MOSBY ONLINE Flashcards
Your patient being treated for bronchogenic adenocarcinoma complains of difficulty swallowing.
His symptom is likely caused by:
A. mucositis
B. poor oxygen exchange
C. perforation of the trachea
D. esophagitis
esophagitis
Rationale:
The esophagus is likely included in the treatment field for this lung cancer patient. Radiation to the esophagus may cause swelling and irritation and make it difficult and uncomfortable for patients to swallow food.
A nonpharmacological management for mild to moderate xerostomia would be:
A. drinking caffeinated beverages
B. eating more fibrous foods
C. drinking thickened shakes
D. eating applesauce and sorbets
eating applesauce and sorbets
Rationale:
Xerostomia can be managed by sucking on hard candies, eating soft, moistened foods, drinking plenty of water, and avoiding caffeine and alcohol.
The following would be appropriate advice for a patient receiving radiation to the whole brain except:
A. wear a hat or scarf to protect the scalp from the sun
B. eat a balanced diet
C. when dry desquamation occurs, use a dandruff shampoo
D. exercise in moderation
when dry desquamation occurs, use a dandruff shampoo
Rationale:
Dandruff shampoo contains harsh chemicals that will likely exacerbate symptoms.
Cultural differences may result in different perceptions of :
A. eye contact
B. touch
C. tone of voice
D. a, b, and c
a, b, and c
Rationale:
Different cultures perceive certain behaviors differently, such as eye contact, touching, tone of voice, and certain body or hand gestures.
A procedure used to stop the transmission of infection from the patient to others is called:
A. aseptic technique
B. reverse isolation
C. sterilization
D. isolation
isolation
Rationale:
A procedure used to stop the transmission of infection from patient to others is called isolation. Reverse isolation stops the transmission of infection from others to the patient. Asepsis and sterilization inhibits the vehicle of disease transmission from objects to patient.
A grade 3 morbidity score for the skin would indicate:
A. confluent moist desquamation
B. swelling with dry desquamation
C. mild redness and itching
D. ulceration or necrosis
confluent moist desquamation
Rationale:
According to RTOG morbidity scoring, a grade 3 skin reaction would mean confluent moist desquamation.
In order to evaluate the blood pressure a___________is required.
A. stethoscope
B. otoscope
C. sphygmomanometer
D. barometer
sphygmomanometer
Rationale:
The sphygmomanometer is the gauge containing mercury that visually demonstrates the systolic and diastolic pressures.
If a patient is experiencing a severe reaction in the perineal area they should not:
A. use hot baths to soothe the skin
B. keep the area dry
C. decrease the likelihood of repeated friction
D. decrease the likelihood of prolonged moisture
use hot baths to soothe the skin
Rationale:
Severe skin reactions are best managed without any extreme temperature, hot or cold.
When taking the pulse you should always use the first two fingers and not the thumb because:
A. The thumb is less sensitive.
B. It looks more professional.
C. Your pulse can be felt in the thumb.
D. It is less awkward.
Your pulse can be felt in the thumb.
If your patient begins to experience a convulsive seizure, you should:
A. insert a bite block into the mouth
B. use a spoon on the tongue
C. administer oxygen
D. monitor the patient to prevent injury
monitor the patient to prevent injury
Rationale:
If a patient begins to have a convulsive seizure, you should make sure that the patient does not injure himself or herself. Call for assistance and, after movements, monitor vital signs.
The normal limits for PSA in the patient under 60 years old is less than or equal to:
A. 4 ng/mL
B. 10 ng/mL
C. 20 ng/mL
D. 40 ng/mL
4 ng/mL
Normal PSA levels in the male under 60 years is less than or equal to 4 ng/mL. The limits increase slightly as the male patient ages.
**PSA = Prostate Specific Antigen
Palliative treatment is:
A. intended to cure
B. for the relief of symptoms
C. the infusion of oxygen into cells
D. treatment for the prevention of cancer spread
for the relief of symptoms
Rationale:
Palliative treatment is intended to bring the relief of symptoms and improve the patient’s quality of life without expectation of cure.
Which of the following is not required for giving consent?
A. legal age and mental competency
B. acknowledgment of risks
C. understanding of procedure
D. medical background and credentials
medical background and credentials
Rationale:
For consent to be given, the patient must be of legal age and have the mental capacity to understand the procedure, risks and benefits, and alternatives.
The patient experiencing dry desquamation should be advised to:
A. apply alcohol every 3 hours
B. lightly coat with petroleum jelly every 3 hours
C. apply radiation dermatitis ointments no sooner than 1 hour before treatment
D. apply scented lotions at their discretion
apply radiation dermatitis ointments no sooner than 1 hour before treatment
When treating the oral cavity, your patient would be expected to complain of:
A. radioactive fillings
B. sore and sensitive teeth
C. sore cheeks and gums
D. metallic taste when eating
sore cheeks and gums
Rationale:
Radiation to the oral cavity will likely cause mucositis. The patient will complain of sore cheeks and gums.
A 3-year-old child is eating in the waiting room. She begins coughing, and her cough is soft and weak. Then she begins making high-pitched noises, and her skin turns blue. What is the most likely cause of her distress?
A. an acute asthma attack
B. a severe or complete airway obstruction
C. infected and swollen vocal cords
D. an epileptic seizure
a severe or complete airway obstruction
Rationale:
This child is probably choking and has an airway obstruction with inadequate air exchange.
The larger the lumen of a needle, the________the gauge.
A. larger
B. smaller
C. thicker
D. darker
smaller
Rationale:
The lumen size of a needle is expressed in gauge. The larger the lumen, the smaller the gauge.
As you are escorting the patient into the room, she begins to collapse. You allow her to slowly slip to the floor. The next appropriate thing to do would be to:
A. call a code
B. get the crash cart
C. start CPR
D. shake the patient and shout name
shake the patient and shout name
A chemical substance(s) used to kill pathogens on equipment is/are called a/an:
1. disinfectant
2. antiseptic
3. antibiotic
————————————————————————–
A. 1
B. 2
C. 3
D. 1, 2, 3
disinfectant (1)
Rationale:
A disinfectant is used to decontaminate equipment or tissues. Antiseptics are used to clean tissues. Antibiotics are used to combat bacterial infections.
The type of nutrition that bypasses the gastrointestinal tract and introduces nutrients into the veins is called:
A. enteral
B. parenteral
C. gastrostomy
D. nasogastrostomy
parenteral
Rationale:
Parenteral nutrition bypasses the gastrointestinal tract and puts nutrients into the patient’s veins.
Clinical manifestations of superior vena cava syndrome include:
A. productive cough with yellow sputum
B. dyspnea, facial and neck edema, and tachycardia
C. bradycardia and diaphoresis
D. fever, nausea, and vomiting
dyspnea, facial and neck edema, and tachycardia
Rationale:
Obstruction of the superior vena cava causes difficulty breathing, swelling in the neck and face, distended veins in the neck, and rapid heart rate.
The normal body substance released by tissue in response to an allergic reaction is:
A. histamine
B. adrenalin
C. thyroxin
D. iodine
histamine
Rationale:
Histamine is naturally released in response to an allergic reaction.
A low residue diet would be recommended for the patient receiving radiation to the:
A. brain
B. larynx
C. bladder
D. esophagus
bladder
Rationale:
Abdominopelvic radiation may induce diarrhea. Those patients treated for cancer involving tissues in the lower abdomen and pelvis should be counseled to adhere to a low residue diet to minimize symptoms of diarrhea.
Which of the following are true regarding management of patients with special conditions (select two):
- Patients with cardiac conditions should be transferred with minimal effort on the patient.
- Paralyzed upper extremities can dangle once the patient is supine.
- One should always move patients with IVs toward the tubing.
- Patients with spinal cord compressions may self-transfer whenever they are able.
- Patients with cardiac conditions should be transferred with minimal effort on the patient.
- One should always move patients with IVs toward the tubing.
Rationale:
Paralyzed limbs should always be supported. Patients with spinal cord compressions should be moved carefully to decrease the risk for further spinal injury.
During injection of contrast for CT simulation, your patient complains of difficulty breathing and feeling faint. He is likely experiencing:
A. moderate symptoms of anaphylactic shock
B. minor symptoms of respiratory distress
C. minor symptoms of depression
D. major symptoms of claustrophobia
moderate symptoms of anaphylactic shock
Rationale:
Anaphylactic shock is not an uncommon response to the injection of contrast material. Moderate signs include difficulty breathing, changing levels of consciousness, nausea, and vomiting. Injection of contrast should stop and physician should be alerted.
Normal rectal temperature for the adult in Fahrenheit is:
A. 98.6
B. 99.6
C. 97
D. 96
99.6
Rationale:
Rectal temperature is approximately 1 degree higher than oral temperature, which is 98.6 degrees Fahrenheit.
Phase I clinical trials are designed to determine the_____and______of a drug in humans.
A. purity; potency
B. potency; risk
C. toxicity; best dose
D. bioavailability; risk
toxicity; best dose
Rationale:
Phase I clinical trials determine the toxicity and optimal dose of a drug.
A grade 1 skin reaction to radiation therapy has the following characteristics (select two):
- dry, scaly skin
- necrosis
- epilation
- ulceration
- dry, scaly skin
- epilation
Rationale:
A grade 1 skin reaction shows the skin with temporary hair loss, erythema, and dryness.
A persistently high arterial blood pressure is known as:
A. hypertension
B. hypotension
C. hypercalcemia
D. hyponatremia
hypertension
An American Indian woman with advanced cancer is comatose and comes for palliative radiation to the cervical spine. She wears a small discolored pouch on a string around her neck. The most appropriate action for the therapist is to:
A. discard the pouch as it may interfere with treatment
B. remove it and place it in an envelope for safe keeping
C. leave it on
D. remove it and tell the family to remove it later
leave it on
Rationale:
American Indians may wear or carry objects that are sacred and are considered curative. As long as it does not interfere with therapy, it should remain on. If any other item would interfere with therapy, it is best to speak with the family before removing it since this patient cannot communicate.
Your patient has had a left modified radical mastectomy and complains of swelling in her left arm especially after increased activity. She is likely showing signs of:
A. overexertion on her left side
B. Increase salt intake
C. lymphedema caused by axillary node resection
D. heart attack
lymphedema caused by axillary node resection
Rationale:
Lymphedema is seen in patients following radical surgeries where lymph nodes have been resected. Backup of lymphatic fluid causes swelling.
A patient known to carry an organism that is easily transmitted by airborne transmission should be placed in a:
A. regular-sized wheelchair
B. typical hospital room
C. room with negative pressure ventilation
D. room with no windows
room with negative pressure ventilation
Which of the following would influence the onset or duration of action for a certain drug?
