IMSA1100 - EXAM 3 CH 18

When gowning another person, a. a nonsterile circulating person pulls up the gown and fastens the back and waistband. b. the nonsterile person picks up the opened gown from behind, and hands it to the sterile person. c. sterile masks are unnecessary. d. the sterile person grabs the gown by the waist and wraps it around their waist with the assistance from the unsterile person.

A A nonsterile circulator pulls up the gown and fastens the back and waistband of the gown.

All of the following situations would require aseptic techniques except a. insertion of barium enema tip. b. insertion of central venous line. c. insertion of an indwelling Foley catheter. d. insertion of an angiographic catheter.

A Among the numerous imaging procedures that require sterile technique are angiography, arthrography, hysterosalpingography, and biopsies in the surgical environment. Additionally, aseptic techniques are used for line placements and indwelling urinary catheters. Barium enema examinations are not considered sterile procedures.

When using a portable C-arm for a surgical hip pinning, a. sterility will be maintained using a "shower curtain" approach. b. snap covers are not recommended. c. the surgeon can reach through the curtain and move the C-arm manually. d. an additional sterile towel is positioned over the incision site and then removed when the C-arm is brought into the field of view for imaging.

A Hip pinning or femur rodding may use an approach known as the shower curtain approach. On the patient's affected side, a sterile clear plastic sheet is suspended from a long horizontal metal bar attached to two vertical suspending rods. An opening is located in the middle of the sheet, which is attached using a special adhesive to the patient, allowing access to the surgical site.

Which of the following represents good sterile technique? a. When using a sterile setup, avoid bending and reaching over it. b. Remove sterile forceps from their container and tap them on the edge so all the solution drips off. c. Any sterile supplies added to a sterile tray, such as cotton balls, can be returned to their containers if not used, as such waste is inefficient and costly. d. The solution in the forceps container should be checked regularly and added to when its level gets too low.

A Necessary sterile supplies can be added to a sterile field using the proper package-opening techniques. Remember that it is unacceptable to reach across a sterile field.

The purpose of the inflatable balloon portion at the tip of the Foley catheter is to a. hold the catheter within the bladder. b. present the backflow of urine into the ureters. c. permit its visualization under fluoroscopy. d. induce the stimulus for voiding.

A On insertion of the Foley catheter, the balloon is filled with sterile water to hold the catheter in place.

When a Foley catheter system is inserted into a patient for an expected period of 4 to 6 weeks, a. a polyvinyl chloride catheter is used. b. a suction pump is attached to the drainage bag to ensure bladder emptying. c. the patient is taught how to remove and replace the Foley using aseptic techniques. d. the catheter will most likely not have an inflatable balloon end.

A Plastic catheters are suitable for short-term use only. Latex catheters can be used for 2 to 3 weeks and polyvinyl chloride catheters for 4 to 6 weeks, but the expensive pure silicone catheters are used only for long-term catheterization of 2 to 3 months.

When using a portable fluoroscopy C-arm in surgery, a. the image receptor and C-arm are draped with a snap cover for sterility. b. the surgery team members operate the fluoroscopy unit. c. the C-arm is disinfected and considered sterile. d. sterile technique is only needed when the C-arm is over the patient's surgical incision.

A The most common approach for draping an image intensifier and C-arm is with a snap cover. A tension band is snapped in place when the image intensifier and C-arm are covered with a sterile cloth or bags. This approach allows the physician to manipulate the C-arm while maintaining a sterile field.

When establishing a sterile field using a sterile drape, a. reach over the sterile field to minimize reach and air motion. b. all drape items must be clean and dry. c. inspect the expiration date to determine if you are using the sterile pack within 36 hours of the expiration date. d. open the sterile package with the top flap set to open toward the person opening the pack.

B In most instances, a sterile field is established using a sterile drape. The first step in using a sterile drape is confirming that the package is sterile. If a package is not clean and dry, it is considered unsterile. If it appears to have been previously opened or if the expiration date has passed, it is also considered unsterile. It is not acceptable to reach over any sterile field.

