Chapter 1: Introduction to Radiation Protection
the goal of reducing retake rates is to obtain optimal radiographic images with the _____ exposure
first
year in which x-ray was discovered
1895
for all medical imaging procedures, what concept or principle should the selection of exposure factors always follow?
ALARA
for many regulatory agencies the ALARA principle provides a method for comparing the amount of radiation used in various health care facilities in a particular area for specific imaging procedures
ALARA
the _____ concept should serve as a guide for the selection of technical exposure factors
ALARA
the rationale for _____ comes from evidence complied by scientists over the past century
ALARA
what principle can be used as a method for comparing the amount of radiation used in various health care facilities in a particular area for specific imaging procedures?
ALARA
diagnostic efficacy is _____ when essential images are produced with the least radiation exposure to the patient
maximized
list three advantages of using the BERT method to compare the amount of radiation received with the natural background radiation received over a given period
(1) BERT does not imply radiation risk, it is simply a means for comparison (2) it emphasizes that radiation is an innate part of our environment (3) it provides an answer that is easy for the patient to comprehend
list four good practices that apply to radiologic technologists and radiologists
(1) are educated in the safe operation of x-ray producing imaging equipment (2) use protective devices whenever possible (3) follow established procedures (4) select x-ray machine settings that significantly reduce radiation exposure to patients and to themselves
what are the radiation workers' responsibilities to maintain an effective radiation safety program?
(1) be aware of rules governing the workplace (2) perform duties consistent with ALARA
list six consequences of ionizing radiation in human cells
(1) creation of unstable atoms (2) production of free electrons (3) production of low-energy x-ray photons (4) creation of highly reactive free molecules [radicals] capable of producing substances poisonous to the cell (5) creation of new biologic molecules detrimental to the living cell (6) injury to the cell that may manifest itself as abnormal function
what are the two objectives of the image wisely campaign?
(1) lowering the amount of radiation used in medically necessary imaging studies (2) eliminating unnecessary procedures
how can imaging personnel apply the three cardinal principles of radiation protection to minimize occupational exposure?
(1) shortening the length of time spent in a room where x-radiation is produced (2) standing at the greatest distance possible from an energized x-ray beam (3) interposing a radiation-absorbent shielding material between the radiographer and the source of the radiation
acronym for as low as reasonably achievable
ALARA
_____ does not imply radiation risk; it is simply a means for comparison
BERT
how can humans safely control the use of radiant energy? 1. by using the knowledge of radiation-induced hazards that has been gained over many years 2. by employing effective methods to limit or eliminate radiation-induced hazards 3. by completely eliminating the use of radiation in the healing arts a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
a. 1 and 2 only
when an imaging procedure is justified in terms of medical necessity, diagnostic efficacy is achieved when optimal-quality images, revealing the presence or absence of disease, are obtained with: a. an effective radiation safety program b. an inspection of the imaging department every day by nationally recognized authorities c. an inspection of the imaging department every day by state-recognized authorities d. a strong legal team to suppress potential lawsuits tat result from poor radiologic practice
a. an effective radiation safety program
radiation has been present on earth since: a. its beginning b. the 14th century c. the 18th century d. the 20th century
a. its beginning
BERT is a: a. method of comparison b. method of optimizing radiation protection c. radiation quantity d. radiation unit
a. method of comparison
occupational and nonoccupational doses will remain well below maximum allowable levels when: a. radiographers and radiologists keep exposure as low as reasonably achievable b. referring physicians stop ordering imaging procedures c. orders for imaging procedures are determined only by medical insurance companies d. patients assume sole responsibility for ordering their imaging procedures
a. radiographers and radiologists keep exposure as low as reasonably achievable
BERT is a method of explaining radiation to the public a. true b. false
a. true
NEXT stands for nationwide evaluation of x-ray trends a. true b. false
a. true
a health care facility must have a written policy statement describing the radiation safety program. the statement must also identify the commitment of management to keep all radiation exposure ALARA and must be available to all employees in the workspace a. true b. false
a. true
after ordering an x-ray examination or procedure, the referring physician must accept basic responsibility for protecting the patient from nonuseful radiation exposure a. true b. false
a. true
diagnostic efficacy provides the basis for determining whether an imaging procedure or practice is justified a. true b. false
a. true
in general terms, risk can be defined as the probability of injury, ailment, or death resulting from an activity a. true b. false
