RADReview - Patient Care

Which of the following apply to informed consent? (select the three that apply) A. Patients who sign their own informed consent must be competent to do so B. Parents and legal guardians can sign informed consent for minors C. Consent is transferrable between providers (i.e., if a patient signs consent and the provider of the procedure changes, they can still use the signed consent form) D. All areas of the consent form must be filled out prior to patient and/or guardian signing E. Patients cannot refuse care after signing informed consent

A, B and D Informed consent is a necessary and mandatory component of a patient's visit. All parties who sign informed consent must be competent to do so; therefore, intoxication and mental incapacities can impact eligibility to sign consent (A). Minors must have a parent or legal guardian sign consent for medical care (B). All consent forms must be completely filled out before the patient signs to avoid legal disputes (D). Consent is not transferrable between providers; all changes made to procedures require a new consent form, especially changes in providers (C). Patients have the right to refuse treatment at any point during their visit (E). (Ehrlich & Coakes, 9th ed., p. 75)

Which of the following are aspects of informed consent: (choose 3) A. The provider must discuss the procedure/treatment with the patient and describe what it will entail B. Alternative procedures and treatments are presented and discussed C. Information on informed consent documents can be filled out after the patient has provided a signature D. The patient must be informed of any risks associated with the procedure or treatment

A, B and D Informed consent is required when performing any medical treatment on a patient. Informed consent is a process that includes discussing the procedure or treatment with the patient (A), presenting alternative treatments (B), discussing risks associated with the treatment (D), and allowing the patient to consent to or refuse the treatment discussed. All information on informed consent documentation must be filled out prior to obtaining the patient' signatures (C), this ensures that all information was presented to the patient, and the documentation must be signed before any treatment can begin. The patient has the right to ask questions about the proposed treatments or procedures, and all medical care can be postponed until the patient feels that their questions were answered. (Pierson and Fairchild, 6th edition, 14-16)

Positive contrast agents are associated with (select the five that apply): A. Iodine B. Negative contrast C. High atomic number D. Radiopacity E. Positive contrast F. Air G. Radiolucency H. Barium

A, C, D, E and H 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 and thereby increasing image contrast (C, D, and E). Examples of positive contrast media are iodinated agents (both water based and oil based) and barium sulfate suspensions (A and H). 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 used are air and various gases (B and G). Because the atomic number of air is also quite different from that of soft tissue, high subject contrast is produced (F). 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 a double-contrast technique are contrast enema (BE), upper GI (UGI) series, and arthrography. (Saia, PREP 9th ed. p. 71)

According to the AHA's Patient Care Partnership, a patient considering options for treatment should be provided which 3 of the following 6 pieces of information: A. The benefits and risks of each treatment B. Details regarding outcomes of other patients who have had the same treatments C. The institution's liability insurance policy D. Whether the treatment is part of a research study E. Financial obligations for utilizing an uncovered treatment option F. A record of recent medical errors at the facility that involved the treatments being considered

A, D and E The Patient's Bill of Rights, as it is more commonly known, is a set of guidelines for healthcare institutions to concerning reasonable expectations about how patients are to be treated, what information they should have access to, and how they can make decisions about their healthcare. When a patient is considering treatment options, the physician and the institution should describe the benefits and risks of each treatment, disclose whether a treatment is experimental or part of a research study, and inform the patient of financial burdens for treatments that are not covered by the patient's health insurance. Liability coverage, other patient outcomes, and medical errors involving other patients are private business of the respective parties and would not be disclosed. (Adler & Carlton, 6th edition, p 370)

What should you do if you discover while taking patient history that the patient scheduled for an intravenous urogram (IVU) takes metformin hydrochloride daily but has no evidence of AKI and with eGFR ≥30 mL/I.73^2? 1. Proceed with the examination if kidney function is normal 2. Instruct the patient to withhold the metformin for 48 hours after the examination 3. Reschedule the examination until the patient have been off metformin for 48 hours A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only Current (2018) American College of Radiology (ACR) recommendations state that "there have been no reports of lactic acidosis following intravenous iodinated contrast medium administration in patients properly selected for metformin use". The ACR recommends that metformin (Glucophage) patients be classified in two ways. Category 1 patients taking metformin are those with no evidence of AKI and with eGFR ≥30 mL/l.73^2 ; these patients need not discontinue metformin before or after receiving contrast, and it is not required that renal function be reassessed following the exam. Category 2 patients taking metformin are those having AKI or severe chronic kidney disease as indicated by eGFR, or that will be undergoing an arterial catheter study; these patients should temporarily discontinue metformin at time of (or prior to) the procedure, and withhold metformin for 48 hours after the procedure. Metformin should be reinstituted only after renal function studies have been reevaluated and found to be acceptable. https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf

Physical changes characteristic of gerontologic patients usually include 1. Loss of bone calcium 2. Loss of hearing 3. Loss of mental alertness A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only Gerontology, or geriatrics, is the study of the elderly. While 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. Today many elderly people remain very active, staying mentally and physically agile well into their so-called golden years. The radiographer must keep this in mind as he or she provides age-specific care to the gerontologic patient. (Torres et al, 6th ed., p. 211)

Which of the following would be useful for an examination of a patient suffering from Parkinson disease? 1. Short exposure time 2. High ratio grid 3. Compensating filtration A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only The shortest possible exposure should be used as a matter of routine. Parkinson disease is characterized by uncontrollable tremors, and the resulting unsharpness can destroy image resolution. High ratio grid will absorb a higher percentage of scattered radiation but increase patient dose. Compensating filtration is unrelated to the problem and is not indicated here. (Fauber, p. 188)

The radiographer must perform which of the following procedures prior to entering a contact isolation room with a mobile x-ray unit? 1. Put on gown and gloves only 2. Put on gown, gloves, mask, and cap 3. Clean the mobile x-ray unit. A. 1 only B. 2 only C. 1 and 3 only D. 2 and 3 only

A. 1 only When performing bedside radiography in a contact isolation room, the radiographer should wear a gown and gloves. 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," whereas the other handles the patient. The mobile unit must be cleaned with a disinfectant upon exiting the patient's room. (Torres et al., 6th ed., p. 69)

When caring for a patient with an IV line, the radiographer should keep the medication A. 18 to 20 inches above the level of the vein B. 18 to 20 inches below the level of the vein C. 28 to 30 inches above the level of the vein D. 28 to 30 inches below the level of the vein

A. 18 to 20 inches above the level of the vein It is generally recommended that the IV bottle/bag be kept 18 to 20 inches above the level of the vein. If the container is too high, the pressure of the IV fluid can cause it to pass through the vein into surrounding tissues, causing a painful and potentially harmful condition. If the IV container is too low, blood may return through the needle into the tubing, form a clot, and obstruct the flow of IV fluid. (Torres et al., 6th ed., p. 323) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 149)

Which of the following would be a reason for performing an orbits series? 1. Hemolytic anemia 2. Prior employment as a steel worker 3. Orthopedic implants A. 2 only B. 2 and 3 only C. 1 and 2 only D. 1, 2, and 3

A. 2 only One major benefit of general radiography is the ability to detect metal debris in various anatomical regions. Prior work in the steel or mechanical industries (2) can result in metal debris in the body, and some patients come into the Radiology Department to receive an orbits series to determine if there are any metal particles in the eyes (A). The debris can go unnoticed or ignored for years, leaving very little visible trace. Joint replacements (3) and hemolytic anemia (1) are not visible (B, C, and D). (Ehrlich & Coakes, 9th ed., p. 416)

What is the needle angle usually recommended for intramuscular drug injection? A. 90° B. 75° C. 45° D. 15°

A. 90° Medications can be administered in a number of ways. Parenteral administration refers to drugs administered via intramuscular, subcutaneously, intravenously, or intrathecally—that is, any way other than by mouth. Intramuscular drug injections usually require that the needle form a 90° angle of injection. For subcutaneous injections the needle should form a 45° angle. Intradermal injections generally require that the needle form about a 15° angle with the arm. (Adler and Carlton, 3rd ed, pp 273-277)

Which of the following women is likely to have the most homogeneous glandular breast tissue? A. A postpubertal adolescent B. A 20-year-old with one previous pregnancy C. A menopausal woman D. A postmenopausal 65-year-old

A. A postpubertal adolescent Breast tissue is most dense, glandular, and radiographically homogeneous in appearance in the postpubertal adolescent. Following pregnancy and lactation, changes occur within the breast that reduce the glandular tissue and replace it with fatty tissue (a process called fatty infiltration). Menopause causes further atrophy of glandular tissue. (Frank, Long, and Smith, 11th ed., vol. 2, pp, 411-413) (Bontrager's Textbook of Radiographic Positioning & Related Anatomy 9th edition by Lampignano & Kendrick page 750)

A radiographer who tells the patient that he or she will have to repeat this uncomfortable examination if the patient does not try harder to cooperate can be accused of A. Assault B. Battery C. False imprisonment D. Defamation

A. Assault Assault is the threat of touching or laying hands on someone. If a patient feels threatened by a practitioner, either because of the tone or pitch of the practitioner's voice or because the practitioner uses words that are threatening, the practitioner can be accused of assault. A radiographer who performs the wrong examination on a patient may be charged with battery. Battery refers to the unlawful laying of hands on a patient. The radiographer also could be charged with battery if a patient were moved about roughly or touched in a manner that is inappropriate or without the patient's consent. False imprisonment may be considered if a patient is ignored after stating that he or she no longer wishes to continue with the procedure or if restraining devices are used improperly or used without a physician's order. The accusation of defamation can be upheld when patient confidentiality is not respected, and as a result, the patient suffers embarrassment or mockery. (Adler and Carlton, 4th ed., p. 374) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 322)

