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WorksheetsMedication Administration SC-IM
Total questions: 87
Worksheet time: 44mins
What is the definition of Subcutaneous (SC) injection?
Subcutaneous (SC) injection is the administration of a medication into tissues just below the dermis of the skin.
Subcutaneous (SC) injection is the administration of a medication directly into the bloodstream.
Subcutaneous (SC) injection is the administration of a medication into the muscle tissue.
Subcutaneous (SC) injection is the administration of a medication into the joint space.
What is the purpose of administering medications subcutaneously?
To provide many kinds of medications administered subcutaneously such as vaccines, insulin (hypoglycemic medication), and heparin (anticoagulant medication).
To ensure medications are absorbed instantly into the bloodstream.
To deliver medications directly into the muscle tissue for rapid effect.
To administer medications only for local anesthesia.
Which of the following is NOT a common site for SC injections?
The outer aspect of the upper arms
The anterior aspect of the thighs
The abdomen
The palm of the hand
List any three common sites for SC injections.
The outer aspect of the upper arms, the anterior aspect of the thighs, the abdomen.
The scalp, the soles of the feet, the palms of the hands.
The back of the neck, the inner thighs, the chest.
The forehead, the lower back, the toes.
Why do SC injection sites need to be rotated?
To minimize tissue damage, aid absorption, and avoid discomfort.
To increase the risk of infection at the site.
To make the injection process more complicated.
To ensure the medication is not absorbed at all.
Identify two areas marked on the diagram.
The outer aspect of the upper arms and the abdomen.
The inner thighs and the lower back.
The palms and the soles of the feet.
The neck and the forehead.
What is the usual size of syringe used for subcutaneous injections?
5-mL
10-mL
1- or 2-mL
20-mL
For an adult of normal weight, what is the correct angle for an insulin needle during a subcutaneous injection?
30 degrees
45 degrees
60 degrees
90 degrees
For a 2-mL syringe, what is the correct angle for subcutaneous injection in an adult of normal weight?
30 degrees
45 degrees
60 degrees
90 degrees
Only ______ doses (0.5 to 1 mL) of medication are usually injected via the subcutaneous route.
small
large
irregular
excessive
Why are medications absorbed more slowly via the subcutaneous route compared to the intramuscular route?
Because subcutaneous tissue does not contain as many blood vessels as muscles, medications are absorbed more slowly than with intramuscular (IM) injections.
Because subcutaneous injections are always given with a smaller needle, which slows absorption.
Because medications given subcutaneously are always less potent than those given intramuscularly.
Because the subcutaneous route causes medications to be broken down by enzymes before absorption.
What is the first step in the pre-procedure for subcutaneous injection?
Wash hands
Verify physician prescription
Prepare medication
Wear gloves
What is the rationale for verifying the physician's prescription before administering medication?
To prevent medication administration error and maintain patient safety.
To reduce the workload of the nursing staff.
To comply with hospital administrative policies only.
To ensure the medication is available in the pharmacy.
What is the rationale for washing hands before the procedure?
To prevent infection
To make hands smell nice
To dry the hands quickly
To show professionalism
Step 19: Identify the appropriate landmarks for the site chosen. Why is this step important?
Injection into correct anatomical site prevents injury to nerves, bone, and blood vessels.
It ensures the medication is absorbed more quickly into the bloodstream.
It helps reduce the pain experienced during the injection.
It allows for the use of larger needles for faster administration.
What is the rationale for this step?
To prevent infection
To increase pain
To delay healing
To cause bleeding
What is the purpose of this step?
To maintain readily accessible for use when withdrawing needle after injection.
To increase the dosage of the medication.
To sterilize the injection site after the procedure.
To dispose of the needle immediately after injection.
What is the rationale for holding the syringe with the dominant hand using thumb, index, and third finger?
To prevent transmission of infection
To increase the speed of injection
To reduce the pain of injection
To avoid air bubbles in the syringe
What should you do with the non-dominant hand when preparing to inject a subcutaneous medication for a thin patient?
Collect skin with the thumb and index fingers.
Massage the area before injection.
Stretch the skin tightly over the injection site.
Tap the site to increase blood flow.
What should you do with the non-dominant hand when preparing to inject a subcutaneous medication for an obese patient?
