A nurse observes a newly licensed nurse administer enoxaparin subcutaneously using a pre- filled syringe. Which of the following indicates appropriate medication administration?
Transferring the medication into a U-100 insulin syringe for injection
Removing the air bubble from the prefilled syringe prior to administration
Inserting the needle into the tissue using a 30-degree angle
Administering the injection in the love handles. 2 in from the umbilicus
The Correct Answer is D
D. Administering the injection in the love handles, 2 inches from the umbilicus. It is important not to remove the air bubble from the prefilled syringe, as it is designed to ensure the entire dose of medication is administered.
A. Enoxaparin should not be transferred into another syringe unless specifically instructed by the manufacturer or pharmacy guidelines. Pre-filled syringes are designed to deliver the correct dose accurately and safely.
B. It is important not to remove the air bubble from the prefilled syringe, as it is designed to ensure the entire dose of medication is administered.
C. A 30-degree angle is too shallow for subcutaneous injections and may result in the medication being deposited too close to the skin surface, potentially causing irritation or affecting absorption.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Sharps containers should be replaced when they are 3/4 full to prevent overfilling, which could increase the risk of needlesticks when trying to dispose of sharps. Ensuring sharps containers are not overfilled helps maintain a safe environment by reducing the risk of accidental puncture injuries during disposal.
A. Used razors should be disposed of in puncture-resistant sharps containers, not in regular wastebaskets. Sharps containers are specifically designed to safely contain sharp objects to prevent accidental injuries.
C. Using two hands to recap a needle is unsafe and increases the risk of accidental needlestick injuries. It's important to educate healthcare workers to avoid recapping needles whenever possible.
D. Breaking needles before disposal is unsafe and increases the risk of injury. Needles should be disposed of intact in a puncture-resistant sharps container.
Correct Answer is A
Explanation
A. Infiltration occurs when IV fluid or medication leaks into the surrounding tissues rather than entering the vein. Coolness, blanching (pale appearance), swelling, and discomfort at the IV site are common signs of infiltration.
B. Local inflammation at the IV site can occur due to irritation or infection. Redness, warmth, swelling, tenderness, and possibly purulent drainage (pus) are typical signs. The description of a cool and blanched IV site does not fit the typical signs of inflammation, which usually involve warmth and redness.
C. Thrombophlebitis is inflammation of a vein with associated blood clot formation. Pain, warmth, redness, and swelling along the path of the vein are common. Thrombophlebitis typically presents with warmth and redness at the site, whereas the cool and blanched appearance described by the student suggests fluid infiltration rather than a thrombus causing inflammation.
D. Phlebitis is inflammation of the vein itself. Pain, redness, warmth, and swelling directly over the vein. Phlebitis usually manifests with warmth and redness, which are not present in the described symptoms.
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