Medication Preparation and Administration of an Intramuscular Injection: Lesson 1

1. The parts of a needle used for medication injection include:

            a) Bevel

            b) Lumen

            c) Shaft

            d) All of the above

 

2. When removing medication from a vial, the nurse should do all of the following EXCEPT:

            a) Swab the rubber top with alcohol and allow to dry

            b) Draw up the medication with the vial on a flat surface

            c) Pierce the rubber stopper in center with the needle tip

            d) Touch the plunger at the knob only

 

3. Which of the following is the FIRST step when preparing to administer an intramuscular injection?

            a) Identify self and patient

            b) Hand hygiene

            c) Draw up medication in a syringe

            d) Check physicianÕs order

 

4. The nurse is preparing to administer an intramuscular injection.  After she draws up the medication, the uncapped needle tip touches the clean counter.  What should the nurse do next?

            a) Replace the needle with a new one

            b) Continue with the preparation and administration

            c) Wipe the needle off with alcohol

            d) Discard both the needle and syringe

 

5. When reconstituting medication in a vial, all of the following are correct EXCEPT:

            a) Draw up the appropriate amount of diluent into the syringe

            b) Insert the needle or blunt cannula through the center of the self-sealing stopper on

     the powdered medication vial

            c) Shake the vial to mix the powdered medication and diluent

            d) Inject the diluent into the powdered medication vial

 

6. After the nurse cleanses the rubber top of the vial with an alcohol wipe, the top should be dry before withdrawing its contents.  Drying is accomplished by:

            a) Wiping the top of the vial with a dry gauze

            b) Blowing off the top of the vial

            c) Waving a hand above the vial to create moving air

            d) Allowing the rubber top to air dry

 

 

7. When mixing medications from two vials in one syringe, which of the following is correct?

            a) After injecting air into the second vial, invert the vial and draw up the prescribed

     amount of medication

            b) After injecting air into the first vial, invert the vial and draw up the prescribed amount

     of medication

            c) Inject air into the first vial only

            d) Inject air into the second vial only

 

8. The medication order requires the nurse to withdraw 2 ml of medication from a vial.  After injecting air into the vial, what is the nurseÕs next step before withdrawing the medication?

            a) Invert the vial and keep the needle or blunt cannula below the fluid level

            b) Invert the vial and keep the needle or blunt cannula above the fluid level

            c) Hold the vial on a flat surface and keep the needle or blunt cannula below the fluid

     level

            d) Hold the vial on a flat surface and keep the needle or blunt cannula above the fluid

     level

 

9.  The label on the medication vial must be checked during medication preparation or administration.  The nurse must read the label:

            a) When the nurse reaches for the medication vial

            b) After retrieving the medication vial from the drawer and compared with the

     Medication Administration Record (MAR)

            c) When the nurse returns the vial to the drawer or before administering to the patient

            d) All of the above

 

10. The ÒRights of Medication AdministrationÓ used to help ensure accuracy when    administering medications include all of the following EXCEPT:

            a) Right medication

            b) Right patient

            c) Right dosage

            d) Right room

            e) Right route

            f) Right time

 

 

 

Answers: Medication Preparation and Administration of an Intramuscular Injection: Lesson 1

1. The parts of a needle used for medication injection include:

            a) Bevel

            b) Lumen

            c) Shaft

            d) All of the above

 

2. When removing medication from a vial, the nurse should do all of the following EXCEPT:

            a) Swab the rubber top with alcohol and allow to dry

            b) Draw up the medication with the vial on a flat surface

            c) Pierce the rubber stopper in center with the needle tip

            d) Touch the plunger at the knob only

 

3. Which of the following is the FIRST step when preparing to administer an intramuscular injection?

            a) Identify self and patient

            b) Hand hygiene

            c) Draw up medication in a syringe

            d) Check physicianÕs order

 

4. The nurse is preparing to administer an intramuscular injection.  After she draws up the medication, the uncapped needle tip touches the clean counter.  What should the nurse do next?

            a) Replace the needle with a new one

            b) Continue with the preparation and administration

            c) Wipe the needle off with alcohol

            d) Discard both the needle and syringe

 

5. When reconstituting medication in a vial, all of the following are correct EXCEPT:

            a) Draw up the appropriate amount of diluent into the syringe

            b) Insert the needle or blunt cannula through the center of the self-sealing stopper on

     the powdered medication vial

            c) Shake the vial to mix the powdered medication and diluent

            d) Inject the diluent into the powdered medication vial

 

6. After the nurse cleanses the rubber top of the vial with an alcohol wipe, the top should be dry before withdrawing its contents.  Drying is accomplished by:

            a) Wiping the top of the vial with a dry gauze

            b) Blowing off the top of the vial

            c) Waving a hand above the vial to create moving air

            d) Allowing the rubber top to air dry

 

 

7. When mixing medications from two vials in one syringe, which of the following is correct?

            a) After injecting air into the second vial, invert the vial and draw up the prescribed

     amount of medication

            b) After injecting air into the first vial, invert the vial and draw up the prescribed amount

     of medication

            c) Inject air into the first vial only

            d) Inject air into the second vial only

 

