TEST BANK Q NURSING SKILLS:
CHAPTER #22 - ADMINISTRATION OF
PARENTERAL MEDICATIONS EXAM
QUESTIONS WITH VERIFIED
ANSWERS
The nurse is preparing an intramuscular injection for a thin elderly patient. The nurse
is aware that the maximum volume most likely tolerated by this patient is which
amount?
a. 1 mL
b. 2 mL
c. 3 mL
d. 5 mL - Answer-ANS: B
Elderly adults and thin patients often tolerate only 2 mL in a single injection. A
normal, well-developed adult can safely tolerate 2 to 5 mL of medication in larger
muscles such as the ventrogluteal. However, clinically, it is unusual to administer
more than 3 mL of medication in a single injection because the body does not absorb
it well.
The nurse is preparing to administer an intramuscular injection via the Z-track
method. Which action should be taken by the nurse?
a. Pinch the skin between the thumb and the first finger.
b. Insert the needle at a 90-degree angle.
c. Immediately remove the needle after injecting the medication.
d. Release the skin before removing the needle from the site. - Answer-ANS: B
For an intramuscular injection, the needle is inserted perpendicular to the patient's
body as close to 90 degrees as possible. In using the Z-track method, the overlying
skin and subcutaneous tissues are pulled approximately 2.5 to 3.5 cm (1 to inches)
laterally to the side with the ulnar side of the nondominant hand. Keep the needle
inserted for 10 seconds after injection to allow the medication to disperse evenly.
Release the skin after withdrawing the needle.
A student nurse is preparing to administer an intramuscular injection into the
ventrogluteal muscle. The nursing instructor should question which action by the
student?
a. Asking the patient to assume a sitting position
b. Placing the heel of the hand over the patient's greater trochanter
c. Asking the patient to flex the knee and hip
d. Using the right hand to locate the injection site on the patient's left side - Answer-
ANS: A
The patient should lie in either the supine or the lateral position while the
ventrogluteal muscle is located. To locate the ventrogluteal site, the heel of the hand
is placed over the greater trochanter of the patient's hip with the wrist almost
perpendicular to the femur. The right hand is used for the left hip, and the left hand is
, used for the right hip. To relax the muscle, the patient lies on the side or back with
the knee and hip flexed.
The nurse is preparing to administer an immunization to a toddler. Which action by
the nurse is appropriate?
a. Grasp the body of the muscle during injection.
b. Place one hand above the knee and one below the knee to find the site.
c. Have the patient's knee flexed with the foot internally rotated.
d. Ask the mother to hold the toddler on his side. - Answer-ANS: A
The vastus lateralis is the preferred injection site for administration of immunizations
to infants, toddlers, and children. With young children, it helps to grasp the body of
the muscle during injection to be sure the medication is deposited in muscle tissue.
The muscle is located on the anterior lateral aspect of the thigh. In an adult, one
hand is placed above the knee and one below the greater trochanter to locate the
muscle. To relax the muscle, the patient lies flat with the knee slightly flexed and the
foot externally rotated or assumes a sitting position. A side-lying position would not
be appropriate for this immunization.
After insertion of the needle into the patient's ventrogluteal muscle, the nurse
aspirates and notices a very small amount of blood in the syringe. What action
should the nurse take?
a. Inject the medication slowly but smoothly.
b. Withdraw the needle, expel the blood from the syringe, reinsert the needle, and
inject the medication.
c. Withdraw the needle, change the needle, insert the needle, and inject the
medication.
d. Withdraw the needle, dispose of the medication and syringe, and prepare another
dose of medication. - Answer-ANS: D
Aspiration of blood into the syringe indicates possible placement into a vein. If blood
appears in the syringe, remove the needle, dispose of the medication and syringe
properly, and prepare another dose of medication for injection.
The nurse is preparing to give a medication by intravenous (IV) bolus. When
assessing the patient's IV insertion site, the nurse notes that it is warm, reddened,
and tender. What action should the nurse take first?
a. Slow the infusion rate and slowly inject the medication.
b. Discontinue the IV infusion.
c. Inject a local anesthetic to relieve the tenderness.
d. Apply warm compresses over the insertion site. - Answer-ANS: B
Swelling, warmth, redness, and tenderness indicate infiltration or phlebitis. Stop the
IV infusion, remove the IV catheter, treat the IV site as indicated by institutional
policy, and insert a new IV catheter if therapy continues.
A patient with a continuous IV infusion has an order for ciprofloxacin to be given IV
piggyback. Which action by the nurse is appropriate for administering the
medication?
a. Hang the bag with ciprofloxacin higher than the continuous infusion bag.
b. Stop the continuous infusion while running the ciprofloxacin.
c. Connect the piggyback tubing into the Y-port on the tubing of the continuous
infusion that is closest to the patient.
