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Radiographic Positioning/Anatomy > Chapter 14 (Urinary System & Venipuncture) > Flashcards

Chapter 14 (Urinary System & Venipuncture) Flashcards

1
Q

Which abdominal muscles run on each side of, and medial and posterior to, the kidneys?
a. Rectus abdominis
b. External obliques
c. Right and left psoas major
d. Erector spinae

A

Right and left psoas major

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2
Q

The average adult kidney measures ____ in length.
a. 2 to 3 inches (5 to 7 cm)
b. 4 to 5 inches (10 to 12 cm)
c. 6 to 8 inches (15 to 20 cm)
d. 8 to 10 inches (20 to 25 cm)

A

4 to 5 inches (10 to 12 cm)

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3
Q

What structure enables the kidneys to be visualized on plain abdominal radiographs?
a. Adipose capsule
b. Renal pyramids
c. Major and minor calyces
d. High volume of blood within the kidney

A

Adipose capsule

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4
Q

Which of the following functions is not performed by the urinary system?
a. Removing nitrogenous wastes
b. Regulating water levels in tissues
c. Regulating the acid-base and electrolyte balance
d. Producing and releasing adrenaline

A

Producing and releasing adrenaline

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5
Q

The term describing the total functioning portions of the kidney is the:
a. renal collecting system.
b. nephron.
c. glomerular capsule.
d. renal parenchyma

A

Renal parenchyma

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6
Q

Urine will travel from the major calyces to the:
a. renal pelvis.
b. ureter.
c. minor calyces.
d. renal pyramids.

A

Renal pelvis

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7
Q

The glomeruli, glomerular capsule, and proximal and distal convoluted tubules are located in the ____ of the kidney.
a. medulla
b. cortex
c. collecting system
d. fibrous capsule

A

Cortex

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8
Q

The structural and functional unit of the kidney is:
a. Bowman capsule.
b. the calyx.
c. the nephron.
d. the glomerulus.

A

The nephron

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9
Q

Which structure of the kidney is labeled 3?
a) Minor calyx
b) Major calyx
c) Renal pelvis
d) Renal pyramid

A

Major calyx

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10
Q

Which structure and/or region of the kidney is labeled 1?
a) Minor calyx
b) Major calyx
c) Renal sinus
d) Medulla

A

Medulla

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11
Q

Which structure is labeled 2?
a) Renal pelvis
b) Ureterovesical junction
c) Ureteropelvis junction
d) Pelvic brim

A

Renal pelvis

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12
Q

What is the structure labeled 6?
a) Renal pelvis
b) Ureterovesical junction
c) Renal sinus
d) Trigone

A

Renal sinuses

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13
Q

One of the three constricted points along each ureter is the pelvic brim. The location of this constricted point is:
a. where the bladder meets the symphysis pubis.
b. at the level of the ischial spines.
c. where the iliac blood vessels cross over the ureters.
d. where the distal ureters connect to the bladder.

A

Where the iliac blood vessels cross over the ureters

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14
Q

What is the total capacity of the average adult bladder?
a. 350 to 500 mL
b. 100 to 250 mL
c. 500 to 750 mL
d. 1000 to 1200 mL

A

350 to 500 mL

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15
Q

Which term describes the act of voiding under voluntary control?
a. Urination
b. Urinary release
c. Incontinence
d. Anuria

A

Urination

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16
Q

The numerous mucosal folds located within the urinary bladder are termed:
a. trigone.
b. mucosa.
c. rugae.
d. vesical mucosa.

A

Rugae

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17
Q

Which of the following compounds is a common cation (+) found in ionic contrast media?
a. Diatrizoate
b. Iodine
c. Meglumine
d. Benzoic acid

A

Meglumine

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18
Q

Which component of an ionic contrast media increases its solubility?
a. Cation
b. Anion
c. Benzoic acid
d. Iodine

A

Cation

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19
Q

Which of the following is true with nonionic-type contrast media?
a. Low osmolality
b. The inability to dissociate into two separate ions
c. Less chance of reaction
d. All of the options

A

All of the options

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20
Q

Which of the following occurs in many patients and is defined as an expected outcome to the introduction of iodinated contrast media?
a. Moderate itching and sneezing
b. Metallic taste in mouth and a temporary hot flash
c. Mild condition of urticaria (hives)
d. All of the options

A

Metallic taste in mouth and a temporary hot flash

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21
Q

The American College of Radiology recommends that metformin (a drug used for diabetes mellitus) be withheld for ____ hour(s) prior to and following a contrast media procedure.
a. 1
b. 8
c. 24
d. 48

A

48

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22
Q

The normal creatinine level (diagnostic indication of kidney function) for an adult is _____ mg/dL.
a. 0.1 to 0.5
b. 0.6 to 1.5
c. 3 to 4.5
d. 6 to 7.5

A

0.6 to 1.5

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23
Q

Normal BUN (blood urea nitrogen) levels in adults should not exceed ____ mg per 100 mL.
a. 1.5
b. 5
c. 10
d. 25

A

25

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24
Q

What is the primary purpose of the premedication procedure before an iodinated contrast media study?
a. Reduces anxiety.
b. Permits greater contrast enhancement of kidneys during an intravenous urography
(IVU).
c. Reduces the severity of a possible contrast media reaction.
d. Decreases blood pressure.

