Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is planning care for a 2-month-old infant following a surgical procedure. Which of the following pain rating scales should the nurse plan to use to determine the infant's level of pain?
A. PANAD scale
B. OUCHER scale
C. FLACC scale
The appropriate pain rating scale to use for a 2-month-old infant is the FLACC (Face, Legs, Activity, Cry, Consolability) scale. The FLACC scale is commonly used for infants and young children who are unable to self-report their pain. It assesses facial expression, leg movement, activity level, cry, and ability to be consoled. Each category is scored on a scale of 0 to 2, and the total score provides an indication of the infant's pain level. The PANAD scale and OUCHER scale are more commonly used for older children, while the FACE scale is specific to assessing pain in individuals with cognitive impairments.
D. FACE Scale
This question is an excerpt from Nurse Dive's nursing test bank - Paediatrics ATI Proctored Exam. Take the full exam now
Full Explanation
The appropriate pain rating scale to use for a 2-month-old infant is the FLACC (Face, Legs, Activity, Cry, Consolability) scale. The FLACC scale is commonly used for infants and young children who are unable to self-report their pain. It assesses facial expression, leg movement, activity level, cry, and ability to be consoled. Each category is scored on a scale of 0 to 2, and the total score provides an indication of the infant's pain level.
The PANAD scale and OUCHER scale are more commonly used for older children, while the FACE scale is specific to assessing pain in individuals with cognitive impairments.
Similar Questions
A nurse is providing care to a child who has an allergy to eggs. The nurse should question the prescription for which of the following immunizations?
A. inactivated poliovirus (PV)
B. influenza live attenuated (LAV)
The influenza LAV is typically produced using egg-based methods, which may pose a risk for individuals with an allergy to eggs. Although the risk of a severe allergic reaction to the influenza vaccine is low, it is recommended to avoid the influenza LAV in individuals with a known severe allergy to eggs. Inactivated poliovirus (PV), Haemophilus influenza type b (Hib), and Hepatitis (Hepi) vaccines do not contain egg proteins and can generally be safely administered to individuals with an egg allergy.
C. Haemophilus influenza type b (Hib)
D. Hepatitis (Hepi)
Full Explanation
The influenza LAV is typically produced using egg-based methods, which may pose a risk for individuals with an allergy to eggs. Although the risk of a severe allergic reaction to the influenza vaccine is low, it is recommended to avoid the influenza LAV in individuals with a known severe allergy to eggs. Inactivated poliovirus (PV), Haemophilus influenza type b (Hib), and Hepatitis (Hepi) vaccines do not contain egg proteins and can generally be safely administered to individuals with an egg allergy.
A nurse is caring for a 6-month-old infant. Which of the following findings should indicate to the nurse that the client is experiencing pain following a procedure?
A. Increased formula consumption
B. Increased crying episodes
Crying is a common behavioral response to pain in infants, and it serves as an important indicator of discomfort. Infants may cry more intensely, have a high-pitched cry, or exhibit inconsolable crying when they are in pain. It is important for the nurse to assess the infant's pain level and provide appropriate interventions to alleviate the discomfort.
C. Decreased respiratory rate
D. Decreased heart rate
Full Explanation
Crying is a common behavioral response to pain in infants, and it serves as an important indicator of discomfort. Infants may cry more intensely, have a high-pitched cry, or exhibit inconsolable crying when they are in pain. It is important for the nurse to assess the infant's pain level and provide appropriate interventions to alleviate the discomfort.
A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?
A. Discourage visits from the client's friends
B. Provide a daily session with a play therapist
C. Encourage the client to complete school work
According to Erikson's theory, the psychosocial task for this age group is industry versus inferiority, where children develop a sense of competence and accomplishment through mastering tasks. By supporting the child's educational activities and encouraging them to complete school work, the nurse helps promote a sense of industry and competence.
D. Vary the child's schedule each day
Full Explanation
According to Erikson's theory, the psychosocial task for this age group is industry versus inferiority, where children develop a sense of competence and accomplishment through mastering tasks. By supporting the child's educational activities and encouraging them to complete school work, the nurse helps promote a sense of industry and competence.
