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

Transferring the medication into a U-100 insulin syringe for injection

Removing the air bubble from the prefilled syringe prior to administration

Inserting the needle into the tissue using a 30-degree angle

Administering the injection in the love handles. 2 in from the umbilicus

Answer and Explanation

The Correct Answer is D

D. Administering the injection in the love handles, 2 inches from the umbilicus. It is important not to remove the air bubble from the prefilled syringe, as it is designed to ensure the entire dose of medication is administered.

A. Enoxaparin should not be transferred into another syringe unless specifically instructed by the manufacturer or pharmacy guidelines. Pre-filled syringes are designed to deliver the correct dose accurately and safely.

B. It is important not to remove the air bubble from the prefilled syringe, as it is designed to ensure the entire dose of medication is administered.

C. A 30-degree angle is too shallow for subcutaneous injections and may result in the medication being deposited too close to the skin surface, potentially causing irritation or affecting absorption.

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Correct Answer is A

Explanation

A. IV solutions and administration sets should typically be changed every 48 to 72 hours to reduce the risk of contamination and infection. This interval helps prevent the buildup of bacteria in the solution and tubing, which could lead to bloodstream infections (BSIs).

B. Checking the client's IV site every is also important for monitoring for signs of infection, infiltration, or phlebitis. However, every 8 hours is too frequent and unnecessary

C. IV tubing should be changed every 72 hours not every 96 hours. Prolonging the use of IV tubing beyond this timeframe increases the risk of bacterial contamination and infection.

D. Transparent dressings are usually changed every 5 to 7 days, or sooner if they become soiled or compromised.

A. Diaphoresis B. Hypotension C. Weight loss D. Tachycardia

Correct Answer is D

Explanation

D. Tachycardia refers to an elevated heart rate. In circulatory overload, the heart may attempt to compensate for the increased fluid volume by pumping faster. This compensatory mechanism aims to maintain adequate tissue perfusion despite the excessive fluid burden.

A. Diaphoresis refers to excessive sweating. It is not typically associated with circulatory overload. Instead, diaphoresis can occur in conditions such as fever, anxiety, or during physical exertion.

B Hypotension refers to low blood pressure. In circulatory overload, the excess fluid in the circulatory system can lead to increased blood pressure rather than hypotension. Hypotension is more commonly associated with hypovolemia (low blood volume) rather than hypervolemia.

C. Weight loss is not a characteristic finding in circulatory overload. On the contrary, patients with fluid overload often experience weight gain due to retained fluid in the body tissues and bloodstream.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving a continuous IV infusion through a short-peripheral device. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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