Identify One or More Choices That Best Complete the Statement

Identify one or more choices that best complete the statement or answer the question.
-The nurse is caring for a 1-year-old patient after surgery for an intracranial shunt replacement. The nurse selects the FLACC scale for assessment because of the toddler's inability to participate in pain evaluation. The nurse will recognize which assessment finding as an indication of some level of pain? Select all that apply.

A) Constantly frowns, clenched jaw, quivering chin
B) Squirms, shifting back and forth, tense
C) Cries steadily and loudly, sometimes screams or sobs
D) Legs are positioned normally and appear relaxed
E) Answers to name, sucks thumb, and holds toy