Which IM injection sites are preferred for the Z-track technique for the administration of medication? (SELECT 2 CORRECT ANSWERS)
Ventrogluteal muscle.
Deltoid muscle.
Dorsogluteal muscle.
Abdomen, 2 inches from umbilicus.
Posterior thigh.
Correct Answer : A,C
Choice A rationale
The ventrogluteal muscle is a preferred site for Z-track injections due to its thick musculature, which minimizes the risk of hitting nerves or blood vessels. Its anatomical location provides a deep, safe space for medication deposition, allowing for effective sealing of the drug within the muscle tissue, preventing leakage and irritation to subcutaneous tissues.
Choice B rationale
The deltoid muscle is generally not preferred for Z-track injections because its smaller muscle mass and proximity to the radial nerve and brachial artery increase the risk of neurovascular injury. While used for some intramuscular injections, the Z-track technique benefits from larger muscle groups to effectively seal the medication.
Choice C rationale
The dorsogluteal muscle, though historically used, is considered less ideal than the ventrogluteal site for Z-track injections due to a higher risk of sciatic nerve injury and penetration of major blood vessels. However, its large muscle mass can still accommodate Z-track injections when alternative sites are contraindicated, if proper landmarks are meticulously observed.
Choice D rationale
The abdomen, 2 inches from the umbilicus, is primarily used for subcutaneous injections, not intramuscular Z-track injections. This area lacks the deep muscle tissue necessary to effectively deposit and seal medication using the Z-track technique, and attempting intramuscular injection here poses a high risk of hitting vital organs.
Choice E rationale
The posterior thigh, specifically the rectus femoris or vastus lateralis, can be used for intramuscular injections, but it is not a primary preferred site for the Z-track technique in adults due to varying muscle thickness and increased potential for discomfort. The ventrogluteal site generally offers a larger and safer muscle mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Pulling the lobe up and back is the correct technique for administering ear drops to adults and children older than three years of age. This maneuver straightens the ear canal in older individuals due to the anatomical development and orientation of the Eustachian tube and external auditory meatus.
Choice B rationale
Instructing parents to hold the child upright for 10 minutes is an appropriate post-administration instruction to facilitate medication absorption and prevent spillage. However, this action is not part of the physical technique for correctly preparing the ear canal for drop instillation.
Choice C rationale
For children under 3 years old, the external auditory canal is straighter and angled differently than in adults. Pulling the pinna down and back straightens this shorter, more upwardly curved canal, allowing the medication to flow more effectively and reach the tympanic membrane for optimal absorption.
Choice D rationale
Massaging the tragus after instillation helps to distribute the medication throughout the ear canal and facilitate its passage deeper. However, massaging the tragus before administering the drops does not contribute to straightening the ear canal and is not a preparatory step for instillation.
Correct Answer is D
Explanation
Choice A rationale
Reading newsprint at 20 inches assesses near vision, but it is not the standard clinical method for comprehensive visual acuity assessment. While it can provide some insight into the patient's functional near vision, a more precise and standardized tool like a Jaeger card or specific near vision charts are preferred for accurate diagnostic evaluation.
Choice B rationale
The Jaeger card is specifically designed to assess near visual acuity, typically held at 14 inches (35 cm) from the eye. While useful for evaluating reading vision, it does not provide information about distance visual acuity, which is a primary component of a comprehensive eye examination and is assessed using a Snellen chart.
Choice C rationale
The confrontation test assesses peripheral vision, not central visual acuity. It involves the examiner bringing fingers or objects into the patient's field of vision from various directions. While an important part of a complete eye examination to detect visual field defects, it does not quantify the sharpness of central vision.
Choice D rationale
The Snellen chart is the gold standard for assessing distance visual acuity. Positioning it 20 feet away standardizes the testing distance, allowing for accurate measurement of visual acuity as a fraction (e.g., 20/20). This provides a reliable and reproducible measure of central vision, critical for diagnosing and monitoring visual impairments.
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