A. purity
B. kidney function
C. nutrition
D. liver function
nutrition
Rationale:
The onset and duration of action may be influenced by many things including the route of administration, dose, patient’s age, health, ethnicity, state of mind, weight, and nutrition (fluid and electrolyte balance).
Deodorants should not be used in areas treated with radiation because:
A. There will be increased scatter radiation.
B. The deodorant will cover the skin markings.
C. Chemicals in the deodorant may be absorbed into the skin.
D. The deodorant may cause a bolus effect.
The deodorant may cause a bolus effect.
A drug that would increase the flow of urine is called a:
A. derivative
B. diuretic
C. digestant
D. demulcent
diuretic
If there is a serious complication during therapy, the patient could initiate legal action against:
1. the physician
2. the hospital
3. the therapist
A. 1 B. 1, 2 C. 1, 3 D. 1, 2, 3
1, 2, 3
Rationale:
Any negligence or malpractice suit related to therapy brings liability to the prescribing and supervising physician, the treatment facility, and the therapist administering therapy.
A patient who is in cardiac arrest is a level_______on the Karnofsky performance scale.
A. 0 B. 20 C. 50 D. 100
0
Rationale:
Karnofsky performance scale measures the patient’s ability to care for oneself and carry out normal activity. 0 to 100 where 0 = dead and 100 is normal.
Proper nutrition for the cancer patient undergoing radiation therapy treatments helps to:
- enhance the effect of the treatments
- improve the mental status of the patient
- divert the patient’s attention from the treatment
- the body to repair the damage caused by the treatmentA. 1, 2
B. 3, 4
C. 1, 2, 4
D. 1, 2, 3, 4
1, 2, 4
Rationale:
Proper nutrition helps the patient fight disease and improve emotional and mental status, and helps with tissue repair.
In case of an emergency, a patient with advanced directives:
A. does not want any type of life-saving treatment
B. wants every type of life-saving treatment
C. has a proxy to make all decisions
D. has prior instructions about care
has prior instructions about care
Rationale:
An advanced directive may be written or verbal and is an expression of what the patient wants in case the patient is unable to make decisions about health. The directives may describe life-saving procedures desired, if any at all, or may designate a proxy to make decisions.
The stages of coping following the diagnosis of cancer include all of the following except:
A. bargaining
B. denial
C. acceptance
D. anticipation
anticipation
Rationale:
The stages of coping include denial, bargaining, depression, anger, and acceptance.
The lithotomy position would be appropriate to examine the:
A. oral cavity
B. perineal area
C. biliary tree
D. axillary lymph nodes
perineal area
Rationale:
Lithotomy is the patient supine with knees bent up toward chest; feet are often in stirrups.
A patient undergoing treatments to the oral cavity and oral pharynx will experience:
1. altered taste
2. sore throat
3. difficulty swallowing
4. cysts in the mouth
A. 2, 4 B. 1, 3 C. 2, 3 D. 1, 2, 3
D. 1, 2, 3
Rationale:
Radiation to the oral cavity, especially to the oropharynx will cause patients to have a change in taste, difficulty swallowing, and throat pain.
A type of isolation used for highly communicable diseases and requiring personnel to wear gown, gloves. and mask would be called___________isolation:
A. respiratory B. strict C. enteric D. aseptic
strict
Rationale:
Strict isolation is used for patients with a highly communicable disease. Gloves, gown, and mask would be required.
Following a seizure, the patient begins to vomit. The head should be lifted and turned to the side to prevent:
A. cramping
B. dehydration
C. loss of consciousness
D. aspiration
aspiration
Rationale:
Turning the patient onto the side prevents aspiration of any expelled fluids from the mouth into the lungs.
Syncope is another name for:
A. fainting B. seizure C. stroke D. heart attack
fainting
A type of shock associated with bacterial infection and its byproduct is called:
A. septic B. neurogenic C. hypovolemic D. anaphylactic
septic
Rationale:
Septic shock is associated with bacterial infections and its toxic byproducts.
The transient sensation of electrical shock traveling down the neck and extremities following radiation to the spine is called:
A. Lhermitte’s sign
B. Babinski’s sign
C. Turner’s syndrome
D. Gardner’s syndrome
Lhermitte’s sign
Rationale:
Lhermitte’s sign is a sensation of electrical shock down the neck and extremities following radiation to the spinal area.
Radiation-induced diarrhea is likely to appear in patients receiving treatment to the pelvis beginning which week of radiation therapy treatment?
A. first
B. second
C. third
D. seventh
third
Rationale:
Using standard fractionation, the patient receiving pelvic irradiation may experience diarrhea beginning the third week of treatment.
Under sterile technique, the area would be disinfected before the start of the procedure in order to:
A. protect the sterile draping from contamination
B. decrease the potential of introducing microorganisms into the area
C. protect the health care worker from disease transmission
D. make it easier for equipment to be used in the area
decrease the potential of introducing microorganisms into the area
Rationale:
During sterile procedures, the area should be disinfected to decrease the potential for microorganisms to contaminate the area.
A dizzy feeling associated with sitting or standing after a prolonged period of bed rest is called:
A. vertigo B. decubitus seizure C. postural hypotension D. cecubitus ulcer
postural hypotension
Rationale:
Light-headedness or dizziness after lying down is caused by a drop in blood pressure and then a sudden increase. Vertigo is also a dizzy feeling but is not necessarily associated with prolonged bed rest or sitting.
Your patient arrives in a wheelchair and is unable to stand. The best transfer method among the following would be:
A. 2-to-3-person lift
B. draw sheet
C. slider board
D. gait belt
2-to-3-person lift
Patients receiving curative doses of radiation to the mediastinum should be advised to:
A. apply an antibacterial ointment to the area
B. eat foods that are salty and spicy
C. avoid foods that are spicy and acidic
D. gargle with mouthwash before radiation therapy
avoid foods that are spicy and acidic
All of the following are methods of delivering oxygen to patients except:
A. nasal cannula
B. face mask
C. IV catheter
D. oxygen tent
IV catheter
Soiled wound dressings should be placed into a_________for disposal.
A. puncture-resistant container
B. tied laundry bag
C. nearby waste basket
D. red biohazard bag
red biohazard bag
Rationale:
Soiled dressings should be handled as potentially infectious and must be placed in biohazardous waste bag.
Deficiency in the number of circulating white blood cells is called:
A. thrombocytopenia
B. leukoplakia
C. leukopenia
D. pancytopenia
leukopenia
Opioids are given to:
A. alleviate pain
B. regulate the heart
C. prevent infection
D. decrease nausea
alleviate pain
Rationale:
Opioids are analgesics or pain relievers.
The blood urea nitrogen (BUN) test is a measure of the amount of nitrogen in the blood in the form of urea, and typically a measurement of the function of which organ?
A. liver
B. kidney
C. bladder
D. adrenal gland
kidney
Rationale:
Nitrogen in the form of urea is excreted by the liver and then filtered from the blood by the kidneys. BUN is an indicator of renal function.
The normal limits for BUN in mg/dL for the adult are:
A. 10 to 20 B. 30 to 40 C. 60 to 80 D. 100 to 110
A. 10 to 20
Rationale:
The normal limits for BUN levels in the blood are 10 to 20 mg/dL.
Erythema is defined as:
A. evacuation of capillaries
B. any congestion of capillaries causing abnormal redness
C. shedding or peeling of dry skin
D. skin with multiple cracks and pustules
any congestion of capillaries causing abnormal redness
Rationale:
Erythema or skin redness is caused by congestion of capillaries.
For your patient experiencing syncope, you should:
A. begin the Heimlich B. help the patient to lie down and elevate the feet C. help the patient to lie down and raise the head D. use the AED
help the patient to lie down and elevate the feet
Rationale:
Syncope is fainting. The fainting victim should be assisted to supine position and feet slightly raised to improve blood flow to the brain.
If your patient expresses that he or she would like to use a heating pad to relieve pain in the area under treatment, your advice should be:
A. to see the physician after use
B. that it should not be used while under treatment
C. that it should only be used after daily treatment
D. that it may be used no less than 1 hour before treatment
that it should not be used while under treatment
Rationale:
Extreme temperatures to irradiated skin will increase reaction.
Signs of increased cranial pressure include all of the following except:
A. nausea B. coma C. intense headache D. bradycardia
bradycardia
Rationale:
Increased cranial pressure may show relatively minor signs such as nausea, vomiting, and headache to extreme signs such as coma or sudden death.
Your patient being treated for bronchogenic adenocarcinoma complains of difficulty swallowing. His symptom is likely caused by:
A. mucositis B. poor oxygen exchange C. perforation of the trachea D. esophagitis
esophagitis
A persistently high arterial blood pressure is known as:
A. hypertension
B. hypotension
C. hypercalcemia
D. hyponatremia
hypertension
A patient receiving doses above 50 Gy to the lacrimal gland may experience temporary:
A. dry eye
B. hair loss
C. dysuria
D. xerostomia
dry eye
Hair loss is usually permanent when the scalp is exposed to radiation doses exceeding:
A. 30 Gy
B. 45 Gy
C. 50 Gy
D. 60 Gy
60 Gy
Rationale:
Radiation doses above 60 Gy may lead to permanent damage to hair follicles.
Your patient has been weighed and the scale reads 55 kg. This is the equivalent of how many pounds?
A. 22 B. 25 C. 121 D. 137
121
Rationale:
1.0 kg is equivalent to 2.2 pounds. 55 kg x 2.2 = 121 pounds.
kg TO lbs = multiple by 2.2
lbs TO kg = divide by 2.2
When assessing pain the radiation therapist must consider the:
1. quality of the pain
2. location of the pain
3. intensity of the pain
4. duration of the pain
A. 2, 3 B. 1, 2 C. 2, 3, 4 D. 1, 2, 3, 4
1, 2, 3, 4
Rationale:
Pain assessment should include quality, location, intensity, and duration of pain.
The most common means of spreading infection is:
A. soiled instruments B. infected patients C. human hands D. domestic animals
human hands
The purpose of isolation is to prevent all of the following except:
A. spread of the patient’s infection to visitors
B. spread of other’s infections to the patient
C. self-contamination of the patient by his or her own
organisms
D. cross-infection of hospital staff working with the patient
self-contamination of the patient by his or her own
organisms
Proper nutrition for the cancer patient undergoing radiation therapy treatments helps to:
1. enhance the effect of the treatments
2. improve the mental status of the patient
3. divert the patient’s attention from the treatment
4. the body to repair the damage caused by the treatment
A. 1, 2
B. 3, 4
C. 1, 2, 4
D. 1, 2, 3, 4
1, 2, 4
Rationale:
Proper nutrition helps the patient fight disease and improve emotional and mental status, and helps with tissue repair.
