Chapter 34: Parenteral Medications
Fundamental Nursing Skills and Concepts 12th Edition, Timby
MULTIPLE CHOICE
1. A patient has a medication order for iron dextran (Imferon) to be given using the Z-track
technique. The rationale for using this method is to:
a. avoid medication irritation.
b. avoid tissue scarring.
c. cause less painful method.
d. protect the sciatic nerve.
ANS: A
Z-track technique should be used with injection of this medication, because it creates
a slanted needle track and avoids seepage of the medication back into subcutaneous or
skin layers.
DIF: Cognitive Level: Comprehension REF: m 694, Skill 35-5
OBJ: Theory #2 TOP: Z Track Technique KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A.
2. When administering an intramuscular injection for a 4-year-old child, the best site to use
is the:
a. gluteus medius.
b. vastus lateralis.
c. ventrogluteal.
d. dorsogluteal.
ANS: B
The vastus lateralis is the best choice for children younger than 5 years old, because
the gluteal muscle is not well developed.
DIF: Cognitive Level: Comprehension REF: m 692 OBJ: Clinical
Practice #7 TOP: Vastus Lateralis Site KEY: Nursing Process
Step: Planning MSC: NCLEX: Physiological Integrity:
reduction of risk
3. The most effective nursing actions to decrease discomfort to the patient during a
parenteral injection would be:
a. inserting the needle while the skin is still wet from the alcohol wipe.
b. asking the patient to look at the injection site for learning purposes.
c. using the smallest gauge needle that is appropriate for the site.
d. removing the needle slowly to avoid damaging the tissue.
ANS: C
Using the smallest gauge needle that is appropriate for the site is one way to decrease
patient discomfort.
DIF: Cognitive Level: Comprehension REF: m 693, Box 35-4
OBJ: Clinical Practice #9 TOP: Parenteral Injection KEY:
Nursing Process Step: Planning MSC: NCLEX: Physiological
Integrity: basic care and comfort
, 4. A patient asks why the clinic nurse asked him to remain in the clinic for 30 minutes after
the injection of penicillin. The nurse explains that it is part of the standards of care to
monitor for:
a. any pain reaction.
b. bleeding at the site.
c. infection at the site.
d. any allergic reaction.
ANS: D
The nurse should plan to monitor this patient for allergic response for 30 minutes after
giving the first dose of a medication.
DIF: Cognitive Level: Application REF: m 694, Safety Alert OBJ:
Clinical Practice #6 TOP: Allergic Reaction to Parenteral Injection
KEY: Nursing Process Step: Assessment MSC: NCLEX:
Physiological Integrity
5. When preparing to reconstitute a drug from a powder form, the nurse should first:
a. use sterile water.
b. vigorously shake the powder prior to reconstituting drug.
c. follow directions on label for diluent to use.
d. discard the vial and the unused medication.
ANS: C
Instructions for the diluent should be followed from the directions on the label.
DIF: Cognitive Level: Application REF: m 678 OBJ: Clinical Practice #4
TOP: Reconstitution KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity:
pharmacological therapies
6. Which medication order should be documented in the MAR and in the nurses notes after
it is given?
a. Digoxin 0.25 mg PO at 9:00 AM
b. Demerol 75 mg IM PRN pain
c. Lasix 40 mg PO twice daily
d. KCl 20 mEq PO daily
ANS: B
PRN and STAT orders are recorded in both the MAR and nurses notes along with the
reason why the medication was given, the result, and the duration of effect of
medication.
DIF: Cognitive Level: Application REF: m 695 OBJ: Clinical Practice
#11 TOP: Documentation KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. A nurse giving a subcutaneous injection will select a:
a. 3-mL syringe and 22-gauge, 1-inch needle.
b. 3- mL syringe and 18-gauge, 1-inch needle.
c. 3- mL syringe and 25-gauge, 5/8-inch needle.
d. 3- mL syringe and 20-gauge, 1-inch needle.
