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A nurse is planning to administer an IM injection into a client's deltoid muscle. Which of the following actions should the nurse take?

A.

Inject the medication 12.7 cm (5 in) below the client's acromion process

B.

Use a 21-gauge needle for the injection

C.

Inject the medication at a 90-degree angle

D.

Inject a volume of less than 2 mL

Answer and Explanation

The Correct Answer is D

A. Injecting the medication 12.7 cm (5 in) below the acromion process is incorrect; the injection site should be approximately 2.5 to 5 cm (1 to 2 inches) below the acromion process.  

 

B. A 21-gauge needle may be appropriate for some IM injections, but a 23- to 25-gauge needle is commonly used for deltoid injections due to the smaller muscle mass.  

 

C. While IM injections into the deltoid are typically given at a 90-degree angle, the volume of medication is the critical factor for this injection site.  

 

D. Injecting a volume of less than 2 mL is correct, as the deltoid muscle can accommodate this amount effectively, while larger volumes should be administered in larger muscles like the vastus lateralis or gluteus medius.


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View Related questions

Correct Answer is A

Explanation

A. Fish, particularly fatty fish such as salmon, mackerel, and sardines, are excellent sources of omega-3 fatty acids, which are beneficial for heart health and reducing inflammation.

B. Leafy green vegetables contain some omega-3 fatty acids, but they are not considered a primary source compared to fish.

C. Dietary supplements can provide omega-3s, but they are not food sources and may not be necessary if individuals can obtain omega-3s from their diet.

D. Corn oil is primarily high in omega-6 fatty acids, which do not provide the same benefits as omega-3s and can lead to an imbalance if consumed in excess.

Correct Answer is A

Explanation

A. Using attentive listening with the client demonstrates the principle of presence by showing that the nurse is fully engaged and invested in the client's experience, fostering a collaborative relationship.

B. While focusing on the client’s present circumstances is important, the personal stories shared by clients can provide context and enhance understanding, so limiting this aspect is not ideal.

C. Offering personal thoughts and beliefs can shift the focus away from the client and is generally not appropriate in professional communication.

D. While verbalizing understanding is a supportive action, it does not fully encapsulate the principle of presence, which emphasizes active engagement and listening.

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