Deck 37: Administering Intradermal, Subcutaneous, and Intramuscular Injections

Question 1

After withdrawing medication and removing the needle from the vial, the nurse notes there is an air bubble in the syringe. The nurse should

A) Return the medication to the vial and attempt to draw it again.
B) Gently shake the syringe in a downward motion.
C) Roll the syringe gently between her hands.
D) Tap the barrel of the syringe to float the bubble toward the needle.

Answer 1

Tap the barrel of the syringe to float the bubble toward the needle.

Question 2

The nurse recognizes that a 22 g $\times$ 1.50-inch needle would be most appropriate for a(n)

A) Adult intradermal injection (ID).
B) Child subcutaneous injection.
C) Adult intramuscular (IM) injection.
D) Newborn IM injection.

Answer 2

Adult intramuscular (IM) injection.

Question 3

To prevent complications from intramuscular injections, a nurse should do all of the following except

A) Wash the hands before preparing injections and on entering a patient's room.
B) Make the needle puncture slowly and with caution.
C) Apply a bandage after giving the injection.
D) Document the site of the injection.

Answer 3

Make the needle puncture slowly and with caution.

Question 4

To prevent lipoatrophy and lipohypertrophy in patients receiving insulin injections, a nurse should

A) Massage the injection site.
B) Occasionally administer injections in the ventrogluteal site.
C) Rotate injection sites around the abdomen.
D) Always inject in the same site.

Question 5

The nurse is administering an intradermal injection for tuberculin testing. Unless contraindicated, the nurse will use the patient's

A) Right ventral forearm.
B) Left ventral forearm.
C) Upper chest.
D) Upper back.

Question 6

The nurse is providing care for a 32-year-old with suspected bowel obstruction who is receiving intramuscular injections of narcotic pain medication. The patient states, "I hate shots. Why can't I just take a pill?" The nurse could best respond with

A) "We want to avoid giving you medication that you have to digest."
B) "Giving the pain medication this way will make it last longer."
C) "Narcotic medications are destroyed by the acid in your stomach."
D) "The drug will be absorbed more slowly this way."

Question 7

The student nurse is preparing to provide 25 mg meperidine (Demerol) IM for pain. The Pyxis is loaded with prefilled 50 mg meperidine syringes. The supervising nurse appropriately intervenes if the student nurse

A) Obtains a Carpuject system to administer the medication.
B) Recaps the needle after the injection.
C) Wastes 25 mg of the meperidine before administration.
D) Unscrews the syringe from the holder before discarding it in the sharps container.

Question 8

A newborn requires an intramuscular injection. Which of the following sites will the nurse first seek to use for the injection?

A) Ventrogluteal site
B) Deltoid
C) Rectus femoris
D) Vastus lateralis

Question 9

The nurse sees that the physician has ordered a subcutaneous heparin injection for a patient. The nurse will plan to give the injection in the

A) Back of the upper arms.
B) Abdomen.
C) Upper buttocks.
D) Anterior thighs.

Question 10

The nurse is preparing to reconstitute a medication in a multiple-dose vial. The nurse correctly understands that the most essential step in this process is

A) Wiping the rubber stopper of the vial with alcohol before and after needle insertion.
B) Instilling the accurate amount of diluent into the vial.
C) Using a filtered needle to draw up the medication.
D) Instilling air into the vial before withdrawing medication.

Question 11

As a nurse, which of the following would you recognize as accurately describing the phenomenon of first-pass metabolism?

A) Sublingual medications pass first through the mucosal lining of the mouth.
B) Intradermal medications are absorbed first by the skin and then by underlying tissue.
C) Oral medications are metabolized by the liver before entering the bloodstream.
D) Intramuscular injections pass through the subcutaneous layer of skin into muscle.

Question 12

The nurse is preparing to provide a subcutaneous injection. The nurse's technique would correctly include

A) Pointing the bevel of the needle up before piercing the skin.
B) Selecting a 14 gauge, 1-1/2'' needle.
C) Placing the total dose of 2.5 mL medication in one syringe.
D) Donning sterile gloves.

