Nokea
At what angle should the nurse insert the needle for an intradermal injection?
- A. 15 degrees
- B. 30 degrees
- C. 45 degrees
- D. 90 degrees
Correct Answer: A
Rationale: When giving an intradermal injection, the needle is inserted bevel up at a 15-degree angle. The nurse would insert the needle at a 90-degree angle for an intramuscular injection or for a patient who is obese and requires a subcutaneous injection. Typically a subcutaneous injection is given at a 45-degree angle.
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What action is most important to minimize tissue damage when administering subcutaneous heparin?
- A. Insert the needle at the appropriate angle
- B. Select the needle length based on the patient's weight
- C. Ensure that there is no hair on the injection site
- D. Rotate the injection site regularly
Correct Answer: D
Rationale: The nurse should rotate the injection sites to minimize the damage caused to the tissue. Inserting the needle at the proper angle and selecting the needle length based on the patient's weight will not significantly help in minimizing tissue damage if the same site is repeatedly injected. It is not necessary to avoid injection sites that have hair as long as the drug is administered in the upper arms, the upper abdomen, and the upper back.
What routes are used for parenteral drug administration? Select all that apply.
- A. Subcutaneous
- B. Intramuscular
- C. Intradural
- D. Intravenous
- E. Intradermal
Correct Answer: A,B,D,E
Rationale: A nurse can administer parenteral drugs via subcutaneous, intramuscular, intravenous, intradermal, and, in some instances, intra-arterial routes by means of a catheter placed by a physician in an artery. The primary health care provider can administer a drug via the intradural route.
What are examples of topical drugs? Select all that apply.
- A. Eyedrops
- B. Suppository
- C. Nebulized bronchodilator
- D. Nicotine patch
- E. Capsule
Correct Answer: A,B
Rationale: Topical drugs are drugs that are applied to the outer layer of the skin but not absorbed through the skin, such as eyedrops and suppositories. A nebulized bronchodilator is an inhaled medication. A nicotine patch delivers the medication transdermally; that is, it is readily absorbed from the skin. A capsule is a form of oral medication.
What actions can nurses take to help prevent drug errors? Select all that apply.
- A. Rechecking all calculations
- B. Always administering the drug before answering any of the client's questions
- C. Avoiding distractions and concentrating on only one task at a time
- D. Confirming any questionable orders
- E. Practicing the five+ 1 rights of drug administration
Correct Answer: A,C,D,E
Rationale: In addition to following the five+ 1 rights of drug administration, a nurse can employ the following strategies to aid in the prevention of drug errors: confirm any questionable orders; when calculations are necessary, verify them with another nurse; listen to the client when he or she questions a drug, the dosage, or the drug regimen; never administer the drug until the client's questions have been adequately researched; and avoid distractions and concentrate on only one task at a time.
What is the most appropriate response when a patient says, 'This doesn't look like my usual pill'?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.