A

Reduces the severity of a possible contrast media reaction

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25
Q

Which of the following drugs is often given before an IVU to reduce the risk of a contrast media reaction?
a. Diazepam
b. Benadryl and prednisone
c. Fluoxetine
d. Verapamil

A

Benadryl and prednisone

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26
Q

Which of the following symptoms is classified as “mild” during a systematic contrast media reaction?
a. Itching
b. Hypotension
c. Extravasation
d. Angioedema

A

Itching

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27
Q

If a patient experiences tachycardia (>100 heartbeats/min) following a systemic contrast media injection, he or she is experiencing a ____ reaction.
a. mild
b. moderate
c. severe
d. vasovagal

A

Moderate

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28
Q

If a patient experiences laryngeal swelling following a contrast media injection, he or she is experiencing a ____ level reaction.
a. mild
b. moderate
c. severe
d. local

A

Severe

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29
Q

The drug Lasix is classified as a:
a. contrast agent.
b. cathartic.
c. diuretic.
d. salicylate.

A

Diuretic

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30
Q

A brief loss of consciousness caused by reduced cerebral blood flow is termed:
a. syncope.
b. brachycardia.
c. hypotension.
d. angioedema.

A

Syncope

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31
Q

A region or area of subcutaneous swelling caused by allergic reaction to foods or drugs is termed:
a. oliguria.
b. micturition.
c. syncope.
d. angioedema.

A

Angioedema

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32
Q

Which of the following symptoms is considered a severe reaction to contrast media and is a life-threatening condition requiring life-saving measures?
a. Tachycardia (rapid heartbeat)
b. Excessive urticaria (hives)
c. Extravasation at the injection site
d. Cardiac arrhythmias

A

Cardiac arrhythmias

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33
Q

Which of the following conditions is considered to be higher risk (a contraindication) for a contrast media reaction?
a. Hematuria
b. Congestive heart failure
c. Urinary tract infection
d. Renal calculi

A

Congestive heart failure

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34
Q

What is the correct course of action for the technologist when, during an injection of contrast media, a patient experiences a side effect of mild hot flashes and some metallic taste in his mouth?
a. Call for a physician to complete the injection.
b. Stop the injection of contrast media immediately.
c. Stop the injection but continue the normal imaging sequence.
d. Reassure the patient and continue the injection and imaging sequence while
observing the patient for a possible more severe reaction to follow.

A

Reassure the patient and continue the injection and imaging sequence while observing the patient for a possible more severe reaction to follow

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35
Q

Which term describes the leakage of contrast media from a vein into the surrounding tissues of the arm? a. Extravasation
b. Filtration
c. Exudation
d. Micturition

A

Extravasation

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36
Q

Which level of contrast media reaction has occurred when the patient develops moderate urticaria?
a. Normal side effect
b. Mild reaction
c. Moderate reaction
d. Severe reaction

A

Moderate reaction

37
Q

Which of the following is considered as a contraindication for an IVU procedure?
a. Hypertension
b. Anuria
c. Hematuria
d. All of the options

A

Anuria

38
Q

Which of the following conditions is considered a moderate-level contrast media reaction requiring treatment?
a. Nausea and vomiting
b. Syncope
c. Tachycardia
d. None of the options

A

Tachycardia

39
Q

What is the recommended treatment protocol for extravasation?
a. Give the patient diphenhydramine (Benadryl).
b. Elevate the limb and apply cold compress over injection site.
c. Increase IV fluids.
d. Give the patient Lasix immediately.

A

Elevate the limb and apply cold compress over injection site

40
Q

The rapid introduction of contrast agents into the vascular system is termed:
a. rapid-fire injection.
b. rapid-drip infusion.
c. bolus injection.
d. IV infusion.

