A client refuses to take a prescribed medication, stating they no longer want to take it. Which nursing response best reflects an appropriate therapeutic approach to support client autonomy and encourage informed decision-making?

A. Pull the skin laterally with the non-injecting hand and maintain this position until the needle is withdrawn slowly, and release the skin slowly: The Z-track technique displaces subcutaneous tissue to create a zigzag path, preventing medication from leaking into subcutaneous tissue. Maintaining lateral tension during injection and slow withdrawal ensures proper deposition and minimizes tissue irritation.

B. Pull the skin taut with the forefinger and thumb of the non-dominant hand before needle insertion: Pulling the skin taut is not part of the Z-track method and does not create the necessary tissue displacement. This technique is more appropriate for standard intramuscular injections without irritant medications.

C. Release the displaced skin quickly before removing the needle to minimize skin trauma: Releasing the skin before needle withdrawal would allow medication to track back into subcutaneous tissue, increasing irritation and tissue staining. Maintaining tension until withdrawal is critical.

D. Massage the injection site vigorously after needle withdrawal to disperse the medication and reduce pain: Massaging an irritant IM injection site can worsen tissue damage, cause staining, and increase discomfort. The Z-track technique is designed to prevent the need for post-injection massage.

A. 6 mL: The directions explicitly instruct adding 6 mL of sterile water to the vial to achieve a final concentration of 500 mg/mL. This volume of diluent ensures proper reconstitution and accurate dosing for intramuscular administration.

B. 3 grams: This represents the total amount of medication in the vial, not the volume of diluent to be added. Confusing the total drug amount with diluent volume would result in incorrect preparation.

C. 500 mg/mL: This is the final concentration of the reconstituted solution, not the amount of diluent. It indicates the strength after adding the correct volume of sterile water.

D. 1 mL: Adding 1 mL of diluent would create a solution with a much higher concentration than intended, leading to potential dosing errors and increased risk of adverse effects.