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
