CPSS Final Exam Questions And
Answers With 100% Solved Solutions
Lecture 1 - Answer- Injections
What is a small bottle that contains a drug? - Answer- ampulle
What is the diameter or barrel size of a needle called? - Answer- Gauge
The higher the number the smaller the gauge
What is the enlarged base by which a hollow needle may be attached to a device? -
Answer- hub
What is a cylindrical container that holds liquids? - Answer- barrel
what is a small container, usually w/ closure, that is used esp for liquids? - Answer- vial
(TQ?) What is the Z-track method used for? - Answer- to prevent leakage of irritating
(vistaril) and discoloring medication (e.g. iron dextran) into the SQ tissue
It may also be used in elderly w/ decreased mm mass
In the Z-track method, which way do you displace the skin: Laterally or Medially? -
Answer- use ULNAR side of nondominent hand to pull skin LATERALLY (displaces
tissue ABOVE the mm)
What size needle length is used for a 200 lbs person? 100 lb? - Answer- 200 - 2 inch
needle
100 - 1.25-1.5 inch needle
what are the indications for injections? - Answer- (1) drug is poorly absorbed or
degraded in GI tract
(2) predictable and rapid drug response during an emergency
(3) pt is uncooperative, unconscious, or unable to take drug through enteral route
(4) localized drug therapy is desired
What are some reasons of "why not" to perform an injection? - Answer- more expensive
must be sterile
takes skilled/trained personel
may be difficult to remove dose if toxic/AE
What does parental refer to? - Answer- any route other than the alimentary canal...so
IM/ID/SQ/IV
,How do you measure the length of a needle? - Answer- from the hub to the tip
Name the needle gauge that is used for the following scenarios:
Blood Withdrawal?
IM injection?
SQ injection?
ID injection? - Answer- Blood withdrawal: 18g
IM injection: 22 gauge
SQ injection: 25-27 gauge
ID injection: 27 gauge
*remember the smaller the gauge the larger the needle diameter*
What must you remember NEVER to do, with regards to needles? - Answer- NEVER
RECAP! (or stick yourself)
A 4 month old pt presents for his vaccinations (IM), what is the perferred location for the
injection and what needle length and gauge would you use? - Answer- Location:
Anteriorlateral thigh
Lengh: 5/8 - 1 inch
Gauge: 25-27
If a toddler/older child presents for his routine vaccination (IM), what is the perferred
location for the injection and what needle length and gauge would you use? - Answer-
Location: Deltoid/Anterlateral thigh
Length: 5/8 - 1 inch
Gauge: 22 - 27
IM injections are (faster/slower) than SQ and (faster/slower) than IV - Answer- Faster
than SQ and Slower than IV
What are the indications for IM injections? - Answer- drugs not easily absorbed orally
immediate rate of onset and duration of action perferred
when parental delivery necessary
What are the contraindication for IM injections? - Answer- cellulitis/dermatitis overlying
the injectin site
What length and gauge is used for IM injections? - Answer- 19-22 gauge
1-1.5 inch needle
,Gauge size in IM injection is dependent on what? - Answer- drug viscosity
Length in IM injection is dependent on what? - Answer- depth of insertion
What type of muscle is utilized in IM injections? - Answer- Striated mm
what are the 3 princple sites for IM injections? - Answer- Gluteus, Vastus Lateralis, and
Deltoid
If performing a IM injection into the gluteus maximus, what is used to determine the
length of the needle? - Answer- Amount of fat - if too short injection is made into fat (no
good)
Hint: women have more fat than men in the gluteus maximus, therefore they are at
higher risk for intralipomatous injection
How many CC's of fluid can be injected in an IM injection in the DELTOID? - Answer- <
2 CC
What is the location for needle insertion in an IM injection into the deltoids? - Answer- 3-
4 cm below acromion
Are IM deltoid injection, perferred more in infants or adults? - Answer- adults
used for vaccination in adults
