Chapter 05: Pain Assessment and Management in Children

Chapter 05: Pain Assessment and Management in Children

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which is the most consistent and commonly used data for assessment of pain in infants?

a.	Self-report
b.	Behavioral
c.	Physiologic
d.	Parental report

 

 

ANS:  B

Behavioral assessment is useful for measuring pain in young children and preverbal children who do not have the language skills to communicate that they are in pain. Infants are not able to self-report. Physiologic measures are not able to distinguish between physical responses to pain and other forms of stress. Parental report without a structured tool may not accurately reflect the degree of discomfort.

 

DIF:    Cognitive Level: Understanding       REF:   p. 152

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

2. Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group?

a.	“No hurt.”
b.	“Red pain.”
c.	“Zero hurt.”
d.	“Least pain.”

 

 

ANS:  A

“No hurt” is a phrase that is simple, concrete, and appropriate to the preoperational stage of the child. Using color is complicated for this age group. The child needs to identify colors and pain levels and then choose an appropriate symbolic color. This is appropriate for an older child. Zero is an abstract construct not appropriate for this age group. “Least pain” is less concrete than “no hurt.”

 

DIF:    Cognitive Level: Applying               REF:   p. 154

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

3. What is an important consideration when using the FACES pain rating scale with children?

a.	Children color the face with the color they choose to best describe their pain.
b.	The scale can be used with most children as young as 3 years.
c.	The scale is not appropriate for use with adolescents.
d.	The FACES scale is useful in pain assessment but is not as accurate as physiologic responses.

 

 

ANS:  B

The FACES scale is validated for use with children ages 3 years and older. Children point to the face that best describes their level of pain. The scale can be used through adulthood. The child’s estimate of the pain should be used. The physiologic measures may not reflect more long-term pain.

 

DIF:    Cognitive Level: Applying               REF:   p. 154

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

4. What describes nonpharmacologic techniques for pain management?

a.	They may reduce pain perception.
b.	They usually take too long to implement.
c.	They make pharmacologic strategies unnecessary.
d.	They trick children into believing they do not have pain.

 

 

ANS:  A

Nonpharmacologic techniques provide coping strategies that may help reduce pain perception, make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics. The nonpharmacologic strategy should be matched with the child’s pain severity and be taught to the child before the onset of the painful experience. Tricking children into believing they do not have pain may mitigate the child’s experience with mild pain, but the child will still know the discomfort was present.

 

DIF:    Cognitive Level: Analyzing             REF:   pp. 163-164    TOP:   Nursing Process: Planning

MSC:  Client Needs: Physiological Integrity

 

5. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?

a.	Tactile stimulation
b.	Commercial warm packs
c.	Doing procedure during infant sleep
d.	Oral sucrose and nonnutritive sucking

 

 

ANS:  D

Nonnutritive sucking attenuates behavioral, physiologic, and hormonal responses to pain. The addition of sucrose has been demonstrated to have calming and pain-relieving effects for neonates. Tactile stimulation has a variable effect on response to procedural pain. No evidence supports commercial warm packs as a pain control measure. With resulting increased blood flow to the area, pain may be greater. The infant should not be disturbed during the sleep cycle. It makes it more difficult for the infant to begin organization of sleep and awake cycles.

 

DIF:    Cognitive Level: Analyzing             REF:   p. 165             TOP:   Nursing Process: Planning

MSC:   Client Needs: Physiological Integrity