Certified Medical Assistant (CMA AAMA)PharmacologyMedium

A medical assistant is preparing to administer a viscous intramuscular penicillin injection to an adult patient. Which needle gauge is most appropriate?

  1. A18 gauge
  2. B27 gauge
  3. C21 gauge
  4. D25 gauge
Show answer & explanation

Correct answer: C. 21 gauge

Viscous medications require a larger-diameter (lower gauge number) needle to allow the thick solution to pass through easily; 21-23 gauge is standard for IM injections of viscous drugs like penicillin. Gauges 25-27 are too fine and may clog or bend, while 18 gauge is typically reserved for drawing up medication or IV access, not IM injection.

Why the other options are wrong

  • A. 18 gauge is too large for routine IM injection and is more commonly used for withdrawing medication from vials.
  • B. 27 gauge is used for very small volumes such as intradermal injections, not viscous IM injections.
  • D. 25 gauge is too narrow and may not allow a thick solution to pass smoothly.

Needle Gauge Selection

Gauge number is inversely related to needle diameter; lower numbers indicate larger bore needles suited for viscous or larger-volume medications.

  • 18-20 gauge: drawing up medication or thick solutions
  • 21-23 gauge: standard IM injections
  • 25-27 gauge: subcutaneous or intradermal injections

Memory trick: 'Lower gauge, bigger hole, thicker flow'

More Pharmacology questions