Injection Med - Exam 3 ("A little better" version)

During a teaching session on self-administration of insulin, the client asks the nurse why it is necessary to bunch the skin before inserting the needle. What is the nurse's best response? "Bunching your skin controls bleeding." "Bunching your skin steadies the syringe." "Bunching your skin ensures complete delivery of the insulin." "Bunching your skin facilitates the placement of the needle in the subcutaneous tissue."

"Bunching your skin facilitates the placement of the needle in the subcutaneous tissue." Explanation: Facilitating the placement of the needle in the subcutaneous tissue is correct, as this action enables the skin to accommodate the length of the needle better. Controlling bleeding, steadying the syringe, and ensuring complete delivery of the insulin are incorrect, as these actions are not why it is necessary to bunch the skin.

The nurse just completed a refresher course on parenteral drug administration. Which statement by the nurse indicates that teaching was effective? "Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." "Reconstitution is a sealed glass cylinder of parenteral medication with an attached needle." "Reconstitution is a glass or plastic container of parental medication with a self-sealing rubber stopper." "Reconstitution is a sealed glass drug container that must be broken to withdraw the medication."

"Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." Explanation: Reconstitution is the process of adding liquid, known as diluent, to a powdered substance. A sealed glass cylinder of parenteral medication with an attached needle is a refilled cartridge, not reconstitution. A glass or plastic container of parental medication with a self-sealing rubber stopper is a vial, not reconstitution. A sealed glass drug container that must be broken to withdraw the medication is an ampoule, not reconstitution.

A client with diabetes who requires the new placement of an insulin pump asks the nurse how it works. What teaching will the nurse provide? "This will be used in addition to giving yourself injections." "You will wear this to receive a stream of insulin 24 hours daily." "Settings can be adjusted for exercise and illness, and bolus doses can be delivered related to meals." "This device contains long-acting insulin."

"Settings can be adjusted for exercise and illness, and bolus doses can be delivered related to meals." Explanation: The nurse will teach that the insulin pump contains rapid-acting insulin and releases ongoing small amounts of insulin (not a stream), and that the client can manually release an additional dose after meals or snacks.

Which statement by a client indicates to the nurse that teaching was effective regarding the different parts of a syringe? "The plunger is the part of the syringe that moves back and forth to withdraw and instill medication." "The barrel is the part of the syringe that resets the dose window to zero following an injection." "The barrel is the part of the syringe to which the needle is attached." "The plunger is the part of the syringe that holds the medication."

"The plunger is the part of the syringe that moves back and forth to withdraw and instill medication." Explanation: The plunger is that part of the syringe that moves back and forth to withdraw and instill the medication. Therefore, this statement is correct. The barrel not resetting the dose window to zero following an injection is one of the characteristics of an insulin pen and is therefore incorrect. It is the tip of the syringe to which the needle is attached, not the barrel. The plunger does not hold the medication; the barrel does.

The charge nurse on the medical/surgical unit is reviewing physician orders for a client with a diagnosis of congestive heart failure. Which infusion orders would the nurse question? 50 mL D5W to run in 60 minutes 250 mL 0.9 NaCl to run in 60 minutes 1000 D5W to run in 30 minutes 20 mL 0.9 NaCl to run in 20 minutes

1000 D5W to run in 30 minutes Explanation: Medications administered by intermittent infusion are supplied either in bags that contain 50 to 250 mL of IV fluid (0.9 normal saline or 5% dextrose in water) or in 20- to 60-mL syringes to be used with an infusion pump.

The nurse is preparing to administer a tuberculin test. At which angle is the nurse expected to instill the drug? 15-degree angle 45-degree angle 90-degree angle 120-degree angle

15-degree angle Explanation: A 15-degree angle is correct, as this allows the drug to be injected between the layers of the skin. A 45-degree angle is incorrect, as this will allow the drug to be injected beneath the skin but above the muscle. A 90-degree angle is incorrect, as this will allow the drug to be injected in the muscle. A 120-degree angle is incorrect, as this will be more suitable for intravenous injections.

The nurse is preparing to administer two IV medications. What is the appropriate nursing action? Prepare to administer through two separate tubes. Administer the drugs through the same tubing. Consult a current drug reference book for IV compatibility. Hold one medication for an hour and administer it after the first medication.

Consult a current drug reference book for IV compatibility. Explanation: The nurse should consult a current drug reference book for compatibility before administering two IV medications. Other answers are incorrect.

A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration? Deltoid Vastus lateralis Ventrogluteal Scapula

Deltoid Explanation: The deltoid is the best site for this medication. Biologicals for infants and young children are administered at the vastus lateralis. The ventrogluteal site is used for depot formulations and irritating medications. The scapula is a site for an intradermal injection.

