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

Insulin is a hormone that helps regulate blood sugar levels. It is usually injected into the fat layer just under the skin (subcutaneous or SubQ) using a syringe and needle or a pen-like device². Insulin syringes are marked in units of insulin, not milliliters or cubic centimeters. The most common insulin syringe holds 1 mL of ﬂuid and has markings for 100 units of insulin². A U-100 syringe means that for every 1 mL of ﬂuid, there are 100 units of insulin³.
To administer 14 units of insulin, you would need to draw up 0.14 mL of ﬂuid in a U-100 syringe. You would inject the insulin into your abdomen, upper arm, butocks, hip, or the front or side of the thigh¹. You would use a diﬀerent area within the site each time you inject insulin to prevent lumps, swelling, or thickened skin¹.

The other options are incorrect because:

b) There is no need to divide the dose into two injections. This would increase the risk of infection and pain.

c) A tuberculin syringe is not designed for insulin administration. It is marked in milliliters or cubic centimeters, not units of insulin. Using a tuberculin syringe could result in an incorrect dose of insulin.

d) The timing of insulin administration depends on the type and duration of insulin. Some insulins are taken before meals, some are taken after meals, and some are taken once or twice a day. The primary healthcare provider should specify when to take the insulin.

A. 1236 mL B. 1250 mL C. 1336 mL D. 1350 mL

Correct Answer is D

Explanation

To find the volume of ﬂuid that will be left at 10:00 am, you need to calculate the following:

- The time elapsed in minutes from 8:45 am to 10:00 am using the formula: Time elapsed (min) = End time (min) - Start time (min)
- The volume of ﬂuid infused in milliliters (mL) during the time elapsed using the formula: Volume infused (mL) = Flow rate (mL/min) x Time elapsed (min)
- The volume of ﬂuid left in milliliters (mL) at 10:00 am using the formula: Volume left (mL) = Initial volume (mL) - Volume infused (mL)

First, use the formula for time elapsed to find how many minutes have passed from 8:45 am to 10:00 am:

Time elapsed (min) = End time (min) - Start time (min)

Since the end time is 10:00 am and the start time is 8:45 am, plug in these values into the formula:

Time elapsed (min) = 600 min - 525 min

Simplify and solve for the time elapsed:

Time elapsed (min) = 75 min

Next, use the formula for volume infused to find the amount of ﬂuid infused in milliliters during the time elapsed:

Volume infused (mL) = Flow rate (mL/min) x Time elapsed (min)

Since the ﬂow rate is 2 mL/min and the time elapsed is 75 min, plug in these values into the formula:

Volume infused (mL) = 2 mL/min x 75 min

Simplify and solve for the volume infused:

Volume infused (mL) = 150 mL

Then, use the formula for volume left to find the amount of ﬂuid left in milliliters at 10:00 am:

Volume left (mL) = Initial volume (mL) - Volume infused (mL)

Since the initial volume is 1500 mL and the volume infused is 150 mL, plug in these values into the formula:

Volume left (mL) = 1500 mL - 150 mL

Simplify and solve for the volume left:

Volume left (mL) = 1350 mL

Therefore, the volume of ﬂuid that will be left at 10:00 am is **1350 mL**.

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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 14 units of insulin to a client. What should a nurse do while administering this medication to the client?

Correct Answer is A

Explanation

A nurse starts an infusion of 1500 mL of normal saline (NS) for a client at 8:45 am at a ﬂow rate of 2 mL/min. The tubing drop factor is 10 drops/mL. Calculate the volume of ﬂuid that will be left at 10:00 am.

Correct Answer is D

Explanation

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