transmission-based precautions: airborne, droplet, and

Review Notes for the contact. Under these guidelines, some conditions or diseases
RADIOGRAPHY EXAM can fall into more than one category. Airborne precautions are
employed with patients suspected or known to be infected with
Chapter 1: Patient Care the tubercle bacillus (TB), chickenpox (varicella), or measles
Notes: (rubeola). Airborne precautions require that the patient wear a
mask to avoid the spread of bronchial secretions or other
1. Instruments required to assess vital signs include pathogens during coughing. If the patient is unable or unwilling
1. a thermometer. to wear a mask, the radiographer must wear one. The
2. a tongue blade. radiographer should wear gloves, but a gown is required only if
3. a watch with a second hand. flagrant contamination is likely. Patients under airborne
(A) 1 only precautions require a private, specially ventilated (negative-
(B) 1 and 2 only pressure) room. A private room is also indicated for all patients
(C) 1 and 3 only on droplet precautions, i.e., with diseases transmitted via large
(D) 1, 2, and 3 droplets expelled from the patient while speaking, sneezing, or
——————————————————————— coughing. The pathogenic droplets can infect others when they
—— come in contact with mouth or nasal mucosa or conjunctiva.
The four vital signs are temperature, pulse, respiration, and Rubella ("German measles"), mumps, and influenza are
blood pressure. Because radiographers may be required to among the diseases spread by droplet contact; a private room
take vital signs in an emergency, they should practice these is required for the patient, and health-care practitioners should
skills. A thermometer is required to take the patient's use gown and gloves. Any diseases spread by direct or close
temperature. A watch with a second hand is required to take contact, such as MRSA (methicillin-resistant Staphylococcus
the patient's pulse and respiration. To measure blood pressure, aureus), conjunctivitis, and hepatitis A, require contact
a blood pressure cuff, sphygmomanometer, and stethoscope precautions. Contact precautions require a private patient room
are required. This is the skill that the radiographer should and the use of gloves, mask, and gown for anyone coming in
practice most frequently, as it is the one most likely to be direct contact with the infected individual or his or her
needed in an emergency situation. A tongue blade is used to environment. (Adler & Carlton, p 215)
depress the tongue for inspection of the throat and is not used
in vital sign assessment. (Torres, p 128) 5. What is the most widely used method of vascular
catheterization?
2. An esophagogram might be requested for patients with (A) Doppler
which of the following esophageal disorders/symptoms? (B) Moniz
1. Varices (C) Grandy
2. Achalasia (D) Seldinger
3. Dysphasia ———————————————————————
(A) 1 only ——
(B) 1 and 2 only With the Seldinger technique, a needle with an inner cannula is
(C) 1 and 3 only used to pierce an artery (usually the femoral). The inner
(D) 1, 2, and 3 cannula is then removed, a flexible guidewire is inserted, the
——————————————————————— needle is removed, and a catheter is slippedover the guidewire
—— into the artery. The guidewire is then removed, leaving the
Dilated twisted veins, or varices, of the esophagus are catheter in the artery. The Seldinger technique reduces the risk
frequently associated with obstructive liver disease or cirrhosis of extravasation (compared to that from a direct needle stick).
of the liver. These esophageal veins enlarge and can rupture, The patient may be positioned as required, andthe radiographs
causing serious hemorrhage. Achalasia is dilation of the may be inspected while the catheter remains safely in place.
esophagus as a result of the cardiac sphincter's failure to relax The axial or brachial arteries may be used, but the femoral is
and allow food to pass into the stomach. Dysphasia is a the most common approach. Doppler is an ultrasonography
speech impairment resulting from a brain lesion; it is unrelated term referring to the detection of movement (e.g., blood flow
to the esophagus. Dysphagia refers to difficulty swallowing and through blood vessels). The Grandy method describes the
is the most common esophageal complaint. Hiatal hernia is routine lateral projection of the cervical spine. Egaz Moniz
another common esophageal problem; it is characterized by introduced cerebral angiography in 1927. (Ballinger & Frank,
protrusion of a portion of the stomach through the cardiac vol 3, pp 30-31)
sphincter. It is a common condition, and many individuals with
the condition are asymptomatic. Each of these conditions of 6. When a patient with an arm injury needs help in undressing,
the esophagus may be evaluated with an esophagogram. the radiographer should
Positions usually include the posteroanterior, right anterior (A) remove clothing from the injured arm first.
