The nurse is preparing to administer a dose of promethazine IM. When pulled up in the syringe, the needle contains 2.5 mL of medication.
The nurse is aware that the medication can be given in which sites. (SELECT 3 CORRECT OPTIONS)

Dorsogluteal.

Abdomen.

Ventrogluteal.

Vastus lateralis.

Deltoid

Answer and Explanation

Correct Answer : C,D,E

Choice A rationale

The dorsogluteal site is generally not recommended for intramuscular injections of 2.5 mL, especially in children or patients with less developed muscle mass, due to the significant risk of sciatic nerve injury and variable muscle depth. Ventrogluteal is preferred for larger volumes.

Choice B rationale

The abdomen is primarily used for subcutaneous injections, not intramuscular injections due to its composition primarily of adipose tissue and lack of substantial muscle mass. Injecting 2.5 mL intramuscularly into the abdomen would be painful, ineffective, and potentially harmful.

Choice C rationale

The ventrogluteal site is a safe and preferred intramuscular injection site, capable of accommodating volumes up to 2.5 mL due to its thick gluteus medius and minimus muscles, far from major nerves and blood vessels, reducing the risk of complications.

Choice D rationale

The vastus lateralis muscle is a large, well-developed muscle, making it a suitable site for intramuscular injections of 2.5 mL, particularly in adults and children. Its accessibility and distance from major nerves make it a safe option for medication administration.

Choice E rationale

The deltoid muscle can accommodate intramuscular injections of up to 2 mL in adults, making it an acceptable site for 2.5 mL if the muscle mass is adequately developed. However, care must be taken to avoid the radial nerve and ensure proper needle length.

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Correct Answer is C

Explanation

Choice A rationale

Dullness upon percussion indicates increased tissue density, such as in consolidation (e.g., pneumonia), pleural effusion, or a tumor. This occurs because the sound waves are attenuated and dampened by the solid or fluid-filled structures, resulting in a short, high-pitched, thudding sound.

Choice B rationale

Tympany is a drum-like, high-pitched, loud sound typically heard over air-filled organs like the stomach or intestines. When percussing the lungs, tympany suggests a large pneumothorax or a distended abdomen impinging on the thoracic cavity, indicating abnormal air accumulation.

Choice C rationale

Resonance is the expected percussive sound over healthy, air-filled lung tissue. It is a low-pitched, clear, hollow sound produced by the vibration of air within the alveoli and bronchi. This sound indicates normal lung aeration and the absence of significant pathology.

Choice D rationale

Hyperresonance is a louder, lower-pitched sound than normal resonance and suggests an increased amount of air in the lung or pleural cavity, such as in emphysema or pneumothorax. This hyperinflation causes greater vibration and a more boomy quality to the sound.

A. Drug allergy. B. Drug tolerance. C. Toxic effect. D. Idiosyncratic reaction.

Correct Answer is D

Explanation

Choice A rationale

A drug allergy is an adverse immune-mediated reaction to a drug, involving antibodies or sensitized lymphocytes. Symptoms can range from rash and itching to anaphylaxis, occurring upon re-exposure. This client's reaction, wakefulness instead of sedation, does not align with typical allergic manifestations involving the immune system.

Choice B rationale

Drug tolerance is a diminished physiological response to a drug after repeated administration, requiring higher doses to achieve the same effect. This develops due to adaptive changes in drug receptors or metabolism. The client's experience of wakefulness, an opposite effect, is not indicative of tolerance to the drug's intended hypnotic action.

Choice C rationale

A toxic effect occurs when drug levels in the body exceed the therapeutic range, leading to harmful effects on organs or systems. This is often dose-dependent and can manifest as organ damage or severe side effects. While adverse, the described reaction of wakefulness is not typically classified as a toxic effect of Ambien.

Choice D rationale

An idiosyncratic reaction is an uncharacteristic or unpredictable response to a drug that is not an allergic reaction and does not involve known pharmacological properties. These reactions are often genetically determined and represent an individual's unique sensitivity. The paradoxical wakefulness from a sedative like Ambien is a classic example of an idiosyncratic drug response.

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The nurse is preparing to administer a dose of promethazine IM. When pulled up in the syringe, the needle contains 2.5 mL of medication. The nurse is aware that the medication can be given in which sites. (SELECT 3 CORRECT OPTIONS)

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Correct Answer is C

Explanation

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Correct Answer is D

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The nurse is preparing to administer a dose of promethazine IM. When pulled up in the syringe, the needle contains 2.5 mL of medication.
The nurse is aware that the medication can be given in which sites. (SELECT 3 CORRECT OPTIONS)