Patient Care

Sternal compressions during CPR are made with the heels of the hands located about A 1 1/2 in. superior to the xiphoid tip B 1 1/2 in. inferior to the xiphoid tip C 3 in. superior to the xiphoid tip D 3 in. inferior to the xiphoid tip

The Correct Answer is: ALocation of the heels of the hands is of great importance during CPR. They should be placed about 1 1/2 in. superior to the xiphoid tip. In this way, the heart will receive the compressions it requires without causing internal injuries. Rib fractures can depress and cause injury to the lung tissues within the rib cage. (Torres et al., 6th ed., pp. 172-176)

Which of the following blood pressure measurements might indicate shock? A Systolic pressure lower than 60 mmHg B Systolic pressure higher than 140 mmHg C Diastolic pressure higher than 140 mmHg D Diastolic pressure lower than 90 mmHg

The Correct Answer is: AShock is indicated by extremely low blood pressure, that is, a systolic blood pressure reading lower than 60 mmHg (below 90 mmHg is considered low blood pressure). Normal blood pressure is 90 to 120 mmHg systolic and 60 to 80 mmHg diastolic. High blood pressure is indicated by systolic pressure higher than 140 mmHg and diastolic pressure higher than 90 mmHg. (Torres et al, p 163)

Pulse is commonly measured at: (1) Radial artery (2) Carotid artery (3) Mandibular artery A 1 only B 1 and 2 only C 1 and 3 only D 2 and 3 only

The most common locations to measure pulse are the following arteries: radial, carotid, brachial, temporal, popliteal, dorsal pedal, femoral, and posterior tibial. The radial artery (A) is located on the anterior side of the wrist just medial to the stylus process of the radius. The carotid artery (2) is located below the mandiublar angle and is not referred to as the mandibular artery (3). (Pierson and Fairchild, 6th edition, 31)

The mode of pathogenic transmission associated with sneezing and coughing is: A Vector B Fomite C Droplet D Direct contact

The spread of infectious microbes by coughing or sneezing is considered droplet transmission. Vectors are vermin and insects that carry pathogens, fomites are inanimate objects, like doorknobs and x-ray markers. Direct contact is when a caregiver touches a patient's skin, body fluids, or secretions in transmission of the pathogenic agent. (Adler and Carlton, 6th edition, p221)

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

For patients with a perforated bowel, which contrast media could be used for a barium enema: 1) Barium sulfate 2) Omnipaque 3) Isovue A 1 only B 3 only C 1 and 3 only D 2 and 3 only

D When a perforated bowel is suspected, it is important for patients to be given water-soluble contrast agents for all GI studies so that if the contrast seeps into the abdominal cavity, it can be absorbed and excreted by the kidneys. Barium sulfate (1) cannot be absorbed through the bloodstream and should not be used in these situations. It could cause harm if it leaks through the perforation and enters the peritoneal cavity.. Water-soluble contrast agents such as omipaque (2) and isovue (3) are useful for perforated bowel. (Lampignano & Kendrick, 9th edition, 500)

Compared to oral temperature, which of the following temperature sites would result in slightly higher values: (1) Rectal (2) Axillary (3) Forehead A 1 only B 2 only C 1 and 3 only D 1 and 2 only

A Choosing a site to measure temperature is dependent on patient age, ability, and condition. While oral temperatures tend to be the most frequent, for infants and those who cannot keep a thermometer under their tongue, other routes are preferable such as the axillary, rectal, temporal lobe, and forehead. The rectal temperature (1) will yield a reading 0.5-1.0°F higher than an oral temperature reading. Both axillary and forehead readings can be 0.5-1.0°F lower than oral temperature readings. (Pierson and Fairchild, 6th edition, 91-95)

Which blood pressure range is typical for adolescents: A 90-100/60-67 B 130-139/80-89 C 120-140/80-90 D 100-120/65-75

At 100-120/65-75 (D), adolescent blood pressure ranges are similar to the normal range for healthy adults: <120/<80. Children 3 months-1 year of age fall into a lower range of 90-100/60-67 (A). A high-normal range for adults, also known to be "prehypertensive", is 130-139/80-89 (B). Normal ranges for those 65 years of age and higher is 120-140/80-90 (C). (Pierson and Fairchild, 6th edition, 31)

A technologist is performing an assisted transfer from wheelchair to radiographic exam table with adjustable height. The patient has previously suffered a CVA and presents with left-side weakness. Which four of the following six options will best achieve a successful transfer with reduced chance of injury for both patient and technologist? A The technologist should discuss the steps of the transfer with the patient beforehand to make sure the patient understands. B The wheelchair seat should be parallel to the exam table and the table should be elevated to a height 5 inches taller than the seat of the chair. C The wheelchair should be turned toward the table at a 45 degree angle, with the patient's weak side closest to the table. D The technologist should squat at the knee and the hip, keeping the back straight offering support and standing with the patient. E The wheelchair should be turned toward the table at a 45 degree angle with the patient's strong side closest to the table. F The footrests of the wheelchair should be pivoted out of the way or removed before beginning.

Before beginning any activity with a patient under your care, take the time to explain what you are about to do with them. Ask some assessment questions to determine patient ability and give the patient a chance to relieve any confusion they might have about the process. Prepare the equipment and the area to ensure a safe lift. Footrests will trip a patient, and should be out of the way during a transfer. A conventional exam table of telescoping height should be brought as low or lower that the height of the wheelchair seat if possible. Finally, position patients with hemiparesis so that their strong side is closer to the destination of transfer, and their weak side is facing you. They will lean into their strong side as they transfer, and many post CVA patients require little help from the caregiver. The motion of the patient should be to stand, turn toward you, and sit. Try to get them sitting again as soon as possible. While they rest with their feet of the side of the exam table, back the wheelchair out, step back in close, and rock them into a supine position with a scoop maneuver under the back of their knees. Be sure to cradle the patient's head with the other arm. (Adler & Carlton, 6th edition, p 155)

Which of the following is a normal BUN level: A 0.25 mg/100mL B 4 mg/100mL C 6.5mg/100mL D 10mg/100mL

Before undergoing a study that requires contrast agents, patients should receive bloodwork to determine if their kidneys can properly filter the contrast. The bloodwork necessary includes the blood urea nitrogen (BUN) and creatinine levels. Normal BUN levels range from 8mg/100mL to 25mg/100mL. Therefore, 10mg/100mL is on the lower end of the value range, however (A), (B), and (C) would all be too low. (Lampignano & Kendrick, 9th edition, 539)

Which of the following factors can cause an increase in blood pressure: (1) Anxiety (2) Younger age (3) Exercise A 2 only B 1 and 3 only C 2 and 3 only D 1, 2, and 3

Blood pressure increases in times of high stress and anxiety (1), during exercise (3), with certain medications, with increased age, with increased blood volume, and with artery condition. Younger patients (2), medications to treat hypertension, increased athleticism and cardiovascular health, and lower blood volume are all contributing factors to lower blood pressure. (Pierson and Fairchild, 6th edition, 104)

For newborns (0-3 months of age), which range is normal for measures pulse rate: A 100-150 BPM B 70-130 BPM C 40-60 BPM D 60-100 BPM