8. The medication order requires the nurse to withdraw 2 ml of medication from a vial.  After injecting air into the vial, what is the nurseÕs next step before withdrawing the medication?

            a) Invert the vial and keep the needle or blunt cannula below the fluid level

            b) Invert the vial and keep the needle or blunt cannula above the fluid level

            c) Hold the vial on a flat surface and keep the needle or blunt cannula below the fluid

     level

            d) Hold the vial on a flat surface and keep the needle or blunt cannula above the fluid

     level

 

9.  The label on the medication vial must be checked during medication preparation or administration.  The nurse must read the label:

            a) When the nurse reaches for the medication vial

            b) After retrieving the medication vial from the drawer and compared with the

     Medication Administration Record (MAR)

            c) When the nurse returns the vial to the drawer or before administering to the patient

            d) All of the above

 

10. The ÒRights of Medication AdministrationÓ used to help ensure accuracy when    administering medications include all of the following EXCEPT:

            a) Right medication

            b) Right patient

            c) Right dosage

            d) Right room

            e) Right route

            f) Right time

 

 

 

Medication Preparation and Administration of an Intramuscular Injection: Lesson 2

1.      All of the following are appropriate sites for the administration of an intramuscular injection except:

a.     Deltoid muscle

b.     Gluteus maximus

c.      Vastus lateralis

d.     Ventrogluteal

 

2.     Possible complications of improper technique when administering an intramuscular injection include which of the following:

a.     Abscesses

b.     Lingering pain

c.      Tissue necrosis

d.     All of the above

 

3.     The angle for injecting the needle when administering an intramuscular injection is:

a.     5-15 degrees

b.     45 degrees

c.      60 degrees

d.     90 degrees

 

4.     The appropriate needle length for administering an intramuscular injection in the Vastus lateralis is:

a.     3/4 inch

b.     1/2 inch

c.      1 inch

d.     3 inches

 

5.      Which of the following appropriate landmark (s) is used by the nurse to identify the Vastus lateralis?

a.     Acromion process

b.     Patella

c.      Clavicle

d.     Greater trochanter

e.     a and c

f.      b and d

 

6.     All of the following equipment is necessary for administering an intramuscular injection except:

a.     Sterile gloves

b.     Sterile syringe

c.      Appropriate needle

d.     Small gauze pad

e.     Medication

 

7.     Which of the following appropriate landmark (s) is used by the nurse to identify the Ventrogluteal site for an intramuscular injection?

a.     Anterior superior iliac spine

b.     Coccyx

c.      Greater trochanter

d.     a and b

e.     a and c

 

8.     The student observes a nurse giving an intramuscular injection to a patient.  The nurse darts the needle quickly into the prepared site.  The student understands that the medication is injected quickly because:

a.     The patient is really uncomfortable

b.     A quick injection is less painful

c.      The nurse is in a hurry

d.     The patient is afraid of needles

 

9.     Place the following steps for administering an intramuscular injection in the correct order:

1.     Remove the needle cap

2.     Withdraw the needle smoothly and apply gentle pressure

3.     Cleanse the area around the injection site

4.     Inject the medication slowly

5.     Quickly dart the needle into the tissue

6.     Displace the skin with nondominant hand

 

a.     3, 1, 5, 6, 4, 2

b.     3, 1, 6, 5, 4, 2

c.      1, 3, 6, 5, 4, 2

d.     3, 1, 5, 4, 2, 6

 

10. While injecting a needle into a patient, you hit the patientÕs bone.  What should you do next?

      a.   Withdraw and discard the needle

      b.   Apply new needle to syringe and administer in alternate site

      c.   Document incident in patientÕs medical record

      d.   All of the above

 

 

 

Medication Preparation and Administration of an Intramuscular Injection: Lesson 2

1.  All of the following are appropriate sites for the administration of an intramuscular   injection except:

a.     Deltoid muscle

b.     Gluteus maximus

c.      Vastus lateralis

d.     Ventrogluteal

 

2. Possible complications of improper technique when administering an intramuscular injection include which of the following:

a.    Abscesses

b.    Lingering pain

c.    Tissue necrosis

d.    All of the above

 

3. The angle for injecting the needle when administering an intramuscular injection is:

a.    5-15 degrees

b.   45 degrees

c.   60 degrees

d.   90 degrees

 

4. The appropriate needle length for administering an intramuscular injection in the Vastus lateralis is:

a.   3/4 inch

b.   1/2 inch

c.   1 inch

d.   3 inches

 

5.   Which of the following appropriate landmark (s) is used by the nurse to identify the Vastus lateralis?

a.   Acromion process

b.   Patella

c.   Clavicle

d.   Greater trochanter

e.     a and c

f.      b and d

 

6.  All of the following equipment is necessary for administering an intramuscular injection except:

a.   Sterile gloves

b.   Sterile syringe

c.   Appropriate needle

d.   Small gauze pad

e.   Medication

 

7.  Which of the following appropriate landmark (s) is used by the nurse to identify the Ventrogluteal site for an intramuscular injection?

