Chapter 22 Parenteral Medications

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Chapter 22  Parenteral Medications

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. The nurse is preparing an injection of 0.45 mL of medication for a pediatric patient. Which syringe is most appropriate?
a.
Tuberculin syringe
b.
Insulin syringe
c.
3-mL syringe
d.
10-mL syringe

ANS: A
The tuberculin syringe is calibrated in hundredths of a milliliter and has a capacity of 1 mL. It is used to prepare small amounts of medication such as small, precise doses for infants or young children. It is also used for intradermal and subcutaneous injections. An insulin syringe is used to administer insulin and is calibrated in units. A 3-mL syringe and a 10-mL syringe are calibrated in 0.2 of a milliliter and are not accurate for small volumes.

DIF: Cognitive Level: Applying REF: Text reference: p. 542
OBJ: Explain the importance of selecting the proper size syringe and needle for an injection.
TOP: Syringes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. The nurse is preparing to administer an intramuscular (IM) injection to a 6-month-old infant. Which injection site is the most appropriate for this patient?
a.
Deltoid muscle
b.
Dorsogluteal injection site
c.
Vastus lateralis
d.
Abdomen 2 inches away from the umbilicus

ANS: C
On the basis of the evidence, the vastus lateralis is the recommended site for pediatric IM injections for infants up to 12 months of age. The deltoid is the recommended site for children 18 months of age and older. The dorsogluteal site should not be used as an IM injection site. The abdomen is used for subcutaneous injection, not for IM injection.

DIF: Cognitive Level: Applying REF: Text reference: p. 539
OBJ: Discuss factors to consider when selecting injection sites.
TOP: Intramuscular Injection Sites in Children
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

3. The nurse is administering a parenteral medication to the patient. Which action by the nurse demonstrates proper technique?
a.
Using strict aseptic technique
b.
Using work-arounds to administer medications in a timely manner
c.
Injecting the medication smoothly but rapidly
d.
Inserting the needle into the patient’s skin smoothly and slowly

ANS: A
Strict aseptic technique is used during all steps of preparation and administration of parenteral medications. Work-arounds bypass a procedure, policy, or protocol and should not be used. Medication should be injected slowly and smoothly. The needle should be inserted smoothly and quickly.

DIF: Cognitive Level: Applying REF: Text reference: p. 540
OBJ: Identify advantages, disadvantages, and risks of administering medication by each injection route. TOP: Aseptic Technique in Injections
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

4. The nurse is preparing a medication that comes in an ampule. Which action by the nurse is appropriate?
a.
Tapping the ampule so fluid moves from the bottom of the ampule to the neck
b.
Avoiding inversion of the ampule after opening to prevent spillage of the medication
c.
Using a filter needle long enough to reach the bottom of the ampule
d.
Guiding the needle against the rim of the ampule to access the medication

ANS: C
Filter needles filter out any fragments of glass, and reaching the bottom of the ampule allows the medication to be completely withdrawn. The top of the ampule is tapped to move the fluid from the neck into the bottom of the ampule, where it is withdrawn. The ampule is held upside down or is set on a flat surface for withdrawal of the medication. The medication will not spill from the ampule after opening unless the needle tip or shaft touches the rim. The rim is considered contaminated and should not be touched by the needle.

DIF: Cognitive Level: Applying REF: Text reference: p. 544
OBJ: Correctly prepare injectable medications from a vial and an ampule.
TOP: Preparing Injections: Ampules and Vials
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

5. The nurse is teaching a patient how to mix 5 units of regular insulin and 15 units of NPH insulin in the same syringe. The nurse determines that further instruction is needed if the patient does which of the following?
a.
Injects 5 units of air into the regular insulin vial first and withdraws 5 units of regular insulin
b.
Injects 15 units of air into the NPH insulin vial but does not withdraw the medication
c.
Withdraws 5 units of regular insulin before withdrawing 15 units of NPH insulin
d.
Calculates the combined total insulin dose as 20 units after withdrawing the regular insulin from the vial

ANS: A
When rapid- or short-acting insulin is mixed with intermediate- or long-acting insulin, air should be injected into the intermediate- or long-acting insulin vial first without withdrawal of the medication. Regular insulin is withdrawn first, and then the combined total insulin dose is calculated before the NPH insulin is withdrawn from the vial.

DIF: Cognitive Level: Applying REF: Text reference: pp. 549-551
OBJ: Correctly administer intradermal, subcutaneous, and intramuscular injections.
TOP: Mixing Insulin KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity

 

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