Pulse rate decreases as we age, with newborns measuring at an average of 100-150 beats per minute (A). Children ages 1 to 10 measure an average of 70-130 beats per minute (B), well-conditioned athletes range at 40-60 beats per minute (C), and adults measure at 60-100 beats per minute. Varying factors such as overall health, medications, and stress can impact pulse rate. (Pierson and Fairchild, 6th edition, 95)

Benefits of proper body mechanics include: (select 3) A Maintenance of balance B Reduction of stress on joints and soft tissue C Increased use of energy D Decreased risk of injury E Decreased safety during transfers

Radiography is a physically demanding branch of the medical field. Radiographers frequently transfer patients from wheelchairs and stretchers to the examination tables and move heavy equipment daily. The use of proper body mechanics ensures that balance has been maintained (A) through widening the base of support, less stress has been put on the joints and soft tissue (B) and there is a decreased risk of injury (D) during movement of heavy machinery and transfers of patients. Raising the examination table to hip height, lifting with the legs instead of the back, and pushing machinery instead of pulling are all ways in which proper body mechanics are beneficial for the radiographer. Proper body mechanics will also reduce the energy expended (C) and increase safety in the workplace. (Pierson and Fairchild, 6th edition, 31)

Which situations may result in a lower than average resting heart rate: (choose 3) A Age over 65 years B Low temperatures C Decreased fitness conditioning D High temperatures E Emotional stress F Increased fitness conditioning G Age younger than 10 years

Resting heart rates vary by age, physical conditioning, emotional distress, medications, and external factors. A lower than average resting heart rate can occur naturally as we age (1), decreased environmental temperatures (2), and increased athleticism (6). Factors such as increased environmental temperatures (4), decreased athleticism (3), emotional stress (5), and ages lower than 10 years (7) often result in higher than average heart rates. (Pierson and Fairchild, 6th edition, 31)

A drug's chemical name is called its A generic name. B trade name. C brand name. D proprietary name.

The Correct Answer is: AA drug's generic name identifies its chemical family. A particular generic drug can be manufactured by several different companies and given different trade names (brand or proprietary names). For example, the drug with the chemical/generic name acetaminophen is known by the trade or brand name Tylenol. Drugs can be classified by either their generic name or their trade name. (Torres et al, p 262)

A vasodilator would most likely be used for A angina. B cardiac arrest. C bradycardia. D antihistamine.

The Correct Answer is: AAnginal pain, caused by constriction of blood vessels, may be relieved with the administration of a vasodilator such as nitroglycerin. Bradycardia (abnormally slow heartbeat) and cardiac arrest are treated with vasoconstrictors such as dopamine or epinephrine to increase blood pressure. Antihistamines such as diphenhydramine (Benadryl) are used to treat allergic reactions and anaphylactic shock. (Adler & Carlton, p 265)

Difficulty in breathing precipitated by stress and causing bronchospasm best describes A asthma. B anaphylaxis. C myocardial infarct. D rhinitis.

The Correct Answer is: AAsthma is characterized by difficulty in breathing, causing bronchospasm. It is often precipitated by stress, and although dyspnea is a symptom, oxygen is not administered. Asthmatics carry a nebulizer that contains a medication to relieve the bronchospasm, thereby relieving their breathing distress. Anaphylaxis is an acute reaction characterized by sudden onset of urticaria, respiratory distress, vascular collapse, or systemic shock; it sometimes leads 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. (Bontrager, p 636)

The condition that results from a persistent fetal foramen ovale is A an atrial septal defect B a ventricular septal defect C a patent ductus arteriosus D coarctation of the aorta

The Correct Answer is: AAtrial septal defect is a small hole (the remnant of the fetal foramen ovale) in the interatrial septum. It usually closes spontaneously in the first months of life; if it persists or is unusually large, surgical repair is necessary. The ductus arteriosus is a short fetal blood vessel connecting the aorta and pulmonary artery that usually closes within 10 to 15 hours after birth. A patent ductus arteriosus is one that persists and requires surgical closure. Ventricular septal defect is a congenital heart condition characterized by a hole in the interventricular septum that allows oxygenated and unoxygenated blood to mix. Some interventricular septal defects are small and close spontaneously; others require surgery. Coarctation of the aorta is a narrowing or constriction of the aorta. (Tortora and Derrickson, 11th ed., p. 794)

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.

The Correct Answer is: ADr. 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)

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

The Correct Answer is: AHospital-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)

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.

The Correct Answer is: AIt 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)

Chest drainage systems should always be keptbelow the level of the patient's chest.above the patient's chest.at the level of the patient's diaphragm. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: AThe chest drainage system unit always should be kept below the level of the patient's chest. Chest tubes are used to remove air, blood, or fluid from the pleural cavity. By draining fluid from the pleural cavity, a collapsed lung, or atelectasis, may be relieved. By relieving the pressure from air in the pleural cavity, a pneumothorax may be reduced. Radiographers must take care that the tubes of the chest drainage unit do not kink and do not get caught on IV poles or radiographic equipment. It is imperative that the unit remain below the level of the chest. The chest drainage system has several components. One component is a chamber that collects the draining fluid. Another component is the suction control chamber. A third component is the water-seal chamber, which prevents air from the atmosphere from entering the system. The last component is the water-seal venting chamber, which allows air to leave the system, thus preventing pressure buildup. In order for the unit to work properly, it must remain below the level of the chest. (Adler and Carlton, 4th ed., pp. 211-212)

Tracheotomy is an effective technique most commonly used to restore breathing when there is A respiratory pathway obstruction above the larynx B crushed tracheal rings owing to trauma. C respiratory pathway closure owing to inflammation and swelling D all the above

The Correct Answer is: AThe respiratory passageways include the nose, pharynx, larynx (upper respiratory structures), trachea, bronchi, and lungs (lower structures). If obstruction of the breathing passageways occurs in the upper respiratory tract, above the larynx (i.e., in the nose or pharynx), tracheotomy may be performed to restore breathing. Intubation can be done into the lower structures, larynx, and trachea, moving aside any soft obstruction and restoring the breathing passageway. (Ehrlich and Coakes, 10th ed., p. 381)

During a grand mal seizure, the patient should be A protected from injury. B placed in a semiupright position to prevent aspiration of vomitus. C allowed to thrash freely. D given a sedative to reduce jerky body movements and reduce the possibility of injury.

The Correct Answer is: AWhen a patient is experiencing a seizure, he or she should be protected from striking any hard surfaces or falling. The patient exhibits uncontrollable body movements. Any attempt to place the patient in a semierect position or to administer a sedative would prove futile. Following the seizure, it is important to place the patient on his or her side to prevent aspiration of any vomitus or oral secretions. (Adler & Carlton, p 248)

Which of the following statements is (are) true regarding a two-member team performing mobile radiography on a patient with MRSA precautions?One radiographer remains "clean"—that is, he or she has no physical contact with the patient.The radiographer who positions the mobile unit also makes the exposure.The radiographer who positions the cassette also retrieves the cassette and removes it from its plastic protective cover. A 1 and 2 only B 1 and 3 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: AWhen a two-member team of radiographers is performing mobile radiography on a patient with contact precautions, such as an MRSA patient, one radiographer remains "clean"—that is, he or she has no physical contact with the patient. The clean radiographer will position the mobile unit and make the exposure. The other member of the team will position the IP and retrieve the IP. As the IP's protective plastic cover is folded down, the "clean" radiographer will remove the cassette from the plastic. Both radiographers should be protected with gowns, gloves, and masks if the patient is on contact precautions. In addition, after the examination is completed, the mobile unit should be cleaned with a disinfectant. Conditions requiring the use of contact precautions also include hepatitis A and varicella infection. (Adler and Carlton, 4th ed., p. 233)

