A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?
Inject 0.3 to 0.5 mL of the solution.
Select an injection site that is free of scar tissue.
Hold the needle at a 30° angle during injection.
Massage the site following the injection.
The Correct Answer is B
A. Inject 0.3 to 0.5 mL of the solution: The typical volume for a tuberculin skin test is 0.1 mL.
B. Select an injection site that is free of scar tissue: Scar tissue can interfere with the reading of the tuberculin skin test, so a site free of scars should be selected.
C. Hold the needle at a 30° angle during injection: The needle should be held at a 5–15° angle for intradermal injections.
D. Massage the site following the injection: Massaging the site is not recommended as it could affect the accuracy of the test.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Lie down with feet elevated if dizziness occurs while taking this medication.: Dizziness may occur due to hypotension caused by nitroglycerin. Elevating the feet can improve blood flow to the brain and alleviate symptoms.
B. Apply the patch daily to a hairless area of the skin.: The patch should be applied to a clean, dry, and hairless area to ensure proper adhesion and absorption of the medication.
C. The medication will be effective 30 to 45 min following application.: Nitroglycerin patches are used for long-term prevention of angina, not immediate relief, which is provided by sublingual or spray formulations. The patch takes several hours to reach full effect.
D. Remove the patch 12 to 14 hr following application.: Removing the patch for 12 to 14 hours each day prevents tolerance to the medication. This is typically referred to as a "nitrate-free" interval.
E. Remove the patch if you experience a headache.: Headaches are a common side effect of nitroglycerin due to vasodilation. Clients should not remove the patch but may use analgesics like acetaminophen to manage the headache.
F. Place the patch on the same area every day.: The patch site should be rotated daily to prevent skin irritation.
Correct Answer is A
Explanation
A. Increased respiratory rate: Naloxone reverses respiratory depression caused by opioids, so an improvement in respiratory rate indicates effectiveness.
B. Report of decreased pain: Naloxone reverses opioid effects, including pain relief. Pain might increase, not decrease, following naloxone administration.
C. Increased temperature: Naloxone does not directly affect body temperature.
D. Decreased blood pressure: Naloxone is not associated with a direct effect on blood pressure; instead, it reverses opioid-induced hypotension.
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