Radiography Prep Questions
Partial restriction of blood supplied to the brain as a result of a temporary or mild occlusion of a cerebral vessel is referred to as (A) TIA (B) CVA (C) syncope (D) epistaxis
(A) A stroke, or cerebrovascular accident (CVA), is an interference with blood supplied to the brain as a result of occlusion or rupture of a cerebral vessel. If the condition results from a partial vessel occlusion, the interference is usually mild and temporary and is referred to as a transient ischemic attack (TIA). The patient may experience temporary blindness in one eye, dysphasia or aphasia, hemiparesis or hemiplegia, or anesthesia. Syncope is the feeling of lightheadedness, faintness, or dizziness. A patient should be immediately assisted to a chair. Bending forward and placing the head between the knees will often help relieve the lightheadedness as blood flow to the brain increases. A nosebleed (epistaxis) may be a result of any one of many causes, including hypertension, dry nasal mucous membranes, sinusitis, or trauma. The patient should be sitting or in a Fowler position. The radiographer should place cold cloths over the patient's nose and back of the neck.
Violations of the ARRT Rules of Ethics include 1. accepting responsibility to perform a function outside the scope of practice 2. failure to obtain pertinent information for the radiologist 3. failure to share newly acquired knowledge with peers (A) 1 only (B) 1 and 2 only (C) 1 and 3 only (D) 1, 2, and 3
(A) Accepting responsibility to perform a function outside the scope of practice is a violation of Ethical Rule #7, which states that it is a violation to "delegate or accept delegation of a radiologic technology function or any other prescribed health care function when the delegation or acceptance could reasonably be expected to create an unnecessary danger to a patient's life, health, or safety. Actual injury to a patient need not be established under this clause." So, accepting a responsibility outside the scope of practice is a violation of an ARRT rule. However, choices 2 and 3 are in violation of the aspirational Code of Ethics.
What is the name of the practice that serves to retard the growth of pathogenic bacteria? (A) Antisepsis (B) Bacteriogenesis (C) Sterilization (D) Disinfection
(A) Antisepsis retards the growth of pathogenic bacteria. Alcohol is an example of an antiseptic. Medical asepsis refers to the destruction of pathogenic microorganisms through the process of disinfection. Examples of disinfectants are hydrogen peroxide, chlorine, and boric acid. Surgical asepsis (sterilization) refers to the removal of all microorganisms and their spores (reproductive cells) and is practiced in the surgical suite. Bacteriogenesis refers to the formation of bacteria.
Blood pressure is measured in units of (A) mm Hg (B) beats per minute (C) degrees Fahrenheit (D) liters per minute (L/min)
(A) Blood pressure is measure in mm Hg. Heart rate, or pulse, is measured in units of beats per minute. Temperature is measured in degrees Fahrenheit. Oxygen delivered is measured in units of liters per minute (L/min). Blood pressure: 90-120/60-80 Pulse Rate: 60-80 BPM Temperature: 97.7-99.5 F Respiratory rate: 12-20 breaths/min
An individual's legal document identifying his/her specific wishes regarding medical care to be provided in the event that he/she is unable to make or communicate decisions is called: 1. advance health care directive 2. informed consent 3. last will and testament (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(A) Many people believe that potential legal and ethical issues can be avoided by creating an Advance Health Care Directive. Because all individuals have the right to make decisions regarding their own health care, this legal document preserves that right in the event an individual is unable to make or communicate those decisions. An Advance Health Care Directive lists the individual's specific wishes, names the individual authorized to make health care decisions, and can include specifics regarding DNR (do not resuscitate), DNI (do not intubate), and/or other end-of-life decisions.
Example(s) of negative contrast agents include 1. air 2. iodine 3. barium sulfate (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(A) Negative, or radiolucent, contrast agents used are air and various gases. Because the atomic number of air is also quite different from that of soft tissue, high subject contrast is produced. Carbon dioxide is absorbed more rapidly by the body than by air.
The usual patient preparation for a UGI examination is (A) NPO 8 hour before the examination (B) light breakfast only the morning of the examination (C) clear fluids only the morning of the examination (D) two ounces of castor oil and enemas until clear
(A) Patient preparation differs for various contrast examination. To obtain a diagnostic examination of the stomach, it must first be empty. The usual UGI preparation is NPO (nothing by mouth) after midnight (approximately 8 hour before the examination). Any material in the stomach can simulate the appearance of disease. An iodinated contrast agent, usually in the form of several pills, is taken by the patient the evening before a scheduled GB examination and only water is allowed the morning of the examination. The patient scheduled for a BE (lower GI) requires a large bowel that is very clean prior to the administration of barium; this requires the administration of cathartics (laxatives) and cleansing enemas. Preparation for an IVU requires that the patient be NPO after midnight; some institutions may require that the large bowel be cleansed of gas and fecal material. Aftercare for barium examinations is also very important. Patients are typically instructed to take milk of magnesia and to drink plenty of water. Because water is removed from the barium sulfate suspension in the large bowel, it is essential to make patients understand the important of these instructions to avoid barium impaction in the large bowel.
