NURS 341 - PAIN (14)

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 statement by the parents indicates a "need" for further teaching? A) "It's better if we are not in the room for this." B) "We can use kangaroo care before and after." C) "We hope you are using a very tiny needle." D) "We can offer him nonnutritive sucking to calm him."

A) "It's better if we are not in the room for this." Increasing the dose of the acetaminophen will not help his pain because he has reached as high a dose of that medication that will work. This is known as the ceiling effect, but explaining that to him will not help his pain. Guided imagery is not the best therapy for his pain, so the physician needs to order a different medication to manage his pain.

For which child would nonopioid analgesics be recommended? A) A child with juvenile arthritis B) A child with end-stage cancer C) A child with a broken arm D) A child with severe postoperative pain

A) A child with juvenile arthritis

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? A) Central nervous system B) Peripheral nervous system C) Digestive system D) Musculoskeletal system

A) Central nervous system Opioid agonists, such as morphine, are associated with numerous adverse effects, resulting primarily from their depressant action on the central nervous system.

he nurse is managing children who have chronic diseases in a neighborhood clinic. What are some examples of chronic conditions? Select all that apply. A) Diabetes mellitus B) Myocardial infarction C) Rheumatoid arthritis D) Compound fracture E) Acute asthma F) Bronchopneumonia

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

The nurse is caring for a child who is recovering from an appendectomy. What is the appropriate term for the pain this child is experiencing? A) Nociceptive pain B) Neuropathic pain C) Chronic pain D) Superficial somatic pain

A) Nociceptive pain

he nurse is researching behavioral-cognitive pain relief strategies to use on a 5-year-old child with unrelieved pain. Which methods might the nurse choose? Select all that apply. A) Relaxation B) Distraction C) Thought stopping D) Massage E) Sucking

A) Relaxation B) Distraction C) Thought stopping Common behavioral-cognitive strategies include relaxation, distraction, imagery, thought stopping, and positive self-talk. Sucking and massage are examples of biophysical interventions.

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? A) Relaxation B) Distraction C) Imagery D) Thought stopping

B) Distraction Distraction involves having the child focus on another stimulus, thereby attempting to shield him from pain. Humor has been demonstrated to be an effective distracting technique for pain management.

Sucking and massage are examples of

biophysical interventions.

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 examples are behavioral indicators? Select all that apply. A) The infant grimaces. B) The infant's heart rate is elevated. C) The infant flails his arms and legs. D) The infant's respiratory rate is elevated. E) The infant is crying uncontrollably. F) The infant's oxygen saturation is low.

A) The infant grimaces. C) The infant flails his arms and legs. E) The infant is crying uncontrollably. In preterm and term newborns, behavioral and physiologic indicators are used for determining pain. Behavioral indicators include facial expression, body movements, and crying. Physiologic indicators include changes in heart rate, respiratory rate, blood pressure, oxygen saturation levels, vagal tone, palmar sweating, and plasma cortisol or catecholamine levels.

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: A) little to no pain. B) mild pain. C) moderate pain. D) severe pain.

A) little to no pain. The Riley Infant Pain Scale measures six parameters: facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. The Pain Observation Scale for Young Children (POCIS) measures seven parameters: facial expression, cry, breathing, torso, arms and fingers, legs and toes, and state of arousal. The CRIES tool assesses five parameters: cry, oxygen required for saturation levels less than 95%, increased vital signs, facial expression, and sleeplessness. The FLACC tool measures five parameters: facial expression, legs, activity, cry, and consolability.

The student nurse is learning about the effects of heat and cold when used in a pain management plan. What accurately describes one of these effects? A) Cold results in vasodilation. B) Cold alters capillary permeability. C) Heat results in vasoconstriction. D) Heat decreases blood flow to the area.

B) Cold alters capillary permeability.