A nurse is administering a hepatitis B immunization injection to an adult client. Which site would the nurse choose for this injection? Vastus lateralis site Deltoid muscle site Ventrogluteal site Dorsogluteal site

Deltoid muscle site Explanation: Hepatitis B virus vaccine is one medication that should be given in the deltoid muscle in adults to induce adequate levels of the antibody. The vastus lateralis muscle and the ventrogluteal muscle can be used for other intramuscular injections. The dorsogluteal muscle is no longer a preferred site for intramuscular injections.

A home care nurse is educating a client with diabetes on how to self-administer insulin. Which teaching point should the nurse include in the education plan? Each time you give the injection rotate the injection site. For each injection use the same site on the body. Insulin syringes and needles may be reused up to three times. Store insulin needles and syringes in a glass container between use.

Each time you give the injection rotate the injection site. Explanation: The nurse will educate the client on the injection sites for insulin injections. Insulin may be administered subcutaneously in the upper arm, anterior or lateral aspects of the thigh, buttocks, or abdomen (avoiding a 2-in [5-cm] radius around the umbilicus). The client should rotate the site for each injection systematically about 1 in (2.5 cm) from the previous injection site. Rotation within one area is preferred to rotation to a new body area with each injection (in order to minimize daily variability in absorption associated with different sites, according to the American Diabetes Association). Needles and syringes should never be reused and have no need to be stored in a glass container.

The nurse is assessing a client with diabetes who has poor vision. Which feature of the insulin pen makes it beneficial for this client? The insulin pen is easily transported on the client. It is easier to learn how to use an insulin pen than a syringe and vial. Each unit of insulin is accompanied by a clicking sound in the pen. With an insulin pen, a large variety of insulin types are available.

Each unit of insulin is accompanied by a clicking sound in the pen. Explanation: Each unit of insulin is accompanied by a clicking sound in the pen. This is a beneficial feature for the client who has poor vision, as the sound will alert the client to count when selecting the prescribed dose. Being easily transported, being easier to learn, and having a variety of types available are all advantages for using insulin pens, but they do speak specifically to this client.

A nurse is preparing an injection by withdrawing the solution from a multidose vial. What is necessary to facilitate withdrawing a medication from the vial? First, inject an equal amount of air into the vial. Withdraw the liquid and then inject an equal amount of air. Insert the needle and slowly withdraw the liquid. Insert a separate needle to equalize the pressure.

First, inject an equal amount of air into the vial. Explanation: To facilitate removal of medication from a multidose vial, first inject an amount of air equal to the amount of the desired quantity of the medication.

An emergency room nurse is ordered to administer nitroglycerin to a client being treated for acute pulmonary hypertension. Which means of drug administration would the nurse use to achieve rapid results in this emergency situation? IV Infusion Oral powder Subcutaneous injection Inhalation

IV Infusion Explanation: Intravenous infusion is the fastest route of administration because the medication goes into the bloodstream immediately and is dispensed over a period of time which is needed in pulmonary hypertension. The second fastest route is an injection because they are quickly absorbed into vessels. Oral medication is a slow route and should not be used in an emergency situation. Medication via patches would not administer the medication quickly enough in an emergency situation. Inhalation medications are specifically given for respiratory issues.

The nurse is preparing to administer a tuberculin test to a client. Which instructions should the nurse provide to the client? Return in 48 to 72 hours for results. Wait here for 60 minutes for results. Call the nurse in 72 hours for results. We will contact you with the results.

Return in 48 to 72 hours for results. Explanation: The nurse must read the results of the tuberculin test on the client's arm in person. The client should be directed to return for results in 48 to 72 hours.

The nurse has confirmed the client's identity and provided a client with oral medications to take. What is the next appropriate nursing intervention? Leave the room. Assess for therapeutic effect of medications. Stay with the client while medications are taken. Document medication administration.

Stay with the client while medications are taken. Explanation: The nurse must wait with the client to personally acknowledge that medications have been taken (or refused). Other actions are taken after the client has taken the medication.

A client is ordered to receive an intramuscular injection of medication. When preparing to administer the injection, the nurse selects the ventrogluteal site based on which reason? The site is in close proximity to the sciatic nerve. The area is free of major blood vessels and fat. There is a high possibility of injecting into subcutaneous fat. The site lies close to the radial nerve.

The area is free of major blood vessels and fat. Explanation: The ventrogluteal site for intramuscular injection is free of major blood vessels and fat. It is considered the safest and least painful site. The dorsogluteal site is near the sciatic nerve and involves a high possibility of injecting into subcutaneous fat. The deltoid region for an intramuscular injection has little overlying subcutaneous fat and lies close to the radial nerve.