Which blood vessels are best suited for determination of pulse rate? (A) Superficial arteries (B) Deep arteries (C) Superficial veins (D) Deep veins
(A) Superficial arteries are best suited for determination of pulse rate. The five most easily palpated pulse points are the radial, carotid, temporal, femoral, and popliteal pulses. The radial pulse is the most frequently used pulse. The apical pulse, at the apex of the heart, is the most accurate and can be determined with the use of a stethoscope.
Which organization has the authority to impose professional sanction on a radiographer? (A) ARRT (B) ASRT (C) JRCRT (D) TJC
(A) The ARRT establishes principles of professional conduct to ensure the best services possible to patients entrusted to our care. These principles are detailed in the ARRT two-part Standards of Ethics, which includes the Code of Ethics and the Rules of Ethics. The 10-part Code of Ethics is aspirational; the 23 Rules of Ethics are enforceable and their violation can result in professional sanction. The ARRT Ethics Committee provides peer review of cases (misdemeanor, felony, etc.) to ensure adherence to standards of professional behavior and possession of the moral character required to practice in the health care professions. If the violator's actions demonstrate that moral character is lacking, that individual can be sanctioned - that is, reprimanded, suspended, revoked, ineligible for certification, and so on - or other sanctions deemed appropriate by the Ethics Committee
A patient's IV container should be hung: (A) 18-24 inches above the vein (B) 18-24 inches below the vein (C) 18-24 inches above the heart (D) 18-24 inches below the heart
(A) The IV container should be hung 18-24 inches above the level of the vein. If placed lower than the vein, solution will stop flowing and blood will return into the tubing. If hung too high, solution can run too fast. Occasionally, the position of the needle or catheter in the vein will affect the flow rate. If the bevel is adjacent to the vessel wall, flow may decrease or stop altogether. Often, just changing the position of the patient's arm will remedy the situation.
What should be the angle formed between the needle and the skin surface for an IV injection? (A) 15 (B) 45 (C) 60 (D) 90
(A) The antecubital vein is the most commonly used venipuncture site for contrast medium administration. The basilic vein, located on the dorsal surface of the hand, is used when the antecubital vein is inaccessible. The cephalic vein may also be used (see Fig 5-1). The needle is inserted into the vein at a 15 degree angle; blood will flow back into the tubing when the needle is correctly positioned. Strict aseptic technique must be used. The needle forms a 90 degree angle with the skin in intramuscular injections and a 45 degree angle in subcutaneous injections.
Which of the following diseases require(s) airborne precaution? 1. TB 2. Varicella 3. Rubella (A) 1 only (B) 1 and 2 only (C) 3 only (D) 1, 2, and 3
(B) Airborne precaution is implemented in patients suspected or known to be infected with the tubercle bacillus (TB), chickenpox (varicella), and measles (rubeola). Airborne precaution requires the patient to wear a surgical string mask to avoid the spread of acid-fast bacilli (in bronchial secretions) and other pathogens during coughing. If the patient is unable or unwilling to wear a mask, the radiographer must wear one. An N95 particular respirator is the mask required for health care workers. The radiographer should wear gloves, but a gown is required only if flagrant contamination is likely. Patients with airborne precautions require a private, specially ventilated (negative-pressure) room. A private room is indicated for all patient on droplet precaution, that is, diseases transmitted via large droplets expelled from the patient while speaking, sneezing, or coughing. The pathogenic droplets can infect others when they come in contact with mouth or nasal mucosa or conjunctiva. Rubella (German measles), mumps, and influenza are among the diseases spread by droplet contact; a private room is required for the patient, the health care practitioners must wear a mask. An N95 particulate respirator mask may be required while a patient with H1N1 is receiving an aerosol-generating procedure.
Parenteral administration of drugs may be performed 1. intrathecally 2. intravenously 3. orally (A) 1 only (B) 1 and 2 only (C) 3 only (D) 1, 2, and 3
(B) Although radiographic contrast media are usually administered orally or intravenously, there are a number of routes or methods of drug administration. Drugs and medications may be administered either orally or parenterally. Parenteral administration refers to any route other than the digestive tract (orally) and includes topical, subcutaneous, intradermal, intramuscular, intravenous, and intrathecal administration.