CHAPTER #22 - ADMINISTRATION OF
PARENTERAL MEDICATIONS EXAM
QUESTIONS WITH VERIFIED
ANSWERS
The nurse is preparing an intramuscular injection for a thin elderly patient. The nurse
is aware that the maximum volume most likely tolerated by this patient is which
amount?
a. 1 mL
b. 2 mL
c. 3 mL
d. 5 mL - Answer-ANS: B
Elderly adults and thin patients often tolerate only 2 mL in a single injection. A
normal, well-developed adult can safely tolerate 2 to 5 mL of medication in larger
muscles such as the ventrogluteal. However, clinically, it is unusual to administer
more than 3 mL of medication in a single injection because the body does not absorb
it well.
The nurse is preparing to administer an intramuscular injection via the Z-track
method. Which action should be taken by the nurse?
a. Pinch the skin between the thumb and the first finger.
b. Insert the needle at a 90-degree angle.
c. Immediately remove the needle after injecting the medication.
d. Release the skin before removing the needle from the site. - Answer-ANS: B
For an intramuscular injection, the needle is inserted perpendicular to the patient's
body as close to 90 degrees as possible. In using the Z-track method, the overlying
skin and subcutaneous tissues are pulled approximately 2.5 to 3.5 cm (1 to inches)
laterally to the side with the ulnar side of the nondominant hand. Keep the needle
inserted for 10 seconds after injection to allow the medication to disperse evenly.
Release the skin after withdrawing the needle.
A student nurse is preparing to administer an intramuscular injection into the
ventrogluteal muscle. The nursing instructor should question which action by the
student?
a. Asking the patient to assume a sitting position
b. Placing the heel of the hand over the patient's greater trochanter
c. Asking the patient to flex the knee and hip
d. Using the right hand to locate the injection site on the patient's left side - Answer-
ANS: A
The patient should lie in either the supine or the lateral position while the
ventrogluteal muscle is located. To locate the ventrogluteal site, the heel of the hand
is placed over the greater trochanter of the patient's hip with the wrist almost
perpendicular to the femur. The right hand is used for the left hip, and the left hand is
, used for the right hip. To relax the muscle, the patient lies on the side or back with
the knee and hip flexed.
The nurse is preparing to administer an immunization to a toddler. Which action by
the nurse is appropriate?
a. Grasp the body of the muscle during injection.
b. Place one hand above the knee and one below the knee to find the site.
c. Have the patient's knee flexed with the foot internally rotated.
d. Ask the mother to hold the toddler on his side. - Answer-ANS: A
The vastus lateralis is the preferred injection site for administration of immunizations
to infants, toddlers, and children. With young children, it helps to grasp the body of
the muscle during injection to be sure the medication is deposited in muscle tissue.
The muscle is located on the anterior lateral aspect of the thigh. In an adult, one
hand is placed above the knee and one below the greater trochanter to locate the
muscle. To relax the muscle, the patient lies flat with the knee slightly flexed and the
foot externally rotated or assumes a sitting position. A side-lying position would not
be appropriate for this immunization.
After insertion of the needle into the patient's ventrogluteal muscle, the nurse
aspirates and notices a very small amount of blood in the syringe. What action
should the nurse take?
a. Inject the medication slowly but smoothly.
b. Withdraw the needle, expel the blood from the syringe, reinsert the needle, and
inject the medication.
c. Withdraw the needle, change the needle, insert the needle, and inject the
medication.
d. Withdraw the needle, dispose of the medication and syringe, and prepare another
dose of medication. - Answer-ANS: D
Aspiration of blood into the syringe indicates possible placement into a vein. If blood
appears in the syringe, remove the needle, dispose of the medication and syringe
properly, and prepare another dose of medication for injection.
The nurse is preparing to give a medication by intravenous (IV) bolus. When
assessing the patient's IV insertion site, the nurse notes that it is warm, reddened,
and tender. What action should the nurse take first?
a. Slow the infusion rate and slowly inject the medication.
b. Discontinue the IV infusion.
c. Inject a local anesthetic to relieve the tenderness.
d. Apply warm compresses over the insertion site. - Answer-ANS: B
Swelling, warmth, redness, and tenderness indicate infiltration or phlebitis. Stop the
IV infusion, remove the IV catheter, treat the IV site as indicated by institutional
policy, and insert a new IV catheter if therapy continues.
A patient with a continuous IV infusion has an order for ciprofloxacin to be given IV
piggyback. Which action by the nurse is appropriate for administering the
medication?
a. Hang the bag with ciprofloxacin higher than the continuous infusion bag.
b. Stop the continuous infusion while running the ciprofloxacin.
c. Connect the piggyback tubing into the Y-port on the tubing of the continuous
infusion that is closest to the patient.
