Question Set 4
Patient Care
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Study Questions
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1.)
The ARRT Standard of Ethics is comprised
of what?
The Code of Ethics and the Rules of Ethics.
2.)
T/F: The ARRT does not review, evaluate, or endorse publications.
True
3.)
The ARRT Standard of ethics is ____________.
aspirational
4.)
T/F: Interpretation and diagnosis are outside the sc
ope of practice for the
profession.
True
5.)
The ARRT Code of Ethics offers __________ for ethical conduct.
suggestions
6.)
The ARRT Rules of Ethics are __________ policies that are _________, if
___________.
enforceable, punishable, if violated
7.)
Why were the ARRT Rules of Ethics created?
To safeguard the patients comfort and safety
8.)
Violating the ARRT Rules of Ethics is subject to ___________.
sanctions
9.)
What are the three goals of the Patients Bill of Rights and Responsibilities?
1.
To strengthen consumer confidence that the health care system is
fair and responsive to consumer needs
2.
To reaffirm the importance of a strong relationship between
patients and their health care providers
3.
To reaffirm the critical role consumers play in sa
feguarding their
own health
10.)
What are the 7 sets of patient rights?
1.
The right to Information
2.
The right to Choose
3.
Access to Emergency Services
4.
Being a Full Partner in Health Care Decisions
5.
Care Without Discrimination
6.
The Right to Privacy
7.
The Right to
Speedy Complaint Resolution
11.)
What is the one responsibility of the patient?
Patients must take greater responsibility for maintaining good health.
12.)
What do we call the State laws that have been developed to govern
communication between health c
are providers and patients?
Informed Consent Laws
13.)
What determines weather consent may be given verbally or if it must be
given in
writing?
The individual State Laws
14.)
T/F: In some states, for procedures that entail greater risks, informed
c
onsent may
only be obtained by a physician.
True
15.)
When is the only time that a patient’s consent may be presumed rather than
obtained?
In an emergency situation.
16.)
What does PHI stand for in regards to HIPAA.
Protected Health Information
1
7.)
T/F:
PHI may legally be used for activities such as teaching, business and
management operations, disclosures required by law, and public health and
other
governmental reporting.
True
18.)
T/F: As a Technologist you must be a patient advocate fir
st and an assistant
to the
physician second.
True
19.)
Define Malpractice.
Malpractice is the failure to do something that a reasonable person, guided
by those considerations which ordinarily regulate human affairs, would
do.
20.)
Define Negl
igence.
Negligence is a breach or failure to fulfill the expected standard of care.
21.)
What must be demonstrated in a lawsuit in order to prove negligence?
1.
Duty
2.
Breach of Duty
3.
Injury
4.
Cause of Injury
22.)
T/F: As a Technologist, you are responsible f
or your own negligent acts,
regardless if another medical professional advises you to act in the negligent
fashion
.
True
23.)
List 4 key screening issues.
1.
The reason for the exam
2.
The potential for pregnancy
3.
The patient’s medical history
4.
The values of
lab tests
24.)
T/F: If there is a discrepancy between the study ordered on the paperwork
and the
one described by the patient, further clarification must be sought.
True
25.)
By asking extensive questions about the patient’s medical history there are
actually two pieces of information we are trying to learn. What are they?
1.
Does the patient have any conditions or tendencies to be intolerant
to a contrast agent?
2.
Does the patient have any history of prior surgeries or treatments
we would expect to cau
se the CT images of this patient to differ
from normal anatomy?
26.)
Why might it be important to ask the patient if they have had had radiation
therapy?
Because scarring caused by radiation therapy mimics lung disease.
27.)
What questions should be as
ked during screening for contrast agents?
1.
Previous reaction to contrast?
2.
Allergies to iodine or barium?
3.
Conditions such as hypertension, heart disease, asthma, sickle cell
anemia, renal impairment or diabetes?
28.)
What are the two types of lab results im
portant to CT?
1.
Tests to determine renal function
2.
Tests to determine the bloods ability to coagulate
29.)
What are the two tests that determine renal function?
BUN and Creatinine
30.)
What does BUN provide?
It provides information about the kidney’s
ability to remove impurities
from the blood.
31.)
What does an elevated BUN indicate the possibility of?
Renal Disease
32.)
What is the normal/acceptable range for BUN values?
5 to 25 mg/dl
33.)
Why can an elevated
creatinine
level be a contraindi
cation for
IV contrast?
Creatinine is a waste product of muscle contraction that is normally
filtered out of the body by the kidneys. Elevated creatinine levels may
indicate impairment of the function of the kidneys.
34.)
What is the normal range
for creatinine?
.6 to 1.7 mg/dl
35.)
What are the three tests that determine the bloods ability to coagulate?
1.
Prothrombin Time (PT)
2.
Partial Thromboplastin Time (PTT)
3.
Platelet Count
36.)
T/F: Platelets are small cell fragments that do not contain a n
ucleus.
True
37.)