A radiographer who performs an x-ray examination on a patient without the patient's consent, or after the patient has refused the examination, may be liable for (A) assault (B) battery (C) slander (D) libel
(B) Assault is to threaten harm; battery is to carry out the threat. A patient may feel sufficiently intimidated to claim assault by a radiographer who threatens to repeat a difficult examination if the patient does not try to cooperate better. A radiographer who performs an examination on a patient without the patient's consent or after the patient has refused the examination may be liable for battery. A charge of battery may also be made against a radiographer who treats a patient roughly or who performs an examination on the wrong patient. A radiographer who discloses confidential information to unauthorized individuals may be found liable for invasion of privacy or defamation. A radiographer whose disclosure of confidential information is in some way detrimental to the patient may be accused of defamation. Spoken defamation is slander; written defamation is libel.
A radiographer should recognize that gerontologic patients often have undergone physical changes that include loss of 1. muscle mass 2. bone calcium 3. mental alertness (A) 1 only (B) 1 and 2 only (C) 1 and 3 only (D) 1, 2, and 3
(B) Gerontology, or geriatrics, is the study of the elderly. Although bone demineralization and loss of muscle mass occur to a greater or lesser degree in most elderly individuals, the radiographer must not assume that all gerontologic patients are hard of hearing, clumsy, or not mentally alert. Nowadays, many elderly people remain very active, staying mentally and physically agile well into their "golden years." The radiographer must keep this in mind as he/she provides age-specific care to the gerontologic patients.
Diseases that can be transmitted by direct contact include 1. skin infections 2. MDROs 3. malaria (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(B) Infectious microorganisms can be transmitted from one pt to other pts or to health care workers, and from health care worker to pts. They are transmitted by means of either direct or indirect contact. Direct contact involves touch. Diseases transmitted by direct contact include skin infections such as boils and MDROs (multidrug-resistant organisms). Indirect contact involves transmission of microorganisms via airborne contamination, fomites, and vectors. Pathogenic microorganisms expelled from the respiratory tract through the mouth or nose can be carried as evaporated droplets through the air or on dust and settle on intermediate objects such as clothing, utensils, or food. Pts with respiratory tract infections and diseases transported to the radiology department, therefore, should wear a mask to prevent such transmission during a cough or sneeze; it is not necessary for the health care professional or transporter to wear a mask (as long as the pt does). Many such microorganisms can remain infection while awaiting transmission to another host. A contaminated inanimate object such as a food utensil, doorknob, or IV pole is referred to as a fomite. A vector is an insect or animal carrier of infectious organisms, such as a rabid animal (e.g., rabies; although the rabid animal is the vector, rabies is contracted by contact), a mosquito that carries malaria, or a tick that carries Lyme disease.
The legislation that guarantees confidentiality of all pt information is: (A) HSS (B) HIPAA (C) HIPPA (D) MQSA
(B) Most institutions now have computerized, paperless systems for patient information transmittal (HIS); these systems must ensure confidentiality in compliance with Health Insurance Portability and Accountability Act (HIPAA) of 1996 regulations. A health care professional generally has access to a computerized system only via a personal password, thus helping ensure confidentiality of pt information. All medical records and other individually identifiable health information, whether electronic, in paper, or oral, are covered by HIPAA legislation and by subsequent Department of Health and Human Services (HHS) rules that took effect in April of 2001.
The ASRT document that defines the radiographer's role is the: (A) Standards of Ethics (B) Practice Standards (C) Standard of Care (D) Legal Standards
(B) Radiographers should be familiar with the Practice Standards published by the ASRT. The Standards provide a legal role definition and identify Clinical, Quality, and Professional Standards of practice - each Standard has its own rationale and identifies general and specific criteria related to that Standard. The student radiographer can access the individual standards, their rationale, and criteria on the ASRT website. The American Registry of Radiologic Technologists (ARRT) establishes principles of professional conduct to ensure the best services possible to patients entrusted to our care. These principles are detailed in the ARRT two-part Standards of Ethics, which includes the Code of Ethics and the Rules of Ethics. The 10-part Code of Ethics is aspirational; the 22 Rules of Ethics are enforceable and their violation can result in professional sanction.
Patient's rights include the following: 1. the right to refuse treatment 2. the right to confidentiality 3. the right to possess one's medical records (A) 1 only (B) 1 and 2 only (C) 1 and 3 only (D) 1, 2, and 3
(B) The AHA identifies 12 important areas in its Patient's Bill of Rights. These include the right to refuse treatment (to the extend allowed by law), the right of confidentiality of records and communication, and the right to continuing care. Other patient rights identified are the right to informed consent, privacy, respectful care, access to personal medical records, refusal to participate in research projects, and an explanation of one's hospital bill.
