Patient Care

Question 1

A patient is required to have the following radiographic examinations:

CT of the abdomen, GI series, and a barium enema. The correct order for the scheduling of these procedures would be:

A. barium enema, GI series, CT of the abdomen.

B. GI series, CT of the abdomen, barium enema.

C. CT of the abdomen, GI series, barium enema.

D. CT of the abdomen, barium enema, GI series.

Answer 1

D. CT of the abdomen, barium enema, GI series.

The correct order for the scheduling of these procedures would be the CT study followed by the barium enema, with the GI series last. Dense barium causes a streak artifact on the CT image, so it is important that computed tomography be performed first. The barium administered during a GI series could interfere with interpretation of a diagnostic enema study.

Question 2

Patient preparation for a CT examination of the abdomen and pelvis may include which of the following?

1. NPO for 4 hours prior to the study
2. Digestion of a fatty meal 1 hour prior to the study.
3. Refraining from urination for 2 hours prior to the study

A. 1 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 2

A. 1 only

Each hospital or private outpatient facility has its own specific protocols regarding patient preparation for CT examinations. However, when possible, all protocols should have patients refrain from eating for some time prior to the scheduled examination. Avoiding eating before a CT scan of the abdomen and pelvis reduces nausea and vomiting from contrast medium injections, decreases patient discomfort from bladder filling during the study, and ensures gastric emptying for more accurate diagnoses. An empty stomach also makes it easier for the patient to consume the necessary oral contrast agent.

Question 3

Patient preparation for a contrast-enhanced CT examination of the chest may include:

A. NPO for 4 hours prior to the examination.

B. low-residue diet for 12 to 24 hours prior to the examination.

C. cleansing enema on the day preceding the examination.

D. no preparation necessary.

Answer 3

A. NPO for 4 hours prior to the examination.

The patient should have nothing by mouth (NPO) for several hours prior to a contrast-enhanced CT examination of the chest. This practice reduces the incidence of nausea, vomiting, and possible aspiration of contrast material.

Question 4

Which of the following laboratory values is used to measure the coagulation ability of a patient prior to an invasive CT study?

1. PTT
2. Hematocrit
3. PT

A. 1 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 4

B. 1 and 3 only

The coagulation capabilities of a patient may be evaluated with the measurement of prothrombin time (PT) and partial thromboplastin time (PTT). Each of these laboratory values attempts to detect deficiencies in the various clotting factors. Hematocrit is the concentration of red blood cells within the total volume of blood; it may be used to evaluate the hydration status of a patient.

Question 5

The normal pulse rate range in a child is:

A. 30 to 50 beats per minute.

B. 60 to 100 beats per minute.

C. 70 to 120 beats per minute.

D. 110 to 150 beats per minute

Answer 5

C. 70 to 120 beats per minute.

The normal range for pulse rate in a child is 70 to 120 beats per minute. This is slightly higher than the range of 60 to 100 beats per minute for an adult.

Question 6

The average range for normal prothrombin (PT) time is approximately:

A. 3 to 5 seconds.

B. 7 to 9 seconds.

C. 12 to 15 seconds.

D. 18 to 23 seconds.

Answer 6

C. 12 to 15 seconds.

Normal prothrombin (PT) times are laboratory-specific and range between approximately 11 and 15 seconds. This test is used to evaluate the coagulation ability of a patient scheduled to undergo an invasive CT procedure.

Question 7

The acronym PTT is used for which of the following laboratory tests?

A. Prothrombin time

B. Passive tachycardia test

C. Partial prothrombin time

D. Partial thromboplastin time

Answer 7

D. Partial thromboplastin time

The partial thromboplastin time indicates the coagulation time of a patient’s blood. It is often abbreviated as PTT.

Question 8

The normal platelet count range for an adult is:

A. 30,000 to 45,000/μL of blood.

B. 75,000 to 125,000/μL of blood.

C. 140,000 to 440,000/μL of blood.

D. 450,000 to 700,000/μL of blood.

Answer 8

C. 140,000 to 440,000/μL of blood.

The other options are incorrect.