Imaging the incorrect patient qualifies as A. Battery B. Assault C. False imprisonment D. Slander

A. Battery It is incredibly important for the technologist to confirm that they have the correct patient before beginning an x-ray examination. Confirmation includes checking the patient's full name, date of birth, and reason for the exam. Battery refers to contact with another individual without their consent. Therefore, performing an x-ray examination on the incorrect patient would be considered battery (A) due to the lack of legal documentation authorizing the exam's performance. Assault (B) would refer to threatening actions against a patient, while false imprisonment (C) can be the unpermitted use of restraints on a patient without a physician's order. Slander (D) is verbal communication regarding a patient (or another individual) that results in defamation of character. (Ehrlich and Coakes, 9th ed., p. 77)

As health care professionals aspire to design their actions to always benefit their patients, to only bring about good for their patients, they are aspiring to what moral principle? A. Beneficence B. Nonmaleficence C. Autonomy D. Veracity

A. Beneficence There are many medicolegal terms with which the radiographer should be familiar. Beneficence refers to decisions and actions made to bring about good, ie, to benefit the patient. Nonmaleficence refers to the prevention of harm to the patient. Autonomy refers to the right of every individual to act with personal self-reliance. Veracity refers to telling the truth. (Adler and Carlton, 7th ed, p 301, 302)

A device used to restrict the free movement of a patient or a body part during the performance of a medical imaging exam is: A. Classified as immobilization, is meant to be temporary, and does not require a separate physician's order B. Classified as a restraint, can remain in place after the exam is over, and does not require a physician's order C. Not recommended for use with pediatric patients D. Can be utilized in place of effective communication with the patient to reduce total exam time

A. Classified as immobilization, is meant to be temporary, and does not require a separate physician's order Immobilization is a utilization of positioning aids and communication techniques to reduce voluntary and involuntary motion on the part of the patient during a radiographic exposure, improving image quality and reducing the need for repeat exposures in the process. Restraints are similar devices that restrict the free movement of a patient or body part but for a different purpose; the patient is a risk to themselves or others. Patient restraints are ordered by a physician and those orders must be reevaluated every twenty-four hours. Immobilizers should be removed after the necessary projections have been completed. (Adler & Carlton, 6th edition, p 164)

In her studies on death and dying, Dr. Elizabeth Kubler-Ross described the first stage of the grieving process as A. Denial B. Anger C. Bargaining D. Depression

A. Denial Dr. Elizabeth Kubler-Ross explains that loss requires gradual adjustment and involves several steps. The first is denial or isolation, where the individual often refuses to accept the thought of loss or death. The second step is anger, as the individual attempts to deal with feelings of helplessness. The next is bargaining, in which the patient behaves as though "being good" like a "good patient" will be rewarded by a miraculous cure or return of the loss. Once the individual acknowledges that this is not likely to happen, depression is the next step. This depression precedes acceptance, where the individual begins to deal with fate or loss. (Adler and Carlton, 4th ed., p. 155) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 132)

The term used to describe expectoration of blood from the bronchi is A. Hemoptysis B. Hematemesis C. Chronic Obstructive Pulmonary Disease (COPD) D. Bronchitis

A. Hemoptysis The expectoration of blood from the larynx, trachea, bronchi, or lungs is termed hemoptysis. Hemoptysis can occur in several diseases, including pneumonia, bronchitis, pulmonary tuberculosis, and others. Hematemesis is vomiting of blood—this can occur with gastric ulcers, gastritis, esophageal varices, and other conditions. (Taber, p. 971) (Mosby's Dictionary of Medicine, Nursing ^& Health Professions 8th edition page 861)

A radiographer who discloses confidential information to unauthorized individuals may be found guilty of A. Invasion of privacy B. Slander C. Libel D. Defamation

A. Invasion of privacy A radiographer who discloses confidential information to unauthorized individuals may be found guilty of invasion of privacy. If the disclosure is in some way detrimental or otherwise harmful to the patient, the radiographer may be accused of defamation. Spoken defamation is slander; written defamation is libel. Assault is to threaten harm; battery is to carry out the threat. (Torres et al, p 11) (Patient Care in Radiolgraphy 7th edition by Ehrlich & Daly page 69)

The legal doctrine respondeat superior relates to which of the following? A. Let the master answer B. The thing speaks for itself C. A thing or matter settled by justice D. A matter settled by precedent

A. Let the master answer The legal doctrine res ipsa locquitur relates to "a matter that speaks for itself." For instance, if a patient were admitted to the hospital to have a kidney stone removed and incorrectly was given an appendectomy, "that speaks for itself," and negligence could be proven. Respondeat superior is the phrase meaning "let the master answer" or "the one ruling is responsible." If a radiographer is negligent, there may be an attempt to prove that the radiologist was responsible because the radiologist oversees the radiographer. Res judicata means "a thing or matter settled by justice." Stare decisis refers to "a matter settled by precedent." (Adler and Carlton, 4th ed., p. 376) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 325)

Hirschsprung disease, or congenital megacolon, is related to which of the following age groups? A. Neonate B. Toddler C. Adolescent D. Adult

A. Neonate Hirschsprung disease, or congenital megacolon, is caused by the absence of some or all of the bowel ganglion cells—usually in the rectosigmoid area but occasionally more extensively. Hirschsprung disease is the most common cause of lower GI obstruction in neonates and is treated surgically by excision of the affected area followed by reanastomosis with normal, healthy bowel. Hirschsprung disease is diagnosed by barium enema or, in mild cases, by rectal biopsy. (Bontrager and Lampignano, 6th ed., p. 660) (Radiographic Pathology for Technologists 7th edition by nina Kowalczyk page 147-148)

A patient who is diaphoretic is experiencing A. Profuse sweating B. Hot, dry skin C. Dilated pupils D. Warm, moist skin

A. Profuse sweating Observation is an important part of the evaluation of acutely ill patients. The patient who is diaphoretic is experiencing profuse sweating. Diaphoresis can be associated with elevated body temperature, exposure to heat, physical exertion, or emotional stress. Hot, dry skin accompanies fever. Warm, moist skin may be a result of anxiety or simply of being in a warm room. The pupils dilate in dimly illuminated places in order to allow more light into the eyes. (Adler and Carlton 5th ed p 172) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 243-264)

The medical abbreviation meaning "three times a day" is A. tid B. qid C. qh D. pc

A. tid Three times a day is indicated by the abbreviation tid. The abbreviation qid means four times a day. Every hour is represented by qh, and pc means after meals. (Adler & Carlton, p 278)

The most frequent site of hospital-acquired infection is the A. urinary tract B. blood C. respiratory tract D. digestive tract

A. urinary tract Hospital-acquired infections (HAIs) are also referred to as nosocomial. Despite the efforts of infectious disease departments, HAIs continue to be a problem in hospitals today. This is at least partly due to there being a greater number of older, more vulnerable patients and an increase in the number of invasive procedures performed today (i.e., needles and catheters). The most frequent site of HAI is the urinary tract, followed by wounds, the respiratory tract, and blood. (Torres et al., 6th ed., p. 47) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 200 )

Which of the following can impede verbal communication effectiveness: (choose 3) A. Decreased distance between the sender and receiver B. Excessive background noise C. Cultural differences D. Increased eye contact E. Increased message complexity

B, C and E Many factors can hinder the effectiveness of verbal communication. Ideally, the distance between the sender and receiver of the information should be minimal (A); this will help reduce the impact of background noise (B). Cultural differences (C) can also cause interruptions in verbal communication. Idiomatic expressions are not universal, and certain phrases or terms can be interpreted as disrespectful depending on the receiver's cultural background. Non-verbal cues can also contribute to the effectiveness of verbal communication, such as eye contact. Decreased eye contact (D) can muddle the message and its meaning, while increased eye contact can demonstrate effectiveness and care. Lastly, the best communication style for patients to understand is clear and concise. Increased message complexity (E) increases the odds that the information can be misconstrued. (Pierson and Fairchild, 6th edition, 30-32)

If prosecuted by the US Department of Justice, what is the criminal penalty for knowingly disclosing a patient's protected health information (PHI)? A. $100,000 fine B. $50,000 fine and up to 1 year imprisonment C. $100,000 fine and up to 5 years imprisonment D. $250,000 fine and up to 10 years imprisonment

B. $50,000 fine and up to 1 year imprisonment Criminal violations of HIPAA are referred from the Department of Health and Human Services to the Department of Justice for prosecution. Individuals or covered entities can be liable for a $50,000 fine and up to 1 year of imprisonment for the criminal violation of obtaining or disclosing PHI (B). Choices (A), (C), and (D) are incorrect as per the previous explanation.(https://www.ama-assn.org/practice-management/hipaa-violations-enforcement, accessed 7/21/2018) (https://www.hipaaguide.net/hipaa-violation-penalties/)

When caring for the elderly, it is important to remember that, as one ages, there is often a decrease in 1. Reaction time 2. Strength 3. Long-term memory A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only Aging is a broad concept that certainly includes physical change, but is a very individual and variable process. The major complaints of the elderly include weight gain, fatigue, decreased bone mass, joint stiffness, and loneliness. As we observe elderly patients we must be mindful that they might experience some decrease in balance, coordination, strength, and reaction time. A decrease in short-term memory can be demonstrated in the elderly, while they still retain remarkable long-term memory. (Ballinger and Frank, vol 3, p 224)

