--------------------------------------------------------------------------------- Study Questions ---------------------------------------------------------------------------------

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