Stretch skin with the thumb and index fingers.
Massage the injection site vigorously.
Tap the skin rapidly to numb the area.
Hold the syringe with both hands.
At what angle should the needle be inserted into the subcutaneous tissue?
90 degree angle
45 degree angle
30 degree angle
15 degree angle
What should you do after the needle is in place during a subcutaneous injection?
Release the tissue after the needle is in place.
Withdraw the needle immediately.
Massage the injection site vigorously.
Change the needle angle before injecting.
Why should medication be administered slowly during a subcutaneous injection?
To avoid irritation to the tissues.
To increase the absorption rate.
To reduce the effectiveness of the medication.
To prevent the medication from being metabolized too quickly.
What should you do after administering the medication during a subcutaneous injection?
Withdraw needle quickly while placing dry cotton gently over site.
Massage the injection site vigorously for 5 minutes.
Apply ice pack immediately to the injection site.
Insert the needle again to ensure full dose delivery.
Why should you not massage the site of injection with cotton after withdrawing the syringe?
Massage causes tissue damage and irritation.
It increases the absorption rate of the drug.
It prevents clot formation at the site.
It reduces the effectiveness of the injection.
Why should the needle be discarded in a sharp container after use?
To maintain infection control.
To save space in the clinic.
To reuse the needle for another patient.
To make disposal easier for janitors.
Why should used gloves be discarded in the proper bag (Red) after a subcutaneous injection?
To maintain infection control.
To save on glove costs.
To make the gloves reusable.
To comply with color-coding for aesthetics.
Why is it important to wash hands after administering a subcutaneous injection?
To maintain infection control.
To prevent bruising at the injection site.
To ensure the medication is absorbed properly.
To reduce pain for the patient.
Why should the nurse record in the patient’s medication chart after administering a subcutaneous injection?
To maintain legal principles.
To increase the dosage for the next injection.
To inform the patient's family.
To reduce the cost of medication.
Why should the site of injection be re-assessed after 15 minutes for any bruising or hardness?
For early detection to any abnormality.
To increase the absorption rate of the medication.
To reduce the pain at the injection site.
To ensure the medication is still present at the site.
Why should any abnormality be reported after a subcutaneous injection?
To take necessary action if needed.
To ignore the abnormality.
To delay the treatment.
To avoid documentation.
Why is it important to rotate insulin injection sites?
To prevent lumps and hardened tissue from developing
To increase pain
To make insulin less effective
To avoid using all possible areas
Which of the following areas are recommended for insulin injection according to the diagram?
Abdomen
Thighs
Upper arms
Buttocks
All of the above
Injecting into lumps or hardened tissue will affect the absorption of insulin and make it ______ effective.
less
more
equally
highly
According to the diagram, what is the correct order for rotating insulin injection sites on the abdomen?
1 → 2 → 3 → 4
4 → 3 → 2 → 1
2 → 1 → 4 → 3
3 → 4 → 1 → 2
Where should insulin be injected according to the instructions?
Into the muscle below the fatty layer
Into the fatty layer beneath the skin
Into the bloodstream directly
Into the bone
Which area absorbs insulin the quickest and most consistently?
Abdomen
Arms
Thighs
Buttocks
Insulin is absorbed quickest and most consistently from the _______ , followed by the arms, the thighs, and the buttocks.
abdomen
shoulder
calf
chest
According to the instructions, how should you rotate injection sites?
By moving 2 fingers' breadth along from your last injection site
By injecting in the same spot every time
By injecting only in the arms
By injecting only in the thighs
How often should you move to a new injection area according to the instructions?
Every day
Every month
Every week or two
Every year
What is the definition of Intramuscular (IM) injection?
Intramuscular (IM) injection is the administration of a medication into muscle tissue.
Intramuscular (IM) injection is the administration of a medication into the bloodstream directly.
Intramuscular (IM) injection is the administration of a medication into the skin surface.
Intramuscular (IM) injection is the administration of a medication into the subcutaneous tissue.
What is the purpose of intramuscular (IM) medication administration?
To provide many kinds of medications administered intramuscularly such as analgesics.
To increase the absorption time of oral medications.
To avoid the use of any needles in medication delivery.
To ensure medications are only delivered to the skin surface.
