Patient Care Flashcards
The normal body temperature taken orally for a healthy adult is:
A. 97.6 degrees F
B. 98.6 degrees F
C. 99.6 degrees F
D. 100.6 degrees F
B. 98.6 degrees F
The normal range for adult pulse rate is:
A. 40-60 beats per minute
B. 60-100 beats per minute
C. 80-100 beats per minute
D. 100-120 beats per minute
B. 60-100 beats per minute
The normal range for adult systolic blood pressure is:
A. 60-80
B. 80-100
C. 100-120
D. 120-140
C. 100-120
The normal range for adult diastolic blood pressure is:
A. 60-80
B. 80-100
C. 100-120
D. 120-140
A. 60-80
The most accurate body temperature measurement can be obtained by what method?
A. oral
B. rectal
C. Tympanic
D. axillary
B. rectal
Which blood pressure reading is associated with the contraction of the left ventricle?
A. systolic
B. diastolic
A. systolic
The diastolic blood pressure is a measurement of the pressure exerted on the arterial walls during:
A. atrial contraction
B. right ventricle contraction
C. relaxation of the left ventricle.
D. relaxation of the atria.
C. relaxation of the left ventricle.
The measurement of oxygen saturation of the blood is accomplished with a:
A. stethescope
B. blood test
C. sphygomanometer
D. pulse oximeter
D. pulse oximeter
A patient could be considered hypoxic if the blood oxygen saturation falls below:
A. 100%
B. 96%
C. 93%
D. 90%
D. 90%
Upon noticing that any of a patient’s vital signs are abnormal, the radiologic technologist’s priority should be to:
A. Complete the exam as quickly as possible so the images are available for diagnosis
B. Stop the exam immediately and stabilize the patient
C. Call a nurse
D. Return the patient to their floor or unit
B. Stop the exam immediately and stabilize the patient
Which of the following respiration rates would most likely apply to an adult patient with a diagnosis of tachypnea?
A. 6 breaths per minute
B. 12 breaths per minute
C. 20 breaths per minute
D. 30 breaths per minute.
D. 30 breaths per minute.
In a trauma situation, which of the following arteries are best for assessing a patient’s pulse die to their larger size and more accurate representation of the heart’s activity?
- femoral
- carotid
- radial
A. 1 only
B. 2 only
C. 1 and 2 only
D. 1, 2 and 3
C. 1 and 2 only
An EKG is a measurement of:
A. electrical activity of the brain
B. the force of contractions of the heart
C. the electrical activity of the heart
D. the pulse rate
C. the electrical activity of the heart
The first phase of contraction of the heart involves contraction of the:
A. left atrium only
B. right atrium only
C. right and left atria
D. right and left ventricles
C. right and left atria
From the ventricles, blood is pushed into the:
A. pulmonary veins and aorta
B. pulmonary artery and aorta
C. atria
D. inferior and superior vena cava
B. pulmonary artery and aorta
The P wave of an EKG pattern represents the:
A. electrical activity through the atria
B. electrical activity through the ventricles
C. resetting of the ventricles
D. contraction of the ventricles without electrical impulses
A. electrical activity through the atria
The P wave of an EKG pattern represents the:
A. electrical activity through the atria
B. electrical activity through the ventricles
C. resetting of the ventricles
D. contraction of the ventricles without electrical impulses
A. electrical activity through the atria
The contraction of the ventricles is represented by which segment of the EKG pattern?
A. P wave
B. QRS Complex
C. ST segment
D. T wave
B. QRS Complex
EKG Gating is used to obtain diagnostic images of the heart:
A. during ventricular contraction
B. during atrial contraction
C. after ventricular contraction when the ventricles are resetting for the next contraction
D. when the heart is at rest between beats.
D. when the heart is at rest between beats.
The purpose of EKG Gating is to:
A. obtain images of the heart without motion blur
B. obtain images of the heart during contraction
C. Eliminate the need for continuous EKG monitoring
D. ensure the patient is closely monitored during imaging exams.
A. obtain images of the heart without motion blur.
During an EKG, the patient is connected to at least ____ electrical leads.
A. two
B. three
C. four
D. five
B. three
The red highlighted segment of this EKG pattern is the:
A. T wave
B. QRS segment
C. P wave
D. ST segment
B. QRS segment
Which labeled segment of the EKG wave is a recording of the electrical simulation causing atrial contraction?