oblique, and right lateral. (Linn-Watson, pp 102, 107) (B) remove clothing from the uninjured arm first.
(C) always remove clothing from the left arm first.
3. The diameter of a needle is termed its (D) always cut clothing away from the injured extremity.
(A) bevel. ———————————————————————
(B) gauge. ——
(C) hub. When assisting the patient with changing, first remove clothing
(D) length. from the unaffected side. If this is done, removing clothing from
——————————————————————— the affected side will require less movement and effort. The
—— patient's clothing should be cut away only as a last resort in
The diameter of a needle is the needle's gauge. The higher the cases of extreme emergency and with the patient's consent.
gauge number, the smaller the diameter and the thinner the (Torres, p 88)
needle. For example, a very tiny-gauge needle (25 gauge) may
be used on a pediatric patient for an intravenous injection, 7. When reviewing patient blood chemistry levels, what is
whereas a large-gauge needle (16 gauge) may be used for considered the normal creatinine range?
donating blood. The hub of a needle is the portion of the (A) 0.6 to 1.5 mg/100 mL
needle that attaches to a syringe. The length of the needle (B) 4.5 to 6 mg/100 mL
varies depending on its use. A longer needle is needed for (C) 8 to 25 mg/100 mL
intramuscular injections, whereas a shorter needle is used for (D) Up to 50 mg/100 mL
subcutaneous injection. The bevel of the needle is the slanted ———————————————————————
tip of the needle. For intravenous injections, the bevel should ——
always face up. (Adler & Carlton, p 294) Creatinine is a normal alkaline constituent of urine and blood,
but increased quantities of creatinine are present in advanced
4. What type of precautions prevents the spread of infectious stages of renal disease. Creatinine and BUN blood chemistry
agents in aerosol form? levels should be checked prior to beginning an intravenous
(A) Strict isolation pyelogram. Increased levels may forecast an increased
(B) Protective isolation possibility of contrast-media induced renal effects and poor
(C) Airborne precautions visualization of the renal collecting systems. The normal
(D) Contact precautions creatinine range is 0.6 to 1.5 mg/100 mL. The normal BUN
——————————————————————— range is 8 to 25 mg/100 mL. (Ballinger & Frank, vol 2, p 126)
——
Category-specific isolations have been replaced by 8. Pulmonary fibrosis can result from the inhalation of dust

1
Property of Hamilcar Eldo B. Chanjueco
particles; this is characteristic of Therefore, the geriatric patient requires extra-gentle treatment.
(A) cystic fibrosis. A mattress pad should always be placed on the radiographic
(B) chronic asthma. table to help prevent skin injury or abrasions. If tape is
(C) pneumoconiosis. required, paper tape should be used instead of adhesive.
(D) pleural effusion. Geriatric patients are also more sensitive to hypothermia
——————————————————————— because of breakdown of the sweat glands and should always
—— be kept covered, both to preserve modesty and for extra
Pneumoconiosis is a condition of the respiratory tract caused warmth. Loss of sensation in the skin increases pain tolerance,
by the occupational inhalation of dust particles and resulting in and so the geriatric patient may not be aware of excessive
pulmonary fibrosis. Silicosis is a serious type of stress on bony prominences like the elbow, wrist, coccyx, and
pneumoconiosis. High-risk occupations for pneumoconiosis ankles. (Dowd & Wilson, vol 2, p 1026)
are mining and stonecutting. Asthma is a kind of COPD.
