Deck 22: Parenteral Medications

Question 1

A raised,hardened,red zone of 5 mm in diameter noted around an intradermal test site would be expected in a:

A) Patient who has no known risk factors for TB
B) Patient who has human immunodeficiency virus (HIV)
C) Patient who is an injection drug user
D) Patient who is employed in a high-risk setting

Answer 1

Patient who has human immunodeficiency virus (HIV)

Question 2

An appropriate maximum amount of medication that could be given intramuscularly to a normal,well-developed adult is:

A) 2 mL
B) 3 mL
C) 5 mL
D) 8 mL

Answer 2

5 mL

Question 3

The nurse is evaluating the integrity of the ventrogluteal injection site.The nurse finds the site by locating the:

A) Middle third of the lateral thigh
B) Greater trochanter, anterior iliac spine, and iliac crest
C) Anterior aspect of the upper thigh
D) Acromion process and axilla

Answer 3

Greater trochanter, anterior iliac spine, and iliac crest

Question 4

What are the anatomical landmarks for the ventrogluteal injection site?

A) Greater trochanter and knee
B) Anterosuperior iliac spine and iliac crest
C) Posterior superior iliac spine and iliac crest
D) Acromion process, scapula, and axilla

Question 5

The nurse is teaching the patient how to prepare 10 units of Regular insulin and 5 units of NPH insulin for injection.What should the nurse instruct the patient to do?

A) Inject air into the Regular insulin, then into the NPH
B) Withdraw the Regular insulin before injecting the air
C) Inject air into and withdraw the NPH immediately
D) Inject air into both vials and withdraw the Regular insulin first

Question 6

Which syringe should the nurse select for an injection of 0.45 mL of medication to a pediatric patient?

A) Tuberculin syringe
B) Insulin syringe
C) Low-dose insulin syringe
D) 3-mL syringe

Question 7

What instructions should the nurse give to the family member who is to administer a subcutaneous insulin injection for a patient?

A) Massage the site after the injection.
B) Select a 25-gauge, ½- to 5/8-inch needle.
C) Insert the needle at a 45-degree angle if 2 inches of tissue can be pinched.
D) Rotate injection site each time from one major site to another.

Question 8

The nurse is preparing to give an IM injection to a 6-month-old infant.Which site is the most appropriate for administration of the injection to this patient?

A) The deltoid muscle
B) The dorsogluteal injection site
C) The vastus lateralis
D) All of the above

Question 9

The nurse prepares to administer an intradermal injection for the administration of medication for:

A) Pain
B) Allergy sensitivity
C) Anticoagulant therapy
D) Low-dose insulin requirements

Question 10

The nurse has drawn up Regular and NPH insulin for administration to her diabetic patient.When the nurse enters the room,the patient has gone to radiology for a chest radiograph and will return in 20 minutes.What should the nurse do with the medication?

A) Put the medication in the refrigerator until he returns
B) Put the medication in the patient's medication box until he returns
C) Keep the syringe in her pocket until he returns
D) Discard the medication and withdraw more when he returns

Question 11

What does the nurse do to administer an intramuscular injection via the Z-track method?

A) Pulls the skin tissue laterally 1 to 1½ inches
B) Does not aspirate back on the syringe
C) Immediately removes the needle after injecting the medication
D) Releases the skin before removing the needle from the site

Question 12

After insertion of the needle into a patient's tissue,a nurse aspirates and notices a very small amount of blood return.What should the nurse do?

A) Continue with the injection
B) Discontinue the procedure and notify the nurse in charge
C) Remove and change the needle, and then readminister the medication
D) Discontinue the procedure and repeat the entire preparation of the medication

Question 13

Intradermal injections are administered correctly when the nurse:

A) Uses a 1-inch needle
B) Selects a 22-gauge needle
C) Injects at a 45-degree angle
D) Identifies the site at 3 fingerwidths below the antecubital space

Question 14

An appropriate technique for administration of a parenteral medication is observed when the nurse:

A) Uses strict aseptic technique
B) Tightly holds the inside surface of the syringe plunger
C) Injects medication as rapidly as possible
D) Slowly inserts the needle through the patient's tissue