Which of the following is the preferred site for IM injections because the area contains no large nerves or blood vessels?
Deltoid
Ventrogluteal
Dorsogluteal
Vastus lateralis
Which anatomical landmarks are used to identify the ventrogluteal site for IM injection?
Acromion process and deltoid muscle
Greater trochanter, anterior superior iliac spine, and iliac crest
Patella and tibial tuberosity
Scapula and axilla
For IM injection in the rectus femoris and vastus lateralis, where should the hands be placed?
Place one hand next to the head of the trochanter and the other hand just above the patella. Use the anterior aspect of middle third (Rectus femoris) or the anterior lateral aspect of middle third (Vastus lateralis) for injection.
Place both hands on the lower third of the thigh, avoiding the upper two-thirds.
Place one hand on the knee and the other on the ankle, injecting in the lower third of the thigh.
Place both hands on the hip, injecting in the upper outer quadrant only.
First, locate the acromion process, place a finger on the process and measure 4 fingerbreadths down. The injection is given into the fullest part of the _______.
deltoid
biceps
trapezius
pectoralis major
Which muscle site was most commonly selected by healthcare professionals for intramuscular injections for many years?
Deltoid
Dorsogluteal
Ventrogluteal
Vastus lateralis
Why is the dorsogluteal muscle site not recommended for self-injection?
It is easy to access
It is difficult to use for self-injection
It is the safest site
It is close to the deltoid muscle
What is the recommended size of syringe for intramuscular injections?
3- to 5-mL syringe
1-mL syringe
10-mL syringe
20-mL syringe
You should not use an injection site that has evidence of infection or injury.
True
False
What is the recommended angle for intramuscular (IM) injection?
45 degrees
60 degrees
90 degrees
120 degrees
Which muscle can receive up to 3 mL of medication during an IM injection?
Deltoid muscle
Gluteus medius and gluteus maximus muscles
Biceps muscle
Triceps muscle
Volumes of _______ of medication can be injected into the deltoid muscle during an IM injection.
0.5 to 1 mL
2 to 3 mL
5 to 10 mL
10 to 20 mL
Medications injected into muscle tissue are absorbed more quickly than subcutaneous injections because of the greater blood supply to the body muscles.
True
False
Which of the following is NOT listed as equipment needed for IM injection?
Medication administration record (MAR)
Alcohol swab
Stethoscope
Proper size syringe (3-5 ml)
What is the rationale for verifying the physician prescription and checking the accuracy and completeness of each MAR (Medication administration record) before an IM injection?
To prevent medication administration error and maintain patient safety.
To reduce the time spent on documentation.
To comply with hospital dress code policies.
To ensure the medication is stored at the correct temperature.
What is the rationale for washing hands before administering an IM injection?
To prevent infection.
To improve blood circulation.
To reduce pain at the injection site.
To increase absorption of the medication.
What is the rationale for preparing equipment before administering an IM injection?
To save time and effort.
To increase the risk of infection.
To confuse the patient.
To delay the procedure.
The rationale for checking the expiration date of medication is ___________.
Dose potency increases or decreases when outdated.
It is required for insurance purposes only.
It helps identify the manufacturer of the medication.
It ensures the medication is stored at the correct temperature.
The rationale for introducing yourself to the patient is ___________.
To build trust.
To check their medical records.
To diagnose their illness immediately.
To administer medication.
The rationale for identifying the patient using at least two identifiers is ___________.
To ensure correct patient receives intervention. To maintain patient safety.
To reduce paperwork for healthcare staff.
To speed up the admission process.
To comply with insurance requirements only.
The rationale for explaining the procedure to the patient is ___________.
To relieve patient’s anxiety and maintain patient’s cooperation.
To increase the duration of the procedure.
To confuse the patient about the treatment.
To delay the start of the procedure.
The rationale for discussing the purpose of each medication, action, and possible adverse effects is ___________.
Patient has right to be informed, and patient’s understanding of each medication improves adherence to drug therapy.
To reduce the cost of medication for the patient.
To ensure the patient can self-prescribe in the future.
To minimize the time spent on patient education.
The rationale for keeping patient’s privacy is ___________.
Patient’s right.
Doctor’s convenience.
Hospital policy only.
To avoid paperwork.
The rationale for disinfecting your hands is ___________.
