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What gauge and length of needle would you select to administer an IM injection of a nonviscous medication in the ventrogluteal site of a 40-year-old male construction worker who is in good health and weighs 185 pounds?
- A. 25 G, 1 inch
- B. 18 G, 1½ inch
- C. 22 G, 1½ inch
- D. 24 G, 2 inch
- E. 20 G, 1 inch
Correct Answer: C
Rationale: For a healthy adult male, a 22-gauge, 1½-inch needle is appropriate for an IM injection in the ventrogluteal site to ensure adequate muscle penetration for a nonviscous medication.
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In which of the following injections should you avoid aspirating before injecting the medication?
- A. IM injection of antibiotics
- B. ID tuberculosis test
- C. Subcut insulin
- D. IM pain medication
- E. Subcut anticoagulant
Correct Answer: B,C,E
Rationale: Aspiration is not required for intradermal (e.g., TB test) or subcutaneous injections (e.g., insulin, anticoagulants) as these routes are not typically associated with blood vessels.
Which of the following steps should the nurse perform when combining two types of insulin and administering them?
- A. Always withdraw intermediate-acting insulin first
- B. When mixing insulins, remember 'clear before cloudy'
- C. Inject with 20-G, 1-inch needle
- D. Insert needle at a 45- or 90-degree angle
- E. Mix Lantus with regular insulin
Correct Answer: B,D
Rationale: When mixing insulins, draw up clear (regular) insulin before cloudy (intermediate-acting) to avoid contamination. A 45- or 90-degree angle is used for subcutaneous injections. Lantus should not be mixed with other insulins.
You are about to administer a standard P.P.D. to a 31-year-old male. Which of the following needles and syringes would be appropriate to use?
- A. Tuberculin syringe with 27-G, ??-inch needle
- B. 1-mL syringe with 20-G, 1½-inch needle
- C. Insulin syringe with 25-G, ??-inch needle
- D. 3-mL syringe with 25-G, ½-inch needle
- E. 1-mL syringe with 18-G, 1-inch needle
Correct Answer: A
Rationale: A tuberculin syringe with a 27-gauge, ??-inch needle is appropriate for a PPD test, which is an intradermal injection requiring a small volume and fine needle.
A parenteral route of medication administration is one that bypasses which of the following?
- A. Stomach
- B. Kidneys
- C. Skin
- D. Heart
- E. Liver
Correct Answer: A,E
Rationale: Parenteral routes (e.g., injections) bypass the gastrointestinal system (stomach) and first-pass metabolism in the liver.
A nurse needs to administer medication from an ampule. What of the following steps should the nurse take when drawing up this medication?
- A. Snap off the ampule neck using a sterile gauze pad
- B. Hold the ampule away from the body when breaking
- C. Tilt the ampule and place the injection needle into the liquid
- D. Avoid tapping the top of the bottle
- E. Use a filter needle to draw up medication
Correct Answer: A,B,C,E
Rationale: Proper ampule use involves breaking the neck with gauze, holding it away from the body, tilting to access liquid, and using a filter needle to prevent glass particles. Tapping is acceptable to move liquid.