Chapter 11: Parenteral Administration: Intradermal, Subcutaneous, and Intramus-cular Routes

Chapter 11: 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?

A.	“Insulin injection sites should always be in the abdomen to ensure absorption into the stomach.”
B.	“It is important to rotate injection sites systematically within one area before progressing to a new site for injection.”
C.	“Following exercise, site rotation is not indicated because the circulation in the muscles will absorb the medication efficiently.”
D.	“If you aspirate, site rotation can be done every other day to avoid developing problems with absorption.”

 

 

ANS:   B

 

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

 

 

DIF:    Cognitive Level: Application             REF:    160

TOP:    Nursing Process Step: Implementation

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

 

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

A.	Aspirate before injecting the medication.
B.	Inject at a 45-degree angle.
C.	Inject at a 90-degree angle.
D.	Massage site following injection.

 

 

ANS:   B

 

	Feedback
A	Heparin should never be aspirated.
B	The skin may need to be pinched and a 45-degree angle used for thin individuals to avoid administration into the muscle.
C	Subcutaneous injections are properly administered at a 45-degree angle.
D	The injection site of heparin should never be massaged.

 

 

DIF:    Cognitive Level: Application             REF:    160

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

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?

A.	Rectus femoris
B.	Dorsogluteal
C.	Deltoid
D.	Ventrogluteal

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Application             REF:    163

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

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 injection. Which needle and syringe will be used?

A.	5/8-inch, 25-gauge needle with 5-mL syringe
B.	1-inch, 28-gauge needle with 4-mL syringe
C.	1 1/2-inch, 21-gauge needle with 3-mL syringe
D.	3-inch, 16-gauge needle with 1.5-mL syringe

 

 

ANS:   C

 

	Feedback
A	This needle is too short and too small to administer a viscous medication.
B	This needle is too small to administer a viscous medication.
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 1/2 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.
D	This needle is too large and too long to administer medication to a patient this size.

 

 

DIF:    Cognitive Level: Application             REF:    161

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity