A 5-year-old child is scheduled for a venipuncture and is anxious about pain. Which intervention BEST reduces procedural pain at the insertion site?
Applying EMLA cream 30-60 minutes before the procedure under an occlusive dressing
Giving the child a sugar solution after the procedure
Placing a cold pack on the site immediately before the needle
Distracting the child with toys during the procedure
The Correct Answer is A
A. EMLA cream (a eutectic mixture of local anesthetics) applied 30–60 minutes before a procedure under an occlusive dressing provides effective topical anesthesia, reducing pain at the venipuncture site. This is evidence-based practice for minimizing procedural pain in children and is particularly effective for needle insertions.
B. Administering a sugar solution (sucrose) is effective primarily for infants under 12 months and is most beneficial when given before or during painful procedures, not after. In a 5-year-old, it has minimal analgesic effect.
C. Applying a cold pack can provide some temporary numbing, but it is less effective than topical anesthetic creams for reducing pain during venipuncture. Additionally, short-duration cold application may not penetrate deep enough to anesthetize the vein adequately.
D. Distraction with toys can reduce anxiety and perceived pain but does not directly numb the insertion site. While helpful as a complementary measure, it is not as effective as topical anesthesia in reducing procedural pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Differentiation refers to cells or structures becoming specialized, whereas development encompasses functional changes and skill acquisition. While differentiation occurs, the scenario emphasizes both physical growth and skill acquisition, making this pairing incomplete.
B. Growth refers to quantitative increases, such as weight and height, and maturation refers to qualitative functional changes over time. While maturation is implied, the scenario specifically highlights skill improvement and the ability to perform complex tasks, which aligns more directly with differentiation.
C. Growth is represented by the child’s appropriate weight gain, a quantitative change. Differentiation is reflected in the improved coordination, problem-solving skills, and ability to perform complex tasks like tying shoelaces. These changes indicate that the child’s structures and functions are becoming more specialized, matching the definition of differentiation.
D. Development focuses on functional abilities and skill acquisition, and maturation refers to functional competency over time. While relevant, this combination does not explicitly include the quantitative growth aspect (weight gain), which is a key part of the scenario.
Correct Answer is C
Explanation
A. A routine abdominal ultrasound is not used to assess bone age or growth delays. While abdominal ultrasounds can detect organ abnormalities, they provide no information about skeletal maturation.
B. A complete blood count (CBC) evaluates blood cell levels and can detect anemia or infection, but it does not provide information about bone growth or skeletal development.
C. A hand-wrist X-ray is the standard diagnostic test to assess bone age and skeletal maturation. By comparing the X-ray of the child’s hand and wrist bones to standardized age-related charts (such as the Greulich and Pyle atlas), providers can determine if the child’s skeletal growth is appropriate for chronological age. This helps identify growth delays, endocrine disorders, or other conditions affecting stature.
D. Anthropometric hand-wrist measurement refers to physical measurements of the hand and wrist, which do not provide sufficient information to determine bone age or detect growth delays. X-ray imaging is required for accurate assessment of skeletal maturity.
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