The nurse is having difficulty assessing the pain of a mentally impaired patient who has an approximate functional level of a 4-year-old child. Which method should the nurse use to determine the patient's pain level?
a. Use the Faces scale.
b. Ask "are you hurting?"
c. Observe the patient's facial expression.
d. Explain to the patient how to use a 0-to-10 pain scale, with 0 being no pain, and 10 being the worst possible pain.
ANS: A
The faces scale was developed for use in children and would be appropriate for someone functioning at a 4-year-old level. D. The 0-to-10 scale is too complex for a 4-year-old. B. C. Facial expression and the response to "Are you hurting?" may be helpful, but they are not as objective as using a research-validated scale.
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