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Practice Exercise 2
Total Questions : 5
Showing 5 questions, Sign in for moreThe primary care provider prescribed 5 mL of a medication to be given deep intramuscular for a 40-year-old female who is 5′7″ tall and weighs 135 pounds. Which is the most appropriate equipment for the nurse to use? Select all that apply
The nurse is to administer 0.75 mL of medication subcutaneously in the upper arm to a 300-pound adult client. The nurse can grasp approximately 2 inches of the client’s tissue at the upper arm. Which is the most appropriate for the nurse to use?
The nurse is to administer a tuberculin test to a client who is 6 feet tall and weighs 180 pounds. Which is the most appropriate for the nurse to use?
The nurse is to administer 0.5 mL of a medication by intramuscular injection to an older emaciated client. Which is the most appropriate for the nurse to use?
A nursing student is preparing to administer insulin to a client with diabetes. Indicate the correct order for the administration of this medication:
Explanation
Safe insulin administration requires assessment, correct preparation (including mixing when necessary), aseptic technique, proper injection technique (pinch, angle), and allowing the medication to be absorbed (counting in place) before removing the needle.
Rationale for correct answer:
4. Assess the skin for the injection: Verify the site is intact (no infection, edema, bruising, scars) and appropriate for injection. Assessment precedes any procedure.
3. Mix the insulins: If the order is for mixed insulin (e.g., NPH + regular), prepare and mix the insulin vials first (roll NPH gently). When drawing up into the syringe, follow “clear before cloudy” (draw regular first, then NPH) to avoid contaminating the short-acting insulin.
1. Cleanse the site with alcohol: Clean the skin (if policy requires/if site is dirty) and allow to air dry to reduce infection risk. Do this after preparation so the site remains clean until injection.
5. Pinch the skin lightly: Creates a fold of subcutaneous tissue to ensure the injection goes into SQ tissue (especially important in lean persons). Pinch position depends on the site and patient habitus.
2. Insert the needle quickly into the subcutaneous tissue: A quick, decisive insertion minimizes pain and places the needle at the correct depth (45° or 90° depending on needle length and amount of subcutaneous tissue).
6. Inject the medication: Depress the plunger steadily to administer the insulin.
7. Count to five: Hold the needle in place for about 5 seconds (some guidelines say 5–10 sec) to ensure full dose delivery and prevent medication tracking back up the tract.
8. Remove the syringe: Withdraw the needle smoothly and safely; dispose immediately in sharps container. Do not massage the site (unless specifically instructed).
Take home points
- Assess first, prepare (mix) then inject.
- Use proper SQ technique (pinch when indicated, insert at correct angle, hold for several seconds, DO NOT massage).
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