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

PGIMER Chandigarh NO - 2015

Nursing Foundation

Easy

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

The tuberculin skin test (Mantoux test) is administered via the intradermal (ID) route.
Intradermal injections require a shallow insertion angle of 5 to 15 degrees to ensure the medication is delivered into the dermis.
This technique creates a visible, raised wheal (or bleb) of 6 to 10 mm in diameter, indicating the test was administered correctly.
The shallow angle ensures the needle tip, with the bevel facing up, is visible through the skin during insertion.

Option B: A 30° angle is too steep for an intradermal injection and too shallow for a typical subcutaneous or intramuscular injection. It does not correspond to a standard parenteral administration route.
Option C: A 45° angle is used for subcutaneous (SC) injections, which deliver medication into the fatty tissue below the dermis.
Option D: A 90° angle is used for intramuscular (IM) injections to deliver medication deep into a muscle. It is also used for subcutaneous injections in patients with more adipose tissue.

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.
Correct administration of a tuberculin skin test is crucial for accurate screening of tuberculosis. An injection that is too deep can cause the PPD solution to be absorbed too quickly, potentially leading to a false-negative result.
A key nursing action is to observe for the formation of a distinct, pale wheal at the injection site. The absence of a wheal indicates an improper technique, and the test may need to be repeated.
What if? If the patient has very thin, fragile skin (e.g., an elderly patient), the nurse should use an even shallower angle, closer to 5 degrees, and be extra cautious to avoid injecting too deeply.

How to Approach the Question

First, identify the procedure mentioned in the question: a 'tuberculin skin test'.
Recall the standard route of administration for this specific test. The tuberculin test is a classic example of an intradermal injection.
Access your knowledge of parenteral injection techniques. Each route (intradermal, subcutaneous, intramuscular) has a specific range of appropriate needle angles.
Match the intradermal route with its correct angle. The standard angle for an intradermal injection is very shallow, between 5 and 15 degrees.
Evaluate the given options and select the one that falls within the correct range for an intradermal injection.

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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