Question 15

A patient is demonstrating the technique for mixing regular and NPH insulins in the same syringe.A nurse evaluates that further instruction is required if the patient first:

A) Aspirates and injects air equal to the regular insulin dose into the vial first and withdraws the regular insulin
B) Aspirates and injects air equal to the NPH insulin into the vial but does not withdraw the medication
C) Withdraws the proper amount of NPH insulin before withdrawing the regular insulin
D) Calculates the combined total of insulin after withdrawing the NPH insulin

Question 16

The nurse is preparing to administer the long-acting insulin glargine (Lantus)as well as Regular insulin to a patient.The nurse realizes that she should:

A) Inject air into the Lantus first and not withdraw medication
B) Inject air into the Regular insulin first and then into the Lantus
C) Use two needles
D) Inject air into the Lantus first and withdraw the Regular

Question 17

The patient is to receive low-molecular-weight heparin by injection.Where on the patient's anatomy should the nurse prepare to inject this medication?

A) Scapular region
B) Vastus lateralis
C) Posterior gluteal
D) Abdomen

Question 18

The nurse is preparing to administer an immunization to a toddler.The preferred site for administration of immunizations in this age group is the:

A) Deltoid muscle
B) Dorsogluteal muscle
C) Vastus lateralis muscle
D) Buttock

Question 19

To administer an injection intradermally,the nurse should:

A) Use a tuberculin or small syringe with a 1-inch needle
B) Inject no more than 1 mL of solution
C) Insert the needle at a 5- to 15-degree angle
D) Expect a small amount of bleeding after injection

Question 20

What is the appropriate technique for the nurse to use to remove medication from an ampule?

A) Keep the needle against the rim of the ampule
B) Break the neck of the ampule toward the hands
C) Tip the ampule to bring all fluid within reach of the needle
D) Add a volume of air to push the medication out into the syringe

Question 21

An appropriate technique for the nurse to implement for a patient with a continuous subcutaneous infusion is to:

A) Change the site every day
B) Use a gauze dressing over the insertion site
C) Select an insertion site over a bony prominence
D) Insert the packaged needle at a 90-degree angle, or according to direction.

Question 22

A _______________ injection is an injection into tissues just under the dermis of the skin.

Question 23

Which of the following methods is used to administer intravenous medications? (Select all that apply.)

A) Piggyback infusion
B) Volume control device
C) Electronic infusion device
D) Bolus injection
E) None of above

Question 24

The nurse is preparing to start an infusion of ciprofloxacin to run as a piggyback infusion.For the system to run properly,the nurse must:

A) Hang the bag lower than the primary infusion
B) Stop the primary bag from running so the piggyback can run
C) Plug the piggyback into the lowest port on the primary bag's tubing
D) Connect the bag to the upper Y-port of a primary infusion line

Question 25

Why is the IV bolus considered a dangerous method by which to administer medications? (Select all that apply.)

A) It does not allow time to correct errors
B) It may be irritating to the lining of blood vessels
C) It can cause pain and abscesses
D) It can cause sloughing of tissues
E) None of above

Question 26

An injection that is given into the body of a muscle is known as an __________________ injection.

Question 27

The nurse administers the intramuscular medication of iron by the Z-track method.Why was the medication administered by this method? (Select all that apply.)

A) Provides faster absorption of the medication
B) Reduces discomfort from the needle
C) Prevents leakage of medication into subcutaneous tissue
D) Prevents the drug from irritating sensitive tissue

Question 28

________________ administration of medication instills medications into body tissues and into the circulatory system by injection.

Question 29

Which part of the syringe must be kept sterile at all times? (Select all that apply.)

A) The needle hub
B) The needle shaft
C) The syringe outer barrel
D) The needle bevel

Question 30

In a volume-controlled administration set,the nurse usually mixes medication with:

A) 10 to 30 mL of solution
B) 50 to 100 mL of solution
C) 100 to 500 mL of solution
D) 500 to 1000 mL of solution

Question 31

Failure to inject a medication correctly may result in which of the following? (Select all that apply.)

A) An inappropriate dug response
B) Nerve injury and/or pain
C) Tissue necrosis
D) Sterile abscess
E) None of above

Question 32

Which of the following are acceptable sites for subcutaneous injections? (Select all that apply.)

