Patient Care Chp 18 (Aseptic Techniques), Patient Care Chp 19 (Nonaseptic Techniques)
A common misunderstanding of patients regarding barium enemas is that: a. the actual barium enema examination is "just another cleansing enema." b. the barium enema is all that is needed as a cleansing enema. c. they will be asked to drink a chalky "milkshake" for the examination. d. they will be expected to defecate during the examination for filming.
A
All of the following are true of cleansing enemas EXCEPT: a. they are intended for the administration of enteric medications. b. they promote the defecation reflex and discharge. c. they are complete when bowel contents are clear and free of fecal matter. d. there are several types of enemas, each with its own strengths and weaknesses
A
All of the following situations would require aseptic techniques EXCEPT: a. barium enema examination. b. insertion of central venous line. c. insertion of an indwelling Foley catheter. d. insertion of an angiographic catheter.
A
As you arrive into a patient's room for transport to radiology, you notice that the patient has an NG tube in place with a syringe upright and pinned to the gown. You should know that this patient: a. has a double-lumen NG tube in place. b. has a Levine line that is single lumen. c. must have the line clamped before transport. d. Both a and c are correct.
A
Giving cleansing enemas "until clear" involves: a. giving two or three enemas until the bowel contents are free of fecal material. b. administering enemas until the patient's state of hydration is at risk. c. giving the patient cleansing enemas until his or her sinuses have drained. d. asking the patient to hold the enema contents until the fluoroscopy schedule is open for the examination.
A
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
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
When gowning another person: a. a nonsterile circulating person pulls the gown up and fastens the back and waistband. b. the nonsterile person picks up the opened gown 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 the unsterile assistant.
A
When using a portable C-arm for a surgical hip pinning: a. sterility will be maintained using a "shower curtain" approach. b. sterile technique is unnecessary. 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
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 unnecessary.
A
Which of the following represents good sterile technique? a. When using a sterile setup, avoid bending or reaching over it. b. Remove sterile forceps from their container and tap them on the edge so all the solution will fall off. c. Any sterile supplies added to a sterile tray, such as cotton balls, should 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
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. employ the highest degree of aseptic techniques. 2. use lead protection when possible, and sterilize after each use. 3. wash hands only after the procedure is complete. 4. wrap all items that may have the potential of coming in contact with the newborn. 5. employ 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
As you begin to perform a hip examination on an elderly female patient who has undergone hip surgery, the patient states that she "needs to go to the bathroom." Which of the following should be done? 1. Use a standard bedpan. 2. Provide for the patient's privacy and locate a fracture bedpan. 3. Be sure to wear gloves and wash your hands. 4. If the bedpan is metallic, run it under warm water for patient comfort and throw it away after each use. 5. You and an assistant should assist the patient with movement onto the bedpan. 6. Return the patient to the nursing floor for cleanup and patient hygiene. a. 1, 3, 4, 5, and 6 only b. 2, 3, and 5 only c. 1, 5, and 6 only d. 2, 3, 5, and 6 only
B
In many instances cleansing enemas are self-administered by the patient before the examination. Instructions for a self-administered enema include: 1. eating fruits and vegetables within 24 hours of the examination. 2. limiting water intake to prevent hydration. 3. using purgation mixtures. 4. eating a low-residue diet. 5. a clear liquid diet including carbonated beverages, clear gelatin, clear broth, and coffee and tea with sugar. 6. administering a cleansing clear water enema. a. 1, 2, 4, 5, and 6 only b. 3, 4, 5, and 6 only c. 2, 3, 5, and 6 only d. 1, 3, 4, and 6 only
B
In order to allow tissue healing from a partial colon resection: a. the patient is kept bedridden for the entire recovery period. b. an external stoma is created to allow for defecation. c. the patient will be kept on a liquid diet for the entire recovery period. d. the patient's colon will be clamped off distal to the resection site.
B
Nasogastric (NG) tubes are inserted through the patient's _____ with the end of the tube placed in the _____. a. mouth; duodenum b. nasopharynx; stomach c. mouth; ileum d. oropharynx; stomach
B
Nasogastric (NG) tubes are inserted with the patient in the _____ position. a. Sims' b. High Fowler's c. Trendelenburg d. recumbent, prone
B
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 use of a water-soluble contrast agent such as Gastrografin for a colon examination is warranted for patients with: a. polyps. b. a possible bowel perforation. c. diverticulosis. d. pancreatitis.