Chemical substances that are used to kill or deactivate pathogenic bacteria are called 1. Antiseptics 2. Disinfectants 3. Toxins. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only Antiseptics and disinfectants are used to deactivate or kill pathogenic microorganisms. Antiseptics (like alcohol) are used to stop the growth/spread of pathogenic microorganisms, especially on living tissue. Disinfectants are used especially on hard surfaces. Sterilization is another associated term; it refers to the killing of all microorganisms and their spores. A toxin is a poison.(Adler & Carlton, 7th ed, p 203)

Maslow's hierarchy of basic human needs includes which of the following? 1. Self-esteem 2. Love and belongingness 3. Death with dignity A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only Psychologist Abraham Maslow described a hierarchy, or pyramid, of needs with primary (physiologic) needs at the base and secondary (nonphysiologic) needs at higher levels. Maslow postulated that as the most basic survival needs are met, new needs emerge. At the bottom of the hierarchy are physiologic needs such as food, water, air, rest, and so on. One step up in the hierarchy is safety and security. Next is love and belongingness, followed by self-esteem and the esteem of others. Last is self-actualization, which is a kind of spiritual growth, satisfaction from life achievement, the feeling of leaving one's mark. (Adler and Carlton, 4th ed., p. 143)

Patients' rights include which of the following? 1. The right to refuse treatment 2. The right to confidentiality 3. The right to possess his or her radiographs A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

B. 1 and 2 only The American Hospital Association identifies 12 important areas in its "Patients' Bill of Rights." These include the right to refuse treatment (to the extent allowed by law), the right to 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 records (not ownership), refuse to participate in research projects, and an explanation of the hospital bill. (Dutton and Ryan 9th ed p 33-35)

Before bringing each patient into the radiographic room throughout the day, the radiographer should 1. Clean the x-ray table and change the pillowcase 2. Assemble the accessories needed for the examination 3. Warm the x-ray tube anode A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only The patient naturally will feel more comfortable and confident if brought into a clean, orderly, x-ray room that has been prepared appropriately for the examination to be performed. A disorderly, untidy room and a disorganized radiographer hardly inspire confidence; more likely, they will increase anxiety and apprehensiveness. The x-ray tube's anode only needs to be warmed when it is cold, at the beginning of the day, not before every patient. (Bontrager and Lampignano, 6th ed., pp. 33-34)

With a patient suffering abdominal pain, it is frequently helpful to 1. Elevate the head slightly with a pillow 2. Perform the examination in the Trendelenburg position 3. Place a support under the knees A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 3 only Strain on the abdominal muscles may be minimized by placing a pillow under the patient's head and a support under the patient's knees. The pillow also relieves neck strain, reduces the chance of aspiration in the nauseated patient, and allows the patient to observe his or her surroundings. The Trendelenburg position causes the diaphragm to assume a higher position and can cause a patient to become short of breath. (Ehrlich, McCloskey, & Daly, pp 93-94)

In the blood pressure reading 140/75 mmHg, what does 140 represent? 1. The phase of relaxation of the cardiac muscle tissue 2. The phase of contraction of the cardiac muscle tissue 3. A higher-than-average diastolic pressure A. 1 only B. 2 only C. 1 and 3 only D. 2 and 3 only

B. 2 only The normal blood pressure range for men and women is a 90 to 120 mmHg systolic reading (left number) and a 60 to 80 mmHg diastolic reading (right number). Systolic pressure is the contraction phase of the left ventricle, and diastolic pressure is the relaxation phase in the heart cycle. (Torres et al., 6th ed., pp. 148-149)

Which of the following patient rights is violated by discussing privileged patient information with an individual who is not involved with the patient's care? 1. The right to considerate and respectful care 2. The right to privacy 3. The right to continuity of care A. 1 only B. 2 only C. 1 and 3 only D. 2 and 3 only

B. 2 only The patient's right to privacy refers to his or her modesty and dignity being respected. It also refers to the professional health-care worker's obligation to respect the confidentiality of privileged information. Communication of privileged information to anyone but health-care workers involved with the patient's care is inexcusable. (Gurley & Callaway, p 187)

Rapid onset of severe respiratory or cardiovascular symptoms after ingestion or injection of a drug, vaccine, contrast agent, or food, or after an insect bite, best describes A. Asthma B. Anaphylaxis C. Myocardial infarction. D. Rhinitis.

B. Anaphylaxis Anaphylaxis is an acute reaction characterized by the sudden onset of urticaria, respiratory distress, vascular collapse, or systemic shock, sometimes leading to death. It is caused by ingestion or injection of a sensitizing agent such as a drug, vaccine, contrast agent, or food, or by an insect bite. Asthma and rhinitis are examples of allergic reactions. Myocardial infarction (MI) is caused by partial or complete occlusion of a coronary artery. (Torres et al, p 165) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 243-264)

Unlawful touching of a person without his or her consent is termed A. Assault B. Battery C. False imprisonment D. Invasion of privacy

B. Battery Battery refers to the unlawful laying of hands on a patient. Battery could be charged if a patient were moved about roughly or touched in a manner that is inappropriate or without the patient's consent. Assault is the threat of touching or laying hands on. If a patient feels threatened by a health care provider either because of the provider's tone or pitch of voice or because of words that are threatening, an assault charge may be made. False imprisonment may be considered if a patient states that he or she no longer wishes to continue with a procedure and is ignored or if restraining devices are used improperly or used without a physician's order. Invasion-of-privacy issues arise when there has been a disclosure of confidential information. (Adler and Carlton, 4th ed., p. 374) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 322)

An RT (ARRT) is the supervising manager of a short-staffed imaging facility in a State having legislation that requires professional certification. A job applicant arrives whose ARRT certification has lapsed. The manager hires him to fill a 20-hour position doing chest and extremity radiography. The supervisor is guilty of A. Breaking the ARRT Code of Ethics B. Breaking the ARRT Rules of Ethics C. Malpractice D. Nothing, because position responsibilities are limited

B. Breaking the ARRT Rules of Ethics The ARRT Standards of Ethics apply to those Registered Technologists holding ARRT certification and Candidates for ARRT certification. The Standards consist of two parts: the Code of Ethics (aspirational) and the Rules of Ethics (mandatory). The ARRT Rules of Ethics are mandatory minimum professional standards for all RTs and candidate RTs. Violators, and individuals who permit violation, of these Rules are subject to sanctions. Rules of Ethics numbers 15 and 21 specifically refer to those who knowingly assist another without proper certification to engage in the practice of radiologic technology, and/or those who fail to promptly report such activity to the ARRT—as being subject to sanction. (ARRT Standards of Ethics)

Which corrective action should be taken when receiving a requisition for a right knee study when the patient is complaining of pain in the mid tibial shaft? A. Take the x-ray examination ordered; the referring physician knows what they are looking for B. Contact the referring physician to clarify the order C .Take the exam of the body part the patient is complaining about, then call the referring physician to amend the order D. Send the patient home and tell them to return with a clarified order

B. Contact the referring physician to clarify the order As technologists it is important to have efficient questioning skills. This can help determine whether or not the orders we are following are correct. In this situation, it is important to contact the ordering physician to clarify the order before performing an examination (B). If at that point you are unable to get in touch with the ordering physician, it is in the best interest of all involved parties to postpone the exam until clarification is provided. The other answer choices are incorrect as per the previous explanation (A, C, and D). (Ehrlich & Coakes, 9th ed., pp. 189-190)

Which of the following legal phrases defines a circumstance in which both the health care provider's and the patient's actions contributed to an injurious outcome? A. Intentional misconduct B. Contributory negligence C. Gross negligence D. Corporate negligence

B. Contributory negligence A circumstance in which both the health care provider's and the patient's actions contribute to an injurious outcome is termed contributory negligence. An example would be a patient who fails to follow the physician's orders or fails to show up for follow-up care and then sues when the condition causes permanent damage. Another example would be a patient who deliberately gives false information about the ingestion of drugs, leading to adverse effects from medications administered. Most states do not completely dismiss injury if there has been negligence on the part of the health care institution, even if the patient's actions contributed substantially to the injury. Rather, comparative negligence is applied, where the percentage of the injury owing to the patient's actions is compared with the total amount of injury. A jury may decide that a physician was negligent in his or her actions, but because the patient lied about using an illegal street drug that contributed to the injurious outcome, the patient is 80% responsible for his or her condition. The party suing may be awarded $100,000 for injuries but actually would receive only $20,000. Gross negligence occurs when there is willful or deliberate neglect of the patient. Assault, battery, invasion of privacy, false imprisonment, and defamation of character all fall under the category of intentional misconduct. Corporate negligence occurs when a corporation (i.e. hospital) fails to meet its legal obligations to its clients (patients). (Ehrlich and Daly, 7th ed., p. 70)

A radiographer who discloses confidential patient information to unauthorized individuals can be found guilty of A. Libel B. Invasion of privacy C. Slander D. Defamation

B. Invasion of privacy A radiographer who discloses confidential information to unauthorized individuals may be found guilty of invasion of privacy. If the disclosure is in some way detrimental or otherwise harmful to the patient, the radiographer may also be accused of defamation. Spoken defamation is slander; written defamation is libel. (Adler and Carlton, 4th ed., pp. 374-375) (Patient Care in Radiolgraphy 7th edition by Ehrlich & Daly page 69)

