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When treating a child experiencing moderate to severe pain, is Morphine considered the "gold standard" in pharmacological intervention? T/F
True
Page 405
You are providing d/c teaching to a mother of a 4 yo with a fractured wrist. She asked how much aspirin is needed if the child is experiencing pain. The nurse should respond:
A) Aspirin should be avoided for children. Ibuprofen is a safer choice.
B) For her weight, 200mg per dose. NTE 2.5g/day
C) I recommend following directions on the bottle
D) You shouldn’t give her that. It can increase the risk of cancer.
A) Aspirin should be avoided for children. Ibuprofen is a safer choice.
Preterm infants feel pain at a greater intensity than older-age children and adults. T/F
True
(pg388)
What type of medication should not be used for infants and children for analgesic or antipyretic purposes because of the high risk of Reye syndrome?
A. Tylenol
B. Morphine
C. Aspirin
D. Dilaudid
C. Aspirin
The parents of a newborn presenting with hypoglycemia inform you about their concern about their child experiencing pain during the heel stick procedure. What nonpharmacologic treatment would you suggest to reduce pain related to this procedure?
A. Applying cold compresses for 10 min after the heel stick
B. Positive self-talk
C. Biofeedback
D. Giving the newborn a pacifier
D. Giving the newborn a pacifier
(pg403)
True or False: A Preschooler is verbally expressive in reporting pain. They use specific words such as "Sharp", "Burning", "Dull", or "Pulling" to describe pain sensations.
False
"Because they may have limited experience with pain, they may have difficulty distinguishing between types of pain" pg 389
Management of procedural-related pain includes the following, except:
a. hiding instruments prior to the procedure
b. letting the child play with instruments prior to procedure
c. applying EMLA cream
d. having the caregiver hug the child
B. letting the child play with instruments prior to the procedure
Page 412
Equipment should be kept out of site until ready to use to reduce distress
Pain that develops within the organs, diffuse and poorly localized, is defined as:
A. Visceral pain
B. Somatic pain
C. Neuropathic pain
D. Nociceptive pain
A. Visceral pain
A nurse is caring for a 5yo child post-op abdominal surgery earlier in the day. The nurse notes the child has not reported pain to any of the staff. Which action by the nurse is indicated?
A) Contact the physician to report the condition.
B) administer prophylactic antibiotics.
C) encourage the child to report pain.
D) observe for behavioral cues consistent with pain.
D) observe for behavioral cues consistent with pain.
pg 395
T/F: Parents always report when they notice changes suggesting that their child is uncomfortable
False
Nursing alert on page 391
"Parents may assume nurses have greater expertise when it comes to assessing their child's pain.... emphasize the importance of parents reporting changes that indicate pain"
What would be a technique used to promote relaxation to a child in pain?
A. Listening to music or singing
B. Encouraging the child to create a pleasurable mental image
C. Holding and stroking the child
D. Teaching the child to say positive statements when experiencing pain
C. Holding and Stroking the child
"Reducing muscle tension and anxiety...child focus on one area of the body and let that body part go limp" pg 402
An adolescent is receiving morphine IV for pain control. Which intervention (s) will be included in the nursing care plan? Select all that apply.
A) provide stand-by assistance when the client uses the bathroom.
B) monitor for fever.
C) Have naloxone readily available.
D) monitor for itching.
E) assess suppressed cough reflex.
A) provide stand-by assistance when the client uses the bathroom.
C) Have naloxone readily available
D) monitor for itching
Page 401
If a child explains that they are feeling pain in their leg that is described as inexplicable, continuous burning, tingling, and spasming, they are describing which classification of pain?
A. visceral pain
B. somatic pain
C. neuropathic pain
D. nociceptive pain
C. neuropathic pain
Page 386
When developing a plan of care for a child in pain, the nurse identifies appropriate strategies aimed at modifying which factors influence pain.
A. Gender
B. Cognitive level
C. Previous pain experiences
D. Anticipatory anxiety
D. Anticipatory anxiety
page 387
"Situational factor that may exacerbate pain"
The nurse is providing post-surgical care for a 5-year-old. The nurse knows to avoid which question when assessing the child’s pain level.