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

The Correct Answer is: AWhen 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)

Skin discoloration owing to cyanosis may be observed in thegums.earlobes.corneas. A 1 only B 1 and 2 only C 3 only D 1, 2, and 3

The Correct Answer is: B Cyanosis is a condition resulting from a deficiency of oxygen circulating in the blood. It is characterized by bluish discoloration of the gums, nailbeds, earlobes, and the area around the mouth. Cyanosis may be accompanied by labored breathing or other types of respiratory distress. (Torres et al., 6th ed., p. 147)

Which of the following is (are) symptom(s) of shock?Pallor and weaknessIncreased pulseFever A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3

The Correct Answer is: BA patient who is going into shock may exhibit pallor and weakness, a significant drop in blood pressure, and an increased pulse. The patient may also experience apprehension and restlessness and may have cool, clammy skin. A radiographer recognizing these symptoms should call them to the physician's attention immediately. Fever is not associated with shock. (Torres et al., 6th ed., p. 163)

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

The Correct Answer is: BAnaphylaxis is an acute reaction characterized by sudden onset of urticaria, respiratory distress, vascular collapse, or systemic shock; it sometimes leads 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 results from a blocked coronary artery. (Adler and Carlton, 4th ed., p. 279)

An acute reaction caused by ingestion or injection of a sensitizing agent describes A asthma B anaphylaxis C myocardial infarction D rhinitis

The Correct Answer is: BAnaphylaxis is an acute reaction characterized by sudden onset of urticaria, respiratory distress, vascular collapse, or systemic shock; it sometimes leads 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 is characterized by difficulty in breathing, causing bronchospasm. It is often precipitated by stress, and although dyspnea is a symptom, oxygen is not administered. Asthmatics carry a nebulizer that contains a medication to relieve the bronchospasm, thereby relieving their breathing distress. Asthma and rhinitis are examples of allergic reactions. (Bontrager and Lampignano, 6th ed., p. 656)

Which of the following is (are) characteristic(s) of anemia?Decreased number of circulating red blood cellsDecreased hemoglobinHematuria A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3

The Correct Answer is: BAnemia is a blood condition characterized by a decreased number of circulating red blood cells and decreased hemoglobin; it has many causes. Adequate hemoglobin is required to provide oxygen to the body. Anemia is treated according to its cause. Hematuria is the term used to describe blood in the urine and is unrelated to anemia. (Tortora and Derrickson, 11th ed., p. 689)

The term dysplasia refers to A difficulty speaking. B abnormal development of tissue. C malposition. D difficult or painful breathing.

The Correct Answer is: BDysplasia refers to abnormal development of tissue—often demonstrated radiographically in skeletal imaging. Difficulty in speaking is termed dysphasia. Malposition refers to an anatomic structure located in a place other than the norm, for example, situs inversus. Difficult or painful breathing is termed dyspnea. (Taber, 20th ed., p. 652)

Graves disease is associated with A thyroid underactivity B thyroid overactivity C adrenal underactivity D adrenal overactivity

The Correct Answer is: BGraves disease is the most frequently occurring form of hyperthyroidism. Graves disease is an autoimmune disorder whose symptoms include enlargement of the thyroid gland and exophthalmos (protrusion of the eyes resulting from fluid buildup behind them). Hypothyroidism can result in cretinism in the child and myxedema in the adult. Adrenal overactivity produces Cushing syndrome; underactivity causes Addison disease. (Tortora and Derrickson, 11th ed., p. 659)

The condition of below-normal blood pressure is termed A hyperthermia. B hypotension. C hypoxia. D bradycardia.

The Correct Answer is: BHypotension occurs if the blood pressure drops below the normal ranges (95/60 mm Hg). It can occur in shock, hemorrhage, infection, and anemia. The condition in which a patient's heart rate slows below 60 beats per minute is bradycardia. Hyperthermia is the condition in which the patient's temperature is well above the normal average range (97.7 to 99.5°F). Hypoxia is a condition in which there is a decrease in the oxygen supplied to the tissues in the body. (Adler & Carlton, pp 181-182)

Examples of means by which infectious microorganisms can be transmitted via indirect contact includea fomite.a vector.nasal or oral secretions. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: BInfectious microorganisms can be transmitted from patients to other patients or to health care workers and from health care workers to patients buy three routes: contact, airborne, and droplet. Contact transmission is either via direct contact or indirect contact. Direct contact involves touch. Indirect contact involves transmission by way of contaminated equipment, supplies, hands. A contaminated object that transmits infection is called a fomite. (Dutton and Ryan, 9th ed., p. 118; Adler and Carlton 7th ed, p199)

Each of the following is an example of a fomite except A a doorknob. B a tick. C a spoon. D an x-ray table.

The Correct Answer is: BMany microorganisms can remain infectious while awaiting transmission to another host. A contaminated inanimate object such as a food utensil, doorknob, or IV pole is referred to as a fomite. A vector is an insect, rodent, or other animal carrier of infectious organisms, such as a rabid animal, a mosquito that carries malaria, or a tick that carries Lyme disease. They can transmit disease through either direct or indirect contact. (Adler and Carlton, 7th ed., p. 195)

Techniques that function to reduce the spread of microbes are termed A surgical asepsis. B medical asepsis. C sterilization. D disinfection.

The Correct Answer is: BMedical asepsis refers to practices that reduce the spread of microbes, and therefore the chance of spreading disease or infection. Washing your hands is an example of medical asepsis. It reduces the spread of infection, but it does not eliminate all microorganisms. Disinfection involves the use of chemicals to either inactivate or inhibit the growth of microbes. The complete killing of all microorganisms is termed sterilization. Surgical asepsis refers to the technique used when performing procedures to prevent contamination. (Adler & Carlton, p 211)

Logrolling is a method of moving patients having suspected A head injury. B spinal injury. C bowel obstruction. D extremity fracture.

The Correct Answer is: BPatients arriving at the emergency department (ED) with suspected spinal injury should not be moved. Anteroposterior (AP) and horizontal lateral projections of the suspected area should be evaluated and a decision made about the advisability of further images. For a lateral projection, the patient should be moved along one plane, that is, rolled like a log. It is imperative that twisting motions be avoided. (Torres et al., 6th ed., p. 87)

A quantity of medication introduced intravenously over a period of time is termed A an IV push. B an infusion. C a bolus. D a hypodermic.

The Correct Answer is: BQuantities of medication can be dispensed intravenously over a period of time via an IV infusion. A special infusion pump may be used to precisely regulate the quantity received by the patient. An IV push refers to a rapid injection; the term bolus refers to the quantity of material being injected. The term hypodermic refers to administration of medication under the skin. (Adler and Carlton, 4th ed., p. 316)

The radiographic accessory used to measure the thickness of body parts in order to determine optimum selection of exposure factors is the A gantry. B caliper. C collimator. D ruler.