The moral principle of preventing harm to a patient is called A. Negligence B. Nonmaleficence C. Veracity D. Fidelity

B. Nonmaleficence Nonmaleficence means doing no harm and is a moral and ethical responsibility of the radiographer. The radiographer must never perform or allow acts that may harm a patient (B). Negligence is a failure of the radiographer to use such care as a reasonably prudent radiographer would use under like or similar circumstances (A). Veracity refers to telling the truth, another moral and ethical responsibility of the radiographer in the performance of their duties (C). Fidelity refers to being faithful, also a moral and ethical responsibility of the radiographer, in performing acts that observe covenants or promises to deliver the best care for their patients (D). (Adler and Carlton, 6th ed., p. 326)

The moral principle that describes the radiographer's aspiration to do no harm or to allow no act that might cause harm to the patient is termed A. Beneficence B. Nonmaleficence C. Autonomy D. Veracity

B. Nonmaleficence There are many medicolegal terms with which the radiographer should be familiar. Beneficence refers to decisions and actions made to bring about good, ie, to benefit the patient. Nonmaleficence refers to the prevention of harm to the patient. Autonomy refers to the right of every individual to act with personal self-reliance. Veracity refers to telling the truth. (Adler and Carlton, 3rd ed, p 308)

Which nonverbal communication term refers to "the demonstration of a movement or gesture": A. Touch B. Pantomime C. Posture D. Appearance

B. Pantomime When working with a patient who has a language or communication barrier, nonverbal communication can often be the best route to obtain the desired movements necessary in the medical field. Pantomime (B) refers to the demonstration of a movement or gesture; for example, showing the patient how to position themselves for a lateral chest x-ray by positioning yourself for one first. Touch (A) is contact with the patient used to palpate for landmarks, for positioning, or to help the patient with transfers. Posture (C) is how we hold our bodies; rigid or loose shoulders, erect spine or slouching. Appearance (D) is conveyed through cleanliness, grooming, clothing choices. Both posture and appearance are crucial nonverbal cues that can demonstrate our personalities and demeanor to others. (Pierson and Fairchild, 6th edition, 31)

Some patients, such as infants and children, are unable to maintain the necessary radiographic position without assistance. If mechanical restraining devices cannot be used, which of the following should be requested or permitted to hold the patient? A. Transporter B. Patient's father C. Patient's mother D. Student radiographer

B. Patient's father If mechanical restraint is impossible, a friend or relative accompanying the patient should be requested to hold the patient. If a parent is to perform this task, it is preferable to elect the father so as to avoid the possibility of subjecting a newly fertilized ovum to even scattered radiation. If a friend or relative is not available, a nurse or transporter may be asked for help. Protective apparel, such as lead apron and gloves, must be provided to the person(s) holding the patient. Radiology personnel must never assist in holding patients, and the individual assisting must never be in the path of the primary beam. (Thompson et al., p. 484) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 153-163)

Verbal disclosure of confidential information that is detrimental to the patient is referred to as A. Battery B. Slander C. Libel D. Assault

B. Slander A radiographer who discloses confidential information to unauthorized individuals may be found guilty of invasion of privacy. If the disclosure is in some way detrimental or otherwise harmful to the patient, the radiographer may be accused of defamation. Spoken defamation is slander; written defamation is libel. Assault is to threaten harm; battery is to carry out the threat. (Torres et al., 6th ed., p. 11)

For medicolegal reasons, radiographic images are required to include all the following information except A. The patient's name and/or identification number B. The patient's birth date C. A right- or left-side marker D. The date of the examination

B. The patient's birth date Every radiographic image must include (1) the patient's name or ID number, (2) the side marker, right or left; (3) the date of the examination; and (4) the identity of the institution or office. Additional information may be included: the patient's birth date or age, name of the attending physician, and the time of day. When multiple examinations (e.g., chest examinations or small bowel images) of a patient are made on the same day, it becomes crucial that the time the radiographs were taken be included on the image. This allows the physician to track the patient's progress. (Frank et al., 11th ed., vol. 1, p. 25) (Bontrager's Textbook of Radiographic Positioning & Related Anatomy 9th edition by Lampignano & Kendrick page 32)

An Advanced Health Care Directive, or living will, is in effect when: A. One physician had verified that the patient cannot make medical decisions on their own B. The patient's condition complies with the state's living will law C. Physical conditions have improved but were previously such that the patient could not make health care decisions D. The patient is of sound mind but refuses treatment

B. The patient's condition complies with the state's living will law An Advanced health Care Directive, or living will, is a legal document outlining a patient's treatment preferences that would go into effect when they can no longer make health care decisions on their own. Living wills can be specific or general and therefore have specific requirements for them to be put into effect. A patient's condition must comply with the state's particular living will law (B). Two physicians must verify that the patient is unable to make their own health care decisions (A), and if their condition improves and allows them to regain the ability to do so the living will would no longer be in effect (C). A living will is not implemented if a patient simply refuses treatment but is otherwise of sound mind (D). (Pierson and Fairchild, 6th edition, 13-14)

The legal doctrine res ipsa locquitur means which of the following? A. Let the master answer B. The thing speaks for itself C. A thing or matter settled by justice D. A matter settled by precedent

B. The thing speaks for itself The legal doctrine res ipsa locquitur relates to a thing or matter that speaks for itself. For instance, if a patient went into the hospital to have a kidney stone removed and ended up with an appendectomy, that speaks for itself, and negligence can be proven. Respondeat superior is the phrase meaning "let the master answer" or "the one ruling is responsible." If a radiographer were negligent, there may be an attempt to prove that the radiologist was responsible, because the radiologist oversees the radiographer. Res judicata means a thing or matter settled by justice. Stare decisis refers to a matter settled by precedent. (Gurley & Callaway, p 194) (Patient Care in Radiolgraphy 7th edition by Ehrlich & Daly page 70)

Hemovac or Penrose drains are used for A. Bile duct drainage B. Tissue drainage of wounds or postoperative drainage C. Decompression of the gastrointestinal tract D. Feeding patients who are unable to swallow food

B. Tissue drainage of wounds or postoperative drainage Hemovac or Penrose drains are used for tissue drainage of wounds or in postoperative drainage. Drainage tubes help prevent the formation of infection or fistulas in wounds and postoperative sites with large amounts of drainage. Bile duct drainage, when necessary, is performed with a T-tube, and radiographers often perform radiographic examinations of the T-tube to verify patency. Nasogastric and nasoenteric tubes may be used either for decompression of the gastrointestinal tract or to feed patients who are unable to swallow food normally. In addition, radiographic examination of the gastrointestinal tract may be performed by introducing a contrast agent into a nasogastric or nasoenteric tube. (Torres et al, pp 255-256) (Bontrager's Textbook of Radiographic Positioning & Related Anatomy 9th edition by Lampignano & Kendrick page 604)

The Heimlich maneuver is used if a patient is A. in cardiac arrest B. choking C. having a seizure D. suffering from hiccups

B. choking The Heimlich maneuver is used when a person is choking. If you suspect that an individual is choking, be certain that the airway is indeed obstructed before attempting the Heimlich maneuver. A person with a completely obstructed airway will not be able to speak or cough. If the person cannot speak or cough, then the airway is obstructed, and the Heimlich maneuver should be performed. The proper method is to stand behind the choking victim with one hand in a fist, thumb side in, midway between the navel and the xiphoid tip. Place the other hand over the closed fist with the palm open and apply pressure in and up. Repeat the thrust several times until the object is dislodged. For an infant, the procedure is modified. Four back blows are given midway between the scapulae using the heel of the hand. If the object is not dislodged, the baby is turned over (being very careful to support the baby's head and spine), and four chests thrusts are performed just below the nipple line using several fingers. (Adler and Carlton, 4th ed., p. 280) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 245-246)

Which of the following is an inappropriate manner of speaking to a patient? A. "Are you warm enough?" B. "Do you have any questions about this examination?" C. "I have several other patients, so please change quickly." D. "Can I help you out of the chair?"

C. "I have several other patients, so please change quickly." The radiographer should never rush the patient. A patient is usually anxious from the start, and the anxiety of being instructed to "hurry up" is likely to make matters worse. The anxious patient will have difficulty following directions, and a good examination might be difficult to achieve. The anxious patient appreciates a radiographer who is compassionate enough to take the extra few minutes necessary for comfort. (Frank, Long, and Smith, 11th ed., vol. 1, p. 21)

Forms of intentional misconduct include 1. Slander 2. Invasion of privacy 3. Negligence A. 1 only B. 2 only C. 1 and 2 only D. 1, 2, and 3

C. 1 and 2 only Verbal defamation of another, or slander, is a type of intentional misconduct. Invasion of privacy (i.e., public discussion of privileged and confidential information) is intentional misconduct. However, if a radiographer leaves a weak patient standing alone to check images or get supplies and that patient falls and sustains an injury, that would be considered unintentional misconduct, or negligence. (Adler and Carlton, 4th ed., pp. 375-376)

A diabetic patient who has taken insulin while preparing for a fasting radiologic examination is susceptible to a hypoglycemic reaction. This is characterized by 1. Fatigue 2. Cyanosis 3. Restlessness A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

C. 1 and 3 only The diabetic patient who has taken their insulin, but not eaten food, can develop hypoglycemia/low blood sugar. Hypoglycemic reactions can be very severe and should be treated with an immediate dose of sugar in the form of juice or candy. Symptoms of hypoglycemia include fatigue, restlessness, irritability, and weakness. Diabetic patients who have taken their insulin prior to a fasting examination should be given priority, and their examinations should be expedited as quickly as possible. (Torres et al., 6th ed., pp. 169-170)

