answer 3

may reduce pain perception.

Question 4

A nurse is gathering a history on a school-age child admitted for a migraine headache.The child states,"I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain?

A) Acute
B) Chronic
C) Recurrent
D) Subacute

Question 5

MATCHING
A patient receiving an intravenous opioid analgesic has become apneic. Match the nursing interventions with the step numbers in order from the highest priority (first intervention) to the lowest priority (last intervention).

Step 2

A)Initiate resuscitation efforts as appropriate
B)Administer the prescribed naloxone (Narcan) dose by slow IV push
C)Prepare to administer naloxone (Narcan) as needed every 2 minutes until desired effect

Question 6

Physiologic measurements in children's pain assessment are:

A) the best indicator of pain in children of all ages.
B) essential to determine whether a child is telling the truth about pain.
C) of most value when children also report having pain.
D) of limited value as sole indicator of pain.

Question 7

Which 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 8

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 the IV infusion.
C) discontinue morphine until the child is fully awake.
D) stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply.

Question 9

MATCHING
A patient receiving an intravenous opioid analgesic has become apneic. Match the nursing interventions with the step numbers in order from the highest priority (first intervention) to the lowest priority (last intervention).

Step 1

A)Initiate resuscitation efforts as appropriate
B)Administer the prescribed naloxone (Narcan) dose by slow IV push
C)Prepare to administer naloxone (Narcan) as needed every 2 minutes until desired effect

Question 10

The nurse is using the FLACC scale to evaluate pain in a preverbal child.The nurse makes the following assessment: Face: occasional grimace; Leg: relaxed; Activity: squirming,tense; Cry: no cry; Consolability: content,relaxed.The nurse records the FLACC assessment as ________.(Record your answer as a whole number.)

Question 11

Which assessment indicates to a nurse that a school-aged 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 12

A lumbar puncture is needed on a school-age child.The most appropriate action to provide analgesia during this procedure is to apply:

A) 4% Liposomal Lidocaine (LMX) 15 minutes before the procedure.
B) a transdermal fentanyl (Duragesic) patch immediately before the procedure.
C) eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure.
D) EMLA 30 minutes before the procedure.

Question 13

The nurse is monitoring a patient for side effects associated with opioid analgesics.Which side effects should the nurse expect to monitor for? (Select all that apply.)

A) Diarrhea
B) Respiratory depression
C) Hypertension
D) Pruritus
E) Sweating

Question 14

Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration? (Select all that apply.)

A) Bran cereal
B) Decrease fluid intake
C) Prune juice
D) Cheese
E) Vegetables

Question 15

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

A) Visual Analog Scale (VAS)
B) Adolescent and pediatric pain tool
C) Oucher tool
D) FACES pain-rating scale

Question 16

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

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

Question 17

Which drug is usually the best choice for patient-controlled analgesia (PCA)for a child in the immediate postoperative period?

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

Question 18

MATCHING
A patient receiving an intravenous opioid analgesic has become apneic. Match the nursing interventions with the step numbers in order from the highest priority (first intervention) to the lowest priority (last intervention).

Step 3

A)Initiate resuscitation efforts as appropriate
B)Administer the prescribed naloxone (Narcan) dose by slow IV push
C)Prepare to administer naloxone (Narcan) as needed every 2 minutes until desired effect

Question 19

Kyle,age 6 months,is brought to the clinic.His parent says,"I think he hurts.He cries and rolls his head from side to side a lot." This most likely suggests which feature of pain?

A) Type
B) Severity
C) Duration
D) Location

Question 20

The nurse caring for the child in pain understands 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.