A nurse is preparing to administer an IM injection to a client who has gonorrhea.
Which of the following actions should the nurse take?
Inject the medication at least 5 cm (2 in) from the umbilicus.
Use the Z-track technique to administer the medication.
Give the medication without aspirating prior to injection.
Administer the medication with a 27-gauge '/,-inch needle.
The Correct Answer is B
Choice A rationale:
Injecting the medication at least 5 cm (2 in) from the umbilicus is not a standard guideline for IM injections. The site of injection depends on factors such as the volume of medication and patient’s age and muscle mass.
Choice B rationale:
Using the Z-track technique to administer the medication is correct. This technique helps to seal the medication in muscle tissue, reducing leakage into subcutaneous tissue.
Choice C rationale:
Giving the medication without aspirating prior to injection is not recommended. Aspiration ensures that the needle is not in a blood vessel before injecting.
Choice D rationale:
Administering the medication with a 27-gauge '/,-inch needle may not be appropriate for an IM injection, especially for adults. A longer and larger gauge needle is typically used for IM injections.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
While it’s important for the client to maintain a balanced diet, consuming a lot of protein with each meal does not specifically benefit a person taking levodopa/carbidopa for Parkinson’s disease.
Choice B rationale:
Levodopa/carbidopa can cause side effects such as uncontrolled muscle movements in the face, arms, legs, or trunk. Therefore, monitoring for an increase in unusual movements is a sign of understanding the potential side effects of the medication.
Choice C rationale:
Levodopa/carbidopa helps manage the symptoms of Parkinson’s disease but does not prevent the disease from progressing.
Choice D rationale:
While levodopa/carbidopa can help reduce symptoms such as stiffness and tremors, it does not typically result in a rapid improvement in condition.
Correct Answer is C
Explanation
Choice A rationale:
Rifampin does not typically cause insomnia.
Choice B rationale:
Rifampin can cause a red or orange discoloration of body fluids, including urine, not blue or green.
Choice C rationale:
It is recommended to take rifampin on an empty stomach, either 1 hour before or 2 hours after a meal.
Choice D rationale:
Unusual hair growth is not a known side effect of rifampin.
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