A nurse observes a newly licensed nurse administer enoxaparin subcutaneously using a pre- filled syringe. Which of the following indicates appropriate medication administration?

D. After administering the PPD solution intradermally, the nurse should not withdraw the needle and massage the site. Massaging can cause the PPD to disperse outside the intended area and affect the accuracy of the test result. Instead, the nurse should gently blot the site with a gauze pad if there is any bleeding, without massaging.

A. For a Mantoux tuberculin skin test, the standard technique involves injecting a small amount of tuberculin purified protein derivative (PPD) intradermally to create a wheal or bleb that is typically 6 mm in diameter. If the nurse creates a bleb significantly larger or smaller than the recommended size, it could affect the interpretation of the test result.

B. It's important to avoid visualizing the needle tip under the skin during the injection. This can lead to inaccurate placement of the PPD solution, potentially resulting in an improperly administered test.

C. Stretching the skin tightly before injection is actually a correct technique for performing a Mantoux tuberculin skin test. This helps stabilize the injection site and ensures the needle is inserted at the correct angle for an intradermal injection.

B When drawing medication from an ampule, especially if it's a solution that may contain particulate matter or to ensure sterility, using a filter needle is recommended. A filter needle has a membrane filter that prevents particles from being drawn into the syringe while allowing the medication to pass through.

A. Shaking a glass ampule is not recommended because it can lead to the introduction of glass particles or cause the solution to foam or become contaminated. Instead, gently flicking the ampule with a finger can help move any solution that may be adhering to the neck downward, but shaking should be avoided.

C. While wearing gloves is important for infection control, sterile gloves are not typically required for withdrawing medication from a single-dose glass ampule. Standard aseptic technique and hand hygiene are usually sufficient.

D. Ampules are designed to be opened by snapping the top away from the body to avoid potential injury from glass shards. The nurse should use a gauze pad or an ampule opener to break the ampule open safely, directing any breakage away from themselves and others.