Nokea
A patient is to receive hydromorphone 1.5 mg IV push now. The medication comes in a prefilled syringe, 2 mg/mL. Identify how many milliliters the nurse will administer for this dose.
Correct Answer: 0.75 mL
Rationale: To calculate: 2 mg/1 mL = 1.5 mg/x mL. Cross-multiply: (2 * x) = (1 * 1.5); 2x = 1.5; x = 1.5/2 = 0.75 mL.
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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.
A 2-year-old child is to receive ear drops. The nurse is teaching the parent about giving the ear drops. Which instruction is appropriate?
- A. Administer the drops without pulling on the ear lobe.
- B. Straighten the ear canal by pulling the lobe upward and back.
- C. Straighten the ear canal by pulling the pinna down and back.
- D. Straighten the ear canal by pulling the pinna upward and outward.
Correct Answer: C
Rationale: For children under 3 years, pulling the pinna down and back straightens the ear canal for proper ear drop administration. The other methods are incorrect for this age group.
While the nurse is assisting a patient in taking his medications, the medication cup falls to the floor, spilling the tablets. What is the nurse's best action at this time?
- A. Discarding the medications and repeating preparation
- B. Asking the patient if he will take the medications
- C. Waiting until the next dose time, and then giving the medications
- D. Retrieving the medications and administering them to avoid waste
Correct Answer: A
Rationale: Medications that fall to the floor are contaminated and must be discarded. The nurse should prepare a new dose to ensure safety. The other actions risk administering contaminated medication or delaying treatment.
The nurse is preparing to give an aqueous intramuscular (IM) injection to an average-sized adult. Which actions are appropriate? (Select all that apply.)
- A. Choose a 26- or 27-gauge, 1/4 to 1/2-inch needle.
- B. Choose a 20- to 25-gauge, 1- to 1 1/2-inch needle.
- C. Choose the dorsogluteal site, the preferred site for IM injections for adults.
- D. Insert the needle at a 45-degree angle.
- E. Insert the needle at a 90-degree angle.
- F. Before injecting the medication, withdraw the plunger to check for blood return.
Correct Answer: B,E,F
Rationale: For IM injections in adults, use a 20- to 25-gauge, 1- to 1 1/2-inch needle, insert at a 90-degree angle, and check for blood return to avoid intravascular injection. The dorsogluteal site is not preferred due to nerve risks; the ventrogluteal site is recommended. A 26- or 27-gauge needle is too small, and a 45-degree angle is for subcutaneous injections.
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).