Pediatric Pain Management Exam Practice
Questions 1–150
1. What is the most reliable method for assessing pain in infants
under 6 months of age?
A. Self-report
B. Numerical Rating Scale
C. Behavioral observation scales
D. Visual Analog Scale
Rationale: Behavioral observation scales, such as the Neonatal
Infant Pain Scale (NIPS), are used in non-verbal infants to assess
pain based on facial expressions, crying, and physiological signs.
2. A 7-year-old child reports pain after surgery. Which tool is most
appropriate?
A. FLACC scale
B. Faces Pain Scale-Revised (FPS-R)
C. NIPS
D. COMFORT scale
Rationale: The FPS-R allows children aged 4–12 to self-report
pain using facial expressions corresponding to pain intensity.
3. Which of the following is a common side effect of opioids in
children?
A. Hyperactivity
B. Constipation
C. Increased appetite
D. Hypertension
Rationale: Opioids commonly cause constipation due to
decreased gastrointestinal motility.
,4. What is the maximum recommended dose of acetaminophen in
children per day?
A. 20 mg/kg/day
B. 40 mg/kg/day
C. 75–90 mg/kg/day
D. 150 mg/kg/day
Rationale: The safe maximum daily dose of acetaminophen for
children is 75–90 mg/kg/day divided into appropriate intervals.
5. A child with sickle cell disease presents with vaso-occlusive pain.
The best initial pain management is:
A. NSAIDs only
B. Opioids with adjunctive NSAIDs
C. Acetaminophen only
D. Ice packs only
Rationale: Severe pain from vaso-occlusive crises often requires
opioids; NSAIDs can be used as adjuncts for inflammation and
pain control.
6. Which non-pharmacologic method is effective in reducing
procedural pain in neonates?
A. Distraction with toys
B. Sucrose or glucose solution
C. Heat application
D. Cold therapy
Rationale: Small amounts of oral sucrose or glucose can trigger
endogenous opioid release and reduce procedural pain in
neonates.
7. For a 10-year-old child, which pain scale is least reliable?
A. Faces Pain Scale-Revised
B. Visual Analog Scale
, C. Numeric Rating Scale
D. Neonatal Infant Pain Scale
Rationale: The NIPS is designed for infants and is not
appropriate for children who can self-report their pain.
8. Which route of opioid administration provides the fastest pain
relief in children?
A. Oral
B. Rectal
C. Intravenous
D. Transdermal
Rationale: IV administration delivers the medication directly into
the bloodstream for rapid onset of analgesia.
9. A child on long-term opioid therapy should be monitored for:
A. Hyperactivity
B. Tolerance and dependence
C. Weight loss
D. Fever
Rationale: Chronic opioid use can lead to tolerance (requiring
higher doses for effect) and physiological dependence.
10. Which NSAID is commonly used for pediatric pain?
A. Celecoxib
B. Ibuprofen
C. Ketorolac IM only
D. Naproxen in adults only
Rationale: Ibuprofen is widely used in children for mild to
moderate pain due to its efficacy and safety profile when dosed
correctly.
11. Which statement regarding acetaminophen in children is
correct?
, A. It has strong anti-inflammatory effects
B. It should never be combined with opioids
C. It is safe for fever and mild pain when dosed appropriately
D. Overdose rarely causes liver injury
Rationale: Acetaminophen is safe for pain and fever when used
within recommended dosages; overdose can lead to
hepatotoxicity.
12. Which of the following is considered a psychological
intervention for pediatric pain?
A. Acetaminophen
B. Guided imagery
C. Morphine
D. Lidocaine patch
Rationale: Guided imagery and relaxation techniques can reduce
pain perception by distracting the child and altering pain
processing.
13. A 5-year-old child refuses IV insertion and shows extreme
distress. The nurse should:
A. Force the child to comply
B. Use distraction techniques and consider topical anesthetics
C. Postpone the procedure indefinitely
D. Sedate without consent
Rationale: Combining distraction with topical anesthetics
reduces procedural pain and distress while respecting the child’s
autonomy.
14. The FLACC pain scale evaluates:
A. Only physiological responses
B. Self-report of pain
C. Face, Legs, Activity, Cry, Consolability
Questions 1–150
1. What is the most reliable method for assessing pain in infants
under 6 months of age?