Which of the following statements would be true regarding tracheostomy patients? 1. Tracheostomy patients have difficulty speaking 2. A routine chest x-ray requires the tracheostomy tubing to be rotated out of view 3. Audible rattling sounds indicate a need for suction A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

C. 1 and 3 only The tracheostomy patient will have difficulty speaking as a result of redirection of the air past the vocal cords. Gurgling or rattling sounds coming from the trachea indicate an excess accumulation of secretions, requiring suction with sterile catheters. Any rotation or movement of the tracheostomy tube may cause the tube to become dislodged, and an obstructed airway could result. (Torres et al., 6th ed., p. 239)

What are the requirements of a hospital or imaging center regarding patient demographic information that appears on a digital image? 1. Workstations that display images with patient demographic information should be located in controlled access areas of the facility 2. Technologists should be able to alter information contained in the image file sent to PACS to correct errors without documenting the change 3. Technologists should be able to change patient information as an error prevention step post processing before sending images to PACS 4. At a minimum, demographic information should include the following: patient name or ID number, exam date, side marker, and facility name where the exam was performed A. 1 and 3 B. 2 and 4 C. 1, 3, and 4 D. 1, 2, and 4

C. 1, 3, and 4 The accuracy and maintenance of privacy of patient demographics is crucial to the safe, ethical practice of radiologic technology. Computer workstations should be placed in areas the general public cannot access, and also have tools in place to preserve privacy, like screen savers and polarizing filters. Technologists should double check patient identifiers displayed on the image in post-processing before sending to PACS. If an error is caught at this step, it can be corrected easily. To provide the radiologist and ordering physician confirmation of patient identity and chronology of care, the patient's name or ID number, side marker, date of the exam, and facility should is the minimum info required on each image. Physicians have several hundred patients they are caring for simultaneously; crucial information reduces confusion that leads to suboptimal care (C). The only choice that is false is that technologists should be able to alter information contained in the image file sent to PACS to correct errors without documenting the change (A, B, and D). Anytime changes are made to the patient's medical record, it is a legal and ethical requirement to document the change and the reason it was made. Unscrupulous practitioners could cover up negligence and other liabilities if this requirement was not in place. (Carter and Veale, 3rd ed., p. 36)

When radiographing the elderly, it is helpful to 1. Move quickly 2. Address them by their full name 3. Give straightforward instructions. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only Elderly patients (actually, most people) dislike being rushed or hurried along. They appreciate the radiographer who is caring and respectful enough to take the extra few moments necessary to progress at a slower speed. Some elderly patients are easily confused, and it is best to address them by their full name and keep instructions simple and direct. The elderly require the same respectful, dignified care as all other patients. (Adler and Carlton, 5th ed., p 137)

Facsimile transmission of health information is 1. Not permitted 2. Permitted for urgently needed patient care 3. Permitted for third-party payer hospitalization certification A. 1 only B. 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only Facsimile transmission of health information is convenient but should be used only to address immediate and urgent patient needs—and every precaution must be taken to ensure its confidentiality. It should be used only with prior patient authorization, when urgently needed for patient care, or when required for third-party payer ongoing hospitalization certification. These recommendations are made by the American Health Information Management Association (AHIMA). (Adler and Carlton, 4th ed., p. 368)

The ARRT Rules of Ethics are 1. Aspirational 2. Mandatory 3. Minimally acceptable standards A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only The ARRT Standards of Ethics is a three-part document. Following the Preamble, it consists of the Code of Ethics, the Rules of Ethics, and Administrative Procedures. The Code of Ethics serves as a guide that imaging professionals use to direct their conduct and growth—it addresses humanistic behavior, delivery of care without bias, good judgment, minimizing exposure to ionizing radiation, assuming responsibility, not attempting to diagnose or interpret, etc. The Code of Ethics is aspirational. The Rules of Ethics are minimally acceptable mandatory and enforceable standards required of all imaging professionals to ensure quality patient care. Violation of the Code of Ethics renders the individual subject to sanction. The Rules of Ethics cover issues such as fraud/deceit regarding individual ARRT certification; subversion/attempt to the subvert the certification examination process; conviction of a crime; failure to report charges concerning the individual's permit, license, or certification; engaging in unethical conduct; etc. There are 20 Rules of Ethics with which the imaging professional should be familiar. (The ARRT Standards of Ethics 2020 pages 1-8)

Honor Code violations that can prevent a radiography student from meeting ARRT certification requirements include 1. Failing one or more courses in the radiography program 2. Being suspended from the radiography program 3. Being dismissed/expelled from a radiography program A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only The word honor implies regard for the standards of one's profession, a refusal to lie/deceive, an uprightness of character or action, a trustworthiness and incorruptibility. Other words used to describe these qualities are honesty, integrity, and probity. These are qualities required of students and health care professionals. This honor/integrity can only be achieved 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. The ARRT publishes an important document regarding Honor Code violations. In order to meet ARRT certification requirements, candidates for the ARRT exam must answer the question: "Have you ever been suspended, dismissed, or expelled from an educational program that you have attended?" ... in addition to reading and signing the "Written Consent under FERPA," allowing the ARRT to obtain specific parts of their educational records concerning violations to an honor code if the student has ever been suspended, dismissed, or expelled from an educational program attended. If the applicant answers "yes" to that question he or she must include an explanation and documentation of the situation with the completed application for certification. If the applicant has any doubts, he or she should contact the ARRT Ethics Requirements Department at (651) 687-0048, ext. 8580. [Source: The American Registry of Radiologic Technologists Standards of Ethics. (Reproduced, with permission, from the ARRT Standards of Ethics. ARRT: 2008. Copyright © 2008 The American Registry of Radiologic Technologists.)]

Which of the following situations would be considered an act of health care fraud? A. Sharing information about a patient's condition with an individual not involved in the patient's care B. Performing a radiographic procedure without the patient's permission C. Erasing a CR image plate to cover up a mistake of performing an x-ray procedure on the wrong body part D. Restraining a patient against their will

C. Erasing a CR image plate to cover up a mistake of performing an x-ray procedure on the wrong body part Willful and intentional misrepresentation of facts constitutes health care fraud. For example, erasing a CR image plate to cover up a mistake of performing an x-ray procedure on the wrong body part would be a fraudulent act (C). Sharing information about a patient's condition with an individual not involved in the patient's care describes a violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as it relates to privacy of records (A). Performing a radiographic procedure without the patient's permission is considered battery (B). Restraining a patient against their will describes false imprisonment (D). (Adler and Carlton, p. 346)

A patient undergoing a routine radiographic exam of the shoulder has a few questions for the technologist post exam. The patient's orthopedic surgeon has scheduled them for a contrast MR study of the shoulder joint, post arthrogram. The patient is nervous about the MR procedure and wants to know what it's like, having never had one before. The technologist should do which of the following? A. Tell the patient about their cousin who suffers from claustrophobia and how her MR exam was a nightmare B. Explain how the MR scanner will use high frequency sound waves and capture the echo created by the tissues of the shoulder to create an image C. Explain that while there is a strong magnetic field in the MR exam, the staff carefully screens patients as part of a strict safety protocol and that the most troubling part is typically the noise, as the machine makes a jackhammer sound during imaging D. Explain that the patient will be injected with a small dose of radioactive isotope and gamma emissions will be captured by a scintillator and an array of photomultiplier tubes

C. Explain that while there is a strong magnetic field in the MR exam, the staff carefully screens patients as part of a strict safety protocol and that the most troubling part is typically the noise, as the machine makes a jackhammer sound during imaging Even a novice technologist should be able to give some information and insight about examinations in other modalities. A rudimentary knowledge of other imaging technologies is necessary in order to ensure that you do not mislead a patient with less than accurate information. Equally important is a technologist's ability to use common language and avoid technical jargon while giving these explanations. MR imaging technology utilizes strong magnetic fields, which may be dangerous if safety protocols are not followed, and a radio wave transmitter/receiver. During imaging, the radio transmitter makes a high-speed repetitive thumping sound, similar to the sound of a jackhammer, a device used in construction and demolition (C). Explaining how the scanner will use high frequency sound waves and capture the echo created by the tissues of the shoulder to create an image would be part of an ultrasound procedure (B). Explaining that the patient will be injected with a small dose of radioactive isotope and gamma emissions will be captured by a scintillator and an array of photomultiplier tubes would be a part of a nuclear medicine procedure and is also a bit too technical to be understood by a layperson (D). Telling the patient about a cousin who suffers from claustrophobia and how her MR exam was a nightmare would be foolish and should not be shared with the patient (A). The technologist has an underlying duty to support the patient's total health, including their emotional well-being. A nervous patient should be addressed with tact and compassion and should not be driven to greater anxiety by sharing anecdotes of other patients' poor experiences. In addition, in choosing option A, the technologist has violated her cousin's privacy and breached the Code of Ethics. (Adler, 6th ed., pp. 7, 134)

Radiographs are the property of the A. Radiologist B. Patient C. Health-Care Institution D. Referring Physician

C. Health-Care Institution Radiographs are the property of the health-care institution and are a part of every patient's permanent medical record. They are often retained on file for about 7 years or, in the case of pediatric patients, until the patient reaches maturity. They are not the personal property of either the radiologist or the referring physician. If a patient changes doctors or needs a second opinion, copies can be requested. The patient may also borrow the originals, which must be returned, or he or she may pay for copies. (Adler & Carlton, p 317) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 318)

