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Chapter 37. Administering Intradermal, Subcutaneous, and Intramuscular Injections
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Chapter 37. Administering Intradermal, Subcutaneous, and Intramuscular Injections
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Chapter 37. Administering Intradermal, Subcutaneous, and Intramuscular InjectionsMultiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing care for a 32-year-old with suspected bowel obstruction who is receiving intramuscular
injections of narcotic pain medication. The patient states, “I hate shots. Why can’t I just take a pill?” The
nurse could best respond with
1. “We want to avoid giving you medication that you have to digest.”
2. “Giving the pain medication this way will make it last longer.”
3. “Narcotic medications are destroyed by the acid in your stomach.”
4. “The drug will be absorbed more slowly this way.”
2. The nurse is teaching a 64-year-old with impaired vision and newly diagnosed diabetes to manage diabetes
and insulin provision. The nurse’s most appropriate course of action is to
1. Have the patient practice injecting her thigh with an empty syringe.
2. Encourage the patient to identify a family member who will be giving the insulin shots.
3. Obtain small insulin syringes that the patient can use to draw up the insulin.
4. Instruct the patient to attend a diabetic support group that is offered on a monthly basis.
3. The student nurse is preparing to provide 25 mg meperidine (Demerol) IM for pain. The Pyxis is loaded with
prefilled 50 mg meperidine syringes. The supervising nurse appropriately intervenes if the student nurse
1. Obtains a Carpuject system to administer the medication.
2. Recaps the needle after the injection.
3. Wastes 25 mg of the meperidine before administration.
4. Unscrews the syringe from the holder before discarding it in the sharps container.
4. The nurse is preparing to provide a subcutaneous injection. The nurse’s technique would correctly include
1. Pointing the bevel of the needle up before piercing the skin.
2. Selecting a 14 gauge, 1-1/2?8" needle.
3. Placing the total dose of 2.5 mL medication in one syringe.
4. Donning sterile gloves.
5. The nurse is preparing to reconstitute a medication in a multiple-dose vial. The nurse correctly understands
that the most essential step in this process is
1. Wiping the rubber stopper of the vial with alcohol before and after needle insertion.
2. Instilling the accurate amount of diluent into the vial.
3. Using a filtered needle to draw up the medication.
4. Instilling air into the vial before withdrawing medication.
6. Which of the following is considered an essential step for the nurse to follow while withdrawing medication
from an ampule?
1. Injecting air into the ampule before withdrawing medication
2. Using a filtered needle to withdraw medication
3. Tapping the bottom of the ampule before breaking the neck
4. Taking care not to invert the ampule while withdrawing medication
7. After withdrawing medication and removing the needle from the vial, the nurse notes there is an air bubble in
the syringe. The nurse should
1. Return the medication to the vial and attempt to draw it again.
2. Gently shake the syringe in a downward motion.
3. Roll the syringe gently between her hands.
, 4. Tap the barrel of the syringe to float the bubble toward the needle.
8. As a nurse, which of the following would you recognize as accurately describing the phenomenon of first-
pass metabolism?
1. Sublingual medications pass first through the mucosal lining of the mouth.
2. Intradermal medications are absorbed first by the skin and then by underlying tissue.
3. Oral medications are metabolized by the liver before entering the bloodstream.
4. Intramuscular injections pass through the subcutaneous layer of skin into muscle.
9. The nurse recognizes that a 22 g 1.50-inch needle would be most appropriate for a(n)
1. Adult intradermal injection (ID).
2. Child subcutaneous injection.
3. Adult intramuscular (IM) injection.
4. Newborn IM injection.
10. As the nurse is giving an intramuscular injection, she notes blood returning into the syringe with aspiration.
The best action by the nurse is to
1. Withdraw the needle and dispose of the syringe.
2. Withdraw the needle, replace the needle, and then provide the injection in a
different location.
3. Push the needle deeper into the muscle and aspirate again.
4. This is a normal finding with an intramuscular injection; the nurse should proceed with
the injection.
11. A nurse correctly recognizes that the safest and most comfortable site for an intramuscular (IM) injection is
1. The ventrogluteal site.
2. The dorsal gluteal site.
3. The vastus lateralis site.
4. The left deltoid site.
12. A nurse correctly recognizes that which of the following types of syringe is calibrated in milliliters?
1. Regular syringe
2. Tuberculin syringe
3. Insulin syringe
4. Single-dose syringe
13. When teaching a student nurse about using syringes, the nurse correctly describes the part of a syringe that
screws into the needle hub as the
1. Barrel.
2. Plunger.
3. Luer-Lok tip.
4. Slip tip.
14. The nurse is administering an intradermal injection for tuberculin testing. Unless contraindicated, the nurse
will use the patient’s
1. Right ventral forearm.
2. Left ventral forearm.
3. Upper chest.
4. Upper back.
15. The nurse sees that the physician has ordered a subcutaneous heparin injection for a patient. The nurse will
plan to give the injection in the
, 1. Back of the upper arms.
2. Abdomen.
3. Upper buttocks.
4. Anterior thighs.
16. A newborn requires an intramuscular injection. Which of the following sites will the nurse first seek to use for
the injection?
1. Ventrogluteal site
2. Deltoid
3. Rectus femoris
4. Vastus lateralis
17. When a nurse administers an intramuscular injection of a viscous medication into a muscular adult, she
correctly uses
1. A long needle with a small gauge.
2. A long needle with a large gauge.
3. A short needle with a small gauge.
4. A short needle with a large gauge.
18. A nurse handling a syringe before administering an injection correctly keeps all parts of the syringe sterile
except the
1. Plunger.
2. Inside of the barrel.
3. Syringe tip.
4. Plastic needle cap.
19. To prevent lipoatrophy and lipohypertrophy in patients receiving insulin injections, a nurse should
1. Massage the injection site.
2. Occasionally administer injections in the ventrogluteal site.
3. Rotate injection sites around the abdomen.
4. Always inject in the same site.
20. To prevent complications from intramuscular injections, a nurse should do all of the following except
1. Wash the hands before preparing injections and on entering a patient’s room.
2. Make the needle puncture slowly and with caution.
3. Apply a bandage after giving the injection.
4. Document the site of the injection.
21. Before administering an intramuscular injection, the nurse should first check to see whether the patient is
taking
1. Aspirin.
2. Acetaminophen.
3. Ginseng.
4. All of the above.
22. Before administering a heparin injection, a nurse needs to have a second nurse verify
1. The strength and dosage of the heparin.
2. The type and dosage of the heparin.
3. The patient’s laboratory results.
4. Whether it should be given via the intramuscular route.
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