a.    Anterior superior iliac spine

b.   Coccyx

c.   Greater trochanter

d.   a and b

e.   a and c

 

8.  The student observes a nurse giving an intramuscular injection to a patient.  The nurse darts the needle quickly into the prepared site.  The student understands that the medication is injected quickly because:

a.   The patient is really uncomfortable

b.   A quick injection is less painful

c.   The nurse is in a hurry

d.   The patient is afraid of needles

 

9.  Place the following steps for administering an intramuscular injection in the correct order:

1.    Remove the needle cap

2.   Withdraw the needle smoothly and apply gentle pressure

3.   Cleanse the area around the injection site

4.   Inject the medication slowly

5.   Quickly dart the needle into the tissue

6.   Displace the skin with nondominant hand

 

a.   3, 1, 5, 6, 4, 2

b.   3, 1, 6, 5, 4, 2

c.   1, 3, 6, 5, 4, 2

d.   3, 1, 5, 4, 2, 6

 

10.  While injecting a needle into a patient, you hit the patientÕs bone.  What should you do next?

      a.   Withdraw and discard the needle

      b.   Apply new needle to syringe and administer in alternate site

      c.   Document incident in patientÕs medical record

      d.   All of the above

 

   Summative Test Questions

 

1.  The nurse walks into a patientÕs room to administer an injection.  What is the FIRST step the nurse

      should take before administering?

                  a.  check the patientÕs arm band

                  b.  wash her hands

                  c.  apply clean gloves

                  d.  clean the injection site

 

2.  The parts of a syringe and needle include all of the following EXCEPT:

                  a.  needle hub

                  b.  stopper

                  c.  barrel

                  d.  plunger

 

3.  When mixing medications from two vials in one syringe, the nurse draws up 3 ml instead of 2 ml of

      medication from the first vial.  What should the nurse do?

                  a.  expel 1 ml of the medication in the syringe into the sink

                  b.  inject 1 ml of the medication in the syringe back into the first vial

                  c.  give the patient 3 ml instead of 2 ml of medication

                  d.  throw away the syringe of medication and start over

 

4.  When reconstituting medication in a vial, which of the following is CORRECT?

                  a.  gently agitate the vial to mix the powdered medication and diluent completely

                  b.  insert the needle or blunt cannula through the center of the self-sealing stopper on the

                       powdered medication vial

                  c.  inject the diluent into the powdered medication vial

                  d.  all of the above

 

5.  When removing medication from a vial, the nurse should do all of the following EXCEPT:

                  a.  swab the rubber top with alcohol and blow on to help dry

                  b.  touch the plunger at the knob only

                  c.  pierce the rubber stopper in the center with the needle tip

                  d. draw up the medication with the vial inverted

 

6.  To administer an intramuscular injection correctly, the nurse must:

                  a.  select the appropriate equipment

                  b.  select the appropriate location

                  c.  use the correct technique

                  d.  all of the above

 

7.  To help decrease patient pain when giving an injection, the nurse should do all of following EXCEPT:

                  a.  withdraw the needle quickly and smoothly

                  b.  maintain a firm grasp on the syringe/needle

                  c.  inject the medication quickly

                  d.  encourage the patient to relax

 

 

 

8.  After giving an intramuscular injection the nurse should do all of the following EXCEPT:

                  a.  recap the needle

                  b.  remove gloves and perform hand hygiene

                  c.  make sure the patient is safe and comfortable

                  d.  document medication administration

 

9.  The correct needle length for administering an intramuscular injection is:

                  a.  3/4 inch  - 5/8 inch

                  b.  1/2 inch – 3/4 inch

                  c.  1 inch – 2 inch

                  d.  3 inch  - 4 inch

 

10.  The nurse knows that the appropriate gauge of the needle she uses will be determined by the:

                  a.  patient size

                  b.  site for injection

                  c.  viscosity of the medication

                  d.  patient age

 

 

 

 

 

 

Answer Key:

1.  b

2.  b

3.  d

4.  d

5.  a

6.  d

7.  c

8.  a

9.  c

10.c

Directions:  This activity will allow you to practice what you have learned in lessons 1 and 2. The equipment for practice may be purchased at the websites listed below or from a supplier of your choice.  After completing both lessons and reviewing the videos, you are to perform a simulated intramuscular injection using an orange (fruit).   You are required to video record yourself performing the simulation.  You will be expected to submit this video to your instructor for evaluation and feedback.

 

 

Disclaimer:  Only use for practice and in the manner described in this lesson. Only perform the injection on the inanimate object(s) described above.  Do not consume fruit following injection.

 

Supplies needed and where to obtain them:

 

Vitality Medical Syringe

Item number:    309575

3mL Syringe, 21 Gauge Needle 1 Inch Length (3cc Syringe with Regular Wall)

$0.35 each

 

Mountainside Medical Saline Vial

SKU:   H01966-07a

Sodium Chloride Injection USP 0.9% Bacteriostatic 30ml

$4.00 per vial

 

Orange (fruit) from local grocery store