The client has an order for Morphine, 2-4mg Q4h PRN. The nurse plans to administer 3mg, and it is supplied as 5mg/mL. What volume of medication will the nurse draw up? (ONLY enter a number, NO units)

A. 90 degrees: The recommended angle for subcutaneous injection using an insulin pen is typically 90 degrees, especially with short needles (4–8 mm). This angle ensures the medication is delivered into the subcutaneous tissue rather than intradermally or intramuscularly, which could alter absorption and efficacy.

B. 45 degrees: A 45-degree angle may be used in patients with very little subcutaneous tissue or when using longer needles to avoid intramuscular injection. However, with most insulin pen needles today, 90 degrees is standard practice.

C. It doesn’t matter: The injection angle is critical for ensuring proper subcutaneous delivery. Administering at an incorrect angle could result in intramuscular injection, faster absorption, or tissue damage, so this is unsafe.

D. 30 degrees: Injecting at 30 degrees is generally reserved for intradermal injections, such as tuberculosis testing, and is not appropriate for insulin pen administration. Using this angle could result in improper dosing and reduced effectiveness.

A. Report the discrepancy immediately after preparing the medication: Once a discrepancy in a controlled substance count is identified, the nurse should not continue handling or preparing the medication. Proceeding with preparation before resolving the discrepancy may further complicate accountability and chain-of-custody documentation.

B. Notify the Doctor and the Pharmacist immediately: Although pharmacy may eventually be involved in reconciliation, the first step is not to notify the physician. The appropriate immediate action is to follow institutional policy by notifying the charge nurse or supervisor responsible for controlled substance oversight rather than the prescribing provider.

C. Stop preparing the medication and notify the appropriate person immediately: A narcotic count discrepancy requires immediate action before any further medication handling occurs. Stopping preparation preserves the integrity of the count, prevents additional documentation errors, and initiates formal investigation per controlled substance regulations and facility policy.

D. Continue to pour as the count only needs to be correct at the end of the shift: Controlled substance counts must be accurate at all times, not just at shift change. Continuing to administer medication when a discrepancy exists violates legal standards, increases diversion risk, and places the nurse’s license at risk.