A. A
B. B.
C. C
D. D
C. C
The normal range of BUN values for adults:
A. 4-8
B. 7-21
C. 10-20
D. 15-30
B. 7-21
The lab test that evaluates the chemical byproduct of metabolism in the muscle is:
A. BUN
B. GFR
C. sedimentation rate
D. creatinine
D. creatinine
Which of the following creatinine mg/dL levels would be considered abnormal?
A. 0.8
B. 1.0
C. 1.5
D. 2.0
D. 2.0
A test of GFR would provide information on which of the following?
A. the amount of creatinine in the blood
B. the amount of waste products that the kidneys can filter
C. the rate at which the kidneys filter waste from the blood
D. the rate of urine production.
C. the rate at which the kidneys filter waste from the blood
What is the normal range for GFR?
A. 90-120
B. 50-80
C. 20-40
D. 10-20
A. 90-120
Which of the following statements concerning kidney function is correct?
A. high creatinine level is associated with a high GFR level
B. high BUN and creatinine levels are associated with a low GFR
C. High BUN and creatinine levels are indicators that iodine contrast media is OK for a patient
D. Lower than normal creatinine and BUN levels indicate that the kidneys are filtering insufficient amounts of waste.
B. high BUN and creatinine levels are associated with a low GFR
Which of the following lab tests would be a test relating to blood coagulation?
A. Prothrombin time (PT)
B. Partial thromboplastin time (PTT)
C. Platelet count
D. International normalized ratio
E. All of the above
E. All of the above
The normal range for platelet count per mm3 is:
A. 1000-4000
B. 50,000-150,000
C. 150,000-400,000
D. 300,000-500,000
C. 150,000-400,000
A PTT result of 50 seconds would indicate which of the following?
A. a shorter than normal blood clotting time
B. a normal clotting time
C. a longer than normal clotting time
C. a longer than normal clotting time
Which of the following would be indicated by a higher than normal PT or PTT value?
A. the patient should not receive iodinated contrast media due to impaired kidney function
B. a procedure requiring a large spinal needle may need to be avoided
C. all injections should be completely avoided
D. all types of contrast media should be avoided.
B. a procedure requiring a large spinal needle may need to be avoided
The normal range for prothrombin time (PT) tests is:
A. 11-13.5 seconds
B. 25 seconds
C. 35-45 seconds
D. 50+ seconds
A. 11-13.5 seconds
The normal range for international normalized ratio (INR) for reporting PTs is:
A. 0.8-1.2
B. 1.5-2.0
C. 2.0-2.5
D. 2.5-5.0
A. 0.8-1.2
Which of the following represents a normal pulse rate for a healthy adult?
A. 45 bpm
B. 75 bpm
C. 115 bpm
D. 135 bpm
B. 75 bpm
Which of the following laboratory values represents the amount of red blood cells in whole blood?
A. Hemoglobin
B. Hematocrit
C. Platelet count
D. White blood cell count (WBC)
B. Hematocrit
What is a normal systolic blood pressure for a healthy adult?
A. 115 mmHg
B. 74 mmHg
C. 41 mmHg
D. 141 mmHg
A. 115 mmHg
The P wave of an electrocardiogram (EKG) pattern represents which of the following?
A. Atrial contraction
B. Ventricular systole
C. Ventricular diastole
D. Myocardial infarction
A. Atrial contraction
A patient undergoing a CT-guided renal biopsy requires what level of sedation?
A. anxiolysis sedation
B. conscious sedation
C. deep sedation
D. general anesthesia
B. conscious sedation
What medication is commonly administered during a CT biopsy for pain control?
A. Midazolam (Versed)
B. Fentanyl (Sublimaze)
C. Diazepam (Valium)
D. Lorazepam (Ativan)
B. Fentanyl (Sublimaze)
The normal range for platelets is:
A. 14 to 17 platelets per microliter
B. 150,000 to 400,000 platelets per microliter
C. 11 to 13.5 platelets per microliter
D. 25 to 25 platelets per microliter
B. 150,000 to 400,000 platelets per microliter
The purpose of evaluating a patient’s partial thromboplastin time (PTT) prior to beginning an interventional CT procedure is to evaluate the patient for:
A. Anemia
B. Renal insufficiency
C. Bleeding risk
D. Contrast allergies
C. Bleeding risk
Which of the following represents a normal oral temperature?
