A nurse is teaching a client about self-administering a subcutaneous injection to the abdomen. Which of the following instructions should the nurse include?
Select an injection site on the abdomen 5 cm (2 in) from the umbilicus.
Expel the air bubble in a prefilled syringe before injecting the medication.
Aspirate prior to injecting the medication.
Insert the needle at a 15° angle.
The Correct Answer is B
Choice A rationale:
Selecting an injection site on the abdomen 5 cm (2 in) from the umbilicus might be an appropriate instruction for some subcutaneous injections, but the specific injection site can vary based on the medication and client's needs. This choice is not a universal instruction for all subcutaneous injections.
Choice B rationale:
Expelling the air bubble from a prefilled syringe before injecting the medication is essential to ensure accurate dosing. Air bubbles can displace medication and lead to underdosing. This step is crucial for safe and effective administration.
Choice C rationale:
Aspirating prior to injecting medication is a technique used for intramuscular injections to ensure the needle is not in a blood vessel. However, for subcutaneous injections, aspirating is not necessary or recommended, as it can cause tissue damage and discomfort.
Choice D rationale:
Inserting the needle at a 15° angle is not a standard practice for subcutaneous injections. Subcutaneous injections are typically administered at a 45° or 90° angle, depending on the needle length and client's body composition. A 15° angle would not ensure proper medication delivery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale:
Dishwashing gloves are often made of latex, which can trigger an allergic reaction in individuals with a latex allergy. Direct contact with latex-containing items should be avoided to prevent allergic responses.
Choice B rationale:
Adhesive tape commonly contains latex and can lead to allergic reactions in individuals with a latex allergy. Avoiding contact with latex-containing items is crucial to prevent potential allergic symptoms.
Choice C rationale:
Macadamia nuts and bananas do not typically contain latex and are not known to trigger latex allergies. While these items can cause allergic reactions in some individuals, they are not relevant to a latex allergy.
Choice D rationale:
While macadamia nuts and bananas can cause allergies in some people, they do not contain latex and are not associated with latex allergies. Therefore, they are not items that the nurse needs to instruct the client to avoid due to their latex allergy.
Choice E rationale:
Rubber bands are often made from latex, which can provoke an allergic reaction in individuals with a latex allergy. Encouraging the client to steer clear of items like rubber bands helps prevent potential allergic responses.
Correct Answer is A
Explanation
Choice A rationale:
Unclamping the client's gastrostomy tube before connecting the syringe is the correct action. This allows the feeding to flow freely into the stomach. Clamping the tube while administering the feeding would prevent the formula from entering the stomach properly.
Choice B rationale:
Verifying the client's gastric pH to be at least 7 prior to feeding is not necessary for administering intermittent enteral feedings. Gastric pH varies widely among individuals and is not a standard requirement before every feeding.
Choice C rationale:
Pouring the client's formula into the syringe and adjusting the syringe's height to control the rate of flow is not recommended. Controlling the rate of flow in this manner is imprecise and can lead to inconsistent delivery of the formula, potentially causing discomfort or complications.
Choice D rationale:
Applying sterile gloves before accessing the client's gastrostomy tube is an important step in infection control, but it is not specifically related to administering intermittent enteral feedings. Sterile gloves are essential to prevent contamination and infection during tube maintenance and insertion, not during the feeding process itself.
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