A) Dorsogluteal
B) Upper arms
C) Abdomen
D) Thighs

Question 33

When assessing a patient's IV insertion site,the nurse notes that it is warm,reddened,and tender.The nurse should first:

A) Slow the infusion rate
B) Discontinue the IV infusion
C) Apply a local anesthetic
D) Apply warm compresses

Question 34

What is an advantage of providing medication via intravenous bolus?

A) A slow onset of medication effects
B) Medications can be given over a longer time frame
C) Medications provide a more accurate dose of medication delivered
D) Hypersensitivity reactions are always delayed

Question 35

When preparing to administer an IV bolus medication with a small-gauge needle,the nurse notes that there is no blood return on aspiration.What should the nurse do?

A) Discontinue the procedure and inform the physician
B) Select a different site and start a new IV
C) Notify the pharmacy
D) Determine the presence of an infiltration

Question 36

To add medication to the intravenous (IV)fluid bag,the nurse should:

A) Shake the bag vigorously to mix the medication
B) Insert medication into the main tubing port
C) Label the outside of the bag with a felt-tip marker
D) Cleanse the injection port with antiseptic before adding the medication.

Question 37

The nurse is preparing to administer an intramuscular medication.In determining what size needle and syringe to use to administer the medication,the nurse must consider which of the following? (Select all that apply.)

A) The quantity of medication
B) The viscosity of the medication
C) The body size of the patient
D) Whether or not the syringe has a safety needle

Question 38

The nurse has a responsibility to ensure that every IM injection is given safely.In doing so,the nurse is trying to prevent which of the following? (Select all that apply.)

A) Abscess formation
B) Sciatic nerve injury
C) Persistent pain
D) Hematoma
E) None of above

Question 39

An ____________ injection is an injection into the dermis just under the epidermis.

Question 40

The nurse is preparing to administer an intravenous (IV)antibiotic using a tandem setup.The nurse must:

A) Connect the tubing to the upper Y-port of the primary infusion line
B) Hang the antibiotic at a higher level than the main IV bag
C) Monitor the tandem setup closely
D) Be sure that the primary line is not running while the antibiotic is running

Question 41

_____________ syringes require special needles,which are twisted onto the tip and lock themselves in place.

Question 42

The patient is complaining of tenderness at his intravenous (IV)insertion site.The nurse examines the site and notices that the site is swollen,warm,and reddened.The nurse stops the intravenous infusion,realizing that the patient has ________________.

Question 43

An intravenous (IV)administration set that attaches just below the primary infusion bag or bottle to control small volumes of fluid is known as a ________________.

Question 44

The most frequent route of exposure to blood-borne disease for health care workers is _________________.

Question 45

A method of medication delivery that involves a small intravenous (IV)bag or bottle connected by a short tubing line connected to the upper Y-port of a primary infusion line is called a _____________ infusion.

Question 46

An IV __________ or "push" usually requires small volumes of fluid,which is an advantage for patients who are at risk for fluid overload.

Question 47

A subcutaneous medication delivery system that allows for continuous administration of medication is known as ________________.

Question 48

The dorsogluteal injection site should not be avoided in favor of the ventrogluteal site because of the risk of damaging the _______________.

Question 49

An _______________ is made of glass with a constricted,prescored neck that needs to be snapped off to allow access to the medication.

Question 50

A ______________ is a small (25 to 250 mL)IV bag or bottle connected to a short tubing line to the lower Y-port of a primary infusion line or to an intermittent venous access.

Question 51

Research suggests that the _____________ area is the most appropriate site for all age groups of children receiving IM injections.

Question 52

The nurse is preparing to draw up medication from an ampule.She realizes that she will need a _________________ to draw up the medication.

Question 53

While checking the patient's intravenous (IV)site,the nurse notices that the site is cool,pale,and swollen.She immediately stops the IV infusion,realizing that these are signs indicating _____________.

Question 54

The method of injecting a medication that requires pulling the skin laterally before injection is known as the ___________________.

Question 55

Injection of a medication into a vein is known as an ________________injection or infusion.

Question 56

A single-dose or multidose container that contains a liquid or dry form of a medication and that has a rubber seal at the top is known as a ________________.