The radiographer must perform the following procedure(s) before entering an isolation room with a mobile x-ray unit: 1. wear a gown and a mask 2. wear a gown, gloves, and possibly a mask 3. clean the mobile x-ray unit (A) 1 only (B) 2 only (C) 1 and 3 only (D) 2 and 3 only
(B) When performing bedside radiography in an isolation room, the radiographer should wear a gown, gloves, and sometimes a mask. The IPs are prepared for the examination by placing a pillowcase over them to protect them from contamination. Whenever possible, one person should manipulate the mobile unit and remain "clean," while the other handles the patient. The mobile unit should be cleaned with a disinfectant before exiting the patient's room.
A patient, aged 55 years, is most accurately described as (A) young adult (B) middle adult (C) older adult (D) elderly
(B) Young adults are described as 19-45 years old. These years, especially early on, are usually a time f gaining greater independence. Later, the demands of career, marriage, and children are of greatest importance. It is a time of beginning to recognize more clearly one's own vulnerability. The young adult depends on a calm, competent professional to ease his/her apprehensions. The middle adult is described as 46-64 years old and the older adult as 65-79 years old. As baby boomers age, these groups are increasing in number.
Which of the following is the first step to be taken in the performance of a radiographic examination? (A) Obtain clinical history (B) Provide appropriate patient assistance (C) Verify patient identity (D) Use appropriate infection control
(C) Although each of these steps is part of a complete radiologic examination, an all-important first step is careful and accurate patient identification. Patient identification, and correctly matching the patient with the intended examination, is a routine activity in the health care environment. The health care worker has primary responsibility for checking/verifying patient identity. Most facilities require checking at least two patient identifiers. Rigorous observance of "timeout" processes prior to procedures can avoid costly events, including those involving patient identification.
Mild systemic reaction to IV contrast material include all of the following, except (A) nausea (B) metallic taste in mouth (C) wheezing (D) flushed appearance
(C) Any reaction to contrast media generally occurs within 2-10 min following injection and can affect all body systems. The body's response to the introduction of contrast material is the production of histamine, which brings about various symptoms. Symptoms of a mild systemic reaction include a flushed appearance, nausea, and metallic taste in the mouth, nasal congestion, a few hives (urticaria), and, occasionally, vomiting. Treatment of these minor symptoms generally consists of administration of either an antihistamine such as diphenhydramine (Benadryl), which blocks the action of the histamine and reduces the body's inflammatory response, or an epinephrine to raise the blood pressure and relax the bronchioles. Potentially life-threatening/anaphylactic systemic responses include respiratory failure, shock, and death within minutes. Early symptoms of anaphylactic reaction include itching of the palms and soles, wheezing, constriction of the throat, dyspnea, dysphagia, hypotension, and cardiopulmonary arrest. The radiographer must maintain the patient's airway, summon the radiologist, and call a "code". The radiographer should then be prepared to stay with the patient and assist until the arrival of the code team.
Which of the following can be transmitted via infected blood? 1. TB 2. AIDS 3. HBV (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(C) Epidemiologic studies indicate that HIV/AIDS can be transmitted only by intimate contact with blood or body fluids of an infected individual. This can occur through the sharing of contaminated needles, through sexual contact, from mother to baby at childbirth, and from transfusion of contaminated blood. Inanimate objects cannot transmit HIV and AIDS. HBV is another blood-borne infection and affects the liver. It is thought that more than 1 million people in the United States have chronic hepatitis B and, as such, can transmit the disease to others. Acid-fast bacillus isolation is implemented in patients suspected or known to be infected with the TB. Acid-fast bacillus isolation requires that the patient wear a mask to avoid the spread of acid-fast bacilli (in bronchial secretions) during coughing.
The belief that one's own cultural ways are superior to any other is termed (A) ethnology (B) ethnobiology (C) ethnocentrism (D) ethnography
(C) Ethnocentrism is the belief that one's personal experience and perception of the world are superior to the experiences and perceptions of others, that is, the belief that one's own cultural ways are superior to any other. Ethnocentrism can be found in all cultures and is the most significant barrier to good intercultural communication. Ethnology is the comparative study of various cultures. Ethnobiology is the study of biological characteristics of various races. Ethnography is the study of a single society's culture.
