PNR 104/PNR104 Exam 3 V2 | Basic Skills,
Quality & Safety in Nursing Practice Q&A
with Rationale | Fortis College
1. A nurse is preparing to administer an intramuscular (IM) injection to an adult client. Which
site is the preferred location for this type of injection to minimize the risk of nerve injury?
A. Ventrogluteal
B. Dorsogluteal
C. Deltoid
D. Vastus Lateralis
Correct Answer: A
Expert Explanation: The ventrogluteal site is the preferred IM site for adults because it is
located away from major blood vessels and nerves. It involves the gluteus medius and
minimus muscles and provides a thick, stable muscle mass for medication. Research
indicates that the dorsogluteal site carries a high risk of sciatic nerve injury and is no
longer recommended.
2. When mixing regular insulin and NPH insulin in the same syringe, what is the correct
sequence the nurse must follow?
A. Draw up NPH first, then regular insulin.
B. Sequence does not matter as long as the total dose is correct.
,C. Draw them into separate syringes and mix them in a cup.
D. Draw up regular insulin first, then NPH insulin.
Correct Answer: D
Expert Explanation: Regular insulin (clear) must be drawn up before NPH insulin (cloudy)
to prevent contaminating the short-acting insulin with the long-acting protein. This process
is often remembered by the mnemonic ‘Clear before Cloudy.’ Ensuring this order protects
the integrity and onset time of the regular insulin dose.
3. A nurse is educating a student about the Six Rights of Medication Administration. Which of
the following is included in these rights?
A. Right Room Number
B. Right Route
C. Right Diagnosis
D. Right Physician
Correct Answer: B
Expert Explanation: The Six Rights include the right patient, right medication, right dose,
right route, right time, and right documentation. Confirming the right route ensures that
the medication is delivered in the manner intended by the prescriber for optimal
absorption. Failure to verify the route can lead to significant patient harm or ineffective
treatment.
, 4. What is the primary purpose of the Z-track technique during intramuscular medication
administration?
A. To prevent medication from leaking back into the subcutaneous tissue.
B. To ensure the needle reaches the bone.
C. To decrease the pain of the needle insertion.
D. To increase the speed of medication absorption.
Correct Answer: A
Expert Explanation: The Z-track method involves pulling the skin and subcutaneous
tissue to the side before inserting the needle. This creates a zig-zag path that seals the
medication within the muscle layer once the tissue is released. It is specifically used for
irritating medications to prevent tissue staining or localized irritation.
5. A client is diagnosed with Clostridium difficile (C. diff). Which infection control measure is
mandatory for the nurse to perform?
A. Hand hygiene using alcohol-based hand rub only.
B. Wearing an N95 respirator mask.
C. Keeping the door closed for negative pressure air flow.
D. Hand hygiene with soap and water after contact.
Correct Answer: D
Quality & Safety in Nursing Practice Q&A
with Rationale | Fortis College
1. A nurse is preparing to administer an intramuscular (IM) injection to an adult client. Which
site is the preferred location for this type of injection to minimize the risk of nerve injury?
A. Ventrogluteal
B. Dorsogluteal
C. Deltoid
D. Vastus Lateralis
Correct Answer: A
Expert Explanation: The ventrogluteal site is the preferred IM site for adults because it is
located away from major blood vessels and nerves. It involves the gluteus medius and
minimus muscles and provides a thick, stable muscle mass for medication. Research
indicates that the dorsogluteal site carries a high risk of sciatic nerve injury and is no
longer recommended.
2. When mixing regular insulin and NPH insulin in the same syringe, what is the correct
sequence the nurse must follow?
A. Draw up NPH first, then regular insulin.
B. Sequence does not matter as long as the total dose is correct.
,C. Draw them into separate syringes and mix them in a cup.
D. Draw up regular insulin first, then NPH insulin.
Correct Answer: D
Expert Explanation: Regular insulin (clear) must be drawn up before NPH insulin (cloudy)
to prevent contaminating the short-acting insulin with the long-acting protein. This process
is often remembered by the mnemonic ‘Clear before Cloudy.’ Ensuring this order protects
the integrity and onset time of the regular insulin dose.
3. A nurse is educating a student about the Six Rights of Medication Administration. Which of
the following is included in these rights?
A. Right Room Number
B. Right Route
C. Right Diagnosis
D. Right Physician
Correct Answer: B
Expert Explanation: The Six Rights include the right patient, right medication, right dose,
right route, right time, and right documentation. Confirming the right route ensures that
the medication is delivered in the manner intended by the prescriber for optimal
absorption. Failure to verify the route can lead to significant patient harm or ineffective
treatment.
, 4. What is the primary purpose of the Z-track technique during intramuscular medication
administration?
A. To prevent medication from leaking back into the subcutaneous tissue.
B. To ensure the needle reaches the bone.
C. To decrease the pain of the needle insertion.
D. To increase the speed of medication absorption.
Correct Answer: A
Expert Explanation: The Z-track method involves pulling the skin and subcutaneous
tissue to the side before inserting the needle. This creates a zig-zag path that seals the
medication within the muscle layer once the tissue is released. It is specifically used for
irritating medications to prevent tissue staining or localized irritation.
5. A client is diagnosed with Clostridium difficile (C. diff). Which infection control measure is
mandatory for the nurse to perform?
A. Hand hygiene using alcohol-based hand rub only.
B. Wearing an N95 respirator mask.
C. Keeping the door closed for negative pressure air flow.
D. Hand hygiene with soap and water after contact.
Correct Answer: D
