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The nurse will plan to use the Z-track method of intramuscular (IM) injections for which situation?
- A. The medication is known to be irritating to tissues.
- B. The patient is emaciated and has very little muscle mass.
- C. The medication must be absorbed quickly into the tissues.
- D. The patient is obese and has a deep fat layer below the muscle mass.
Correct Answer: A
Rationale: The Z-track method is used for medications that irritate tissues or cause staining, preventing leakage into subcutaneous tissues. It is not specifically for emaciated or obese patients or for rapid absorption.
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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.
A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the medication. The nurse needs to remember which correct instruction regarding how to give this medication?
- A. Break the tablet into halves or quarters.
- B. Dissolve the tablet in a small amount of water before giving it.
- C. Do not crush or break the tablet before administration.
- D. Crush the tablet as needed to ease administration.
Correct Answer: C
Rationale: Sustained-release (SR) tablets must not be crushed or broken to maintain their controlled-release properties and prevent rapid absorption or gastrointestinal irritation.
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 giving an intradermal (ID) injection and will choose which syringe for this injection?
- A. interderm_1.PNG
- B. interderm_2.PNG
- C. interderm_3.PNG
- D. interderm_4.PNG
Correct Answer: B
Rationale: The proper size syringe for ID injection is a 1-mL tuberculin. The other syringes pictured are incorrect. Insulin syringes (marked in units) are not used for intradermal injections.