Your patient is complaining of pain upon swallowing. You should advise this patient to:
A. apply an antibacterial ointment to the chest B. eat foods that are salty and spicy C. eat foods that are soft and bland D. drink fluids only
eat foods that are soft and bland
Which of the following is not a likely side effect of cyto-toxic chemotherapy drugs?
A. nausea B. cardiac toxicity C. myelosuppression D. stroke
stroke
Rationale:
Stroke is caused by a decrease in blood flow to the brain and is not known to be directly caused by chemotherapy.
Sterile materials can be handled without contamination only by using:
1. sterile gloved hands
2. sterile transfer forceps
3. clean gloved hands
4. clean transfer forceps
A. 1, 2 B. 1, 4 C. 2, 3 D. 3, 4
1, 2
Rationale:
Sterile materials must be handled with sterile gloves or sterile forceps.
Neutropenia describes a decrease in the number of circulating:
A. basophils B. WBCs C. neutrophils D. RBCs
neutrophils
Rationale:
A decrease in neutrophils in the blood is referred to as neutropenia.
Dyspnea is a common symptom of lung cancer. Dyspnea is:
A. clubbing of the fingers
B. difficulty breathing
C. loss of normal skin color
D. rapid breathing
difficulty breathing
Superior vena cava syndrome occurs when:
A. Excess fluid in the pericardial space causes pressure and compromises the heart’s ability to pump.
B. Excess fluid in the pleural cavity leads to dyspnea.
C. ECG shows tachycardia.
D. Compression from a tumor or enlarged lymph nodes causes obstruction of the superior vena cava.
D. Compression from a tumor or enlarged lymph nodes causes obstruction of the superior vena cava.
Rationale:
SVC syndrome is caused by pressure on the superior vena cava from a tumor or enlarged lymph nodes.
Total body irradiation acute side effects include (select two):
1. nausea 2. parotiditis 3. pneumonitis 4. hypothyroidism
- nausea
- parotiditis
Rationale:
Acute effects following TBI include nausea, vomiting, orthostatic hypotension, mucositis, diarrhea, and parotiditis.
In order to limit the risk of pathogen exposure in patient care areas, it is best practice to avoid:
A. disposable bite blocks
B. latex gloves
C. artificial flowers
D. potted plants
potted plants
Rationale:
Potted plants may harbor bacteria in foliage and damp soil. It is best practice to keep potted plants out of patient care areas.
Measuring the heart rate by using a stethoscope over the patient’s heart is an assessment of the:
A. carotid pulse
B. apical pulse
C. pedal pulse
D. radial pulse
apical pulse
Rationale:
The apical pulse is measured at the apex of the heart and requires listening at the chest with the ear or stethoscope.
125 pounds is equivalent to___________kg.
A. 276 B. 57 C. 125 D. 63
57
Rationale:
Use the conversion factor 2.2. 1 Kg = 2.2 pounds. 125/2.2 = 57.
kg TO lbs = multiple by 2.2
lbs TO kg = divide by 2.2
When moving a patient the radiation therapist should keep in mind the following principle (s):
1. A narrow base of support will provide greater stability in lifting against gravitational pull.
2. The closer to the body the weight is held, the more weight can be moved.
3. The farther from the body the weight is held, the easier the weight can be moved.
4. Pulling or sliding an object requires less effort than lifting against the force of gravity.
A. 1, 4 B. 2, 4 C. 1, 2 D. 1, 3
2, 4
Rationale:
When moving patients, weight should be held close to the body. Pulling is better than lifting.
Contact with secretions transferred by sneezing, coughing, or talking is an example of which kind of means of transmission?
A. direct B. indirect C. droplet D. airborne
droplet
Rationale:
Droplet contact is a means of transmission by being in proximity of sneezing, coughing, or talking persons.
The most appropriate position for examination of the perineal area is:
A. Sim's B. Trendelenberg C. lithotomy D. Fowler's
lithotomy
Rationale:
Lithotomy position has the patient supine with both legs elevated and with knees toward the chest. This position is appropriate for examination of the perineal area.
The systolic pressure represents:
A. the highest point reached during contraction of the ventricles
B. the lowest point to which the pressure drops during relaxation of the ventricles
C. the highest point reached during the contraction of the aorta
D. the lowest point reached during the relaxation of the aorta
the highest point reached during contraction of the ventricles
Rationale:
The systolic pressure is given first and is the highest point during contraction of the ventricles.
Which of the following factors contributes to cancer fatigue?
1. pain
2. metabolic changes
3. treatment
A. 1, 2
B. 1, 3
C. 2, 3
D. 1, 2, 3
1, 2, 3
Rationale:
Cancer-related fatigue may be a result of uncontrolled pain, metabolic changes, treatments, and psychological status.
Your patient is suspected to have a perforated bowel. Which contrast agent is best to use for visualization of the bowel on conventional X-ray?
A. esophatrast barium paste B. rectal barium sulfate C. oral iodine based contrast D. intravenous iodinated contrast
oral iodine based contrast
Rationale:
Barium is inert and should not be used for the bowel if perforation is suspected. IV administered iodine will not demonstrate in the bowel using X-ray.
A necessary instrument for examination of the inner ear would be the:
A. speculum
B. ophthalmoscope
C. otoscope
D. sigmoidoscope
otoscope
Rationale:
The otoscope is used to examine the inner ear. Oto- is the prefix for ear.
The normal pulse rate in the adult is:
A. 60 to 90 bts/min
B. 15 to 20 bts/min
C. 30 to 50 bts/min
D. 100 to 150 bts/min
60 to 90 bts/min
Rationale:
The normal pulse or heart rate is 60 to 90 beats per minute in the adult.
Epistaxis is another name for:
A. seizure B. fainting C. nosebleed D. vomiting
nosebleed
Endocrine glands are characterized by :
A. saliva production
B. blood cell production
C. carbon dioxide excretion
D. secretion of hormones
secretion of hormones
Rationale:
Endocrine glands secrete hormones into the bloodstream.
Endocrine glands are characterized by :
A. saliva production
B. blood cell production
C. carbon dioxide excretion
D. secretion of hormones
secretion of hormones
Rationale:
Endocrine glands secrete hormones into the bloodstream.
according to MOSBY - The normal limits for BUN in mg/dL for the adult are: ____________
A. 10 to 20 mg/dL.
B. 30 to 40 mg/dL.
C. 60 to 80 mg/dL.
D. 100 to 110 mg/dL.
10 to 20 mg/dL
whereas jess said they are 7-10
The drug Decadron is used to decrease:
A. pain
B. erythema
C. diarrhea
D. inflammation
inflammation
Rationale:
Decadron is an anti-inflammatory steroid used to manage inflammation and sometimes radiation or chemotherapy-induced nausea and vomiting.
The following would be appropriate advice for a patient receiving radiation to the whole brain except:
A. wear a hat or scarf to protect the scalp from the sun
B. eat a balanced diet
C. when dry desquamation occurs, use a dandruff shampoo
D. exercise in moderation
when dry desquamation occurs, use a dandruff shampoo
Rationale:
Dandruff shampoo contains harsh chemicals that will likely exacerbate symptoms.
About one week after the infusion of certain chemotherapy agents, the skin in a previously irradiated area may show signs of erythema, blistering, and pain. This phenomenon is known as radiation:
A. phlebitis B. recall C. necrosis D. fibrosis
recall
Rationale:
Radiation recall occurs about one week after the administration of chemotherapy drugs like doxorubicin, daunorubicin, 5 FU, or bleomycin. The previously treated area may become red, blistery, and painful.
If an area is to be completely free of pathogens, you should follow:
A. surgical asepsis
B. gloved technique
C. medical asepsis
D. clean technique
surgical asepsis
Your patient has been weighed and the scale reads 150 pounds. This is the equivalent of how many kilograms?
A. 60 B. 68 C. 330 D. 375
68
Rationale:
1.0 kg is equivalent to 2.2 pounds. 150 pounds/2.2 = 68 kilograms.
kg TO lbs = multiple by 2.2
lbs TO kg = divide by 2.2
The pathogen among the following that commonly causes infection in cancer patients is:
A. pseudomonas B. streptococci C. staphylococci D. hepatitis B
pseudomonas
Rationale:
Pseudomonas is a bacterium that is commonly an agent of severe nosocomial infections.
To properly care for the skin in the radiation treatment area, the patient should (select two):
- avoid exposure to the sun
- protect the skin from cold weather
- use ice packs in areas of inflammation
- use heating pads in areas of pain
1 and 2
Rationale:
Proper skin care for the radiation therapy patient includes protecting the skin from any extreme temperatures, hot or cold.
Your next patient is waiting on a gurney in the supine position. He or she complains of feeling nauseous and ready to vomit. Which position should you help this patient to assume?
A. Trendelenberg B. semi-Fowler's C. prone D. lateral
lateral
Rationale:
If the patient begins vomiting, the lateral recumbent position will help prevent aspiration of fluids.
describe the “Trendelenberg” position
feet higher than head; head declined and feet elevated/angled up
describe the “Fowler’s” position
sitting position, legs of patient may be straight or bent
General signs and symptoms of shock include all of the following except:
A. weak, thready pulse
B. rapid heartbeat
C. increased temperature
D. hypotension
increased temperature
Rationale:
Symptoms of shock include weak, rapid and thready pulse, cold and clammy skin, and decrease in blood pressure.
Opioids are given to:
A. alleviate pain
B. regulate the heart
C. prevent infection
D. decrease nausea
alleviate pain
Rationale:
Opioids are analgesics or pain relievers.
A patient who is in cardiac arrest is a level_______on the Karnofsky performance scale.
A. 0
B. 20
C. 50
D. 100
0
Rationale:
Karnofsky performance scale measures the patient’s ability to care for oneself and carry out normal activity. 0 to 100 where 0 = dead and 100 is normal.
In case of an emergency, a patient with advanced directives:
A. does not want any type of life-saving treatment
B. wants every type of life-saving treatment
C. has a proxy to make all decisions
D. has prior instructions about care
has prior instructions about care
Rationale:
An advanced directive may be written or verbal and is an expression of what the patient wants in case the patient is unable to make decisions about health. The directives may describe life-saving procedures desired, if any at all, or may designate a proxy to make decisions.
If your patient asks what the CT simulation images show, you should:
A. Be honest and show patient what you have seen.
B. Tell the patient to speak with the department manager.
C. Advise the patient to speak with the radiation oncologist.
D. Give copies of the images to the patient.
Advise the patient to speak with the radiation oncologist.