The Correct Answer is: BRadiographic technique charts are highly recommended for use with every x-ray unit. A technique chart identifies the standardized factors that should be used with that particular x-ray unit, for various examinations/positions, of anatomic parts of different sizes. To be used effectively, these technique charts require that the anatomic part in question be measured correctly with a caliper. A gantry is a component of a computed tomography imaging system, a collimator is used to determine the size of the x-ray field. (Bushong, 11 ed, p 450)

With a patient suffering abdominal pain, it is frequently helpful to1.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

The Correct Answer is: BStrain 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)

The medical term for nosebleed is A vertigo. B epistaxis. C urticaria. D aura.

The Correct Answer is: BThe 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. Urticaria is a vascular reaction resulting in dilated capillaries and edema and causing the patient to break out in hives. An aura may be classified as either a feeling or a sensory response (such as flashing lights, tasting metal, smelling coffee) that precedes an episode such as a seizure or a migraine headache. (Adler & Carlton, p 247)

The most commonly used method of low-flow oxygen delivery is the A oxygen mask. B nasal cannula. C respirator. D oxyhood.

The Correct Answer is: BThe most commonly used method of low-flow oxygen delivery is the nasal cannula. It can be used to deliver oxygen at rates from 1 to 4 L/min at concentrations of 24% to 36%. The nasal cannula also provides increased patient freedom to eat and talk, which a mask does not. Masks are used for higher-flow concentrations of oxygen, over 5 L/min; depending on the type of mask, they can deliver anywhere from 35% to 60% oxygen. Respirators and ventilators are high-flow delivery mechanisms that are used for patients who are in severe respiratory distress or are unable to breathe on their own. Oxyhoods or tents generally are used for pediatric patients who may not tolerate a mask or cannula. The amount of oxygen delivered is somewhat unpredictable, especially if the opening is accessed frequently. Oxygen delivery may be between 20% and 100%. (Adler and Carlton, 4th ed., p. 204)

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

The Correct Answer is: BThe 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)

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

The Correct Answer is: BThe 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)

A MRI procedure is contraindicated for a patient who has A a herniated disk. B aneurysm clips. C dental fillings. D subdural bleeding.

The Correct Answer is: BThe presence of aneurysm clips is contraindication for magnetic resonance imaging (MRI); even a slight shift can cause damage. MRI can be performed for a herniated disk and subdural bleeding. Dental fillings do not contraindicate MRI. (Torres et al., 6th ed., p. 363)

A patient developed hives several minutes after injection of an iodinated contrast agent. What type of drug should be readily available? A Analgesic B Antihistamine C Anti-inflammatory D Antibiotic

The Correct Answer is: BWhen a contrast medium is injected, histamines are produced to protect the body from the foreign substance. An antihistamine (such as diphenhydramine [Benadryl]) blocks the action of the histamine and reduces the body's inflammatory response to the contrast medium. An analgesic (such as aspirin) relieves pain. An anti-inflammatory drug (such as ibuprofen) suppresses the inflammation of tissue. Antibiotics (such as penicillin) help fight bacterial infections. (Torres et al, p 166)

While measuring blood pressure, the first pulse that is heard is recorded as the A diastolic pressure. B systolic pressure. C venous pressure. D valvular pressure.

The Correct Answer is: BWith the blood pressure cuff wrapped snugly around the patient's brachial artery and the pump inflated to approximately 180 mm Hg, the valve is opened only slightly to release pressure very slowly. With the stethoscope over the brachial artery, listen for the pulse while watching the mercury column (gauge). Note the point at which the first pulse is heard as the systolic pressure. As the valve is opened further, the sound is louder; the point at which it suddenly becomes softer is recorded as the diastolic pressure. (Torres et al., 6th ed., p. 149)

Where is the "sterile corridor" located? A Just outside the surgical suite B Immediately inside each operating room door C Between the draped patient and the instrument table D At the foot end of the draped patient

The Correct Answer is: C When radiographs in the surgical suite are required, the radiographer is responsible for ensuring that surgical asepsis is maintained. This requires proper dress, cleanliness of equipment, and restricted access to certain areas. An example of a restricted area is the "sterile corridor," which is located between the draped patient and the instrument table and is occupied only by the surgeon and the instrument nurse. (Adler & Carlton, p 220)

Which of the following conditions describes a patient who is unable to breathe easily while in the recumbent position? A Dyspnea B Apnea C Orthopnea D Oligopnea

The Correct Answer is: CA patient with orthopnea is unable to breathe while lying down. When the body is recumbent, the diaphragm and abdominal viscera move to a more superior position. It is therefore more difficult to breathe deeply. Patients with orthopnea must be examined in an erect or semierect position. Dyspnea refers to difficulty breathing in any body position. Apnea describes cessation of breathing for short intervals. Oligopnea is infrequent breathing—as slow as 6 to 10 respirations per minute. (Ehrlich, McCloskey, & Daly, p 127)

Which of the following medical equipment is used to determine blood pressure?Pulse oximeterStethoscopeSphygmomanometer A 1 and 2 only B 1 and 3 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: CA stethoscope and a sphygmomanometer are used together to measure blood pressure. The first sound heard is the systolic pressure, and the normal range is 90 to 120 mm Hg. When the sound is no longer heard, the diastolic pressure is recorded. The normal diastolic range is 60 to 80 mm Hg. Elevated blood pressure is called hypertension. Hypotension, or low blood pressure, is not of concern unless it is caused by injury or disease; in that case, it can result in shock. A pulse oximeter is used to measure a patient's pulse rate and oxygen saturation level. (Adler and Carlton, 4th ed., p. 202)

Guidelines for cleaning contaminated objects or surfaces include which of the following?Clean from the least contaminated to the most contaminated areas.Clean in a circular motion, starting from the center and working outward.Clean from the top down. A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3

The Correct Answer is: CBecause hospitals are the refuge of the sick, they can also be places of disease transmission unless proper infection control guidelines are followed. When cleaning contaminated objects or surfaces such as the radiographic table, it is important to clean from the least contaminated to the most contaminated area and from the top down. Soiled gowns and linens should be folded from the outside in and disposed of properly. When the patient's skin is being prepared for surgery, it is often cleaned in circular motion starting from the center and working outward; however, this motion is not used for objects or surfaces. (Torres et al., 6th ed., p. 66)

Which of the following is a condition in which an occluded blood vessel stops blood flow to a portion of the lungs? A Pneumothorax B Atelectasis C Pulmonary embolism D Hypoxia

The Correct Answer is: CBlood pressure in the pulmonary circulation is relatively low, and therefore, pulmonary vessels can easily become blocked by blood clots, air bubbles, or fatty masses, resulting in a pulmonary embolism. If the blockage stays in place, it results in an extra strain on the right ventricle, which is now unable to pump blood. This can result in congestive heart failure. Pneumothorax is air in the pleural cavity. Atelectasis is a collapsed lung or part of a lung. Hypoxia is a condition of low tissue oxygen.