Types of NG/NI/NE tubes include 1. Port-A-Cath 2. Sengstaken-Blakemore 3. Miller-Abbott (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(C) GI tubes can be nasogastric (NG), nasointestinal (NI), or nasoenteric (NE). NG tubes, such as the Dobhoff tube, are used as feeding tubes for patients whose condition prevents normal swallowing. NI/NE tubes can be used following digestive tract surgery to remove gastric fluids and/or air (decompression; e.g., Levin and Salem-Sump tubes). NG and NI/NE tubes may be single or double lumen and can sometimes be temporarily disconnected for radiographic examinations. The single-lumen NG or NI/NE tube can be clamped, but the double-lumen tube must NEVER be clamped. If clamped, the walls of the double-lumen tube could adhere permanently. Instead, the tip of a syringe is inserted into the lumen and the syringe and the tube then pinned (open side up) to the patient's gown. Care must be taken not to disturb the placement of the GI tube. Examples of single-lumen NE tubes are the Cantor and Harris tubes; the Miller-Abbott tube is a double-lumen NE tube. The Sengstaken-Blakemore tube is a triple-lumen tube with a gastric balloon, an esophageal balloon, and a gastric suction port; it is often used in the treatment of bleeding esophageal varices.
What is the single most effective means of controlling the spread of infectious microorganisms? (A) Wearing gloves (B) Wearing masks (C) Hand washing (D) Sterilization
(C) Health care practitioners must exercise strict infection control precautions so that they or their equipment will not be the source of health care-associated infection (HAIs). Contaminated waste products, soiled linen, and improperly sterilized equipment are all means by which microorganisms can travel. Not ever patient will come in contact with these items; however, the health care professional is in constant contact with patients and is therefore a constant threat to spread infection. Microorganisms are most commonly spread by way of the hands; therefore, hand washing/sanitizing before and after examination of each patient is the most effective means of controlling the spread of microorganisms. Disinfectants, antiseptics, and germicides are used in many hand-washing liquids.
Occurrences that can keep a radiography student from meeting ARRT certification requirements include: 1. being suspended from a radiography program 2. being dismissed/expelled from a radiography program 3. failing more than one course in his/her radiography program (A) 1 only (B) 2 only (C) 1 and 2 only (D) 1, 2, and 3
(C) Honor/integrity can only be achiever in an environment where intellectual honesty and personal integrity are highly valued, and where the responsibility for communicating and maintaining these standards is widely shared. In order to meet ARRT certification requirements, candidates for the ARRT examination must answer the question "Have you ever been suspended, dismissed, or expelled from an educational program that you attended in order to meet ARRT certification requirements?" in addition to reading and signing the "Written Consent under FERPA," allowing the ARRT to obtain special parts of their educational records concerning violations to an honor code. If the applicant answers "yes" to that question he/she must include an explanation and documentation of the situation with the complete application for certification. If the applicant has any doubts, he/she should contact the ARRT Ethics Requirements Department at (651) 687-0048, ext. 8580.
Lyme disease is a condition caused by bacteria carried by deer ticks. The tick bite may cause fever, fatigue, and other associated symptoms. This is an example of transmission of an infection by (A) droplet contact (B) the airborne route (C) a vector (D) a vehicle
(C) Lyme disease is a condition that results from transmission of an infection by a vector ("deer" tick). Vectors are insects and animals carrying disease. Droplet contact involves contact with secretions (from the nose, mouth) that travel via a sneeze or cough. Airborne route involves evaporated droplets in the air that transfer disease.
A patient's feeling of spinning, or the room spinning around him, is called (A) orthostatic hypotension (B) epistaxis (C) vertigo (D) syncope
(C) Objective vertigo is the sensation of having objects (or the room) spinning about the person; subjective vertigo is the sensation of the person spinning about. It is often associated with an inner-ear disturbance. Pts experiencing true vertigo (as opposed to dizziness or lightheadedness) are often very nauseous and must be protected from falls. A pt who reports feeling dizzy or faint (syncope) should be immediately assisted to a chair. Bending forward and placing the head between the knees will often help relieve the lightheadedness as blood flow to the brain increases. In more severe cases, a pt who cannot be assisted to a chair should be lowered to a recumbent position. Elevation of the lower legs, or use of the Trendelenburg position, is helpful. Orthostatic, or postural, hypotension is a decrease in blood pressure that occurs on rising to the erect position. It can be severe enough to cause fainting in individuals who have been confined to bed for several days. A nosebleed (epistaxis) may be a result of any one of many causes including hypertension, dry nasal mucous membranes, sinusitis, or trauma. The pt should be in a sitting or Fowler position. The radiographer should place cold cloths over the pt's nose and back of the neck.
