Child Life Exam Pain Management 2 — Questions and Answers
Question 1: Which pain scale is most appropriate for a 3-year-old child who is non-verbal?
- FLACC scale (Correct answer)
- Numeric Rating Scale (NRS)
- Visual Analog Scale (VAS)
- McGill Pain Questionnaire
Correct answer: FLACC scale
The FLACC (Face, Legs, Activity, Cry, Consolability) scale is a behavioral observational tool validated for non-verbal and preverbal children.
Question 2: A child life specialist is preparing a 7-year-old for a venipuncture. Which cognitive-behavioral strategy is MOST effective for procedural pain management?
- Guided imagery and distraction (Correct answer)
- Pharmacologic sedation
- Passive restraint
- Post-procedure reward only
Correct answer: Guided imagery and distraction
Guided imagery and distraction are evidence-based non-pharmacologic cognitive-behavioral strategies that reduce procedural pain and anxiety in school-age children.
Question 3: What is the primary goal of providing accurate preparatory information to a child before a painful procedure?
- To reduce anxiety and increase sense of control (Correct answer)
- To obtain informed consent from the child
- To replace pharmacologic pain management
- To shorten procedure duration
Correct answer: To reduce anxiety and increase sense of control
Accurate preparation reduces uncertainty-related anxiety and gives children a sense of control, which lowers perceived pain intensity.
Question 4: Which of the following best describes the gate control theory of pain as it applies to child life practice?
- Non-painful stimuli can modulate pain signals in the spinal cord (Correct answer)
- Pain is purely a physiological response with no psychological component
- Children feel less pain than adults due to immature nerve pathways
- Opioid receptors gate pain transmission in the brainstem
Correct answer: Non-painful stimuli can modulate pain signals in the spinal cord
Gate control theory explains that non-painful sensory input (touch, vibration, distraction) can 'close the gate' on pain signals traveling to the brain, informing many CLS interventions.
Question 5: An adolescent rates their post-surgical pain as 8/10 but appears calm and is watching TV. How should the child life specialist respond?
- Accept the self-report as the primary indicator and advocate for pain management (Correct answer)
- Assume pain is well-controlled based on behavioral appearance
- Suggest the rating is exaggerated and encourage a lower score
- Defer entirely to the nurse's behavioral observation
Correct answer: Accept the self-report as the primary indicator and advocate for pain management
Self-report is the gold standard for pain assessment; an adolescent's numeric rating must be accepted and advocated for regardless of outward appearance.
Question 6: Which non-pharmacologic intervention uses rhythmic breathing and muscle relaxation to decrease pain perception in pediatric patients?
- Progressive muscle relaxation (Correct answer)
- Pharmacologic premedication
- Physical restraint
- Therapeutic play debriefing
Correct answer: Progressive muscle relaxation
Progressive muscle relaxation involves tensing and releasing muscle groups in coordination with breathing, activating the parasympathetic response to reduce pain.
Question 7: A parent insists their child does not need pain medication because 'kids bounce back quickly.' What is the best child life response?
- Provide education that untreated pain can cause physiological harm and impair healing (Correct answer)
- Agree with the parent to maintain the therapeutic alliance
- Immediately escalate to the medical team without talking to the parent
- Document the conversation and take no further action
Correct answer: Provide education that untreated pain can cause physiological harm and impair healing
Untreated pediatric pain causes physiological stress responses, impairs immune function, and can lead to chronic pain sensitization; educating parents is a key CLS role.
Child Life Exam Pain Management 2
Which pain scale is most appropriate for a 3-year-old child who is non-verbal?