Rationale:
If a patient is interested in knowing what the images taken during CT simulation shows, the therapist should explain that the images will be used for planning and refer patient to the radiation oncologist with questions about what appears in the images.
Patients suffering from wet desquamation should be advised to:
A. keep the area clean and dry
B. soak the area with hydrogen peroxide
C. dab the area with alcohol
D. apply petroleum jelly-saturated gauze daily
keep the area clean and dry
Rationale:
In areas where the skin has broken, the area should be kept clean and dry.
When your patient complains of dysphagia, you should advise him or her to:
A. eat smaller portions of food B. cut food into smaller pieces C. eat while slightly reclined D. take a mild analgesic
cut food into smaller pieces
**dysphagia = difficulty swallowing
Rationale:
Your patient complaining of dysphagia has difficulty swallowing. Smaller pieces of food and softer foods are helpful. It is important for the patient to continue eating full meals.
Normal rectal temperature for the adult in Fahrenheit is:
A. 98.6 B. 99.6 C. 97 D. 96
99.6
Rationale:
Rectal temperature is approximately 1 degree higher than oral temperature, which is 98.6 degrees Fahrenheit.
In the adult, a platelet count within normal range would be approximately_______mm^3:
A. 5,000
B. 10,000
C. 100,000
D. 400,000
400,000
Rationale:
Normal adult platelet count ranges from 150 to 450 thousand per mm cubed.
Which of the following instruments is used to measure the pulse and oxygen concentration in the blood?
A. sphygmomanometer
B. electrocardiograph
C. pulse oximeter
D. speculum
pulse oximeter
Rationale:
The pulse oximeter measures the pulse and oxygen saturation in the blood.
Patients at increased risk for developing increased cranial pressure are:
A. patients with basal cell carcinoma B. patients with adenocarcinoma of the cervix C. patients receiving concurrent radiation therapy and chemotherapy D. patients with primary or metastatic tumors of the brain or spinal cord
patients with primary or metastatic tumors of the brain or spinal cord
Rationale:
Increased cranial pressure is caused by an obstruction of free flow of cerebral spinal fluid or infringement on space in the skull.
The normal range for platelets in the adult is:
A. 5 to 10 thousand/mm3 B. 4 to 6 million/mm3 C. 5 to10 million/mm3 D. 150 to 500 thousand/mm3
150 to 500 thousand/mm3
When developing a nutritional plan for a patient, the following should be considered:
1. tumor location
2. mode of therapy
3. patient’s food intake
4. emotional status
1, 2, 3, 4
Rationale:
A nutritional program can be developed for a patient after consideration of where the tumor is located, what type of treatment the patient is undergoing, the patient’s current intake of food, and the emotional status of the patient.
A type of isolation used for highly communicable diseases and requiring personnel to wear gown, gloves. and mask would be called___________isolation:
A. respiratory B. strict C. enteric D. aseptic
strict
Rationale:
Strict isolation is used for patients with a highly communicable disease. Gloves, gown, and mask would be required.
Total body irradiation acute side effects include (select two):
- nausea
- parotiditis
- pneumonitis
- hypothyroidism
1 and 2
Rationale:
Acute effects following TBI include nausea, vomiting, orthostatic hypotension, mucositis, diarrhea, and parotiditis.
define “parotiditis”
inflammation and swelling of one or both parotid glands or other salivary glands
define “hypothyroidism”
too little thyroid hormone production
define “orthostatic”
low blood pressure (ie. hypotension) that occurs UPON STANDING
define “mucositis”
inflammation of mucous membranes lining the mouth and digestive tract all the way to the anus … can occur in any mucous membrane
what is the difference between HYPOtension and HYPERtension?
HYPO = low blood pressure
HYPER = high blood pressure
define “pneumonitis”
inflammation of the lungs
Which of the following foods should be avoided by patients receiving radiation therapy to the pelvis?
1. corn
2. oatmeal
3. raw vegetables
1, 2, 3
Rationale:
Patients receiving therapy to the pelvis SHOULD FOLLOW A LOW FIBER DIET so, foods such as corn, oatmeal, raw vegetables, and raw fruit should be avoided.
The stages of coping following the diagnosis of cancer include all of the following except:
A. bargaining B. denial C. acceptance D. anticipation
anticipation
Rationale:
The stages of coping include denial, bargaining, depression, anger, and acceptance.
medical “wasting away” is defined by what term?
cachexia
Characteristics of cachexia include all of the following except:
A. weight gain
B. anorexia
C. early satiety
D. asthenia
weight gain
define “satiety”
the satisfied feeling of being full after eating
define “asthenia”
weakness; lack of energy and strength
As you are escorting the patient into the room, she begins to collapse. You allow her to slowly slip to the floor. The next appropriate thing to do would be to:
A. call a code
B. get the crash cart
C. start CPR
D. shake the patient and shout name
shake the patient and shout name
Rationale:
Feedback: Once the patient is safely on the floor you MUST DO A QUICK RESPONIVNESS CHECK by shaking and shouting out to the patient: perhaps “Mrs.___are you ok?”
If you need to help the patient with the use of a bed pan, the following must be observed (select two):
- Privacy must be respected.
- Clean gloves should be used to remove the bed pan.
- Mask should be worn to remove the bed pan.
- Allow patient to maneuver on and off the bed pan.
1 and 2
Rationale:
When helping a patient with a bed pan, the patient’s privacy must be respected. The caregiver should wear gloves when removing the bed pan and patient should be assisted on and off the bed pan.
Phase I clinical trials are designed to determine the_____and______of a drug in humans.
A. purity; potency B. potency; risk C. toxicity; best dose D. bioavailability; risk
toxicity; best dose
Contact with secretions transferred by sneezing, coughing, or talking is an example of which kind of means of transmission?
A. direct
B. indirect
C. droplet
D. airborne
droplet
The appropriate personnel protective equipment for the care of a patient with suspected TB infection would include:
A. respiratory mask B. goggles C. gown D. booties
respiratory mask
Rationale:
When caring for a patient with suspected TB or one in the early stages of treatment for TB, fitted respiratory masks should be worn by caregivers.
A sign of low oxygen content in the body is:
A. epistaxis
B. diaphoresis
C. cyanosis
D. hypertension
cyanosis
Rationale:
A sign of low oxygen content is cyanosis or blue coloring of skin or nail beds.
define “epitaxis”
nosebleed
define “diaphoresis”
excessive swelling due to an underlying health condition or medication
Which type of nutritional support bypasses the gastrointestinal tract and introduces nutrients into the veins?
A. total parenteral B. enteral C. gastroplasty D. endotracheal
total parenteral
Rationale:
Total parenteral nutrition places nutrients directly into the veins.
Regarding management of skin reactions, all of the following are true except:
A. Erythematous areas should be kept moist.
B. Prevention of further injury is best.
C. Corn starch may bring some relief.
D. Heat and sunlight should be avoided.
Erythematous areas should be kept moist.
Rationale:
Areas of skin reactions should be kept clean and dry. Extreme temperatures increase chances of friction. A natural powder like cornstarch may soothe itching.
The five stages of grieving were identified by:
A. Wilhelm Roentgen
B. Fredric Juliot
C. Elisabeth Kubler-Ross
D. Abraham Maslow
Elisabeth Kubler-Ross
Rationale:
Dr. Kubler-Ross identified the five stages of grieving: anger, denial, depression, bargaining, and acceptance.
Breast self-examinations should be performed:
A. daily
B. weekly
C. monthly
D. yearly
monthly
Rationale:
Breast self-examinations should be performed monthly, several days after menstruation in premenopausal women.
As you become aware that your patient is positive for MRSA infection, you should prepare to care for him or her with:
A. gloves and gown B. gloves and goggles C. gloves and respiratory mask D. goggles
gloves and gown
Rationale: **Methicillin-resistant Staphylococcus aureus (MRSA)
MRSA transmission is currently transmitted through direct and indirect contact. Caregivers should follow universal precautions and wear gloves and gown, thoroughly disinfect areas contacted by the patient after care, and follow strict hand-washing procedure.
The method by which all healthcare workers can control the transmission of blood borne diseases is known as:
A. enteric precautions
B. universal precautions
C. AFB precautions
D. strict isolation
universal precautions
Rationale:
Universal precaution is the method used to control the transmission of bloodborne diseases.
Total parenteral nutrition is also known as:
A. hyperalimentation
B. sensoria
C. ascites
D. hyperosmolation
hyperalimentation
Rationale:
Total parenteral nutrition is used to increase nutrients and may also be called hyperalimentation.
define “hyperalimentation”
a form of nutrition that is delivered into a vein
define “sensoria”
the parts of the brain or mind concerned with the reception and interpretation of sensory stimuli
define “ascites”
the build-up of fluid in the space between the lining of the abdomen and abdominal organs
define “hyperosmolation”
a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances… drawing water out of the body’s other organs (including the brain)
what type of nutrition is used to increase nutrients, and may also be called hyperalimentation?
Total parenteral nutrition
Signs of increased cranial pressure include all of the following except:
A. nausea
B. coma
C. intense headache
D. bradycardia
bradycardia
Rationale:
Increased cranial pressure may show relatively minor signs such as nausea, vomiting, and headache to extreme signs such as coma or sudden death.
The normal limits for PSA in the patient under 60 years old is less than or equal to:
A. 4 ng/mL
B. 10 ng/mL
C. 20 ng/mL
D. 40 ng/mL
4 ng/mL
Rationale: **PSA = Prostate Specific Antigen
Normal PSA levels in the male under 60 years is less than or equal to 4 ng/mL. The limits increase slightly as the male patient ages.
Normal PSA levels in the male under 60 years is less than or equal to ___ ng/mL
4
Cultural differences may result in different perceptions of :
A. eye contact
B. touch
C. tone of voice
D. a, b, and c
a, b, and c
Rationale:
Different cultures perceive certain behaviors differently, such as eye contact, touching, tone of voice, and certain body or hand gestures.
For your patient experiencing syncope, you should:
A. begin the Heimlich
B. help the patient to lie down and elevate the feet
C. help the patient to lie down and raise the head
D. use the AED
help the patient to lie down and elevate the feet
Rationale:
Syncope is fainting. The fainting victim should be assisted to supine position and feet slightly raised to improve blood flow to the brain.
Under sterile technique, the area would be disinfected before the start of the procedure in order to:
A. protect the sterile draping from contamination
B. decrease the potential of introducing microorganisms into the area
C. protect the health care worker from disease transmission
D. make it easier for equipment to be used in the area
decrease the potential of introducing microorganisms into the area
Rationale:
During sterile procedures, the area should be disinfected to decrease the potential for microorganisms to contaminate the area.
