The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

Massage the site gently after injection.

Ensure bevel of the needle is pointing up.

Hold the syringe perpendicular to the skin.

Select upper arm as the injection site.

Answer and Explanation

The Correct Answer is B

B. The needle should be inserted with the bevel facing up (visible through the skin). The goal is to deposit the medication into the epidermal layer (not subcutaneous tissue).

A. Massaging the site after injection can cause the medication to spread beyond the intended area, leading to inaccurate results or potential complications.

C. The correct angle for an intradermal injection is 5 to 15-degree angle. This angle allows for proper placement of the medication just below the epidermis.

D. Intradermal injections are usually administered on the forearm or the upper back, where the skin is thin and easily lifted to create a wheal.

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Correct Answer is C

Explanation

C. When providing health teaching to older adult clients, using everyday language is crucial. Older adults may have varying levels of health literacy and cognitive abilities, so using simple, clear language facilitates better understanding and comprehension of the information being provided.

A. Underlining key words on the written information may be helpful for emphasizing important points, but it is not as critical as using everyday language to enhance understanding

B. Speaking loudly and facing the client may not be necessary for all older adult clients and could even be perceived as patronizing or disrespectful.

D. Providing a very well-lit meeting space is important for optimizing visual acuity, especially for older adults who may have age-related changes in vision. However, while adequate lighting is beneficial, it is not as critical

A. Impaired physical mobility. B. Self-care deficit. C. Risk for infection. D. Risk for impaired skin integrity.

Correct Answer is D

Explanation

D. Neuropathy, especially when associated with numbness and tingling in the lower extremities, poses a significant risk for impaired skin integrity. The loss of sensation can lead to decreased awareness of pressure, friction, or trauma to the feet, making the client more susceptible to skin breakdown, ulcers, and injuries.

A. Increasing numbness and tingling in the lower extremities, which primarily suggests neuropathic symptoms rather than impaired mobility.

B. A self-care deficit may arise if the client's neuropathy significantly affects their ability to perform foot care tasks independently. However, self-care deficit becomes a priority concern.

C. Neuropathy can increase the risk of foot injuries due to decreased sensation, which in turn can lead to infections if not promptly addressed. However, while infection is a potential complication, the immediate concern in this scenario is preventing the development of skin breakdown and ulcers.

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The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When providing health teaching to older adult clients, which action is most important for the nurse to implement?

Correct Answer is C

Explanation

The nurse is caring for a client with a history of neuropathy who reports increasing numbness and tingling in the lower extremities. Which problem should the nurse determine is the priority for promoting foot care at this time?

Correct Answer is D

Explanation

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