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Computed Tomography > Patient Care > Flashcards

Patient Care Flashcards

1
Q

Mr Jones is scheduled for a CT of the chest. As you review his history, he confides that he is extremely concerned that the study will find cancer, particularly as he has smoked cigarettes for more than 20 years. Your response is:

A

I understand your concern, and know that waiting to get an answer can be excruciating. We will get the results to your physician just as soon as we can.

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2
Q

You are taking a patient’s medical history. You are unsure what he means when he says, “Oh, yeah, I’ve had lots of times when my kidneys just shut down and they had to give them a kick start.” Using reflective speech, you

A

Say, “So you’ve experienced kidney failure in the past that required dialysis?”

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3
Q

Regarding an order for a CT examination, all of the following statements are true EXCEPT:

A

CT examinations can be only ordered by a physician.

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4
Q

Which of the following is NOT an acceptable method of verifying a patient’s identity?

A

Use the sign on the door of the patient’s room or ask the patient what hospital room they are assigned to.

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5
Q

Why is a patient questioned regarding whether they have a history of an overactive thyroid?

A

To determine whether an iodinated contrast agent can be administered intravenously

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6
Q

Blood urea nitrogen (BUN) and serum creatinine provide information about a patient’s

A

Kidney function

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7
Q

For which of the following examinations is it common to check laboratory results for prothrombin time (PT), partial thromboplastin time (PTT), and platelet count?

A

CT-guided biopsy

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8
Q

Which of the following is a TRUE statement regarding signed consent forms?

A

If written consent is required it must be signed by the patient before the administration of any medication for pain relief or sedation.

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9
Q

All of the following are true statements regarding patient restraints EXCEPT:

A

Patients are restrained primarily as a convenience for the technologist.

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10
Q

Why is it important for the technologist to note the patient’s breathing, skin coloration, and overall health before the examination begins?

A

It will help the technologist notice signs should adverse effects occur during the scan process.

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11
Q

Which of the following is NOT considered one of the vital signs?

A

Weight

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12
Q

Where is the pedal pulse felt?

A

Posterior ankle or top of the foot

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13
Q

What is the normal range for the respiratory rate of an adult?

A

14- 20

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14
Q

The normal range of blood pressure in children is

A

Lower than adults

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15
Q

To distinguish adjacent tissues on a CT image, the tissues must

A

have different densities

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16
Q

A contrast material that is of a substantially higher density than that of the surrounding structures can be referred to as a ________ agent.

A

Positive

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17
Q

The structural property of a contrast agent regarding the number of particles in solution compared with blood is known as

A

Osmolality

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18
Q

The intravenous infusion of HOCM may result in

A

Dehydration

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19
Q

Which factors affect the viscosity of an intravenous iodinated contrast agent?

A

Iodine concentration & temperature of the agent

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20
Q

An imaging center’s protocol for a routine body CT on an adult patient calls for the administration of 100 mL of an LOCM with a concentration of 320 mgI/mL. A particular patient has very poor veins, necessitating venipuncture with a smaller than recommended caliber of indwelling catheter. Concerns about the precarious venous access have resulted in the decision to use a lower concentration (less viscous) contrast agent. What volume of an LOCM with a concentration of 240 mgI/mL will deliver an equivalent amount of iodine to that of the dose called for in the protocol?

A

133 mL

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21
Q

Why is there such a wide variation in the literature among quoted incidences of adverse reactions to contrast media?

A

There is no standard definition of adverse reactions or standard system to classify their severity.

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22
Q

Which is an example of a chemotoxic reaction to intravascular contrast media?

A

Contrast-induced nephropathy

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23
Q

Contrast reactions that are accompanied by a temporary drop in blood pressure, bronchospasms, facial edema, urticaria, and laryngeal edema are generally classified as

A

Moderate reactions

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24
Q

Comparing the reported rate of adverse reaction,

A

LOCM are much lower than HOCM, by a factor of approximately four to five times.

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25
Q

When a patient who previously reacted to HOCM is given an LOCM for a subsequent study, the risk of a repeat reaction is approximately

A

5%

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26
Q

What is the single best method of reducing the risk of idiosyncratic contrast medium reaction?

A

Use LOCM

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27
Q

The basic functioning unit of the kidney is the

A

Nephron

28
Q

Which statement is true concerning the use of serum creatinine (SeCr) to assess renal function?

A

Measuring SeCr is a fast and inexpensive way to estimate renal function.

29
Q

Which of the following are considered at high risk for developing CIN?

A

Patients with diabetes mellitus and preexisting renal insufficiency

30
Q

Which is a true statement regarding the risks posed by intravascular contrast media in combination with the drug metformin?

A

When renal dysfunction occurs in patients taking metformin, the drug can accumulate and result in lactic acidosis

31
Q

After the injection of an iodinated contrast medium, patients with brain metastasis have an increased risk of

A

Seizures

32
Q

What is the most common type of delayed reaction to intravascular contrast medium?

A

Skin reactions

33
Q

Barium leaking into the peritoneal cavity is referred to as

A

Barium peritonitis

34
Q

Given orally, compare LOCM with HOCM.

