The nurse is testing a patient's visual accommodation, which finding would the nurse expect to see?

Choice A rationale

A 10-15 degree angle is used for intradermal injections, where the medication is deposited just beneath the epidermis, creating a bleb or wheal. This shallow angle ensures the medication remains within the superficial layers of the skin for diagnostic purposes like allergy testing.

Choice B rationale

Intramuscular injections are administered at a 90-degree angle to ensure the needle penetrates deeply into the muscle tissue, bypassing the subcutaneous layer. This angle facilitates rapid absorption into the well-vascularized muscle and minimizes the risk of medication leakage into the subcutaneous tissue or irritation.

Choice C rationale

A 45-degree angle is typically used for subcutaneous injections, where the medication is deposited into the adipose tissue beneath the dermis. This angle is chosen to avoid injecting into muscle while still reaching the subcutaneous layer for systemic absorption.

Choice D rationale

A 60-degree angle is not a standard injection angle for common parenteral routes. The primary angles used for injections are 10-15 degrees (intradermal), 45 degrees (subcutaneous), and 90 degrees (intramuscular). Deviating from standard angles can compromise medication delivery and patient safety.

The aortic valve is best auscultated at the second intercostal space (ICS) along the right sternal border. This anatomical landmark corresponds to the superficial projection of the aorta and is where the sounds of aortic valve closure and blood flow through the aorta are most clearly transmitted to the chest wall. Optimal sound transmission is achieved by minimizing intervening tissue. Pulmonic rationale:

The pulmonic valve is best auscultated at the third intercostal space (ICS) along the left sternal border, also known as Erb's point. While the pulmonic area is typically at the second ICS left sternal border, Erb's point provides a broader area for detecting murmurs related to both the pulmonic and aortic valves. This location provides good sound transmission for the pulmonary artery. Tricuspid rationale:

The tricuspid valve is best auscultated at the fourth intercostal space (ICS) along the left sternal border. This location overlies the right ventricle and the tricuspid valve, allowing for clear detection of its closure sounds and any associated murmurs. The proximity of the valve to the chest wall at this point facilitates optimal auscultation. Mitral rationale:

The mitral valve is best auscultated at the fifth intercostal space (ICS) at the midclavicular line (MCL). This location is also known as the apex of the heart, where the left ventricle's impulse is strongest. Sounds produced by the mitral valve, particularly during its closure, are best heard here due to the direct anatomical projection and maximal cardiac impulse. .