A nurse is preparing to administer an IM injection to a client who has gonorrhea.
Which of the following actions should the nurse take?
Inject the medication at least 5 cm (2 in) from the umbilicus.
Use the Z-track technique to administer the medication.
Give the medication without aspirating prior to injection.
Administer the medication with a 27-gauge '/,-inch needle.
The Correct Answer is B
Choice A rationale:
Injecting the medication at least 5 cm (2 in) from the umbilicus is not a standard guideline for IM injections. The site of injection depends on factors such as the volume of medication and patient’s age and muscle mass.
Choice B rationale:
Using the Z-track technique to administer the medication is correct. This technique helps to seal the medication in muscle tissue, reducing leakage into subcutaneous tissue.
Choice C rationale:
Giving the medication without aspirating prior to injection is not recommended. Aspiration ensures that the needle is not in a blood vessel before injecting.
Choice D rationale:
Administering the medication with a 27-gauge '/,-inch needle may not be appropriate for an IM injection, especially for adults. A longer and larger gauge needle is typically used for IM injections.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Renal excretion time slows for medication. As people age, kidney function gradually decreases, which slows the excretion of medications. This can lead to increased levels of the drug in the body, which can increase the risk of side effects.
Choice B rationale:
Hepatic enzymes do not process medications more rapidly in older adults. In fact, liver function also decreases with age, which can slow the metabolism of medications.
Choice C rationale:
Brain receptors do not become less sensitive to medications in older adults. The sensitivity of brain receptors to medications can vary widely and is not necessarily related to age.
Choice D rationale:
Gastric emptying rate does not increase with age. On the contrary, it often slows down, which can affect the absorption of some medications.
Correct Answer is C
Explanation
Choice A rationale:
Pinching the tube while connecting the syringe to it could potentially damage the tube and does not aid in medication administration.
Choice B rationale:
Elevating the head of the client’s bed to only 10° may increase the risk of aspiration. The head of the bed should be elevated to at least 30° during medication administration and for at least an hour afterward.
Choice C rationale:
Flushing the tube with normal saline following medication administration helps ensure that all medication has been administered and helps maintain tube patency.
Choice D rationale:
Combining crushed medications together in a single syringe can lead to drug interactions and can also increase the risk of tube clogging. Each medication should be administered separately.
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