A nurse is caring for a 5-year-old child who has been complaining of abdominal pain for the past 24 hours.
The child is able to communicate verbally and is able to describe the pain as "sharp" and "crampy.”..
The child is also guarding the abdomen and has limited range of motion.
Which of the following statements by the nurse would be most appropriate?
"I'm going to give you some medicine to make the pain go away.”..
"I'm going to call the doctor and see if they want us to order any tests.”..
"It's important to tell me how much pain you're in so that I can help you.”..
"You're a very brave boy/girl.
know it's hard to deal with pain.”..
The Correct Answer is B
Choice A rationale:
Offering medication without a clear diagnosis or doctor's assessment is not appropriate, as it could lead to improper treatment.
The child's condition should be evaluated before administering any medication.
Choice C rationale:
While it is important to assess the child's pain level, this statement doesn't address the need for further evaluation to determine the cause of the pain.
Pain assessment is a part of the nursing process, but in this case, it should be preceded by a medical evaluation.
Choice D rationale:
Complimenting the child for their bravery is a positive interaction, but it doesn't address the need for further evaluation or intervention to identify the cause of the pain.
The rationale for choice B is as follows: In this scenario, the nurse should prioritize the child's safety and well-being.
The child is experiencing abdominal pain described as "sharp" and "crampy," and there are signs of guarding and limited range of motion.
These symptoms could be indicative of a serious underlying issue, such as appendicitis.
Therefore, the most appropriate action is to call the doctor and discuss the need for further tests.
It's essential to rule out any potential surgical or medical emergencies before addressing the pain symptomatically.
This approach ensures that the child's condition is properly evaluated, and appropriate interventions can be initiated if necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","E"]
Explanation
Choice A rationale:
Abdominal organs Visceral pain is pain that originates from the internal organs.
Abdominal organs, such as the liver, stomach, and intestines, are common sources of visceral pain in children.
This pain is often described as dull, crampy, and poorly localized.
Choice B rationale:
Skeletal muscles Skeletal muscles are not considered sources of visceral pain.
Visceral pain is specific to the internal organs, and skeletal muscles are part of the musculoskeletal system, which generates somatic pain when injured or strained.
Choice C rationale:
Ligaments Ligaments are not considered sources of visceral pain.
Visceral pain arises from the internal organs and is different from pain related to connective tissues like ligaments.
Choice D rationale:
Joints Joints are not considered sources of visceral pain.
Visceral pain primarily arises from the internal organs and is distinct from joint-related pain.
Choice E rationale:
Chest organs Chest organs, such as the heart and lungs, are also common sources of visceral pain in children.
Visceral pain originating from the chest may present as a deep, aching sensation and is often associated with conditions like pneumonia or cardiac issues.
Correct Answer is C
Explanation
Choice A rationale:
Acute Pain Acute pain is typically a sudden and intense pain that serves as a warning sign for the body.
It is usually associated with recent tissue damage or injury.
The clinical manifestations mentioned in the question, such as sharp or throbbing pain, tenderness at the site of injury, and localized erythema or swelling, are consistent with acute pain.
However, these symptoms alone do not provide enough information to confirm acute pain, and the other options are more suitable explanations.
Choice B rationale:
Chronic Pain Chronic pain is characterized by long-lasting discomfort that persists beyond the expected time for tissue healing.
The symptoms described in the question, such as sharp or throbbing pain, tenderness, erythema, and swelling, are not typically associated with chronic pain.
Chronic pain is more commonly linked to persistent, dull, and aching sensations, often lasting for extended periods.
Therefore, this choice does not align with the clinical manifestations presented.
Choice C rationale:
Nociceptive Pain Nociceptive pain is pain that results from the activation of nociceptors, which are specialized pain receptors that respond to tissue damage.
Clinical manifestations of nociceptive pain include sharp or throbbing pain, tenderness at the site of injury, and localized erythema or swelling.
This choice is the most appropriate answer because the symptoms described in the question align with nociceptive pain.
Choice D rationale:
Neuropathic Pain Neuropathic pain is associated with nerve damage or dysfunction.
It typically involves symptoms such as burning or shooting pain, numbness or tingling, and abnormal sensitivity to touch.
While some of these symptoms were mentioned in the question, the presence of localized erythema and swelling is not characteristic of neuropathic pain.
Therefore, this choice is not the most suitable option for the clinical manifestations presented.
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