A

Bolus injection

41
Q

In preparation for a venipuncture, a tourniquet should be applied ____ above or proximal to the site of injection.
a. 1 to 2 inches (2.5 to 5 cm)
b. 3 to 4 inches (7.5 to 10 cm)
c. 6 to 7 inches (15 to 18 cm)
d. 8 to 10 inches (20 to 25 cm)

A

3 to 4 inches (7.5 to 10 cm)

42
Q

The most common size needle used for bolus injection of contrast agents for adult patients is _____ gauge.
a. 23 to 25
b. 14 to 16
c. 18 to 22
d. 28

A

18 to 22

43
Q

Which of the following veins is not normally used during venipuncture?
a. Median cubital
b. Axillary
c. Cephalic
d. Basilic

A

Axillary

44
Q

Patchy blunting of the calyces is a radiographic sign of:
a. polycystic kidney disease.
b. renal hypertension.
c. chronic pyelonephritis.
d. ectopic kidney.

A

Chronic pyelonephritis

45
Q

Ureteric compression is contraindicated for patients with a history of:
a. hematuria.
b. abdominal mass.
c. hypertension.
d. flank pain.

A

Abdominal mass

46
Q

How is contrast media normally introduced during a retrograde cystogram?
a. Intravenously
b. With an injection through the urethra with a large syringe and catheter
c. Gravity flow through a catheter
d. Either with an injection through the urethra with a large syringe and catheter or
gravity flow through a catheter

A

Gravity flow through a catheter

47
Q

What is the recommended position for a male retrograde urethrogram?
a. 30-degree right posterior oblique (RPO)
b. 45-degree RPO
c. Lateral
d. 2-degree left anterior oblique (LAO)

A

30-degree right posterior oblique (RPO)

48
Q

With automatic exposure control (AEC), which ionization chamber(s) should be activated for an AP projection taken during an IVU?
a. Left and right upper chambers
b. Center chamber
c. Left chamber
d. Center and right upper chamber

A

Left and right upper chambers

49
Q

Which one of the following veins is NOT selected for venipuncture during an IVU?
a. Basilic
b. Cephalic
c. Axillary
d. Median cubital

A

Axillary

50
Q

Where is the central ray (CR) centered for a nephrotomogram of the kidneys?
a. At the xiphoid process
b. At the iliac crest
c. Midway between the iliac crest and the xiphoid process
d. Midway between the ASIS and the iliac crest

A

Midway between the iliac crest and the xiphoid process

51
Q

A nephrogram taken during an IVU demonstrates that the renal parenchyma is poorly visualized, but the calyces are contrast enhanced. What is the most likely reason for this radiographic outcome?
a. The kVp may have been too high.
b. The contrast media was diluted.
c. The patient has hypertension.
d. The exposure was not taken soon enough following the injection.

A

The exposure was not taken soon enough following the injection

52
Q

A radiograph of a left posterior oblique (LPO) position taken during an IVU reveals that the right kidney is foreshortened and superimposed over the spine. What must the technologist do to correct this error during the repeat exposure?
a. Decrease rotation.
b. Increase rotation.
c. Increase CR angulation.
d. Place the patient in the RPO position to better demonstrate the right kidney.

A

Decrease rotation

53
Q

A radiograph of an AP projection taken during a retrograde cystogram reveals that the floor of the bladder is superimposed over the symphysis pubis. What error led to this radiographic finding?
a. Excessive CR angulation
b. Rotation of the pelvis
c. Insufficient CR angulation
d. Excessive filling of the bladder with contrast media

A

Insufficint CR angulation

54
Q

A patient comes to radiology for an IVU. During the procedure, the radiologist suspects nephroptosis. Which of the following positions best demonstrates this condition?
a. Erect
b. Prone
c. Supine with ureteric compression
d. RPO and LPO

A

Erect

55
Q

A patient comes to radiology for an IVU. The clinical history states that the patient may have an enlarged prostate gland (benign prostatic hyperplasia). Which of the following positions best demonstrates this condition?
a. AP erect, prevoiding and voiding
b. PA prone, CR perpendicular
c. AP supine with a 15-degree CR caudad angle
d. 30-degree RPO

A

AP erect, prevoiding and voiding

56
Q

A patient comes to radiology, after surgery of the abdomen, for an IVU with an order for ureteric compression to enhance pelvicalyceal filling. What should the technologist do?
a. Use mild ureteric compression only.
b. Place the patient into a Trendelenburg position instead of compression.
c. Perform all projections erect.
d. Raise the Foley bag above the tabletop to keep the contrast media in the kidneys
longer.

A

Place th patient into a Trendelenburg position instead of compression

57
Q

A patient comes to radiology for an IVU. He has a clinical history of renal hypertension. How should the IVU procedure be altered for this patient?
a. Keep ureteric compression inflated for all projections.
b. Give the patient a diuretic agent before the procedure.
c. Provide images every 30 minutes after the injection.
d. Shorten the time between exposures.