A

In some instances, particularly with infants, LOCM may provide significant advantages over the HOCM agents.

35
Q

Which is NOT a true statement regarding the placement of a peripheral IV line for the administration of an iodinated contrast agent for a scan of the abdomen?

A

An indwelling catheter, butterfly infusion set, or straight needle can be used, depending on the preference of the technologist

36
Q

What type of catheter do most manufacturers recommend be flushed with heparinized saline sole after their use?

A

Open ended CVAD catheters

37
Q

Which is a true statement regarding implantable ports?

A

Among CVADS, ports have the lowest incidence of infection because they are completely buried under the skin and there is no site for microorganisms to enter

38
Q

The difference between the bolts phase, the nonequilibrium phase, and the equilibrium phase of contrast enhancement is primarily determined by the

A

Injection rate and scan delay

39
Q

The arteriovenous iodine difference is calculated by

A

Comparing an HU measurement of the aorta to that of the inferior vena cava

40
Q

Another name of the Bolus phase of contrast enhancement is the

A

Arterial phase

41
Q

Iodinated contrast is administered at a rate of 3 mL/s for a routine abdominal scan in which the protocol calls for a delay of 60 seconds between the start of injection and the start of scanning. Soon after the start of the contrast injection, the patient begins to experience an intense warm feeling and, being surprised by this, calls for the technologist. How long beyond the 60 seconds can the technologist delay the scan acquisition (so that he might comfort the patient) without risk of degrading the diagnostic utility of the study?

A

30-40 seconds

42
Q

The general rules of contrast media injection regarding injecting rate and scan delay do not apply to

A

Routine brain scanning

43
Q

When can a drip infusion technique for contrast media administration be used?

A

For a study of the brain when the clinical indication is suspicion of tumor

44
Q

All of the following are disadvantages of the hand bolus technique of contrast administration EXCEPT

A

It can not be used for injection into standard PICC lines

45
Q

The volume of contrast administered is increased from 100 mL to 150 mL. The flow rate is unchanged at 3mL/s. What can be expected?

A

The duration of the contrast injection is increased

46
Q

Because of the patient’s IV access the flow rate of a contrast injection is reduced from the protocol of 4mL/s to 2mL/s. What other adjustment is likely to be made?

A

A scan delay is increased

47
Q

What injection technique is used for most clinical applications?

A

Uniphasic injection with a constant flow rate

48
Q

What effect does a patient’s cardiac output status have on contrast enhancement?

A

A cardiac output is reduced, there is a progressively longer delay in the time required for the contrast bolus to reach peak aortic enhancement

49
Q

The test bolus method is used to determine the scan delay for a CT angiography study. 10 trial images are taken @ 2 second intervals beginning 12 seconds after the start of the test injection. Maximum enhancement in the selected region of interest is seen on the 4th image. What scan delay range is optimal?

A

20-23 seconds

50
Q

The rational use of CT involves which two key components?

A

Appropriate selection of patients and the minimization of the radiation dose without compromising diagnostic quality

51
Q

Which unit universally expresses dose?

A

There is no consensus regarding an expression of dose, and many units have been used

52
Q

The unit of ionizing radiation exposure in air is the

A

Roentgen (R)

53
Q

The unit of absorbed dose is the

A

Radiation absorbed dose (rad) or gray (Gy)

54
Q

The Système International d’Unités (SI) for ionizing radiation

A

Is used internationally
replaces the unit known as the rad
replaces the unit known as the rem

55
Q

The quality factor (Q) is used to

A

Account for the different health effects produced from different types of ionizing radiation

56
Q

Which of the following statements is TRUE concerning the measurement referred to as effective dose?

A

It is a weighted average of organ doses

57
Q

The areas of scatter into adjacent tissue are sometimes called

A

Tails

58
Q

The dose to the central slice plus the dose from the scatter into nearby slices equals

A

MSAD

59
Q

Which is now the preferred expression of radiation dose in CT dosimeter?

A

CTDI vol

60
Q

The relationship between mAs and dose is

A

Linear; the higher the mAs, the higher the dose

61
Q

When looking at the overall radiation dose from radiologic sources, CT contributes

A

A disproportionately high percentage of the total

62
Q

Keeping in mind how a parent will perceive risk to their child, guidelines have been outlined for CT examinations of pediatric patients. Which of the following is NOT one of the recommendations?

A

The parent should sign a consent from acknowledging that out of every 100 children who undergo CT examination, 1 will develop a fatal cancer in life

63
Q

The latency time for cancer induction in the dose ranges used in CT is estimated to be between

A

10-30 years

64
Q

Children are more radiosensitive than adults for all of the following reasons EXCEPT

A

In children the latency time for cancer induction is only a few months

65
Q

Which of the following are strategy that may reduce the radiation dose to the patient?

A

Adjusting mAs to suit individual patient size
Avoid increasing kVP beyond 120
Increasing pitch
Performing multiphase studies only when clinical indications exist

Computed Tomography (2 decks)

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