Ch 35

Nurse has an order to admin an injection of purified protein derivative (PPD) by the intradermal route. The maximum amount of medication that can be given using this route is: a. 0.1 mL. b. 0.75 mL. c. 0.5 mL. d. 0.2 mL.

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

A nurse giving a subcutaneous injection will select: a. 3 mL syringe and 22 gauge, 1 1/2 inch needle. b. 3 mL syringe and 18 gauge, 1 1/2 inch needle. c. 3 mL syringe and 25 gauge, 5/8 inch needle. d. 3 mL syringe and 20 gauge, 1 inch needle

3 mL syringe and 25 gauge, 5/8 inch needle. For subcutaneous injection, it is best to use a 25 gauge, 5/8 inch needle.

The best angle to insert the needle when admin a subcutaneous injection is at an angle of: a. 45 to 90 degrees. b. 30 to 45 degrees. c. 15 to 30 degrees. d. 5 to 15 degrees.

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

When preparing to reconstitute a med from a powder form, the nurse should first: a. use sterile water. b. vigorously shake the powder prior to reconstituting medication. c. follow directions on label for diluent to use. d. discard the vial and the unused medication.

follow directions on label for diluent to use. Instructions for the diluent should be followed from the directions on the label.

You are preparing to mix short acting and long acting insulin. Prioritize these step accordingly. (Separate letters with a comma and space as follows: A, B, C, D, E, F.) a. Withdraw prescribed amount of short-acting insulin. b. Inject air into short-acting insulin. c. Check medications with eMAR and MAR using three medication checks. d. Choose and prepare site before injection. e. Withdraw prescribed amount of long-acting insulin. f. Inject air into long-acting insulin.

Check medications with eMAR and MAR using three medication checks. Inject air into long-acting insulin. Inject air into short-acting insulin. Withdraw prescribed amount of short-acting insulin. Withdraw prescribed amount of long-acting insulin. Choose and prepare site before injection. These are the proper steps to take when mixing short and long acting insulin in one syringe.

Which med order should be documented in the MAR and in the nurses' notes after given? a. Digoxin 0.25 mg PO at 9:00 AM. b. Demerol 75 mg IM PRN pain. c. Lasix 40 mg PO twice daily. d. KCl 20 mEq PO daily.

Demerol 75 mg IM PRN pain. PRN and STAT orders are recorded in the eMAR, MAR and nurses' notes along with the reason why the medication was given, the result, and the duration of effect of medication.

When administering intramuscular injection to an adult patient using the ventro-gluteal site, the nurse should use which landmark to locate the area for injection? a. The lower end of the trochanter and the knee b. The upper end of the trochanter and the knee c. The head of the trochanter and the posterior iliac spine d. The head of the trochanter and the anterior iliac spine

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

A hospitalized patient has an order for subcutaneous heparin. The best location to administer this med is the: a. upper arm. b. anterior thigh. c. buttock. d. abdomen.

abdomen 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.

Patient asks why the clinic nurse asked him to remain in the clinic for 30 minutes after the injection of penicillin. The nurse explains it is part of the standards of care to monitor for: a. any pain reaction. b. bleeding at the site. c. infection at the site. d. any allergic reaction.

any allergic reaction. The nurse should plan to monitor this patient for allergic response for 30 minutes after giving the first dose of a medication.

A nurse has admin a Tuberculin skin test to a patient in the outpatient clinic at 9am on Monday. The patient should be scheduled to return to the clinic to have the result read: a. late Monday afternoon. b. late Tuesday afternoon. c. any time on Wednesday. d. any time on Friday.

any time on Wednesday. The results of the Tuberculin skin test should be read within 48 to 72 hrs after injection.

When admin heparin, the nurse will avoid: a. using the lower abdomen as an injection site. b. rotating sites. c. massaging area for more than 3 seconds. d. aspirating before injection.

aspirating before injection. The nurse should not aspirate before the insertion of heparin because evidence does not support this practice.

A patient has a medication order for iron dextran (Imferon) to be given using the Ztrack technique. The rationale for using this method is: a. avoid medication irritation. b. avoid tissue scarring. c. cause less painful method. d. protect the sciatic nerve.

avoid medication irritation. Ztrack 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.

When reconstituting a med from a powder, the nurse will: (Select all that apply.) a. confirm the type of diluent required. b. use only a 23-gauge needle to inject a reconstituted medication. c. thoroughly mix solute with diluent. d. roll the solute between hands to warm powder. e. label the medication as to the amount of medication per volume after dilution.

confirm the type of diluent required. thoroughly mix solute with diluent. label the medication as to the amount of medication per volume after dilution. After confirming the type of diluent required, the solute must be mixed thoroughly with the recommended diluent, then labeled as to the amount of medication per volume after dilution.