A. 94° F
B. 97° F
C. 100° F
D. 101° F
B. 97° F
Immobilizing of the diaphragm will be immediately detected by evaluating the patient’s:
A. pulse rate
B. respiratory rate
C. oxygen saturation
D. end-tidal CO2
B. respiratory rate
Which of the following tests should be used to evaluate a patient’s risk of poor blood clotting?
A. Hematocrit
B. Hemoglobin
C. Creatine
D. Prothrombin time (PT)
D. Prothrombin time (PT)
Which of the following represents a normal prothrombin time (PT)?
A. 15 to 17 seconds
B. 150,000 to 400,000 seconds
C. 11 to 13.5 seconds
D. 25 to 35 seconds
E. 0.8 to 1.2 seconds
C. 11 to 13.5 seconds
Which of the following body locations is most appropriate for pulse oximetry?
A. index finger
B. lower lip
C. forearm
D. nose
A. index finger
Which of the following lab tests may indicate active bleeding or blood loss?
A. Creatinine
B. Hematocrit
C. Platelet count
D. White blood cell (WBC) count
B. Hematocrit
In a normal electrocardiogram (EKG), ventricular systole is represented by:
A. P wave
B. QRS complex
C. T wave
D. U wave
B. QRS complex
Blood test that measures the percentage of the volume of whole blood that is made up of red blood cells. This measurement depends on the number of red blood cells and the size of red blood cells.
Hematocrit (HCT)
The hematocrit is generally included as part of a __________.
Complete blood count (CBC)
Hematocrit (HCT)
Normal values are roughly in the range of _________. Females are generally lower, while males usually have a higher hematocrit.
35%-50%
Low hematocrits are often the result of _______ and/or ______.
Anemia; bleeding.
An iron rich protein carried by red blood cells (RBC) to transport oxygen. A measure of this level helps to identify anemia, bleeding, or a number of other conditions.
Hemoglobin (Hgb)
Normal range of hemoglobin (Hgb) for males:
14-17 gm/dL
Normal range of hemoglobin (Hgb) for females:
12-15 gm/dL
This test evaluates the number of platelets in the blood and the body’s clotting activity. High counts may represent clotting disorders while low counts indicate the potential for bleeding or bleeding disorders.
Platelets (Plt)
Platelets (Plt)
Normal range:
150,000-400,000 platelets per microliter
A blood test that measures the time it takes for the liquid portion (plasma) of blood to clot.
Prothrombin Time (PT)
Prothrombin Time (PT)
Normal range:
11-13.5 seconds
Partial Thromboplastin Time (PTT)
Normal range:
25-35 seconds.
Represents the coagulation tendency of blood.
International Standardized Ratio (INR)
International Standardized Ratio (INR)
Normal range:
0.8-1.2
Allows a patient to undergo potentially painful procedures without the risks associated with general anesthesia. The consciousness is altered with the intent to:
- minimize anxiety
- increase pain tolerance
- induce amnesia of the unpleasant events of the procedure.
All of this should be accomplished while also protecting and maintaining the patient’s vital signs.
Sedation (with analgesia)
Represents the balance between heat that’s produced by metabolim, muscular activity, and other factors and heat lost through the skin, lungs, and body wastes. A change in this pattern usually signals the onset of illness.
Body Temperature
Oral temperature in adults normally ranges from ____ to ____.
97° to 99° F (36.1 to 37.5°C)
Lateral force that blood exerts on arterial walls, is affected by the force of ventricular contractons, arterial wall elasticity, peripheral vascular resistance, and blood volume and viscosity.
Blood Pressure.
Occurs when the left ventricle contracts. It reflects the integrity of the heart, arteries, and arterioles.
Systolic Pressure.
Occurs when the left ventricle relaxes. It indicates blood vessel resistance.
Diastolic Pressure
Recorded as the number of cycles per minute, with inspiration and expiration making up one cycle.
Respirations
A medical device used to measure the oxygen saturation in the blood.
Pulse oximeter
Most common pulse oximeter type. In this design, a light emitter and sensor are placed opposite each other on pulsatile tissue such as a finger or ear. This information can me used noninvasively to help evaluate the hemodynamic status of a patient and to detect hypoxemia in various clinical settings.
Transmission probe
Recommended for all patients undergoing moderate sedation. It is more sensitive indicator of a patient’s respiratory status compared to pulse oximetry. Commonly accomplished using the nasal cannula used to deliver oxygen.