Question 9

A normal range for systolic blood pressure in an adult is:

A. 40 to 60 mm Hg.

B. 60 to 90 mm Hg.

C. 80 to 120 mm Hg.

D. 95 to 140 mm Hg.

Answer 9

D. 95 to 140 mm Hg.

The normal range for systolic blood pressure in adults is 95 to 140 mm Hg. Systolic pressure is the measurement of blood pressure at its peak during contraction of the heart.

Question 10

The normal range of respirations for an adult is:

A. 5 to 10 breaths per minute.

B. 12 to 20 breaths per minute.

C. 20 to 30 breaths per minute.

D. 35 to 50 breaths per minute

Answer 10

B. 12 to 20 breaths per minute.

The normal range for adult respirations is 12 to 20 breaths per minute.

Question 11

The average range for normal adult BUN levels is approximately:

A. 1 to 4 mg/dL.

B. 5 to 20 mg/dL.

C. 23 to 30 mg/dL.

D. 45 to 60 mg/dL

Answer 11

B. 5 to 20 mg/dL.

The average range for normal adult blood urea nitrogen (BUN) levels is approximately 5 to 20 mg/dL.

Question 12

The portion of the cardiac cycle in which the heart muscle is in relaxation is termed:

A. systole.

B. diastole.

C. fibrillation.

D. interphase.

Answer 12

B. diastole.

Diastole is the period of time when the heart muscle is relaxing. Ventricular diastole is relaxation of the ventricles, whereas atrial diastole is relaxation of the atria.

Question 13

Which of the following refers to the period of the cardiac cycle known as complete cardiac diastole?

1. Relaxation of the left and right ventricles
2. Relaxation of the left and right atria
3. The T wave of the electrocardiogram (ECG)

A. 1 only

B. 2 only

C. 1 and 2 only

D. 1, 2, and 3

Answer 13

D. 1, 2, and 3

Complete cardiac diastole corresponds to the period of relaxation of the heart muscle. It consists of ventricular and atrial diastole and is indicated by the T wave of an electrocardiogram (ECG).

Question 14

Cardiac CT images are typically acquired during which phase of the heart’s cycle?

A. Systolic phase

B. Equilibrium phase

C. Diastolic phase

D. Ejection phase

Answer 14

C. Diastolic phase

The heart is optimally imaged with the least artifact from motion during its period of relaxation, otherwise known as the diastolic phase of the cardiac cycle.

Question 15

The normal range for the International Normalized Ratio (INR) for prothrombin time (PT) results is:

A. 0.2 to 0.5.

B. 0.8 to 1.2.

C. 2.2 to 3.5.

D. 6.1 to 8.6.

Answer 15

B. 0.8 to 1.2.

The INR compares a patient’s PT with a control sample for a more accurate result. The normal range for INR is 0.8 to 1.2.

Question 16

Parenteral contrast administration refers to which of the following?

A. Oral administration

B. Rectal administration

C. Intravenous administration

D. Nasogastric administration

Answer 16

C. Intravenous administration

The injection of a medication or contrast agent directly into the bloodstream is a type of parenteral administration. Other parenteral routes include intramuscular, subcutaneous, intradermal, and intrathecal.

Question 17

Which of the following terms describes a condition in which cerebral ischemia is caused by systemic hypotension?

A. Vasovagal reaction

B. Myocardial infarction

C. Transient ischemic attack

D. Hydrocephalus

Answer 17

A. Vasovagal reaction

The term vasovagal pertains to systemic hypotension often leading to cerebral ischemia.

Question 18

A patient has a severe vagal reaction to iodinated contrast material that includes bradycardia. Initial treatment may consist of:

A. atropine.

B. diazepam.

C. Zantac.

D. Proventil.

Answer 18

A. atropine.

Patients suffering from vagal reactions to iodinated contrast agents present with hypotension and bradycardia. Treatment includes increasing blood pressure with IV fluids and intravenous administration of atropine to block vagal stimulation of the heart.

Question 19

A high-osmolar contrast material has an average osmolality of:

A. 100 to 300 mOsm/kg water.

B. 600 to 850 mOsm/kg water.

C. 1000 to 2400 mOsm/kg water.

D. 4000 to 7000 mOsm/kg water.

Answer 19

C. 1000 to 2400 mOsm/kg water.

The osmolality of a contrast material is a measure of the number of particles per kg of water. Osmolality is a factor in determining the potential for adverse reactions to iodinated contrast material. Ionic contrast media, which dissolve into a large number of anions and cations in solution, have an average osmolality between 1000 and 2400 mOsm/kg.

