MIDTERM ch 15, 16, 18, 19 Flashcards
What is the primary goal of pain assessment in pediatric patients?
a) To determine the child’s pain tolerance level
b) To identify the source of pain for diagnostic purposes
c) To provide accurate information about the pain’s location, intensity, and effects on functioning
d) To assess the parent’s perception of the child’s pain
c) To provide accurate information about the pain’s location, intensity, and effects on functioning
Rationale: The primary goal of pain assessment in children is to gather precise details about the location and intensity of pain and understand how it affects the child’s overall functioning. This information guides appropriate pain management strategies.
What type of information is crucial to obtain from parents during a pain history assessment of a child?
a) The child’s pain tolerance level
b) The child’s preferred activities
c) The child’s typical response to pain and coping strategies
d) The parent’s medical history
c) The child’s typical response to pain and coping strategies
Rationale: Parents can provide valuable information about how the child typically expresses, copes with, and manages pain, as well as what works best to alleviate it.
When assessing a child’s pain history, what is the primary reason for asking parents about the child’s preferred word for pain?
a) To improve communication with the child
b) To determine the child’s literacy level
c) To teach the child standardized medical terminology
d) To gauge the child’s maturity level
a) To improve communication with the child
Rationale: Knowing the child’s preferred term for pain facilitates clear and effective communication between the nurse and the child.
A child has had several painful procedures in the past. What behavior might this child exhibit during future painful experiences compared to a child with fewer painful experiences?
a) Increased stress and anxiety
b) Fewer overt signs of stress
c) Hypervigilance to the environment
d) Increased reliance on parents for comfort
b) Fewer overt signs of stress
Rationale: Children with a history of several painful experiences may not exhibit the same types of stressful behaviors as those with limited pain experiences due to learned coping mechanisms.
When conducting a pain history, why is it important to ask older children about their past experiences with painful procedures?
a) To assess their pain tolerance
b) To compare their pain threshold with their peers
c) To determine if they understand the purpose of the procedure
d) To develop a pain management plan based on previous effective strategies
d) To develop a pain management plan based on previous effective strategies
Rationale: Understanding what interventions have been effective in the past helps tailor a pain management plan that meets the child’s individual needs.
Why might children modify their pain descriptions during an assessment?
a) They want to avoid medical interventions.
b) They lack the vocabulary to describe pain accurately.
c) They adjust their responses based on what they think will happen as a result.
d) They are unsure of the purpose of the questions.
c) They adjust their responses based on what they think will happen as a result.
Rationale: Children may alter their pain descriptions depending on their expectations about what actions the nurse or caregiver might take.
When asking parents about what works best to alleviate their child’s pain, which type of response should the nurse prioritize?
a) Specific interventions that the child prefers
b) General advice from the parent’s own experiences
c) The effectiveness of over-the-counter medications
d) The child’s history of medication allergies
a) Specific interventions that the child prefers
Rationale: Understanding what the child finds effective for pain relief ensures that the nurse can implement strategies that align with the child’s preferences and comfort.
A nurse is assessing a child’s pain history. Which question would best help identify the child’s coping strategies?
a) “What do you do when something hurts?”
b) “Where do you hurt the most?”
c) “What medicines have you taken for pain?”
d) “Who helps you when you are in pain?”
a) “What do you do when something hurts?”
Rationale: This question directly explores the child’s personal strategies for managing pain, which is critical for developing an effective pain management plan.
During a pain history assessment, why is it important to ask children what they want the nurse to do for their pain?
a) To establish rapport with the child
b) To involve the child in creating a care plan
c) To teach the child self-management skills
d) To assess the child’s understanding of their condition
b) To involve the child in creating a care plan
Rationale: Asking children for their input on pain management promotes a sense of control and helps the nurse develop a care plan tailored to the child’s needs and preferences.
Which factor is most important when selecting a pain assessment tool for use in pediatric patients?
a) The tool is simple to use and quick to administer
b) The tool requires minimal input from parents or caregivers
c) The tool is approved by the healthcare facility
d) The tool is validated and reliable for the target population
d) The tool is validated and reliable for the target population
Rationale: The most important factors in selecting a pain assessment tool are its validity (accuracy in measuring the intended concept) and reliability (consistency of results). These ensure that the tool provides accurate and trustworthy data.
A nurse uses a pain assessment tool with a pediatric patient. Which outcome demonstrates the tool’s reliability?
a) It provides consistent pain scores across different raters.
b) It measures both physical and emotional aspects of pain.
c) It identifies pain intensity on a 0-10 scale.
d) It includes both subjective and objective pain data.
a) It provides consistent pain scores across different raters.
Rationale: Reliability refers to the ability of a pain assessment tool to yield consistent results when used by the same or different raters, ensuring its dependability in clinical practice.
What is the primary purpose of using behavioral pain scales, such as the Neonatal Infant Pain Scale (NIPS), in nonverbal children?
a) To standardize pain management protocols
b) To identify physical causes of pain
c) To quantify pain based on observed behaviors
d) To assess the effectiveness of medication compliance
c) To quantify pain based on observed behaviors
Rationale: Behavioral pain scales, like NIPS, are used to objectively measure and quantify pain in nonverbal children by observing their physical and behavioral indicators.