A. Self-report
B. Numerical Rating Scale
C. Behavioral observation scales
D. Visual Analog Scale
Rationale: Behavioral observation scales, such as the Neonatal
Infant Pain Scale (NIPS), are used in non-verbal infants to assess
pain based on facial expressions, crying, and physiological signs.
2. A 7-year-old child reports pain after surgery. Which tool is most
appropriate?
A. FLACC scale
B. Faces Pain Scale-Revised (FPS-R)
C. NIPS
D. COMFORT scale
Rationale: The FPS-R allows children aged 4–12 to self-report
pain using facial expressions corresponding to pain intensity.
3. Which of the following is a common side effect of opioids in
children?
A. Hyperactivity
B. Constipation
C. Increased appetite
D. Hypertension
Rationale: Opioids commonly cause constipation due to
decreased gastrointestinal motility.
,4. What is the maximum recommended dose of acetaminophen in
children per day?
A. 20 mg/kg/day
B. 40 mg/kg/day
C. 75–90 mg/kg/day
D. 150 mg/kg/day
Rationale: The safe maximum daily dose of acetaminophen for
children is 75–90 mg/kg/day divided into appropriate intervals.
5. A child with sickle cell disease presents with vaso-occlusive pain.
The best initial pain management is:
A. NSAIDs only
B. Opioids with adjunctive NSAIDs
C. Acetaminophen only
D. Ice packs only
Rationale: Severe pain from vaso-occlusive crises often requires
opioids; NSAIDs can be used as adjuncts for inflammation and
pain control.
6. Which non-pharmacologic method is effective in reducing
procedural pain in neonates?
A. Distraction with toys
B. Sucrose or glucose solution
C. Heat application
D. Cold therapy
Rationale: Small amounts of oral sucrose or glucose can trigger
endogenous opioid release and reduce procedural pain in
neonates.
7. For a 10-year-old child, which pain scale is least reliable?
A. Faces Pain Scale-Revised
B. Visual Analog Scale
, C. Numeric Rating Scale
D. Neonatal Infant Pain Scale
Rationale: The NIPS is designed for infants and is not
appropriate for children who can self-report their pain.
8. Which route of opioid administration provides the fastest pain
relief in children?
A. Oral
B. Rectal
C. Intravenous
D. Transdermal
Rationale: IV administration delivers the medication directly into
the bloodstream for rapid onset of analgesia.
9. A child on long-term opioid therapy should be monitored for:
A. Hyperactivity
B. Tolerance and dependence
C. Weight loss
D. Fever
Rationale: Chronic opioid use can lead to tolerance (requiring
higher doses for effect) and physiological dependence.
10. Which NSAID is commonly used for pediatric pain?
A. Celecoxib
B. Ibuprofen
C. Ketorolac IM only
D. Naproxen in adults only
Rationale: Ibuprofen is widely used in children for mild to
moderate pain due to its efficacy and safety profile when dosed
correctly.
11. Which statement regarding acetaminophen in children is
correct?
, A. It has strong anti-inflammatory effects
B. It should never be combined with opioids
C. It is safe for fever and mild pain when dosed appropriately
D. Overdose rarely causes liver injury
Rationale: Acetaminophen is safe for pain and fever when used
within recommended dosages; overdose can lead to
hepatotoxicity.
12. Which of the following is considered a psychological
intervention for pediatric pain?
A. Acetaminophen
B. Guided imagery
C. Morphine
D. Lidocaine patch
Rationale: Guided imagery and relaxation techniques can reduce
pain perception by distracting the child and altering pain
processing.
13. A 5-year-old child refuses IV insertion and shows extreme
distress. The nurse should:
A. Force the child to comply
B. Use distraction techniques and consider topical anesthetics
C. Postpone the procedure indefinitely
D. Sedate without consent
Rationale: Combining distraction with topical anesthetics
reduces procedural pain and distress while respecting the child’s
autonomy.
14. The FLACC pain scale evaluates:
A. Only physiological responses
B. Self-report of pain
C. Face, Legs, Activity, Cry, Consolability
