Deck 35: Administering Intradermal, Subcutaneous, and Intramuscular Injections

Question 1

The nurse performs the proper technique when withdrawing medication 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.

Answer 1

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

A) avoid medication irritation.
B) avoid tissue scarring.
C) cause less painful method.
D) protect the sciatic nerve.

Answer 2

avoid medication irritation.

Question 3

The best angle to insert the needle when administering 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.

Answer 3

45 to 90 degrees.

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:

A) late Monday afternoon.
B) late Tuesday afternoon.
C) any time on Wednesday.
D) any time on Friday.

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:

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.

Question 6

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

A) upper arm.
B) anterior thigh.
C) buttock.
D) abdomen.

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?

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

Question 8

When the nurse is preparing to draw medication 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.

Question 9

When reinforcing instructions to a patient who will self-administer insulin injections at home, it is 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.

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:

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.

Question 11

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

A) needle.
B) outside of the barrel.
C) sides of the plunger.
D) tip of the syringe.

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:

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.

Question 13

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

A) gluteus medius.
B) vastus lateralis.
C) ventrogluteal.
D) dorsogluteal.

Question 14

To ensure the proper administration 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.

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:

A) 0.1 mL.
B) 0.75 mL.
C) 0.5 mL.
D) 0.2 mL.

Question 16

A nurse has opened and used part of a new multidose 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.

Question 17

When withdrawing medication 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.

Question 18

The most effective nursing actions 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.

Question 19

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

A) determine if the two 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.

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:

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.

Question 21

When administering 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.

Question 22

The nurse is educating a patient who weighs 325 pounds on how to administer 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.

Question 23

You are preparing to mix short-acting and long-acting insulin. Prioritize these steps 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.

Question 24

The IM injection site recommended for infants under 12 months of age is the _________________.

Question 25

When reconstituting a medication 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.

Question 26

A patient asks why the clinic nurse asked him to remain in the clinic for 30 minutes after the injection of penicillin. The nurse explains that 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.

Question 27

When preparing to reconstitute a medication 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.

Question 28

A nurse giving a subcutaneous injection will select a:

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.

Question 29

Which medication order should be documented in the MAR and in the nurses' notes after it is 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.