The nurse is caring for a child who reports chronic pain. What is the priority nursing assessment? A) How the pain impacts the child's and family's stress level B) The pain's history, onset, intensity, duration, and location C) The child's and parents' feeling of anxiety and depression D) The child's cognitive level and emotional response

B) The pain's history, onset, intensity, duration, and location Assessment of the child's pain is key; it is the priority assessment and is the only answer that focuses on the child's physiologic need. Assessment of how the pain impacts the child's and family's stress, feelings of anxiety, hopelessness, and depression, as well as the child's cognitive level and emotional response, are secondary after the pain is explored.

When the nurse is assessing a child's pain, which is most important? A) Obtaining a pain rating from the child with each assessment B) Using the same tool to assess the child's pain each time C) Documenting the child's pain assessment D) Asking the parents about the child's pain tolerance

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

The nurse is teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacologic methods. Which parent statement signifies successful child teaching? A) 'I will avoid using descriptive words like pinching, pulling, or heat.' B) 'I will not use positive reinforcement until the technique is perfected.' C) 'I will begin using the technique before he experiences pain.' D) 'I will be honest and tell him that the procedure will hurt a lot.'

C) 'I will begin using the technique before he experiences pain.'

A nurse is providing teaching to the mother of an adolescent girl about how to manage menstrual pain nonpharmacologically. Which statements by the mother indicates a need for further teaching? A) "I need to help her learn techniques to distract her; card games, for example." B) "I need to be able to identify the subtle ways she shows pain." C) "I need to follow these instructions exactly for them to work properly." D) "I need to encourage her to practice and utilize these techniques."

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

The nurse is administering pain medication for a child with continuous pain from internal injuries. Which method would be ordered to dispense the medication? A) Administer the medication PRN (as needed). B) Administer the mediation when pain has peaked. C) Administer the medication around the clock at timed intervals. D) Administer the medication when the child complains of pain.

C) Administer the medication around the clock at timed intervals.

The nurse is caring for a child who is experiencing pain related to chemotherapy treatment. What is a behavioral factor that might affect the child's pain experience? A) Knowledge of the therapy B) Fear about the outcome of therapy C) Participation in normal routine activities D) Ability to identify pain triggers

C) Participation in normal routine activities Participation in normal routine activities is a behavior factor. Knowledge of the therapy and ability to identify pain triggers are cognitive factors. Fear about the outcome of therapy is an emotional factor. Situational factors involve factors or elements that interact with the child and his or her current situation involving the experience of pain.

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 statement indicates the mother understands the technique? A) "We will imagine that we are on the beach in Florida." B) "We can talk about our favorite funny movie and laugh." C) "She can let her body parts go limp, working from head to toe." D) "We'll repeat 'quick stick, feel better, go home soon' several times."

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

The nurse is counseling the parents of a 9-year-old boy who is receiving morphine for postoperative pain. Which statement from the nurse accurately reflects the pain experience in children? A) 'You can expect that your child will tell you when he is experiencing pain.' B) 'Your child will learn to adapt to the pain he is experiencing.' C) 'Your child will experience more adverse effects to narcotics than adults.' D) 'It is very rare that children become addicted to narcotics.'

D) 'It is very rare that children become addicted to narcotics.'

Which tool would be the "least" appropriate scale for the nurse to use when assessing a 4-year-old child's pain? A) FACES pain rating scale B) Oucher pain rating scale C) Poker chip tool D) Numeric pain intensity scale

D) Numeric pain intensity scale The numeric pain intensity scale can be used with children as young as 5 years of age, but the preferred minimum age for using this tool is 7 years. The FACES and Oucher pain rating scales and the poker chip tool are appropriate pain assessment tools for a 4-year-old.

The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which adverse effect of the medication? A) Epidural hematoma B) Arachnoiditis C) Spinal headache D) Respiratory depression

D) Respiratory depression

The nurse is using the acronym QUESTT to assess the pain of a child. Which is an accurate descriptor of this process? A) Question the child's parents. B) Understand the child's pain level. C) Establish a caring relationship with the child. D) Take the cause of pain into account when intervening.

D) Take the cause of pain into account when intervening.