When a radiographer is obtaining a patient history, both subjective and objective data should be obtained. An example of subjective data is that (A) the patient appears to have a productive cough (B) the patient has a blood pressure of 130/95 mm Hg (C) the patient states that she experiences extreme pain in the upright position (D) the patient has a palpable mass in the right upper quadrant of the left breast
(C) Obtaining a complete and accurate history from the pt for the radiologist is an important aspect of a radiographer's job. Both subjective and objective data should be collected. Objective data include signs and symptoms that can be observed, such as a cough, a lump, or elevated blood pressure. Subjective data relate to what the patient feels and to what extent. A patient may experience pain, but is it mild or severe? Is it localized or general? Does the pain increase or decrease under different circumstances? A radiographer should explore this with the pt and document the information on the requisition for the radiologist.
If a pt lacks decision-making capacity, his/her rights can be exercised on his/her behalf by 1. designated surrogate 2. designated by proxy 3. no one (A) 1 only (B) 2 only (C) 1 and 2 only (D) 3 only
(C) Pt's rights can be exercised on the pt's behalf by a designated surrogate or proxy decision maker if the pt lacks decision-making capacity, is legally incompetent, or is a minor. Many people believe that potential legal and ethical issues can be avoided by creating an Advance Health Care Directive or Living Will. Because all individuals have the right to make decisions regarding their own health care, this legal document preserves that right in the event an individual is unable to make those decisions. An Advance Health Care Directive or Living Will, names the individual authorized to make all health care decisions and can include a living will, giving specifics regarding DNR, DNI, and/or other end-of-life decisions.
What is the most frequently used site for an IV injection of contrast agents? (A) Basilic vein (B) Cephalic vein (C) Antecubital vein (D) Femoral vein
(C) The antecubital vein is the most commonly used injection site for contrast medium administration. It is not used for infusions that take longer than 1 hour because of its location at the bend of the elbow. The basilic vein, located on the dorsal surface of the hand, is used when the antecubital bein is inaccessible. The cephalic vein may also be used. Strict aseptic technique must be used for all intravenous injections.
A radiographer who discloses confidential information to unauthorized individuals may be found liable for (A) assault (B) battery (C) intimidation (D) defamation
(D) A radiographer who discloses confidential information to unauthorized individuals may be found guilty of invasion of privacy or defamation. A radiographer whose disclosure of confidential information is in some way detrimental to the patient may be accused of defamation. Spoken defamation is libel. Assault is to threaten harm; battery is to carry out the threat.
Body reaction to a sensitizing agent can occur as a result of 1. absorption 2. injection 3. ingestion (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) Anaphylaxis is a life-threatening allergic reaction that affects millions of Americans every year and can be caused by a variety of allergens. It can result from the body's sensitivity and allergic reaction to certain foods, insect venom, medications, anesthetics, and latex. The reaction can be the result of ingestion, injection, or absorption of the sensitizing agent.
Successful, effective communication includes proficiency in the following skills: 1. writing 2. speech 3. observation (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) Communication can be achieved in many forms; those forms can be verbal or nonverbal. Effective and professional patient communication skills are essential; the interaction between the patient and the radiographer generally leaves the patient with a lasting impression of his/her health care experience. The radiographer's communication skills must include a proficiency in observational skills, listening skills, speaking skills, and writing skills.
All of the following are useful resources for non-English-speaking patients, except (A) automated language lines (B) special dual-headset phones (C) a certified interpreter (D) a family member or friend
(D) Communication difficulties can arise with non-English-speaking pts. Most hospitals and large clinics have a list of resource people, automated systems, Language Lines, special dual-headset phones, or similar accommodations to assist with interpretation when there is a language barrier. A certified interpreter is most helpful because he/she translates exactly what has been said, rather than a family member or friend who might edit or try to examine what he/she thinks is implied. People whose second language is English occasionally lose their ability to communicate in that second language during times of trauma, illness, or stress. Volume, speed, and tone of voice may also be determined by culture. In addition, expressions/figures of speech such as "a piece of cake" or "home free" may not be understood by these pts or their families.
Terms correctly associated with positive contrast agents include all of the following, except (A) radiopaque (B) iodinated (C) high atomic number (D) carbon dioxide
(D) Contrast media or contrast agents can be described as either positive (radiopaque) or negative (radiolucent). Positive, or radiopaque, contrast agents have a higher atomic number than the surrounding soft tissue, resulting in a greater attenuation/absorption of x-ray photons, thereby increasing image contrast. Examples of positive contrast media are iodinated agents (both water based and oil based) and barium sulfate suspensions. The inert characteristics of barium sulfate render it the least toxic contrast medium. On the other hand, iodinated contrast media have characteristics that increase their likelihood of producing side effects and reactions. Negative, or radiolucent, contrast agents are used with air and various gases. Carbon dioxide is absorbed more rapidly by the body than by air. Negative contrast is often used with positive contrast in examinations termed double-contrast studies. The function of the positive agent is usually to coat the various parts under study, while the air fills the space and permits visualization through the gaseous medium. Examinations that frequently use double-contrast technique are contrast enema (BE), upper GI (UGI), and arthrography.