A common neonatal chest disorder requiring portable radiography in the neonatal unit is transient tachypnea of the newborn (TTN). Radiographs are taken to visualize the chest for respiratory distress, and in doing so, the imaging professional must 1. use the highest degree of aseptic techniques. 2. use lead protection when possible, and sterilize after each use. 3. surgically scrub your hands to replace gloves in order to position the neonate with better precision. 4. wrap all items that may have the potential of coming in contact with the newborn. 5. use contact or shadow shielding for patient protection. 6. treat the procedure as a sterile procedure similar to surgery. a. 1, 3, 4, and 6 only b. 1, 2, 4, and 5 only c. 3, 4, 5, and 6 only d. 1, 3, 5, and 6 only

B Neonatal infant patients require many therapeutic interventions to support them, which may lead to frequent invasive procedures and long exposure to the hospital environment. Frequent radiographs are taken, and special attention must be given to gonadal protection, medical asepsis, and protecting the neonate from unsterile materials by wrapping them with clean wraps.

When performing portable radiography on neonatal infants, a. gonadal protection is not important because the reproductive organs are undeveloped. b. aseptic techniques are especially important because of the infant's weak immune system. c. the portable radiographic unit must be wiped down within 24 hours before the procedure. d. sterile technique procedures should be adhered to strictly.

B Sepsis and nosocomial infections are recognized as major threats that result in significant morbidity and mortality each year in neonatal units. Thus, in neonatal radiography, maintaining asepsis as much as possible is important.

The goal of aseptic technique is to a. protect the radiographer from infection. b. protect the patient from pathogenic microbes. c. prevent the spread of infection from the patient to any equipment in the examination room. d. protect the surgical team from an infected patient.

B The goals of aseptic technique are to protect the patient from infection and to prevent the spread of pathogenic microorganisms.

Which of the following statements is false? a. A sterile person may touch only what is sterile. b. Create sterile fields early in the morning while equipment is clean and equipment is clean. c. A sterile field must be watched continually to be considered sterile. d. If a solution soaks through a sterile field to a nonsterile field, the wet area must be redraped.

B The goals of aseptic technique are to protect the patient from infection and to prevent the spread of pathogens and harmful microorganisms. Sterile fields should be created no sooner than the needed procedure time to prevent transient contamination as a function of time delays and they must be monitored continually once established.

When handling a patient with a Foley catheter in place, a. the drainage bag should be placed at the same level or higher than the bladder. b. avoid kinks in the tubing and keep the drainage bag lower than the bladder. c. it is advisable to clamp the tubing to do a lengthy small bowel study. d. never let the volume of urine fill more than 30% of the collection bag capacity.

B The urine collection bag and tubing should not be kinked and should be kept below the level of the bladder to prevent reflux of urine back into the bladder. Failure to do so can lead to infection.

If the sterility of an object is unknown, which of the following should be done? a. Ask the physician if it is alright to use the object. b. Use the object as long as the expiration date has not passed. c. Consider the object unsterile and do not use it. d. Clean the object with a disinfectant or antimicrobial before using it.

C A sterile field is a specified area that is considered free of viable microorganisms and is known to be sterile by those involved in the procedure. If there is any doubt as to the sterility of a field or any item or fluid, it must be considered unsterile and replaced.

When creating a sterile field, it is important for the imaging professional to a. establish the sterile field as early in the day as possible to create an awareness of the scheduled procedure. b. remember that anything above the ankles is considered sterile. c. keep sterile gloves in sight and above the waist level. d. remember that any moisture that develops on the sterile field can be dried using an infrared lamp.

C A sterile field is a specified area that is considered free of viable microorganisms. It is regarded to be everything above waist level.

