FINAL EXAM Flashcards
A hospitalized patient develops a wound infection following surgery. This type of transmission is known as:
- Fomite
- Vector
- Aerosol
- Nosocomial
- Nosocomial
The first sound you hear when taking a blood pressure is:
- Diastolic sound
- Apnea sound
- Auscultation
- Systolic sound
- Systolic sound
In a healthy adult, a single respiration consists of:
- An exhalation
- An inspiration and expiration
- An inspiratory phase
- An expiration phase
- An inspiration and expiration
A level of consciousness is all of the following except:
- Unresponsive
- Alert
- Depressed
- Reacts to painful stimuli
- Depressed
Elisabeth Kubler Ross:
- Was a pediatrician who studied dying infants
- Developed a theory on the five stages a person moves through when dealing with a loss
- Wrote a book on denial and bargaining
- Described the five stages of anger management
- Developed a theory on the five stages a person moves through when dealing with a loss
A major strategy to utilize in order to gain a patient’s trust
- Make direct eye contact
- Speak with your back to the patient
- Speak very loudly and quickly
- Stand a distance away with arms crossed
- Make direct eye contact
Sterile fields:
- Never require constant monitoring to be considered sterile
- Can have unsterile supplies added to them
- Have a 1 inch border around the outer edge that are considered unsterile
- Can be prepared for use several days in advance
- Have a 1 inch border around the outer edge that are considered unsterile
Buffers are activities that:
- Should be avoided during stressful situations
- Increase the negative effects of stress
- Decrease the negative effects of stress
- Make you angry
- Decrease the negative effects of stress
The single most important means of preventing the spread of infection is:
- Wearing of gown, gloves and mask
- Covering your mouth when you cough
- Handwashing
- Sterilizing instruments
- Handwashing
Which of the following conditions is called the “silent killer?”
- Influenza
- Arthritis
- Contact dermatitis
- Hypertension
- Hypertension
Touch can be used for:
- Emotional support
- Palpating a bony radiologic landmark
- Emphasis to gently direct a patient to move in a given direction
- All of the above
- All of the above
To prevent the spread of infection, gloves must be:
- Powered
- Vinyl
- Latex
- Changed between patients
- Changed between patients
To prevent the spread of infection, facility issued scrubs to be worn in the operating room and procedural areas should
- Never be worn to or from work
- Be worn in the general public during your lunch break
- Be worn home every night after your shift
- Always be worn outside of the facility
- Never be worn to or from work
Gowns are considered sterile:
- The entire gown is considered sterile
- Only from the waist up
- On the sleeves and from the waist up
- On the sleeves only
- On the sleeves and from the waist up
To assist the patient in meeting their physiological needs you can:
- Offer them a warm blanket
- Tell them you will stay with them
- Tell them they are cooperating well
- Tell them their family is waiting for them
- Offer them a warm blanket
Procedures commonly performed in medical imaging under surgical aseptic technique include all of the following except:
- Angiography
- Image guided biopsies
- Ankle x-ray
- Myelograms
- Ankle x-ray
A Cardinal Rule when caring for mature adults is:
1. Treat with patience and respect 2. Assume they are not very health savy 3. Speak very loudly 4. Speak very quickly
1.
Treat with patience and respect
Monitoring vitals signs helps to obtain information about which of the following:
1. Homeostasis 2. Response to therapy 3. Potential life threatening conditions 4. All of the above
4.
All of the above
Fight or flight is a physiological reaction to a real or imagined threat arising from what emotions:
1. Sadness and loneliness 2. Love and longing 3. Fear and anger 4. Happiness and peacefulness
3.
Fear and anger
When interacting with a patient the most effective way to get cooperation is:
1. Give them your total and complete attention 2. Make them feel they are important 3. Both 1 and 2 4. Neither 1 or 2
3.
Both 1 and 2
Your patient has been waiting for over than hour for his procedure and appears very angry. What statement would be most effective with this patient?
- I am very sorry that you had to wait so long for your procedure
- Relax, life is too short to get upset and angry
3.
If you would just calm down, I will be able to get your procedure completed as soon as possible - Sorry it’s taking so long, I had to take care of another really sick patient
1.
I am very sorry that you had to wait so long for your procedure
Survival techniques for studying include all of the following except:
- Developing a positive can do attitude
- Deferring all forms of studying until the night before the exam
- Using as many senses as possible - seeing, saying and writing
- Reviewing new material soon after introduction
2.
Deferring all forms of studying until the night before the exam
Always use two identifiers to verify a patient’s identity. The best two identifiers are:
1. Patient's full name and home address 2. Patient's full name and cell phone number 3. Patient's full name and date of birth 4. Patient's full name and social security number
3.
Patient’s full name and date of birth
Bradycardia is:
A fast heart rate
A slow heart rate
No pulse
A device used to pace the heart
A slow heart rate
The American Registry of Radiologic Technologists Code of Ethics includes all the following except:
1.
Advancing the principle objective of the profession to provide services with respect for the dignity of mankind
2.
Acting in a professional manner in providing high quality patient care
3.
Cost of a radiological license
4.
Delivery of care without discrimination on the basis of race, sex, creed, religion or socioeconomic status
3.
Cost of a radiological license
An example of an airborne infection is:
1. Meningitis 2. HIV 3. Hepatitis B 4. Tuberculosis
4.
Tuberculosis
What is the most common cause of a fever in a patient?
Low metabolic rate
Viral and bacterial infections
Low cellular activity
Heart attack
Viral and bacterial infections
Hand hygiene is performed:
1. Before touching a patient 2. After touching a patient 3. After donning gloves 4. All of the above
4.
All of the above
The process of positive patient identification includes:
- Asking the patient to state their first and last name, and date of birth
- Never asking the patient “Are you Mr. or Mrs. _______?”
- Comparing patient’s stated information to the ID band and with the requisition for services
- All of the above
4.
All of the above
The highest level of achievement in Maslow’s Hierarchy of Needs is:
1. Love 2. Self-actualization 3. Physiological 4. Safety
2.
Self-actualization
Standard Precautions should be utilized for:
1. Pediatric patients 2. Patients with oozing wounds 3. All Patients 4. Patients with influenza
3.
All Patients
The US agency that defines the processes for Standard Precautions is:
1. The Standard Precaution Commission 2. The Agency for Infection and Virus Management 3. The Center for Disease Control 4. The Center for Disease Management
3.