To "excuse" suboptimal images, a radiographer makes a note on the exam requisition claiming that the patient "was uncooperative." That radiographer can legally be found guilty of A. Battery B. Slander C. Libel D. Tort

C. Libel Battery refers to the unlawful use of force against a person. If a health care professional communicates false information to a third party, that health care professional can be found guilty of defamation. Spoken defamation is slander; written defamation is libel. (Saia, PREP, 4th ed, p 8)

Patients are instructed to remove all jewelry, hair clips, metal prostheses, coins, and credit cards before entering the room for an examination in A. Sonography B. Computed Tomography (CT) C. Magnetic Resonance Imaging (MRI) D. Nuclear Medicine

C. Magnetic Resonance Imaging (MRI) Patients are instructed to remove all jewelry, hair clips, metal prostheses, coins, and credit cards before entering the room for MRI. MRI does not use radiation to produce images but instead uses a very strong magnetic field. All patients must be screened prior to entering the magnetic field to be sure that they do not have any metal on or within them. Proper screening includes questioning the patient about any eye injury involving metal, cardiac pacemakers, aneurysm clips, insulin pumps, heart valves, shrapnel, or any metal in the body. This is extremely important, and if there is any doubt, the patient should be rescheduled for a time after it has been determined that it is safe for him or her to enter the room. Patients who have done metalwork or welding are frequently sent to diagnostic radiology for screening images of the orbits to ensure that there are no metal fragments near the optic nerve. Any external metallic objects, such as bobby pins, hair clips, or coins in the pocket, must be removed, or they will be pulled by the magnet and can cause harm to the patient. Credit cards and any other plastic cards with a magnetic strip will be wiped clean if they come in contact with the magnetic field. (Torres et al., 6th ed., pp. 362-363) (Bontrager's Textbook of Radiographic Positioning & Related Anatomy 9th edition by Lampignano & Kendrick page 778)

Which of the following patient identifiers is not considered protected information: A. Address B. Date of Birth C. Medical Record Number D. Social Security Number

C. Medical Record Number The Health Insurance Portability and Accountability Act outlines rules to protect health care information. Common identifiers are considered protected information and cannot be included in email or text correspondence and cannot be given to those who are not directly involved in the patient's care. The patient's name, address (A), date of birth (B), and social security number (D) are all considered protected identifiers. The medical record number (C), however, is location-specific and does not link directly to the patient if it is on its own. Therefore, the medical record number is not considered protected information and can be included in digital correspondence. (Pierson and Fairchild, 6th edition, 13-14)

The ethical principle that aspires never to, above all, do harm describes A. Fidelity B. Veracity C. Nonmalficence D. Beneficence

C. Nonmalficence Fidelity, veracity, nonmalficence, and beneficence are all ethical principles. Nonmalficence is the principle that refers to the prevention of harm. Beneficence is the ethical principle that refers to bringing about good or benefiting others. Fidelity refers to faithfulness, and veracity refers to truthfulness. (Adler and Carlton, 4th ed., p. 352) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 301-302)

Hand gestures, pantomime, and facial expressions are all forms of which type of communication: A. Verbal B. Audible C. Nonverbal D. Attentive listening

C. Nonverbal When working with patients, both verbal and nonverbal skills can come together to create effective communication. Examples of nonverbal communication include hand gestures (A), pantomime (B), facial expressions (C), appearance/cleanliness of the caregiver, body positions and movements, posture, and touch. Examples of verbal communication include tone of voice, use of idiomatic expressions, speed of speaking, and volume of speech. Attentive listening (D) is a nonverbal skill that is used when receiving verbal communication. (Pierson and Fairchild, 6th edition, 28-32)

When interviewing a patient, what is it that the health care professional can observe? A. Symptoms B. History C. Objective signs D. Chief complaint

C. Objective signs Interviewing skills and the collection of valuable, objective, and subjective patient data (clinical history) are an important function of the health care professional. Objective data are those that are discernible to the senses of the interviewer—objective signs that can be heard, seen, or felt. Subjective data are those that can be discerned only by the patient—pain, emotions, and so on. Chief complaint is the principal medical problem as stated by the patient. (Adler and Carlton, 4th ed., p. 159) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 136)

The term "health care proxy" is synonymous with: A. Living will B. DNR C. Power of Attorney D. AHA

C. Power of Attorney The term "health care proxy" refers to an individual chosen by the patient to carry out medical decisions for them when they are physically unable to make decisions on their own. The health care proxy can also be referred to as a power of attorney (C), and can refuse or request treatment on behalf of the patient. Both the living will (A) and DNR, or "do not resuscitate" (B) are legal documents known as advance health care directives. These documents provide instructions on treatment requests or refusals when patients can no longer actively participate in their own healthcare decisions (such as in a state of unconsciousness). The AHA (D), or American Hospital Association, is a nationally recognized organization aimed at serving hospital and healthcare networks. (Pierson and Fairchild, 6th edition, 13-15)

Nitroglycerin _____ blood vessels, resulting in _____ blood flow. A. Relaxes; decreased B. Constricts; decreased C. Relaxes; increased D. Constricts; increased

C. Relaxes; increased Nitroglycerin is a vasodilator that can be used to increase blood flow to heart muscle. To increase blood flow, vasodilators act by relaxing the walls of the blood vessels, which increases the amount of blood that can be transported to necessary tissues. A constriction of blood vessels that would decrease blood flow would be caused by vasoconstrictors, such as epinephrine. (Ehrlich and Coakes, 9th ed., pp. 230-235)

A radiographer has recently joined your staff. You are aware that this individual has had her ARRT certification revoked. Realizing that your state requires certification, you speak to a supervisor about the matter. Your supervisor replies that he knows but made an exception "because we are so short staffed." You should A. Report this to the next supervisor in charge B. Report this to the facility administrator C. Report this directly to the ARRT D. Do and/or say nothing

C. Report this directly to the ARRT The ARRT Rules of Ethics are mandatory minimum professional standards for all RTs and candidate RTs. Violators, and individuals who permit violation, of these Rules are subject to sanctions. Rules of Ethics numbers 15 and 21 specifically refer to those who knowingly assist another without proper certification to engage in the practice of radiologic technology, and/or those who fail to promptly report such activity to the ARRT—as being subject to sanction. (ARRT Standards of Ethics)

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. The patient states that she experiences extreme pain in the upright position Obtaining a complete and accurate history from the patient 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 patient and document the information on the requisition for the radiologist. (Adler and Carlton, 4th ed., p. 158) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page )

All of the following are part of the patient's bill of rights except A. The right to refuse treatment B. The right to review one's records C. The right to order an x-ray procedure D. The right to have an advance directive

C. The right to order an x-ray procedure The AHA published a Patient's Bill of Rights that detailed 12 specific areas of patients' rights and the health care professional's ethical (and often legal) responsibility to adhere to these rights. The Patient's Bill of Rights is summarized as follows: 1. The right to considerate and respectful care 2. The right to be informed completely and understandably 3. The right to refuse treatment 4. The right to have an advance directive (e.g., a living will or health care proxy) 5. The right to privacy 6. The right to confidentiality 7. The right to review one's records 8. The right to request appropriate and medically indicated care and services 9. The right to know about institutional business relationships that could influence treatment and care 10. The right to be informed of, consent to, or decline participation in proposed research studies 11. The right to continuity of care 12. The right to be informed of hospital policies and procedures relating to patient care, treatment, and responsibilities Although it is the patient's right to appropriate and medically indicated care and services, only the physician may order an x-ray procedure—just as it is only the physician who may order prescription drugs. The AHA recently replaced the Patient's Bill of Rights with The Patient Care Partnership—Understanding Expectations, Rights and Responsibilities. This plain-language brochure includes the essentials of the Patient's Bill of Rights and reviews what patients can and should expect during a hospital stay. (Ehrlich et al., 6th ed., pp. 61-62)

A signed consent form is necessary prior to performing all the following procedures except A. Myelogram B. Cardiac catheterization C. Upper GI series D. Interventional vascular procedure

C. Upper GI series A signed consent form (informed consent) is not necessary prior to performing an upper GI series. Informed consent is necessary before performing any procedure that is considered invasive or that carries considerable risk. A myelogram, a cardiac catheterization, and an interventional vascular procedure are all invasive procedures, and all carry some degree of risk. A physician should explain to the patient what those risks are as well as the risk of not having the procedure. In addition, the patient should be made aware of alternative procedures and the risks associated with the alternatives. Only after the patient has been made aware and all questions have been answered appropriately should the informed consent be signed. A radiographer is not responsible for obtaining informed consent. However, in some institutions, it may be departmental procedure for the radiographer to check the chart and see whether there is a signed consent form in place. (Adler and Carlton, 4th ed., p. 377) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 325-326)

A consent form, signed by the patient and the physician, is necessary prior to performing all of the following procedures EXCEPT A. Myelogram B. Cardiac catheterization C. Upper GI series D. Interventional vascular procedure

