If a nurse needs to administer 3 mL of medication intramuscularly to an adult patient, which site should be used for the injection?

Dorsal gluteal

Deltoid

Vastus lateralis

Lateral piriformis

Answer and Explanation

The Correct Answer is C

Choice A rationale:

The dorsal gluteal site, also known as the dorsogluteal site, was once a common choice for intramuscular injections. However, it has fallen out of favor due to several concerns, including:

Risk of sciatic nerve injury: The sciatic nerve, the largest nerve in the body, runs deep within the gluteal region. Injections into the dorsal gluteal site have a higher risk of accidentally hitting this nerve, which can lead to pain, numbness, and weakness in the leg.

Difficulty in landmarking: Accurately locating the dorsal gluteal site can be challenging, especially in patients with excessive adipose tissue or those who are unable to position themselves properly. Incorrect injection placement can increase the risk of tissue damage and poor drug absorption.

Pain: The dorsal gluteal site is often more painful than other intramuscular injection sites, likely due to the presence of more nerve endings in the area.

Choice B rationale:

The deltoid muscle, located in the upper arm, is a common site for intramuscular injections, particularly for vaccines. However, it has limitations when it comes to administering larger volumes of medication:

Small muscle mass: The deltoid is a relatively small muscle, limiting the amount of medication that can be safely injected. It's generally recommended to inject no more than 1-2 mL of medication into the deltoid muscle.

Proximity to nerves and blood vessels: The deltoid muscle is located near the radial nerve and brachial artery. Improper injection technique could potentially injure these structures.

Choice C rationale:

The vastus lateralis muscle, located in the anterolateral aspect of the thigh, is considered the preferred site for intramuscular injections in adults when the volume of medication exceeds 2 mL. Here's why:

Large muscle mass: The vastus lateralis is a large, thick muscle, capable of accommodating larger volumes of medication (up to 5 mL).

Easy to access: The vastus lateralis is easily accessible and can be injected with the patient in a sitting or lying position.

Fewer nerves and blood vessels: The vastus lateralis has fewer major nerves and blood vessels compared to other injection sites, reducing the risk of injury.

Pain tolerance: Studies have shown that injections into the vastus lateralis are generally less painful than injections into the deltoid or gluteal muscles.

Choice D rationale:

The lateral piriformis muscle is not a recognized or recommended site for intramuscular injections. It's a deep muscle located within the pelvic region, making it difficult to access and posing a higher risk of injury to surrounding structures.

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Correct Answer is B

Explanation

Choice A rationale:

Echinacea: It has anti-inflammatory properties and is not typically associated with exacerbating rheumatoid arthritis symptoms. Studies have shown potential benefits in reducing inflammation, including evidence of possible effectiveness for osteoarthritis and rheumatoid arthritis. However, more research is needed to confirm its efficacy and safety in rheumatoid arthritis.

Choice B rationale:

Turmeric:

Curcumin, the active component of turmeric, has both anti-inflammatory and pro-inflammatory effects.

While it has potential benefits for some inflammatory conditions, it can also stimulate the immune system, which could worsen rheumatoid arthritis symptoms in certain individuals.

Studies have shown mixed results, with some indicating potential benefits and others suggesting a possible worsening of symptoms.

Due to this uncertainty, caution is advised, and patients with rheumatoid arthritis should consult with their healthcare providers before using turmeric supplements.

Choice C rationale:

Ginger: It has well-documented anti-inflammatory properties and is not known to exacerbate rheumatoid arthritis symptoms.

Studies have shown ginger to be potentially effective in reducing pain and inflammation in individuals with rheumatoid arthritis.

It is generally considered safe for use in this population.

Choice D rationale:

Valerian: It is a herb primarily used for its sedative and sleep-promoting effects.

It has not been shown to have any significant impact on inflammation or rheumatoid arthritis symptoms. There is no evidence to suggest that it would worsen the condition.

A. Metformin 0.5 g PO B. Methotrexate 15.0 mg PO C. Meropenem 1.0 g IV D. None of the above

Correct Answer is C

Explanation

Choice A rationale:

Incorrect dosage form: Metformin is typically administered orally as a tablet or liquid suspension, not as a powder for reconstitution (PO).

Missing route of administration: The medication order does not specify the route of administration, such as oral (PO), intravenous (IV), or intramuscular (IM).

Potential for medication errors: The lack of clarity in the medication order could lead to errors in administration, such as giving the wrong dose or administering the medication by the wrong route.

Choice B rationale:

Incorrect dosage unit: Methotrexate is typically administered in milligrams (mg), not grams (g).

Potential for overdose: The order for 15.0 g of methotrexate is a very high dose that could lead to serious adverse effects, including toxicity and death.

Choice C rationale:

Correctly written: The medication order specifies the drug name (meropenem), the dose (1.0 g), the dosage form (IV), and the route of administration (IV).

Appropriate dosage range: The dose of 1.0 g of meropenem is within the typical dosage range for this antibiotic.

Clear and concise: The medication order is clear, concise, and easy to understand, which helps to reduce the risk of medication errors.

Choice D rationale:

Incorrect: While choices A and B are both incorrect, choice C is a correctly written medication order.

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If a nurse needs to administer 3 mL of medication intramuscularly to an adult patient, which site should be used for the injection?

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Naxlex Comprehensive Predictor Exams

Which herbal supplement is likely to exacerbate symptoms for a patient with rheumatoid arthritis?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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