The cardinal signs of inflammation include: *choose all that apply
- pain
- heat
- redness
- itchingA. 1, 3
B. 3, 4
C. 1, 2, 3
D. 1, 3, 4
1, 2, 3
Rationale:
The four cardinal signs of inflammation are pain, heat, swelling, and redness.
Accidental needle stick injuries could lead to transmission of:
A. cancer
B. tuberculosis
C. herpes simplex
D. hepatitis B
hepatitis B
Rationale:
Hepatitis B is a virus transmitted through blood and body fluids.
Which type of patient would make it unsafe to use a glass thermometer to measure body temperature?
A. adolescent B. elderly C. disoriented D. coherent
disoriented
Rationale:
It is not safe to use a glass thermometer on patients who are disoriented, epileptic, combative, or incoherent.
define “epileptic”
a group of disorders marked by problems in the normal functioning of the brain
Patients most prone to falls are:
1. frail and elderly
2. confused or suffering dementia
3. suffering from sensory deficits
4. on psychoactive drugs
A. 1, 3
B. 1, 2, 3, 4
C. 2, 3
D. 1, 2, 3
1, 2, 3, 4
Rationale:
Patients most prone to fall are the elderly and demented patients. Patients who are suffering from sensory deficits or on psychoactive drugs are also prone to falling.
The average diastolic pressure in the adult is about:
A. 80 to100 mm of Hg
B. 60 to 90 mm of Hg
C. 50 to 100 mm of Hg
D. 110 to 140 mm of Hg
60 to 90 mm of Hg
Rationale:
The average diastolic pressure at relaxation of the heart is 60 to 90 mm of Hg.
Which of the following factors contributes to cancer fatigue?
1. pain
2. metabolic changes
3. treatment
A. 1, 2
B. 1, 3
C. 2, 3
D. 1, 2, 3
1, 2, 3
Rationale:
Cancer-related fatigue may be a result of uncontrolled pain, metabolic changes, treatments, and psychological status.
A patient who is documented as “afebrile” has:
A. an elevated temperature
B. normal body temperature
C. elevated titers to staphylococcus
D. no titers to staphylococcus
normal body temperature
Rationale:
Afebrile means without fever.
define “Afebrile”
Afebrile means without fever; having a normal body temp
Your diabetic patient has been waiting for 3 hours for his appointment and has not eaten. If he becomes hypoglycemic, he may describe feeling:
A. faint and weak
B. trembling and sweaty
C. sluggish and sleepy
D. a, b, and c
a, b, and c
Rationale:
For the diabetic eating on schedule is important. If meals are missed, a drop in blood sugar will cause the patient to feel weak and faint. He or she may begin to tremble and sweat. In extreme cases patient may feel sleepy and begin to loose consciousness.
Which of the following dental reactions is common when irradiating the oral cavity?
A. neuropathy B. plaque C. caries D. discoloration
caries
Rationale:
Radiation promotes tooth decay, especially in already compromised teeth.
define “neuropathy”
a nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness in different parts of the body
The medical abbreviation used to describe drugs taken only when needed is:
A. STAT
B. PRN
C. BID
D. NPO
PRN
Rationale:
Medications prescribed to be taken as needed may show the abbreviation PRN From the Latin: pro re nata (according to circumstances).
Neutropenia describes a decrease in the number of circulating:
A. basophils
B. WBCs
C. neutrophils
D. RBCs
neutrophils
Which artery is most often used to take the pulse in the ambulatory adult?
A. brachial
B. femoral
C. pedal
D. radial
radial
**ambulatory = walky talky patient
Rationale:
The radial pulse at the wrist is the most often used to take the pulse in the ambulatory adult.
MRSA stands for:
A. methicillin-resistant staphylococcus aureus
B. methotrexate-reacting streptococcal antibiotic
C. mechlorethamine-resistant streptococcal antigen
D. mechlorethamine-resistant staphylococcus aureus
methicillin-resistant staphylococcus aureus
Hair loss is usually permanent when the scalp is exposed to radiation doses exceeding:
A. 30 Gy B. 45 Gy C. 50 Gy D. 60 Gy
60 Gy
Rationale:
Radiation doses above 60 Gy may lead to permanent damage to hair follicles.
If helping with catheterization, before opening the sterile Foley catheter package, the therapist should check the:
A. expiration date
B. method of sterilization
C. shelf life
D. balloon
expiration date
Rationale:
Before opening the sterile Foley catheter, the therapist should check the expiration date and Foley size.
The transient sensation of electrical shock traveling down the neck and extremities following radiation to the spine is called:
A. Lhermitte's sign B. Babinski's sign C. Turner's syndrome D. Gardner's syndrome
Lhermitte’s sign
Rationale:
Lhermitte’s sign is a sensation of electrical shock down the neck and extremities following radiation to the spinal area.
_________ sign is a sensation of electrical shock down the neck and extremities following radiation to the spinal area.
Lhermitte’s
Using a stethoscope alone would assess:
A. pulse rate
B. blood pressure
C. pathogen load
D. pulmonary and cardiac sounds
pulmonary and cardiac sounds
Rationale:
The stethoscope is used to assess respiratory and cardiac sounds.
Patients receiving pelvic treatments, using standard fractionation, may experience diarrhea within the:
A. first week of treatment
B. second week of treatment
C. third week of treatment
D. last week of treatment
third week of treatment
Rationale:
Radiation-induced diarrhea usually occurs around the third or fourth week of treatment uses standard fractionation schemes.
The larger the lumen of a needle, the________the gauge.
A. larger
B. smaller
C. thicker
D. darker
smaller
Rationale:
The lumen size of a needle is expressed in gauge. The larger the lumen, the smaller the gauge.
Erythema is defined as:
A. evacuation of capillaries
B. any congestion of capillaries causing abnormal redness
C. shedding or peeling of dry skin
D. skin with multiple cracks and pustules
any congestion of capillaries causing abnormal redness
Rationale:
Erythema or skin redness is caused by congestion of capillaries.
There is a temporary increase in the number of___________when infection is present.
A. leukocytes
B. thrombocytes
C. erythrocytes
D. platelets
leukocytes
Rationale:
When infection is present, there is an increase in leukocytes.
Deficiency in the number of circulating white blood cells is called:
A. thrombocytopenia
B. leukoplakia
C. leukopenia
D. pancytopenia
leukopenia
Rationale:
Leuko- is the prefix for white blood cells; -penia is the suffix for a decrease.
Having a low platelet count puts the patient at risk for:
A. decreased oxygen B. decreased ability to fight infection C. excessive bleeding D. excessive atrophy
excessive bleeding
Rationale:
Platelets are responsible for coagulation and clotting.
Which of the following are adverse results of cachexia?
1. increased caloric intake
2. impairment of immunities
3. changes in metabolism
4. electrolyte imbalance
A. 2, 4
B. 1, 2, 4
C. 2, 3, 4
D. 1, 2, 3, 4
2, 3, 4
Rationale:
Cachexia can decrease the patient’s ability to fight infection. Changes in metabolism and electrolyte imbalance may also occur.
The appropriate personnel protective equipment (PPE) for the care of a patient with confirmed MRSA infection would include:
A. respiratory mask
B. goggles
C. gown
D. gloves
gloves
Rationale:
MRSA is transmitted by contact. Gloves should be worn when caring for MRSA infected patients.
When transporting or transferring a patient with a chest drainage tube, you should:
A. make sure there are no kinks in the tube
B. place the bottle on the patient’s chest
C. clamp off the tube
D. all of the above
make sure there are no kinks in the tube
Rationale:
Chest drainage tubes should always be positioned and handled so that free fluid flow into the tube is not inhibited.
When the patient has agreed to a procedure, the form that documents this agreement is the:
A. release form
B. notice of HIPAA practices
C. patient information form
D. informed consent
informed consent
Rationale:
The informed consent documents the patient’s agreement to a certain procedure.
Your patient has a continuous infusion chemotherapy regulator. During treatment, the regulator apparatus begins to alarm. You should:
A. silence the alarm
B. reset the regulator
C. alert a physician or nurse
D. pull the catheter out and reinsert
alert a physician or nurse
Rationale:
Intravenous regulators control infusion rate. Adjusting the regulator without knowledge, may place the patient at risk for underdosing or overdosing. Professionals knowledgeable about regulator operations and drug administrations, such as the physician or nurse, should be alerted to attend to regulators when they malfunction or give warning alarms.
Your patient being treated for bronchogenic adenocarcinoma complains of difficulty swallowing. His symptom is likely caused by:
A. mucositis
B. poor oxygen exchange
C. perforation of the trachea
D. esophagitis
esophagitis
Rationale:
The esophagus is likely included in the treatment field for this lung cancer patient. Radiation to the esophagus may cause swelling and irritation and make it difficult and uncomfortable for patients to swallow food.
If a healthcare worker is accidentally punctured by a contaminated needle, the potential route of disease transmission is:
A. droplet
B. airborne
C. fomite
D. contact
fomite
Rationale:
The fomite is an inanimate object or material through which disease-producing agents may be conveyed.
The radiation side effect that causes inflammation of the epithelial lining of the bladder is called:
A. colitis
B. cystitis
C. proctitis
D. trigonitis
cystitis
Rationale:
Inflammation of the epithelial lining of the bladder is called cystitis.
The type of nutrition that bypasses the gastrointestinal tract and introduces nutrients into the veins is called:
A. enteral
B. parenteral
C. gastrostomy
D. nasogastrostomy
parenteral
Rationale:
Parenteral nutrition bypasses the gastrointestinal tract and puts nutrients into the patient’s veins.
A low residue diet would be recommended for the patient receiving radiation to the:
A. brain B. larynx C. bladder D. esophagus
bladder
Rationale:
Abdominopelvic radiation may induce diarrhea. Those patients treated for cancer involving tissues in the lower abdomen and pelvis should be counseled to adhere to a low residue diet to minimize symptoms of diarrhea.
The normal body substance released by tissue in response to an allergic reaction is:
A. histamine
B. adrenalin
C. thyroxin
D. iodine
histamine
Rationale:
Histamine is naturally released in response to an allergic reaction.
The drug administration route providing the quickest response would be the:
A. subcutaneous route
B. enteral route
C. intramuscular route
D. intravenous route
intravenous route
Rationale:
The intravenous route leads to quick distribution of drug administered.
Primary skin cancers with the worst prognosis are:
A. basal cell carcinoma B. squamous cell carcinoma C. Bowen's disease D. melanoma
melanoma
Rationale:
Melanomas are the deadliest skin cancers.
Which of the following is not a likely side effect of cyto-toxic chemotherapy drugs?
