A nurse is preparing to administer an intradermal injection for a tuberculin screening. Identify the sequence of steps the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Insert the needle into the dermis layer of skin.

Inject the medication slowly with the skin pulled taut.

Cleanse the skin using a circular motion.

Produce a small wheal on the surface of the skin.

Hold the needle with the bevel facing up.

Answer and Explanation

The Correct Answer is C,E,A,B,D

C. Cleanse the skin using a circular motion: Cleaning the site first prevents infection and prepares the area for safe injection. Using a circular motion from the center outward helps remove microorganisms without contaminating the injection site.

E. Hold the needle with the bevel facing up: Positioning the needle bevel up ensures a smoother entry into the dermis and reduces tissue trauma, which is important for accurate intradermal administration.

A. Insert the needle into the dermis layer of skin: The needle is inserted at a very shallow angle into the dermis. Proper placement is essential for the tuberculin test to produce a valid reaction.

B. Inject the medication slowly with the skin pulled taut: Slowly injecting the medication ensures it remains in the dermis and prevents leakage into subcutaneous tissue. Pulling the skin taut stabilizes the area and allows for precise administration.

D. Produce a small wheal on the surface of the skin: The appearance of a small, raised wheal confirms that the medication has been correctly administered intradermally. This wheal is necessary for the subsequent reading of the tuberculin test.

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Correct Answer is D

Explanation

A. Liver toxicity: Prednisone is metabolized by the liver but is not commonly associated with hepatotoxicity. Liver function monitoring is not a primary concern for long-term prednisone therapy.

B. Hemolytic anemia: Prednisone does not typically cause hemolytic anemia. Its primary hematologic effects involve immunosuppression rather than direct destruction of red blood cells.

C. Hypoglycemia: Prednisone can increase blood glucose levels by promoting gluconeogenesis and reducing peripheral glucose uptake, which may lead to hyperglycemia rather than hypoglycemia.

D. Bone loss: Long-term use of prednisone decreases calcium absorption and bone formation, increasing the risk of osteoporosis and fractures. Monitoring bone density and implementing preventive measures is essential for clients on chronic corticosteroid therapy.

A. Elevated blood pressure B. Decreased pulse rate C. Decreased gastrointestinal motility D. Flattened neck veins

Correct Answer is A

Explanation

A. Elevated blood pressure: Excess fluid in the vascular system increases circulating volume, which raises blood pressure. This is a common early sign of fluid overload and can lead to additional complications if not addressed promptly.

B. Decreased pulse rate: Fluid overload typically causes an increased pulse rate as the heart works harder to manage the extra volume. A decreased pulse is not a usual manifestation of fluid overload.

C. Decreased gastrointestinal motility: Fluid overload does not directly reduce gastrointestinal motility. Bowel slowing is more commonly associated with medications, immobility, or other systemic conditions rather than excess IV fluid.

D. Flattened neck veins: Fluid overload usually causes distended neck veins due to increased central venous pressure. Flattened neck veins suggest hypovolemia or low circulating blood volume rather than overload.

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A nurse is preparing to administer an intradermal injection for a tuberculin screening. Identify the sequence of steps the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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