Pleural effusion is characterized by a collection of fluid in the 13. When a GI series has been requested on a patient with a
pleural cavity and is usually a manifestation of serious suspected perforated ulcer, the type of contrast medium that
underlying disease. Cystic fibrosis is a hereditary disorder that should be used is
affects the function of not only the lungs, but also many (A) thin barium sulfate suspension.
exocrine glands. (Carlton & Adler, p 258) (B) thick barium sulfate suspension.
(C) water-soluble iodinated media.
9. You receive a patient who is complaining of pain in the area (D) oil-based iodinated media.
of the left fourth and fifth metatarsals; however, the requisition ———————————————————————
asks for a left ankle exam. What should you do? ——
(A) Perform a left foot exam. Whenever a perforation of the GI tract is suspected, a water-
(B) Perform a left ankle exam. soluble contrast agent (such as Gastrografin or oral Hypaque)
(C) Perform both a left foot and a left ankle exam. should be used because it is easily absorbed from within the
(D) Check with the referring physician. peritoneal cavity. Leakage of barium sulfate into the peritoneal
——————————————————————— cavity can have serious consequences. Water-soluble contrast
—— agents may also be used in place of barium sulfate when the
Although it is never the responsibility of the radiographer to possibility of barium impaction exists. Oil based contrast
diagnose, it is the responsibility of every radiographer to be agents are rarely used today. (Ballinger & Frank, vol 2, p 94)
alert. The patient should not be subjected to unnecessary
radiation from an unwanted exam. Rather, it is the 14. The complete killing of all microorganisms is termed
radiographer's responsibility to check with the referring (A) surgical asepsis.
physician and report the patient's complaint. (Ehrlich & (B) medical asepsis.
McCloskey, p 14) (C) sterilization.
(D) disinfection.
10. In what order should the following exams be performed? ———————————————————————
1. Upper GI ——
2. Intravenous pyelogram (IVP) The complete killing of all microorganisms is termed
3. Barium enema sterilization. Surgical asepsis refers to the technique used to
(A) 3, 1, 2 prevent contamination when performing procedures. Medical
(B) 1, 3, 2 asepsis refers to practices that reduce the spread of microbes,
(C) 2, 1, 3 and therefore the chance of spreading disease or infection.
(D) 2, 3, 1 Handwashing is an example of medical asepsis. It reduces the
——————————————————————— spread of infection, but does not eliminate all microorganisms.
—— Disinfection involves the use of chemicals to either inactivate
When scheduling patient examinations, it is important to avoid or inhibit the growth of microbes. (Adler & Carlton, p 200)
the possibility of residual contrast medium covering areas that
will be of interest on later examinations. The IVP should be 15. Which ethical principle is related to the theory that patients
scheduled first because the contrast medium used is excreted have the right to decide what will or will not be done to them?
rapidly. The barium enema should be scheduled next. Finally, (A) Autonomy
the upper GI is scheduled. There should not be enough barium (B) Beneficence
remaining from the previous BE to interfere with the (C) Fidelity
examination of the stomach or duodenum, although a (D) Veracity
preliminary scout film should be taken in each case. (Torres, p ———————————————————————
212) ——
Autonomy is the ethical principle that is related to the theory
11. Symptoms of impending diabetic coma include that patients have the right to decide what will or will not be
1. increased urination. done to them. Beneficence is related to the idea of doing good
2. sweet-smelling breath. and being kind. Fidelity is faithfulness and loyalty. Veracity is
3. extreme thirst. not only telling the truth, but also not practicing deception.
(A) 1 and 2 only (Adler & Carlton, p 341)
(B) 1 and 3 only
(C) 2 and 3 only 16. Which of the following exams require(s) restriction of the
(D) 1, 2, and 3 patient's diet?
