The nurse is preparing to administer a rectal suppository.
In what position should the nurse place the client?

Sims.

Dorsal recumbent.

Prone.

Supine.

Answer and Explanation

The Correct Answer is A

Choice A rationale

The Sims position, also known as left lateral position with the right knee flexed, is ideal for rectal suppository administration. This position allows for optimal visualization and access to the anus, while gravity aids in the retention of the suppository by minimizing premature expulsion.

Choice B rationale

The dorsal recumbent position, where the patient lies on their back with knees flexed and feet flat on the bed, is not optimal for rectal suppository administration. This position makes rectal access difficult and does not utilize gravity to aid in suppository retention, potentially leading to discomfort.

Choice C rationale

The prone position, where the patient lies on their stomach, is not suitable for rectal suppository administration. This position severely limits access to the rectal area, making insertion difficult and uncomfortable for both the patient and the nurse.

Choice D rationale

The supine position, where the patient lies flat on their back, is not ideal for rectal suppository administration. Similar to dorsal recumbent, this position makes adequate visualization and comfortable access to the anus challenging, potentially increasing patient discomfort and insertion difficulty.

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Correct Answer is D

Explanation

Choice A rationale

The abdomen, specifically 2 inches from the umbilicus, is a common site for subcutaneous injections due to the presence of ample adipose tissue, which allows for slower absorption of medications like insulin or heparin. Intradermal injections require a site with a thin epidermis and minimal subcutaneous tissue to ensure the medication remains within the dermal layer, making the abdomen unsuitable.

Choice B rationale

The anterior thigh is a common site for intramuscular injections, particularly in infants, due to the large muscle mass (vastus lateralis). While it can be used for subcutaneous injections, its muscularity and varying skin thickness make it less ideal for the precise shallow angle required for an intradermal injection, where the goal is to deposit the medication into the dermis.

Choice C rationale

The posterior upper arm, specifically the triceps area, is frequently utilized for subcutaneous injections, such as insulin or certain vaccines, because it offers sufficient subcutaneous tissue. However, similar to the anterior thigh, its anatomical characteristics with thicker skin and subcutaneous fat layers make it less optimal for the very superficial intradermal injection technique.

Choice D rationale

The upper chest, particularly below the clavicle and above the breasts, is an appropriate site for intradermal injections. This area, along with the inner forearm and upper back, has a thin epidermis and less subcutaneous tissue, which facilitates the proper placement of the medication within the dermis, allowing for the formation of a visible wheal, a key indicator of a successful intradermal injection.

A. True. B. False. C. It depends on the client's preference. D. It depends on the medication type.

Correct Answer is B

Explanation

Choice A rationale

Giving water after a buccal medication would cause the medication to be swallowed. Buccal medications are designed for absorption through the rich vascularization of the buccal mucosa, allowing direct entry into the systemic circulation and bypassing first-pass hepatic metabolism. Swallowing defeats this purpose.

Choice B rationale

Buccal medications are intended to dissolve slowly in the buccal pouch (between the cheek and gums) and be absorbed directly into the bloodstream through the mucous membranes. Consuming water would wash the medication away, leading to premature swallowing and subsequent degradation by gastric enzymes or first-pass metabolism in the liver, thus reducing its therapeutic effect.

Choice C rationale

The client's preference for water does not supersede the pharmacokinetic principles governing buccal medication administration. The route of administration is chosen specifically for its absorption profile, and introducing water compromises the intended local absorption mechanism, regardless of patient comfort.

Choice D rationale

The type of medication is precisely why water should be avoided. Buccal medications, by their very design, rely on sustained contact with the oral mucosa for systemic absorption. Regardless of the specific drug, water interferes with this fundamental mechanism, rendering the buccal route ineffective.

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The nurse is preparing to administer a rectal suppository. In what position should the nurse place the client?

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Naxlex Comprehensive Predictor Exams

In addition to the forearm, which of these sites are commonly used for the administration of an intradermal injection?

Correct Answer is D

Explanation

The nurse should give a client half a glass of water after taking a buccal medication.

Correct Answer is B

Explanation

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The nurse is preparing to administer a rectal suppository.
In what position should the nurse place the client?