: Pain Assessment and Management in Children
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. 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...
WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Chapter 05: Pain Assessment and Management in Children
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. 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
ANS: D
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.
DIF: Cognitive Level: Apply REF: p. 115
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity
2. The nurse is caring for a 6-year-old girl who had surgery 12 hours ago. The child tells the
nurse that she does not have pain,NURSINGTB.COM
but a few minutes later she tells her parents that she does.
Which should the nurse consider when interpreting this?
a. Truthful reporting of pain should occur by this age.
b. Inconsistency in pain reporting suggests that pain is not present.
c. Children use pain experiences to manipulate their parents.
d. Children may be experiencing pain even though they deny it to the nurse.
ANS: D
Children may deny pain to the nurse because they fear receiving an injectable analgesic or
because they believe they deserve to suffer as a punishment for a misdeed. They may refuse to
admit pain to a stranger but readily tell a parent. Truthfully reporting pain and inconsistency
in pain reporting suggesting that pain is not present are common fallacies about children and
pain. Pain is whatever the experiencing person says it is, whenever the person says it exists.
Pain would not be questioned in an adult 12 hours after surgery.
DIF: Cognitive Level: Analyze REF: p. 116
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Physiologic Integrity
3. A nurse is gathering a history on a school-age child admitted for a migraine headache. The
child states, “I have been getting a migraine every 2 or 3 months for the last year.” The nurse
documents this as which type of pain?
a. Acute
b. Chronic
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, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
c. Recurrent
d. Subacute
ANS: C
Pain that is episodic and reoccurs is defined as recurrent pain. The time frame within which
episodes of pain recur is at least 3 months. Recurrent pain in children includes migraine
headache, episodic sickle cell pain, recurrent abdominal pain (RAP), and recurrent limb pain.
Acute pain is pain that lasts for less than 3 months. Chronic pain is pain that lasts, on a daily
basis, for more than 3 months. Subacute is not a term for documenting type of pain.
DIF: Cognitive Level: Understand REF: p. 118
TOP: Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Physiologic Integrity
4. Physiologic measurements in children’s pain assessment are:
a. the best indicator of pain in children of all ages.
b. essential to determine whether a child is telling the truth about pain.
c. of most value when children also report having pain.
d. of limited value as sole indicator of pain.
ANS: D
Physiologic manifestations of pain may vary considerably, not providing a consistent measure
of pain. Heart rate may increase or decrease. The same signs that may suggest fear, anxiety, or
anger also indicate pain. In chronic pain, the body adapts, and these signs decrease or
stabilize. Physiologic measurements are of limited value and must be viewed in the context of
a pain-rating scale, behavioral assessment, and parental report. When the child states that pain
NURSINGTB.COM
exists, it does. That is the truth.
DIF: Cognitive Level: Understand REF: p. 119
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity
5. Nonpharmacologic strategies for pain management:
a. may reduce pain perception.
b. make pharmacologic strategies unnecessary.
c. usually take too long to implement.
d. trick children into believing they do not have pain.
ANS: A
Nonpharmacologic techniques provide coping strategies that may help reduce pain perception,
make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics.
Nonpharmacologic techniques should be learned before the pain occurs. With severe pain, it is
best to use both pharmacologic and nonpharmacologic measures for pain control. The
nonpharmacologic strategy should be matched with the child’s pain severity and taught to the
child before the onset of the painful experience. Some of the techniques may facilitate the
child’s experience with mild pain, but the child will still know the discomfort was present.
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