Nokea
You would aspirate before injecting the medication in which of the following injections?
- A. 1 mL promethazine IM in the dorsagluteal
- B. 1 mL purified protein derivative ID
- C. Novolin R insulin 4 units subcut
- D. Heparin 1,000 units subcut
- E. Cyanocobalamin 1,000 mcg Z-track
Correct Answer: A,E
Rationale: Aspiration is performed for IM injections, including Z-track, to check for blood and avoid intravenous administration. It is not required for intradermal or subcutaneous injections.
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What angle of insertion should be used for intramuscular injections?
- A. 15 degrees
- B. 30 degrees
- C. 45 degrees
- D. 90 degrees
Correct Answer: D
Rationale: Intramuscular injections require a 90-degree angle to ensure the medication reaches the muscle tissue.
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.
Which of the following sites provides the best and most consistent absorption of insulin?
- A. Upper back
- B. Back of upper arms
- C. Deltoid
- D. Dorsal gluteal
- E. Abdomen
Correct Answer: E
Rationale: The abdomen provides the fastest and most consistent absorption for insulin due to its subcutaneous fat and blood supply.
What angle of insertion can be used for subcutaneous injections in patients of all sizes?
- A. 15 degrees
- B. 30 degrees
- C. 45 degrees
- D. 90 degrees
Correct Answer: C,D
Rationale: Subcutaneous injections can be administered at a 45-degree angle for most patients or a 90-degree angle for those with sufficient subcutaneous tissue, depending on needle length and patient size.
Which of the following sites would be appropriate to use for an intramuscular injection in a 14-month-old infant with pneumonia?
- A. Femoris rectus
- B. Deltoid
- C. Vastus lateralis
- D. Ventrogluteal
- E. Dorsogluteal
Correct Answer: C,D
Rationale: The vastus lateralis and ventrogluteal sites are appropriate for IM injections in a 14-month-old due to sufficient muscle mass and safety.