The Center for Disease Control
Which of the following would fall within a normal range for an adult’s blood pressure:
1. 144/98 2. 110/74 3. 156/188 4. 78/52
2.
110/74
Hypotension can be caused by:
1. Vomiting and diarrhea 2. An increase in total blood volume 3. Constipation 4. Drinking too many fluids
1.
Vomiting and diarrhea
Normal range for an adult’s heart rate is:
1. 60-100 beats per minute 2. 120-160 beats per minute 3. 12-20 beats per minute 4. 80-100 beats per minute
1.
60-100 beats per minute
A culturally competent healthcare worker:
1. Values diversity 2. Possess the capacity for cultural self assessment 3. Delivers care with dignity and respect to all patients regardless of their cultural background 4. All of the above
4.
All of the above
According to Elisabeth Kubler Ross’s Theory:
- All persons experience the stages in an exact sequence
- Every person will not experience all stages of death and dying in the same exact order
- Justification is the first stage of death and dying
- Every person will achieve acceptance of their loss
2.
Every person will not experience all stages of death and dying in the same exact order
Which level of Maslow’s Hierarchy of Needs pertains to the patient that is fearful that missing time from work due to illness could result in a loss of employment?
1. Love and Belonging 2. Safety 3. Self Actualization 4. Physiological
2.
Safety
Hypothermia is:
1. A respiratory rate below 12 breaths per minute 2. A respiratory rate above 20 breaths per minute 3. A temperature below 37° C 4. A temperature above 99.5° F
3.
A temperature below 37° C
Handwashing is:
- An activity that should be avoided as it is drying to the hands
- The absolute best single activity to prevent the spread of infection
- Not as effective as using gloves
- Marginal at best in preventing the transmission of infection
2.
The absolute best single activity to prevent the spread of infection
Dyspnea is:
1. Necessary for cellular repair 2. A rapid pulse 3. A drug that must be prescribed by a physician 4. A state of difficult breathing
4.
A state of difficult breathing
Considerations when caring for a toddler (1-3 years) are all of the following except:
1. They cannot interpret the future 2. They can rationalize 3. Their concept in time is essentially now 4. Should not be left unattended
2.
They can rationalize
Stress is:
1. A demand on time, energy and resources 2. A fear of not being able to meet goals and obligations 3. Often can be manifested by physical symptoms of rapid breathing and pulse rate 4. All the above
4.
All the above
A patient with hypertension is at risk for:
Selected Answer: Correct Stroke Answers: Diabetes mellitus Rubella Correct Stroke Tuberculosis
Stroke
An example of a contact infection is:
1. Tuberculosis 2. Influenza 3. MRSA 4. Mumps
3.
MRSA
If no pulse can be felt at the wrist, palpate at the:
1. Radial artery 2. Ankle artery 3. Cephalic vein 4. Carotid artery in the neck
4.
Carotid artery in the neck
This is often referred to as the fifth vital sign:
1. Pain assessment 2. Pulse oximetry 3. Dietary intake 4. Level of consciousness
1.
Pain assessment
Healthcare providers have access to information in patient’s medical records, failure to abide by the guidelines set forth by HIPPA could:
- Place one’s job in jeopardy and/or result in disciplinary action
- Potentially impact professional licensure
- Be discovered by audits routinely performed by facilities of electronic medical records
- All of the above
- All of the above
Thoracostomy tubes are:
- Used to re-establish negative pressure in the pleural cavity
- Always attached to a pleurovac or Heimlich valve
- Used to treat complications from lung biopsy, rib fractures and central line placements
- All of the above
- All of the above
Which of the following should be present when checking your work area for emergency equipment:
1. Ambu bag 2. Suctioning catheters 3. Suction canister connected to wall suction or a portable suctioning device 4. All of the above
- All of the above
A precaution that should be taken when caring for a patient with a Foley catheter:
1.
The level of the drainage bag should always be kept lower than the bladder to prevent reflux of urine back into the bladder
2.
Suctioning equipment may be needed as an emergency measure
3.
Avoid any tugging on the catheter as the balloon in the bladder could damage the urethra or cause pain
4. Both 1 & 3
- Both 1 & 3
As a healthcare provider we all utilize many forms of social media. All of the following are good guidelines to follow with the exception of:
- Never post pictures of a patient
- Avoid describing your patients, even if not using their names in postings
3.
It’s okay to discuss your workday and the types of patients you cared for, as long as you don’t include their name or date of birth
4.
Be extremely mindful of all of your communication on any form of social media so as to not share any medical information you obtained in the care of your patients
3.
It’s okay to discuss your workday and the types of patients you cared for, as long as you don’t include their name or date of birth
PICCS (peripherally inserted central catheters) are
- Used when peripheral IV access is difficult or not possible
- Placed when long term IV access is needed
- Often used when a patient needs long term antibiotic therapy
- All of the above
4.
All of the above
Which is true as it relates to objective data
- Pain is an objective finding
- Something that is perceived by the affected individual only
- It is perceptible to the senses - can be seen, heard or felt
- A feeling of sadness would be considered objective
3.
It is perceptible to the senses - can be seen, heard or felt
Which of the following is a consideration(s) for patients presenting to the radiology department with a tube or line:
- If the line or tube should become displaced it may be life threatening
- Reinsertion could involve another surgery or procedure
- The most vulnerable time is during patient transfers
- All of the above
4.
All of the above
At the beginning of each work shift it is important to:
1. Assess your procedure room for the presence of emergency equipment 2. Print the daily patient schedule 3. Check the time of your lunch break 4. Check your personal phone for text messages
1.
Assess your procedure room for the presence of emergency equipment
Entries to a paper medical record must:
1. Be entered in ink 2. Only contain approved abbreviations 3. Be timed and dated 4. All of the above
4.
All of the above
For the patient presenting for a GI study, which of following history questions would be most appropriate to ask?
1. Do you have any nausea, vomiting or diarrhea? 2. Do you have painful urination? 3. Has your appetite been poor? 4. Both 1 & 3
4.
Both 1 & 3
Which is not true of a medical record as it pertains to a court of law
- It is a legal document that is admissible as evidence in court
- Care that is not documented in the medical record is considered care that was not done
- The original record is always left with the judge in court
- A health information manager may be required to honor a subpoena for the record
3.
