Identify the image

NORCET 9 Prelims-2025

Nursing Foundation

Medium

Appeared in: NORCET 9 Prelims-2025

Explanation

The image shows an intradermal injection, identified by the shallow 10-15 degree angle of the needle and the formation of a distinct, raised bleb (wheal) on the skin.
This specific technique, especially when performed on the volar (inner) aspect of the forearm, is characteristic of the Mantoux test (tuberculin skin test).
The purpose of injecting into the dermis is to create a localized reaction for easy observation, as the dermis has slow absorption and is rich in immune cells.
The option 'Montax' is a common misspelling of 'Mantoux', which is the correct term for this procedure.

Option A: Gardasil is the HPV vaccine, which is administered intramuscularly (IM), deep into the deltoid muscle, not intradermally.
Option B: Heparin is an anticoagulant administered subcutaneously (into the fatty tissue, often in the abdomen) or intravenously (IV).
Option D: This option is incorrect because the procedure shown is clearly identifiable as a Mantoux test, even with the misspelling in the original options.

Visual 1: Diagram: A comparative diagram showing the angles of insertion for Intradermal (10-15°), Subcutaneous (45-90°), and Intramuscular (90°) injections, highlighting the different skin layers targeted.
Visual 2: Infographic: A step-by-step guide on how to correctly administer and read a Mantoux test, including images of positive and negative results (induration).
Visual 3: Chart: A visual chart comparing different routes of parenteral medication administration (ID, SC, IM, IV) with examples of medications for each route.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of injection techniques and associated medical tests as background academic context rather than a clinical decision trigger.
Correctly identifying and performing injection techniques is a fundamental nursing skill crucial for patient safety and test accuracy. Using the wrong technique can lead to incorrect test results, medication errors, or patient injury.
For the Mantoux test, an incorrect injection (e.g., too deep, resulting in no bleb) can cause a false-negative result, potentially delaying the diagnosis and treatment of tuberculosis.
A nurse must be able to differentiate between a localized reaction to the injection itself and a true positive induration, which requires careful assessment 48-72 hours later.

How to Approach the Question

First, carefully analyze the image for key visual cues. Note the location on the body (forearm), the equipment (syringe), the angle of the needle, and the skin's reaction (formation of a bleb).
Recognize the technique shown is an intradermal injection, characterized by the shallow angle and the wheal.
Next, evaluate each option based on your knowledge of medication and vaccine administration routes.
Eliminate options that are administered via different routes. Gardasil is intramuscular, and Heparin is subcutaneous or intravenous.
Identify that 'Montax' is a likely misspelling of 'Mantoux', which is the test that uses the exact intradermal technique shown in the image.
Conclude that the image depicts a Mantoux test, making the corrected option the right answer.

Concept Tested & Keywords

Concept Tested: Identification of injection techniques and associated medical tests.
Stem keywords: Identify, image, injection, forearm
Lead-in keywords: Identify the image
Clinical cues: Presence of a bleb/wheal on the forearm after injection.

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