👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Basic Care & Comfort🔖 Free to read, print, and share
Also known as: measuring pain in kids · child pain scale · FLACC scale · Wong-Baker faces
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Use this quick-reference guide to spot, treat, and prevent Pediatric Pain Assessment on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Infant
FLACC scale (0-3 yr)
Face, Legs, Activity, Cry, Console
📌 Preschool
FACES (Wong-Baker) ≥ 3 yr
Point to face that hurts
📌 School
Numeric 0-10 scale ≥ 7-8 yr
✅ Do
Behavior = best cue in infants
Believe child's self-report
Reassess after intervention
📚 Pediatric Pain Assessment — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Pain is the fifth vital sign and must be assessed using a tool matched to the child's age and developmental level. Self-report is the gold standard whenever the child can provide it. Key principle: choose the right scale for the right age, and never assume a quiet child is pain-free.
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Key points
Understand these first
FLACC (Face, Legs, Activity, Cry, Consolability) is a behavioral scale for nonverbal children, infants, and ages roughly 2 months to 7 years.
Wong-Baker FACES and the Faces Pain Scale-Revised are used for children about 3 years and older who can point to a face.
The Numeric Rating Scale (0-10) is appropriate for school-age children (about 7+) who understand numbers.
CRIES is a behavioral and physiologic scale used for neonates and preterm infants.
Physiologic signs (tachycardia, hypertension, sweating, dilated pupils) may indicate acute pain but are unreliable for chronic pain.
Infants in pain show high-pitched crying, facial grimacing, clenched fists, and rigid or flailing body posture.
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Nursing priorities
What to do, in order
Select and use a developmentally appropriate, validated pain scale and use the SAME tool for reassessment.
Accept the child's self-report as the most accurate measure of pain when available.
Reassess pain after every intervention at the expected peak effect (about 30 minutes IV, 60 minutes oral).
Combine pharmacologic relief with nonpharmacologic measures: distraction, swaddling, sucrose for neonates, positioning, comfort.
Involve parents, who know the child's baseline behavior and comfort cues.
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Red flags — report now
Escalate immediately
Never assume a sleeping or withdrawn child has no pain; children in chronic pain may guard and self-quiet.
Untreated or escalating pain with deteriorating vital signs requires prompt provider notification.
Do not use an adult numeric scale on a preverbal child; mismatched tools yield invalid scores.
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Patient teaching
What patients must know
Teach parents to use the same faces or number scale at home to track relief.
Explain that comfort measures like holding, distraction, and routine reduce a child's fear and pain.
Reassure parents that treating pain promptly does not cause addiction and aids healing.
❓ Pediatric Pain Assessment: NCLEX FAQs
What are the priority nursing interventions for Pediatric Pain Assessment?
Select and use a developmentally appropriate, validated pain scale and use the SAME tool for reassessment. Accept the child's self-report as the most accurate measure of pain when available. Reassess pain after every intervention at the expected peak effect (about 30 minutes IV, 60 minutes oral). Combine pharmacologic relief with nonpharmacologic measures: distraction, swaddling, sucrose for neonates, positioning, comfort.
What are the warning signs of Pediatric Pain Assessment a nurse must report?
Never assume a sleeping or withdrawn child has no pain; children in chronic pain may guard and self-quiet. Untreated or escalating pain with deteriorating vital signs requires prompt provider notification. Do not use an adult numeric scale on a preverbal child; mismatched tools yield invalid scores.
What do I need to know about Pediatric Pain Assessment for the NCLEX?
FLACC (Face, Legs, Activity, Cry, Consolability) is a behavioral scale for nonverbal children, infants, and ages roughly 2 months to 7 years. Wong-Baker FACES and the Faces Pain Scale-Revised are used for children about 3 years and older who can point to a face. The Numeric Rating Scale (0-10) is appropriate for school-age children (about 7+) who understand numbers. CRIES is a behavioral and physiologic scale used for neonates and preterm infants.
What patient teaching is important for Pediatric Pain Assessment?
Teach parents to use the same faces or number scale at home to track relief. Explain that comfort measures like holding, distraction, and routine reduce a child's fear and pain. Reassure parents that treating pain promptly does not cause addiction and aids healing.
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Quick Tip
FLACC (Face, Legs, Activity, Cry, Consolability) is a behavioral scale for nonverbal children, infants, and ages roughly 2 months to 7 years.