YOU
A child who is terminally ill with bone cancer is in severe pain. Nursing interventions should be based on the knowledge that
A. large doses of opioids are justified when there are no other treatment options.
B. children tend to be overmedicated for pain.
C. giving large doses of opioids causes euthanasia.
D. narcotic addiction is common in terminally ill children.
A. large doses of opioids are justified when there are no other treatment options.
Nonpharmacologic strategies for pain management
A. may reduce pain perception.
B. make pharmacologic strategies unnecessary.
C. usually take too long to implement.
D. trick children into believing they do not have pain.
A. may reduce pain perception.
A nurse is caring postoperatively for an 8-year-old child with multiple fractures and other trauma resulting from a motor vehicle injury. The child is experiencing severe pain. Which is an important consideration in managing the child’s pain?
A. Give only an opioid analgesic at this time.
B. Increase the dosage of analgesic until the child is adequately sedated.
C. Give the child a clock and explain when he or she can have pain medications.
D. Plan a preventive schedule of pain medication around the clock.
D. Plan a preventive schedule of pain medication around the clock.
A nurse is assessing a pediatric patient in the intensive care unit. Which finding on the COMFORT score if noted would not require intervention relative to pain management?
A. Score of 8
B. Score of 10
C. Score of 25
D. Score of 40
C. Score of 25
The most consistent indicator of pain in infants is
A. increased respirations.
B. increased heart rate.
C. clenching the teeth and lips.
D. a facial expression of discomfort.
D. a facial expression of discomfort.
The nurses caring for a child are concerned about the child’s frequent requests for pain medication. During a team conference, a nurse suggests that they consider administering a placebo instead of the usual pain medication. This decision should be based on knowledge that
A. the absence of a response to a placebo means the child’s pain has an organic basis.
B. it is unjustified and unethical to administer placebos instead of pain medication.
C. a positive response to a placebo will not occur if the child’s pain has an organic basis.
D. administering a placebo instead of the usual pain medication is effective in determining whether a child’s pain is real.
B. it is unjustified and unethical to administer placebos instead of pain medication.
The nurse is caring for a comatose child with multiple injuries. The nurse should recognize that pain
A. cannot occur if child is comatose.
B. may occur if child regains consciousness.
C. requires astute nursing assessment and management.
D. is best assessed by family members who are familiar with child.
C. requires astute nursing assessment and management.
A pediatric patient is brought to the clinic for follow up immunizations and is apprehensive about injections and needles. Which method could the nurse implement to facilitate administration of immunization without causing the child undue anxiety?
A. Offer the child an ice cream if you are allowed to give the injection.
B. Tell the patient’s mother that she must swaddle him and cover his eyes tightly once the medication is drawn up and ready to be injected.
C. Encourage the child to talk about the toy he is holding and focus on the conversation to allay the child’s fears.
D. Instead of an injection, provide the medication via a topical route.
C. Encourage the child to talk about the toy he is holding and focus on the conversation to allay the child’s fears.
A nurse is starting an intravenous (IV) line for a school-age child with cancer. The child says, “I have had a million IVs. They hurt.” The nurse’s response should be based on the knowledge that
A. children tolerate pain better than adults.
B. children become accustomed to painful procedures.
C. children often demonstrate increased behavioral signs of discomfort with repeated painful procedures.
D. children often lie about experiencing pain.
C. children often demonstrate increased behavioral signs of discomfort with repeated painful procedures.
A child who has been receiving morphine by the intravenous (IV) route will now start receiving it orally. In order for equianalgesia (equal analgesic effect) to be achieved, the oral dose will be
A. same as the IV dose.
B. greater than the IV dose.
C. one half of the IV dose.
D. one fourth of the IV dose.
B. greater than the IV dose.
A child is being seen in the emergency department with multiple facial abrasions and lacerations. The combination agent lidocaine, adrenaline, and tetracaine (LAT) is applied topically to the wounds. The purpose of this combination therapy is to
A. cleanse the wound.
B. promote scab formation.
C. prevent infection of the wound.
D. provide anesthesia to the wound.
D. provide anesthesia to the wound.
Which 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 of age.
C. The scale is not appropriate for use with adolescents.
D. The scale is useful in pain assessment but is not as accurate when assessing physiologic responses.
B. The scale can be used with most children as young as 3 years of age.
Transdermal fentanyl (Duragesic) is being used for an adolescent with cancer who is in hospice care. The adolescent has been comfortable for several hours but now complains of severe pain. The most appropriate nursing action is to
A. administer meperidine (Demerol) intramuscularly.
B. use a nonpharmacologic strategy.
C. administer morphine sulfate immediate release (MSIR) intravenously.
D. place another fentanyl (Duragesic) patch on the adolescent.
C. administer morphine sulfate immediate release (MSIR) intravenously.
The nurse is caring for a 12-year-old child who sustained major burns when putting charcoal lighter on a campfire. The nurse observes that the child is “very brave” and appears to accept pain with little or no response. What is the most appropriate nursing action?
A. Request a psychological consultation.
B. Ask why the child does not have pain.
C. Praise the child for the ability to withstand pain.
D. Encourage continued bravery as a coping strategy.
A. Request a psychological consultation.
Which type of disease presentations are associated with recurrent pain in children? (Select all that apply.)
A. Daily headache
B. Migraine headache
C. Abdominal pain
D. Complex regional pain syndrome
E. Phantom limb pain
B. Migraine headache
C. Abdominal pain
E. Phantom limb pain
A 6-year-old is hospitalized with a fractured femur. Based on the nurse’s knowledge of pain assessment tools and child development, which assessment tools are most appropriate for this age child? (Select all that apply.)
A. Oucher scale
B. CRIES scale
C. Poker chip tool
D. Faces pain scale
E. Postoperative pain score
B. CRIES scale
C. Poker chip tool
Which medication order would require immediate intervention by the nurse in order to prevent potential complications for the pancytopenic cancer pediatric patient?
A. Offer fluids to hydrate the patient
B. Administer Aleve for relief of joint related pain
C. Administer Neupogen as ordered
D. Administer morphine for severe pain as ordered
B. Administer Aleve for relief of joint related pain