Which of the following pathologic conditions would require a decrease in exposure factors? A Congestive heart failure B Pneumonia C Emphysema D Pleural effusion

The Correct Answer is: CEmphysema is abnormal distension of the pulmonary alveoli (or tissue spaces) with air. The presence of abnormal amounts of air makes a decrease from normal exposure factors necessary to avoid excessive receptor exposure. Congestive heart failure, pneumonia, and pleural effusion all involve abnormal amounts of fluid in the chest and, therefore, would require an increase in exposure factors. (Carlton and Adler, 4th ed., p. 251)

Of the four stages of infection, which is the stage during which the infection is most communicable? A Latent period B Incubation period C Disease phase D Convalescent phase

The Correct Answer is: COf the four stages of infection, the stage during which the infection is most communicable is the disease phase. In the initial phase, the latent period, the infection is introduced and lies dormant. As soon as the microbes begin to shed, the infection becomes communicable. The microbes reproduce (during the incubation period), and during the actual disease period signs and symptoms of the infection may begin. The infection is most active and communicable at this point. As the patient fights off the infection, and the symptoms regress, the convalescent (recovery) phase occurs. (Torres et al, p 56)

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

The Correct Answer is: CPatients 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)

Blood pressure may be expressed as 120/95. What does 95 represent?1.The phase of relaxation of the cardiac muscle tissue2.The phase of contraction of the cardiac muscle tissue3.A higher-than-average diastolic pressure A 1 only B 2 only C 1 and 3 only D 2 and 3 only

The Correct Answer is: CThe normal blood pressure range for men and women is 90 to 120 mmHg systolic reading (top number) and 60 to 80 mmHg diastolic reading (bottom 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 statements would be true regarding tracheostomy patients?Tracheostomy patients have difficulty speaking.A routine chest x-ray requires the tracheostomy tubing to be rotated out of view.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

The Correct Answer is: CThe 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)

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

The Correct Answer is: CThe 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.)]

Anaphylaxis is the term used to describe A an inflammatory reaction. B bronchial asthma. C acute chest pain. D allergic shock.

The Correct Answer is: DA severe allergic reaction affecting several tissue functions is referred to as anaphylaxis or anaphylactic shock. It is characterized by dyspnea (difficulty breathing) caused by rapid swelling of the respiratory tract and a sharp drop in blood pressure. Individuals who are sensitive to bee stings and certain medications, including iodinated contrast agents, are candidates for this reaction. (Adler & Carlton, p 240)

Extravasation occurs when A there is an absence of collateral circulation B there is a multitude of vessels supplying one area C excessive contrast medium is injected D contrast medium is injected into surrounding tissue

The Correct Answer is: DExtravasation occurs when medication or contrast medium is injected into the tissues surrounding a vein rather than into the vein itself. It can happen when the patient's veins are particularly deep and/or small. If this happens, the needle should be removed, pressure applied to prevent formation of a hematoma, and then hot or cold packs applied (according to facility protocol) to relieve pain. (Torres et al., 6th ed., p. 324)

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

The Correct Answer is: DIpecac 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)

Some proteins in latex can produce mild to severe allergic reactions. Medical equipment that could contain latex includestourniquets.enema tips.catheters. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: DMedical equipment that could contain latex includes disposable gloves, tourniquets, blood pressure cuffs, stethoscopes, IV tubing, oral and nasal airways, enema tips, endotracheal tubes, syringes, electrode pads, catheters, wound drains, and injection ports. It should be noted that when powdered latex gloves are changed, latex protein/powder particles get into the air, where they can be inhaled and come in contact with body membranes. Studies have indicated that when unpowdered gloves are worn, there are extremely low levels of the allergy-producing proteins present. (OSHA/latex, www.sbaa.org/atf/cf/%7B99DD789C-904D-467E-A2E4-DF1D36E381C0%7D/Latex_2006.pdf )

All the following statements regarding oxygen delivery are true except A oxygen is classified as a drug and must be prescribed by a physician. B the rate of delivery and mode of delivery must be part of a physician order for oxygen. C oxygen may be ordered as continuously or as needed (prn). D none of the above; they are all true.

The Correct Answer is: DNone of the statements in the question is false; all are true. Oxygen is classified as a drug and must be prescribed by a physician. The rate and mode of delivery of oxygen must be specified in the physician's orders. It can be ordered to be delivered continuously or as needed. (Adler and Carlton, 4th ed., p. 203)

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

The Correct Answer is: DNormal 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)

Symptoms of inadequate oxygen supply includedyspnea.cyanosis.retraction of intercostal spaces. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: DOxygen is taken into the body and supplied to the blood to be delivered to all body tissues. Any tissue(s) lacking in or devoid of an adequate blood supply can suffer permanent damage or die. Oxygen may be required in cases of severe anemia, pneumonia, pulmonary edema, and shock. Symptoms of inadequate oxygen supply include dyspnea, cyanosis, diaphoresis, retraction of intercostal spaces, dilated nostrils, and distension of the veins of the neck. The patient who experiences any of these symptoms will be very anxious and must not be left unattended. The radiographer must call for help, assist the patient to a sitting or semi-Fowler position (the recumbent position makes breathing more difficult), and have oxygen and emergency drugs available. (Taber, 20th ed., p. 653)

All the following are rules of good body mechanics except A keep back straight, avoid twisting B keep the load close to the body C push, do not pull, the load D keep a narrow base of support

The Correct Answer is: DProper body mechanics can help to prevent painful back injuries by making proficient use of the muscles in the arms and legs. Proper body mechanics includes a wide base of support. The base of support is the part of the body in touch with the floor or other horizontal plane. The back always should be kept straight; twisting increases the chance of injury. When lifting a load, keep it as close to the body as possible to avoid back strain. Always push a load (such as a mobile x-ray machine) rather than pull it. (Torres et al., 6th ed., pp. 82-83)

All the following statements regarding pediatric positioning are true except A for radiography of the kidneys, the CR should be directed midway between the diaphragm and the symphysis pubis. B if a pediatric patient is in respiratory distress, a chest radiograph should be obtained in the AP projection rather than in the standard PA projection. C chest radiography on a neonate should be performed in the supine position. D radiography of pediatric patients with a myelomeningocele defect should be performed in the supine position.

The Correct Answer is: DRadiography of pediatric patients with a myelomeningocele defect should be performed in the prone position rather than in the routine supine position. The supine position would put unnecessary pressure on the protrusion of the meninges and spinal cord. All the other statements in the question are true. The anatomic dimensions of children are different from those of adults, and this must be kept in mind when performing pediatric radiography. The liver occupies a larger area of the abdominal cavity in a child than in an adult. This causes the kidneys to be in a lower position. Generally, the kidneys will be midway between the diaphragm and the symphysis pubis. Chest radiography for the pediatric patient varies depending on the age of the child. Neonates are routinely radiographed in the supine position. Although infants also may be examined in the supine position, it is preferable to examine them by placing the infant securely in a support device to obtain a good PA erect radiograph. Exceptions to this rule are made if the infant is in respiratory distress. To avoid aggravating the respiratory distress, an erect AP radiograph usually is obtained. (Dowd and Tilson, 2nd ed., vol. 2, pp. 1004-1005, 1013)

When medications are administered parenterally, they are given A orally B orally or intravenously C intravenously or intramuscularly D by a route other than via the GI tract

The Correct Answer is: DSome medications cannot be taken orally. They may be destroyed by the GI juices or may irritate the GI tract. Medications that are administered by any route other than orally are said to be given parenterally. This can include intravenous, intramuscular, topical, intrathecal, or subcutaneous modes of medication administration. (Torres et al., 6th ed., p. 270)

Radiographers should wear gloves when they might come in contact with1.wounds.2.mucous membrane.3.body fluids containing blood. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: DThe Centers for Disease Control and Prevention (CDC) has established rules that serve to protect health care workers. The CDC states that human blood and certain body fluids must be treated as though they contain pathogenic microorganisms. Therefore health care workers wear gloves whenever they might come in contact with blood, synovial fluid, mucous membrane, CSF, seminal or vaginal fluid, wounds, and any surface or body fluid containing blood. If there is any concern of spray or splash of these body fluids, a gown and eye shields should also be worn. (Ballinger and Frank, 10th ed, vol 1, p 16)

You have encountered a person who is apparently unconscious. Although you open his airway, there is no rise and fall of the chest, no detectable pulse, and you can hear no breath sounds. You should A begin mouth-to-mouth rescue breathing, giving two full breaths. B proceed with the Heimlich maneuver. C begin external chest compressions at a rate of 70-80 compressions/min. D begin external chest compressions at a rate of at least 100 compressions/min.