When gowning and gloving for a sterile procedure, it is important to remember that a. the techniques are the same as gowning for medical asepsis. b. sterile gloves must be put on outside of the sterile work area. c. after gowning, the front of the gown down to the waist, and the sleeves are considered sterile. d. when passing a sterile team member, you must pass each other face to face in order to see any contamination.

C After the gown is on, only the sleeves and front of the gown down to the waist are considered sterile. To maintain sterile technique when wearing a sterile gown and gloves, persons must pass each other back to back.

When performing dressing changes, it is important to remember that a. working on the dressing change as a single person is highly recommended to prevent contamination. b. dressing changes can be performed once there is a color change on the dressing surface. c. if the wound is purulent, gowns are recommended. d. sterile gowns are only needed if the wound is openly draining.

C Dressings are best changed in a team setting with another health care worker. The physician is responsible for ordering dressing changes. Literature recommends that gowns should be used if the wound is purulent. In a standard precautions environment, gowns are required at all times.

The inflatable balloon portion of the Foley catheter is typically filled with a. radiopaque contrast material. b. carbon dioxide. c. sterile water. d. denatured alcohol.

C On insertion of the Foley catheter, the balloon is filled with sterile water to hold the catheter in place.

You are working as a radiographer in a busy imaging department, late into the evening. You receive a request for a portable chest radiograph on a cardiac patient in the ICU. Your coworker comments that he just did a portable chest procedure on the same patient approximately 15 minutes earlier and questions why they are ordering another one so soon. The rationale for this next chest image would most likely be a. the floor had a change in nursing staff and they are re-ordering the examination to make sure it was completed. b. a new resident cardiologist arrived for his shift and wants his own image. c. the patient has a central venous line, and the physician wants to check the repositioning. d. the patient is now sleeping, and a better image can now be achieved.

C Radiographers often perform chest radiography, especially portable procedures, before and after the insertion of chest tubes and vascular lines to check line placement or the presence of a pneumothorax.

Which of the following should be examined first when a sterile package is used? a. The tightness of the wrapping b. Type of material used to wrap the package c. Expiration date d. Way the package is folded

C The first step in using a sterile package is confirming that the package is sterile. If a package is not clean and dry, it is considered unsterile. If it appears to have been previously opened or if the expiration date has passed, it is also considered unsterile.

The role of the imaging technologist during cardiac pacemaker studies is to a. assist the surgeon with sterile technique. b. position the patient into various oblique angles for static radiographic images. c. operate fluoroscopy for the physician as he or she guides the pacemaker into position. d. provide nursing care to the patient and monitor the electrophysiology data.

C The role of the radiographer is to operate the fluoroscopy unit, which will allow the physician to place the pacemaker wires (leads) correctly.

You are about to assist with a sterile procedure. In scrubbing for the procedure, it is important to a. tightly wrap surgical tape around your rings and watch, before scrubbing. b. keep your arms down when scrubbing to prevent fluids running up your arm. c. scrub the fingers completely, as well as the front and back of your hands, for 3 minutes. d. use a surgical antimicrobial solution such as alcohol or antiseptic soap.

C The sterile scrub consists of scrubbing with an antimicrobial agent. Remove all jewelry, including watches. Wash hands and arms with antiseptic soap. Clean subungual areas with nail file. Scrub the sides of each finger, between the fingers, and the back and front of the hand for 3 minutes. Scrub the arm with the hands higher than the elbows. Each side of the arm is washed to 3 inches above the elbow for 1 minute. The hands remain above the elbows at all times.

Two people in sterile attire should pass each other in which of the following ways? a. Front to back b. Back to front c. Back to back

C To maintain sterile technique when wearing a sterile gown and gloves, persons must pass each other back to back. The backs of sterile gowns are considered unsterile.

When putting on a pair of sterile gloves using the self-gloving, open technique, a. jewelry must be wrapped in skin tape and may remain on during gloving. b. the glove package is open and positioned so the wearer crosses his or her arm over the left glove to reach for the right glove. c. the first glove is picked up by the inside cuff with one hand, being careful not the touch the outside of the glove. d. the remaining glove is grabbed by the outside and placed on the unsterile hand, making it sterile.