The original record is always left with the judge in court
History elements that could be important to gather with patients in the radiology department are:
1. Allergies to medications, tape, latex, imaging contrast 2. Laterality of complaint 3. Laboratory results and major system diseases 4. All of the above
4.
All of the above
The safest place for an oxygen tank during patient transport is:
- At the foot of the bed on the stretcher mattress
- Having the patient hold it with both hands to be sure it is secure
- On the stretcher between the patient’s legs
- In the tank holder on the stretcher or wheelchair that is designed for E cylinders
4.
In the tank holder on the stretcher or wheelchair that is designed for E cylinders
When taking a patient history the interviewer should:
1. Establish rapport and open communication 2. Show respect, be genuine 3. Display a polite and professional demeanor 4. All of the above
4.
All of the above
Which of the following is true of mammography records:
- They are governed by the Mammography Medical Record Act (MMRA)
- A facility cannot upon request transfer a mammogram to another physician
3.
A facility must keep a mammogram in the permanent record of the patient for no less than 10 years - A facility is not obligated to give the mammogram to the patient
3.
A facility must keep a mammogram in the permanent record of the patient for no less than 10 years
Which of the following implanted devices would be very common in a patient receiving chemotherapy?
1. Dual or single lumen port 2. PICC 3. Arterial line 4. Peripheral IV
1.
Dual or single lumen port
Endotracheal tubes are used for all of the following except:
1. To ventilate coma induced patients 2. Fluid Administration 3. For shock and diseases that impair gas exchanges and upper airway obstruction 4. To provide oxygen and ventilate during the administration of general anesthesia
2.
Fluid Administration
Patients with endotracheal and tracheostomy tubes may often need:
1. Large amounts of fluids 2. A high fat diet 3. A risk to fall bracelet 4. Suctioning
4.
Suctioning
Securing devices are used to:
1. Prevent accidental removal of tubes, lines or drains 2. Administer fluids 3. Control bleeding 4. None of the above
1.
Prevent accidental removal of tubes, lines or drains
The following is true about HIPPA:
- It is the Health Insurance Portability and Accountabiity Act
- Sets standards that serve to protect health information from inappropriate access or use
- Mandates both security and privacy of medical information
- All of the above
4.
All of the above
Which of the following is an example of an open ended question:
1. "Does your right or left arm hurt?" 2. "Do you have pain?" 3. "I am going to take an x-ray of your right leg." 4. "Your wrist only hurts when you (pause by interviewer) ?"
4.
“Your wrist only hurts when you (pause by interviewer) ?”
Care must be taken when oxygen is in use because:
1. There could potentially be a risk of fire 2. Some surgical prepping agents if not properly dried could be flammable in the presence of oxygen 3. It smells very bad 4. Both 1 & 2
4.
Both 1 & 2
What is an “E” cylinder as it pertains to oxygen therapy?
- A small tank containing oxygen that is most commonly used as a portable source of oxygen
2.
A small portable tank used to provide oxygen to patients when they are being transported throughout the hospital - A small tank of oxygen that should be assessed frequently for remaining level of oxygen
- All of the above
4.
All of the above
Which of the following statements is not true of arterial lines:
1. If accidentally dislodged, require direct constant pressure over puncture site to prevent hemorrhage and control bleeding 2. Are placed in very large veins 3. Are used mainly for monitoring 4. Can be accessed for drawing of frequent blood gases
2.
Are placed in very large veins
Which special patient condition would likely make the transfer or repositioning more challenging:
1. Presence of a chest tube 2. Patient is receiving artificial ventilation via an endotracheal tube and is attached to a ventilator 3. Patient has multiple allergies 4. Both 1 & 2
4.
Both 1 & 2
Systolic blood pressure can be defined as the:
- Pressure of the pulmonary vein
- Lowest point to which the blood pressure drops during relaxation of the heart
- Difference between the contraction and relaxation phase of the heart
- Highest point of pressure reached during contraction of the heart
4.
Highest point of pressure reached during contraction of the heart
Contact Plus Precautions are used for patients that have:
1. Measles 2. Pertussis 3. MRSA 4. C-difficile
4.
C-difficile
Hand washing:
- Must be a vital practice in all patient care settings
- Is the single most important means of preventing the spread of infection
- Involves a mechanical and physical process
- All of the above
4.
All of the above
Which of the following will not protect you from violating HIPPA
- Resisting the temptation to “snoop” in a patient’s medical record
2.
Properly disposing of any written material that may contain patient medical information not part of the medical record - i.e. operating room schedule - Sharing your computer sign on password
- Always logging out of the patient’s medical record when leaving the computer
3.
Sharing your computer sign on password
Which of the following techniques should be used when trouble shooting an oxygen line:
- Follow the line from the patient to the oxygen source
- Disconnect the line to see if you smell any oxygen flowing
- Run water through the line to see if there is a leak
- Remove the nasal cannula from the patient
1.
Follow the line from the patient to the oxygen source
Which of the following are true about bubble bottles attached to oxygen tubing:
1. They are used to humidify the oxygen 2. Must be filled with water 3. Should never be filled with any type of fluids 4. Both 1 & 2
4.
Both 1 & 2
A nephrostomy tube is:
1.
A tube for which careful attention must be given when transferring a patient, as dislodgement would involve another procedure for reinsertion.
2.
Often placed when a kidney stone is obstructing urine flow from the kidney
3.
A drainage tube that is percutaneously placed in a kidney
4.
All of the above
4.
All of the above
Which is not true of a patient’s medical record?
1. It is a legal document 2. It is a single record 3. Only exists in paper form 4. Attests to all care rendered to the patient
3.
Only exists in paper form
For the patient receiving oxygen therapy the healthcare provider must always be aware of the availability of oxygen for their patient. Which of the following is not true?
- There is a continuous supply of oxygen when it is being delivered from the wall in a hospital
2.
An “E’ cylinder can supply up to 24 hours of oxygen to a patient receiving 2 liters per minute
3.
A full “E” cylinder can provide up to 5 hours of oxygen for the patient receiving 2 liters per minute
4.
A full “E” cylinder of oxygen will deplete at about 50 minutes if the patient is receiving 12 liters per minutes
2.
An “E’ cylinder can supply up to 24 hours of oxygen to a patient receiving 2 liters per minut
When removing an oxygen tank from the storage rack
1. Assume it is full if in the full rack 2. Always check the gauge to be certain the tank contains oxygen 3. Check to see if the tag says full 4. Look for a purple tag which indicates the tank is full
2.