The Correct Answer is: DThe long tradition of ABC'c (airway, breathing, chest compressions) has been changed to CAB (chest compressions, airway, breathing). If the victim is unable to be roused, the rescuer should start with 30 compressions, at a rate of 100 compressions per minute. The victim's airway should then be opened and rescue breathing begun. This is accomplished by tilting back the head and lifting the chin. However, if the victim may have suffered a spinal cord injury, the spine should not be moved, and the airway should be opened using the jaw-thrust method. The rescuer next listens to breathing sounds and watches for the rise and fall of the chest to indicate breathing. If there is no breathing, the rescuer pinches the victim's nose and delivers two full breaths via mouth-to-mouth rescue breathing. (Adler and Carlton, 7th ed., p. 247)

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

The answer is 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)

Which of the following items are categorized as vital signs? (select the four that apply) A Blood pressure B Electrocardiograph (ECG or EKG) C Respiratory rate D Pulse rate E Complete blood count (CBC) F Temperature

The answer is A, C, D, and F. Vital signs are measurements taken to assess body functionality. Vital signs include blood pressure (A), respiratory rate (C), pulse rate (D), and temperature (F) measurements. Electrocardiograms (B) and a complete blood count (E) are tests that can be performed on the patient to determine specific irregularities in functionality, such as changes in cardiac activity (ECK/EKG) and red blood cell count (CBC), but are not measures considered vital signs. (Ehrlich and Coakes, 9th ed., pp. 194-200)

From the following list, select 4 appropriate choices for safe lifting of a heavy object from the floor to a table. A Bend your knees and keep your back straight. B Walk toward the table as you lift, to save time. C Lift the object to a standing position, and then walk the object to the table. D Hold your breath as you brace to lift. E Bend at the waist. F Keep your feet apart, slightly wider than your shoulders. G Bring the object in close to your body. H Stand slightly to the left or the right of the object and twist as you reach for it.

The answer is A, C, F, and G. Safe lifting and handling techniques are a foundational concept to adopt as a novice student technologist. Preventing back injuries is vital for the longevity of a technologist's career. Proper technique is to get as close as you can to the object, and squared up to it, so that your left and right arms and legs will each lift half the weight (G). Keeping your feet apart widens your base of support and makes you less likely to lose your balance during the lift (F). Bend at the knee and keep the back straight; the back muscles are design for support, while the quadriceps are designed to lift heavy weight(A and E). The lifter should get to a fully upright position before walking with the load, to ensure balance is maintained, and should breathe through the lifting process (B and C). Holding your breath through a lift is a warning sign that the object may be too heavy for an individual lifter; if the lifter proceeds, they may succumb to orthostatic hypotension as they stand (D). (Adler & Carlton, 6th ed., pp. 153-154)

Droplet precautions protect against all of the following EXCEPT A tuberculosis B whooping cough C bacterial meningitis D influenza

The answer is A. Droplet transmission is a process that involves dispersal of tiny droplets caused by coughing or sneezing. Influenza, whooping cough, and bacterial meningitis are spread from person to person by the droplet process (B, C, and D). Tuberculosis is classified by airborne transmission; the distinction is that it can be transmitting by the normal breathing process (A). Tuberculosis bacteria can remain infective over long durations and distances. Negative pressure room isolation and N-95 respirators are necessary to effectively counter airborne transmission. Droplet transmission is a transmission of proximity, and a conventional facemask is sufficient to reduce the chance of infection. (Adler & Carlton, 6th ed., p. 220)

A technologist brings the portable machine to the ED, preparing to take a portable chest x-ray on the patient in critical bay 4. As you approach, the nursing assistant is already in the room with a sphygmomanometer at the bedside. What is she about to measure? A Blood pressure B Oxygen concentration in the blood C Respiration exhalation force D Cerebral spinal fluid pressure

The answer is A. Vital signs are a basic skill set expected of all health care professionals. A sphygmomanometer measures blood pressure (A). A pulse oximeter measures oxygen concentration in the blood (B). Respiration exhalation force is not a vital sign, but is part of a recovery regimen for pneumonia and other lower respiratory pathology (C). Cerebral spinal fluid pressure, also not a vital sign, can be measured as part of a lumbar puncture to correlate suspicion of meningitis (D).(Adler & Carlton, 6th ed., p. 183)

Which of the following medications would most likely be prescribed for a patient suffering from congestive heart failure or hypertension? A Cathartic B Diuretic C Antihistamine D Anticholinergic

The answer is B. Adiureticmedication increases the amount of urine excreted by the kidneys, thus reducing blood volume. This reduces strain on the heart and peripheral arteries in cases of congestive heart failure and high blood pressure, respectively (B). Acatharticmedication causes the bowel to be purged during patient preparation for gastrointestinal and urinary tract procedures, or to relieve constipation (A). Anantihistaminemedication such as diphenhydramine, or Benadryl, inhibits release of histamine in a patient suffering from an allergic reaction to a water-soluble iodinated contrast agent (C). Ananticholinergicmedication such as atropine increases heart rate, which increases blood pressure (D).(Adler and Carlton, 6th ed., p. 281)

Which of the following could be a side effect from antiarrhythmic medications? A Tachycardia B Bradycardia C Diarrhea D Constipation

The answer is B. Antiarrhythmic medications aim to relieve cardiac dysrhythmia/arrhythmia. Side effects include bradycardia and congestive heart failure (B). Tachycardia, diarrhea, and constipation are not common side effects for these types of medications (A, C, and D).(Ehrlich & Coakes, 9th ed., p. 232)

To compensate for gerontological body changes, reducing exposure factors would help to compensate for 1. Decreased muscle mass 2. Increased bone density 3. Weight loss 4. Reduced alertness A 1 and 2 only B 1 and 3 only C 1, 2, and 4 only D 2, 3, and 4 only

The answer is B. As patients enter the geriatric stage of life, there are a few common characteristics that may arise: a loss of muscle mass, decreased bone density, reduce mental alertness, and overall weight loss. A reduction in exposure technique may prove beneficial to maintain appropriate receptor exposure and reduce unnecessary dose. Conditions that would require a reduction in technique selection include loss of muscle mass,decreased bone density, and weight loss. Increased bone density and decreased mental alertness would not necessitate a reduction in technique.(Lampignano & Kendrick, 9th ed., p. 361)

The needle angle usually used for subcutaneous injection is A 15 degrees B 45 degrees C 90 degrees D 180 degrees