A. nausea
B. cardiac toxicity
C. myelosuppression
D. stroke
stroke
Rationale:
Stroke is caused by a decrease in blood flow to the brain and is NOT known to be directly caused by chemotherapy.
A patient suffering from a bacterial infection may have an elevated body temperature resulting from _____________released by the bacteria.
A. antigens
B. antibodies
C. immunoglobulins
D. pyrotoxins
pyrotoxins
Rationale:
Pyrotoxins are chemical agents released by some bacteria triggering fever.
When assessing pain the radiation therapist must consider the:
1. quality of the pain
2. location of the pain
3. intensity of the pain
4. duration of the pain
A. 2, 3
B. 1, 2
C. 2, 3, 4
D. 1, 2, 3, 4
1, 2, 3, 4
Rationale:
Pain assessment should include quality, location, intensity, and duration of pain.
If the patient has been taking an oral narcotic for pain and after 2 weeks reports that the drug is no longer controlling the pain, the reaction is called:
A. addiction
B. dependency
C. tolerance
D. anaphylactic shock
tolerance
Rationale:
In some instances, patients may build a tolerance for a certain drug, making the drug ineffective.
If you touch a contaminated object during hand-washing, you should:
A. start washing the hands again from the beginning
B. repeat scrubbing of that area only
C. apply an antiseptic solution to the area
D. put on sterile gloves
start washing the hands again from the beginning
Rationale:
If your hands become contaminated during washing, you should begin the wash over again.
When caring for a patient who is unconscious, it is important to make sure that:
A. airways remain clear
B. legs remain elevated
C. no medications are given
D. enteral nutrition is started
airways remain clear
Rationale:
When caring for an unconscious patient it is important that airways remain clear and vital signs are monitored.
When moving a patient the radiation therapist should keep in mind the following principle (s):
- A narrow base of support will provide greater stability in lifting against gravitational pull.
- The closer to the body the weight is held, the more weight can be moved.
- The farther from the body the weight is held, the easier the weight can be moved.
- ## Pulling or sliding an object requires less effort than lifting against the force of gravity.A. 1, 4
B. 2, 4
C. 1, 2
D. 1, 3
2, 4
Rationale:
When moving patients, weight should be held close to the body. Pulling is better than lifting.
When caring for a patient on oxygen therapy, the therapist must remember that oxygen:
A. can be administered as needed
B. must be ordered by the physician
C. is a vasodilator
D. is inflammable
must be ordered by the physician
Rationale:
Oxygen can be toxic so when caring for a patient on oxygen, it is important tot remember that the administration has been ordered by a physician and the liter flow should not be changed without physician order.
The signs of a petite seizure include (select two):
- sudden cessation of focus and response
- violent, jerky motions
- sudden gasp or sharp vocal cry
- shortness of breath
1, 3
Rationale:
A petite seizure may be short lived and only exhibit minor signs like the loss of focus or concentration or a quick vocal reflex.
Sterile materials can be handled without contamination only by using:
1. sterile gloved hands
2. sterile transfer forceps
3. clean gloved hands
4. clean transfer forceps
A. 1, 2 B. 1, 4 C. 2, 3 D. 3, 4
1, 2
Rationale:
Sterile materials must be handled with sterile gloves or sterile forceps.
Rigid muscles and jerky body movements are seen in patients experiencing:
A. shock
B. airway obstruction
C. cerebral vascular accident
D. convulsive seizure
convulsive seizure
Rationale:
During a convulsive seizure, the patient will show rigid muscles and jerky movements.
The use of barium would not be indicated in a patient who has suspected:
A. bowel perforation
B. diabetes
C. congestive heart failure
D. renal failure
bowel perforation
Rationale:
Since barium is inert, it is not advisable to use it for gastrointestinal studies in patients with bowel perforation or obstruction.
A drug that would increase the flow of urine is called a:
A. derivative
B. diuretic
C. digestant
D. demulcent
diuretic
Rationale:
A diuretic increases the flow of urine.
A diabetic patient has been waiting for a long while and complains of hunger and dizziness. The therapist should:
A. administer insulin
B. give juice or candy
C. apply warm compress to the forehead
D. begin rescue breathing
give juice or candy
Rationale:
The diabetic patient who has not eaten will suffer from hypoglycemia (hunger, dizziness, sweating, trembling). A small amount of sugar will alleviate symptoms.
Which of the following most accurately describes when chest compressions should be started?
A. as soon as you find no signs of circulation
B. after reassessing the victim’s breathing
C. after giving 2 initial ventilations and no circulation is confirmed
D. whenever you find an unresponsive person
after giving 2 initial ventilations and no circulation is confirmed
Rationale:
Chest compressions should be given only when there is no circulation AND AFTER 2 initial rescue breaths
Which of the following would influence the onset or duration of action for a certain drug?
A. purity B. kidney function C. nutrition D. liver function
nutrition
Rationale:
The onset and duration of action may be influenced by many things including the route of administration, dose, patient’s age, health, ethnicity, state of mind, weight, and nutrition (fluid and electrolyte balance).
An oncologic emergency associated with bone metastasis especially is:
A. hypercalcemia
B. hypoglycemia
C. ketoacidosis
D. hyperthyroidism
hypercalcemia
Rationale:
Hypercalcemia is an elevated amount of calcium in the blood. Bone metastasis could lead to this oncologic emergency.
_______________ is an elevated amount of calcium in the blood
**hint “hyper-______”
Hypercalcemia
define “ketoacidosis”
high levels of ketones cause the blood to become more acidic
A grade 3 morbidity score for the skin would indicate:
A. confluent moist desquamation
B. swelling with dry desquamation
C. mild redness and itching
D. ulceration or necrosis
confluent moist desquamation
Rationale:
According to RTOG morbidity scoring, a grade 3 skin reaction would mean confluent moist desquamation.
what does RTOG stand for?
The Radiation Therapy Oncology Group (RTOG)
The systolic pressure represents:
A. the highest point reached during contraction of the ventricles
B. the lowest point to which the pressure drops during relaxation of the ventricles
C. the highest point reached during the contraction of the aorta
D. the lowest point reached during the relaxation of the aorta
**hint - it really comes down to knowing if systolic pressure occurs in/with aorta or ventricles…
the highest point reached during contraction of the ventricles
Rationale:
The systolic pressure is given first and is the highest point during contraction of the ventricles.
**sys is above, contract tight hug for sys, you want to visit sys
The erosion of a bronchial tumor may lead to pneumothorax. The principle treatment for this condition would be placement of a:
A. bronchoscope B. chest tube C. pacemaker D. tracheotomy
chest tube
Rationale:
Pneumothorax is an accumulation of air in the pleural cavity. A chest tube would allow excess air to escape.
**pneumoTHORAX
define “pneumothorax”
an abnormal collection of air in the space between the thin layer of tissue that covers the lungs and chest cavity
A patient who has experienced a severe anaphylactic reaction to contrast may be administered:
A. cysteine B. epinephrine C. Valium D. dopamine
epinephrine
Rationale:
A severe anaphylactic reaction to contrast may cause cardiac and respiratory distress/arrest. Epinephrine may be administered from the crash cart to rescue this patient.
All of the following are possible complications of intravenous injections EXCEPT:
A. air emboli
B. infection
C. phlebitis
D. congestive heart failure
congestive heart failure
Rationale:
Congestive heart failure is often result of a chronic heart condition and not associated with acute, immediate consequence of IV injection.
define “phlebitis”
inflammation of a vein, usually in legs
Your patient arrives in a wheelchair and is unable to stand. The best transfer method among the following would be:
A. 2-to-3-person lift
B. draw sheet
C. slider board
D. gait belt
2-to-3-person lift
Rationale:
The 2-to-3-person lift is the best method for patients unable to stand and be transferred from wheelchair to table. This method is safe for the patient and prevents injury to the therapist assisting the patient.
**gait belt is good IF patient is weight bearing - Jess
The average rate for respiration in the adult, in breaths/minute is:
A. 40 to 50
B. 60 to 70
C. 10 to 20
D. 80 to 90
10 to 20
Rationale:
The average rate of respiration in the adult is 10 to 20 breaths per minute.
When a patient is receiving oxygen, it is important for the therapist to do all of the following except:
A. carry the tank by the regulator apparatus B. maintain the prescribed flow C. see that the tube is not accidentally clamped shut D. make sure that the tank does not run out of oxygen
carry the tank by the regulator apparatus
Rationale:
Carrying the tank by the regulator may cause detachment after which the tank would become a dangerous projectile.
Dysphagia is a common complaint of patients diagnosed with:
A. tracheal cancer
B. esophageal cancer
C. skin cancer
D. laryngeal cancer
esophageal cancer
Rationale:
Dysphagia is difficulty swallowing and is a common symptom of cancer of the esophagus.
The five rights of drug administration include all of the following EXCEPT:
A. right dose
B. right patient
C. right drug
D. right sequence
right sequence
Rationale:
The five rights include:
–>right dose, patient, drug, time, and route.
A patient experiencing radiation-induced diarrhea should be placed on which type of diet?
A. high fiber B. low residue C. low sodium D. high glucose
low residue
Rationale:
A low residue diet will help minimize diarrhea.
Small, adhesive disks attached to the skin for the purpose of administering medications uses the _______________route.
A. enteral B. intramuscular C. topical D. buccal
topical
Rationale:
The topical route allows medications to be administered through the skin. Medications may be in the form of creams, salves, or on adhesive disks. Specifically, skin patches use the transdermal route.
The way a drug interacts with the body to produce its intended effect is called its:
A. metabolism
B. rate of absorption
C. mechanism of action
D. half-life
mechanism of action
Rationale:
A drug’s mechanism of action is the WAY that it interacts and produces its intended effect.
The blood urea nitrogen (BUN) test is a measure of the amount of nitrogen in the blood in the form of urea, and typically a measurement of the function of which organ?
A. liver
B. kidney
C. bladder
D. adrenal gland
kidney
Rationale:
Nitrogen in the form of urea is excreted by the liver and then filtered from the blood by the kidneys. BUN is an indicator of renal function.
Enteric precautions must be taken when dealing with:
A. vomitus
B. fecal material
C. blood
D. airborne organisms
fecal material
Rationale:
Enteric precautions require extra care when handling feces.
**Enteric precautions are taken to prevent infections that are transmitted primarily by direct or indirect contact with fecal material
A patient undergoing treatments to the oral cavity and oral pharynx will experience:
1. altered taste
2. sore throat
3. difficulty swallowing
4. cysts in the mouth
—————————————————————-
A. 2, 4 B. 1, 3 C. 2, 3 D. 1, 2, 3
1, 2, 3
Rationale:
Radiation to the oral cavity, especially to the oropharynx will cause patients to have a change in taste, difficulty swallowing, and throat pain.
