Deck 23: Administration of Parenteral Medications

Question 1

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

Answer 1

The lower abdomen

Question 2

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.

Answer 2

The nurse palpates a hard, dense, raised area 14 mm across.

Question 3

The nurse prepares to administer a 3-mL intramuscular (IM)injection of an antibiotic to an 85-year-old 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

Answer 3

Divides the injection into two separate syringes

Question 4

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 healthcare provider of the situation.
C) Continue to administer the ordered medication.
D) Stop the administration and discard the syringe.

Question 5

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

A) Insert the needle at a 45- to 90-degree angle.
B) Massage the area after performing the injection.
C) Administer the injection without aspirating.
D) Inject at least 7.6 cm (3 inches) from the umbilicus.

Question 6

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 7

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 8

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 antiinflammatory drug
D) A 60-year-old patient with kidney stones

Question 9

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 10

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

A) Check with the healthcare 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 to 72 hours.

Question 11

The nurse is teaching a patient to self-administer insulin.The patient is 5 feet tall and weighs 197 pounds.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 12

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 should 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 healthcare provider orders oral insulin for patients with pain.
D) There are techniques that will minimize the pain of the injection, though not eliminate it.

Question 13

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 healthcare 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.

Question 14

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) Pinch a large area of skin and inject heparin into the center of the skin fold.

Question 15

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

Question 16

The nurse prepares to administer 2.2 mL of an oil-based medication intramuscularly to a male patient who is 5 feet 10 inches tall and weighs 165 pounds.Which needle and syringe combination should 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 17

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 to 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 18

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 peaks within 15 minutes.
B) Prepare for hyperglycemia 2 hours after taking insulin.
C) Keep insulin refrigerated after administering the first dose.
D) Eat right after taking regular insulin to avoid hypoglycemia.

Question 19

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 20

A patient is admitted to the emergency department after a motor vehicle accident.The nurse sustains an accidental needlestick injury while performing a venipuncture on the 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 21

The nurse instructs the patient on mixing NPH and regular insulin in the same syringe. Match the steps in order that the patient should follow to ensure accurate dosing.

9. Step 5

A)Withdraw the NPH insulin.
B)Withdraw the regular insulin.
C)Remove bubbles from regular insulin.
D)Inject air equal to the NPH insulin volume into the vial.
E)Inject air equal to the regular insulin volume into the vial.

Question 22

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.

Question 23

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 intravenous (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 healthcare provider to obtain the best approach.

Question 24

MATCHING
The nurse prepares to initiate a continuous subcutaneous injection (CSCI). Match the steps of the nursing interventions.

2. Step 2

A)Insert the needle at 45- to 90-degree angle.
B)Connect the tubing of the needle to the tubing of the pump.
C)Cleanse the site with alcohol and chlorhexidine.
D)Apply occlusive dressing over the insertion site.

Question 25

MATCHING
The nurse prepares to initiate a continuous subcutaneous injection (CSCI). Match the steps of the nursing interventions.

4. Step 4

A)Insert the needle at 45- to 90-degree angle.
B)Connect the tubing of the needle to the tubing of the pump.
C)Cleanse the site with alcohol and chlorhexidine.
D)Apply occlusive dressing over the insertion site.

Question 26

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 27

MATCHING
The nurse prepares to initiate a continuous subcutaneous injection (CSCI). Match the steps of the nursing interventions.

1. Step 1

A)Insert the needle at 45- to 90-degree angle.
B)Connect the tubing of the needle to the tubing of the pump.
C)Cleanse the site with alcohol and chlorhexidine.
D)Apply occlusive dressing over the insertion site.

Question 28

The nurse instructs the patient on mixing NPH and regular insulin in the same syringe. Match the steps in order that the patient should follow to ensure accurate dosing.

6. Step 2

A)Withdraw the NPH insulin.
B)Withdraw the regular insulin.
C)Remove bubbles from regular insulin.
D)Inject air equal to the NPH insulin volume into the vial.
E)Inject air equal to the regular insulin volume into the vial.

Question 29

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 30

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 31

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 32

The nurse instructs the patient on mixing NPH and regular insulin in the same syringe. Match the steps in order that the patient should follow to ensure accurate dosing.

5. Step 1

A)Withdraw the NPH insulin.
B)Withdraw the regular insulin.
C)Remove bubbles from regular insulin.
D)Inject air equal to the NPH insulin volume into the vial.
E)Inject air equal to the regular insulin volume into the vial.

Question 33

The nurse instructs the patient on mixing NPH and regular insulin in the same syringe. Match the steps in order that the patient should follow to ensure accurate dosing.

8. Step 4

A)Withdraw the NPH insulin.
B)Withdraw the regular insulin.
C)Remove bubbles from regular insulin.
D)Inject air equal to the NPH insulin volume into the vial.
E)Inject air equal to the regular insulin volume into the vial.

Question 34

The nurse instructs the patient on mixing NPH and regular insulin in the same syringe. Match the steps in order that the patient should follow to ensure accurate dosing.

7. Step 3

A)Withdraw the NPH insulin.
B)Withdraw the regular insulin.
C)Remove bubbles from regular insulin.
D)Inject air equal to the NPH insulin volume into the vial.
E)Inject air equal to the regular insulin volume into the vial.

Question 35

MATCHING
The nurse prepares to initiate a continuous subcutaneous injection (CSCI). Match the steps of the nursing interventions.

3. Step 3

A)Insert the needle at 45- to 90-degree angle.
B)Connect the tubing of the needle to the tubing of the pump.
C)Cleanse the site with alcohol and chlorhexidine.
D)Apply occlusive dressing over the insertion site.

Question 36

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

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