Chapter 10: Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes

Chapter 10: Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is educating a patient about diabetes. Based on recommendations from the American Diabetes Association, which statement by the nurse is best regarding site rotation?

ANS:  B

The American Diabetes Association Clinical Practice recommendations include rotating injections systematically at one site before progressing to another. Insulin is not absorbed into the stomach. Failure to rotate sites can result in lipohypertrophy or lipoatrophy. When subcutaneous (subcut) insulin is administered, aspiration should never be performed.

DIF:    Cognitive Level: Application           REF:   Page 132        OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

NOT:  CONCEPT(S): Clinical Judgment; Safety; Patient Education

2. Which technique by the nurse is accurate when administering heparin to a thin, older adult patient?

ANS:  B

For thin individuals, the skin may need to be pinched and a 45-degree angle used to avoid administration into the muscle. Heparin should never be aspirated. Subcut injections are properly administered at a 45-degree angle. The injection site of heparin should never be massaged.

DIF:    Cognitive Level: Application           REF:   Page 136        OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Safety; Development

3. The nurse is preparing to administer kindergarten immunizations at the local health clinic. Which anatomic site would be best for the injection of the immunizations containing 0.5 mL?

ANS:  C

The deltoid muscle is often used because of its easy access and the fact that it can tolerate 0.5 mL of medication volume. Having the child disrobe is not efficient in this setting.

DIF:    Cognitive Level: Application           REF:   Page 138 | Page 139

OBJ:   5                    TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Safety; Development

4. A 65-year-old man who weighs 180 lb (81.8 kg) is to receive 1.5 mL of a viscous antibiotic by intramuscular (IM) injection. Which needle and syringe will be used?

ANS:  C

It is important to correlate the syringe size to the size of the patient and the tissue mass. The usual amount injected intramuscularly is 0.5 to 2 mL. Needle lengths commonly used for adults are 1 to 1 inches long. A longer needle may be used for a significantly obese adult. Commonly used needle gauges for IM injections are 20 to 22 gauge. A 5/8 inch, 25-gauge needle is too short and too small to administer a viscous medication. A 1 inch, 28-gauge needle is too small to administer a viscous medication. A 3 inch, 16-gauge needle is too large and too long to administer medication to a patient this size.

DIF:    Cognitive Level: Application           REF:   Page 136        OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:   CONCEPT(S): Clinical Judgment; Safety