Question 20

Which of the following is an advantage of nonionic contrast media over ionic media?

A. Lower cost

B. Decreased nephrotoxicity

C. Decreased enhancement

D. Reduced incidence of adverse reaction

Answer 20

D. Reduced incidence of adverse reaction

Nonionic contrast material is associated with a lower incidence of adverse reactions than to ionic media. Nonionic media are also higher in cost but unfortunately offer no reduction in renal toxicity.

Question 21

The maximum dose of intravenous iodinated contrast for a child should not exceed:

A. 1 mg/kg body weight.

B. 3 mg/kg body weight.

C. 5 mg/kg body weight.

D. 10 mg/kg body weight.

Answer 21

B. 3 mg/kg body weight.

The maximum dose of intravenous iodinated contrast agent should not exceed 3 mg/kg of body weight during pediatric CT examinations. Contrast loads in excess of this limit have been reported to cause acute osmolar poisoning in children.

Question 22

Which of the following is/are included in the signs and symptoms of hypovolemic shock?

1. Hypertension
2. Oliguria
3. Pallor

A. 1 only

B. 1 and 3 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 22

C. 2 and 3 only

Hypovolemic shock is caused by an insufficient volume of circulating blood. The common signs and symptoms of hypovolemic shock are pallor (absence of color in the skin), hypotension, tachycardia, and oliguria (decreased urine production).

Question 23

Parenteral routes of medication administration include which of the following?

1. Subcutaneous
2. Intradermal
3. Transdermal

A. 1 only

B. 1 and 2 only

C. 2 and 3 only

D. 1, 2, and 3

Answer 23

B. 1 and 2 only

Parenteral routes of medication administration include intramuscular, intravenous, intradermal, and subcutaneous.

Question 24

The plasma half-life of intravenously administered iodinated contrast material is approximately:

A. 30 minutes.

B. 60 minutes.

C. 2 hours.

D. 12 hours.

Answer 24

C. 2 hours.

After approximately 2 hours, the percentage of iodinated contrast material in blood plasma is reduced to half of the administered volume.

Question 25

Which of the following is not a category of isolation technique?

A. Enteric precautions

B. Gram-negative isolation

C. Contact isolation

D. Strict isolation

Answer 25

B. Gram-negative isolation

The categories of isolation technique are drainage-secretion precautions, enteric precautions, acid-fast bacillus isolation, respiratory isolation; contact isolation, and strict isolation.

Question 26

Which of the following is the correct order for the stages of infection?

A. Incubation, prodromal, active, convalescence

B. Convalescence, active, prodromal, incubation

C. Prodromal, incubation, convalescence, active

D. Incubation, convalescence, prodromal, active

Answer 26

A. Incubation, prodromal, active, convalescence

The course of an infection can be divided into four stages. The incubation stage begins when a pathogenic organism enters the host. The prodromal stage is characterized by the appearance of early signs and symptoms of the disease process. The active or full stage consists of the maximum appearance of the signs and symptoms of the disease. During the last stage, convalescence, the symptoms begin to diminish and may eventually completely subside.

Question 27

Infection may occur indirectly through contact with contaminated objects known as:

A. vectors.

B. fomites.

C. vehicles.

D. hosts.

Answer 27

B. fomites.

Fomites are objects that have been contaminated by an infectious organism or microbe. The spread of the infection may occur when someone comes in contact with the fomite. This is an indirect means of infection transmission.

Question 28

Which of the following types of isolation precautions is used to protect immunosuppressed patients from possible infection?

A. Enteric precautions

B. Strict isolation

C. Contact isolation

D. Drainage-secretion precautions

Answer 28

B. Strict isolation

Strict isolation is used with patients at risk of infection because of immunosuppression or some other form of debilitative disease. This type of precaution technique was previously referred to as “protective” or “reverse” isolation.

Question 29

The addition of __________ makes an autoclave more efficient at sterilization than an oven.

A. antiseptic solution

B. moisture

C. extreme pressure

D. ultraviolet light

Answer 29

B. moisture

An autoclave is a mechanical device used for sterilization. It involves the use of heat and steam under pressure to eliminate microbes. An oven uses only high heat and is not as efficient as an autoclave.