Superior vena cava syndrome occurs when:
A. Excess fluid in the pericardial space causes pressure and compromises the heart’s ability to pump.
B. Excess fluid in the pleural cavity leads to dyspnea.
C. ECG shows tachycardia.
D. Compression from a tumor or enlarged lymph nodes causes obstruction of the superior vena cava.
Compression from a tumor or enlarged lymph nodes causes obstruction of the superior vena cava.
Rationale:
SVC syndrome is caused by pressure on the superior vena cava from a tumor or enlarged lymph nodes.
A dizzy feeling associated with sitting or standing after a prolonged period of bed rest is called:
A. vertigo
B. decubitus seizure
C. postural hypotension
D. cecubitus ulcer
postural hypotension
Rationale:
Light-headedness or dizziness after lying down is caused by a drop in blood pressure and then a sudden increase. Vertigo is also a dizzy feeling but is not necessarily associated with prolonged bed rest or sitting.
describe the difference between “vertigo” and “postural hypotension”
both relate to light-headedness and dizziness, however, vertigo does not have to be associated with sitting or prolonged bed rest… when postural hypotension does
Your patient is suspected to have a perforated bowel. Which contrast agent is best to use for visualization of the bowel on conventional X-ray?
A. esophatrast barium paste
B. rectal barium sulfate
C. oral iodine based contrast
D. intravenous iodinated contrast
oral iodine based contrast!!!!
Rationale:
Barium is inert and should not be used for the bowel if perforation is suspected. IV administered iodine will not demonstrate in the bowel using X-ray.
When preparing for a sterile procedure, the skin should be disinfected by moving the cleaning solution:
A. from the outside in toward the procedure locale B. in a back and forth motion C. from the inside, then away from the procedure locale D. in alternating circles and sweeps
from the inside, then away from the procedure locale
Rationale:
When preparing for sterile procedure, the skin should be disinfected by moving the cleaning solution from near the site out toward the periphery in single motions. Cleaning solution should not be introduced to a disinfected spot.
125 pounds is equivalent to___________kg.
A. 276 B. 57 C. 125 D. 63
57
Rationale:
Use the conversion factor 2.2. 1 Kg = 2.2 pounds. 125/2.2 = 57.
kg TO lbs = multiple by 2.2
lbs TO kg = divide by 2.2
The manubrium of the sternum articulates with the:
A. clavicle
B. clavicle and 1st rib
C. clavicle, 1st and 2nd rib
D. 1st and 2nd rib
clavicle and 1st rib
Rationale:
The upper portion of the sternum, the manubrium, articulates with the clavicle and 1st rib.
The most common nosocomial infections occur as:
A. blood borne infections
B. respiratory tract infections
C. wound infections
D. urinary tract infections
urinary tract infections
Rationale:
Nosocomial infections most commonly occur in the urinary tract.
Radiation-induced diarrhea is likely to appear in patients receiving treatment to the pelvis beginning which week of radiation therapy treatment?
A. first B. second C. third D. seventh
third
Rationale:
Using standard fractionation, the patient receiving pelvic irradiation may experience diarrhea beginning the third week of treatment.
Treatment would likely be interrupted if the patient’s platelet count was about:
A. 250,000 B. 125,000 C. 350,000 D. 90,000
90,000
Rationale:
The normal platelet count ranges from 150,000 to 450,000 in the adult.
The therapist’s first duty is to the:
A. hospital
B. radiation oncologist
C. department manager
D. patient
patient
Rationale:
The therapist is expected to work in collaboration with hospital staff under the supervision of the manager and radiation oncologist, but should first be an advocate for the patient.
Mucositis is more likely to occur in which of the following malignant conditions?
A. basal cell carcinoma B. bladder carcinoma C. breast carcinoma D. leukemia
leukemia
Rationale:
Mucositis is the irritation of the mucosal membranes in the gastrointestinal tract. Among the cases listed, the patient receiving systemic therapy for leukemia is more likely to experience mucositis.
Radiation to which of the following areas may result in myelosuppression?
A. ilia, vertebrae, ribs, skull, sternum, and long bones B. tibia, ribs, skull, and sternum C. ulna, sternum, and vertebrae D. skull, ribs, patella, and metacarpals
ilia, vertebrae, ribs, skull, sternum, and long bones
Rationale:
Myelosuppression may be caused at doses above 20 Gy to the sternum, iliac crests, ribs, spine, skull, and long bones.
A necessary instrument for examination of the inner ear would be the:
A. speculum B. ophthalmoscope C. otoscope D. sigmoidoscope
otoscope
Rationale:
The otoscope is used to examine the inner ear. Oto- is the prefix for ear.
Malnutrition caused by a physiological change or malfunction is called:
A. anorexia
B. bulimia
C. cachexia
D. emacia
cachexia
Rationale:
Cancer cachexia is weight loss or malnutrition caused by some physiological situation secondary to cancer.
When your patient has symptoms of mild mucositis, you should advise a:
A. regular diet B. high fiber diet C. soft, bland diet D. clear liquid diet
soft, bland diet
Rationale:
Mild mucositis can be managed by instituting a soft, bland diet.
When treating the oral cavity, your patient would be expected to complain of:
A. radioactive fillings
B. sore and sensitive teeth
C. sore cheeks and gums
D. metallic taste when eating
sore cheeks and gums
Rationale:
Radiation to the oral cavity will likely cause mucositis. The patient will complain of sore cheeks and gums.
A procedure used to stop the transmission of infection from the patient to others is called:
A. aseptic technique
B. reverse isolation
C. sterilization
D. isolation
isolation
Rationale:
A procedure used to stop the transmission of infection from patient to others is called isolation. Reverse isolation stops the transmission of infection from others to the patient. Asepsis and sterilization inhibits the vehicle of disease transmission from objects to patient.
Which of the following is a sign or symptom of dehydration?
A. esophagitis B. poor skin turgor C. increased urinary output D. improved wound healing
poor skin turgor
Rationale:
Poor skin turgor, decreased urinary output, and slowed wound healing are signs of dehydration.
Within the first two weeks of standard, fractionated radiation therapy, the patient will experience:
1. erythema
2. moist desquamation
3. epilation
A. 1, 2 B. 1, 3 C. 2, 3 D. 1, 2, 3
1, 3
Rationale:
Using standard, fractionated radiation therapy (180 to 200 cGy per fraction) the patient will experience erythema and epilation within the first two weeks.
define “epilation”
removal of body hair
While moving a patient with a chest tube, the tube becomes dislodged. The therapist should:
A. complete the move and get a new tube
B. call for immediate transfer to medical imaging
C. apply an airtight dressing over the opening
D. reinsert the tube
apply an airtight dressing over the opening
Rationale:
If a chest tube becomes dislodged, an airtight dressing should be applied, and then the nurse or physician should be notified.
Patients should be warned to avoid_________because it repels, rather than attracts moisture to the skin.
A. petroleum jelly
B. lanolin based
C. water-based salve
D. mild soap
petroleum jelly
Rationale:
Petroleum jelly should be avoided for radiation dermatitis since it repels moisture. Moisture helps in healing.
The Trendelenberg position is appropriate for a patient experiencing a medical emergency such as:
A. seizure
B. shock
C. cardiac arrest
D. respiratory distress
shock
Rationale:
The Trendelenberg position has the patient’s feet slightly elevated to promote blood flow to the heart. The position would be beneficial for a patient in shock or syncope (ie. loss of consciousness).
Caution must be taken when disposing of needles and syringes. The therapist should:
A. place needles and syringes in waste basket as soon as possible
B. recap the needle, with syringe attached before disposing
C. place the syringe with the uncapped needle into a contaminated waste container
D. detach the needles from the syringe and put the needle in contaminated waste container
place the syringe with the uncapped needle into a contaminated waste container
Rationale:
Used needles and syringes should be placed in a contaminated waster container. Do not attempt to recap or detach needles from syringes, as this will increase needle-stick injury risk.
Through which route are most drugs excreted from the body after metabolism?
A. liver B. pancreas C. kidney D. skin
kidney
Rationale:
Most drugs are metabolized by the liver and then excreted through the kidneys.
Most drugs are metabolized BY the ______ and then EXCRETED through the kidneys.
liver
A patient receiving doses above 50 Gy to the lacrimal gland may experience temporary:
A. dry eye
B. hair loss
C. dysuria
D. xerostomia
dry eye
Rationale:
The lacrimal gland is responsible for the production of tears. Doses above 50 Gy may temporarily cause decreased production of tears, causing the patient to have dry eyes.
what is the medical def for having a burning sensation when urinating?
dysuria
Patients receiving curative doses of radiation to the mediastinum should be advised to:
A. apply an antibacterial ointment to the area
B. eat foods that are salty and spicy
C. avoid foods that are spicy and acidic
D. gargle with mouthwash before radiation therapy
avoid foods that are spicy and acidic
Rationale:
Radiation to the mediastinum will likely lead to esophagitis. Spicy and acidic foods should be avoided.
A 3-year-old child is eating in the waiting room. She begins coughing, and her cough is soft and weak. Then she begins making high-pitched noises, and her skin turns blue. What is the most likely cause of her distress?
A. an acute asthma attack
B. a severe or complete airway obstruction
C. infected and swollen vocal cords
D. an epileptic seizure
a severe or complete airway obstruction
Rationale:
This child is probably choking and has an airway obstruction with inadequate air exchange.
A patient in with a systemic infection risks ________shock.
A. anaphylactic
B. hypovolemic
C. cardiogenic
D. septic
septic
Rationale:
Septic shock is a type of shock possible when a patient suffers from systemic infection.
A type of shock associated with bacterial infection and its byproduct is called:
A. septic B. neurogenic C. hypovolemic D. anaphylactic
septic
Rationale:
Septic shock is associated with bacterial infections and its toxic byproducts.
When working with the adolescent patient, it is important to remember that:
A. They tend to move more slowly. B. They may be hard of hearing. C. An adolescent fears compromise of his or her physical appearance. D. Adolescents can easily understand abstract concepts.
An adolescent fears compromise of his or her physical appearance.
Rationale:
Adolescent patients are in the development stage and are in the midst of building self-esteem and seeking approval from their peers. Physical appearance often drives self-esteem and peer approval.
A persistently high arterial blood pressure is known as:
A. hypertension B. hypotension C. hypercalcemia D. hyponatremia
hypertension
Rationale:
High blood pressure is also known as hypertension.
Wet desquamation may be best managed by:
A. applying ice packs B. keeping the area clean and dry C. exposing the area to warm compresses D. cleaning with soap and water
keeping the area clean and dry
The lumen size for a urinary catheter is expressed in:
A. cc B. mL C. gauge D. French
French
Rationale:
The lumen size of the urinary catheter is expressed in French. The lower the French size, the smaller the lumen.