C When using the open-glove technique, it is important that you pick up the glove by its inside cuff with one hand. Do not touch the outside surface of the glove or the glove wrapper. The glove is then pulled onto the hand without touching the inside surface of the glove, which is actually the outside surface of the folded cuff.

8. When opening a sterile tray, your fingers a. may not touch any metal content. b. must be covered with sterile gloves. c. may not touch any cloth content. d. must never touch the inside of the tray.

D A sterile field is a specified area (such as within a tray or on a sterile towel) that is considered free of viable microorganisms. Touching the inside of the tray creates an unsterile situation and must be reported.

If you suspect the radiologist has unknowingly contaminated his or her glove, which of the following should you do? a. Ignore the contamination as it is their responsibility to know their own contamination. b. Remain silent so as not to jeopardize the case and complete a sentinel event report afterward. c. Confirm the contamination with a second person, and if there is agreement, inform the radiologist. d. Make the radiologist aware of the possible contamination immediately.

D A sterile field must be continually monitored for sterility. If it becomes contaminated for any reason, the physician must be notified immediately regardless of the circumstances. To do otherwise could jeopardize patient safety and be considered unethical.

When opening and pouring sterile solutions, a. remove the cap and place it on a corner of the sterile field with the lid down. b. wipe up any spills of solution using a sterile towel. c. hold the bottle approximately 6 inches above the basin when pouring to form a steady stream of fluid. d. hold the bottle with the label facing up to prevent fluids from staining the label.

D Sterile solutions are frequently poured into a metal or other container within the sterile field. Begin with verifying the contents and expiration date on the solution. When possible, show the name to another health care person for verification. Remove the lid or cap from the bottle and place it on an unsterile surface. Hold the bottle with the label uppermost so that poured solution cannot stain and obscure the label. With as little of the bottle as possible over the field, hold it at a height of approximately 1 to 2 inches over the bowl so that no splashing occurs.

When opening and pouring sterile solutions, a. both the inside and outside of the container are considered sterile. b. move the sterile basin to the edge of the sterile field. c. show the solution name and strength to another person before pouring. d. move the sterile basin to the edge of the sterile field and show the solution name and strength to another person before pouring are appropriate.

D Sterile solutions are frequently poured into a metal or other container within the sterile field. Bottles containing sterile solutions usually are considered sterile on the inside but contaminated on the outside. Begin with verifying the contents and expiration date on the solution. When possible, show the name to another health care person for verification. When pouring into a sterile basin, move the basin to the edge of the sterile field to avoid splashing contents onto the sterile field area.

Hazardous drug-related waste materials a. include only pharmaceuticals, to prevent needle perforations through the collection bag. b. deal with bodily discharges such as sputum and feces. c. are collected in clear bags for identification. d. require the labeling of needle containers and breakable items of hazardous waste.

D The Occupational Safety and Health Administration (OSHA) Technical Manual Part IV (section c) requires the labeling of needle containers and breakable items of hazardous waste as hazardous drug waste only. Thick, leak-proof plastic bags, colored differently from other hospital trash bags, should be used for routine collection of discarded gloves, gowns, tubing, and other disposable materials.

When performing radiologic examinations on patients with chest tubes, a. the chest drainage system has three compartments

collection chamber, water seal chamber, and suction control chamber. b. check for the color of the drainage and report any pale amber color indicating serous fluid. c. the exterior chamber of the assembly must remain higher than the patient's chest level to prevent retrograde flow. d. All of the above are correct. : A Radiographers often perform chest radiography before and after the insertion of chest tubes to ensure proper placement. Chest drainage systems have three compartments to which chest tubes are attached. The exterior assembly of the chest tubes must always remain lower than the patient's chest. Additionally, any change in chest fluid color must be reported, particularly a dark red color.