Question 1

A student nurse is preparing to administer an intramuscular injection into the ventrogluteal muscle.The nursing instructor should question which action by the student?

Accepted Answer

The patient should assume a side-lying position for the ventrogluteal injection, not a sitting position. The other actions are correct for administering an injection in this site.

Question 2

The nurse is preparing several medications that are administered parenterally.The patient receiving which medication will have an intradermal injection?

Accepted Answer

Intradermal injections are used for allergy testing to evaluate the patient's immune response to different allergens. Opioids, low-molecular-weight heparin, and glargine insulin are administered via other routes such as intravenous, subcutaneous, or intramuscular.

Question 3

The nurse is teaching a family member of an obese patient how to administer a subcutaneous U-100 insulin injection to the patient.Which instruction should be included in the teaching plan?

Accepted Answer

For an obese patient,the skin is pinched and the needle is inserted quickly and firmly at a 90-degree angle.Massage can damage underlying tissue.Subcutaneous U-100 insulin is given using an insulin syringe with a preattached needle of 28 to 31 gauge.Injection site rotation is no longer necessary because newer human insulins carry a lower risk for hypertrophy.Patients choose one anatomical area (e.g. ,the abdomen)and systematically rotate sites within that region-a practice that maintains consistent insulin absorption from day to day.

Question 4

The nurse is preparing to administer an intravenous (IV)antibiotic using a mini-infusion pump.Which action should the nurse do first?

Accepted Answer

After connecting the prefilled syringe to the mini-tubing,the nurse carefully applies pressure to the syringe plunger to fill the tubing with fluid and to ensure that the tubing is free of air bubbles to prevent air embolus.After the tubing is filled with fluid,the syringe is placed into the mini-infusion pump and is hung on an IV pole.Then the mini-infusion tubing is connected to the main IV line.

Question 5

The nurse is preparing to administer a medication using a volume-controlled administration set or Volutrol.Which action should the nurse do first?

Accepted Answer

The Volutrol is filled with the desired amount of intravenous (IV)fluid (50 to 100 mL)by opening the clamp between the Volutrol and the main IV bag.After the Volutrol is filled with the desired amount of fluid,the clamp is closed and the clamp on the air vent of the Volutrol is checked and opened if necessary.The injection port on the Volutrol is cleaned,and the medication is injected through the port.

Question 6

The nurse is preparing to administer an immunization to a toddler.Which action by the nurse is appropriate?

Accepted Answer

Grasping the body of the muscle during injection is the appropriate action because it ensures that the needle is inserted into the muscle, which is the recommended site for immunization in toddlers.

Question 7

The nurse is preparing an intramuscular injection for a thin older patient.The nurse is aware that the maximum volume most likely tolerated by this patient is which amount?

Accepted Answer

The answer of The nurse is preparing an intramuscular injection...

Question 8

A patient with a continuous intravenous (IV)infusion has a prescription for ciprofloxacin to be given by IV piggyback.Which action by the nurse is appropriate for administering the medication?

Accepted Answer

Hanging the piggyback bag higher allows gravity to help the medication infuse properly without interrupting the continuous infusion.

Question 9

The nurse is preparing an injection of 0.45 mL of medication for a pediatric patient.Which syringe is most appropriate?

Accepted Answer

The tuberculin syringe is the most appropriate choice as it allows for measurement of small volumes with high accuracy. It is designed to measure up to 1 mL with very fine gradations (up to 0.01 mL). Insulin syringes may also be used for small volumes but are typically calibrated for insulin units rather than milliliters. The 3-mL and 10-mL syringes are designed for larger volumes and may not provide the necessary accuracy for a small volume injection.

Question 10

The nurse is preparing to administer an intramuscular injection via the Z-track method.Which action should be taken by the nurse?

Accepted Answer

When using the Z-track method for an intramuscular injection, the nurse should insert the needle at a 90-degree angle to ensure the medication is deposited deep into the muscle tissue. The Z-track method involves pulling the overlying skin and tissue to one side before administering the medication and holding it in place until the needle is withdrawn, which helps to minimize leakage of medication into the subcutaneous tissue or out of the injection site. The nurse should release the skin before removing the needle from the site to minimize the trauma to the tissue. Pinching the skin between the thumb and the first finger is not a recommended step in the Z-track method. Finally, the nurse should not immediately remove the needle after injecting the medication; instead, they should hold the needle in place for a few seconds to ensure that the medication is fully deposited before withdrawing the needle.

Question 11

The nurse is preparing a medication that comes in an ampoule.Which action by the nurse is appropriate?