Micro-organisms that cause infection can be classified as:
1. fungi
2. bacteria
3. viruses
4. vectors
A. 1, 2 B. 2, 3 C. 1, 2, 3 D. 1, 2, 3, 4
1, 2, 3
Rationale:
Fungi, bacteria, and viruses can cause infection. A vector is a carrier for the microorganism, usually an animal/insect.
Metastatic disease may lead to an abnormal accumulation of fluid in the pericardial sac. This may lead to:
A. mitral stenosis B. tachycardia C. pericarditis D. pericardial tamponade
pericardial tamponade
Rationale:
Pericardial tamponade is a result of abnormal pressure on the cardiac muscle; it manifests as irregular heartbeat and may ultimate lead to cardiac arrest.
Which of the following are true regarding management of patients with special conditions (select two):
- Patients with cardiac conditions should be transferred with minimal effort on the patient.
- Paralyzed upper extremities can dangle once the patient is supine.
- One should always move patients with IVs toward the tubing.
- Patients with spinal cord compressions may self-transfer whenever they are able.
1, 3
Rationale:
Paralyzed limbs should always be supported. Patients with spinal cord compressions should be moved carefully to decrease the risk for further spinal injury.
Your patient receiving radiation to the neck complains of dry mouth and thick, ropy saliva. He is experiencing:
A. xerostomia B. dysphasia C. mucostitis D. trismus
xerostomia
Rationale:
Xerostomia, or dry mouth, is caused by decreased saliva and can manifest as thickened saliva.
define “trismus”
restriction of opening mouth; difficulty moving jaw
The volume percentage of red blood cells in whole blood per 100 ml is the:
A. erythrocytes
B. leukocytes
C. hematocrit
D. hemaglobin
hematocrit
Rationale:
The hematocrit is the volume percentage or erythrocytes in whole blood.
define “hematocrit”
the amount of whole blood that is made up of RBCs
define “hemaglobin”
an iron containing pigment of red blood cells
-carry oxygen from the lungs to all parts of the body
define “erythrocyte”
a type of blood cell that is made in the bone marrow and found in the blood
-contain hemoglobin
Diastolic pressure is the pressure within the arteries that exists while the heart is:
A. contracting
B. resting
C. compressed
D. infracting
resting
Rationale:
The diastolic pressure indicates pressure in the arteries when the heart is at rest.
The type and degree of radiation skin reactions depend on all the following factors EXCEPT:
A. size of the treatment field B. level of stress C. total dose D. beam energy
level of stress
Rationale:
The type and degree of skin reaction depends on the volume treated, the dose given, and energy of the beam.
The medication used to decrease the possibility of clot formation is:
A. inderal
B. epinephrine
C. heparin
D. zofran
heparin
Rationale:
Heparin is used to reduce the possibility of clots.
Syncope is another name for:
A. fainting B. seizure C. stroke D. heart attack
fainting
The most common means of spreading infection is:
A. soiled instruments
B. infected patients
C. human hands
D. domestic animals
human hands
Your patient is complaining of pain upon swallowing. You should advise this patient to:
A. apply an antibacterial ointment to the chest B. eat foods that are salty and spicy C. eat foods that are soft and bland D. drink fluids only
eat foods that are soft and bland
Rationale:
Esophagitis can be painful. Soft and bland foods are recommended.
A grade 1 skin reaction to radiation therapy has the following characteristics (select two):
- dry, scaly skin
- necrosis
- epilation
- ulceration
1, 3
Rationale:
A grade 1 skin reaction shows the skin with temporary hair loss, erythema, and dryness.
In order to evaluate the blood pressure a___________is required.
A. stethoscope B. otoscope C. sphygmomanometer D. barometer
sphygmomanometer
Rationale:
The sphygmomanometer is the gauge containing mercury that visually demonstrates the systolic and diastolic pressures.
A chemical substance(s) used to kill pathogens on equipment is/are called a/an:
1. disinfectant
2. antiseptic
3. antibiotic
A. 1
B. 2
C. 3
D. 1, 2, 3
1
Rationale:
A disinfectant is used to decontaminate equipment or tissues. Antiseptics are used to clean tissues. Antibiotics are used to combat bacterial infections.
Antiseptics are used to clean _______.
tissues
Antibiotics are used to combat _________ infections.
bacterial
The lumen size for a needle is expressed in:
A. cc
B. mL
C. gauge
D. French
gauge
Rationale:
The lumen size for a needle is expressed in gauge. The lower the gauge size, the larger the lumen.
The pulse in the adult is most commonly evaluated at all the following sites EXCEPT:
A. carotid artery B. femoral artery C. aorta D. radial artery
aorta
Rationale:
The adult pulse is most commonly measured at the temporal, carotid, radial, or femoral arteries.
Measuring the heart rate by using a stethoscope over the patient’s heart is an assessment of the:
A. carotid pulse
B. apical pulse
C. pedal pulse
D. radial pulse
apical pulse
Rationale:
The apical pulse is measured at the apex of the heart and requires listening at the chest with the ear or stethoscope.
The normal pulse rate in the adult is:
A. 60 to 90 bts/min B. 15 to 20 bts/min C. 30 to 50 bts/min D. 100 to 150 bts/min
60 to 90 bts/min
Rationale:
The normal pulse or heart rate is 60 to 90 beats per minute in the adult.
A patient showing signs of shock should be placed in the Trendelenberg position to:
A. increase blood flow to the heart B. increase circulating blood volume C. relax venous spasms D. increase oxygen to the lungs
increase blood flow to the heart
Rationale:
Trendelenberg positions the patient supine with feet slightly elevated to improve blood flow to the heart during shock, when blood pressure is lowered.
Proper nutrition for the cancer patient undergoing radiation therapy treatments helps to:
1. enhance the effect of the treatments
2. improve the mental status of the patient
3. divert the patient’s attention from the treatment
4. the body to repair the damage caused by the treatment
A. 1, 2 B. 3, 4 C. 1, 2, 4 D. 1, 2, 3, 4
1, 2, 4
Rationale:
Proper nutrition helps the patient fight disease and improve emotional and mental status, and helps with tissue repair.
Skin damage can be caused by:
A. friction damage, as loose dressings slip back and forth
B. repeated application and removal of adhesive tape
C. long-lasting contact with soaked dressings
D. a, b, and c
a, b, and c
Rationale:
Skin damage should be avoided. Excess friction, taking on and off of tape, and unchanged dressings can damage the skin.
Your patient has had a left modified radical mastectomy and complains of swelling in her left arm especially after increased activity. She is likely showing signs of:
A. overexertion on her left side
B. Increase salt intake
C. lymphedema caused by axillary node resection
D. heart attack
lymphedema caused by axillary node resection
Rationale:
Lymphedema is seen in patients following radical surgeries where lymph nodes have been resected. Backup of lymphatic fluid causes swelling.
All of the following are methods of delivering oxygen to patients EXCEPT:
A. nasal cannula
B. face mask
C. IV catheter
D. oxygen tent
IV catheter
Rationale:
Oxygen is not administered intravenously.
The patient experiencing dry desquamation should be advised to:
A. apply alcohol every 3 hours
B. lightly coat with petroleum jelly every 3 hours
C. apply radiation dermatitis ointments no sooner than 1 hour before treatment
D. apply scented lotions at their discretion
apply radiation dermatitis ointments no sooner than 1 hour before treatment
Rationale:
Radiation dermatitis creams are appropriate for dry desquamation and have no harsh additives.
During injection of contrast for CT simulation, your patient complains of difficulty breathing and feeling faint. He is likely experiencing:
A. moderate symptoms of anaphylactic shock
B. minor symptoms of respiratory distress
C. minor symptoms of depression
D. major symptoms of claustrophobia
moderate symptoms of anaphylactic shock
Rationale:
Anaphylactic shock is not an uncommon response to the injection of contrast material. Moderate signs include difficulty breathing, changing levels of consciousness, nausea, and vomiting. Injection of contrast should stop and physician should be alerted.
Important aspects of wearing a mask include all of the following except:
A. The mask must be made of cotton.
B. The mask must completely cover the nose and mouth.
C. Breathing should be through the mask not around the mask.
D. Glasses should be worn outside the mask.
the mask must be made of cotton
Rationale:
Mask does not have to be made of cotton. However, there should be no gaps between the mask and face, and glasses should be on the outside to maintain continuous contact between the mask and the face.
Soiled wound dressings should be placed into a_________for disposal.
A. puncture-resistant container B. tied laundry bag C. nearby waste basket D. red biohazard bag
red biohazard bag
Rationale:
Soiled dressings should be handled as potentially infectious and must be placed in biohazardous waste bag.
A grade 1 morbidity score for the colon would indicate:
A. diarrhea requiring parenteral support
B. ulceration or perforation
C. obstruction
D. change in frequency of bowel habits
change in frequency of bowel habits
Rationale:
According to RTOG morbidity scoring, a grade 1 side effect for the colon is a mild change in bowel habits.
The patient experiencing confluent mucositis should be advised to:
A. gargle with a commercial mouthwash
B. eat only acidic foods
C. avoid acidic foods
D. drink cold liquids only
avoid acidic foods
Rationale:
Patients with mucositis should be advised to eat soft, bland foods.
If there is a serious complication during therapy, the patient could initiate legal action against:
1. the physician
2. the hospital
3. the therapist
A. 1 B. 1, 2 C. 1, 3 D. 1, 2, 3
1, 2, 3
Rationale:
Any negligence or malpractice suit related to therapy brings liability to the prescribing and supervising physician, the treatment facility, and the therapist administering therapy.
The purpose of isolation is to prevent all of the following except:
A. spread of the patient’s infection to visitors
B. spread of other’s infections to the patient
C. self-contamination of the patient by his or her own
organisms
D. cross-infection of hospital staff working with the patient
self-contamination of the patient by his or her own
organisms
Rationale:
Isolation prevents disease spreading from patient to patient, patient to workers, workers to patients, patients to visitors, and visitors to patients.
Palliative treatment is:
A. intended to cure
B. for the relief of symptoms
C. the infusion of oxygen into cells
D. treatment for the prevention of cancer spread
for the relief of symptoms
Rationale:
Palliative treatment is intended to bring the relief of symptoms and improve the patient’s quality of life without expectation of cure.
Following a seizure, the patient begins to vomit. The head should be lifted and turned to the side to prevent:
A. cramping
B. dehydration
C. loss of consciousness
D. aspiration
aspiration
Rationale:
Turning the patient onto the side prevents aspiration of any expelled fluids from the mouth into the lungs.
