APHA Administration Techniques & Routes 2 — Questions and Answers
Question 1: When administering a vaccine intramuscularly to a 4-month-old infant, which site is preferred?
- Deltoid muscle
- Anterolateral thigh (Correct answer)
- Ventrogluteal site
- Dorsogluteal site
Correct answer: Anterolateral thigh
The anterolateral thigh (vastus lateralis) is the preferred IM injection site for infants because it has sufficient muscle mass and is easily accessible.
Question 2: For subcutaneous (SC) vaccine injections, the needle is typically inserted at which angle?
- 90 degrees
- 45 degrees (Correct answer)
- 15 degrees
- 60 degrees
Correct answer: 45 degrees
SC injections are administered at a 45-degree angle to place vaccine into the subcutaneous tissue layer beneath the skin.
Question 3: A patient is receiving Td vaccine. After aspirating the syringe, no blood appears. What is the current CDC/ACIP recommendation regarding aspiration?
- Aspiration is required before all IM vaccine injections
- Aspiration is no longer recommended for routine IM vaccine administration (Correct answer)
- Aspirate only when injecting into the deltoid
- Aspirate for 5 seconds before injecting any vaccine
Correct answer: Aspiration is no longer recommended for routine IM vaccine administration
ACIP no longer recommends aspiration for IM vaccine injections because the intended injection sites do not contain large blood vessels.
Question 4: Which vaccine is administered via the intranasal route?
- Inactivated influenza vaccine (IIV)
- Live attenuated influenza vaccine (LAIV) (Correct answer)
- Pneumococcal vaccine (PPSV23)
- Hepatitis A vaccine
Correct answer: Live attenuated influenza vaccine (LAIV)
LAIV (FluMist) is the only vaccine routinely administered intranasally, delivered as a spray into each nostril.
Question 5: When multiple vaccines are administered at the same visit, what is the recommended approach for injection site selection?
- Use only one limb to minimize trauma
- Administer all injections in the same site 1 inch apart
- Use separate anatomic sites, preferably different limbs (Correct answer)
- Rotate between arms and legs with at least 2 days apart
Correct answer: Use separate anatomic sites, preferably different limbs
Each vaccine should be administered at a separate anatomic site, ideally in different limbs, to allow attribution of local reactions to specific vaccines.
Question 6: The rotavirus vaccine (RV1, RV5) is administered via which route?
- Intramuscular
- Subcutaneous
- Oral (Correct answer)
- Intradermal
Correct answer: Oral
Rotavirus vaccines are oral vaccines delivered as liquid drops directly into the infant's mouth.
Question 7: What needle length is generally recommended for IM injection in an adult with average body weight (60–90 kg)?
- 5/8 inch
- 1 inch (Correct answer)
- 1.5 inches
- 2 inches
Correct answer: 1 inch
A 1-inch needle is recommended for IM injection in average-weight adults (60–90 kg) to reliably reach deltoid muscle.
APHA Administration Techniques & Routes 2
When administering a vaccine intramuscularly to a 4-month-old infant, which site is preferred?