Chapter 39 Pain Management for Children

Chapter 39  Pain Management for Children

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. When assessing a child for pain, the nurse is aware that

a. neonates do not feel pain.
b. pain is an individualized experience.
c. children do not remember pain.
d. a child must cry to express pain.

ANS: B
The manner and intensity of how a child expresses pain is dependent on the individual
child’s experiences. Neonates do express a total-body response to pain with a cry that is
intense, high pitched, and harsh sounding. Children of all ages have been reported to have
sleeping and eating disruptions after painful experiences. Not all children will cry to express
pain.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 869 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity

2. When pain is assessed in an infant, it is inappropriate to assess for

a. facial expressions of pain.
b. localization of pain.
c. crying.
d. thrashing of extremities.

ANS: B
Infants cannot localize pain to any great extent. Frowning, grimacing, and facial flinching in
an infant may indicate pain. Infants often exhibit high-pitched, tense, harsh crying to express
pain. Infants may exhibit thrashing extremities in response to a painful stimulus.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 872 | Box 39.2 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity

3. The nurse knows that physiologic changes associated with pain in the neonate include

a. increased blood pressure and decreased arterial saturation.
b. decreased blood pressure and increased arterial saturation.
c. increased urine output and increased heart rate.
d. decreased urine output and increased blood pressure.

ANS: A
An increase in blood pressure and a decrease in arterial saturation can be noted when the
neonate is feeling pain. Urinary output changes have not been associated with pain.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 872 | Box 39.2 OBJ: Nursing Process: Assessment

MSC: Client Needs: Physiologic Integrity

4. What myth may interfere with the treatment of pain in infants and children?

a. Infants may have sleep difficulties after a painful event.
b. Children and infants are more susceptible to respiratory depression from narcotics.
c. Pain in children is multidimensional and subjective.
d. A child’s cognitive level does not influence the pain experience.

ANS: B
No data are available to support the belief that infants and children are at higher risk of
respiratory depression when given narcotic analgesics. This is a myth. It is true that infants
may have sleep difficulties after a painful event. This is not a myth. Pain in children is
multidimensional and subjective. The child’s cognitive level, along with emotional factors
and past experiences, does influence the perception of pain in children. This is not a myth.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 871 | Table 39.1 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity

5. The nurse caring for the child in pain knows that distraction

a. can give total pain relief to the child.
b. is effective when the child is in severe pain.
c. is the best method for pain relief.
d. must be developmentally appropriate to refocus attention.

ANS: D
Distraction can be very effective in helping to control pain, but it must be appropriate to the
child’s developmental level. Distraction can help control pain, but it is rarely able to provide
total pain relief. Children in severe pain are not distractible. Children may use distraction to
help control pain, but it is not the best method for pain relief.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 876 OBJ: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity