Deck 24: Parenteral Medications

Question 1

A toddler is to receive an intramuscular injection.What action can the nurse take to make the injection less traumatic?

A) Have the parents hold the toddler down during the injection.
B) Collaborate with the health care provider about what to do.
C) Encourage the toddler to move the leg after the injection.
D) Obtain an order for EMLA cream or vapo-coolant spray.

Answer 1

Obtain an order for EMLA cream or vapo-coolant spray.

Question 2

The nurse is providing teaching for a patient who needs an intradermal test for tuberculosis.What information does the nurse include?

A) Check with the health care provider in 2 hours for test results.
B) Relaxation helps make this type of injection painless.
C) A total of 0.1 mL of solution will be injected into the muscle.
D) The test must be read in 48-72 hours.

Answer 2

The test must be read in 48-72 hours.

Question 3

The nurse prepares to administer an irritating medication by the Z-track technique.Which technique does the nurse use to administer this intramuscular (IM) injection properly?

A) Inserts the needle and pulls the skin laterally before injecting the medication.
B) Has the patient lie in a supine position to prevent medication leakage.
C) Waits 10 seconds and releases the skin before withdrawing the syringe.
D) Pulls the patient's skin laterally before inserting the needle.

Answer 3

Pulls the patient's skin laterally before inserting the needle.

Question 4

The nurse prepares to administer 2.2 mL of an oil-based medication intramuscularly to a fit young adult patient who is 5 feet 10 inches tall and weighs 165 pounds.Which needle and syringe combination will the nurse choose to administer the injection?

A) 20-gauge, 1 1/2-inch needle on a 3-mL syringe
B) 21-gauge, 1 1/2-inch needle on a 5-mL syringe
C) 23-gauge, 1-inch needle on a 3-mL syringe
D) 25-gauge, 1-inch needle on a 5-mL syringe

Question 5

A nurse sustains an accidental needlestick injury while performing a venipuncture on a patient.What is the nurse's priority?

A) Determine whether the needle was sterile.
B) Follow agency policy for employee injuries.
C) Inform the provider to screen the patient for antibodies.
D) Obtain patient history of communicable diseases.

Question 6

When administering an intramuscular (IM) injection, the nurse obtains blood during aspiration.What action by the nurse is appropriate?

A) Wait 30 minutes before giving the ordered medication.
B) Notify the health care provider of the situation.
C) Continue to administer the ordered medication.
D) Stop the administration and discard the syringe.

Question 7

The nurse instructs a patient with diabetes mellitus about subcutaneous insulin administration.What does the nurse include in patient teaching?

A) Remember that NPH insulin is clear and is drawn up last when mixing types.
B) Prepare for hyperglycemia 2 hours after taking insulin.
C) Keep insulin refrigerated after administering the first dose.
D) Carry 15 g of carbohydrates with you at all times.

Question 8

The nurse prepares to administer a 3-mL intramuscular (IM) injection of an antibiotic to a thin older patient.What action does the nurse take to administer the medication correctly?

A) Prepares the patient for a subcutaneous injection.
B) Divides the injection into two separate syringes.
C) Positions the patient for injection in the dorsogluteal area.
D) Avoids aspirating when injecting in the deltoid muscle.

Question 9

The nurse is teaching a patient to self-administer insulin.Which of the following does the nurse include in patient teaching?

A) Insert the needle into abdominal tissue at a 90-degree angle.
B) Include an air space when drawing up the prescribed dose.
C) Aspirate before injecting to ensure that the needle is not in a vessel.
D) Instruct the patient to use an insulin syringe with a 1-inch needle.

Question 10

The nurse is reviewing the records of four patients on heparin therapy.Which patient does the nurse determine has the highest risk for a bleeding disorder during heparin therapy?

A) A 10-year-old patient with an acute viral infection
B) A female patient who gave birth more than 6 weeks ago
C) A patient who takes a nonsteroidal anti-inflammatory drug
D) A 60-year-old patient with kidney stones

Question 11

The nurse prepares an insulin injection for the patient who has diabetes mellitus.Which does the nurse implement for correct insulin administration?

A) Gives regular insulin within 15-30 minutes of meals.
B) Injects insulin just removed from the refrigerator.
C) Examines vials of NPH insulin for abnormal cloudiness.
D) Administers NPH insulin for sliding-scale insulin dosing.

Question 12

The nurse evaluates the tuberculosis skin test results for a patient who recently emigrated from Southeast Asia.Which result is consistent with the presence of tuberculosis antibodies in the patient's system if the nurse reads the test 72 hours after injection?

A) The injection site is an 11-mm red, warm, swollen area.
B) The skin around the injection site is black, dry, and scaly.
C) The nurse palpates a hard, dense, raised area 14 mm across.
D) According to the patient, the skin around the injection site feels cool.

Question 13

Which technique does the nurse use to administer a parenteral medication properly?

A) Inserts the needle with the bevel facing downward.
B) Pushes the needle through the patient's tissue slowly.
C) Applies sterile technique to draw up the medication.
D) Uses a 16- or 18-gauge needle with aqueous solutions.

Question 14

The nurse is caring for a 14-year-old patient with diabetes mellitus who does not want to self-administer insulin because it is too painful.Which information does the nurse use in response to the patient's concern?

A) Adolescents are usually enthusiastic about self-care.
B) Insulin mixed with a local anesthetic decreases pain.
C) The health care provider orders oral insulin for patients with pain.
D) There are techniques that will minimize the pain of the injection.

Question 15

The nurse's outcome for the patient is, "Patient self-administers subcutaneous heparin before discharge." What does the nurse include in patient teaching?

A) Expect large areas of bruising around the injection site.
B) Promote heparin absorption by massaging the injection site.
C) Choose one large area for consistent heparin absorption.
D) Inject heparin into the abdomen but avoid the umbilical area.

Question 16

The nurse is teaching a patient to self-administer subcutaneous heparin at home.What does the nurse include in patient teaching?

A) Use a 22-gauge, 1-inch needle for the heparin injections.
B) Change needles after withdrawing the heparin from the vial.
C) Instruct the patient and family to recap all needles used at home.
D) Administer the heparin in the abdomen, 2 cm away from umbilicus.

Question 17

The patient wants to receive insulin by continuous subcutaneous injection (CSCI).Which injection site does the nurse suggest for the patient?

A) The upper arm
B) The upper chest
C) The lower abdomen
D) The thigh

Question 18

The nurse evaluates the patient's ability to self-administer a subcutaneous injection of the anticoagulant enoxaparin.What action by the patient indicates a need for additional patient teaching?

A) Inserts the needle at a 45-to-90-degree angle.
B) Massages the area after performing the injection.
C) Administers the injection without aspirating.
D) Injects at least 7.6 cm (3 inches) from the umbilicus.

Question 19

The nurse is instructing a nursing student in proper technique for an intradermal injection.Which does the nurse use to evaluate proper technique for a tuberculin skin test after injecting the solution?

A) The nurse palpates a deep, firm pocket of the test solution.
B) The nurse observes a nearly clear bubble slightly under the skin.
C) A small trickle of blood appears at the puncture site within minutes.
D) A 2-cm (3/4-inch) pink, flattened area develops at the injection site within 1 hour.

Question 20

The nurse prepares an IM injection to administer a medication available in a glass ampule.Which step does the nurse take to administer the injection properly?

A) Labels the ampule with date and time of the first dose.
B) Ensures that the cartridge is fully seated into the syringe.
C) Cleans the rubber top carefully before inserting the needle.
D) Uses a filter needle to withdraw the contents of the ampule.

Question 21

After teaching students about IV push medications, the faculty quizzes them on the advantages and disadvantages of this route of administration.Which responses by the students are correct? (Select all that apply.)

A) Medications given IV push have a rapid onset of action.
B) The risk of infiltration or extravasation is higher.
C) All medications can be delivered by IV push.
D) Barriers to absorption are eliminated.
E) Doses can be titrated quickly to patient need.

Question 22

The nurse is preparing to administer morphine sulfate IV push to a patient in pain.The morphine comes pre-drawn into a syringe with 0.3 mL of fluid.What action by the nurse is best?

A) Dilute the medication to prevent it from collecting in "dead spaces."
B) Verify with the pharmacy that the dose sent is the correct amount.
C) Using sterile technique, transfer the medication to a tuberculin syringe.
D) Give the medication as ordered and document the patient's response.

Question 23

Which angle should the nurse use to administer an intramuscular (IM) injection for a patient who is 5 feet 6 inches tall and weighs 140 pounds?

