Nokea
A patient is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. The nurse will use which angle for the needle insertion?
- A. 15 degrees
- B. 45 degrees
- C. 60 degrees
- D. 90 degrees
Correct Answer: D
Rationale: The proper angle for IM injections is 90 degrees to ensure the medication reaches the muscle layer. The other angles are incorrect for IM administration.
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The nurse is giving liquid medications through a percutaneous endoscopic gastrostomy (PEG) tube. Which technique is correct?
- A. Administering the medications using a 3-mL medication syringe
- B. Applying firm pressure on the syringe's piston to infuse the medication
- C. Flushing the tubing with 30 mL of saline after the medication has been given
- D. Using the barrel of the syringe, allowing the medication to flow via gravity into the tube
Correct Answer: D
Rationale: For PEG tubes, medications are poured into the syringe barrel with the piston removed, allowing gravity flow to prevent tube damage. A 3-mL syringe is too small, firm pressure is unsafe, and saline flush is incorrect (tap water is used).
The nurse will plan to use the Z-track method of intramuscular (IM) injections for which situation?
- A. The medication is known to be irritating to tissues.
- B. The patient is emaciated and has very little muscle mass.
- C. The medication must be absorbed quickly into the tissues.
- D. The patient is obese and has a deep fat layer below the muscle mass.
Correct Answer: A
Rationale: The Z-track method is used for medications that irritate tissues or cause staining, preventing leakage into subcutaneous tissues. It is not specifically for emaciated or obese patients or for rapid absorption.
The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection?
- A. Using the Z-track method
- B. Inserting the needle at a 5- to 15-degree angle until resistance is felt
- C. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angle
- D. Spreading the skin tightly over the injection site, inserting the needle, and then releasing the skin
Correct Answer: C
Rationale: For subcutaneous injections in obese patients, pinching the skin and inserting the needle at a 90-degree angle ensures delivery into the subcutaneous tissue. The Z-track method is for IM injections, a 5- to 15-degree angle is incorrect, and spreading the skin is not appropriate for subcutaneous administration.
After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. Which of these is the best action for the nurse to take at this time?
- A. Apply heat.
- B. Massage the area.
- C. Do nothing.
- D. Report the bleb to the physician.
Correct Answer: C
Rationale: A small bleb is an expected outcome after an intradermal injection for skin testing, indicating proper administration. No further action is needed.
The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken next?
- A. Flushing the lock
- B. Regulating the IV flow
- C. Clamping the tubing for 10 minutes
- D. Holding the patient's arm up to improve blood flow
Correct Answer: A
Rationale: Flushing the IV lock with saline or heparin (per facility policy) after administering an IV push medication ensures the medication is cleared from the lock and prevents clotting. The other actions are not appropriate.