Editing Nursing Skills and Procedures – RN Practice Questions (section)

==Question 12==
A registered nurse must administer 3 mL of a viscous intramuscular antibiotic to an adult client. Which site should the nurse select, and how should the injection be given?
# Deltoid, at a 90 degree angle, without Z-track.
# Dorsogluteal, at a 90 degree angle, using Z-track.
# Ventrogluteal, at a 90 degree angle, using Z-track.
# Vastus lateralis, at a 45 degree angle, using Z-track.

'''Answer:''' 3 (C). Ventrogluteal, at a 90 degree angle, using Z-track.

''Rationale:'' The ventrogluteal site accommodates up to about 3 mL in an adult, is free of major nerves and large vessels, and is preferred for viscous or irritating medications. Z-track technique seals the medication in the muscle and prevents tracking into subcutaneous tissue. The deltoid in option 1 holds only about 1 mL and is too small for this volume. The dorsogluteal site in option 2 is no longer recommended because of sciatic nerve injury risk. Intramuscular injections are given at 90 degrees, not 45 degrees, so option 4 is incorrect in technique even though the vastus lateralis is an acceptable site.