a. true
radiation produced from an x0ray tube is an example of controllable radiant energy a. true b. false
a. true
radiologic technologists and radiologists are educated in the safe operation of radiation-producing imaging equipment a. true b. false
a. true
radiology departments, or individual radiologic technologists, can "pledge" to image gently a. true b. false
a. true
the basic principles of time, distance, and shielding can be applied for the safety of both the patient and the radiographer a. true b. false
a. true
the joint commission specifies that all imaging equipment that uses ionizing radiation be regularly tested by qualified personnel and properly maintained a. true b. false
a. true
the millisievert (mSv) is the SI subunit of EfD a. true b. false
a. true
various methods of radiation protection may be applied to ensure safety for persons employed in radiation industries, including medicine, and for the population at large a. true b. false
a. true
damage to a living tissue of animals and humans exposed to radiation
adverse biologic effects
makes patients feel that they are active participants in their own health care
appropriate and effective communication
management in a health care facility should perform a periodic exposure _____ to determine how radiation exposure in the workplace may be lowered
audit
x-rays: 1. can have varying degrees of penetration in normal biologic tissue 2. can be focused by a lens 3. are invisible a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
b. 1 and 3 only
the millisievert (mSv), a subunit of the sievert (Sv), is equal to: a. 1/10,000 of a Sv b. 1/1000 of a Sv c. 1/100 of a Sv d. 1/10 of a Sv
b. 1/1000 of a Sv
which of the following terms is an attempt to provide a quantity this is a measure of general harm in humans? a. absorbed dose b. effective dose c. exposure d. diagnostic efficacy
b. effective dose
BERT is based on an annual U.S. population exposure of approximately 1 mSv per year a. true b. false
b. false (3 mSv per year)
man-made radiation is more dangerous than an equal amount of natural radiation a. true b. false
b. false (danger is the same)
the ability of x-rays to cause injury in normal biologic tissue just became apparent recently a. true b. false
b. false (has been known since early 1900s)
humans are not continuously exposed to sources of ionizing radiation a. true b. false
b. false (humans are continuously exposed to sources of ionizing radiation)
x-rays are a form of nonionizing radiation a. true b. false
b. false (ionizing radiation)
BERT implies risk from radiation exposure a. true b. false
b. false (is a means of comparison)
diagnostic efficacy is not an important part of radiation protection in the healing arts a. true b. false
b. false (is an important part of radiation protection in the healing arts)
production of high-energy x-ray photons is a consequence of ionization in human cells a. true b. false
b. false (low-energy)
most patients are unaware that most of their background radiation comes from artificial radioactivity in their own body a. true b. false
b. false (natural radiation)
a threshold exists for radiation-induced malignant disease a. true b. false
b. false (no threshold does)
it is the responsibility of the referring physician to provide the necessary resources and appropriate environment in which to execute an ALARA program in a health care facility a. true b. false
b. false (responsibility of employer)
if a radiographer makes an error in selecting technical radiographic exposure factors for a specific projection of an anatomic body part, the projection can be repeated without an increase in radiation dose for the patient and a potential dose increases for the radiographer a. true b. false
b. false (the projection can be repeated with an increase in radiation dose for the patient and a potential dose increases for the radiographer)
when radiation is safely and prudently used in the imaging of patients, the benefit of the exposure can be _____ and the potential risk of biologic damage is _____ a. minimized, maximized b. maximized, minimized c. minimized, minimized d. maximized, maximized
b. maximized, minimized
to implement an effective radiation safety program in a facility that provides imaging services, the employer must provide all of the following except: a. an appropriate environment in which to execute an ALARA program and the necessary resources to support the program b. x-ray equipment that can produce only very low kilovoltage and very high milliamperage c. a written policy statement describing this ALARA program and identifying the commitment of management to keeping all radiation exposure ALARA that is available to all employees in the workplace d. periodic exposure audits to determine how radiation in the workplace may be lowered
b. x-ray equipment that can produce only very low kilovoltage and very high milliamperage
method for comparing the amount of radiation received from a radiologic procedure with natural background radiation received over a specified period, such as days, weeks, months, or years
background equivalent radiation time (BERT)
ionizing radiation, such as x-rays, has both a _____ and a _____ potential
beneficial destructive
when ionizing radiation is used to obtain a mammogram for the welfare of a patient, the directly realized _____ of the exposure to this radiant energy _____ any slight _____ of inducing a radiogenic malignancy or any genetic defect
benefits far outweigh chance
how can humans safely control the use of radiant energy?