A) 15 degrees
B) 45 degrees
C) 60 degrees
D) 90 degrees

Question 24

A patient is receiving the first of three ordered blood transfusions.The nurse needs to administer an IV antibiotic.What action by the nurse is most appropriate?

A) Wait until after the transfusions are complete.
B) Stop the transfusion, flush the line, hang the antibiotic.
C) Ensure the blood bag in hanging lower than the piggyback.
D) Starts a new IV site in order to give the antibiotic on time.

Question 25

The nurse is preparing to give an injection in the ventrogluteal injection site.Which pair of anatomical landmarks does the nurse use for this site?

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

Question 26

The nurse needs to administer an intramuscular (IM) injection to a patient who is 7 months old.Which is the best site for the nurse to use for the injection?

A) Deltoid
B) Dorsogluteal
C) Ventrogluteal
D) Vastus lateralis

Question 27

A patient is to receive an antibiotic via IV piggyback through a running IV.After completing the 3 safety checks what action by the nurse is next?

A) Obtain an infusion pump from central supply.
B) Assess the patient's IV site for redness or swelling.
C) Determine if the antibiotic is compatible with the running IV fluid.
D) Prime the IV tubing, hang the IV piggyback, and program the pump.

Question 28

A patient has an IV solution running via IV pump.The nurse needs to administer an IV push medication that is not compatible with the primary solution.What action by the nurse is best?

A) Discontinue the running IV solution.
B) Flush the tubing before and after giving the medication.
C) Start a new IV site on the opposite arm.
D) Ask the provider for an alternative route.

Question 29

The student nurse is administering an IM injection to an 8-year-old.Which actions require intervention by the faculty member? (Select all that apply.)

A) Selects a 1-inch needle.
B) Cleanses the deltoid muscle.
C) Prepares the ventrogluteal site.
D) Chooses a 21-gauge needle.
E) Injects up to 3 mL of fluid.

Question 30

The nurse administers intradermal injections for allergy testing.Which is the best technique for the nurse to use for skin testing?

A) Select a 22-gauge needle.
B) Inject at a 45-degree angle.
C) Choose the back for the first test.
D) Inject below the antecubital space.

Question 31

A nurse has taught a patient general information about insulin administration.When using the teach-back method, what statements by the patient indicates good understanding? (Select all that apply.)

A) "I will check the bottle before use for any changes in appearance."
B) "I will rotate my injection sites around my abdomen."
C) "I will give my injection at least 2 inches from my belly button."
D) "I don't need to check my blood glucose if my dose doesn't change."
E) "I don't have to refrigerate the bottle of insulin I am using."

Question 32

The nursing manager is concerned about the number of needlesticks the staff is experiencing.Which of the following actions would help this situation? (Select all that apply.)

A) Ensure that sharps containers are readily available through the unit.
B) Request administration invests in needless and engineered safety syringes.
C) Instruct the staff to recap needles slowly and carefully to avoid injury.
D) Review incident reports to see if there is a common cause of needlesticks.
E) Volunteer to evaluate sharps engineered safety needle brands.

Question 33

The faculty member observes a student nurse administering an IV push medication through a saline lock.What action by the student requires the faculty to intervene?

A) Checks a resource for the rate of administration.
B) Flushes after the medication with saline quickly.
C) Follows the medication with a heparin flush.
D) Stays with the patient for several minutes after the IV push.

Question 34

The nurse is preparing to give a patient a medication via a piggyback infusion.What is the safest action for the nurse to take?

A) Fill the tubing with medication before connecting it to the Y-port.
B) Obtain a second IV site where the infusion will be administered.
C) Ask the patient his or her preference about starting a new IV line.
D) Consult with the health care provider to obtain the best approach.

Question 35

The nurse is preparing to administer the anticoagulant enoxaparin subcutaneously.Which injection site is most appropriate for the nurse to use?

A) Thighs
B) Deltoid area
C) Sides of abdomen
D) Ventrogluteal area

Question 36

The nurse instructs a patient's partner to administer subcutaneous regular Humulin insulin.What information should the nurse include in the partner's teaching?

A) Select a 25-gauge, 5/8-inch needle.
B) Massage the site after the injection.
C) Always insert the needle at a 90-degree angle.
D) Use a different injection site each time.