Nokea
The nurse is to administer a subcutaneous (SC) injection. Which technique is correct?
- A. Pull the skin taut. Insert a 21-gauge needle at a 90-degree angle.
- B. Pinch the skin. Insert a 25-gauge needle at a 45-degree angle.
- C. Stretch the skin taut. Insert a 27-gauge needle at a 10-degree angle.
- D. Pinch the skin. Insert a 21-gauge needle at a 60-degree angle.
Correct Answer: B
Rationale: The skin should be pinched, and a 25-gauge needle should be inserted at a 45-degree angle. Answer 1 describes an IM injection. Answer 3 describes an intradermal injection.
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The client in end-stage renal disease is a Jehovah's Witness. The HCP orders erythropoietin (Epogen), a biologic response modifier, subcutaneously for anemia. Which action should the nurse take?
- A. Question this order because of the client's religion.
- B. Encourage the client to talk to his or her minister.
- C. Administer the medication subcutaneously as ordered.
- D. Obtain the informed consent prior to administering.
Correct Answer: C
Rationale: Epogen is synthetic, not blood-derived, so it’s acceptable for Jehovah’s Witnesses. Administer as ordered; questioning, minister consultation, or consent are unnecessary.
The client in the intensive care department has a nasogastric tube for continuous feedings. The nurse is preparing to administer nifedipine (Procardia XL) via the N/G tube. Which procedure should the nurse follow?
- A. Crush the medication and dissolve it in water.
- B. Administer and flush the N/G tube with cranberry juice.
- C. Give the medication orally with pudding.
- D. Do not administer the medication and notify the HCP.
Correct Answer: D
Rationale: Procardia XL is extended-release and cannot be crushed or given via NG tube; HCP notification is needed for an alternative form.
The client is experiencing supraventricular tachycardia (SVT). Which antidysrhythmic medication should the nurse prepare to administer?
- A. Atropine.
- B. Amiodarone.
- C. Adenosine.
- D. Dobutamine.
Correct Answer: C
Rationale: Adenosine is first-line for SVT, rapidly terminating the arrhythmia, per ACLS guidelines. Other drugs are used for different rhythms.
The nurse is teaching a group of women in a community clinic about prevention of osteoporosis. Which of the following over-the-counter medications should the nurse recognize as having the most elemental calcium per tablet?
- A. Calcium chloride
- B. Calcium citrate
- C. Calcium gluconate
- D. Calcium carbonate
Correct Answer: D
Rationale: Calcium carbonate. Calcium carbonate contains 400 mg of elemental calcium in 1 gram of calcium carbonate.
The 54-year-old female client with severe menopausal symptoms is prescribed hormone replacement therapy (HRT). Which secondary health screening activity should the nurse recommend for HRT?
- A. A Pap smear every six (6) months.
- B. A yearly mammogram.
- C. A bone density test every three (3) months.
- D. A serum calcium level monthly.
Correct Answer: B
Rationale: HRT increases breast cancer risk; yearly mammograms are recommended for screening, per ACOG guidelines. Other tests are not standard.