——————————————————————— 1. GI series
—— 2. Abdominal survey
When a diabetic patient misses an insulin injection, the body 3. Pyelogram
loses its ability to metabolize glucose, and ketoacidosis can (A) 1 only
occur. If this is not quickly corrected, the patient may become (B) 1 and 2 only
comatose. Symptoms of impending coma include increased (C) 1 and 3 only
urination,sweet (fruity) breath, and extreme thirst. Other (D) 2 and 3 only
symptoms are weakness and nausea. (Torres, p 159) ———————————————————————
——
12. Increased pain threshold, breakdown of skin, and atrophy A patient who is having a GI series is required to be NPO for at
of fat pads and sweat glands are all important considerations least 8 h prior to the exam; food or drink in the stomach can
when working with which group of patients? simulate disease. A patient who is scheduled for a pyelogram
(A) Infants must have the preceding meal withheld to avoid the possibility
(B) Children of aspirating vomitus in case of an allergic reaction. An
(C) Adolescents abdominal survey does not require the use of contrast media,
(D) Geriatric patients and no patient preparation is necessary. (Torres, pp 212-213)
———————————————————————
—— 17. While in your care for a radiologic procedure, a patient
Increased pain threshold, breakdown of skin, and atrophy of fat asks to see his chart. Which of the following is the appropriate
pads and sweat glands are all important considerations when response?
working with geriatric patients. Many changes occur as our (A) Inform the patient that the chart is for health-care providers
bodies age. Although muscle is replaced with fat, the amount to view, not the patient.
of subcutaneous fat is decreased, and the skin atrophies. (B) Inform the patient that you do not know where the chart is.

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Property of Hamilcar Eldo B. Chanjueco
(C) Inform the patient that he has the right to see his 21. The most effective method of sterilization is
chart, but that he should request to view it with his (A) dry heat.
physician, so that it is properly interpreted. (B) moist heat.
(D) Give the patient the chart and leave him alone for a few (C) pasteurization.
minutes to review it. (D) freezing.
———————————————————————
*If a patient in your care asks to see his or her chart, the ——
appropriate response is to refer the patient to his or her The most effective method of sterilization is moist heat, using
physician. A patient does have the right to review his or her steam under pressure. This is known as autoclaving.
own medical record; however, the patient should do so in the Sterilization with dry heat requires higher temperatures for
presence of the physician so that the patient does not longer periods of time than sterilization with moist heat.
misinterpret the information and so that the physician can Pasteurization is moderate heating with rapid cooling; it is
address concerns or answer questions. It is not appropriate to frequently used in the commercial preparation of milk and
hand over the chart to a patient, nor is it appropriate to deceive alcoholic beverages such as wine and beer. It is not a form of
the patient into believing that the chart is not available for sterilization. Freezing can also kill some microbes, but it is not
viewing or that the patient has no right to review the chart. a form of sterilization. (Torres, p 106)
(Adler & Carlton, p 343)
22. Local anesthetics are likely to be used in all of the following
01094B|Patient education, safety, and comfort radiographic examinations except
Skin discoloration due to cyanosis may be observed in the (A) lower-extremity arteriography.
1. gums. (B) arthrography.
2. nailbeds. (C) myelography.
3. thorax. (D) postoperative or T-tube cholangiography.
(A) 1 only ———————————————————————
(B) 1 and 2 only ——
(C) 3 only Local anesthetics are often used to alleviate the pain caused
(D) 1, 2, and 3 by the insertion of a large-caliber needle for the injection of
——————————————————————— contrast media, as in arteriography, arthrography, or
—— myelography. A T-tube cholangiogram is a postoperative
Cyanosis is a condition resulting from a deficiency of oxygen examination of the biliary tract. This examination is painless
circulating inthe blood. It is characterized by bluish and permits administration of the contrast medium via the T
discoloration of the gums, nailbeds, and earlobes, and around tube. (Ballinger & Frank, vol 2, p 78)
the mouth. Cyanosis may be accompanied by labored
breathing or other types of respiratory distress. (Torres, p 137) 23. The type of shock associated with pooling of blood in the
peripheral vessels is classified as
18. When disposing of contaminated needles, they are placed (A) neurogenic.
in a special container using what procedure? (B) cardiogenic.