Accepted Answer

Using a filter needle is appropriate to prevent glass particles from being drawn into the syringe after breaking the ampoule.

Question 12

The nurse is teaching a patient how to mix 5 units of regular insulin and 15 units of NPH insulin in the same syringe.The nurse determines that further instruction is needed if the patient does which of the following?

Accepted Answer

When rapid- or short-acting insulin is mixed with intermediate- or long-acting insulin,air should be injected into the intermediate- or long-acting insulin vial first without withdrawal of the medication.Regular insulin is withdrawn first,and then the combined total insulin dose is calculated before the NPH insulin is withdrawn from the vial.

Question 13

The nurse administers a tuberculin screening test to a patient who has no known risk factors for tuberculosis (TB).When the test site is read 48 hours later,which result is considered positive?

Accepted Answer

A raised,reddened,or hard zone around the test site indicates a positive tuberculin skin test.An induration of 15 mm or more indicates a positive reaction in patients with no known risk factors for tuberculosis (TB).An induration that measures 5 mm or more in diameter indicates a positive TB reaction in patients who are human immunodeficiency virus (HIV)positive,have fibrotic changes on chest radiograph consistent with previous TB infection,have had organ transplants,or are immunosuppressed.An induration of 10 mm or more indicates a positive TB reaction in patients who are recent immigrants;injection drug users;residents and employees in high-risk settings;patients with certain chronic illnesses;children younger than 4 years of age;and infants,children,and adolescents exposed to high-risk adults.

Question 14

A patient has prescriptions for 10 units of glargine insulin and 5 units of regular insulin to be given at the same time.Which action by the nurse is appropriate?

Accepted Answer

Glargine insulin should not be mixed with any other insulin. Therefore, the nurse should give two separate injections using different needles and syringes.

Question 15

The nurse is teaching a patient how to inject low-molecular-weight heparin.What instruction should be included in the teaching plan?

Accepted Answer

Gentle pressure for 30 to 60 seconds prevents bleeding at the site.To minimize the pain and bruising associated with low-molecular-weight heparin (LMWH),it is given subcutaneously on the right or left side of the abdomen,at least 2 inches away from the umbilicus;this area is commonly referred to as a patient's "love handles." LMWH comes in a prefilled syringe,and the air bubble should not be expelled before administration.Aspiration after a subcutaneous injection is not necessary.Aspiration after an LMWH injection is not recommended.

Question 16

The nurse is administering a parenteral medication to the patient.Which action by the nurse demonstrates proper technique?

Accepted Answer

Using strict aseptic technique is essential when administering parenteral medications to prevent infection and ensure patient safety. Work-arounds should not be used as they may compromise medication administration accuracy or patient safety. Injecting the medication smoothly but rapidly or inserting the needle into the patient's skin smoothly and slowly can vary depending on the medication and patient's individual factors.

Question 17

The nurse is preparing to administer an intramuscular (IM)injection to a 6-month-old infant.Which injection site is the most appropriate for this patient?

Accepted Answer

The vastus lateralis is the preferred site for IM injections in infants under 12 months because it is well-developed and has fewer nerves and blood vessels, reducing the risk of injury.

Question 18

The nurse is preparing to administer an intradermal injection to an adult patient.Which action should be taken by the nurse?

Accepted Answer

Intradermal injections are typically administered at a 5- to 15-degree angle, and the site is often 3 finger widths below the antecubital space.

Question 19

The nurse is preparing to give a medication by intravenous (IV)bolus.When assessing the patient's IV insertion site,the nurse notes that it is warm,reddened,and tender.What action should the nurse take first?

Accepted Answer

The signs of warmth, redness, and tenderness at the IV site indicate phlebitis or infection. The nurse should discontinue the IV infusion to prevent further complications and assess for alternative IV access.

Question 20

The student nurse is preparing to administer an intravenous (IV)bolus medication through a small-gauge IV catheter.The student notes that there is no blood return on aspiration.Which action by the student should the nursing instructor question?

Accepted Answer

If there is no blood return on aspiration, it is possible that the catheter is not in the vein and may be in tissue or muscle, which could result in infiltration of the medication. Therefore, the best action would be to immediately stop the infusion and remove the catheter to prevent further harm to the patient. Checking the IV site for redness and swelling is a good assessment to perform, but it should not be the primary action taken in this scenario. Checking to see if the IV is infusing without difficulty may not be an accurate indicator of where the catheter is located. Injecting the medication without having proper placement of the IV catheter may also cause harm to the patient.

Quiz 22: Parenteral Medications