To prevent infection.
To improve skin color.
To moisturize the skin.
To remove jewelry.
The rationale for wearing disposable gloves is __________.
To prevent infection.
To keep hands warm.
To improve grip strength.
To make hands look professional.
The rationale for checking 14 rights of medication administration is _________.
To keep patient’s safety.
To reduce paperwork.
To increase medication costs.
To speed up the process.
The rationale for preparing medication from vial or ampule is ___________.
To administer correct dose to the patient.
To increase the shelf life of the medication.
To reduce the potency of the drug.
To make the medication taste better.
What is the correct way to hold the syringe before an injection?
Between thumb and index of dominant hand
Between thumb and index of non-dominant hand
With both hands
With only the index finger
What is the purpose of applying the Z-track technique by pulling the skin during an injection?
To prevent leakage of medication into subcutaneous tissues, seal medication in the muscle, and minimize irritation
To make the injection faster
To reduce pain only
To avoid using a syringe
At what angle should the needle be inserted with the dominant hand during an intramuscular injection?
45 degrees
60 degrees
90 degrees
30 degrees
Why should you support the tip of the lure lock of the syringe with the non-dominant hand during an injection?
To stabilize the syringe and prevent discomfort.
To increase the speed of injection.
To reduce the dosage of medication.
To make the needle sharper.
Why is aspiration performed during an injection?
To avoid injection in any blood vessel either (vein or artery).
To increase the speed of injection.
To reduce the pain of injection.
To ensure the medication is mixed properly.
If blood appears in the syringe during injection, what should you do?
Withdraw the needle, discard the syringe and prepare a new injection.
Continue injecting as planned.
Push the plunger slowly to see if the blood disappears.
Shake the syringe to mix the blood and medication.
If no blood return in the syringe, inject the prescribed medication amount slowly. What is the rationale for this step?
To reduce pain and tissue trauma and reduces chance of leakage of medication back through needle track.
To maintain infection control.
To ensure continuity of care.
Why should you wait 10 seconds, then quickly withdraw the needle at the same angle at which it was inserted?
To allow time for medication to be absorbed into muscle before removing syringe.
To prevent the needle from bending during withdrawal.
To reduce the risk of air bubbles entering the muscle.
To ensure the injection site remains sterile.
What is the rationale for this step?
To prevent irritation to tissues. Massage damages underlying tissue.
To increase blood flow to the area.
To promote faster healing of wounds.
To reduce the risk of infection.
After injection, where should you discard the needle?
In a sharp container.
In a regular trash bin.
In a recycling bin.
In a sink.
In a plastic bag.
Why is it important to remove and discard gloves after injection?
To prevent transmission of infection.
To save gloves for future use.
To make the process faster.
To avoid staining the gloves.
What is the purpose of washing hands after injection?
To maintain infection control.
To increase blood pressure.
To reduce pain from injection.
To improve digestion.
Why should you record in the patient’s medication chart (date, time, and signature of the nurse) after injection?
To ensure continuity of care.
To increase paperwork for nurses.
To delay patient discharge.
To confuse other healthcare staff.
What is the rationale for this step?
For early detection to any abnormality.
To delay the diagnosis of disease.
To increase the risk of complications.
To avoid any medical intervention.
Why should you report significant deviations from normal to the primary care provider after injection?
To maintain patient's safety.
To reduce paperwork.
To avoid patient interaction.
To speed up the process.
Refer to the diagram and description of the Z-track ("Zig-zag") injection. What is the first step in the Z-track injection technique?
Insert the needle
Tense the tissue laterally at the injection site
Withdraw the needle
Release the tissue
Refer to the diagram and description of the Z-track ("Zig-zag") injection. After the injection, the tissues are slowly ______ while the needle is withdrawn.
released
compressed
stretched
twisted
Refer to the diagram and description of the Z-track ("Zig-zag") injection. What is the purpose of tensing the tissue laterally at the injection site before inserting the needle?
To make the injection less painful
To pull the skin, subcutaneous tissue, and fat planes into a "Z" formation
To increase blood flow
To reduce the amount of medication needed
Refer to the diagram and description of the Z-track ("Zig-zag") injection. True or False: The track is sealed as each tissue plane slides by the other after the injection.
True
False