End-tidal CO2 monitoring.
Records the heart’s electrical activity as waveforms that display the phases of depolarization (contraction) and repolarization (relaxation). Used to diagnose and monitor certain disorders, such as myocardial infarction and pericarditis. Also allows for identification of rhythm disturbances, conduction abnormalities, and electrolyte imbalances.
Electrocardiography (EKG)
In medical imaging, EKG is especially used for two important functions:
- To monitor a patient’s heart activity during an interventional procedure.
- To precisely time imaging of the heart with the beating of the heart. (EKG gating)
EKG
The _____ is a record of the electrical activity through the atria.
P wave
EKG
The ______ is a record of the movement of electrical impulses through the ventricles (ventricular systole).
QRS complex
EKG
The _____ shows when the ventricle is contracting but no electricity is flowing through it; usually appears as a straight, level line between the QRS complex and the T wave.
ST segment
EKG
The ______ shows when the ventricles are resetting electrically and preparing for their next muscle contraction (ventricular diastole).
T wave.
A patient with pre-existing renal insufficiency is scheduled for a CT angiography of the pulmonary arteries. Which of these laboratory values must be evaluated before scanning the patient? (Select two)
A. Creatinine
B. Partial Thromboplastin time (PTT)
C. Glomerular Filtration Rate (GFR)
D. Complete Blood Count (CBC)
A. Creatinine and C. Glomerular Filtration Rate (GFR)
The worst possible outcome of an adverse reaction to iodinated contrast is:
A. Syncope
B. Seizure
C. Laryngeal edema
D. Cardiopulmonary arrest.
D. Cardiopulmonary arrest.
For how long should the technologist physically palpate the injection site after initiating contrast injection?
A. 5 seconds
B. 15 seconds
C. Until the injection is complete
D. Physical palpation is not required.
B. 15 seconds
After 24 hours, the primary side effect of contrast extravasation is:
A. Numbness
B. Nausea
C. Inflammation
D. Urticaria
C. Inflammation
After cleaning the skin with a 70% alcohol antiseptic solution, when should the intravenous catheter be inserted?
A. After the solution dries
B. Before the solution dries
C. As soon as possible.
A. After the solution dries
Resorption of extravasated contrast can be accelerated by: (select two)
A. Applying hot and cold compresses
B. Administering anti-histamines
C. Elevating the affected limb
D. Administering corticosteroids
A. Applying hot and cold compresses and
For intravenous (IV) injection, the biological toxicity of iodine is minimized by:
A. Warming the contrast prior to injection
B. Attaching the iodine to a benzine ring.
C. Diluting the iodine in water
D. Injecting only 100% pure iodine.
B. Attaching the iodine to a benzine ring.
The attenuating properties of a contrast agent are most influenced by its:
A. Ionicity
B. Osmolarity
C. Atomic Number
D. Chemical toxicity
C. Atomic Number
The most severe contrast reactions require treatment with:
A. Hydromorphone (Dilaudid)
B. Epinephrine (Adrenaline)
C. Fentanyl (Sublimaze)
D. Midazolam (Versed)
B. Epinephrine (Adrenaline)
When beginning a peripheral venous catheter, what kind of gloves are required for aseptic technique?
A. Clean gloves are required
B. Sterile gloves are required
C. No gloves are required
A. Clean gloves are required
During a CT procedure, the technologist should stop injecting intravenous contrast if the patient reports:
A. Sensation of warmth
B. Swelling at the injection site
C. Coldness at the injection site
D. Metallic taste
B. Swelling at the injection site
A water-soluble contrast agent that is ionic will also be:
A. Low osmolar relative to human serum
B. High osmolar relative to human serum
C. Iso-osmolar relative to human serum
B. High osmolar relative to human serum
Which three of the following conditions will increase a patient’s risk for contrast-induced nephrotoxicity? (Select three)
A. Pre-existing renal insufficiency
B. Type-B diabetes
C. Acute head trauma
D. Acute dehydration
A. Pre-existing renal insufficiency, B. Type-B diabetes, and D. Acute dehydration
A CT angiography study is ordered for an elderly patient. If his creatinine is 0.6 mg/dL, how should the technologist proceed with the study?