Always check the gauge to be certain the tank contains oxygen
When caring for a patient receiving oxygen therapy which of the following are true:
- The flow of oxygen should be continuous and never stopped
2.
Always check to be sure the patient is connected to a source of oxygen either from the wall or a portable tank
3.
It would be okay to remove the oxygen delivery device from the patient when performing a radiological study - Both answer 1 & 2 are true
4.
Both answer 1 & 2 are true
Which of the following is a device that is surgically implanted under the skin and is not visible externally:
1. Chest tube 2. Urinary catheter 3. Cardiac pacemaker 4. Tracheostomy tube
3.
Cardiac pacemaker
When would it be acceptable to access the medical record of Dr. Brown who is an attending surgeon at your hospital?
- Never, it is a HIPPA violation
2.
He just had a serious car accident and you are concerned about the extend of his injuries because you are friends with his daughter
3.
If he is going to be your patient for a ultrasound guided liver biopsy and you needed to check his laboratory results - It would be acceptable at any time as he is an employee where you work
3.
If he is going to be your patient for a ultrasound guided liver biopsy and you needed to check his laboratory results
A Greenfield Filter is a device that:
1. Filters the blood to trap blood clots from reaching the heart 2. Is placed in the inferior vena cava 3. Is inserted through the femoral vein and placed just below the kidneys 4. All of the above
4.
All of the above
Which of the following is not true as it relates to the medical record in radiology:
- A physicians order is not needed for certain studies
- Must contain at least two patient identifiers
- A written report by a radiologist must be completed for every service rendered
- A diagnostic sign or symptom must accompany each request for a study or procedure
1.
A physicians order is not needed for certain studies
Pain balls are:
1.
Attached to a catheter that is placed in wound and provide a continous infusion of a pain controlling agent
2.
Balls filled with chilled water and placed over a wound for pain control
3.
Foam balls that patients squeeze to reduce stress and pain
4.
Given to pediatric patients to play with to reduce their perception of pain
1.
Attached to a catheter that is placed in wound and provide a continous infusion of a pain controlling agent
Should a chest tube become dislodged you should:
1. Reinsert it in the chest wall 2. Do nothing, it's not really a problem 3. Ask the patient to take a deep breath 4. Immediately place a dressing over the chest tube puncture site, ideally this should be a Vaseline dressing if available
4.
Immediately place a dressing over the chest tube puncture site, ideally this should be a Vaseline dressing if available
Since the 1970’s, the number of prescription drugs on the market has:
1. Stayed about the same 2. Dramatically decreased 3. Increased by 50 percent 4. Increased over tenfold
4.
Increased over tenfold
A drug can be defined as:
1. Any chemical substance that produces a biologic response in a living system 2. A substance used in medicine to aid in the diagnosis, treatment, or prevention of disease 3. A medicine used to cure viral diseases 4. Both 1 & 2
4.
Both 1 & 2
The science concerned with the origin, nature, effects and use of drugs is:
1. Pathophysiology 2. Paleontology 3. Pharmacy 4. Pharmacology
4.
Pharmacology
The chemical name of a drug:
1. Name given to the drug when it becomes commercially available 2. Identifies the actual chemical structure complex 3. Is a very short name for the drug 4. Identifies the method of action
2.
Identifies the actual chemical structure complex
The generic name of a drug is:
Selected Answer: Correct4. All of the above Answers: 1. Typically never capitalized 2. Name given when the drug becomes commercially available 3. A simpler name derived from the chemical name Correct4. All of the above
4
Nonprescription drugs:
1. Can only be dispensed by a pharmacist 2. Can never be refilled 3. Are also known as over-the-counter drugs 4. Can only be obtained legally with a prescription
3.
Are also known as over-the-counter drugs
Which of the following is not a “Right” of drug administration:
1. Right patient 2. Right time 3. Right color of medication 4. Right dose
3.
Right color of medication
A common drug used in radiology for conscious sedation is Fentanyl, care must be taken when this drug is used because:
- It can interfere with the function of the patient’s pacemaker
- No special care is required, it is a very safe drug
- It can significantly depress the respiratory system
- It can cause a severe rash on the patient’s feet
3.
It can significantly depress the respiratory system
While in the radiology department for a chest x-ray, your patient asks for a Tylenol. Which of the following is true?
- Tylenol should never given be to a radiology patient as it could cause a contrast reaction
- A physician’s order is required before any medication can be administered to a patient
- Okay to give to the patient a Tylenol as it is an over the counter medication
- Patient should not receive a Tylenol as it would interfere with the chest x-ray
2.
A physician’s order is required before any medication can be administered to a patient
Medications can come in many different dose forms. A capsule is:
- Medication that is contained in a gelatin shell
- Medication that is given intravenously
- Medication that is compressed into a hard disc
- A drug form that can be applied to the skin and absorbed into the bloodstream
1.
Medication that is contained in a gelatin shell
Blood tests are very valuable because:
1. The results can indicate how well organs such as the kidneys, liver, thyroid, and heart are functioning 2. They can be used to diagnose conditions and diseases 3. They assess if medications are working 4. All of the above
4.
All of the above
The BUN (blood urea nitrogen) is all of the following except:
1. An indicator of kidney function 2. Measure of nitrogen in blood that comes from the waste product urea Correct3. A urine test that measures the amount of the waste product urea 4. A value that increases with age
3
Which of the following are not a cause of an elevated BUN?
1. Kidney disease 2. High protein diets 3. Dehydration Correct4. Overhydration
4
Creatinine is:
- Usually a higher level in men than women because men have greater bone mass
- A chemical waste product produced by the bones
Correct3.
A chemical waste product produced by muscle
4.
Not an important lab value when assessing a patient prior to the administration of contrast media
3
The hematocrit is:
- The volume percentage of red blood cells in blood
- A measure of blood clotting time
- The volume percentage of white blood cells in the blood
- The number of red blood cells in the bloodv
1.
The volume percentage of red blood cells in blood
White blood cells are
1. Also called leucocytes 2. Cells of the immune system that are invovled in protecting against infection 3. Often reduced in number by radiation and chemotherapy Correct4. All of the above
4
Blood cells that carry oxygen are:
1. Red blood cells 2. Leucocytes 3. White blood cells 4. Oxycytes
1.