The answer is B. Drugs and medications may be administered either orally or parenterally. Parenteral administration refers to any route other than via the digestive tract and includes topical (i.e., applied to the surface), subcutaneous (i.e., beneath the skin), intradermal (i.e., within the dermis/skin), intramuscular (i.e., within a muscle), intravenous (IV; i.e., within a vein), and intrathecal (i.e., within the spinal canal) administrations. The needle angle for an intravenous injection is 15 degrees, for a subcutaneous injection it is 45 degrees, and it is 90 degrees for an intramuscular injection (A, B, and C). (Ehrlich and Coakes 10 ed., p. 273)

The expansion and recoil of an artery describes a vital sign measurement called A auscultation B the pulse C a bruit D stroke volume

The answer is B. Vital signs are measurements of a patient's homeostasis, which is the body's way of regulating the relative constancy of its internal environment to promote healthy survival. The radiographer must be knowledgeable of vital sign measurements to properly assess their patients when necessary—before, during, and after radiographic procedures. One such measurement is pulse strength and rate. The expansion and recoil (relaxation) of a peripheral systemic artery describes thepulse. The pulse involves the expansion and relaxation of the arterial walls in response to the changing blood pressures occurring when the left ventricle of the heart contracts during systole and relaxes during diastole. The pulse can be felt by placing fingertips over an artery that lies near the surface of the body and over a bone or other firm base. The major locations, or pulse points, include the superficial temporal artery, common carotid artery, facial artery, axillary artery, brachial artery, radial artery, femoral artery, popliteal artery, posterior tibial artery, and dorsalis pedis artery (B).Auscultationis the action of listening to sounds from the heart, lungs, or other organs using a stethoscope (A). Abruitis an abnormal sound caused by turbulent flow of blood in an artery (C).Stroke volumerefers to the volume of blood pumped from the ventricles per contraction (D).(Patton and Thibodeaux, 15th ed., pp. 306-307)

Emphysema is a destructive pathology, requiring an adjustment in radiographic technique for adequate exposure. Which of the following is NOT a symptom of emphysema? A Barrel-like diameter of chest B Depression of shoulders C Retraction of neck muscles D Wheezing

The answer is B. Emphysema is marked by a loss of elasticity in the lung tissue, preventing adequate exhalation. This causes air to remain in the chest cavity, which increases intrathoracic volume and causes the barrel-like appearance of the chest (A). The increased thoracic diameter also causes an elevation of the shoulders and retraction of cervical muscles (C). The patient can also display symptoms such as wheezing (D) and cyanosis of the lips and fingernails due to decreased oxygen absorption. (Ehrlich and Coakes, 9th ed., pp. 193-194)

Early symptoms of anaphylaxis include all EXCEPT which of the following? A Itching of palms and soles B Dysphagia C Cool skin D Tingling

The answer is C. Anaphylaxis is a severe allergic reaction. Early phases of anaphylaxis include itching of the palms and soles, dysphagia, tingling, warmth, difficulty breathing, and a feeling of impending doom (A, B, and D). Cool skin would be indicative of shock rather than anaphylaxis (C).(Ehrlich & Coakes, 9th ed., pp. 296-297)

A patient suffering from hematuria A is vomiting blood B has excessive waste urea in the bloodstream C tests positive for blood in their urine D exhibits urine output that is visibly bloody

The answer is C. Hematuria is an abnormal condition where blood is found to be present in the patient's urine (C). While severe cases may change the color of the urine to a characteristic red hue, mild cases of hematuria often are occult, only discovered by lab analysis of a urine sample (D). Hematemesis is the medical term for vomiting blood, and uremia is the medical term for excess urea in the blood (A and B). (Leonard 8th ed., p. 334)

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

The answer is C. 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)

Cyanosis is blueish hue to the skin due to which of the following? A Decreased blood flow B Increased oxygenation C Decreased oxygenation D Increased blood flow

The answer is C. Skin color is an important quality to observe in patients, as changes during an exam can imply medical emergencies. Skin color can also represent a medical condition. With respiratory illnesses, such as emphysema, the patient might have a blueish hue to their nailbeds and lips called cyanosis. This is indicative of a lack of oxygenation (C). The other answer choices are incorrect as per the previous explanation (A, B, and D).(Ehrlich & Coakes, 9th ed., p. 193)

Of the following, which patient(s) would present an increased risk of barium aspiration during an upper GI series? A Stroke patients B Mentally challenged patients C Patients with altered mental status D All the above

The answer is D. Aspiration occurs when a patient inhales a liquid or solid matter through the nose, throat, or trachea into the lungs. Stroke patients may have anoxic or hypoxic damage to a part of the brain that causes dysphagia, or difficulty swallowing, thereby increasing the risk of aspiration through an incompletely closed epiglottis (A). Mentally challenged patients may be unable to understand the radiographer's directions and, therefore, may take in a breath at the same time they are drinking barium, thus allowing the barium to enter their lungs through an open epiglottis (B). The same is possible for patients with altered mental status (C). The radiographer must properly assess the patient's condition prior to an upper gastrointestinal procedure and observe closely during the procedure to respond quickly in the event of aspiration. If aspiration occurs, the radiographer should turn the patient on their side immediately and be prepared to assist with suctioning of the airway, if necessary (D).(Adler and Carlton, 6th ed., p. 306)

A radiographer is performing a radiographic procedure and notices that the patient has a labored and difficult breathing pattern. This respiratory pattern indicates which of the following conditions? A Eupnea B Apnea C Hyperventilation D Dyspnea

The answer is D. Dyspneais labored or difficult breathing and is often associated with hypoventilation, which means slow or shallow respirations (D).Eupnearefers to a normal breathing pattern or respiratory rate, which in a healthy adult should be 12-20 breaths per minute. Healthy children under the age of ten have slightly higher rates of 20-30 breaths per minute, whereas healthy infants may have normal respiratory rates of 30-60 breaths per minute (A).Apnearefers to cessation of breathing, whether it be intermittent such as during sleep apnea or a complete lack of breathing for a prolonged period, which is calledrespiratory arrest, a medical emergency (B).Hyperventilation, also referred to astachypnea, refers to rapid respirations and is usually associated with physical exertion or occurs during stressful or hysterical psychological events (C).(Patton and Thibodeau, 15th ed., p. 356)

A patient arrives at the ED with a knife wound to the abdomen; the patient's shirt and pants are soaked with blood. The patient's blood pressure has dropped to 90/40 mm Hg and her pulse is 134 bpm. What type of shock is the patient experiencing? A Cardiogenic B Neurologic C Iatrogenic D Hypovolemic

The answer is D. Shock is a physiologic reaction that is classified by root causes. Cardiogenic shock manifests as a result of acute cardiac or respiratory pathology, such as myocardial infarction or pulmonary embolus (A). Neurologic shock is caused by damage to the brain or spinal cord, preventing the transmission of nervous system signals to various body processes (B). Hypovolemic shock, which is the correct answer, is caused by a loss of significant blood volume (D). In this case, the loss of blood was the result of the stab wound. Iatrogenic refers to transmission of infectious pathogens by physician and is not a type of shock (C).(Adler & Carlton, 6th ed., p. 262)

