Nokea
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.
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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).
A patient is receiving eyedrops that contain a beta-blocker medication. The nurse will use what method to reduce systemic effects after administering the eyedrops?
- A. Wiping off excess liquid immediately after instilling the drops
- B. Having the patient close the eye tightly after the drops are instilled
- C. Having the patient try to keep the eye open for 30 seconds after the drops are instilled
- D. Applying gentle pressure to the patient's nasolacrimal duct for 30 to 60 seconds after instilling the drops
Correct Answer: D
Rationale: Applying gentle pressure to the nasolacrimal duct for 30-60 seconds reduces systemic absorption of eyedrops by preventing drainage into the nasal cavity. The other methods do not effectively reduce systemic effects.
When giving parenteral medications, the nurse will use Standard Precautions, which include what action?
- A. Bending the needle to prevent reuse
- B. Recapping needles to prevent needle sticks
- C. Discarding all syringes and needles in the trash can
- D. Discarding all syringes and needles in a puncture-resistant container
Correct Answer: D
Rationale: Standard Precautions require discarding syringes and needles in a puncture-resistant container to prevent needle-stick injuries. Bending or recapping needles and using a trash can are unsafe.
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.
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.