COMPLETE SOLUTIONS
A 2-year-old child has been returned to the nursing unit after an
inguinal hernia repair. Which pain assessment tool should the
nurse use to assess this child for the presence of pain?
a. FACES pain rating tool
b. Numeric scale
c. Oucher scale
d. FLACC tool Correct Answers d. FLACC tool
A behavioral pain tool should be used when the child is
preverbal or doesn't have the language skills to express pain.
The FLACC (face, legs, activity, cry, consolability) tool should
be used with a 2-year-old child. The FACES, numeric, and
Oucher scales are all self-report pain rating tools. Self-report
measures are not sufficiently valid for children younger than 3
years of age because many are not able to accurately self-report
their pain
A 64-year-old patient just returned from surgery. She is
breathing rapidly and moving constantly in bed. She states, "I
am scared and I hurt so much." What would be an appropriate
intervention? Select all that apply.
,a) Immediately notify the surgeon of these data (physical
symptoms and patient's statement).
b) State calmly, "I am going to do everything I can to make you
more comfortable."
c) Tell the patient you would like to help her calm down and
take some deep breaths.
d) Ask the nursing assistive personnel to stay with the patient
while you get an analgesic for her.
e) Turn on the television to distract her from the pain and
anxiety. Correct Answers b) State calmly, "I am going to do
everything I can to make you more comfortable."
c) Tell the patient you would like to help her calm down and
take some deep breaths.
d) Ask the nursing assistive personnel to stay with the patient
while you get an analgesic for her.
Relaxation exercises, deep breathing, and other
nonpharmacological measures can also help to take the edge off
the patient's pain experience and help the patient to feel more in
control; therefore, you should provide comfort measures to the
patient. The goal would be to calm her so you can perform a
thorough assessment. Calming anxiety also helps to relieve pain.
Analgesics help reduce pain, which will also lessen the anxiety
that can aggravate a pain experience. You would not call the
,surgeon before the assessment, but rather after you have
determined that her condition requires medical evaluation.
Although turning on the television might be helpful by
providing distraction, for others the noise might overstimulate
and further increase the pain. It would be better to manage the
pain with therapeutic measures, instead of turning on the
television while the patient is still in pain.
A 70-year-old male with diabetic peripheral neuropathy reports
a burning sensation in his feet. He also states, "Those pain pills
make me feel funny and they don't help my pain, so I don't take
them." Which of the following is likely to be most beneficial for
treating this patient's neuropathic pain?
a) Opioid analgesic (morphine)
b) NSAID (ibuprofen)
c) Antiepileptic drug (gabapentin)
d) Narcotic analgesic with acetaminophen (hydrocodone)
Correct Answers c) Antiepileptic drug (gabapentin)
Gabapentin is an antiepileptic (also known as an anticonvulsant)
that is also used in adults to treat neuropathic pain. Opioids (e.g.,
morphine, hydrocodone) are most effective for certain types of
pain. For instance, visceral pain, which is more generalized, is
most responsive to opioid treatment, whereas neuropathic pain is
, resistant to opioids. Acetaminophen alone is likely not strong
enough to relieve neuropathic pain.
A 73-year-old patient admitted after a stroke has expressive
aphasia. Which pain intensity scales would be appropriate to use
with this patient? Select all that apply.
a) Visual analogue
b) Numerical rating
c) Wong-Baker face rating
d) Simple descriptor
e) PAINAD scale Correct Answers a) Visual analogue
b) Numerical rating
c) Wong-Baker face rating
The visual analogue requires patients to point to a location on a
line that reflects their pain level. Some patients have difficulty
with the abstract nature of this scale. The Wong-Baker face
rating scale uses simple illustrations of faces to depict various
levels of pain. The scale was developed for children but has
proved effective for adults with communication and cognitive
impairments. When using the numerical rating scale, the patient
must choose a number from 0 to 10 to denote his pain level. This
scale is sometimes difficult for clients with cognitive