What two tests asses the series of chemical interactions required to form a
blood
clot?
PT and PTT
38.)
What are the typically accepted values for PT, PTT and Platelet count?
PT =
10 to 14 seconds
PTT =
20 to 40 seconds
Platelet Count =
150,000/mm³ to 400,000/mm³
39.)
What are the two ways that x
-
rays which penetrate the tissues can cause
damage
to the body?
1.
By breaking electron bonds and forming ion pairs (Indirect Effect)
(more likely)
2.
By directly disrupting the DNA
bonds within the nuclei of cells in
the patient’s body (Direct Effect)(less likely)
40.)
As a result of radiation exposure during pregnancy, there is an increased
incidence of what?
Prenatal deaths
Abnormalities
Mental Retardation
Neonatal Deaths due to
complications
41.)
When dealing with strictly x
-
rays, what is the most common unit for
measuring
absorbed radiation dosage?
The rad
42.)
How much radiation is in 1 rad?
1 rad = 0.01 joules of energy per kilogram of matter (the patients weight)
43.)
Radiation strictly from x
-
rays is measured in _____ or ______. Sv and rem
are
used to measure __________________ radiation.
rad or Gy (Gray), any kind of
44.)
rem and Sievert are a measurement of what?
“Effective Dose” or “Dose Equivalent”
45.)
Wh
at is the average annual radiation dose equivalent from radon?
2 rem
46.)
The _________ the distance traveled through the tissue and the ________ the
tissue the x
-
ray photons penetrate, the more the dose is decreased along the
photons’
path.
great
er, denser
47.)
What are the typical skin radiation doses for CT scans of the head, body and
the
localizer scan?
Head Scan
1
-
5 rads
Body Scan
2
-
6 rads
Localizer Scan
0.05
-
0.1 rads
48.)
What is the approximate Skin Dose and Center Dose for a 30 s
lice CT study?
Skin Dose
5 rad
Center Dose
1 rad
49.)
What is the approximate Skin Dose and Center Dose for 1 radiography film?
Skin Dose
.5 rad
Center Dose
0.15 rad
50.)
What is the approximate Skin Dose and Center Dose for 5 radiography
film
s?
Skin Dose
2.5 rad
Center Dose
0.75 rad
51.)
What do we call radiation that extends outside of the intended slice?
Radiation Penumbra
52.)
How is the actual dose from multiple adjacent slices measured?
By an important indicator of radiation do
se called the CT dose index, or
CTDI.
53.)
The ___________ is an indicator of radiation dose which includes the
radiation
located within the intended slice thickness as well as that from the
penumbra.
The CT Dose Index or CTDI
54.)
T/F: The CTDI d
oes not factor in the variation in dose due to gaps or
overlaps in
adjacent slices.
True
55.)
The ________ assumes that consecutive slices are contiguous.
CTDI
56.)
In order to account for gaps or overlaps between adjacent slices there is
another
i
ndicator of dose called the _____________________________.
Multiple Slice Average
Dose
or MSAD
57.)
The MSAD is _________ than the CTDI when the slices or loops of the helix
overlap and the MSAD is ___________ than the DTDI when there are gaps
gr
eater, lower
58.)
T/F: The more slices collected by the MDCT scanner in a single rotation, the
less
the penumbra effect adds to the total patient dose.
True
59.)
There is no federally imposed limit to radiation exposure.
True
60.)
T/F: The further
the CT Tube is situated from the patient, the lower the
absorbed
dose.
True
61.)
How does varying the collimation affect the dose for that slice?
Collimation determines the radiation penumbra and it also affects scatter
radiation.
62.)
T/F: C
ollecting multiple slices at the same time on a MDCT scanner delivers
more dose to the patient than does conventional or serial scanning.
True
63.)
Why was dose
-
optimized software developed?
As a response to the realization that the newer scanners (
MDCT) would
otherwise increase the dose to the patient.
64.)
What does the dose
-
optimized software do?
It automatically adjusts the mA
65.)
What are the four hardware factors affecting dose?
1.
X
-
ray tube to patient distance
2.
Filtration
3.
Pre
-
patient Coll
imation
4.
Multi
-
row detector design along with dose minimizing software
66.)
Manufacturers claim that their dose
-
optimizing software which
automatically
varies the mA allows for dose reductions ranging from ______
% to ______%.
15% to 55%.
67.)
What are
some other features for minimizing the radiation dose to the
patient
found on new CT scanners?
“Noise Reduction Algorithms
I
mprovements in the efficiency of the detectors
68.)
There is a __________ relationship between mAs and dose.
Linear
69.)
T/F:
kVp is usually only decreased to minimize dose in small patients.
True
70.)
Slice thickness really only affects the dose to the patient on MDCT scanners.
False: Slice thickness really only affect the dose to the patient on single
-
row detector s
canners.
71.)
T/F: For MDCT scanners, the slice thickness always affects the dose.
False: For MDCT scanners, the slice thickness does not affect the dose.
