A child is brought to the emergency
3
department in acute pain following a
trauma. An analgesic is prescribed.
Which method for administering
medication to the child is anticipated?
  intravenous administration
The nurse is caring for a school-age
child who had an appendectomy the
day before. The parents express
concern about the use of pain
medications. Which is
the best nursing response?
  Educate the parents about the
need for pain relief in proper
doses.
The neonatal nurse is preparing to
perform a heel prick for blood work
on a 3-day-old infant. Which
procedural pain management will the
nurse provide the client?
 pacifier with oral glucose
A 7-year-old child has a prescription
for 10 mg/kg PO acetaminophen. The
child weighs 55 lb (25 kg). The
acetaminophen is supplied as 80 mg
tablets. How many tablets should the
nurse administer? Record your answer
using a whole number.
  
The nurse is preparing a 6-year-old
child for a bone marrow biopsy. The
child is very anxious about going
through this procedure. Which nursing
diagnosis best fits this situation?
  Fear related to anticipation of
painful procedure
The nurse is working with a 5-year-old
boy who must receive repeated
intravenous injections as part of his
treatment. He hates the injections,
however, and is frightened whenever
he sees the syringe and needle. In an
attempt to overcome this fear, the
nurse holds the syringe up for him to
see and tells him, "This looks kind of
like a space rocket, don't you think?
Here comes the space rocket—it
needs to refuel." Which pain
management technique is the nurse
using here?
  Imagery
The nurse is providing postsurgical
care for a 4-year-old boy following
hernia repair. Before surgery, the
nurse taught the child to use the
poker chip tool to rate his pain. When
assessing the child's postsurgical pain,
the boy refuses to touch the chips and
clings to his mother. How should the
nurse respond?
  Give the mother the FACES
pain rating scale to use with her
son.
The nurse is caring for a pediatric
client following an open
appendectomy. The client rates the
pain an "8" on a 0 to 10 pain scale and
the nurse administers morphine
sulfate intravenously to the client per
the primary health care provider's
prescription. Which nursing action
is priority following administration of
the medication?
  Monitor the client's respiratory
status.
The nurse is caring for a 7-year-old
postoperative child who is reporting
an 8 out of 10 on a pain intensity
scale. The child's parent is requesting
pain medication. The child received
ibuprofen 3 hours ago. What is the
correct nursing action?
  Contact the health care
provider and request an opioid
pain medication.
A 7-year-old boy tells the nurse that
his head sometimes hurts after he
eats ice cream. The nurse recognizes
that this type of pain is:
  Acute referred pain
A 4-year-old child is scheduled for an
MRI. The child's parent is informed
that the child will be free of pain but
sedated to ensure stillness during the
procedure. Which type of anesthesia
does the nurse expect this child to
have?
  Conscious sedation
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?
  Cold alters capillary
permeability.
The nurse is caring for a term neonate
suffering from meconium aspiration in
the nursery. The nurse reviews orders
for a peripherally inserted central
catheter (PICC) line placement and
intubation. Which statement
demonstrates the nurse's knowledge
of painful procedures as related to a
neonate?
  The newborn's pain pathway
components are developed
enough at birth to experience
pain.
A 5-year-old arrives at the emergency
department and reports abdominal
pain. After performing an assessment
and laboratory work, the health care
provider diagnoses appendicitis. The
nurse knows that this child is
experiencing which type of pain?
  Visceral
A young child is hospitalized with
pneumonia. Upon admission the
client states not having pain but just a
bad cough. A few hours later, the child
he begins reporting pain in the right
lower back. This first report of feeling
pain refers to:
  pain threshold.
The nurse is working in the emergency
department when an adolescent
arrives via ambulance. The adolescent
was found in a semiconscious state
and next to an empty bottle of
acetaminophen. While the adolescent
continues to improve in the acute
setting, which long-term consequence
of the overdose may be seen in the
coming months?
  liver dysfunction
The nurse is caring for an 11-year-old
who has returned from an abdominal
appendectomy secondary to a
perforated appendix. Morphine is
prescribed intravenously for pain
relief. The nurse evaluates that the
pain medication is therapeutic if which
outcome (s) occurs? Select all that
apply.
 The child resumes play activities
with coloring books.
 The child's pulse rate returns to
84 beats/min.
 The child states the pain is now
tolerable and walks to the
bathroom.
 The child rates pain as down
from a 8 to an 3, using a 0 to 10
pain scale.
The nurse is caring for a 4-year-old
child about to undergo wound care for
a full-thickness (third-degree) burn
injury. Which form of pain relief
should the nurse anticipate?
  conscious sedation

A 5-year-old child has been admitted
to the hospital and is going to have an
IV started in the procedure room.
Which instructions will
be most helpful for the child and the
parent?
  Have the parent sing softly to
the child during the procedure.
The nurse is caring for a 12-year-old
postoperative spinal rod placement
client with scoliosis. Which factor
might intensify the child's
postoperative pain experience?
  The client had a painful
experience with an
appendectomy at age 10.
The mother of a male neonate being
prepared for circumcision asks the
nurse if the baby can feel pain. Which
response by the nurse
is most accurate?
  "Even though the nervous
system continues to develop,
some pain will be present
related to prenatal neural
development."