A nurse using the Faces, Legs, Activity, Cry, and Consolability (FLACC) tool observes that a nonverbal child has tense legs, is fidgeting, crying occasionally, and is difficult to console. What is the nurse’s next step?
a) Provide pain medication based on the FLACC score.
b) Notify the physician immediately.
c) Reassess the child’s pain in 30 minutes.
d) Document the behaviors and reassess using another tool.
a) Provide pain medication based on the FLACC score.
Rationale: The FLACC tool quantifies pain based on observed behaviors, and the score guides the nurse in providing appropriate interventions, such as pain medication.
When using the Neonatal Infant Pain Scale (NIPS), which of the following behaviors would the nurse assess?
a) Verbal expression of pain and vital signs
b) Crying, facial expressions, and limb movement
c) Reflex responses and oxygen saturation levels
d) Sleep patterns and respiratory rate
b) Crying, facial expressions, and limb movement
Rationale: The NIPS tool evaluates specific physical and behavioral indicators, including crying, facial expressions, and movement, to assess pain in neonates and nonverbal children.
A 6-month-old infant is being assessed for pain using the FLACC tool. Which of the following would contribute to the scoring?
a) Duration of crying and heart rate changes
b) Facial grimacing and difficulty consoling the infant
c) Sleeping patterns and muscle tone
d) Parent’s report of pain behaviors
b) Facial grimacing and difficulty consoling the infant
Rationale: The FLACC tool assesses five categories: facial expression, leg movement, activity level, crying, and consolability to evaluate pain in nonverbal children.
Which statement accurately describes the FLACC tool in pediatric pain assessment?
a) It is suitable for children who can verbalize their pain intensity.
b) It provides a numerical pain score based solely on vital signs.
c) It is designed to assess behavioral indicators of pain in nonverbal children.
d) It evaluates cognitive responses to pain stimuli.
c) It is designed to assess behavioral indicators of pain in nonverbal children.
Rationale: The FLACC tool is an observational scale used to assess pain in nonverbal children by evaluating behavioral indicators such as facial expressions, leg movement, activity, crying, and consolability.
Which facial expression would indicate the highest level of pain in an infant according to the scoring criteria?
a) Restful face with neutral expression
b) Furrowed brow, chin, and jaw with tight facial muscles
c) Occasional grimace with relaxed facial muscles
d) Open mouth with no visible expression
b) Furrowed brow, chin, and jaw with tight facial muscles
Rationale: Tight facial muscles and furrowing of the brow, chin, and jaw are indicators of severe pain in an infant according to the characteristic scoring criteria.
When assessing an intubated infant, which observation would indicate a “silent cry”?
a) Lack of sound with no facial movement
b) Loud, continuous moaning
c) Intermittent crying with relaxed breathing patterns
d) Obvious facial movements without audible crying
d) Obvious facial movements without audible crying
Rationale: Silent crying may occur in intubated infants, indicated by visible facial movements despite the absence of sound.
Which arm movement suggests the presence of pain in an infant?
a) Tense, straight arms with rigidity
b) Random movements of arms
c) Slow, controlled arm movements
d) Relaxed arms with no visible tension
a) Tense, straight arms with rigidity
Rationale: Tense or rigid arm movements, or rapid extension and flexion, are indicators of pain in an infant.
What breathing pattern is most consistent with moderate pain in an infant?
a) Usual breathing pattern maintained
b) Gagging or holding breath
c) Irregular or faster than usual breaths
d) Loud gasping with intermittent pauses
c) Irregular or faster than usual breaths
Rationale: Moderate pain can cause changes in breathing, such as irregular or faster-than-usual patterns, as described in the scoring criteria.
What leg movement would score the lowest on the pain scale for an infant?
a) Tense, straight legs with rigidity
b) Random movements of legs
c) Rapid extension and flexion
d) No movement of legs
b) Random movements of legs
Rationale: Relaxed, random leg movements indicate a lack of pain, which corresponds to the lowest pain score.
An infant is thrashing and fussy during an assessment. How would you classify the infant’s state of arousal?
a) Quiet and peaceful
b) Restless and alert
c) Alert and thrashing
d) Sleeping peacefully
c) Alert and thrashing
Rationale: Thrashing and fussiness are indicative of pain, which corresponds to a higher score on the state of arousal criteria.
Which cry pattern is most consistent with severe pain in an infant?
a) Quiet, not crying
b) Mild moaning or intermittent cry
c) Loud screaming with a rising, shrill, continuous cry
d) Occasional whimpering
c) Loud screaming with a rising, shrill, continuous cry
Rationale: A loud, shrill, continuous cry is indicative of severe pain according to the scoring criteria.
What state of arousal would indicate that an infant is experiencing mild pain?
a) Quiet and peaceful
b) Alert and settled
c) Sleeping peacefully
d) Fussy but not thrashing
d) Fussy but not thrashing
Rationale: Mild pain may cause the infant to become fussy, restless, or slightly agitated, but not exhibit severe behaviors like thrashing.