Chapter 36 Pain Management in Children

19. For which of the following children would nonopioid analgesics be recommended?

A child with juvenile arthritis

2. The nurse is managing children who have chronic diseases in a neighborhood clinic. Which of the following are examples of chronic conditions? Select all answers that apply.

A) Diabetes mellitus C) Rheumatoid arthritis E) Acute asthma

14. The nurse is researching behavioral-cognitive pain relief strategies to use on a 5-year-old child with unrelieved pain. Which of the following methods might the nurse choose? Select all answers that apply.

A) Relaxation B) Distraction C) Biofeedback D) Thought stopping

22. The nurse has applied EMLA cream as ordered. How does the nurse assess that the cream has achieved its purpose?

Lightly tap the area where the cream is.

30. Pentazocine is prescribed for a child with moderate pain. The nurse identifies this drug as an example of which type?

Mixed opioid agonist-antagonist

3. The nurse is caring for a child who is recovering from an appendectomy. Which of the following is the appropriate term for the pain this child is experiencing?

Nociceptive pain

11. Which tool would be the least appropriate scale for the nurse to use when assessing a 4-year-old child's pain?

Numeric pain intensity scale

27. The nurse is conducting a pain assessment of a 10-year-old boy who has been taking acetaminophen for chronic knee pain. The assessment indicates that the recommended dose is no longer providing adequate relief. What is the appropriate nursing action?

Obtain an order for a different medication.

5. The nurse is caring for a child who is experiencing pain related to chemotherapy treatment. Which of the following is a behavioral factor that might affect the child's pain experience?

Participation in normal routine activities

25. The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which of the following adverse effects of the medication?

Respiratory depression

13. The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant's facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment tool is being used by the nurse?

Riley Infant Pain Scale

12. The nurse uses the FLACC behavioral scale to assess a 6-year-old's level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing:

Severe pain

23. The nurse is preparing to administer a topical anesthetic for a 10-year-old girl with a chin laceration. The nurse would expect to apply which of the following as ordered in preparation for sutures?

TAC (tetracaine, epinephrine, cocaine

9. The nurse is using the acronym QUESTT to assess the pain of a child. Which of the following is an accurate descriptor of this process? .

Take the cause of pain into account when intervening

24. The nurse is caring for a child who is complaining of chronic pain. Which of the following is the priority nursing assessment?

The pain's history, onset, intensity, duration, and location

10. When the nurse is assessing a child's pain, which of the following is most important?

Using the same tool to assess the child's pain each time

7. A nurse is providing teaching to the mother of an adolescent girl about how to manage menstrual pain non pharmacologically. Which of the following statements by the mother indicates a need for further teaching?

"I need to follow these instructions exactly for them to work properly."

18. The nurse is teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacologic methods. Which of the following parent statements signifies successful child teaching?

"I will begin using the technique before he experiences pain."

8. The nurse is counseling the parents of a 9-year-old boy who is receiving morphine for postoperative pain. Which of the following statements from the nurse accurately reflects the pain experience in children?

"It is very rare that children become addicted to narcotics."

26. The nurse is providing teaching to the parents of a newborn prior to a heelstick. The nurse is describing the procedure and recommending various methods for the parents to help comfort their baby. Which of the following statements by the parents indicates a need for further teaching?

"It's better if we are not in the room for this."

16. The nurse is providing instructions to a mother on how to use thought stopping to help her child deal with anxiety and fear associated with frequent painful injections. Which of the following statements indicates the mother understands the technique?

"We'll repeat 'quick stick, feel better, go home soon' several times."

28. The nurse is preparing a child for a lumbar puncture. How far ahead of the procedure should the nurse apply the EMLA cream?

3 hours

21. The nurse is administering pain medication for a child with continuous pain from internal injuries. Which of the following methods would be ordered to dispense the medication?

Administer the medication around the clock at timed intervals.

6. The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use of behavioral and physiologic indicators for determining pain. Which of the following examples are behavioral indicators? Select all answers that apply.

A) The infant grimaces. C) The infant flails his arms and legs. E) The infant is crying uncontrollably

1. The nurse is teaching the student nurse the physiology involved in pain transmission. Which of the following statements accurately describes a physiologic event in the nervous system related to pain transmission? Select all answers that apply.

B) When nociceptors are activated by noxious stimuli, the stimuli are converted to electrical impulses that are relayed to the spinal cord and brain. C) Myelinated A-delta fibers are large fibers that conduct the impulse at very rapid rates; unmyelinated small C fibers transmit the impulse slowly. D) Once in the dorsal horn of the spinal cord, the nerve fibers divide and then cross to the opposite side and rise upward to the thalamus. F) Peripheral sensitization allows the nerve fibers to react to a stimulus that is of lower intensity than would be needed to cause pain.

20. Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug causing most of the adverse effects?

Central nervous system

17. The student nurse is learning about the effects of heat and cold when used in a pain management plan. Which of the following accurately describes one of these effects?

Cold alters capillary permeability.

29. The nurse is explaining the effects of heat application for pain relief. Which of the following would the nurse be likely to include as an effect?

Increased pressure on nociceptive fibers

4. The nurse is conducting an assessment of a high school track athlete. He tells the nurse he is experiencing pain along his outer thigh. He describes it as tight, achy, and tender, particularly after he runs. The nurse understands that he is most likely experiencing what kind of pain?

Deep somatic

15. The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What pain management technique is the nurse using?

Distraction