B
To facilitate removal of a nasogastric tube, the patient is: a. sedated heavily. b. encouraged to take a deep breath. c. in the Trendelenburg position. d. all of the above.
B
When a barium examination of an ostomy patient is performed: a. the patient is imaged in the prone position. b. it is important to prevent leakage of the barium around the stoma site. c. glucagon is never given to such patients. d. a larger volume of barium is used than in a conventional barium enema.
B
When establishing a sterile field using a sterile drape: a. it is acceptable to reach over the sterile field in order 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
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 in order to do a lengthy small bowel study. d. never let the volume of urine fill more than 30% of the collection bag capacity.
B
When performing a barium enema examination: a. show the patient the entire volume of enema solution to prepare them for the study. b. suspend the enema bag above the table at a height no greater than 30 inches. c. continue emptying the barium solution as the patient cramps to encourage peristalsis. d. encourage the patient to use short breaths or gasps and to tighten abdominal movements, similar to a bowel movement.
B
2. Nasogastric (NG) tubes are inserted through the patient's _____ with the end of the tube placed in the _____. a. Mouth, duodenum b. Oropharynx; stomach c. Nasopharynx; stomach d. Mouth; ileum
C
When performing portable radiography on neonatal infants: a. gonadal protection is not important, as the reproductive organs have yet to form. b. aseptic techniques are especially important because of the infant's weak immune system. c. the portable radiographic unit must be wiped down after the procedure within 24 hours. d. the radiographer should wash his or her hands before the procedure only.
B
Which of the following is a TRUE statement regarding cleansing enemas? a. Oil retention enemas are used to "harden" stool material for more complete evacuation. b. A hypertonic or Fleet enema is used for patients unable to handle large fluid enema volumes. c. Hypotonic enemas can be performed repeatedly until the stool is clear. d. An enema consisting of salt with approximately 500 mL of water is harmful to infants and should never be performed.
B
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 staff members are fresh 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 re-draped.
B
3. The most common type of nasogastric tube used for stomach decompression is the: a. Swan-Ganz catheter b. Central venous pressure line c. Single-lumen Levin tube d. Peripherally inserted central catheter (PICC)
C
9. The use of water-soluble contrast agent such as Gastrografin for a colon examination is warranted for patients with: a. Pancreatitis b. Polyps c. A possible bowel perforation d. Diverticulosis
C
After bedpan use, hygiene of the female patient's perineum is important. Proper cleansing of this region requires using gloves and several folded tissues to wipe the region: a. from the anus to the mons pubis. b. transversely between gluteal folds. c. from the mons pubis to the anus. d. in circular motions.
C
For a single-contrast barium enema: a. approximately 500 mL of barium are used for an adult. b. air or carbon dioxide is used as a contrast agent. c. spot images of the cecum, hepatic flexure, splenic flexure, and sigmoid are taken. d. a postevacuation film image is unnecessary.
C
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 it has not been dropped on the floor. c. Consider the object unsterile and do not use it. d. Clean the object with a disinfectant or antimicrobial before using it.
C
The administration of glucagon shortly before a double-contrast barium enema is intended to: a. increase liver function and the release of glycogen. b. cause the gallbladder to empty. c. relieve bowel spasm. d. increase peristalsis to improve bowel motility.
C
The inflatable balloon portion of the Foley catheter is typically filled with: a. radiopaque contrast material. b. carbon dioxide. c. sterile water. d. mineral oil.
C
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
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 d. Front to front
C
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
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
When putting on a pair of sterile gloves using the self-gloving, open technique: a. jewelry 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, now making it sterile.
