Nokea
A parenteral route of medication administration is one that bypasses which of the following?
- A. Stomach
- B. Kidneys
- C. Skin
- D. Heart
- E. Liver
Correct Answer: A,E
Rationale: Parenteral routes (e.g., injections) bypass the gastrointestinal system (stomach) and first-pass metabolism in the liver.
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What gauge and length of needle would you select to administer an IM injection of a nonviscous medication in the ventrogluteal site of a 40-year-old male construction worker who is in good health and weighs 185 pounds?
- A. 25 G, 1 inch
- B. 18 G, 1½ inch
- C. 22 G, 1½ inch
- D. 24 G, 2 inch
- E. 20 G, 1 inch
Correct Answer: C
Rationale: For a healthy adult male, a 22-gauge, 1½-inch needle is appropriate for an IM injection in the ventrogluteal site to ensure adequate muscle penetration for a nonviscous medication.
In which of the following injections should you avoid aspirating before injecting the medication?
- A. IM injection of antibiotics
- B. ID tuberculosis test
- C. Subcut insulin
- D. IM pain medication
- E. Subcut anticoagulant
Correct Answer: B,C,E
Rationale: Aspiration is not required for intradermal (e.g., TB test) or subcutaneous injections (e.g., insulin, anticoagulants) as these routes are not typically associated with blood vessels.
A nurse is caring for a 65-year-old female with type I diabetes. The patient is receiving an insulin bolus for a glucose reading of 310 mg/dL. How will the nurse give the insulin bolus?
- A. Give the medication all at once
- B. Give the medication before meals
- C. Give the medication after meals
- D. Give the medication before and after meals and at bedtime
Correct Answer: A
Rationale: An insulin bolus for a high glucose reading (310 mg/dL) is given all at once to rapidly correct the hyperglycemia.
Which of the following steps should the nurse perform when combining two types of insulin and administering them?
- A. Always withdraw intermediate-acting insulin first
- B. When mixing insulins, remember 'clear before cloudy'
- C. Inject with 20-G, 1-inch needle
- D. Insert needle at a 45- or 90-degree angle
- E. Mix Lantus with regular insulin
Correct Answer: B,D
Rationale: When mixing insulins, draw up clear (regular) insulin before cloudy (intermediate-acting) to avoid contamination. A 45- or 90-degree angle is used for subcutaneous injections. Lantus should not be mixed with other insulins.
Which site of subcutaneous administration has the most rapid absorption of insulin?
- A. Vastus lateralis
- B. Dorsogluteal site
- C. Back of upper arm
- D. Abdomen
- E. Deltoid
Correct Answer: D
Rationale: The abdomen has the fastest insulin absorption due to its rich blood supply and consistent subcutaneous tissue.