A. Used an increased injection rate
B. Use a reduced contrast volume
C. Follow the pre-medication protocol prior to scanning
D. Follow the normal contrast protocol.
D. Follow the normal contrast protocol.
A patient arrives in your department from a nearby critical access hospital. The patient received a CT chest with contrast one hour ago, and a CT abdomen with contrast scan is being requested now. Which of these situations indicate that a second dose of contrast be administered?
A. The patient’s creatinine is less than 2.0
B. The patient shows signs of serious internal injuries
C. The patient received less than 150 ml for the previous scan
D. The patient has no known iodine allergies.
B. The patient shows signs of serious internal injuries
Which of the following techniques help minimize the nephrotoxic effects of iodinated contrast?
A. Pre-scan hydration for 24 hours
B. Post-scan steroid administration for 12 hours
C. Pre-scan nothing by mouth (NPO) for 1 hour
D. Post-scan anxiolytic medication for 24 hours
A. Pre-scan hydration for 24 hours
If IV contrast must be injected through a catheter in the wrist, the risk of extravasation can be minimized by decreasing the:
A. Injection rate
B. Contrast volume
C. Scan delay time
D. Contrast temperature.
A. Injection rate
A patient arrives in the CT department for a CT of the neck, chest, abdomen and pelvis to evaluate for metastatic cancer. Under what circumstances can the technologist use the patient’s central venous catheter for pressure injection?
A. Only if peripheral veins are inaccessible
B. Only if the patient agrees to it
C. Only if the catheter is rated for pressure injection
D. Only if the ordering physician is readily available.
C. Only if the catheter is rated for pressure injection
When a pregnant patient undergoes a contrast-enhanced CT imaging procedure, the patient should be educated on potential harm to the fetus from: (Select two)
A. Normal saline
B. Water-soluble iodine
C. Radiation
D. Barium sulfate
B. Water-soluble iodine and C. Radiation
To reduce the risk of an iodinated contrast reaction, preventative medication must be administered:
A. Orally
B. Intravenously
C. Prior to the procedure
D. With adequate hydration
C. Prior to the procedure
All IV injectable contrast agents in CT are:
A. Low-osmolar
B. Non-ionic
C. Water-soluble
D. Low-viscosity
C. Water-soluble
All IV injectable contrast agents in CT are:
A. Low-osmolar
B. Non-ionic
C. Water-soluble
D. Low-viscosity
C. Water-soluble
The most beneficial effect of using non-ionic contrast agents for intravenous injection is:
A. Decreased volume requirements
B. Decreased toxicity
C. Increased tissue discrimination
D. Increased differential attenuation
B. Decreased toxicity
For contrast pre-medication, a typical anti-histamine dose is:
A. 1 mg
B. 50 mg
C. 500 mg
D, 1 g
B. 50 mg
Consider a CT department planning to change it’s IV contrast supplier. Which of these contrast agents will demonstrate the fewest side effects in patients?
A. Ionic compound with 1,500 mOsm/L
B. Ionic compound with 580 mOsm/L
C. Non-ionic compound with 77r mOsm/L
D. Non-ionic compound with 290 mOsm/L
D. Non-ionic compound with 290 mOsm/L
A technologist attempts and fails to cannulize the basilic vein in mid-forearm. Which of the following sites should NOT be cannulized on the second attempt?
A. Basilic vein distal to the initial site
B. Basilic vein proximal to the initial site
C. Cephalic vein distal to the initial site
D. Cephalic vein proximal to the initial site
A. Basilic vein distal to the initial site
When a technologist starts a peripheral catheter, which three of the following must be documented in the patient’s medical record? (select three)
A. Date of insertion
B. Site
C. Hub color
D. Gauge
E. Ordering physician.
A. Date of insertion
B. Site
D. Gauge
Which two adverse contrast reactions require that the patient be monitored for a period of time prior to discharge? (Select two)
A. Scattered urticaria
B. Rhinorrhea
C. Hypertension
D. Nausea
A. Scattered urticaria
B. Rhinorrhea
Which of these medications are commonly administered to the patient following a mild reaction to iodinated contrast?
A. Hydromorphone (dilaudid)
B. Midazolam (Versed)
C. Fentanyl (Sublimaze)
D. Diphenhydramine (Benadryl)
D. Diphenhydramine (Benadryl)
Patients with a known iodine allergy may receive iodine contrast in CT only when the patient has:
A. Been pre-hydrated prior to the scan
B. Arranged dialysis following the scan
C. Received immune-suppressors prior to the scan
D. Arranged for hydration following the scan.
C. Received immune-suppressors prior to the scan
_____ contrast agents are those that dissociate into charged particles in the presence of water and the blood. Known to be pore toxic to patients, in part because they have an increased osmolarity.