A nurse needs to administer a subcutaneous heparin injection to a client. Which injection site is most suitable for heparin? abdomen back upper chest forearm

abdomen Explanation: The abdomen area is the preferred site for a subcutaneous heparin injection because of less pain intensity. The forearm, back, and upper chest are common sites for an intradermal injection, not a subcutaneous injection.

A nurse needs to administer an intradermal injection to a client. What is the most common site for administering an intradermal injection? forearm chest back stomach

forearm Explanation: The most common site for an intradermal injection is the inner aspect of the forearm. Intradermal injections are commonly used for diagnostic purposes. Examples include tuberculin tests and allergy testing. Small volumes, usually 0.01 to 0.05 mL, are injected because of the small tissue space. Other areas that may be used are the back and upper chest, not the stomach.

Which component of a syringe's needle does the nurse recognize that refers to width? lumen shaft bevel gauge

gauge Explanation: The gauge of a needle refers to width. The lumen is the opening of the needle; the shaft is the length of the needle; the bevel is the slanted portion of the needle that provides access into the vein.

A nurse is using the Z-track technique to administer an injection to a client. Which injection route utilizes the Z-track technique? intravenous intramuscular intradermal subcutaneous

intramuscular Explanation: When administering intramuscular injections, nurses may administer drugs that may be irritating to the upper levels of tissue by the Z-track technique. Clients report slightly less pain during (and the day after) a Z-track injection compared with the usual intramuscular injection technique. The Z-track technique is not suitable for intravenous injections, as they are administered into the veins, nor is it used for intradermal or subcutaneous injections.

The Z-track technique is utilized during drug administration by which route? intramuscular subcutaneous intradermal intravenous

intramuscular Explanation: The Z-track technique is used for intramuscular injections to prevent leakage of medication into the needle track, thus minimizing discomfort.

After administering medication to a client subcutaneously, the nurse removes the needle at the same angle at which it was inserted. Which explains the nurse's action? verifies correct injection of the drug minimizes tissue trauma to the client prevents needlestick injuries helps to control placement of the needle

minimizes tissue trauma to the client Explanation: Removing the needle at the same angle at which it was inserted to administer medication minimizes tissue trauma and discomfort to the client. To verify correct injection of the drug, the nurse pushes the plunger and watches for a small wheal. To prevent needlestick injuries, the nurse covers the needle with a protective cap. Holding the client's arm and stretching the skin taut helps to control placement of the needle.

What is the best explanation from the nurse as to why a client must return to the unit in 48 hours after having a tuberculin skin test intradermal? to determine the extent to which the client responded to the drugs to administer timely emergency treatment to implement measures to reduce the transmission of microorganisms to prevent interfering with test results

o determine the extent to which the client responded to the drugs Explanation: Determining the extent to which the client has responded to the drugs is correct, as this allows the nurse to observe the area for signs of local reaction in which the standard time is 24-48 hours. Ensuring that emergency treatment is quickly administered is incorrect since the nurse is to observe the client for allergy to the test in the first 30 minutes. Reducing the risk for the transmission of microorganisms is incorrect since this could be achieved by the nurse removing gloves and performing hand hygiene immediately after administering the drug. Preventing interference with test results is incorrect, as the nurse could instruct the client not to rub the area.

The nurse is preparing to give a vaccination to an infant. At which site should the nurse plan to administer the injection? vastus lateralis deltoid rectus femoris dorsogluteal

vastus lateralis Explanation: The vastus lateralis site is particularly desirable for infants and children, whose gluteal muscles are poorly developed.

Which anatomic site is recommended for intramuscular injections for adults? vastus lateralis epidermis of inner forearm ventrogluteal muscles subcutaneous fat

ventrogluteal muscles Explanation: The ventrogluteal site involves the gluteus medius and gluteus minimus muscles in the hip area. This site is recommended for adults because there are no large nerves or blood vessels, it is removed from bone tissue, it is clean, and the client may lie on the back, abdomen, or side for the injection.

A nurse is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which situation? when the client has disorders that affect the absorption of medications when the drug needs to act on the client very slowly when the client wants to avoid the discomfort of an intradermal injection when the drug needs to be administered only once

when the client has disorders that affect the absorption of medications Explanation: Intravenous administration may be chosen when clients have disorders, such as severe burns, that affect the absorption and metabolism of medications. IV therapy is also used in an emergency when a quick response is needed. Intravenous administration is not chosen when a client wants to avoid the discomfort of an intradermal injection but rather when the client wants to avoid the discomfort of repeated intramuscular injections. A single administration of a drug does not indicate the need for intravenous administration.