Patient has an order to receive two intramuscular injections in the same syringe. The nurse should initially: a. determine if the 2 medications are compatible in the same syringe. b. obtain a larger syringe that will accommodate both medications. c. select two syringes to give the medications separately. d. ask the patient whether he would prefer one or two injections.

determine if the 2 medications are compatible in the same syringe. The first step is to determine whether the two medications are compatible in the same syringe.

The nurse computes the dose of med as 2.4 million units of penicillin to be delivered in 4 mL. The nurse should: a. give the 4 mL using a 5 mL syringe. b. inform the charge nurse that the dose is too large to be given IM. c. divide the dose into two 3 mL syringes and give as a divided dose. d. ask the primary care provider if another medication can be used.

divide the dose into two 3 mL syringes and give as a divided dose. The maximum number of milliliters that can be injected into the ventro-gluteal 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.

When withdrawing med from an ampule, the best needle to use is a: a. beveled needle. b. 1 inch needle. c. 1 1/2 inch needle. d. filter needle.

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

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: a. shake both vials vigorously before use. b. inject air into the short acting clear insulin. c. withdraw the short acting clear insulin. d. inject air into the long acting cloudy insulin.

inject air into the long acting cloudy insulin. 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.

To ensure the proper admin of a tuberculin test, the nurse will: a. use a 3 mL syringe. b. choose a 21 gauge, 1 inch needle. c. insert the needle at a 30-degree angle. d. inject slowly to form a bleb.

inject slowly to form a bleb 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 bump or bleb underneath the skin.

The nurse performs the proper technique when withdrawing med from the vial by: a. wiping the rubber stopper with a povidone iodine swab. b. inserting the needle into the vial at a 90-degree angle. c. injecting into the vial an amount of air that is equal to the dose. d. keeping the needle above the level of solution while withdrawing into the syringe.

injecting into the vial an amount of air that is equal to the dose. 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.

A nurse has just admin a med to a patient using a syringe that is not a safety syringe. To dispose of the needle and syringe safely, the nurse should: a. recap the needle and dispose of it in the trash receptacle. b. recap the needle and dispose of it in the sharps container. c. leave the needle uncapped and dispose of it in the trash receptacle. d. leave the needle uncapped and dispose of it in the sharps container.

leave the needle uncapped and dispose of it in the sharps container Needles are not to be recapped and should be deposited in sharps container.

The nurse understands that the only part of the syringe that can be touched and not contaminated is : a. needle. b. outside of the barrel. c. sides of the plunger. d. tip of the syringe.

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

The nurse is educating a patient who weighs 325 lbs on how to admin a subcutaneous would suggest that the patient would: a. require a longer needle because of his weight. b. experience a faster response to the medication. c. use a 15 degree angle to inject the medication. d. need extra pressure at the injection site to prevent bleeding.

require a longer needle because of his weight. For the obese patient, the needle length should be longer than the needle length for a thin person because of excess fatty layers.

When reinforcing instructions to a patient who will self administer insulin injections at home, it's important to remind the patient to: a. always use a new insulin vial with each dose. b. rotate injection sites systematically. c. use a tuberculin syringe to draw up insulin. d. aspirate before injecting the insulin.

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

The most effective nursing action to decrease discomfort to the patient during a parenteral injection would be: a. inserting the needle while the skin is still wet from the alcohol wipe. b. asking the patient to look at the injection site for learning purposes. c. using the smallest gauge needle that is appropriate for the site. d. removing the needle slowly to avoid damaging the tissue.

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

The IM injection site recommended for infants under 12 months of age is the ( blank ).

vastus lateralis The vastus lateralis muscle is the site of choice for infant under 12 months for IM injections.

When administering an intramuscular injection for a 4yr old child, the best site to use is the: a. gluteus medius. b. vastus lateralis. c. ventrogluteal. d. dorsogluteal.

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

When the 8yr old child complains that he does not want to have a "shot," the nurse explains that the use of a parenteral route: a. is the best way to give medicine. b. will hasten the action of the medication. c. will take less medicine to make him well. d. will be painless because the needles are so sharp.

will hasten the action of the medication 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 admin a medication.

When the nurse is preparing to draw med from an ampule, the proper procedure is to: a. allow medication to float freely in the body, neck, and stem. b. wrap the neck with a gauze or alcohol sponge to the open ampule. c. break the ampule so that it opens toward her. d. inject air into the ampule to ease the withdrawal of the medication.

wrap the neck with a gauze or alcohol sponge to the open ampule. 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 cut when the ampule is snapped open.

A nurse has opened and used part of a new multi-dose vial. The nurse should: a. write the current date on the vial. b. wipe the top of the vial. c. check the expiration date of the vial. d. replace the plastic top that covered the vial.

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