by using the knowledge of radiation-induces hazards that has been gained over many years and by employing effective methods to limit or eliminate those hazards
repetition of a radiographic exposure because of poor patient positioning results in: a. no significant change in total radiation exposure to the patient or the radiographer b. a slight decrease in total radiation exposure to the patient and the radiographer c. an increase in total radiation exposure to the patient and the radiographer d. a significant decrease in total radiation exposure to the patient and the radiographer
c. an increase in total radiation exposure to the patient and the radiographer
which of the following recommend the use of background equivalent radiation time for improvising patient understanding and reducing fear and anxiety associated with having an x-ray procedure? a. environmental protection agency b. occupational safety and health administration c. national council on radiation protection and measurements d. nuclear regulatory commission
c. national council on radiation protection and measurements
which of the following INCREASES radiation exposure to the patient and potentially to the radiographer? a. production of optimal quality images with the first exposure b. use of appropriate radiation protection procedures c. repeated radiographic exposures as a result of technical error or carelessness d. limited radiographic examination, as ordered by the radiologist
c. repeated radiographic exposures as a result of technical error or carelessness
typically, people are more likely to accept a risk if they perceive that: a. they have no other options b. they have positive assurance that they will have a good outcome in terms of prognosis c. the potential benefit to be obtained is greater than the risk involved d. the radiologic procedure will absolutely not cause any pain or discomfort
c. the potential benefit to be obtained is greater than the risk involved
a consequence of ionization in human cells
creation of free radicals
for CT the joint commission requires: 1. annual education of staff in dose reduction techniques 2. minimum qualification for medical physicists 3. documentation of CT radiation dose 4. management of CT protocols to minimize radiation dose a. 1, 2, and 3 only b. 1, 3, and 4 only c. 2, 3, and 4 only d. 1, 2, 3, and 4
d. 1, 2, 3, and 4
cardinal principles of radiation protection include: 1. time 2. distance 3. shielding a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
d. 1, 2, and 3
effective radiation protection measures take into consideration: 1. both human and environmental physical determinants 2. technical elements 3. procedural factors a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
d. 1, 2, and 3
the ALARA philosophy should: 1. be a main part of every health care facility's personnel radiation control program 2. be maintained because at this time there are no firm dose limits established for the amount of radiation that patients may receive for individual imaging procedures 3. be maintained and show all reasonable actions that will reduce dose to patients and personnel below required limits have been considered a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
d. 1, 2, and 3
to reduce radiation exposure to the patient: 1. reduce the amount of the x0ray "beam on" time 2. use as much distance as warranted between the x-ray tube and the patient for the examination 3. always shield the patient with appropriate gonadal and/or specific area shielding devices a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
d. 1, 2, and 3
which of the following cardinal principles of radiation protection can be applied to both the patient and the radiographer? 1. time 2. distance 3. shielding a. 1 and 2 only b. 1 and 3 only c. 2 and 3 only d. 1, 2, and 3
d. 1, 2, and 3
when illness or injury occurs or when a specific imaging procedure for health screening purposes is prudent, a patient may: a. be forced by the referring physician to assume a large risk of exposure to ionizing radiation to obtain unnecessary diagnostic medical information b. be forced by the referring physician to assume the relatively large risk of exposure to ionizing radiation to obtain essential diagnostic information c. elect to assume the relatively large risk of exposure to ionizing radiation to obtain essential diagnostic medical information d. elect to assume a relatively small risk of exposure to ionizing radiation to obtain essential diagnostic medical information
d. elect to assume a relatively small risk of exposure to ionizing radiation to obtain essential diagnostic medical information
the most effective tool for diagnosing breast cancer continues to be: a. posteroanterior (PA) and lateral chest x-ray examinations b. clinical breast self-examination c. clinical breast examination by a physician d. high-quality mammography
d. high-quality mammography
in medicine, when radiation safety principles are correctly applied during imaging procedures, the energy deposited in living tissue by the radiation can be limited. this results in: a. completely eliminating the possibility for reducing the potential for adverse effects b. no change in the possibility for reducing the potential for adverse effects c. increasing the potential for adverse biologic effects d. reducing the potential for adverse biologic effects
d. reducing the potential for adverse biologic effects
any radiation exposure that does NOT benefit a person in terms of diagnostic information obtained from diagnostic images for the clinical management of medical needs is termed: a. artificial radiation b. enhanced natural background radiation c. man-made radiation d. unnecessary radiation
d. unnecessary radiation
what are adverse biologic effects?