Red blood cells
Why would a blood test called a Protime be important to obtain prior to a liver biopsy, for a patient who takes the medication Coumadin?
- It is not a test that would be ordered for a patient on Coumadin
- It is a test that will measure the oxygen in the patient’s blood
3.
It is a test that measures white blood cells and will determine if the patient is at risk for an infection post biopsy - It is a blood test that measures the clotting tendency of the blood
4.
It is a blood test that measures the clotting tendency of the blood
Which of the following would not effect the oxygen saturation of the blood?
1. Sleep apnea 2. A high white blood count 3. A very low red blood cell count 4. Respiratory disease
2.
A high white blood count
Platelets are:
- Small plate shaped blood cells that assist the body in protecting against infection
- Cells produced by the muscles and released into the blood stream
- Blood cells that function to release the hormones necessary to coagulate blood
- Blood cells which are not impacted by bone marrow disease
3.
Blood cells that function to release the hormones necessary to coagulate blood
Osmolality is:
- A measure of the total number of particles in a solution per pound of water
- A measure of the total number of blood cells in a solution
- A measure of the total number of particles in a solution per kilogram of water
- The total number of osmoles in a given solution
3.
A measure of the total number of particles in a solution per kilogram of water
The most ideal osmolality of a contrast media for intravenous use is:
- Contrast media with osmolality that is the closest to that of blood
- Contrast media that is twice the osmolality of blood
- Osmolality is not a consideration when choosing an ideal contrast media
- None of the above
1.
Contrast media with osmolality that is the closest to that of blood
Which of the following is true as it relates to the need for informed consent for patients receiving contrast media:
- Informed consents are mandatory for any patient receiving contrast media
- Informed consents are only necessary when administering high osmolality contrast medium
- As contrast reactions are so rare, it is never necessary to obtain an informed consent.
4.
Whether an informed consent is obtained is based in state law and institutional and departmental policy
4.
Whether an informed consent is obtained is based in state law and institutional and departmental policy
Mild contrast reaction treatment would include all of the following except:
1. Oxygen by mask 2. Many times no treatment at all is indicated 3. Monitor vital signs and maintain IV access during an observation period 4. Advise patient to increase fluid intake
1.
Oxygen by mask
Regardless of adverse reaction classification (mild, moderate or severe) which of the following interventions is always indicated:
1. Maintaining IV access 2. Monitoring of vital signs 3. High flow oxygen administration 4. Both 1 and 2
4.
Both 1 and 2
Appropriate considerations must always be given to patients who may receive contrast media. These considerations include:
- An assessment of patient risk versus benefit of receiving contrast media
2.
Whether there are imaging alternatives that would provide the same or better diagnostic information without the use of contrast media - A very valid reason clinical reason for use of contrast media
- All of the above are appropriate considerations
4.
All of the above are appropriate considerations
Which of the following would be considered a mild adverse reaction to contrast media?
1. Chest pain 2. Protracted nausea and vomiting 3. Facial edema 4. 1-3 small hives
4.
1-3 small hives
As life threatening reactions can occur following the administration of contrast media which of the following are important processes to include in your professional practice:
- Always check your assigned clinical area for the presence of emergency equipment
- Know the location of contrast reaction boxes
3.
Be aware of the quickest form of communication to summon a radiology nurse and/or a radiologist - All of the above
4.
All of the above
Delayed reaction to contrast media include of all the following except:
- Symptoms are usually self limiting and require minimal treatment
- Can occur 3 to 7 days after the administration of the contrast media
3.
Will never progress to severe symptoms requiring medical care by an allergist or dermatologist - Manifestations are usually skin rashes
3.
Will never progress to severe symptoms requiring medical care by an allergist or dermatologist
Oral contrast media agents are used for:
1. Radiology fluoro studies such as upper GI series and small bowel follow-through 2. Ultrasound studies of the stomach 3. CT studies to highlight the GI tract in imaging of the abdomen and pelvis 4. Both 1 and 3
4.
Both 1 and 3
GI contrast media used in conventional fluoroscopic exams:
1. Barium sulfate 2. Gastrografin 3. Gastroview 4. All of the above
4.
All of the above
A contraindication for the administration of Barium Sulfate is:
1. Suspected bowel perforation 2. Gall bladder disease 3. Low red blood cell count 4. Kidney disease
1.
Suspected bowel perforation
Complications from Barium Sulfate are:
1. Most generally very mild 2. Physiological responses such as nausea, vomiting, and abdominal cramping 3. Allergic which can include rash and itching 4. All of the above
4.
All of the above
Which of the following is not true as it pertains to GI contrast media used for CT scan studies:
1. Usually diluted and mixed with favoring 2. Aspiration and hypovolemia are not a concern as this media is administered in very diluted form 3. Always given in an undiluted form 4. Gastrogafin and Gastroview are names of the most commonly used agents
3.
Always given in an undiluted form
Risk factors for adverse intravenous contrast media reactions include:
1. Asthma 2. Anxiety 3. Renal Insufficiency 4. All of the above
4.
All of the above
When screening a patient for allergies prior to intravenous contrast media administration, which of the following is not of concern
1. Previous contrast reaction 2. A shellfish allergy 3. History of muliple allergies to food, medications and environmental agents 4. Prior history of anaphylactic reaction to one or more drugs
2.
A shellfish allergy
Which of the following statements is not true of the management of patients taking Metformin as it pertains to intravenous contrast media administration:
1.
Patients with normal kidney function and no known comorbidies do not need to discontinue metformin prior to receiving intravenous contrast media
2.
They are at higher risk than other patients for the development of post-contrast acute kidney injury
3.
Patients known to have acute kidney injury or severe chronic kidney disease should temporarily discontinue metformin prior to the study
4.
There have been no reports of lactic acidosis in this patient population following contrast administration in properly screened and selected patients.
2.
They are at higher risk than other patients for the development of post-contrast acute kidney injury
According to the American College of Radiology, 2015 Manual on Contrast Media, contrast induced nephropathy:
1. Is a very real, but very rare entity 2. The exact pathophysiology is not well understood 3. Most important risk factor appears to be pre-exisiting severe renal unsufficiency 4. All of the above
4.
All of the above
Air embolism is a complication which can occur following the administration of intravenous contrast media. Which of the following statements is not true:
- Symptoms include air hunger, cough, and chest pain
- Can be potentially fatal
- Treatment would include placing the patient left side down
- It is a complication that occurs in 9 out of 10 patients
4.