Fundamental Nursing Skills and Concepts 12th Edition, Timby
MULTIPLE CHOICE
1. A patient has a medication order for iron dextran (Imferon) to be given using the Z-track
technique. The rationale for using this method is to:
a. avoid medication irritation.
b. avoid tissue scarring.
c. cause less painful method.
d. protect the sciatic nerve.
ANS: A
Z-track technique should be used with injection of this medication, because it creates
a slanted needle track and avoids seepage of the medication back into subcutaneous or
skin layers.
DIF: Cognitive Level: Comprehension REF: m 694, Skill 35-5
OBJ: Theory #2 TOP: Z Track Technique KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A.
2. When administering an intramuscular injection for a 4-year-old child, the best site to use
is the:
a. gluteus medius.
b. vastus lateralis.
c. ventrogluteal.
d. dorsogluteal.
ANS: B
The vastus lateralis is the best choice for children younger than 5 years old, because
the gluteal muscle is not well developed.
DIF: Cognitive Level: Comprehension REF: m 692 OBJ: Clinical
Practice #7 TOP: Vastus Lateralis Site KEY: Nursing Process
Step: Planning MSC: NCLEX: Physiological Integrity:
reduction of risk
3. The most effective nursing actions to decrease discomfort to the patient during a
parenteral injection would be:
a. inserting the needle while the skin is still wet from the alcohol wipe.
b. asking the patient to look at the injection site for learning purposes.
c. using the smallest gauge needle that is appropriate for the site.
d. removing the needle slowly to avoid damaging the tissue.
ANS: C
Using the smallest gauge needle that is appropriate for the site is one way to decrease
patient discomfort.
DIF: Cognitive Level: Comprehension REF: m 693, Box 35-4
OBJ: Clinical Practice #9 TOP: Parenteral Injection KEY:
Nursing Process Step: Planning MSC: NCLEX: Physiological
Integrity: basic care and comfort
, 4. A patient asks why the clinic nurse asked him to remain in the clinic for 30 minutes after
the injection of penicillin. The nurse explains that it is part of the standards of care to
monitor for:
a. any pain reaction.
b. bleeding at the site.
c. infection at the site.
d. any allergic reaction.
ANS: D
The nurse should plan to monitor this patient for allergic response for 30 minutes after
giving the first dose of a medication.
DIF: Cognitive Level: Application REF: m 694, Safety Alert OBJ:
Clinical Practice #6 TOP: Allergic Reaction to Parenteral Injection
KEY: Nursing Process Step: Assessment MSC: NCLEX:
Physiological Integrity
5. When preparing to reconstitute a drug from a powder form, the nurse should first:
a. use sterile water.
b. vigorously shake the powder prior to reconstituting drug.
c. follow directions on label for diluent to use.
d. discard the vial and the unused medication.
ANS: C
Instructions for the diluent should be followed from the directions on the label.
DIF: Cognitive Level: Application REF: m 678 OBJ: Clinical Practice #4
TOP: Reconstitution KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity:
pharmacological therapies
6. Which medication order should be documented in the MAR and in the nurses notes after
it is given?
a. Digoxin 0.25 mg PO at 9:00 AM
b. Demerol 75 mg IM PRN pain
c. Lasix 40 mg PO twice daily
d. KCl 20 mEq PO daily
ANS: B
PRN and STAT orders are recorded in both the MAR and nurses notes along with the
reason why the medication was given, the result, and the duration of effect of
medication.
DIF: Cognitive Level: Application REF: m 695 OBJ: Clinical Practice
#11 TOP: Documentation KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. A nurse giving a subcutaneous injection will select a:
a. 3-mL syringe and 22-gauge, 1-inch needle.
b. 3- mL syringe and 18-gauge, 1-inch needle.
c. 3- mL syringe and 25-gauge, 5/8-inch needle.
d. 3- mL syringe and 20-gauge, 1-inch needle.
