Upon assessment of the lungs, the nurse hears continuous, high-pitched, musical sounds. This should be documented as:

Choice D Reason: 21g 1.5 in (3.8 cm) needle to the right ventrogluteal area. Use Z-track technique.

Choice A Reason:

Using a 23-gauge, 1-inch needle for an intramuscular (IM) injection in the deltoid muscle is generally appropriate for adults. The deltoid muscle is a common site for IM injections, especially for small volumes of medication (up to 2 mL). The acromion process is a correct landmark for locating the deltoid muscle. However, the deltoid muscle is not the best site for larger volumes or more viscous medications. Additionally, the needle length might not be sufficient for individuals with more subcutaneous fat, potentially leading to suboptimal medication delivery.

Choice B Reason:

A 25-gauge, 0.5-inch needle is typically used for subcutaneous injections rather than intramuscular injections. The rectus femoris muscle can be used for IM injections, but it is not the preferred site due to the potential for increased pain and discomfort. Aspiration before injection is a debated practice; current guidelines suggest that aspiration is not necessary for most IM injections, except when injecting into the dorsogluteal site, which is not recommended due to the risk of hitting the sciatic nerve.

Choice C Reason:

A 27-gauge, 1.5-inch needle is appropriate for IM injections, and the vastus lateralis is a suitable site, especially for infants and young children. However, massaging the injection site after administering an IM injection is not recommended. Massaging can cause the medication to disperse into the subcutaneous tissue, reducing its effectiveness and potentially causing irritation or bruising.

Choice D Reason:

Using a 21-gauge, 1.5-inch needle for an IM injection in the ventrogluteal area is considered safe and effective. The ventrogluteal site is preferred for IM injections because it is free from major nerves and blood vessels, reducing the risk of injury. The Z-track technique is used to prevent medication from leaking into the subcutaneous tissue, ensuring that it remains in the muscle for proper absorption. This technique is particularly useful for medications that can stain or irritate the skin and subcutaneous tissue.

The correct answer is a.

Choice A Reason:

The statement “Biofeedback” is correct. Biofeedback is a technique that uses electronic monitoring devices to help individuals gain control over involuntary bodily functions such as heart rate, muscle tension, and blood pressure. During biofeedback sessions, sensors are attached to the body to measure physiological functions, and the feedback from these sensors helps clients learn to control their physical responses to stress. This method is particularly effective for managing conditions like chronic pain, anxiety, and hypertension.

Choice B Reason:

The statement “Acupuncture” is incorrect. Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to balance the flow of energy or qi. While acupuncture can help manage stress and pain, it does not use electronic monitoring devices to provide feedback on physiological functions5. Instead, it relies on the practitioner’s skill and knowledge of acupuncture points and meridians.

Choice C Reason:

The statement “Reiki” is incorrect. Reiki is a form of energy healing that involves the practitioner placing their hands lightly on or just above the client’s body to channel healing energy. Reiki aims to promote relaxation, reduce stress, and support the body’s natural healing processes. However, it does not involve the use of electronic monitoring devices to provide feedback on physiological functions.

Choice D Reason:

The statement “Autogenic training” is incorrect. Autogenic training is a relaxation technique that involves self-suggestion and visualization to induce a state of relaxation and reduce stress. It focuses on creating sensations of warmth and heaviness in different parts of the body through repeated phrases and mental imagery. While effective for stress management, it does not use electronic monitoring devices to provide feedback on physiological functions.