Equipment that might be needed for intravenous drug/contrast medium administration include(s) 1. heparin lock 2. needles 3. infusion set (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) IV fluids and/or medications are administered to meet specific patient needs. Medications administered intravenously result in rapid patient response; medications are often delivered in this fashion in emergency and critical situations. Patients who are dehydrated and require fluid and electrolyte replacement will have these (normal saline or D5W) administered intravenously. IV equipment includes needles, syringes, fluids such as normal saline or D5W (a solution of 5% dextrose in water), IV catheters, heparin locks, IV poles, and infusion sets.
Increased pain threshold, breakdown of skin, and atrophy of fat pads and swear glands are all important considerations when working with which of the following groups of patients? (A) Infants (B) Children (C) Adolescents (D) Geriatric patients
(D) Increased pain threshold, breakdown of skin, and atrophy of fat pads and sweat glands are all important considerations when working with geriatric patients. Many changes occur as our bodies age. Although muscle is replaced with fat, the amount of subcutaneous fat is decreased and the skin atrophies. Therefore, the geriatric patient requires extra gentle treatment. A mattress pad should always be placed on the radiographic table to help prevent skin injury or abrasions. If a tape is required, the paper tape should be used instead of the adhesive tape. Geriatric patients are also more sensitive to hypothermia because of the breakdown of the sweat glands and always should be kept covered both to preserve modesty and for extra warmth. Loss of sensation in the skin increases pain tolerance, so the geriatric patient may not be aware f excessive stress on bony prominences such as the elbow, wrist, coccyx, and ankles.
Medical equipment that might contain latex include 1. catheters 2. endotracheal tubes 3. syringes (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) Latex products are manufactured from a milky fluid derived from the rubber tree, and severe chemicals are added to the fluid during the manufacture of commercial latex. Some proteins in latex can produce mild to severe allergic reactions; chemicals added during processing can also cause skin rashes. A wide variety of products contain latex: medical supplies, PPE, and many household items. Medical equipment that could contain latex include disposable gloves, catheters, tourniquets, endotracheal tubes, syringes, enema tips, stethoscopes, and so on. The intermittent use of latex products generally causes no health problems. However, workers in the health care industry are at risk for developing latex allergy if they use latex gloves frequently. Other workers at risk because of frequent latex glove use are hairdressers, housekeepers, food service workers, and so on, and those involved in the manufacture of latex products.
Which of the following is/are means of transmission of microorganisms? 1. Vector 2. Fomite 3. Airborne (A) 1 only (B) 1 and 2 only (C) 3 only (D) 1, 2, and 3
(D) Microorganisms can be transmitted via droplet, airborne, and contact (direct or indirect). Other sources of transmission are vehicle and vector. Pathogenic microorganisms expelled from the respiratory tract through the mouth or nose can be carried as evaporated droplets through the air or on dust and settle on clothing, utensils, or food. A contaminated inanimate object such as a pillowcase, x-ray table, or IV pole is referred to as a fomite. A vector is an insect or animal carrier of infectious organisms, such as a rabid animal (rabies), a mosquito that carries malaria, or a tick that carries Lyme disease.
Misunderstandings between cultures can happen as a result of 1. looking directly into someone's eyes 2. the use of certain gestures 3. standing too close while speaking to another (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) Misunderstandings between cultures can occur as a result of the use of gestures, which have different meanings in different countries. In the US and Europe, the "thumbs-up" gesture has a positive implication. However, it is considered rude in Australia and obscene in the Middle East. Other examples of potentially misunderstood gestures include the following: if you compliment a Mexican child, you must touch the head, whereas in Asia, it is not acceptable to touch the head of a child; in the Philippines, it is rude to beckon with the index finger; furthermore, in the United States, people are comfortable speaking about 18 inches apart, whereas in the Middle East, people stand much closer together when they talk; in England, people stand further apart.
Which of the following is/are symptom(s) of inadequate oxygen supply? 1. Diaphoresis 2. Cyanosis 3. Retracted intercostal spaces (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) Oxygen is taken into the body and supplied to the blood to be delivered to all body tissues. Any tissue(s) lacking in or devoid of an adequate blood supply can suffer permanent damage or die. Oxygen may be required in cases of severe anemia, pneumonia, pulmonary edema, and shock. Symptoms of inadequate oxygen supply include dyspnea, cyanosis, diaphoresis, retraction of intercostal spaces, dilated nostrils, and distention of the veins of the neck. A patient who experiences any of these symptoms will be very anxious and must not be left unattended. The radiographer must call for help, assist the patient to a sitting or semi-Fowler position (the recumbent position makes breathing more difficult), and have oxygen and emergency drugs available.
