The nurse preparing an intramuscular injection for an 18-month-old child is aware that the maximum volume of medication that can be injected into one site is:
3ml
1 ml
5ml
2ml
The Correct Answer is B
Intramuscular medication administration in toddlers requires consideration of muscle mass, vascular absorption, tissue tolerance, and risk of neuromuscular injury. The developing musculature of children under 2 years limits injectable volume capacity, making dose distribution and appropriate site selection essential for safe pharmacologic delivery.
Rationale:
A. A 3 mL intramuscular injection exceeds recommended tissue capacity for an 18-month-old child. Excessive volume increases risk of pain, muscle fiber damage, poor absorption, and local complications such as induration or nerve compression.
B. A maximum volume of 1 mL is recommended because toddler muscles have limited muscle bulk and reduced tissue distensibility. This volume promotes effective medication absorption while minimizing discomfort, tissue trauma, and leakage from the injection site.
C. A 5 mL injection is appropriate only for larger adult muscle groups with substantial muscular development. In toddlers, this volume can cause severe tissue stretching, impaired absorption, and increased risk of localized injury.
D. Although 2 mL may occasionally be tolerated in older children, it generally exceeds safe limits for most 18-month-olds. Smaller pediatric muscles cannot reliably accommodate this injection volume without increasing tissue irritation and procedural pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Otic medication administration in young children requires anatomical straightening of the external auditory canal to ensure optimal drug delivery to the tympanic membrane. In toddlers, the ear canal is shorter and more horizontally oriented, requiring specific auricle manipulation for effective instillation.
Rationale:
A. Pulling the auricle up and back is appropriate for adults and older children whose ear canal has a more inferior and posterior angulation. In a 2-year-old, this technique misaligns the canal, reducing medication penetration and therapeutic effectiveness.
B. Pulling the auricle down and back is the correct technique for children under 3 years. It straightens the more horizontal external auditory canal, allowing optimal flow of medication to the tympanic membrane and improving absorption of otic antibiotics like gentamicin.
C. Pulling the auricle down and out does not effectively straighten the pediatric ear canal. This positioning fails to align the external auditory canal properly, resulting in poor drug distribution and potential leakage of medication from the ear canal.
D. Pulling the auricle up and out is anatomically incorrect for all age groups. It distorts the ear canal rather than straightening it, leading to inadequate medication delivery and possible discomfort during administration of otic preparations.
Correct Answer is B
Explanation
Infants primarily explore their environment through oral sensory stimulation, driven by immature cognitive development and dominant sensorimotor behavior. This stage involves learning via taste, touch, and mouthing as part of early sensorimotor exploration and neurodevelopmental adaptation.
Rationale:
A. Remaining in one area and observing surroundings reflects passive visual engagement but is not the primary exploratory behavior. Infants actively interact with objects rather than solely observing, making this option incorrect as the main method of exploration.
B. Putting objects in the mouth is the primary mode of sensory exploration in infancy. This oral stage allows infants to investigate texture, shape, and taste, but also increases risk of aspiration and poisoning, making home safety education essential.
C. Isolated play is not characteristic of normal infant development. Infants require social and sensory interaction for cognitive growth. Isolation does not represent exploratory behavior and therefore is not a correct description of how infants learn about their environment.
D. Curiosity about people and places emerges later in development but does not define infant exploration. While social recognition develops, infants primarily rely on oral-motor exploration rather than cognitive curiosity about unfamiliar environments or individuals.
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