Ionic
The most common iodinated (water-soluble) contrast agents are ______, which means they do not form changed particles in the blood.
Non-ionic.
The measure of the osmotic pressure of a solution concerning the number of particles per volume of solution.
Osmolarity
Blood and human serum have an osmolarity of approximately ______ mOsm/L.
300
_______ contrast agents typically have higher osmolarity and more side effects.
Ionic
_______ contrast media have lower osmolality and tend to have fewer side effects.
Non-ionic
One contrast agent (Visipaque 320) is sometimes called _______ because its osmolarity is virtually identical to blood.
Iso-asmolar
- Has a high atomic number (Z=56)
- Excellent element for contrast enhancement in the GI system.
- Suspended in water, but not actually dissolved.
- Not water-soluble.
- Administered orally or rectally, NEVER intravenously.
Barium
CT contrast agents must have a ______ concentration than agents used in fluoroscopy.
Lower
Barium suspensions used for fluoroscopy have a barium concentration of 40% or more, while suspensions used in CT are approximately _____.
2%
For intravenous injection, the biological toxicity of iodine is minimized by:
A. Warming the contrast prior to injection
B. Attaching the iodine to a benzene ring
C. Diluting the iodine in water
D. Injecting only 100% pure iodine.
B. Attaching the iodine to a benzene ring
Tissue differentiation in computed tomography is based on:
A. Differential attenuation of the radiation beam
B. Variable nuclear resonance
C. Tissue harmonics
D. Variable electrical stimulation in tissues.
A. Differential attenuation of the radiation beam
Ioxaglate (Hexabrix) is an IV-injectable contrast agent that dissociates into positive and negative particles in water. This agent is considered:
A. Non-ionic
B. Ionic
C. Non-toxic
D. Low osmolar
B. Ionic
A water- soluble contrast agent that is ionic will also be:
A. Low osmolar relative to human serum
B. High osmolar relative to human serum
C. Iso-osmolar relative to human serum
B. High osmolar relative to human serum
The osmolarity of blood and human serum is approximately:
A. 10 mOsm/L
B. 40 mOsm/L
C. 300 mOsm/L
D. 1,500 mOsm/L
C. 300 mOsm/L
The most beneficial effect of using non-ionic contrast agents for IV injection is:
A. decreased volume requirements
B. decreased toxicity
C. increased tissue discrimination
D. increased differential attenuation
B. decreased toxicity
Consider a CT department planning to change its IV contrast supplier. Which of these contrast agents will demonstrate the fewest side effects in patients?
A. Ionic compound with 1,500 mOsm/L
B. Ionic compound with 580 mOsm/L
C. Non-ionic compound with 774 mOsm/L
D. Non-ionic compound with 290 mOSm/L
D. Non-ionic compound with 290 mOSm/L
The attenuating properties of a contrast agent is most influenced by its:
A. Ionicity
B. Osmolarity
C. Atomic Number
D. Chemical Toxicity
C. Atomic Number
All of the following contrast agents are commonly used in CT imaging. Which of the following contrast agents are NOT considered water-soluble?
A. Metrizoate
B. Ioxaglate
C. Iohexol
D. Barium Sulfate
D. Barium Sulfate
All IV-injectable contrast agents in CT are:
A. Low-osmolar
B. Non-ionic
C. Water-soluble
D. Low-viscosity
C. Water-soluble
What is the primary difference between barium-sulfate suspensions prepared for fluoroscopy and barium-sulfate suspensions prepared for CT?
A. Barium-sulfate suspensions are less concentrated.
B. Barium-sulfate suspensions are less toxic.
C. Barium-sulfate suspensions are less stable.
D. Barium-sulfate suspensions are less expensive.
A. Barium-sulfate suspensions are less concentrated.
A byproduct of protein metabolism in the liver which must be collected and excreted by the kidneys.
Urea
Measures the amount of nitrogen in the blood in the form of urea.
Blood Urea Nitrogen (BUN)
Blood Urea Nitrogen (BUN) normal range:
7-21 mg/dL
A BUN above _____ may indicate renal failure.
50.
Chemical byproduct of metabolic activity in the muscles.
