A nurse is preparing to administer ceftriaxone 3 mL intramuscularly to an adult client. Which of the following actions should the nurse plan to take?

Select a 5/8-inch needle.

Choose a 25-gauge needle.

Locate the ventrogluteal site.

Inject at a 45° angle.

Answer and Explanation

The Correct Answer is C

A. Select a 5/8-inch needle: A 5/8-inch needle is too short for an IM injection in an adult, as it may not reach the muscle tissue adequately.
B. Choose a 25-gauge needle: A 25-gauge needle is too small for an IM injection, as it may make the administration of a 3 mL volume difficult and painful.
C. Locate the ventrogluteal site: The ventrogluteal site is a preferred site for IM injections because it is free of major nerves and blood vessels and can accommodate larger volumes like 3 mL.
D. Inject at a 45° angle: IM injections should be administered at a 90° angle to ensure the medication is delivered into the muscle tissue.

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Correct Answer is D

Explanation

A. Explain the procedure to the client: While explaining the procedure is important, it does not directly address the client's privacy concerns.
B. Obtain assistance so the client does not become resistant to the procedure: Obtaining assistance may help with the procedure but does not address the client's privacy concerns and might increase their anxiety.
C. Gather the equipment necessary before starting the procedure: Gathering equipment is important for preparedness but does not directly address privacy concerns.
D. Close the door and cover the client during the procedure: Closing the door and covering the client directly addresses privacy concerns and helps the client feel more comfortable and secure.

A. Keep the collection container at room temperature. B. At the beginning of the collection time, urinate and then discard the urine C. At the end of the collection time, urinate and save the urine in a separate container. D. Save each urine collection in a separate container.

Correct Answer is B

Explanation

A. Keep the collection container at room temperature. The collection container should be kept refrigerated or on ice to prevent bacterial growth and preserve the sample.
B. At the beginning of the collection time, urinate and then discard the urine. This is the correct method to ensure the 24-hour collection period starts with an empty bladder.
C. At the end of the collection time, urinate and save the urine in a separate container. The final urine at the end of the collection period should be added to the collection container, not saved separately.
D. Save each urine collection in a separate container: All urine collected over the 24-hour period should be saved in the same container to provide an accurate total volume for analysis.

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A nurse is preparing to administer ceftriaxone 3 mL intramuscularly to an adult client. Which of the following actions should the nurse plan to take?

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