C
Which of the following should be examined first when a sterile package is used? a. Way the package is folded b. Type of material used to wrap the package c. Expiration date d. Way the package is taped
C
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 after 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
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 co-worker 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
1. Nasogastric (NG) tubes are inserted with the patient in the _____ position. a. Trendelenburg b. Sims' c. Recumbent, prone d. High Flower's
D
10. In preparation of a barium examination of a colostomy patient, it is important to: a. Tell the patient to not take his or her bismuth antiodor tablets before the examination b. Understand the sensitivity of these patients to their condition and lifestyle change c. Irrigate the stoma the night before the morning of the examination d. Do all of the above
D
4. To confirm the placement of an NG tube in its proper position, a physician may use: a. A syringe to remove gastric contents as proof b. Fluoroscopy or radiography for visualization c. Feedback from the patient by asking if he or she can feel it in the stomach d. Both a and b
D
5. When transporting a patient with a nasogastric (NG) tube to medical imaging: a. Confirm the suction pressure before disconnecting the tube b. Make sure the NG tube is secured to the patient's nose c. Confirm the allowable time for suction interruption d. Do all of the above
D
6. After bedpan use, hygiene of the female patient's perineum is important. Proper cleansing of this region requires using gloves and several folded tissues to wipe the region: a. Transversely between gluteal folds b. From the anus to the mons pubis c. In circular motions d. From the mons pubis to the anus
D
7. When performing a cleansing enema on an adult patient: a. Lukewarm water just above body temperature is used b. The patient is placed in the Sims' position for enema tip insertion c. After the bowel is filled with liquid, generally more than 500 mL, the patient should rest quietly to allow the liquids to work d. All of the above are appropriate
D
8. When performing a barium enema examination: a. Show the patient the entire volume of enema solution to prepare them for the study b. Encourage the patient to use short breaths or gasps and to tighten abdominal movements, similar to a bowel movement c. Continue emptying the barium solution as the patient cramps to encourage peristalsis d. Suspend the enema bag above the table at a height no greater than 30 inches
D
During surgical procedures using a portable C-arm, it is important to remember that: a. communication with the surgeon is critical to examination success. b. no two cases are ever the same and routine surgical fluoroscopy is unlikely. c. technologists must be prepared for a stressful environment and using their highest critical thinking skills. d. all of the above are important.
D
If you suspect the radiologist has contaminated his or her glove, which of the following should you do? a. Ignore the contamination so as not to delay the case. b. Tell the radiologist after the procedure has been completed. c. Confirm the contamination with a second person, and if he or she is in agreement, inform the radiologist. d. Make the radiologist aware of the possible contamination immediately
D
In preparation for a barium examination of a colostomy patient, it is important to: a. tell the patient to not take his or her bismuth antiodor tablets before the examination. b. understand the sensitivity of these patients to their condition and lifestyle change. c. irrigate the stoma the night before and morning of the examination. d. do all of the above.
D
Postprocedural care for patients who have had a colon examination should include: a. instructions for maintaining hydration. b. an increase in fluid intake and dietary fiber for a few days after the examination. c. an awareness of the change in stool color to an ashen, gray color and the importance of eliminating the barium during defecation. d. all of the above.
D
The most common type of nasogastric tube used for stomach decompression is the: a. Swan-Ganz catheter. b. central venous pressure line. c. peripherally inserted central catheter (PICC). d. single-lumen Levin tube.
D
To confirm the placement of an NG tube in its proper position, a physician may use: a. a syringe to remove gastric contents as proof. b. fluoroscopy or radiography for visualization. c. feedback from the patient by asking if he or she can feel it in the stomach. d. both a and b.
D
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
When opening and pouring sterile solutions: a. both the inside and outside of the container are considered sterile. b. confirm the solution name and strength three times before pouring. c. show the solution name and strength to another person before pouring. d. both b and c are appropriate.
D
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 12 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
When performing a cleansing enema on an adult patient: a. lukewarm water just above body temperature is used. b. the patient is placed in the Sims' position for enema tip insertion. c. after the bowel is filled with liquid, generally more than 500 mL, the patient should rest quietly to allow the liquids to work. d. all of the above are appropriate.
D
When performing dressing changes, it is important to remember that: a. working with a team member is beneficial. b. dressing changes must be performed after a physician orders the procedure. c. if the wound is purulent, gowns are recommended. d. all of the above are important.
D
When performing radiologic examinations on patients with chest tubes: a. remember that 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 dark red color. c. the exterior chamber of the assembly must remain lower than the patient's chest level. d. all of the above are correct
D
When transporting a patient with a nasogastric (NG) tube to medical imaging: a. confirm the suction pressure before disconnecting the tube. b. make sure the NG tube is secured to the patient's nose. c. confirm the allowable time for suction interruption. d. do all of the above.
D
When working with a nonambulatory male patient who needs to void: a. ask the patient how much assistance he feels he needs, and allow him to use a urinal. b. after the patient has voided, record the volume of urine in the patient's chart if documentation is required. c. dispose of the urine in the toilet and rinse the urinal with cold water. d. remove your disposable gloves, wash your hands, and place the soiled urinal in a receptacle for resterilization. e. do all of the above
E