The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

Massage the site gently after injection.

Ensure bevel of the needle is pointing up.

Hold the syringe perpendicular to the skin.

Select upper arm as the injection site.

Answer and Explanation

The Correct Answer is B

B. The needle should be inserted with the bevel facing up (visible through the skin). The goal is to deposit the medication into the epidermal layer (not subcutaneous tissue).

A. Massaging the site after injection can cause the medication to spread beyond the intended area, leading to inaccurate results or potential complications.

C. The correct angle for an intradermal injection is 5 to 15-degree angle. This angle allows for proper placement of the medication just below the epidermis.

D. Intradermal injections are usually administered on the forearm or the upper back, where the skin is thin and easily lifted to create a wheal.

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Correct Answer is D

Explanation

D. When encountering a medication dosage that appears unusually large or different from what is expected, the nurse should always verify the prescription with the healthcare provider before administering the medication. This step ensures patient safety and helps prevent medication errors.

A. Giving the dosage recommended in the drug handbook may not be appropriate if the prescribed dosage differs significantly from the usual or recommended dosage due to patient- specific factors or other considerations.

B. In situations where the prescribed dosage seems unusually large or different from the usual guidelines, it is essential to confirm with the healthcare provider who wrote the prescription to ensure accuracy and appropriateness for the specific patient.

C. Administering the medication as prescribed without further clarification could potentially lead to harm if the prescribed dosage is incorrect or inappropriate for the patient's condition.

A. Switch to a non-rebreather mask. B. Verify placement of pulse oximeter. C. Increase the oxygen to 3 L/minute. D. Remove nasal cannula.

Correct Answer is B

Explanation

B. When the oxygen saturation is lower than expected, the nurse's first action should be to verify the accuracy of the reading by ensuring the proper placement and functioning of the pulse oximeter. This involves checking that the pulse oximeter probe is securely attached to the client's finger or other appropriate site and that there are no obstructions or interference affecting the reading.

A. A non-rebreather mask delivers higher concentrations of oxygen compared to a nasal cannula and is typically used when a client requires higher levels of oxygen supplementation. However, switching to a non-rebreather mask may not be appropriate without further assessment.

C. Increasing the oxygen flow rate to 3 L/minute would deliver a higher concentration of oxygen to the client, potentially improving oxygen saturation. However, increasing the oxygen flow should be done cautiously and based on clinical assessment to avoid oxygen toxicity.

D. Removing the nasal cannula would deprive the client of supplemental oxygen, which may not be appropriate if the client's oxygen saturation is already low. Oxygen supplementation is typically provided to improve oxygenation and support vital organ function.

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The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

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Correct Answer is B

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