Nokea
You are preparing an intramuscular injection of vitamin K for a newborn who weighs 8 pounds and 8 ounces (3.8 kg). Which of the following needle sizes would be appropriate to use?
- A. 29 g ? 7/8 in
- B. 25 g ? 7/8 in
- C. 21 g ? 1 in
- D. 18 g ? 1 in
- E. 22 g ? 1½ in
Correct Answer: B
Rationale: A 25 g ? 7/8 in needle is appropriate for IM injections in newborns, ensuring penetration into the muscle (vastus lateralis) without excessive depth.
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Which of the following drugs requires a second and third nurse to verify the dosage?
- A. Insulin
- B. Epinephrine
- C. Heparin
- D. Purified protein derivative
Correct Answer: A,C
Rationale: Insulin and heparin are high-alert medications requiring double or triple verification to prevent dosage errors.
Which site is the site of choice for IM injections in the majority of patients?
- A. Dorsal gluteal
- B. Deltoid
- C. Ventrogluteal
- D. Vastus lateralis
Correct Answer: C
Rationale: The ventrogluteal site is preferred for IM injections due to its safety, minimal risk of nerve or blood vessel damage, and adequate muscle mass.
What gauge and length needle would you select to administer an IM injection of a viscous medication, such as gamma globulin, in the ventrogluteal site of a 29-year-old male body builder who is in good health and weighs 203 pounds?
- A. 25 g ? 1.5 in
- B. 20 g ? 1/2 in
- C. 21 g ? 7/8 in
- D. 24 g ? 1 in
- E. 18 g ? 1½ in
Correct Answer: E
Rationale: For a viscous medication like gamma globulin in a muscular adult, a larger gauge (18?21 g) and longer needle (1?1½ in) are needed to penetrate the muscle deeply. An 18 g ? 1½ in needle is appropriate for the ventrogluteal site in a muscular male.
What is the maximum volume you can instill in the ventrogluteal site of a very large muscular female of approximately 240 pounds?
- A. 3 mL
- B. 2 mL
- C. 1 mL
- D. 0.5 mL
- E. 0.1 mL
Correct Answer: A
Rationale: The ventrogluteal site in a large, muscular adult can accommodate up to 3 mL due to its larger muscle mass.
The health-care provider has written an order to administer a PPD to Thomas Staccotti. As you gather your equipment and supplies, you know that you will need which of the following size needles and syringe?
- A. 18 g ? 1 in
- B. 20 g ? 7/8 in
- C. 25 g ? 7/8 in
- D. 23 g ? 1 in
Correct Answer: C
Rationale: For a PPD (purified protein derivative) test, which is an intradermal injection, a small gauge needle (25?27 gauge) with a short length (3/8 to 5/8 inch) is required to ensure the medication is injected just below the skin surface. A 25 g ? 7/8 in needle is appropriate.