NURS 101L: Medication Administration Mastery (Oral, SQ, IM) - 2026
Update WCU
1. A nurse is preparing to administer an intramuscular injection to a 2-year-old
child. Which site is the preferred choice based on muscle development and
safety?
A. Deltoid
B. Dorsogluteal
C. Vastus Lateralis
D. Ventrogluteal
Answer: C
Rationale: The vastus lateralis is the preferred site for IM injections in infants and toddlers
because it is the most developed muscle in that age group.
2. Which of the following is a critical action when utilizing the Z-track method
for an intramuscular injection?
A. Massage the site vigorously after withdrawing the needle.
B. Inject the medication as quickly as possible to reduce pain.
C. Aspirate for 15 seconds to ensure no blood return.
D. Pull the overlying skin and subcutaneous tissue 2.5 to 3.5 cm laterally.
Answer: D
Rationale: The Z-track method involves pulling the skin laterally to seal the medication in
the muscle and prevent leakage into subcutaneous tissue.
,3. A nurse is preparing 5 units of Regular insulin and 10 units of NPH insulin in
one syringe. Which step should the nurse perform first?
A. Draw up the Regular insulin.
B. Draw up the NPH insulin.
C. Inject air into the Regular vial.
D. Inject air into the NPH vial.
Answer: D
Rationale: The correct sequence for mixing insulin is: Inject air into the cloudy (NPH), then
inject air into the clear (Regular), draw up clear, then draw up cloudy.
4. What is the appropriate needle gauge and length for a subcutaneous injection
in an average-weight adult?
A. 25 gauge, 5/8 inch
B. 22 gauge, 1 inch
C. 18 gauge, 1.5 inch
D. 20 gauge, 1.5 inch
Answer: A
Rationale: Subcutaneous injections typically use a 25- to 27-gauge needle that is 3/8 to
5/8 inches long.
5. When administering an oral medication to a patient with dysphagia, which
nursing action is most appropriate?
A. Place the medication in the back of the throat.
B. Have the patient tilt their head back while swallowing.
C. Crush all medications and mix them with water.
D. Consult with a pharmacist to see if a liquid form or crushing is safe.
Answer: D
Rationale: Not all medications (like SR or EC) can be crushed. Safety requires verifying the
formulation and potential alternatives with a pharmacist.
, 6. To locate the ventrogluteal site, the nurse places the palm of the hand over
which anatomical landmark?
A. Anterior superior iliac spine
B. Greater trochanter
C. Iliac crest
D. Ischial tuberosity
Answer: B
Rationale: The palm is placed over the greater trochanter, the index finger on the anterior
superior iliac spine, and the middle finger toward the iliac crest.
7. The nurse is administering 2 mL of a non-irritating medication IM to an adult.
Which site is generally considered the safest and least painful for this volume?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Rectus femoris
Answer: B
Rationale: The ventrogluteal site is the preferred IM site for adults as it lacks major nerves
and blood vessels and can accommodate larger volumes.
8. A patient is prescribed a sublingual medication. The nurse should instruct the
patient to:
A. Swallow the pill with a full glass of water.
B. Place the medication under the tongue and let it dissolve.
C. Chew the medication thoroughly before swallowing.
D. Place the medication between the cheek and the gum.
Answer: B
Rationale: Sublingual medications must dissolve under the tongue to be absorbed through
the mucous membranes directly into the bloodstream.
Update WCU
1. A nurse is preparing to administer an intramuscular injection to a 2-year-old
child. Which site is the preferred choice based on muscle development and
safety?
A. Deltoid
B. Dorsogluteal
C. Vastus Lateralis
D. Ventrogluteal
Answer: C
Rationale: The vastus lateralis is the preferred site for IM injections in infants and toddlers
because it is the most developed muscle in that age group.
2. Which of the following is a critical action when utilizing the Z-track method
for an intramuscular injection?
A. Massage the site vigorously after withdrawing the needle.
B. Inject the medication as quickly as possible to reduce pain.
C. Aspirate for 15 seconds to ensure no blood return.
D. Pull the overlying skin and subcutaneous tissue 2.5 to 3.5 cm laterally.
Answer: D
Rationale: The Z-track method involves pulling the skin laterally to seal the medication in
the muscle and prevent leakage into subcutaneous tissue.
,3. A nurse is preparing 5 units of Regular insulin and 10 units of NPH insulin in
one syringe. Which step should the nurse perform first?
A. Draw up the Regular insulin.
B. Draw up the NPH insulin.
C. Inject air into the Regular vial.
D. Inject air into the NPH vial.
Answer: D
Rationale: The correct sequence for mixing insulin is: Inject air into the cloudy (NPH), then
inject air into the clear (Regular), draw up clear, then draw up cloudy.
4. What is the appropriate needle gauge and length for a subcutaneous injection
in an average-weight adult?
A. 25 gauge, 5/8 inch
B. 22 gauge, 1 inch
C. 18 gauge, 1.5 inch
D. 20 gauge, 1.5 inch
Answer: A
Rationale: Subcutaneous injections typically use a 25- to 27-gauge needle that is 3/8 to
5/8 inches long.
5. When administering an oral medication to a patient with dysphagia, which
nursing action is most appropriate?
A. Place the medication in the back of the throat.
B. Have the patient tilt their head back while swallowing.
C. Crush all medications and mix them with water.
D. Consult with a pharmacist to see if a liquid form or crushing is safe.
Answer: D
Rationale: Not all medications (like SR or EC) can be crushed. Safety requires verifying the
formulation and potential alternatives with a pharmacist.
, 6. To locate the ventrogluteal site, the nurse places the palm of the hand over
which anatomical landmark?
A. Anterior superior iliac spine
B. Greater trochanter
C. Iliac crest
D. Ischial tuberosity
Answer: B
Rationale: The palm is placed over the greater trochanter, the index finger on the anterior
superior iliac spine, and the middle finger toward the iliac crest.
7. The nurse is administering 2 mL of a non-irritating medication IM to an adult.
Which site is generally considered the safest and least painful for this volume?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Rectus femoris
Answer: B
Rationale: The ventrogluteal site is the preferred IM site for adults as it lacks major nerves
and blood vessels and can accommodate larger volumes.
8. A patient is prescribed a sublingual medication. The nurse should instruct the
patient to:
A. Swallow the pill with a full glass of water.
B. Place the medication under the tongue and let it dissolve.
C. Chew the medication thoroughly before swallowing.
D. Place the medication between the cheek and the gum.
Answer: B
Rationale: Sublingual medications must dissolve under the tongue to be absorbed through
the mucous membranes directly into the bloodstream.