It is a complication that occurs in 9 out of 10 patients
Treatment of contrast extravasation would include:
1. Advising the patient to increase their fluid intake 2. Application of either an ice or a warm pack 3. Placing the patient on their right side 4. Oxygen administration
2.
Application of either an ice or a warm pack
Superficial veins of the upper extremity are:
1. Located just below the skin 2. Are buried well beneath the skin 3. Run very parallel to the arteries 4. None of the above
1.
Located just below the skin
Which of the following can affect the ease of intravenous access:
1. Age and hydration 2. History of allergies 3. Sex of the patient 4. Type of contrast media to be used
1.
Age and hydration
Which of the following is an appropriate statement when preparing a patient for intravenous contrast administration:
1. You will probably wet your pants 2. You are going to receive a strong dye through your vein 3. No need to worry, contrast is very safe 4. Contrast media leaves your body through the urine, but you will not notice any difference in the color of your urine.
4.
Contrast media leaves your body through the urine, but you will not notice any difference in the color of your urine.
You need to obtain intravenous access on a patient who is going to receive intravenous contrast media via an automatic power injector. Which of the following is the most appropriate intravenous catheter for this patient:
1. 20 gauge angiocatheter 2. 23 gauge butterfly needle 3. 25 gauge butterfly needle 4. 27 gauge butterfly needle
1.
20 gauge angiocatheter
Severe contrast reactions can be life threatening. Which of the following would be a life threatening situation in which a code or 911 call would be indicated:
1. Nasal congestion 2. Hypertensive crisis 3. Patient complaint of headache with nausea 4. Sneezing
2.
Hypertensive crisis
What can be done to reduce the possibility of an allergic reaction for a patient who has a history of a contrast allergy:
- Administer intravenous fluids prior to the study
- Use a high osmolality contrast media for the study
- Instruct the patient to fast for 24 hours prior to the procedure
- Premedication with Benadryl and Prednisone
4.
Premedication with Benadryl and Prednisone
When screening a patient prior to the administration of contrast media, which of the following Glomerular Filtration Rates (GFR) would be of concern:
1. GFR of less than 30 ml/min 2. GFR of greater than 90 ml/min 3. GFR is not an important consideration for the administration of contrast media 4. GFR of greater than 200 ml/min
1.
GFR of less than 30 ml/min
When calculating Glomerular Filtration Rate, which of the following would be needed for the calculation
1. Creatinine value 2. Patient's age 3. Patient's gender 4. All of the above
4.
All of the above
What is the most common cause of an elevated white blood cell count:
1. Infection 2. Chemotherapy 3. Head trauma 4. Blood loss
1.
Infection
As a student in a radiological program in the state of New York which of the following is true:
1.
You are not permitted to administer contrast media to patients, nor obtain intravenous access
2.
You are not permitted to administer contrast media; but you are permitted to obtain intravenous access on patients
3.
You are permitted to administer contrast media under supervision
4.
You are permitted to administer contrast media
1.
You are not permitted to administer contrast media to patients, nor obtain intravenous access
…Patient care ranks among the top 10 most hazardous occupations for _____ to _____ and _____?
…12% of nurses consider leaving nursing due to low _____ _____ at average age of __?
…Over 52% of nurses complain of chronic _____ _____ lasting more than __ days within the past __ months?
The average nurse lifts an estimated __ tons per shift?
…Patient care ranks among the top 10 most hazardous occupations for injuries to muscles and joints?
…12% of nurses consider leaving nursing due to low back pain at average age of 39?
…Over 52% of nurses complain of chronic back pain lasting more than 14 days within the past 6 months?
The average nurse lifts an estimated 2 tons per shift?
4 patients X 6 lifts X 170 lbs = 4,080 lbs per shift
TRUE/FALSE
“Classes in body mechanics and lifting techniques keep staff from getting hurt.”
FALSE
TRUE/FALSE
“Lifting equipment will slow me down on the job.”
FALSE
On time and less strain
TRUE/FALSE
“Patients won’t like being moved with slings and lifting equipment.”
FALSE
Actually research shows that patients feel safer when they are handled and moved with sturdy and strong equipment.
Define ergonomics
Greek for “work” Greek for “laws”
So, ergonomics is the “laws of work!”
Ergonomics is the science of fitting the task to the worker and product to the user
-NOT fitting the worker to the task or product.
Define the following transfers
Lateral Transfers:
Transfers Involving Sitting/Standing Positions:
Repositioning:
Floor:
Define the following transfers
Lateral Transfers: Move patients sideways. e.g. from a bed to a stretcher
Transfers Involving Sitting/Standing Positions: e.g. bed-to-chair, chair-to-toilet
Repositioning: Move patients up or side-to-side in bed, turning in bed.
Floor: Move patients who have fallen.
What are the patient care risk factors
Awkward postures Lifting heavy loads Excessive pushing/pulling Frequent/repeated lifting and moving Tasks that last a long time (duration) Reaching
NIOSH weight limits
Manual Materials Handling Maximum = ? pounds
Patient Handling/Lifting Maximum = ? pounds
NIOSH weight limits
Manual Materials Handling Maximum = 51 pounds
Patient Handling/Lifting Maximum = 35 pounds
When should lifting equipment be used?
Over 35 pounds
Patients weigh too much (>35 lbs) for you to lift them without mechanical assistance.
BMI for bariatric patients?
