Accurate pain assessment is one of the most important skills every nurse must master. Whether you’re preparing for the NCLEX, building your skills as a new registered nurse, or refreshing your knowledge with a nursing bundle, knowing how to evaluate and document pain properly helps deliver safe and effective patient care.
🩺 Why Is Pain Assessment Important?
Pain is called the 5th vital sign — it affects healing, sleep, mood, and quality of life. Patients depend on RN nurses to recognize and manage their pain, so good assessment and clear documentation are vital for treatment decisions.
On the NCLEX, you’ll often see questions about choosing the best pain assessment tool for different patients.
🗂️ Key Pain Assessment Tools for Nurses
Here are the most common tools every nurse should know and use in practice:
1️⃣ Numeric Rating Scale (NRS)
Who it’s for: Most adults and older kids who can communicate clearly.
✅ Ask:
“On a scale of 0 to 10, where 0 means no pain and 10 means the worst pain you can imagine, what number is your pain right now?”
✅ Document:
- The patient’s exact number.
- Location, duration, and what makes it better or worse.
2️⃣ Visual Analog Scale (VAS)
Who it’s for: Patients who prefer to point or mark pain on a line.
✅ How it works:
The patient marks a spot on a 10 cm line between “no pain” and “worst pain.”
✅ Nursing tip:
Good for patients who struggle to verbalize pain numbers.
3️⃣ Wong-Baker FACES Pain Scale
Who it’s for: Young children (3+) and some elderly patients with communication barriers.
✅ How it works:
Show a series of faces ranging from happy (no pain) to crying (worst pain). The patient points to the face that matches how they feel.
✅ NCLEX tip:
Perfect for pediatric nursing questions!
4️⃣ FLACC Scale
Who it’s for: Infants, non-verbal patients, or those who can’t self-report pain.
✅ What FLACC means:
Face, Legs, Activity, Cry, Consolability — each scored 0–2.
✅ Nursing use:
Add up the scores (total 0–10). Higher scores mean more pain.
5️⃣ PAINAD Scale
Who it’s for: Patients with advanced dementia.
✅ What it measures:
Breathing, vocalization, facial expression, body language, and consolability.
✅ Nursing note:
Helpful in long-term care and hospice.
✅ How to Document Pain Like a Pro
Documentation is just as important as assessment. Every RN nurse should chart:
- Pain score (e.g., NRS or FLACC number)
- Location (where is the pain?)
- Quality (sharp, dull, throbbing?)
- Duration (when did it start?)
- Aggravating/relieving factors
- Response to interventions (Did pain meds help? By how much?)
Always reassess pain 30–60 minutes after interventions and update the chart.
🎓 Pain Assessment Tips for NCLEX and Nursing Practice
✅ Always use the right tool for the patient’s age and mental status.
✅ Reassess and document pain often — before and after interventions.
✅ Don’t ignore non-verbal signs like grimacing, guarding, or restlessness.
✅ Use your nursing bundle practice sheets to review pain scales and scenarios.
🗝️ Key Takeaway
A good nurse knows that pain is what the patient says it is. Accurate pain assessment and documentation help patients get the relief they need and keep your nursing practice safe and professional.