What is the DANGER for injecting children w/ IM injection in the deltiod? - Answer-
RADIAL nerve injury
What is the PERFERRED location for IM injection in pts <3 y/o? - Answer- Vastus
Lateralis (anterolateral thigh)
used for vaccination in children
What volume can be injected in the thigh in kids? - Answer- 0.5-2 cc
The vastus lateralis LACKS nerves and vessels, however the the injection can still be
painful due to what? - Answer- Fascia Lata
What is the PERFERRED route for IM injections in pts > 2 y/o? - Answer- Gluteus
Maximus
Larger volumes OK, not used for vaccinations
Where should the needle be placed in a gluteal IM injection? - Answer- UPPER/OUTER
QUADRANT OF BUTTOX
, In a gluteal injection, what you be careful of not to injure? - Answer- sciatic nerve and
superior gluteal mm
In adults, the needle is inserted:
A. Anteriorly
B. Perpendicular
C. Inferiorly
D. Laterally - Answer- A. Anteriorly
What gauge needle is used to draw up medication from the vial? - Answer- 18-22 gauge
How much air should be pulled into the syringe after your have drawn the appropriate
amount of mediation from the vial using asceptic technique? - Answer- 2 cc of air
What method should you use when cleaning the injection site with an alcohol wipe? -
Answer- bulls-eye
What is the angle that you hold the syringe in reference to the injection site? - Answer-
90 degrees (like a dart)
Once needle is injected into the skin, what must you do? - Answer- Aspirate back to
make sure you are NOT in a vessel - if blood is encountered withraw needle, prepare
new syringe, try new site
What is the MAX that can be injected in an IM injection? - Answer- 0.5 cc max in infants
2.0 cc max in children
Do you remove the needle from the injection side at the same angle that you inserted? -
Answer- YES! (90 degrees)
Do you massage IM injections? - Answer- yes (unless C/I)
When is massage C/I in IM injections? - Answer- Z-Track Method
What are the potenital complications of an IM injection? - Answer- (1) Injection into
vessel (Toxic reaction, vessel injury, hematoma)
(2) Injection into nerve (pain, paresthesia, nerve damage)
(3) Needle breath off (into mm)
(4) Sterile/Septic Abscess (sterility issue/site overuse)
Answers With 100% Solved Solutions
Lecture 1 - Answer- Injections
What is a small bottle that contains a drug? - Answer- ampulle
What is the diameter or barrel size of a needle called? - Answer- Gauge
The higher the number the smaller the gauge
What is the enlarged base by which a hollow needle may be attached to a device? -
Answer- hub
What is a cylindrical container that holds liquids? - Answer- barrel
what is a small container, usually w/ closure, that is used esp for liquids? - Answer- vial
(TQ?) What is the Z-track method used for? - Answer- to prevent leakage of irritating
(vistaril) and discoloring medication (e.g. iron dextran) into the SQ tissue
It may also be used in elderly w/ decreased mm mass
In the Z-track method, which way do you displace the skin: Laterally or Medially? -
Answer- use ULNAR side of nondominent hand to pull skin LATERALLY (displaces
tissue ABOVE the mm)
What size needle length is used for a 200 lbs person? 100 lb? - Answer- 200 - 2 inch
needle
100 - 1.25-1.5 inch needle
what are the indications for injections? - Answer- (1) drug is poorly absorbed or
degraded in GI tract
(2) predictable and rapid drug response during an emergency
(3) pt is uncooperative, unconscious, or unable to take drug through enteral route
(4) localized drug therapy is desired
What are some reasons of "why not" to perform an injection? - Answer- more expensive
must be sterile
takes skilled/trained personel
may be difficult to remove dose if toxic/AE
What does parental refer to? - Answer- any route other than the alimentary canal...so
IM/ID/SQ/IV
,How do you measure the length of a needle? - Answer- from the hub to the tip
Name the needle gauge that is used for the following scenarios:
Blood Withdrawal?
IM injection?
SQ injection?
