Pillitteri: Maternal and Child Health Nursing, 5th Edition
Chapter 38: Pain Management in Children
1. You are caring for an infant who will have surgery. What type of pain assessment would you
use?
A) None, because infants do not remember pain.
B) None, because infants do not feel pain.
C) A self-pain rating scale from 1 to 10.
D) Observation of facial and body actions.
Ans: D
Client Needs: B-2: Nursing process
Cognitive Level: Application
Difficulty: Moderate
Objective: 2
Feedback: Infants do feel pain, so it needs to be rated, prevented, and managed. Because they
are preverbal, observation is the best method to evaluate pain in infants.
2. You teach a child to use a FACES pain rating scale before surgery. At that time, she points to
the smiling face. Following surgery when you suspect she has pain, she points again to the
smiling face. You would interpret this as
A) she does not have pain.
B) she is using the scale to predict what she would like, not what she has.
C) she has difficulty focusing on the right side of the scale.
D) you must be interpreting her degree of pain falsely.
Ans: B
Client Needs: D-4: Nursing process
Cognitive Level: Application
Difficulty: Difficult
Objective: 2
Feedback: Preschoolers use “magical thinking,” or believe that what they wish will come true.
They may use pain scales, therefore, to “wish” for a smiling face, rather than for rating their
pain.
3. You teach a child to imagine that she is swimming in a cool, shady park where nothing can
This study source was downloaded by 100000875267864 from CourseHero.com on 03-02-2025 19:46:43 GMT -06:00
https://www.coursehero.com/file/18433315/Chapter-38-Pain-Management-in-Children/
harm her during a blood drawing procedure. This technique is called
A) imagery.
B) thought stopping.
C) park therapy.
D) nerve stimulation.
Ans: A
Client Needs: D-1: Nursing process
Cognitive Level: Application
Difficulty: Moderate
Objective: 6
Feedback: Because children have keen imaginations, they are able to substitute a pleasant
thought for an unpleasant one (substitution of meaning or imagery).
4. You plan to apply EMLA cream to decrease the pain of an injection. Which of the following
would be the best technique?
A) Apply it immediately before the painful procedure.
B) Wipe it off at least 15 minutes before the procedure.
C) Do not cover it after application to prevent it from discoloring.
D) Apply it at least 1 hour before the procedure.
Ans: D
Client Needs: D-2: Nursing process
Cognitive Level: Comprehension
Difficulty: Moderate
Objective: 5
Feedback: EMLA, a topical anesthetic cream, must be applied at least 1 hour before a procedure
to be effective. It should be covered after application to prevent the child from tasting it (which
could anesthetize the gag reflex) and for maximum absorption.
5. Conscious sedation is a pain management technique that is used with children. During
conscious sedation for a preschooler, which of the following actions would be most important?
A) Keeping the room absolutely quiet so the child can sleep.
B) Assessing vital signs frequently because they can become depressed.
C) Asking the child to periodically count from 1 to 10.
D) Keeping the child's head in a dependent position.
Ans: B
Client Needs: D-2: Nursing process
Cognitive Level: Application
This study source was downloaded by 100000875267864 from CourseHero.com on 03-02-2025 19:46:43 GMT -06:00
https://www.coursehero.com/file/18433315/Chapter-38-Pain-Management-in-Children/
Difficulty: Moderate
Objective: 6
Feedback: Conscious sedation is the use of a drug such as pentobarbital sodium to induce a
conscious but sleepy state. Vital signs must be monitored closely to be certain the child's vital
centers do not become depressed.
6. Behavioral cues must be used to assess for the presence of pain in infants. Which of the
following behaviors suggests pain in a 2-month-old infant?
A) Decreased intake with each feeding.
B) Sleeping longer during naps.
C) Crying when put on abdomen.
D) Continued crying after diaper change and being fed.
Ans: D
Client Needs: D-1: Nursing process
Cognitive Level: Application
Difficulty: Difficult
Objective: 2
Feedback: One of the key behavioral indicators of pain in infants is when they are not comforted
despite typical measures. If the infant has been fed, diapered, and held and continues to cry, this
suggests pain. A 2-month-old infant will usually protest being placed on the abdomen for any
length of time.
7. A 5-year-old boy has been crying when the nurse enters the room. He denies having any pain,
although he is cradling his fractured left arm. What would be the most likely reasons he denies
having any pain?
A) He received an injection in the emergency room.
B) He thinks he needs to be brave.
C) He is afraid of going to sleep.
D) He is afraid of the nurse.
Ans: A
Client Needs: B-2: Nursing process
Cognitive Level: Comprehension
Difficulty: Moderate
Objective: 2
Feedback: If children fear an injection, they may not be honest about their pain. Other methods
and routs of managing pain must be considered in the pediatric population to avoid inflicting
additional pain and fear with injections.
This study source was downloaded by 100000875267864 from CourseHero.com on 03-02-2025 19:46:43 GMT -06:00
https://www.coursehero.com/file/18433315/Chapter-38-Pain-Management-in-Children/
This study source was downloaded by 100000875267864 from CourseHero.com on 03-02-2025 19:46:43 GMT -06:00
https://www.coursehero.com/file/18433315/Chapter-38-Pain-Management-in-Children/
Powered by TCPDF (www.tcpdf.org)