APHA Injection Safety & Infection Control 2 — Questions and Answers
Question 1: What is the maximum recommended injection volume for a single IM injection in the deltoid muscle of an adult?
- 0.5 mL
- 5 mL
- 1 mL
- 2 mL (Correct answer)
Correct answer: 2 mL
The deltoid muscle can accommodate up to 2 mL per injection; larger volumes should be divided or administered in a larger muscle group such as the vastus lateralis.
Question 2: After withdrawing the needle from a patient using a safety syringe, when should the safety mechanism be activated?
- After washing hands following the injection
- Immediately after the needle is withdrawn from the patient (Correct answer)
- Just before placing the syringe in the sharps container
- After documenting the vaccine administration
Correct answer: Immediately after the needle is withdrawn from the patient
Safety devices must be activated immediately after needle withdrawal to eliminate the window of exposure to the unsheathed needle.
Question 3: Under OSHA's Bloodborne Pathogens Standard, what must an employer provide to a worker following a needlestick injury?
- Immediate termination of duties for 48 hours
- Post-exposure evaluation and follow-up at no cost to the worker (Correct answer)
- Self-reporting documentation only, with no required employer action
- Mandatory HIV testing of the source patient without consent
Correct answer: Post-exposure evaluation and follow-up at no cost to the worker
OSHA's Bloodborne Pathogens Standard requires employers to provide post-exposure evaluation and follow-up at no cost to the employee after a needlestick event.
Question 4: According to current CDC/ACIP guidelines, should a vaccine administrator aspirate (pull back on the plunger) before injecting a vaccine intramuscularly?
- Yes, aspiration is required for all IM injections to prevent intravascular injection
- Yes, but only for SC injections
- No, aspiration is not recommended for routine vaccine administration (Correct answer)
- Yes, aspiration is required in patients on anticoagulants
Correct answer: No, aspiration is not recommended for routine vaccine administration
CDC and ACIP no longer recommend aspiration before routine IM vaccine injections, as evidence does not support the benefit and it increases patient discomfort.
Question 5: What is the correct skin preparation technique before administering a vaccine injection?
- Wipe the site with an alcohol swab and inject immediately while still wet
- Wipe the site with an alcohol swab and allow the skin to dry before injecting (Correct answer)
- Apply povidone-iodine and wait 3 minutes before injecting
- No skin preparation is necessary for routine vaccine injections
Correct answer: Wipe the site with an alcohol swab and allow the skin to dry before injecting
Alcohol should be applied and allowed to dry completely before injection to ensure effective disinfection and prevent stinging from residual alcohol.
Question 6: Regarding personal protective equipment (PPE) during routine vaccine administration, which statement is most accurate?
- Full gowns and face shields are required for all vaccine administrations
- Gloves are recommended and required when blood contact is anticipated, though not universally mandated by OSHA for routine injections (Correct answer)
- No PPE is needed since vaccines are not themselves bloodborne pathogens
- Double-gloving is required for all immunization procedures
Correct answer: Gloves are recommended and required when blood contact is anticipated, though not universally mandated by OSHA for routine injections
OSHA does not universally mandate gloves for routine injections but requires them when blood contact is likely; many public health guidelines recommend gloves as standard practice.
Question 7: Sharps containers should be sealed and disposed of when they reach what fill level?
- Completely full to maximize container use
- Three-quarters (¾) full (Correct answer)
- Half (½) full
- One-quarter (¼) full
Correct answer: Three-quarters (¾) full
Sharps containers should be sealed and disposed of when ¾ full; filling beyond this risks needlestick injury when accessing or sealing the container.
APHA Injection Safety & Infection Control 2
What is the maximum recommended injection volume for a single IM injection in the deltoid muscle of an adult?