A nurse is caring for a 9-year-old client who is immediately postoperative. The client is nonverbal and has both cognitive and developmental delays. Which of the following pain scales should the nurse use to evaluate the client's pain?

Choice A reason:

The FACES Scale is a visual pain scale typically used for children who can understand and verbalize their pain intensity. It consists of a series of faces with varying expressions, from smiling to crying, to help the child express their pain level. However, since the client in question is nonverbal and has cognitive and developmental delays, this scale may not be suitable as they might not be able to communicate using this tool effectively.

Choice B reason:

The Numerical Scale involves asking the patient to rate their pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain imaginable. While this scale is commonly used for older children and adults, it may not be appropriate for a nonverbal and developmentally delayed 9-year-old client, as they may not understand or be able to use numbers effectively to express their pain.

Choice C reason:

The FLACC pain assessment scale is designed for nonverbal or preverbal individuals, including children and those with cognitive impairments. FLACC stands for Face, Legs, Activity, Cry, and Consolability. Each category is scored from 0 to 2 or 0 to 3, depending on the version used, based on specific observed behaviors. The scores are then totaled to give an overall pain assessment. This scale is particularly suitable for the current client's condition as it focuses on observable behaviors rather than verbal communication.

Choice D reason:

The Visual Analog Scale (VAS) requires the patient to mark a point along a line that represents their pain intensity, with one end indicating no pain and the other end indicating the worst pain. Although this scale is useful for older children and adults, it may not be appropriate for a 9-year-old client with cognitive and developmental delays who might not fully comprehend the concept of the scale.

"We allow our children the freedom to decide their own behavior.”

Choice A reason:

This statement does not indicate a permissive parenting style. In fact, it suggests an authoritative or authoritarian style, where the parents make decisions for their children without considering their input. The parents' imposition of their decisions on their children's time indicates a more controlling approach.

Choice B reason:

This statement also does not reflect a permissive parenting style. Instead, it represents an authoritative or authoritarian style, where the parents expect obedience and compliance without allowing room for questions or autonomy. This approach tends to be more structured and directive.

Choice C reason:

This statement demonstrates the use of a permissive parenting style. In permissive parenting, parents tend to be lenient and allow their children considerable freedom in decision-making and behavior. By giving their children the freedom to decide their own behavior, the parents are adopting a permissive approach, which can sometimes lead to indulgence and lack of necessary boundaries.

Choice D reason:

This statement does not indicate a permissive parenting style either. Instead, it suggests an authoritative or democratic style, where the parents explain the reasoning behind the rules they set. This approach encourages understanding and cooperation but is different from permissiveness.