Creatinine
Low _____ levels may indicate muscular problems.
creatinine
______ levels fluctuate with age, gender, muscle mass, and hydration.
Creatinie
Creatinine normal range:
0.7-1.5 mg/dL
A creatinine above ______ may indicate renal failure for most patients.
2.0
This test estimates the rate at which the kidneys (glomerulus) are filtering waste from the blood. The calculation for estimating this includes creatinine level, age, and gender.
Glomerular Filtration Rate (GFR)
GFR normal range:
90-120 ml/min/1.73m2
A GFR below _____ may indicate renal failure.
30
Which of these techniques help to minimize the nephrotoxic effects of iodinated contrast?
A. Pre-scan hydration for 24 hours
B. Post-scan steroid administration for 12 hours
C. Pre-scan NPO for 1 hour
D. Post-scan anxiolytic medication for 24 hours.
A. Pre-scan hydration for 24 hours
A CT angiography study is ordered for an elderly patient. If his creatinine is 0.6 mg/dL, how should the technologist proceed with the study?
A. Use an increased injection rate
B. Use a reduced contrast volume
C. Follow the pre-medication protocol prior to scanning
D. Follow the normal contrast protocol
D. Follow the normal contrast protocol
A blood-urea-nitrogen of 11 mg/dL is:
A. below the normal range
B. above the normal range
C. within the normal range
C. within the normal range
Which of these tests may be used to evaluate a patient’s renal function? Select multiple:
A. INR
B. GFR
C. Creatinine
D. PTT
B. GFR
C. Creatinine
For patients with an iodine allergy, safe injection of IV contrast can be accomplished by:
A. Pre-scan hydration for 24 hours
B. Pre-scan corticosteroid administration
C. Pre-scan NPO for 1 hour
D. Post-scan anti-histamine medication
B. Pre-scan corticosteroid administration
Which of these medications are used to decrease the likelihood of contrast reactions in patients with a known iodine allergy?
A. Prednisone
B. Diphenhydramine (Benadryl)
C. Methylprednisone (Solu-Medrol)
D. Hydromorphone (Dilaudid)
A. Prednisone
B. Diphenhydramine (Benadryl)
C. Methylprednisone (Solu-Medrol)
For contrast premedication, a typical anti-histamine dose is:
A. 1 mg
B. 50 mg
C. 500 mg
D. 1 g
B. 50 mg
To reduce the risk of an iodinated contrast reaction, preventative medication MUST be administered:
A. Orally
B. IV
C. Before the procedure
D. With adequate hydration
C. Before the procedure
A technologist attempts and fails to cannulize the basilic vein in the mid-forearm. Which of the following sites should NOT be cannulized on the second attempt?
A. Basilic vein distal to the initial site
B. Basilic vein proximal to the initial site
C. Cephalic vein distal to the initial site
D. Cephalic vein proximal to the initial site
A. Basilic vein distal to the initial site
Why should small veins of the hands and wrist be avoided for IV-contrast injection?
A. They are too small to be cannulated
B. They are too small to tolerate pressure-injection
C. They are too distal for effective bolus tracking.
D. They are too closely associated with surrounding arteries.
B. They are too small to tolerate pressure-injection
During intravenous cannulation, when should hand hygiene be performed?
A. Before palpating the insertion site
B. After palpating the insertion site
C. During catheter insertion
D. After catheter insertion
E. All of the above
E. All of the above
When starting a peripheral venous catheter, what kind of gloves are required for aseptic technique?
A. Clean gloves are required
B. Sterile gloves are required
C. No gloves are required
A. Clean gloves are required
After cleaning the skin with a 70% alcohol antiseptic solution, when should the IV catheter be inserted?
A. After the solution dries
B. Before the solution dries
C. As soon as possible
A. After the solution dries
Which of the following are reasons to stop injecting IV contrast during a CT procedure?
A. The patient reports a sensation of warmth
B. The patient reports swelling at the injection site
C. The patient reports coldness at the injection site
D. The patient reports a metallic taste
B. The patient reports swelling at the injection site
If IV contrast must be injected through a catheter in the wrist, the risk of extravasation can be minimized by:
A. Decreasing the injection rate
B. Decreasing the contrast volume
C. Decreasing the scan delay time
D. Decreasing the contrast temperature
A. Decreasing the injection rate
What is the primary purpose of injecting the patient with normal saline prior to scanning?