If an inpatient experiences a syncopal episode during a radiographic procedure in the medical imaging department, how should the radiographer respond? 1. Assist the patient into a dorsal recumbent position and elevate their feet and legs above the level of their head 2. Loosen any tight clothing on the patient 3. Apply a moist compress to the patient's forehead and have them remain recumbent until they feel capable of undergoing the remainder of the procedure or returning to their room A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The answer is D. Syncope is a temporary condition of shock due to lack of blood flow to the brain and is considered a minor medical emergency. The radiographer shouldplace the patient in a dorsal recumbent position, either on the floor if the patient was standing or on the radiographic table, stretcher, or bed. The patient'sfeet should be elevated above the level of the patient's headusing supportive devices such as sponges or pillows. Alternatively, if the patient is lying on a tilting radiographic table, the patient's head should be lowered into a Trendelenburg position. This increases the blood flow to the patient's head, which helps to alleviate the syncopal episode. Additionally, byloosening any tight clothingthe patient may be wearing, systemic blood can more freely flow from the body into the heart and therefore a larger blood volume can be pumped to the patient's brain. Finally, by placing acool moist compresson the patient's head, this alleviates stress and assists in the patient's recovery until they feel capable of either completing the procedure or returning to their room (D). The other choices are incorrect as per the previous explanation (A, B, and C).(Adler and Carlton, 6th ed., p. 269)

Functions of the Swan-Ganz catheter include(s) evaluation of 1. Oxygen saturation 2. Medication effects 3. Ventricular failure A 1 only B 2 only C 2 and 3 only D 1, 2, and 3

The answer is D. The Swan-Ganz catheter is inserted into the pulmonary artery, often performed in the patient's room by a physician. While in the pulmonary artery, functions of the Swan-Ganz include the measurement of cardiac output and efficacy of administered cardiac medications (2), to evaluate for ventricular failure (3), to measure oxygen saturation of the blood (1), and to see how stress and/or exercise impact cardiac function (D). To ensure that the catheter placement is correct, a chest x-ray is most often performed. The other choices are incorrect as per the previous explanation (A, B, and C). (Ehrlich and Coakes, 9th ed., p. 384)

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/l.732 ?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 has been off metformin for 48 hours. A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3

The correct answer is (A). 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.732 ; 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

All the following rules regarding proper hand washing technique are correct except A keep hands and forearms higher than elbows. B use paper towels to turn water off. C wash to 1 inch above the wrists D carefully wash all surfaces and between fingers.

The correct answer is: (A) Frequent and correct hand hygiene is an essential part of medical asepsis; it is the best method for avoiding the spread of microorganisms. If the faucet cannot be operated with the knee or a foot pedal, it should be opened and (especially) closed using paper towels. Care should be taken to wash all surfaces of the hand and between the fingers thoroughly. All hand surfaces should be washed to about 1 inch above the wrists. The hands and forearms always should be lower than the elbows. Unbroken skin prevents the entry of microorganisms. Any exposed break in the skin should be covered with a waterproof protective covering. (Dutton and Ryan 9th ed p 113)

The risk of inoculation with HIV is considered high for which of the following entry sites?Broken skinPerinatal exposureAccidental needle stick A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The correct answer is: (B) The overall chance that a person will become infected with HIV is high with entry sites such as the anus, broken skin, shared needles, infected blood products, and perinatal exposure. Low-risk entry methods include oral and nasal, conjunctiva, and accidental needle stick. (Ehrlich and Coakes., 9th ed., p. 149

The frequency of cardiac ventricular contractions is reported in which value: A BPH B BPM C BPS D BPI

The frequency of cardiac ventricular contractions, or heart rate, is reported in beats per minute. Beats per minute is often abbreviated to beats/min or BPM. Normal resting heart ranges in adults are between 60-100 BPM. Variations can occur due to physical fitness levels, heart conditions, and age. (Pierson and Fairchild, 6th edition, 95)

Which of the following is a concept of proper body mechanics: A Reducing the base of support by bringing your feet closer together creates a more stable foundation when lifting objects over your head B Increasing distance between your center of gravity and the center of gravity for the object you are moving will increase the leverage needed to perform the action C Pulling objects is easier on the joints and expends less energy than pushing an object D Decreased the distance between yourself and the patient you are transferring allows for better use of your upper extremities in the transfer

Two concepts of body mechanics are necessary before moving, lifting, or carrying objects: widen the base of support (A) and bring your center of gravity close to the objects center of gravity (B, D). Increasing the base of support by widening your stance helps to increase balance and utilize your core for stability. Pushing an object will be easier and expend less energy than pulling an object (C) because it allows you to engage your core and put your weight behind an object for movement, such as with the c-arm and c-arm tower. It is also safer to push an object so that you can see what is ahead, rather than twisting your body to see what is behind you during movement. (Pierson and Fairchild, 6th edition, 131-135)

A technologist encountering a patient that experiences vertigo should: A Administer oxygen at a rate of at least 3 liters/minute. B Begin CPR. C Bring the patient a cold compress to place against their forehead. D Guide the patient to a sitting or recumbent position.

Vertigo is dizziness and is often a precursor to syncope. A patient who experiences vertigo should be guided to a sit or lie down, which avoids injury from falling. Oxygen requires a physician's order and may be an appropriate follow-up step. Cold compresses effectively neutralize nausea. CPR should only be administered if the patient is unresponsive and does not exhibit a pulse or respirations. (Adler & Carlton, 6th edition, p 270)

When lifting a patient from a wheelchair: (1) Bend down and place your arms underneath their arms, then use your back to straighten out until they are in a standing position (2) Use your legs to push yourself up as you stand while maintaining normal lumbar lordosis and tightening of the core (3) When lifting with two or more persons, discuss the transfer before attempting it to reduce confusion and strain A 2 only B 1 and 2 only C 1 and 3 only D 2 and 3 only

When a patient is being transferred from a wheelchair, unless the patient can safely stand on their own, a 2-person transfer is best to reduce risk of injury to both the patient and medical workers. Using proper body mechanics by utilizing the legs to push your body up while maintaining proper lordosis and core tightening will reduce the risk of back injuries (2). When using more than one person in the transfer, be sure to clearly communicate the role each will play in the transfer before beginning (3); this will reduce improper lifting techniques, confusion, and injury. Never use your back muscles to lift a patient, this could result in serious injury (1). Keep your back straight and squat down rather than bending down. (Pierson and Fairchild, 6th edition, 132-133)

The term used to describe an individual with a core temperature higher than 100°F: A Pyrexic B Hypoexemic C Anemic D Anaerobic

When a person is running a fever, they are termed "pyrexic" (A), which translates to a temporary increase in normal core temperature (98.6°F). Hypoxemic (B) related to low blood oxygenation, while Anaerobic (D) translates to "without oxygen" and is typically used to describe cellular functions or exercise. Anemic (C) or anemia is a disorder of the red blood cells. (Pierson and Fairchild, 6th edition, 92)

Which of the following should be avoided during patient transfers: (choose 3) A Jerking movements B Twisting C Tightening of the core D Use of short lever upper extremities E Bending of the lower back

When performing a patient transfer, in order to prevent injury, smooth fluid movements should be used rather than jerking movements (A), you should always look ahead rather than twisting your body (B), and the back should always remain in neutral lordosis when lifting. Tightening of the core and using the upper extremities as short levers by maintaining close centers of gravity can also help protect the back from injury. (Pierson and Fairchild, 6th edition, 132-133)