Question 13

When a nurse administers an intramuscular injection of a viscous medication into a muscular adult, she correctly uses

A) A long needle with a small gauge.
B) A long needle with a large gauge.
C) A short needle with a small gauge.
D) A short needle with a large gauge.

Question 14

A nurse correctly recognizes that which of the following types of syringe is calibrated in milliliters?

A) Regular syringe
B) Tuberculin syringe
C) Insulin syringe
D) Single-dose syringe

Question 15

Which of the following is considered an essential step for the nurse to follow while withdrawing medication from an ampule?

A) Injecting air into the ampule before withdrawing medication
B) Using a filtered needle to withdraw medication
C) Tapping the bottom of the ampule before breaking the neck
D) Taking care not to invert the ampule while withdrawing medication

Question 16

A nurse handling a syringe before administering an injection correctly keeps all parts of the syringe sterile except the

A) Plunger.
B) Inside of the barrel.
C) Syringe tip.
D) Plastic needle cap.

Question 17

A nurse correctly recognizes that the safest and most comfortable site for an intramuscular (IM) injection is

A) The ventrogluteal site.
B) The dorsal gluteal site.
C) The vastus lateralis site.
D) The left deltoid site.

Question 18

When teaching a student nurse about using syringes, the nurse correctly describes the part of a syringe that screws into the needle hub as the

A) Barrel.
B) Plunger.
C) Luer-Lok tip.
D) Slip tip.

Question 19

As the nurse is giving an intramuscular injection, she notes blood returning into the syringe with aspiration. The best action by the nurse is to

A) Withdraw the needle and dispose of the syringe.
B) Withdraw the needle, replace the needle, and then provide the injection in a different location.
C) Push the needle deeper into the muscle and aspirate again.
D) This is a normal finding with an intramuscular injection; the nurse should proceed with the injection.

Question 20

The nurse is teaching a 64-year-old with impaired vision and newly diagnosed diabetes to manage diabetes and insulin provision. The nurse's most appropriate course of action is to

A) Have the patient practice injecting her thigh with an empty syringe.
B) Encourage the patient to identify a family member who will be giving the insulin shots.
C) Obtain small insulin syringes that the patient can use to draw up the insulin.
D) Instruct the patient to attend a diabetic support group that is offered on a monthly basis.

Question 21

Before administering a heparin injection, a nurse needs to have a second nurse verify

A) The strength and dosage of the heparin.
B) The type and dosage of the heparin.
C) The patient's laboratory results.
D) Whether it should be given via the intramuscular route.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 22

The home care nurse is preparing to provide an intramuscular injection to a 42-year-old woman. Which of the following supplies will the nurse need to complete this task?

A) Alcohol prep pad
B) Sterile gloves
C) Syringe
D) 25 g $\times$ 1/2-inch needle
E) Needle disposal container

Question 23

Before administering an intramuscular injection, the nurse should first check to see whether the patient is taking

A) Aspirin.
B) Acetaminophen.
C) Ginseng.
D) All of the above.

Question 24

The nurse is preparing to administer insulin that was drawn up in the medication room. To recap the needle before walking to the patient's room, it is necessary for the nurse to do which of the following?

A) Place the cap on a flat surface.
B) Lay the cap with the open end extending beyond the countertop edge.
C) Push the cap onto the exposed needle using the dominant hand.
D) Maintain sterility of the syringe and needle.
E) Scoop the cap onto the tip of the syringe needle.

Question 25

Place the following steps of withdrawing medication from a vial in the order in which a nurse would appropriately perform them (1-6). (Enter the number of each step in the proper sequence, do not use commas).
1. Pierce the rubber stopper at a 90-degree angle.
2. Invert the vial and syringe.
3. Inject air into the vial.
4. Pull the plunger back to the desired level to fill the syringe with air.
5. Withdraw the appropriate amount of medication into the syringe.
6. Wash hands.

Question 26

The nursing student is studying how to provide medications via parenteral routes. Which of the following would be topics under study?

A) Intradermal tuberculin test (PPD)
B) Intravenous morphine (morphine sulfate)
C) Oral warfarin (Coumadin)
D) Intramuscular ketorolac (Toradol)
E) Subcutaneous regular insulin (Humulin R)