A. To flush the catheter of debris
B. To prime the injector tubing
C. To check the patency of the catheter
D. To distend the vein
C. To check the patency of the catheter
For how long should the technologist physically palpate the injection site after initiating contrast injection?
A. 5 seconds
B. 15 seconds
C. Until the injection is complete
D. Physical palpation is not required
B. 15 seconds
The medical term referring to the leakage of contrast (or any fluid) outside of the blood vessel.
Extravasation
During a CT with contrast, the patient begins to itch profusely. This is most likely a sign of:
A. Adverse reaction
B. Contrast extravasation
C. Acute nephrotoxicity
D. Venous air embolism
A. Adverse reaction
The most commonly reported adverse reaction to iodinated contrast is:
A. Scattered urticaria
B. Rhinorrhea
C. Hypertension
D. Nausea
A. Scattered urticaria
Resorption of extravasated contrast can be accelerated by (choose multiple):
A. Applying hot and cold compresses
B. Elevate the affected limb
C. Administering anti-histamines
D. Administering corticosteroids
A. Applying hot and cold compresses
B. Elevate the affected limb
After 24 hours, the primary side effect of contrast extravasation is:
A. Numbness
B. Nausea
C. Inflammation
D. Urticaria
C. Inflammation
Which of these medications are commonly administered to patients after a mild reaction to iodinated contrast?
A. Hydromorphone (Dilaudid)
B. Midazolam
C. Fentanyl (Sublimaze)
D. Diphenhydramine (Benadryl)
D. Diphenhydramine (Benadryl)
A patient in your department is injected with an iodinated contrast material. Which of these reactions would be described as a normal response to the contrast agent?
A. Sensation of warmth
B. Profuse urticaria
C. Persistent vomiting
D. Pulmonary edema
A. Sensation of warmth
What is the technologist’s first responsibility during an adverse reaction?
A. Call for nursing and physician on staff
B. Acquire vital signs
C. Discontinue contrast administration
D. Call a code blue
C. Discontinue contrast administration
The worst possible outcome of an adverse reaction to iodinate contrast is:
A. Syncope
B. Seizure
C. Laryngeal edema
D. Cardiopulmonary Arrest
D. Cardiopulmonary Arrest
Which of these conditions put a patient at increased risk for contrast-induced nephrotoxicity? Choose multiple
A. Pre-existing renal insufficiency
B. Type-B diabetes
C. Acute dehydration
D. Acute head trauma
A. Pre-existing renal insufficiency
B. Type-B diabetes
C. Acute dehydration
What is the main concern with giving iodinated contrast to pregnant patients?
A. Contrast is known to cross the placenta into the fetus
B. Contrast is known to cause spontaneous miscarriage
C. Contrast is known to cause congenital abnormalities
D. Contrast is known to cause pre-term birth
A. Contrast is known to cross the placenta into the fetus
When iodinated contrast is intravenously administered to a lactating patient, the contrast volume is injected by a breastfeeding infant is:
A. Approximately equal to the volume received by the mother
B. Significantly less than the volume received by the mother
C. None; iodinated contrast is not excreted in breast milk
B. Significantly less than the volume received by the mother
A breast-feeding mother undergoes a CTA of the chest with contrast for pulmonary embolism. If she does not want the infant ingesting iodinated contrast in the breast milk, she should:
A. Abstain from breast-feeding for 1 hour after the scan
B. Abstain from breast-feeding for 4 hours after the scan
C. Abstain from breast-feeding for 24 hours after the scan
D. Abstain from breast-feeding for 2 days after the scan
C. Abstain from breast-feeding for 24 hours after the scan
What known risks exist for an infant ingesting iodinated contrast in breast milk?
A. Contrast-induced carcinogenesis
B. Contrast-induced nephrotoxicity
C. Contrast-induced diarrhea
D. There are no known risks
D. There are no known risks
When IV contrast is administered to patients receiving dialysis, the technologist can minimize further harms from to the patient by:
A. Arranging dialysis before the scan
B. Using the smallest possible volume of contrast
C. Following the contrast with additional normal saline
D. Injecting at a decreased rate
B. Using the smallest possible volume of contrast
In patients with end-stage renal failure, possible harms from iodinated contrast include all of the following EXCEPT:
A. Additional renal damage
B. Adverse reaction
C. Volume overload
D. Osmotic overload
A. Additional renal damage
