When administering a tuberculin skin test, the nurse should insert needle at a?

DHS 2018 shift 1st

Nursing Foundation

Easy

Appeared in: DHS 2018 shift 1st

Explanation

A tuberculin skin test is administered via an intradermal (ID) injection.
The purpose of an ID injection is to deposit the substance into the dermis, the layer of skin just below the epidermis.
This technique requires a shallow insertion angle of 5 to 15 degrees, with the needle's bevel facing up.
Correct administration is confirmed by the appearance of a small, raised bleb or wheal on the skin's surface.

Option B: A 30-degree angle is not a standard angle for any of the three main parenteral injection routes. It is too steep for an intradermal injection and generally too shallow for a subcutaneous or intramuscular injection.
Option C: A 45-degree angle is used for subcutaneous (SC) injections, which deliver medication into the fatty tissue beneath the skin. Injecting tuberculin into this layer would lead to rapid absorption and an inaccurate test result.
Option D: A 90-degree angle is used for intramuscular (IM) injections to deliver medication deep into a muscle. This is far too deep for a tuberculin test.

Clinical Relevance

Nursing practice connection: Knowing Parenteral medication administration: Intradermal injection technique helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Using the correct 5-15 degree angle is critical for the accuracy of a tuberculin skin test. If the needle goes too deep (subcutaneously), the tuberculin PPD may be absorbed systemically, leading to a false-negative result.
The formation of a distinct bleb is the nurse's immediate visual confirmation of a correctly administered intradermal injection.
What if? If a bleb does not form or if the injection site bleeds after needle withdrawal, it suggests the injection was given too deeply. The test is considered invalid and must be repeated at another site, usually on the other arm or at least 2 inches away from the first site.

How to Approach the Question

First, identify the key procedure in the question: 'tuberculin skin test'.
Next, recall the specific route of administration for this procedure. Tuberculin tests are a form of diagnostic skin testing, which always uses the intradermal (ID) route.
Access your knowledge of the different parenteral injection techniques and their corresponding needle angles.
Remember that ID injections are the most superficial, requiring the shallowest angle (5-15 degrees) to ensure the substance is deposited just under the epidermis into the dermis.
Compare this required angle to the options provided. The 15° option falls squarely within the correct range.
Eliminate the other options by associating them with their correct routes: 45° for subcutaneous and 90° for intramuscular.

Concept Tested & Keywords

Concept Tested: Parenteral medication administration: Intradermal injection technique
Stem keywords: tuberculin skin test, administering, insert needle, angle
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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