A. Would you say that the pain you are feeling is sharp or dull?
B. Would you point to the cartoon face that best describes your pain?
C. Would you point to the spot where your pain is?
D. Would you please show me which photograph and number best describes your hurt?
A. Would you say that the pain you are feeling is sharp or dull?
Preschool-age children may have difficulty distinguishing types of pain page 389
What are the receptors located at the ends of the peripheral nerve fibers that extend from the spinal cord to various areas throughout the body's tissues?
A. pain receptors
B. nociceptors
C. transceptors
D. neuroreceptors
B. Nociceptors
page 384
The nurse assesses a newborn by rating facial expression, body movement, sleep, verbal, consolability, and response to movement/touch. What scale is he using?
A. The Riley Infant Pain Scale
B. The neonatal infant pain scale (NIPS)
C. Pain observation scale for young children (POCIS)
D. FLACC behavioral scale
E. CRIES scale for neonatal post-op pain assessment
A. The Riley Infant Pain Scale (p.396)
What does the FLACC scale stand for and what is it used for? Name the 5 key assessments
Face, Legs, Activity, Cry, and Consolability
Behavioral pain assessment in nonverbal young children
(page reference: 398)
4. Nociceptors become activated when exposed to noxious stimuli. All of the following are types of noxious stimuli EXCEPT:
A) physical
B) mechanical
C) chemical
D) thermal
A) physical (384pg)
After teaching a child’s parents about the different methods of distraction that can be used for pain management, which statement by the parents indicates a need for additional teaching?
A. “We’ll have her focus on her hand and count each finger slowly”
B. “We’ll read some of her favorite stories to her”
C. “We’ll have her image that she’s at the beach this summer”
D. “She likes to play video games, so we’ll bring in some from home”
C. “We’ll have her image that she’s at the beach this summer”
page 402
If there’s an absence of typical behaviors indicating pain during a painful procedure, what other pain responses can be observed in a full-term newborn? Select all that apply
A. Increased vagal tone
B. Decreased oxygenation
C. Bradycardia
D. Decreased vagal tone
B. Decreased oxygenation
D. Decreased vagal tone
Page 388 -- Bradycardia only for preterms, vagal tone would decrease not increase
The nurse is explaining to a new graduate nurse about how to assess for pain in an infant. The nurse knows the teaching was effective when the graduate nurse identifies which symptom(s) as a sign of pain? Select all that apply:
A. Nociceptive pain
B. Chronic Pain
C. Visceral Pain
D. Neuropathic pain
E. Somatic pain
F. Cutaneous pain
A. Grimacing
B. Tachypnea
C. Muscle tension
D. Crying
E. Vigorous body movement
F. Agitation
Page 388
The two types of nonpharmacologic pain management to treat mild pain in children include behavioral-cognitive strategies and biophysical strategies. Which of the statements below are correct? Select all that Apply:
A. Behavioral-cognitive strategies include imagery, massage, and pressure
B. Biophysical strategies include heat and cold applications
C. Behavioral-cognitive strategies include relaxation and distraction
D. Biophysical strategies include relaxation and distraction
E. Behavioral-cognitive strategies include imagery
B. Biophysical strategies include heat and cold applications
C. Behavioral-cognitive strategies include relaxation and distraction
E. Behavioral-cognitive strategies include imagery
page 402
What AGE group typically uses the FACES pain rating scale?
A. Children 3 to 8 years of age
B. Children 2 to 9 years of age
C. Children 2 to 6 years of age
D. Children 1 to 3 years of age
A. Children 3 to 8 years of age
Page 382
Which situation would alert you to the presence of pain? Select all that apply
A. A full-term newborn with a HR of 170bpm and high-pitched cry
B. An infant crying with decreased O2 saturation
C. A 7 years-old boy who is staring at the television during a procedure
D. An infant sleeping in the bassinet with a HR of 125 bpm
E. A toddler clinging to the parents when you approach him
A. A full term newborn with a HR of 170bpm and high-pitched cry
B. An infant crying with decreased O2 saturation
C. A 7 years-old boy who is staring at the television during a procedure (Withdrawal reaction from fear of being embarrassed by acting out)
E. A toddler clinging to the parents when you approach him -- (regressive behavior)
(Page 388)