> 30 BMI
Remember these devices
Transfer Belts Non-Friction Device HoverMatt HoverJack Total Assist Lift Ceiling Lift Sit-to-Stand Lift
Remember these devices
Transfer Belts Non-Friction Device HoverMatt HoverJack Total Assist Lift Ceiling Lift Sit-to-Stand Lift
Define ethics
Rules of conduct or standards by which a certain group regulates its actions and sets standards for its members
Professional ethics:
Will encounter situations that you find deeply _____
Usually unrelated to clinical procedures or medical interventions
May involve basic human rights
Right to _____, _____, right to be told the _____
May encounter conflicting _____ or _____ systems that can compromise patient care
Professional ethics:
Will encounter situations that you find deeply disturbing
Usually unrelated to clinical procedures or medical interventions
May involve basic human rights
Right to privacy, dignity, right to be told the truth
May encounter conflicting value or belief systems that can compromise patient care
Professional ethics:
Professionals must make difficult choices that depend on their understanding of moral principles such as _____, _____
Virtues of _____ and _____
Fundamental responsibilities such as _____ and _____ to both patients and physicians
Professional ethics:
Professionals must make difficult choices that depend on their understanding of moral principles such as justice, beneficence
Virtues of compassion and caring
Fundamental responsibilities such as honesty and loyalty to both patients and physicians
Principles of professional ethics written in a _____
These _____ can be frustrating because may not relate to your specific situation
When faced with an ethical problem or dilemma, many professionals simply obey the rules of their institution, follow the policies of their supervisors or chose the least objectionable course of action
Principles of professional ethics written in a code
These codes can be frustrating because may not relate to your specific situation
When faced with an ethical problem or dilemma, many professionals simply obey the rules of their institution, follow the policies of their supervisors or chose the least objectionable course of action
JUST REMEMBER
Your professional conduct must be based on complete, uncompromised devotion to patients as individuals in providing them with the highest possible quality of medical care
JUST REMEMBER
Your professional conduct must be based on complete, uncompromised devotion to patients as individuals in providing them with the highest possible quality of medical care
Science of rightness and wrongness of human conduct known as natural _____.
Society expects professionals to be guided by a _____ of _____ beyond mere conformity to law.
This standard of conduct, this common concern for collective self _____, this control of the profession from within is known as ethics.
Science of rightness and wrongness of human conduct known as natural reason.
Society expects professionals to be guided by a standard of conduct beyond mere conformity to law.
This standard of conduct, this common concern for collective self discipline, this control of the profession from within is known as ethics.
The system of ethics is closely related and overlaps two other systems designed to control society
Laws: ?
Morals: ?
The system of ethics is closely related and overlaps two other systems designed to control society
Laws: regulations established by a government that are applicable to people within a certain political subdivision
Morals: generally accepted customs of right living and conduct and an individual’s practice in relation to these customs
In 1914 this case laid the foundation for the relationship between patients and health care practitioners
What is it?
Schloendorf v, Society of New York Hospital
Six functions of the doctrine
- Protects individual _____
- Protects the patient’s _____ as a human being
- Avoids _____ and _____
- Encourages health care practitioners to consider their decisions carefully
- Fosters rational decision making by the _____
- Involves the _____ in medicine
Six functions of the doctrine
- Protects individual autonomy
- Protects the patient’s status as a human being
- Avoids fraud and duress
- Encourages health care practitioners to consider their decisions carefully
- Fosters rational decision making by the patient
- Involves the public in medicine
CIVIL LAW
Applies to the rights of _____ or _____
Remedies involve _____ or _____ to make plaintiff whole again
Amount of _____ generally determined by a jury following a trial
CIVIL LAW
Applies to the rights of individuals or entities
Remedies involve money or compensation to make plaintiff whole again
Amount of compensation generally determined by a jury following a trial
CRIMINAL LAW
Created to provide guidance and protection to those injured by offenses against _____.
Serves to deter, punish, and rehabilitate persons who perform _____ acts
Criminal conduct can include forgery, burglary, murder, assault, battery, theft, rape and false imprisonment
CRIMINAL LAW
Created to provide guidance and protection to those injured by offenses against society.
Serves to deter, punish, and rehabilitate persons who perform criminal acts
Criminal conduct can include forgery, burglary, murder, assault, battery, theft, rape and false imprisonment
CRIMINAL OR CIVIAL LAW?
A person is practicing medicine without a license?
A patient receives too much medication because the tech failed to properly administer the correct dose, causing kidney failure?
The state requires that child or elder abuse be reported and a nurse or rad tech refuses to report the abuse?
CRIMINAL OR CIVIAL LAW?
A person is practicing medicine without a license?
criminal
A patient receives too much medication because the tech failed to properly administer the correct dose, causing kidney failure?
civil
The state requires that child or elder abuse be reported and a nurse or rad tech refuses to report the abuse?
criminal
INFORMATION THAT MAY BE USED TO DETERMINE STANDARDS OF CARE
Federal and state regulations Position descriptions Curriculum guides Institutional policies and procedures Professional customs Standards of Practice Rules of Ethics
[Practice Standards for Medical Imaging and Radiation Therapy ]
Appendix __ - page __
Outlines the practices in clinical, quality, and professional performance.
Is used to determine whether an individual is compliant with a national standard.
[Practice Standards for Medical Imaging and Radiation Therapy]
Appendix A - page 461
Outlines the practices in clinical, quality, and professional performance.
Is used to determine whether an individual is compliant with a national standard.
For the radiological technologist, the objectives are: preserving life, ______ to the patient, and obtaining _____ as quickly as possible
For the radiological technologist, the objectives are: preserving life, avoiding further harm to the patient, and obtaining medical assistance as quickly as possible
_____ for the need for assistance is a critical first step; the technologist must be able to recognize when assistance is warranted.
Recognition for the need for assistance is a critical first step; the technologist must be able to recognize when assistance is warranted.
PRIORITIES
- Ensure an open airway
- Control _____
- Take _____ to prevent shock
- Attend to _____ and _____
- Provide _____ support.
- Continually reevaluate and follow up appropriately.
PRIORITIES
- Ensure an open airway
- Control bleeding
- Take measures to prevent shock
- Attend to wounds and fractures
- Provide emotional support.
- Continually reevaluate and follow up appropriately.
Define crash casrt
The cart is a wheeled container of drugs and equipment needed to handle a life threatening situation
Outpatient facilities do not have crash carts and must utilize an immediate call to 911
What’s in a crash cart?
Defibrillator
Oxygen tank
Ambu bag
Emergency drugs
Intubation supplies
Suction
The crash cart is checked _____ by an assigned person. A _____ log is completed validating the equipment is intact and functional.
The crash cart is checked daily by an assigned person. A daily log is completed validating the equipment is intact and functional.
AED
_____ automated or _____ automated – analyze the patient’s cardiac rhythm and determine whether defibrillation is necessary.
AED
Fully automated or semi automated – analyze the patient’s cardiac rhythm and determine whether defibrillation is necessary.
CONTRAST REACTION BOX
An emergency tackle box that has the _____ and _____ needed to treat a contrast reaction.
This box is also checked _____ and documented in a log.
CONTRAST REACTION BOX
An emergency tackle box that has the drugs and equipment needed to treat a contrast reaction.
