A nurse is preparing to perform a heel-stick procedure on a 2-day-old newborn. Which intervention BEST represents nonpharmacologic pain management for neonates?
Applying EMLA cream immediately before the procedure without waiting
Administering an intramuscular opioid prior to the procedure
Distracting the newborn with toys and verbal explanations
Giving a small dose of oral sucrose solution and providing nonnutritive sucking
The Correct Answer is D
A. EMLA cream is a pharmacologic intervention because it contains local anesthetics (lidocaine and prilocaine) that numb the skin. It must be applied 30–60 minutes before the procedure under an occlusive dressing to achieve effective analgesia. Applying it immediately before a heel stick would not provide pain relief and does not qualify as nonpharmacologic.
B. Intramuscular opioids are systemic pharmacologic agents used for moderate to severe pain. They carry risks such as respiratory depression, sedation, and hypotension in neonates, so they are rarely used for minor procedures like heel sticks.
C. Distraction with toys or verbal explanations is ineffective for neonates because infants at 2 days old cannot process or respond to visual or verbal cues. Cognitive engagement strategies work only in older infants and children.
D. Oral sucrose combined with nonnutritive sucking (e.g., using a pacifier) is a safe and evidence-based nonpharmacologic method for reducing procedural pain in neonates. Sucrose triggers the release of endogenous opioids in the central nervous system, which decreases the perception of pain. Nonnutritive sucking provides comfort and a calming effect, further reducing physiological stress responses such as increased heart rate, blood pressure, and crying. Studies show that this intervention effectively lowers behavioral and physiological indicators of pain during minor procedures such as heel sticks, venipuncture, or immunizations. This method is preferred for routine procedures in neonates because it is simple, safe, and effective without the risks associated with pharmacologic agents.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Delaying pain management is not appropriate in a child experiencing a vaso-occlusive crisis. Pain relief is a priority nursing intervention, and documenting refusal without offering alternatives does not address the child’s suffering.
B. Forcing medication or implying it is mandatory can increase the child’s fear and anxiety, potentially worsening pain and reducing cooperation. It is not a therapeutic approach and does not respect the child’s autonomy.
C. Waiting is unsafe and unethical. A pain score of 10/10 indicates severe pain that requires prompt management. Delaying treatment can increase the risk of pain-related complications, including stress-induced vaso-occlusion or prolonged crisis.
D. Since the child refuses IV opioids due to fear of needles, the nurse should first implement alternative strategies while respecting the child’s autonomy. Nonpharmacologic interventions for sickle cell pain include distraction techniques such as videos, games, or music, guided imagery or relaxation exercises, heat application to affected joints, and deep breathing exercises. These approaches can reduce anxiety and pain perception and can be used immediately while exploring other analgesic options, such as oral opioids, patient-controlled analgesia, or topical analgesics.
Correct Answer is ["130 to 140"]
Explanation
The 1-hour GTT is a screening test for gestational diabetes mellitus (GDM) performed between 24–28 weeks of gestation. The client drinks a 50-gram glucose solution, and blood glucose is measured 1 hour later.
- A result ≤130–140 mg/dL is considered normal, indicating the client is unlikely to have GDM.
- A result above 130–140 mg/dL is considered positive, prompting a 3-hour, 100-gram OGTT to confirm the diagnosis.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.