Pathogens are 1. always harmful 2. sometimes harmful 3. capable of producing disease (A) 1 only (B) 2 only (C) 1 and 3 only (D) 2 and 3 only
(D) Pathogens are causative agents -- microorganisms capable of producing disease. Pathogens termed opportunistic are usually harmless, but can become harmful if introduced into a part of the body where they do not normally reside, or when introduced into an immunocompromised host. Blood-borne pathogens reside in blood and can be transmitted to an individual exposed to the blood or body fluids of the exposed individual. Common blood-borne pathogens include hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV). Because radiography often involves exposure to sickness and disease, the radiographer must be aware of, and conscientiously practice, infection prevention and control measures.
In which of the following conditions is protective, or reverse, isolation indicated? 1. Transplant recipient 2. Chemotherapy recipient 3. Leukemia (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) Protective, or reverse, isolation is used to keep the susceptible patient from becoming infected. Burn pts who have lost their means of protection (their skin) have increased susceptibility to bacterial invasion. Protective isolation is particularly important in caring for immunodeficient patients such as those who have received chemotherapy, transplant recipients, and leukemia patients. These pts are unable to combat infection and are more susceptible to infection. They are treated with strict isolation technique, that is, taking care to protect the pt from contamination.
All of the following are correct concepts of good body mechanics during patient lifting/moving, except (A) the radiographer should stand with feet approximately 12 inches apart and with one foot slightly forward (B) the body's center of gravity should be positioned over its base of support (C) the back should be kept straight; avoid twisting (D) when carrying a heavy object, hold it away from the body
(D) Rules of good body mechanics include the following: when carrying a heavy object, hold it close to the body; the back should be kept straight; avoid twisting when lifting an object; bend the knees and use leg and abdominal muscles to lift (rather than the back muscles); and whenever possible, push or roll heavy objects (rather than lifting or pushing). To transfer the patient with maximum safety, the radiographer must correctly use certain concepts of body mechanics. First, a broad base of support lends greater stability; therefore, the radiographer should stand with his/her feet approximately 12 inches apart and with one foot slightly forward. Second, stability is achieved when the body's center of gravity (center of the pelvis) is positioned over its base of support. For example, leaning away from the central axis of the body makes the body more vulnerable to losing balance; if the feet are close together, balance is even more difficult to maintain.
Which of the following gauge needles has the smallest bore? (A) 12 (B) 18 (C) 20 (D) 23
(D) The diameter of a needle is identified as its gauge. As the diameter of its bore decreases, the gauge increases. Hence, a 23-gauge needle has a smaller diameter bore than an 18-gauge needle. Hypodermic needles are generally used for phlebotomy (i.e. blood samples), whereas butterflies and IV catheters are used more frequently for injections such as contrast media. If an infusion injection is required, an IV catheter is generally preferred. The hub of the hypodermic needle is attached to a syringe, while the hub of the butterfly tubing or IV catheter may be attached to a syringe or an IV container via an IV infusion set.
Examples of nonverbal communication include 1. appearance 2. eye contact 3. touch (A) 1 only (B) 1 and 2 only (C) 2 and 3 only (D) 1, 2, and 3
(D) The importance of effective and professional patient communication skills cannot be overemphasized; the interaction between the patient and the radiographer generally leaves the patient with a lasting impression of his/her health care experience. Of course communication refers not only to the spoken word (i.e., verbal communication) but also to unspoken/nonverbal communication. Facial expression can convey caring and reassurance or impatience and disapproval. Pursed lips, pointed fingers, frowns, and hands on hips all indicate disapproval. Similarly, a radiographer's touch can convey his/her commitment to considerate care, or it can convey a rough, uncaring, hurried attitude. Making eye contact while speaking is generally considered polite and respectful in the United States, whereas it can be considered just the opposite in other cultures (e.g., Asian, East Indian, Native American). Our appearance gives an impression of how we feel about our work and our patients; it is very much a part of communication, and we should strive for a professional appearance/image.
Which of the following communicate(s) messages to the patient? 1. Facial expression 2. Eye contact 3. Personal appearance (A) 1 only (B) 1 and 2 only (C) 3 only (D) 1, 2, and 3
(D) The interaction between a pt and a radiographer generally leaves a lasting impression on the pt's health care experience. Communication may be verbal or nonverbal. Verbal communication involves tone and rate of speech, as well as what is being said. It involves personalization and respect. Nonverbal communication involves facial expression, professional appearance, orderliness of radiographic department, and preparation and efficiency of the radiograher.