This box is also checked daily and documented in a log.
SHOCK
What is it?
Several types of shock:
Hypovolemic: ?
Cardiogenic: ?
Neurogenic: ?
Vasogenic or Anaphylactic: ?
SHOCK
A failure of the circulatory system to support vital body functions.
Several types of shock:
Hypovolemic: caused by loss of blood
Cardiogenic: caused by a cardiac disorder (myocardial infarction)
Neurogenic: caused by anesthesia or spinal injury
Vasogenic or Anaphylactic: caused by sepsis, anesthesia, allergic reaction
Technologist will most often come in contact with either _____ shock or _____ shock
Technologist will most often come in contact with either hypovolemic shock or anaphylactic shock
_____ shock could be encountered when a patient experiences an allergic reaction to contrast media
Anaphylactic shock could be encountered when a patient experiences an allergic reaction to contrast media
Factors that contribute to the progression of shock:
Sudden change in body _____
Increase of _____, _____, or _____
To help prevent progression technologist must keep the patient as _____ as possible
Maintain proper body _____
Factors that contribute to the progression of shock:
Sudden change in body temperature
Increase of pain, stress, or anxiety
To help prevent progression technologist must keep the patient as comfortable as possible
Maintain proper body temperature
SIGNS AND SYMPTOMS OF SHOCK
Restlessness Apprehension Tachycardia Decreasing Blood Pressure Cool, Clammy skin Pallor
HEAD/SPINAL CORD INJURIES
Levels of consciousness:
_____ & _____
_____ but can be aroused
_____ and only reacts to _____ stimuli
_____ and unresponsive to virtually all stimuli
HEAD/SPINAL CORD INJURIES
Levels of consciousness:
Alert & oriented
Drowsy but can be aroused
Unconscious and only reacts to painful stimuli
Comatose and unresponsive to virtually all stimuli
HYPOGYLCEMIA: ?
This can be caused by the patient taking their usual dose of insulin and not eating because fasting maybe required of the procedure.
This then leads to an _____ reaction.
Symptoms: ?
HYPOGYLCEMIA: excessive insulin is present
This can be caused by the patient taking their usual dose of insulin and not eating because fasting maybe required of the procedure.
This then leads to an insulin reaction.
Symptoms: intense hunger, weak, shaky, excessive sweating, confusion, irritability - sometimes to the point of aggression.
Patients often will tell you that they are feeling the onset of these symptoms.
HYPOGLYCEMIA
Treatment?
Treatment: Quick Form of carbohydrate
Glucose tablets
Orange Juice
Sugared soda
Candy Bar
Takes 10 - 15 minutes to take effect.
Keep patient sitting or lying down quietly (exertion will further deplete the glucose level)
If patient becomes incoherent or unconscious call for emergency help
Hyperglycemia: ?
Develops gradually - over _____ or _____
Symptoms: ?
Leads to diabetic coma if untreated
Hyperglycemia: excessive sugar in the blood
Develops gradually - over hours or days
Symptoms: excessive thirst and urination, dry mucosa, rapid, deep breathing, drowsiness and confusion
Leads to diabetic coma if untreated
Hyperglycemia
Treatment: ?
Hyperglycemia
Treatment: Insulin
If this condition is believed to be present the technician must get help.
Asthma: ?
Symptoms: ?
Treatment: ?
Asthma: If an asthmatic patient is stressed, as in a Radiological Procedure, an attack can happen.
Symptoms: Wheezing, shortness of breath
Treatment: Inhaler or other bronchodilator
Choking: ?
Symptoms: ?
Treatment: ?
Choking: Complete or partial airway obstruction
Symptoms: Patient unable to speak
Treatment: Heimlich Maneuver
Can happen during Modified Barium Swallow
What is CPR?
What is CAB?
Cardiopulmonary Resuscitation (CPR)
CAB: Compressions Airway Breathing Defibrillation
CVA (Cerebral Vascular Accident ) - ?
Symptoms: ?
Treatment: ?
CVA (Cerebral Vascular Accident) - Stroke
Symptoms: paralysis on one side, slurred speech or complete loss of speech, dizziness, headache, loss of vision (usually one eye), loss of consciousness
Treatment: Get Help Immediately
Nausea and Vomiting:
Treatment: ?
Nausea and Vomiting:
Treatment: Slow deep breaths through the mouth
Ensure the patient does not choke on vomitus - turn patient to lateral decubitus position - if they are unable to move to this position turn their head to side
Provide emesis bag, cold wet cloth
Orthostatic Hypotension - ?
Treatment: ?
Orthostatic Hypotension - Condition where the patient’s blood pressure suddenly drops when they move from a lying to a sitting or standing position – symptom is lightheadedness
Best treatment is to have patient move very slowly, first to a sitting then standing position.
Epistaxis: ?
Treatment: ?
Epistaxis: Nosebleed
Treatment: Sitting position, leaning forward, pressure to the midline nasal cartilage
If bleeding doesn’t stop within 15 minutes medical help is needed
Vertigo and Syncope: ?
Treatment: ?
Vertigo and Syncope: Dizziness and Fainting
Treatment: Vertigo -Assist patient to a sitting or recumbent position to prevent falling
Syncope - Increase blood flow to the head - recumbent position with feet elevated, moist cloth to forehead - call for Help
Orthostatic Hypotension: ?
Treatment: ?
Orthostatic Hypotension: Vertigo or syncope upon standing
Treatment: Have patient return to sitting or recumbent position, when dizziness stops attempt standing again, first have patient dangle at side of bed, if they are not dizzy attempt standing again. If after second attempt to stand patient becomes dizzy again get help.
Seizures: ?
Symptoms: ?
Seizures: Caused by a variety of factors - not well understood
Symptoms: Mild - brief loss of consciousness, stare into space for a brief period of time
Severe - involuntary movement of muscles on one or both sides - may last a few seconds to several minutes, drooling.
Hemorrhage: ?
Treatment: ?
Hemorrhage: Bleeding outside a vessel
Treatment: Apply direct pressure over site using gloved hand and sterile pads.
What is dehiscence
what should be done
Patient’s suture separate and abdominal contents spill out of cavity
Patient should be sitting slightly so further pressure isn’t applied to site.
Severity of latex allergy?
Reactions can be mild, moderate or severe (anaphylactic)
Before using any products containing latex check for allergy – gloves, catheters