C. Upper GI series Informed consent is a legal standard for all procedures that are classified as invasive. An invasive procedure is defined as any procedure in which the patient's skin is pierced with a needle or blade. All invasive procedures carry additional risk—at a minimum, the risk of infection. Informed consent must precede these procedures, and must contain the following elements, conducted by the performing physician: • An explanation of the procedure and the risks associated with the procedure • Information regarding alternative methods/ exams that are available to the patient • An opportunity for the patient to ask questions and potentially refuse the procedure Myelograms, interventional vascular procedures, and cardiac catheterizations all involve piercing the patient's skin with a needle, and thus require informed consent (A, B, and D). The UGI only involves the patient drinking barium contrast, typically, and does not require a documented consultation before beginning (C). General consent, for all non-invasive procedures, is given when the patient is registered and signs a "permission to treat" document. The right to refuse care is absolute regardless of circumstance, and the patient may revoke consent, both general and informed, at any time. (Adler, 6th ed., p. 348)

The medical term for hives is A. Vertigo B. Epistaxis C. Urticaria D. Aura

C. Urticaria Urticaria is a vascular reaction resulting in dilated capillaries and edema and causing the patient to break out in hives. The medical term for nosebleed is epistaxis. Vertigo refers to a feeling of "whirling" or a sensation that the room is spinning. Some possible causes of vertigo include inner ear infection and acoustic neuroma. An aura may be classified as either a feeling or a sensory response (such as flashing lights, tasting metal, or smelling coffee) that precedes an episode such as a seizure or a migraine headache. (Adler and Carlton, 4th ed., p. 286) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 293)

Which ethical principle is related to sincerity and truthfulness? A. Beneficence B. Autonomy C. Veracity D. Fidelity

C. Veracity Veracity (i.e., sincerity) is not only telling the truth but also not practicing deception. Autonomy is the ethical principle that is related to the theory that patients have the right to decide what will or will not be done to them. Beneficence is related to the idea of doing good and being kind. Fidelity is faithfulness and loyalty. (Adler and Carlton, 4th ed., p. 253) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 302)

The medical abbreviation meaning "every hour" is A. tid B. qid C. qh D. pc

C. qh The abbreviation for every hour is qh. The abbreviation tid means three times a day, and qid means four times a day. After meals is abbreviated pc. (Adler & Carlton, p 278)

A radiologic technologist can be found guilty of a tort in which of the following situations? 1. Failure to shield a patient of childbearing age from unnecessary radiation 2. Performing an examination on a patient who had refused the examination 3. Performing an examination on the wrong patient A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 A tort is an intentional or unintentional act that involves personal injury or damage to a patient. Allowing a patient to be exposed to unnecessary radiation, either by neglecting to shield the patient or by performing an unwanted examination, would be considered a tort, and the radiographer would be legally accountable. Discussing a patient's condition with a third party undoubtedly would be considered a serious intentional tort. (Torres et al., 6th ed., p. 15)

Air and gas can be used as contrast agents in which of the following studies? 1. Arthrography 2. Myelography 3. Fluoroscopy A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Air and gas provides negative contrast to imaging studies. Since air and gas do not absorb many x-rays, they show up as dark substances during x-ray studies. Carbon dioxide (CO2) is often used as a negative contrast agent. Studies in which a negative contrast agent can be beneficial include GI studies under fluoroscopy (3) and general x-ray, arthrography (1), and myelography (2) (A, B, C, and D). (Ehrlich & Coakes, 9th ed., p. 351)

Symptoms associated with a mild to moderate allergic reaction to contrast media include 1. sneezing 2. hoarseness 3. wheezing A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 All these symptoms are related to a respiratory reaction. There also may be urticaria, scratchy throat, nasal congestion. The patient who has received contrast media should be watched closely. If any symptoms arise, the radiologist should be notified immediately. (Dutton and Ryan, 9th ed., p. 183)

When radiographing young children, it is helpful to: 1. Let them bring a toy 2. Keep explanations simple and honest 3. Be cheerful and unhurried A. 1 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Children are often fearful of leaving familiar surroundings, and being able to take along a familiar toy is helpful. A calm and cheerful radiographer can be reassuring to the anxious child. Honesty is essential, and simple explanations are best. (Ehrlich and Coakes 10th ed, p 110)

Which of the following medical devices and/or implants are visible on radiographic images? 1. Intrauterine devices (IUDs) 2. Inner ear prosthesis 3. Aneurysm clips A. 2 only B. 3 only C. 1 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Image production is reliant on differential absorption of x-ray particles; therefore, any items that contain metal are visible on radiographs and fluoroscopic images. For surgical and medical implants, such as intrauterine devices (1), certain inner ear prostheses (2), aneurysm clips (3), and orthopedic replacements, removal is not possible and exam pre-screening can indicate when these are present (D). Unfortunately, some devices and implants will obstruct necessary anatomy, such as with pacemakers and shoulder imaging; however, nothing can be done to avoid these situations. The other answer choices are incorrect as per the previous explanation (A, B, and C). (Ehrlich & Coakes, 9th ed., p. 416)

Which of the following factors can contribute to hypertension? 1. Obesity 2. Smoking 3. Stress A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Normal blood pressure is 90 to 120 mmHg systolic and 60 to 80 mmHg diastolic. High blood pressure (hypertension) is indicated by systolic pressure higher than 140 mmHg and diastolic pressure higher than 90 mmHg. Hypertension can be identified as extreme or moderate. Extreme hypertension can result in brain damage within just a few minutes. Moderate hypertension can cause damage to organs: the lungs, kidneys, brain, heart, and so on. Various disease processes can produce hypertension as well as contributing factors such as medications, obesity, smoking, and stress. (Adler and Carlton, 4th ed., p. 201)

Which of the following must be included in a patient's medical record or chart? 1. Diagnostic and therapeutic orders 2. Medical history 3. Informed consent A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The Joint Commission [formerly the Joint Commission on the Accreditation of Health-care Organizations (JCAHO)] is the organization that accredits health care organizations in the United States. The Joint Commission sets forth certain standards for medical records. In keeping with these standards, all diagnostic and therapeutic orders must appear in the patient's medical record or chart. In addition, patient identification information, medical history, consent forms, and any diagnostic and therapeutic reports should be part of the patient's permanent record. The patient's chart is a means of communication between various health care providers. (Torres et al., 6th ed., p. 19)

Which of the following must be included in the patient's medical record or chart? 1. Diagnostic and therapeutic orders 2. Medical history 3. Informed consent A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) is the organization that accredits health-care organizations in the United States. The JCAHO sets forth certain standards for medical records. In keeping with these standards, all diagnostic and therapeutic orders must appear on the patient's medical record or chart. Additionally, patient identification information, medical history, consent forms, and any diagnostic and therapeutic reports should also be part of the patient's permanent record. The patient's chart is a means of communication between various health-care providers. (Torres et al, 6th ed., p. 19)

The legal document or individual authorized to make an individual's health care decisions, should the individual be unable to make them for himself or herself, is the 1. Advance health care directive 2. Living will 3. Health care proxy A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The patient's rights can be exercised on the patient's behalf by a designated surrogate or proxy decision maker if the patient 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. Since all persons 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 health care proxy authorized to make all health care decisions and can include specifics regarding DNR (Do not resuscitate), DNI (Do not intubate), and/or other end-of-life decisions. (Adler and Carlton, 4th ed., p. 155)

Which of the following diastolic pressure readings can indicate hypertension? A. 40 mm Hg B. 60 mm Hg C. 80 mm Hg D. 100 mm Hg

D. 100 mm Hg The diastolic number is the bottom (right) number in a blood pressure reading. The normal range for diastolic pressure is considered to be 50 to 70 mm Hg. A diastolic pressure reading of 80 can be considered pre-hypertension and a reading of 110 mmHg can indicate hypertension. A diastolic pressure of 40 mm Hg might indicate shock. The systolic number is the top (left) number in a blood pressure reading. The normal systolic pressure range is 90 to 120 mm Hg. (Dutton and Ryan, 9th ed., p. 133,141)

In what order should the following contrast examinations be performed on the same patient? 1. Upper GI series 2. IVU 3. BE A. 3, 1, 2 B. 1, 3, 2 C. 2, 1, 3 D. 2, 3, 1

D. 2, 3, 1 When scheduling more than one contrast examination on the same patient, it is important to avoid the possibility of residual contrast medium covering areas that will be of interest on later examinations. The IVU [also referred to as an intravenous pyelogram (IVP)] should be scheduled first because the contrast medium used is excreted rapidly. The BE should be scheduled next. Finally, the upper GI series is scheduled. There should not be enough barium remaining from the previous BE to interfere with the examination of the stomach or duodenum, although a preliminary scout image should be taken in each case. (Torres et al., 6th ed., p. 234)

You are about to perform an arthrogram on a non-English speaking patient. Which of the following communication techniques is likely to be most effective at bridging the language barrier as you give the patient instructions and a brief description of the exam? A. Use common English rather than medical jargon to describe the procedure, stopping frequently to confirm that the patient understands B. Look up a translation of your explanation on a web-based translation software. Do your best to read the passage to the patient C. Invite the patient's daughter, who happens to speak both languages, into the exam, to translate your instructions D. Call the recommended telephone translator on the designated phone, supplied by the hospital for scenarios such as this. Explain to the translator what you wish to communicate and hand the phone to the patient, so that the translator can convey the information

D. Call the recommended telephone translator on the designated phone, supplied by the hospital for scenarios such as this. Explain to the translator what you wish to communicate and hand the phone to the patient, so that the translator can convey the information Language barriers are a communication issue that can quickly lead to a patient safety issue. Telephonic translators are a common resource in hospitals and imaging centers nationwide. The translators who answer these lines have been educated and certified in not just common terms and phrases but have also learned medical terminology as well. For this reason, they are more reliable than patient's family members and software translations available on the internet, both of which may not translate some of the medical terms correctly. By far, choice A is the worst choice, as the health care professional seems to be just ignoring the language barrier. (Adler & Carlton, 6th edition, p138)

