Exhibits

Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.

Ask the healthcare provider to prescribe a nonsteroidal antiinflammatory drug.

Have one of the parents hold the baby.

Perform guided imagery.

Consult a child life specialist.

Encourage the baby's mother to breastfeed the baby.

Wait 1 hour, reassess, and give medication if the FLACC score remains elevated.

Request a prescription for an opioid.

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A"}}

Ask the healthcare provider to prescribe a nonsteroidal anti-inflammatory drug (NSAID)
NSAIDs such as ibuprofen are commonly used for postoperative pain relief in infants. They provide anti-inflammatory effects and pain control without the risk of respiratory depression seen with opioids. Given the infant’s surgical status, an NSAID can be an effective pain management option when prescribed appropriately.
Have one of the parents hold the baby: Parental presence and skin-to-skin contact are effective non-pharmacologic pain management strategies for infants. Holding and gentle rocking can provide comfort, reduce stress, and help lower the infant’s FLACC score by promoting relaxation.
Perform guided imagery: Guided imagery requires cognitive maturity, which a 4-month-old infant lacks. This technique is more appropriate for older children who can understand and visualize calming scenes. For infants, tactile and auditory comfort measures (such as holding and swaddling) are more effective.
Consult a child life specialist: A child life specialist can assist in non-pharmacologic pain management strategies, such as age-appropriate distraction techniques, comfort positioning, and soothing interventions. While the infant may not engage in interactive play, the specialist can help guide parents in comforting their baby.
Encourage the baby's mother to breastfeed the baby: The infant is NPO (nothing by mouth) postoperatively, meaning breastfeeding is contraindicated at this time. Providing oral intake against medical orders could lead to complications, especially after fundoplication surgery, which affects gastric emptying.
Wait 1 hour, reassess, and give medication if the FLACC score remains elevated: Delaying pain relief for an infant experiencing postoperative pain is not appropriate. Infants cannot verbalize pain, and an elevated FLACC score indicates discomfort. Instead of waiting, the nurse should take immediate action by implementing comfort measures and/or requesting appropriate pain medication.
Request a prescription for an opioid: If the infant's pain is moderate to severe, an opioid (such as morphine) may be needed for adequate pain relief. Opioids are used cautiously in infants due to the risk of respiratory depression, but they are appropriate for postoperative pain control when NSAIDs alone are insufficient.

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Correct Answer is D

Explanation

A. Influenza. Influenza is a viral illness that causes respiratory symptoms and fever, but it is not associated with acute rheumatic fever (ARF). ARF is an inflammatory response to a bacterial infection, specifically Group A Streptococcus (GAS).
B. Chickenpox. Chickenpox, caused by the varicella-zoster virus, leads to fever and a vesicular rash but does not trigger rheumatic fever. Rheumatic fever results from an abnormal immune response following a Streptococcus pyogenes infection.
C. Mumps. Mumps is a viral infection affecting the salivary glands, causing swelling and fever, but it is unrelated to the pathophysiology of ARF. The condition primarily spreads through respiratory droplets, and its complications are distinct from rheumatic fever.
D. Sore throat. A recent sore throat, especially if caused by untreated or inadequately treated Group A Streptococcus, is the most significant risk factor for developing acute rheumatic fever. ARF is an autoimmune inflammatory response occurring weeks after streptococcal pharyngitis, potentially leading to carditis, arthritis, and chorea. Prompt diagnosis and treatment of strep throat with antibiotics can prevent ARF.

A. FLACC Postoperative Pain Scale B. Riley Infant Pain Scale C. Poker Chip Tool D. Visual Analog Scale E. Numeric F. FACES

Correct Answer is ["A","B"]

Explanation

A. FLACC Postoperative Pain Scale: The FLACC (Face, Legs, Activity, Cry, Consolability) Scale is commonly used for infants and young children who cannot verbally report their pain. It assesses behavioral cues such as facial expressions, leg movement, activity level, crying, and ability to be consoled, making it appropriate for this 4-month-old infant.
B. Riley Infant Pain Scale: This scale is specifically designed for infants under 1 year of age. It evaluates facial expression, sleep patterns, movements, crying, and verbal cues to determine the level of discomfort. Since this infant is postoperative and unable to self-report pain, this scale is a useful tool.
C. Poker Chip Tool: This tool is used for older children, typically 4 years and above, who can understand the concept of counting and associating poker chips with pain intensity. It is not appropriate for a 4-month-old infant who lacks the cognitive ability to use symbolic representation.
D. Visual Analog Scale: This scale requires the client to mark pain intensity on a continuous line, making it appropriate only for older children (around 7 years and older) who understand abstract concepts. A 4-month-old infant cannot comprehend or use this scale.
E. Numeric: The numeric pain scale (0–10) is used for older children and adults who can assign a number to their pain. Infants and young children cannot use this scale, making it inappropriate for this client.
F. FACES: The Wong-Baker FACES Pain Rating Scale is designed for children 3 years and older who can recognize and correlate facial expressions with pain levels. A 4-month-old does not have the cognitive ability to use this scale reliably.

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Exhibits Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.

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Naxlex Comprehensive Predictor Exams

A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant?

Correct Answer is D

Explanation

Exhibits The nurse determines the client is in pain. Which pain scales would be appropriate for this client? Select all that apply.

Correct Answer is ["A","B"]

Explanation

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Exhibits

Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.