The pediatric nurse is mentoring a
new graduate in the care of children
experiencing pain. The nurse knows
the teaching was effective when the
new graduate makes which statement
as the rationale for considering pain
assessment?
  Pain assessment needs to be
done at regular intervals.
Which statement is the goal of
distraction techniques used to control
pain?
  to divert the child's attention
away from the pain through
controlled, purposeful
behaviors
When children are not able to
communicate pain verbally, the nurse
can use a behavioral assessment. The
nurse knows that this assessment
will least likely include:
  sleep patterns.
An adolescent is brought to the
emergency department after being
injured during a baseball game. The
adolescent reports significant ankle
pain, rating it as 8 on a scale of 0 to
10. Based on the nurse's
understanding of pain impulses, the
nurse would identify the adolescent's
pain as reflecting which type of pain?
 Somatic
An adolescent is experiencing severe
pain due to a sickle cell crisis. Which
medication would be best for the
nurse to administer?
  hydromorphone
The nurse is caring for children on a
postoperative unit. Which nursing
action promotes the most efficient
pain control?
  Anticipate when pain will occur
and plan interventions to
prevent it.
A nurse is explaining to a parent about
avoiding the use of aspirin for pain
relief for flu-like symptoms. Which
rationale does the nurse provide?
  Aspirin with the flu can lead to
Reye syndrome.
Parents are to bring their kindergarten
child to the outpatient department for
a venous blood sample. They have
EMLA cream to apply at home prior to
the procedure and have been shown
two areas on the child's arms where
they should place the cream.
Transportation time is 15 minutes.
Their appointment is for 2:45 p.m. At
what time should the parents apply
the cream and occlusive dressings to
both arms?
  Between 1:15 p.m. and 1:45
p.m.
A 10-year-old child is scheduled for
open reduction and internal fixation of
the tibia following a skateboard
accident. The nurse anticipates which
pain medication and administration
method will best provide postsurgical
pain relief for this child immediately
after surgery?
  morphine given as an
intravenous injection
A newborn who is suspected of having
leukemia is being prepared for bone
marrow aspiration. The newborn's
mother asks whether any type of
sedation or anesthesia will be used.
What statement should the nurse
make in response?
   "Because this is a painful
procedure, your child will
receive moderate sedation to
alleviate pain."
When educating a parent on how to
support the child while experiencing a
painful procedure, what is
the best information for the nurse to
convey?
  Explain in detail the role of the
parent as a coach and
emphasize the coping plan.
A nurse is caring for a child who is
grimacing but reports having no pain.
What might be the rationale for a child
being reluctant to express pain?
  fearing getting a "shot" to
relieve the pain
A 4-year-old child is scheduled for a
magnetic resonance imaging of the
skull following a bicycle accident.
Which medication would the nurse
administer to keep the child still
during this procedure?
  conscious sedation
The nurse is planning care for a
premature infant who will be
undergoing an invasive procedure.
While pain medication will be
administered, which additional
nonpharmacologic technique would
be best to incorporate into the client's
treatment plan?
  music therapy
A parent expresses concern about a
child who is reporting shoulder pain
following abdominal laparoscopic
appendectomy. What is the
nurse’s best response to this concern?
  "This is referred pain and is
normal after surgery."
A six-year-old child is observed
sucking the thumb and baby talking
while hospitalized for cellulitis. How
would the nurse explain this to the
parents?
  The child may be in pain.
The nurse caring for an infant
prepares to perform a heel stick. The
parents are at the bedside and ask the
nurse if their infant will feel pain when
stuck. Which is the best response for
the nurse to make?
  Opioid pain medications should
not be prescribed for young
  “Your infant will experience children due to side effects.
pain for a brief moment when  Children will be truthful when
the heel is stuck.” asked if they are experiencing
sensations of pain.
 Behavioral cues often correlate
What behavioral responses to pain accurately with the intensity of
would a nurse observe from an infant the child's pain .
younger than age 1?
The nurse is assessing the abdomen
of a preschooler admitted for lower
right quadrant pain. Which
  Reflex withdrawal to stimulus
assessment questions provide helpful
and facial grimacing
data? Select all that apply.
 "Touch the spot on your tummy
The nurse is caring for a 12-year-old where it hurts."
with cerebral palsy who is unable to  "Choose the face that shows
communicate verbally. Which pain how you feel now." (FACES pain
assessment tool is rating scale)
the most appropriate for the nurse to
use when assessing pain in this client?
A child is being treated for pain. The
nurse is obtaining a pain history from
the parent. Which question(s) would
  Face, leg, activity, cry, and
the nurse ask the parent to obtain the
consolability (FLACC)
appropriate information about the
descriptors
child's pain? Select all that apply.
 "Has your child been in pain
The nurse is reviewing literature about before?"
pain management in children. Which  "When your child has had pain,
statement(s) would the nurse identify how did the child react?"
as a misconception regarding pain in  "If your child has been treated
children? Select all that apply. for pain, how did the child
 Newborns typically do not feel indicate relief?"
pain due to immature nerve  "Does your child have chronic
patterns. pain?"
 "Is there any sign your child
exhibits that makes you believe
the child is in pain?"