72.)
What are some other ways to minimize dose?
Reduce repeat scans
Reformat rather than re
-
s
can
Reduce multiple scans
73.)
During the CT scan, the patient should be monitored both __________ and
____________.
visually and verbally
74.)
If a patient is sedated, what type of monitoring device is recommended?
A Pulse Oximeter
75.)
How do you
identify Cardiac Arrest?
No Pulse
No respiration
Vomiting
Seizure
Damp bluish or grayish skin tone
Incontinence or defecation
76.)
What are some signs of a Seizure?
Uncontrollable muscular contractions
Facial Twitching
Blank facial expression
Loss of mot
or activity
Difficulty breathing
Confusion
77.)
What should you do if your patient is having a seizure?
All restraints and objects that could cause harm should be removed and the
patient should be eased into a resting position (e.g., on the patient ta
ble, a
chair, or the floor).
78.)
What results from a lack of blood flow to the brain?
Stroke
79.)
What are some signs of a stroke?
Inability to communicate
bilateral or unilateral numbness or paralysis
Pupil disparity
Incontinence
Hypertension
80
.)
What should be done when a patient has a stroke?
Monitor vital signs frequently
Prepare patient for airway ventilation, suction, intravenous fluids
and possible CPR
81.)
What results from insufficient blood flow to the tissues and vital organs?
Shoc
k
82.)
What can cause shock?
Loss of blood volume
Sudden massive vasodilation
83.)
What type of shock occurs from IV contrast injection?
Anaphylactic shock (sudden massive vasodilation)
84.)
What are some signs of shock?
Altered levels of consciousn
ess
Hypotension
Cool bluish or grayish skin tone
Tachycardia
Restlessness
85
.)
What are the key vital signs and their normal values?
1.
Temperature:
Orally
97˚ F to 99˚ F
Axilla
96.5˚ F to 98.5˚ F
Rectal
97.5˚ F to 99.5˚ F
2.
Pulse:
Adult
70 to 100 BPM
Athletic
45 to 60 BPM
Child
95 to 110 BPM
Infant
100 to 180 BPM
3.
Blood Pressure
:
Systolic
Diastolic
Adult
90
-
140
60
-
90
Childr
en
85
-
130
45
-
85
4.
Respiratory rate
:
Respirations/minute
Adults
12
-
20
Children
15
-
30
Infants
25
-
50
86
.)
How should you treat a patient experiencing shock?
They should be kept warm with legs elevated (provided there are no
bleeding wounds i
n the upper body or head). If it is anaphylactic shock a
medication such as epinephrine can be administered.
87.)
How accurately should temperatures be recorded?
To the nearest tenth of a degree
88.)
What do we call the rules that all health care w
orkers must follow in order to
minimize the spread of infection?
Standard or Universal Precautions
89.)
When and why was the necessity for universal precautions first identified?
In the mid 1980s as a result of the HIV epidemic
90.)
Give three exam
ples of bloodborne pathogens.
1.
Hepatitis B
2.
Hepatitis C
3.
HIV
91.)
In 1996 the definition and recommendations for Universal Precautions was
revised and given a new name. What was that name?
Standard Precautions
92.)
What body substances does st
andard precautions apply to?
Blood
Body Fluids
Secretions
Excretions (except sweat)
Non
-
Intact Skin
Mucous Membranes
93.)
What are some of the more common standard precaution procedures?
Handwashing
Gloves
Mask, Eye Protection, Face Shield
Gowns
Steriliz
ing Equipment
Linens
Needles
Patient placement
94.)
What form of infection transmission occurs by dissemination of either
airborn
e
droplet nuclei (small
-
particle residue [5 um or smaller in size] of
evaporated droplets that
m
ay remain suspended in the
air f
or long periods of
time) or dust particles containing the
infectious agent?
Airborne Transmission
95.)
What do we call the precautions associated with airborne infection
transmission?
Airborne Precautions
96.)
List the Airborne Precautions.
N
egative air pressure in room (6 to 12 air changes per hour)
Wear N95 respirator into room
Place mask on patient if transport is necessary
97.)
What type of infection transmission involves contact of the conjunctivae or
the
mucous membranes of the nose or
mouth of a susceptible person with
large
-
particle
droplets (larger than 5 um in size) containing microorganisms
generated from an infected
person.
Droplet Transmission
98.)
What do we call the precautions used when dealing with droplet infection
tran
smission?
Droplet Precautions
99.)
List the Droplet Precautions.
Maintain at least 3 feet between infected patients and other patients
The door may remain open
Wear a mask when working within 3 feet of the patient
Mask patient during transport if possible
100.)
H
ow far can droplets travel?
Up to 3 feet
101.)
Which type of precautions are designed to reduce the risk of transmission of
epidemiologically important microorganisms by direct contact?
Contact Precau
tions
102.)
L
ist the Contact Precautions.
Gloves and Handwashing
Wear a Gown
Wear Gloves and gown during transport
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