You receive a patient who is complaining of pain in the area of the left fourth and fifth metatarsals; however, the requisition asks for a left ankle examination. What should you do? A. Perform a left foot examination B. Perform a left ankle examination C. Perform both a left foot and a left ankle examination D. Check with the referring physician

D. Check with the referring physician Although it is never the responsibility of the radiographer to diagnose a patient, it is the responsibility of every radiographer to be alert. The patient should not be subjected to unnecessary radiation from an unwanted examination. Rather, it is the radiographer's responsibility to check with the referring physician and report the patient's complaint. (Ehrlich & McCloskey, p 14) (Radiation Protection in Medical Radiography 8th edition by Statkiewicz, Visconti, Ritenour, Haynes page 245)

You are working in the outpatient department and receive a patient who is complaining of pain in the right hip joint; however, the requisition asks for a left femur examination. What should you do? A. Perform a right hip examination B. Perform a left femur examination C. Perform a both right hip and a left femur examination D. Check with the referring physician

D. Check with the referring physician Although it is never the responsibility of the radiographer to diagnose a patient, it is the responsibility of every radiographer to be alert. The patient should not be subjected to unnecessary radiation from an unwanted examination. Rather, it is the radiographer's responsibility to check with the referring physician and report the patient's complaint. (Ehrlich and Daly, 7th ed., p. 74) (Radiation Protection in Medical Radiography 8th edition by Statkiewicz, Visconti, Ritenour, Haynes page 248)

Joseph Luckett Jr, is a competent second-year student. He has been imaging patients under indirect supervision for most of the day. All CR images are viewed at the workstation on the computer monitor, before being sent to the radiologist. After taking posteroanterior (PA) and lateral chest projections on a patient with a positive purified protein derivative (PPD) test, Joseph notices that he has "clipped" the apices on the PA projection. As per the policy of the department and program, he must consult with a technologist before repeating any images. The technologist takes a quick glance at his image and says, "It looks fine. Send it." "But what about the apices?" Joseph asks. He knows that imaging the apices is extremely important in suspected cases of TB. The technologist does not take a second look. "That's okay. It's just a routine. Send it." What is the most appropriate immediate action for Joseph to take? A. Ignore the technologist's advice and repeat the PA view B. Send the images as suggested by the technologist C. Send the images but, without informing the technologist, add the following comment: "Technologist advised against a repeat." D. Explain the clinical history to the technologist and stress that he is uncomfortable sending a suboptimal study

D. Explain the clinical history to the technologist and stress that he is uncomfortable sending a suboptimal study Wrong action, also vindictiveness or malice. Ethically, sending the image would not be beneficial to the patient, and the ethical principle of beneficence suggests that our actions always should benefit the patient. In a worse-case scenario, the patient could have TB, but because of the missing apices, the radiologist could read the image as negative. The radiologist might request that the patient return for a repeat image—further inconveniencing the patient and adding to his or her stress. Adding a negative comment to the study without first consulting with the technologist implies malice or vindictiveness. Repeating the image against the technologist's advise would be a definite violation of department and program policy. Joseph should not discredit his own judgment or intuitions. He should first attempt to resolve the matter by discussing it with the technologist. (Adler and Carlton, 4th ed., pp. 347-357)

What is the appropriate action if a patient has signed consent for a procedure but, once on the radiographic table, refuses the procedure? A. Proceed—the consent form is signed B. Send the patient back to his or her room C. Honor the patient's request and proceed with the next patient D. Immediately stop the procedure and inform the radiologist and the referring physician of the patient's request

D. Immediately stop the procedure and inform the radiologist and the referring physician of the patient's request According to the patient's bill of rights, the patient's verbal request supersedes any prior written consent. It is not appropriate to dismiss the patient without notifying the referring physician and the radiologist. The patient may very well need a particular radiographic examination to make a proper diagnosis or for preoperative planning, and the radiographer must inform the physician of the patient's decision immediately. (Ehrlich et al., 6th ed., pp. 54-55) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 325-326)

The legal doctrine respondeat superior means which of the following? A. A matter settled by precedent B. A thing or matter settled by justice C. The thing speaks for itself D. Let the master answer

D. Let the master answer Respondeat superior is a phase meaning "let the master answer" or "the one ruling is responsible." If a radiographer were negligent, there may be an attempt to prove that the radiologist was responsible because the radiologist oversees the radiographer. The legal doctrine res ipsa locquitur relates to a thing or matter that speaks for itself. For instance, if a patient went into the hospital to have a kidney stone removed and ended up with an appendectomy, that speaks for itself, and negligence can be proven. Res judicata means a thing or matter settled by justice. Stare decisis refers to a matter settled by precedent. (Gurley and Callaway, 6th ed., p. 200) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 235)

Streptococcus pyogenes, Candida albicans, Bordetella pertussis, and Mycobacterium tuberculosis are pathogens that cause disease in which body system? A. Blood B. Genitourinary tract C. Skin D. Respiratory tract

D. Respiratory tract Streptococcus pyogenes causes strep throat. Candida albicans causes pneumonia and causes thrush in infants. Bordetella pertussis causes whooping cough. Mycobacterium tuberculosis causes tuberculosis. All of these are diseases that affect the respiratory system (D). Choices (A), (B), and (C) are incorrect as per the previous explanation. (Ehrlich and Coakes, 9th ed., p. 140)

All the following are part of the Patient's Bill of Rights except the right to A. Voluntary participation in proposed research studies B. Continuity of care C. Considerate and respectful care D. Review any hospital/institutional records

D. Review any hospital/institutional records The AHA publishes a Patient's Bill of Rights, which details 12 specific areas of patients' rights and the health care professional's ethical (and often legal) responsibility to adhere to these rights. The Patient's Bill of Rights is summarized as follows: 1. The right to considerate and respectful care 2. The right to be informed completely and understandably 3. The right to refuse treatment 4. The right to have an advance directive (e.g., a living will or health care proxy) 5. The right to privacy 6. The right to confidentiality 7. The right to review one's records 8. The right to request appropriate and medically indicated care and services 9. The right to know about institutional business relationships that could influence treatment and care 10. The right to be informed of, consent to, or decline participation in proposed research studies 11. The right to continuity of care 12. The right to be informed of hospital policies and procedures relating to patient care, treatment, and responsibilities Although it is the patient's right to appropriate and medically indicated care and services, only a physician may order an x-ray procedure—just as it is only the physician who may order prescription drugs. Although it is the patient's right to review his or her records and the patient's right to know about institutional business relationships that could influence treatment and care, the patient does not have the right to review just any hospital/institutional records. The AHA recently replaced the Patient's Bill of Rights with The Patient Care Partnership—Understanding Expectations, Rights and Responsibilities. This plain-language brochure includes the essentials of the Patient's Bill of Rights and reviews what patients can and should expect during a hospital stay. (Ehrlich et al., 6th ed., pp. 61-62)

An autoclave is used for A. Dry heat sterilization B. Chemical sterilization C. Gas sterilization D. Steam sterilization

D. Steam sterilization Sterilization is the complete elimination of all living microorganisms, and it can be accomplished by several methods. Pressurized steam, in an autoclave, is probably the most familiar means of sterilization; the pressure allows higher temperatures to be achieved. Gas or chemical sterilization is used for items that are unable to withstand moisture and/or high temperatures. Other methods of sterilization include dry heat, ionizing radiation, and microwaves (nonionizing radiation). (Torres et al, p 116) (Introduction to Radiologic & Imaging Sciences & Patient Care 7th edition by Carlton & Adler page 203)

The infection streptococcal pharyngitis ("strep throat") is caused by a A. virus B. fungus C. protozoon D. bacterium

D. bacterium Streptococcal pharyngitis ("strep throat") is caused by bacteria. To know this, you have to remember that bacteria are classified according to their morphology (i.e., size and shape). The three classifications are spirals, rods (bacilli), and spheres (cocci). Viruses, unlike bacteria, cannot live outside a human cell. Viruses attach themselves to a host cell and invade the cell with their genetic information. Various fungal infections may grow on the skin (cutaneously), or they may enter the skin. Fungal infections that enter the circulatory or lymphatic system can be deadly. Protozoa are one-celled organisms classified by their motility. Ameboids move by locomotion, flagella use their protein tail, cilia possess numerous short protein tails, and sporozoans actually are not mobile. (Adler and Carlton, 4th ed., pp. 221-223) (Radiographic Pathology for Technologists 7th edition by nina Kowalczyk page 69 )

Ipecac is a medication used to induce vomiting and is classified as a(n) A. diuretic B. antipyretic C. antihistamine D. emetic

D. emetic Ipecac is a medication used to induce vomiting and is classified as an emetic. This is easy to remember if you think of what an emesis basin is for. A diuretic is a medication that stimulates the production of urine. Lasix (furosemide) is an example of a diuretic. An antipyretic is used to reduce fever. Tylenol (acetaminophen) is an example of an antipyretic. An antihistamine is used to relieve allergic effects. Benadryl (diphenhydramine hydrochloride) is an example of an antihistamine that is often on hand in radiology departments in the event of a minor reaction to contrast media. (Adler & Carlton, p 265) (Patient Care in Radiolgraphy 7th edition by Ehrlich & Daly page 229-231)