# Drag each client to the most appropriate pain-assessment tool for the situation described.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393519&lang=en  
> language: en  
> subject: Nonpharmacological Comfort  
> category: BCC

## Question

Drag each client to the most appropriate pain-assessment tool for the situation described.

**1.** Alert postoperative adult who can describe pain and choose a number

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**2.** Older adult with mild cognitive impairment who understands the 0-to-10 scale

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**3.** 8-year-old who can self-report and understands the faces scale

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**4.** 5-year-old who can point to the face that matches current pain

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**5.** 6-month-old infant after surgery who cannot self-report

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**6.** Preverbal 2-year-old during a painful dressing change

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**7.** Older adult with advanced dementia who can no longer self-report pain

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

**8.** Intubated critically ill adult who cannot communicate during repositioning

Select a category
CPOT
FLACC
PAINAD
Wong-Baker FACES
Numeric Rating Scale 0–10

## Explanation

Use a numeric rating scale for clients who understand and can quantify their pain. A faces self-report scale can help children who understand the faces format. FLACC is an observational tool for infants and young children who cannot self-report. PAINAD was developed for advanced dementia, and CPOT is validated for critically ill adults who cannot communicate, including mechanically ventilated clients.

## In-depth explanation

Quick answer
First ask, Can this client self-report reliably? If yes, use an appropriate self-report scale; if no, match a validated behavioral tool to the population.

Why this is correct
NRS and faces scales measure the client's own report. FLACC observes pediatric behaviors, PAINAD targets pain behaviors in advanced dementia, and CPOT assesses behavioral pain indicators in critically ill adults who cannot communicate.

Legacy correction
The prior item assigned FLACC to an intubated adult. Adult critical-care validation studies support CPOT as the more appropriate population-specific tool.Primary studies
1CPOT validation in adult critical care
2PAINAD development and psychometric evaluation
3Wong-Baker FACES validation in pediatric emergency care

## Clinical scenario

Pain assessment across populations
Use self-report whenever the client can reliably report pain. When self-report is not possible, choose a validated behavioral tool for the client's age and clinical population.

## Key concepts

- **CPOT** — Critical-Care Pain Observation Tool for critically ill adults who cannot reliably self-report.
- **PAINAD** — Pain Assessment in Advanced Dementia, an observational tool for clients with advanced dementia.
- **FLACC / PAINAD** — FLACC for nonverbal children; PAINAD for adults with advanced dementia — both are behavioral observation tools.

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