A nurse is administering an intradermal injection to a patient. Which statements are correct? Select all that apply.

A depressed area around the injection sites indicates a positive reaction.

After the insertion of the needle, a healthcare provider should aspirate for a blood return.

The needle is inserted with the bevel of the needle upward at a 10- to 15-degree angle.

The inner arm or upper back are the preferred sites.

Answer and Explanation

Correct Answer : C,D

These statements are correct because they follow the guidelines for intradermal injections, which are used for skin testing, such as for allergies or tuberculosis. Intradermal injections are given into the dermis, which is the layer of skin below the epidermis.
The needle is inserted with the bevel of the needle upward at a 10- to 15-degree angle to ensure that the medication is delivered into the dermis and not into the subcutaneous tissue or the epidermis. The bevel is

the slanted part of the needle tip that creates a sharp point. Inserting the needle with the bevel upward also reduces tissue trauma and bleeding.
The inner arm or upper back are the preferred sites for intradermal injections because they have thin skin and minimal hair, which makes it easier to see and measure any reactions. The inner arm is usually used for adults, while the upper back is used for children.
The other statements are not correct because they do not apply to intradermal injections or they contain false information.

a. A depressed area around the injection sites indicates a positive reaction. This statement is false because a depressed area, also known as induration, indicates a negative reaction. A positive reaction is indicated by a raised area, also known as a wheal, that is larger than a certain size depending on the type of test.

b. After the insertion of the needle, a healthcare provider should aspirate for a blood return. This statement does not apply to intradermal injections because aspiration is not necessary for this type of injection. Aspiration is the process of pulling back on the plunger of the syringe to check for blood in the needle before injecting the medication. This is done to avoid injecting into a blood vessel, which can cause adverse eﬀects or reduce the eﬀectiveness of the medication. However, intradermal injections are given into very superficial layers of skin where there are no blood vessels, so aspiration is not required.

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Correct Answer is A

Explanation

The IV infusion will be completed at 13:20.

This answer is correct because it is based on a simple division and addition calculation. The nurse can divide the total volume of the infusion by the infusion rate to get the duration of the infusion in hours, as follows:

1000 mL / 250 mL/hr = 4 hr

Therefore, the infusion will take 4 hours to complete. The nurse can add 4 hours to the start time of the infusion to get the end time, as follows:

09:20 + 4:00 = 13:20

Therefore, the IV infusion will be completed at 13:20.

A. Draw up one-half of the NPH insulin followed by one-half of the regular insulin and repeat. B. Draw up one-half of the regular insulin followed by one-half of the NPH insulin and repeat. C. Draw up the NPH insulin into the insulin syringe followed by the regular insulin. D. Draw up the regular insulin into the insulin syringe followed by the NPH insulin.

Correct Answer is D

Explanation

The correct technique for preparing this insulin order is to follow these steps¹²:

- Perform hand hygiene and put on gloves.
- Mix NPH (cloudy) insulin by gently rotating the vial between the palms of your hands. Do not shake the vial.
- Clean the tops of both vials with alcohol swabs and let them dry.
- Draw up the amount of air equal to the dose of NPH insulin into a syringe. Inject the air into the NPH vial without touching the needle to the solution. Withdraw the needle and syringe without drawing up any insulin. This will create positive pressure in the NPH vial and make it easier to draw up later.
- Draw up the amount of air equal to the dose of regular (clear) insulin into the same syringe. Inject the air into the regular vial and invert the vial. Make sure the needle tip is below the ﬂuid level and draw up slightly more than the dose of regular insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the regular vial.
- Reinsert the needle and syringe into the NPH vial without touching the needle to the solution. Invert the vial and draw up slightly more than the dose of NPH insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the NPH vial.
- Check that you have the correct doses of both insulins in one syringe. The total volume should be equal to the sum of both doses.
- Administer the dose within 5 to 10 minutes after drawing up because regular insulin binds to NPH and this decreases its action.

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A nurse is administering an intradermal injection to a patient. Which statements are correct? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A primary healthcare provider prescribes a medication of 1250 mg diluted in 1000 mL. A nurse starts the infusion at 09:20 at a rate of 250 mL/hr. What time will the intravenous (IV) infusion be completed?

Correct Answer is A

Explanation

The patient needs both regular insulin and NPH insulin to be administered subcutaneously. The nurse will mix both insulins in the same syringe. What is the correct technique for preparing this insulin order?

Correct Answer is D

Explanation

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