Question 1

The nurse performs the proper technique when withdrawing medication from the vial by:

Accepted Answer

The vial should be wiped with an alcohol swab before use, the needle should be inserted at a slight lateral angle to avoid coring the rubber stopper, and an amount of air equal to the dose should be injected into the vial, while the needle is kept below the level of the solution to withdraw the dose.

Question 2

A patient has a medication order for iron dextran (Imferon) to be given using the Z-track technique. The rationale for using this method is to:

Accepted Answer

Z-track technique should be used with injection of this medication, because it creates a slanted needle track and avoids seepage of the medication back into subcutaneous or skin layers.

Question 3

The best angle to insert the needle when administering a subcutaneous injection is at an angle of:

Accepted Answer

The needle is inserted at a 45- or 90-degree angle depending on the needle length and the size of the patient.

Question 4

A nurse has administered a Tuberculin skin test to a patient in the outpatient clinic at 9:00 AM on Monday. The patient should be scheduled to return to the clinic to have the result read:

Accepted Answer

The results of the Tuberculin skin test should be read within 48 to 72 hours after injection.

Question 5

The nurse computes the dose of medication as 2.4 million units of penicillin to be delivered in 4 mL. The nurse should:

Accepted Answer

The maximum number of milliliters that can be injected into the ventrogluteal muscle is 3 mL. If the person has small muscle mass, or if the dose exceeds 3 mL, the dose should be divided into two doses.

Question 6

A hospitalized patient has an order for subcutaneous heparin. The best location to administer this medication is the:

Accepted Answer

The optimal site for heparin injection is the abdomen, because this area is not involved in muscular activity, as are the arms, buttocks, and legs.

Question 7

When administering an intramuscular injection to an adult patient using the ventrogluteal site, the nurse should use which landmark to locate the area for injection?

Accepted Answer

The head of the trochanter and the anterior iliac spine are the landmarks used to give an injection in the ventrogluteal site. The ventrogluteal site is the safest in regard to possible injury to the patient's sciatic nerve.

Question 8

When the nurse is preparing to draw medication from an ampule, the proper procedure is to:

Accepted Answer

The medication should rest in the body of the ampule before being withdrawn, and the neck should be wrapped to protect the nurse from glass cuts when the ampule is snapped open.

Question 9

When reinforcing instructions to a patient who will self-administer insulin injections at home, it is important to remind the patient to:

Accepted Answer

The patient should rotate injection sites systematically to promote absorption and to decrease tissue irritation.

Question 10

When the 8-year-old child complains that he does not want to have a "shot," the nurse explains that the use of a parenteral route:

Accepted Answer

The parenteral route will hasten the action of the medication. Although the equipment is better, there is still some pain involved in a parenteral application. The parenteral method is not always the best way to administer a medication.

Question 11

The nurse understands that the only part of the syringe that can be touched and not contaminated is the:

Accepted Answer

The needle, inside of the barrel, sides of the plunger, and tip of the syringe must be kept sterile.

Question 12

A patient has an order to receive a mixture of short- and long-acting insulin. The first step to properly draw them up in the same syringe is to:

Accepted Answer

The vials should be rolled gently to mix the insulin suspension evenly, but they should not be shaken. Air is injected first into the long acting cloudy insulin vial and then into the short acting clear insulin vial.

Question 13

When administering an intramuscular injection for a 4-year-old child, the best site to use is the:

Accepted Answer

The vastus lateralis is the best choice for children younger than 5 years old, because the gluteal muscle is not well developed.

Question 14

To ensure the proper administration of a tuberculin test, the nurse will:

Accepted Answer

An intradermal injection should be done using a 1 mL syringe with a 25, 27, or 29 gauge needle that is 5/8 inch long. The needle is inserted at a 15 degree angle, and medication is injected slowly to form a bump or a bleb underneath the skin.

Question 15

The nurse has an order to administer an injection of purified protein derivative (PPD) by the intradermal route. The maximum amount of medication that can be given using this route is:

Accepted Answer

The maximum dose that can be given via the intradermal route is 0.1 mL.

Question 16

A nurse has opened and used part of a new multidose vial. The nurse should:

Accepted Answer

Before replacing a newly opened multidose vial in the medication storage area, the nurse should write the date the vial was opened, because out of date medication can chemically change.

Question 17

When withdrawing medication from an ampule, the best needle to use is a:

Accepted Answer

Medication should be withdrawn from an ampule using a filter needle, which prevents small glass fragments from being drawn into the syringe.

Question 18

The most effective nursing actions to decrease discomfort to the patient during a parenteral injection would be:

Accepted Answer

Using the smallest gauge needle that is appropriate for the site is one way to decrease patient discomfort.

Question 19

A patient has an order to receive two intramuscular injections in the same syringe. The nurse should initially:

Accepted Answer

The first step is to determine whether the two medications are compatible in the same syringe.

Question 20

A nurse has just administered a medication to a patient using a syringe that is not a safety syringe. To dispose of the needle and syringe safely, the nurse should:

Accepted Answer

Needles are not to be recapped and should be deposited in the sharps container.

Quiz 35: Administering Intradermal, Subcutaneous, and Intramuscular Injections