The nurse is teaching a client how to self-administer subcutaneous heparin injections.
Which instruction should the nurse include?
Inject in abdominal area at least 2 inches from the umbilicus.
Rotate injections between the abdomen and gluteal areas.
Massage the injection site to increase absorption.
Expel the air in the prefilled syringe prior to injection.
The Correct Answer is A
Inject in abdominal area at least 2 inches from the umbilicus.
When administering subcutaneous heparin injections, it is important to choose an injection site on either your tummy or outer areas of your left or right thigh.
Your tummy is usually best as the injection site and it is important that you change the site each time 1.
The heparin needs to go into the fat layer under the skin 2.
Choice B is incorrect because injections should not be rotated between the abdomen and gluteal areas.
Choice C is incorrect because massaging the injection site is not recommended.
Choice D is incorrect because air bubbles in a pre-filled syringe should not be expelled prior to injection 2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
When checking the restraints, the most important action for the nurse to take is to assess capillary refill distal to the restraints.
This helps to ensure that the restraints are not too tight and that blood flow to the extremities is not compromised.
Choice A, reinserting the peripheral IV catheter, may be necessary but is not the most important action in this situation.
Choice B, verifying that the restraints can be quickly released, is important for safety but does not directly address the client’s physical well-being.
Choice D, replacing the nasogastric tube, may also be necessary but is not the most important action in this situation.
Correct Answer is A
Explanation
Charting by exception means that the nurse only documents findings that deviate from the established norm or expected outcome.
In this case, the nurse should document the assessment that is not within normal limits, which is “Basilar lung sounds that are diminished in the left lung.”
Choice B is not the answer because contraction of the left pupil when light shines in the right eye is a normal finding known as consensual pupillary response.
Choice C is not the answer because capillary refill of 2 seconds in the lower right foot is a normal finding.
Choice D is not the answer because active bowel sounds in the lower right quadrant are a normal finding.
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