A

Shorten the time between exposures

58
Q

A patient comes to radiology with a history of vesicourethral reflux. The patient states that she is highly sensitive to iodinated contrast media. Which of the following alternative procedures could be performed to demonstrate this condition?
a. Radionuclide scan
b. Sonography
c. CT
d. MRI (magnetic resonance imaging)

A

Radionuclide scan

59
Q

A male patient comes to radiology for a voiding cystourethrogram. Which of the following projections and/or positions would be performed for this procedure?
a. 30-degree RPO
b. Erect lateral
c. Recumbent lateral
d. Erect PA

A

30-degree RPO

60
Q

A patient, during an injection of contrast media, complains about pain at the injection site. The radiographer notices a moderate degree of swelling beneath the skin. The radiographer stops the injection and suspects the needle has slipped out of the vein. What should the radiographer do after removing the needle to alleviate the patient’s discomfort?
a. Give the patient diphenhydramine (Benadryl).
b. Elevate the limb and place a cold compress over the injection site.
c. Place ice over the injection site.
d. Flex and extend the elbow to increase absorption of contrast media into the soft
tissues.

A

Elevate the limb and place a cold compress over the injection site

61
Q

A patient comes to radiology for an IVU. His laboratory report indicates a creatinine level of 0.7 mg/dL. What should be the technologist’s next step?
a. Proceed with the study.
b. Notify the radiologist of an elevated creatinine level.
c. Notify the erring physician of an elevated creatinine level.
d. Escort the patient to the emergency department (ED) right away.

A

Proceed with the study

62
Q

A patient with a possible ureteric stone comes from the emergency department (ED) for an IVU. She has a blood urea nitrogen (BUN) level of 50. Which of the following imaging modalities is recommended for this patient?
a. IVU using ionic contrast media
b. Sonography
c. CT
d. MRI

A

CT

63
Q

During an IVU, the patient develops severe urticaria. What should be the next action taken by the technologist?
a. Call a code emergency.
b. Comfort the patient; this is a common side effect.
c. Give the patient diphenhydramine (Benadryl).
d. Get medical assistance.

A

Get medical assistance

64
Q

A patient experiences a hot flash after the injection of an iodinated contrast media. What should be the next action taken by the technologist?
a. Call a code emergency.
b. Comfort the patient; this is a common side effect.
c. Give the patient diphenhydramine (Benadryl).
d. Get medical assistance.

A

Comfort the patient; this is a common side effect

65
Q

(T/F) The suprarenal glands are part of the endocrine system.

A

False

66
Q

(T/F) The left kidney is generally slightly lower, or more inferior, than the right.

A

False

67
Q

(T/F) Ionic contrast agents use a parent compound of a carboxyl group (benzoic acid).

A

True

68
Q

(T/F) Nonionic contrast agents create a hypertonic condition in the blood plasma as compared with ionic contrast agents.

A

False

69
Q

(T/F) Nonionic contrast agents may increase the severity of side effects as compared with ionic contrast agents.

A

False

70
Q

(T/F) Nonionic contrast agents contain no positively charged cations.

A

True

71
Q

(T/F) A vasovagal contrast media reaction can be a life-threatening condition.

A

True

72
Q

(T/F) A medical emergency must be declared if the patient experiences a moderate contrast media reaction.

A

True

73
Q

(T/F) Extravasation is classified as a local reaction.

A

True

74
Q

(T/F) Phlebitis is considered to be a systemic contrast media reaction.

A

False

75
Q

(T/F) Venipuncture procedures may be performed by a technologist only if a physician is present in the room or is in an adjoining room.

A

False

76
Q

(T/F) Patients (or legal guardian) must sign an informed consent form before a venipuncture procedure.

A

True

77
Q

(T/F) The bevel of the needle must be facing downward during the actual puncture into a vein.

A

False

78
Q

(T/F) If available, the technologist should use a central line catheter to introduce contrast agents into the patient.

A

False

79
Q

(T/F) Over-the-needle catheters are often used for drip infusion studies.

A

True

80
Q

(T/F) The technologist should leave a butterfly needle in the vein for the first part of the IVU following injection.

A

True

81
Q

(T/F) CT (computed tomography) of the kidney for renal calculi does not require the use of intravenous contrast media.

A

True

82
Q

(T/F) Laboratory tests are an effective method of confirming cystitis.

A

True

83
Q

(T/F) If an IVU is performed on a female, a pregnancy screening history must be obtained.

A

True

84
Q

(T/F) Generally, female patients cannot be shielded during an IVU (except for nephrotomography).

A

True

85
Q

(T/F) It is recommended to inject contrast media through a shunt when one is present in the patient.

A

False

86
Q

(T/F) If both procedures are ordered on the same day, a barium enema must be performed before an IVU.

A

False

87
Q

(T/F) All reactions, regardless to their severity, must be documented.

A

True

88
Q

(T/F) A true allergic reaction is also called an anaphylactic reaction.

A

True

Radiographic Positioning/Anatomy (5 decks)

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