ID injection? - Answer- Blood withdrawal: 18g
IM injection: 22 gauge
SQ injection: 25-27 gauge
ID injection: 27 gauge
*remember the smaller the gauge the larger the needle diameter*
What must you remember NEVER to do, with regards to needles? - Answer- NEVER
RECAP! (or stick yourself)
A 4 month old pt presents for his vaccinations (IM), what is the perferred location for the
injection and what needle length and gauge would you use? - Answer- Location:
Anteriorlateral thigh
Lengh: 5/8 - 1 inch
Gauge: 25-27
If a toddler/older child presents for his routine vaccination (IM), what is the perferred
location for the injection and what needle length and gauge would you use? - Answer-
Location: Deltoid/Anterlateral thigh
Length: 5/8 - 1 inch
Gauge: 22 - 27
IM injections are (faster/slower) than SQ and (faster/slower) than IV - Answer- Faster
than SQ and Slower than IV
What are the indications for IM injections? - Answer- drugs not easily absorbed orally
immediate rate of onset and duration of action perferred
when parental delivery necessary
What are the contraindication for IM injections? - Answer- cellulitis/dermatitis overlying
the injectin site
What length and gauge is used for IM injections? - Answer- 19-22 gauge
1-1.5 inch needle
,Gauge size in IM injection is dependent on what? - Answer- drug viscosity
Length in IM injection is dependent on what? - Answer- depth of insertion
What type of muscle is utilized in IM injections? - Answer- Striated mm
what are the 3 princple sites for IM injections? - Answer- Gluteus, Vastus Lateralis, and
Deltoid
If performing a IM injection into the gluteus maximus, what is used to determine the
length of the needle? - Answer- Amount of fat - if too short injection is made into fat (no
good)
Hint: women have more fat than men in the gluteus maximus, therefore they are at
higher risk for intralipomatous injection
How many CC's of fluid can be injected in an IM injection in the DELTOID? - Answer- <
2 CC
What is the location for needle insertion in an IM injection into the deltoids? - Answer- 3-
4 cm below acromion
Are IM deltoid injection, perferred more in infants or adults? - Answer- adults
used for vaccination in adults
What is the DANGER for injecting children w/ IM injection in the deltiod? - Answer-
RADIAL nerve injury
What is the PERFERRED location for IM injection in pts <3 y/o? - Answer- Vastus
Lateralis (anterolateral thigh)
used for vaccination in children
What volume can be injected in the thigh in kids? - Answer- 0.5-2 cc
The vastus lateralis LACKS nerves and vessels, however the the injection can still be
painful due to what? - Answer- Fascia Lata
What is the PERFERRED route for IM injections in pts > 2 y/o? - Answer- Gluteus
Maximus
Larger volumes OK, not used for vaccinations
Where should the needle be placed in a gluteal IM injection? - Answer- UPPER/OUTER
QUADRANT OF BUTTOX
, In a gluteal injection, what you be careful of not to injure? - Answer- sciatic nerve and
superior gluteal mm
In adults, the needle is inserted:
A. Anteriorly
B. Perpendicular
C. Inferiorly
D. Laterally - Answer- A. Anteriorly
What gauge needle is used to draw up medication from the vial? - Answer- 18-22 gauge
How much air should be pulled into the syringe after your have drawn the appropriate
amount of mediation from the vial using asceptic technique? - Answer- 2 cc of air
What method should you use when cleaning the injection site with an alcohol wipe? -
Answer- bulls-eye
What is the angle that you hold the syringe in reference to the injection site? - Answer-
90 degrees (like a dart)
Once needle is injected into the skin, what must you do? - Answer- Aspirate back to
make sure you are NOT in a vessel - if blood is encountered withraw needle, prepare
new syringe, try new site
What is the MAX that can be injected in an IM injection? - Answer- 0.5 cc max in infants
2.0 cc max in children
Do you remove the needle from the injection side at the same angle that you inserted? -
Answer- YES! (90 degrees)
Do you massage IM injections? - Answer- yes (unless C/I)
When is massage C/I in IM injections? - Answer- Z-Track Method
What are the potenital complications of an IM injection? - Answer- (1) Injection into
vessel (Toxic reaction, vessel injury, hematoma)
(2) Injection into nerve (pain, paresthesia, nerve damage)
(3) Needle breath off (into mm)
(4) Sterile/Septic Abscess (sterility issue/site overuse)