damage to living tissue of animals and humans exposed to ionizing radiation
the degree to which the diagnostic study accurately reveals the presence or absence of disease in a patient
diagnostic efficacy
one of the three cardinal principles of radiation protection
distance
imaging facilities must have an effective radiation safety program that provides patient protection and patient _____
education
in medicine, when radiation safety principles are correctly applied during imaging procedures, the _____ deposited in living tissue by the radiation can be limited, thereby reducing the potential for adverse _____
energy biologic effects
_____ is the amount of ionization produced in air when ionizing is present
exposure
patients not only should be made aware of what a specific procedure involves and what type of cooperation is required but also must be informed of what needs to be done, if anything, as a _____ to their examination
follow-up
BERT emphasizes that radiation is a(n) _____ part of our environment
innate
x-rays are a form of _____ radiation; therefore their use in medicine for the detection of disease and injury requires _____ measures
ionizing protective
produces positively and negatively charged particles (ions) when passing through normal matter
ionizing radiation
based on evidence that living tissue of animals and humans can be damaged by exposure to ionizing radiation
justification for reduction of unnecessary radiation exposure
diagnostic efficacy provides the basis for determining whether an imaging procedure or practice is _____
justified
on what are reference values for patient dose based?
large scale surveys of actual measurement of x-ray machines in hospitals
radiation exposure should always be kept at the _____ possible level for the general public
lowest
SI subunit of measure for the radiation quantity, "absorbed dose"
milligray (mGy)
a subunit of the sievert equal to 1/1000 of a sievert
millisievert (mSv)
children are significantly _____ sensitive to ionizing radiation than are adults
more
have the responsibility to select technical exposure factors that significantly reduce radiation exposure to patients and themselves
nonoccupational doses
radiation workers are required to perform their _____ practices in a manner consistent with the ALARA principle
occupational
synonymous with the acronym ALARA
optimization for radiation protection
radiologic technologists and radiologists use _____ devices whenever possible
protective
fear of being exposed to radiation
radiation phobia
effective measures employed by radiation workers to safeguard patients, personnel, and the general public form unnecessary exposure to ionizing radiation
radiation protection
individual in a hospital setting expressly charged by the administration to be directly responsible for the execution, enforcement, and maintenance of the ALARA program
radiation safety officer (RSO)
a disease process that does not have a fixed threshold
radiation-induced cancer
regarding the ALARA program in a hospital setting, what are three responsibilities for the program that are entrusted to the radiation safety officer by the administration?
responsible for the execution, enforcement, and maintenance of the ALARA program
in the medical industry with reference to the radiation sciences, the possibility of inducing adverse biologic effects such as injury to the skin or induction of cancer or a genetic defect after irradiation
risk
radiographers should select the _____ radiation exposure that produces useful radiographic images
smallest
the millisievert (mSv) is a _____ of the sievert (Sv)
subunit
type of approach in patient care that has gained an increasing awareness in recent years
team approach
conducted to provide data on systems as they exist in the united states on the date of the latest survey
the NEXT program
a partnership of medical societies whose overall common purpose is to reduce the radiation dose for pediatric patients
the alliance for radiation safety in pediatric imaging
requires monitoring of patient dose in CT and in interventional procedures
the joint commission
if a patient is having a chest x-ray examination and the patient asks the radiographer, "how much radiation will I receive from this x-ray?" how should the radiographer respond?
they can respond by using an estimation based on the comparison of radiation received from the x-ray examination to natural background radiation received, for example, over a certain number of days. thus they can say "the radiation received from having a chest x-ray examination is equivalent to what would be received while spending approximately 10 days in your natural surroundings
to use _____ as a basic principle for radiation, a radiographer can reduce the duration of unnecessary exposure
time
what are the three cardinal principles of radiation protection?
time distance shielding
what is the responsibility of the technologist with regard to calculation of radiation dose for a specific patient?
to make sure that the radiologist and/or medical physicist has the info needed to carry out the dose estimate
what is the goal of modern radiation protection programs?
to protect persons from both short term and long term effects pf radiation
responsibility of facilities and radiographs that provide imaging services
to provide high-quality imaging services
there is no existing data regarding any _____ effects from the x-rays used in examinations
unsafe
creation of _______ atoms is a consequence of ionization in healthy tissue
unstable
how can radiologic technologists reduce radiation exposure to patients and to themselves?
using protective devices whenever possible, by following established procedures, and by selecting x-ray machine settings that significantly reduce radiation exposure to patients and themselves
how is risk weighed against benefit in medical radiography?
when ionizing radiation is used for the welfare of the patient, the realized benefits of this exposure to radiant energy must far outweigh any slight chance of inducing a radiogenic malignancy or any genetic defects
an ionizing radiation passes through matter, what is the event that may cause injury in normal biologic tissue?
when passing through normal matter, ionizing radiation procedures positively and negatively charged particles (ions) along its path the production of these ions, as well as the electrons ejected in the process, are the events that may cause injury in normal biologic tissue
how fast do x-rays travel in a straight line until they interact with atoms?
x-rays travel in straight lines and at the speed of light (300 million meters per second) until they interact with atoms