The practical nurse (PN) is administering an intradermal (ID) injection to a client. Which action should the PN take?
Ensure bevel of the needle is pointing up.
Hold the syringe perpendicular to the skin.
Select upper arm as the injection site.
Massage the site gently after injection.
The Correct Answer is A
Rationale:
A. This option is correct because for an intradermal injection, the bevel of the needle should be pointing up to allow proper placement of the medication into the dermis, creating a small bleb or wheal. Correct bevel orientation helps ensure accurate absorption and prevents leakage.
B. This option is incorrect because the syringe should be held at a 5–15 degree angle to the skin, not perpendicular. Holding it perpendicular (90 degrees) is appropriate for intramuscular injections, not intradermal.
C. This option is partially correct because the upper arm is a common site for ID injections, but other sites such as the forearm or upper back can also be used. Bevel orientation is the critical action for proper administration.
D. This option is incorrect because massaging the injection site is not recommended for intradermal injections, as it can disperse the medication and affect test results (e.g., tuberculin skin test).
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Related Questions
Correct Answer is C
Explanation
Rationale:
A. This option is incorrect because motivational phrases are more aligned with affirmations or cognitive-behavioral techniques. While they may support coping, they are not the primary focus of guided imagery.
B. This option is incorrect because emotional reflection involves thinking about personal feelings or experiences, which may increase awareness of discomfort or stress rather than reduce the perception of pain.
C. This option is correct because guided imagery involves focusing the client’s attention on a positive, calming, and often external mental image, such as a peaceful beach, garden, or mountain scene. Directing attention to a positive external place helps shift focus away from pain, promotes relaxation, reduces stress, and enhances the perception of comfort.
D. This option is incorrect because tranquil sounds may be used in relaxation or meditation techniques, but they are not the central focus of guided imagery, which relies on creating a detailed mental image rather than auditory stimuli alone.
Correct Answer is []
Explanation
Rationale:
• Malnutrition: Laboratory results show low prealbumin (10 mg/dL), low albumin (3.3 g/dL), and low serum transferrin (180 mg/dL), indicating protein-calorie malnutrition. The client also has significant weight loss (9 kg/20 lb) and refuses oral intake, reinforcing the diagnosis.
• Elevate head of bed to 45 degrees: Reduces risk of aspiration during enteral feeding.
• Check gastric pH: Confirms proper placement of the nasogastric tube and ensures safety before feeding; helps prevent complications like aspiration or feeding intolerance.
• Weight: Monitoring weight helps assess nutritional status and effectiveness of enteral feeding interventions.
• Gastric residual: Monitoring residual volume ensures tolerance to feeding, prevents overfeeding, and reduces risk of aspiration.
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