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A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during teaching sessions with the patient?
- A. Repeat subsequent puffs, if ordered, after 5 minutes.
- B. Inhale slowly while pressing down to release the medication.
- C. Inhale quickly while pressing down to release the medication.
- D. Administer the inhaler while holding it 3 to 4 inches away from the mouth.
Correct Answer: B
Rationale: Inhaling slowly while pressing the inhaler ensures proper medication delivery to the lungs. The inhaler should be 1-2 inches from the mouth or use a spacer, and subsequent puffs should be 1-2 minutes apart, not 5 minutes.
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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.
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.
When administering medication by IV bolus (push), the nurse will occlude the IV line by which method?
- A. Injecting the bolus without pinching the tubing
- B. Pinching the tubing just above the injection port
- C. Pinching the tubing just below the injection port
- D. Pinching the tubing just above the drip chamber of the infusion set
Correct Answer: B
Rationale: Occluding the IV line by pinching the tubing just above the injection port prevents backflow and ensures the medication is delivered correctly during an IV bolus. The other methods are incorrect.
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.
The nurse is about to give a rectal suppository to a patient. Which technique would facilitate the administration and absorption of the rectal suppository?
- A. Having the patient lie on the right side, unless contraindicated
- B. Having the patient hold his or her breath during insertion of the medication
- C. Lubricating the suppository with a small amount of petroleum-based lubricant before insertion
- D. Encouraging the patient to lie on the left side for 15 to 20 minutes after insertion
Correct Answer: D
Rationale: Positioning the patient on the left side and using a water-soluble lubricant facilitates insertion and absorption of a rectal suppository. The patient should remain on the left side for 15-20 minutes. Petroleum-based lubricants are not used, and breath-holding is not necessary.