(A) Recap the needle, remove the syringe, and dispose of the (C) hypovolemic.
needle. (D) septic.
(B) Do not recap the needle, remove the syringe, and dispose ———————————————————————
of the needle. ——
(C) Recap the needle and dispose of the entire syringe. The type of shock associated with the pooling of blood in the
(D) Do not recap the needle and dispose of the entire peripheral vessels is classified as neurogenic shock. This
syringe. occurs in cases of trauma to the central nervous system that
——————————————————————— results in decreased arterial resistance and pooling of blood in
—— peripheral vessels. Cardiogenic shock is related to cardiac
Most needle sticks occur during attempts to recap a needle. failure and results from interference with heart function. It can
Proper disposal of contaminatedneedles and syringes is occur in cases of cardiac tamponade, pulmonary embolus, or
becoming more vital as HIV, AIDS, and HBV reach epidemic myocardial infarction. Hypovolemic shock is related to loss of
proportions. To prevent the spread of any possible infection, large amounts of blood, either from internal bleeding or from
handle contaminated materials as little as possible. Therefore, hemorrhage associated with trauma. Septic shock, along with
do not attempt to recap a needle; instead, dispose of the entire anaphylactic shock, is generally classified as vasogenic shock.
syringe with the needle attached in the special container that is (Adler & Carlton, p 266)
available. (Torres, p 279)
24. When radiographing the elderly, it is helpful to
19. Radiographs are the property of the 1. move quickly.
(A) radiologist. 2. address them by their full name.
(B) patient. 3. give straightforward instructions.
(C) health-care institution. (A) 1 only
(D) referring physician. (B) 1 and 2 only
——————————————————————— (C) 2 and 3 only
—— (D) 1, 2, and 3
Radiographs are the property of the health-care institution and ———————————————————————
are a part of every patient's permanent medical record. They ——
are often retained on file for about 7 years or, in the case of Elderly patients dislike being pushed or hurried along. They
pediatric patients, until the patient reaches maturity. They are appreciate the radiographer who is caring enough to take the
not the personal property of either the radiologist or the extra few minutes necessary to comfort them. Some elderly
referring physician. If a patient changes doctors or needs a patients are easily confused, and it is best to address them by
second opinion, copies can be requested. The patient may their full name and keep instructions simple and direct. The
also borrow the originals, which must be returned, or he or she elderly require the same respectful, dignified care as all other
may pay for copies. (Ehrlich et al, pp 82-83) patients. (Adler & Carlton, pp 129-130)

20. A radiographer who discloses confidential information to 25. Sterile technique is required when contrast agents are
unauthorized individuals may be found guilty of administered
(A) invasion of privacy. (A) rectally.
(B) slander. (B) orally.
(C) libel. (C) intrathecally.
(D) defamation. (D) through a nasogastric tube.
——————————————————————— ———————————————————————
—— ——
A radiographer who discloses confidential information to Sterile technique is required for the administration of contrast
unauthorized individuals may be found guilty of invasion of media by the intravenous and intrathecal (intraspinal) methods.
privacy. If the disclosure is in some way detrimental or Sterile technique is also required for injection of contrast media
otherwise harmful to the patient, the radiographer may also be during arthrography. Aseptic technique is used for
accused of defamation. Spoken defamation is slander; written administration of contrast media by means of the oral and
defamation is libel. (Saia, p 8) rectal routes, as well as through the nasogastric tube. (Torres,
p 246)

3
Property of Hamilcar Eldo B. Chanjueco
 ———————————————————————
26. Which of the following should be used to disinfect the area ——
after a blood spill? Osteoarthritis is a progressive degenerative joint disorder
(A) Soap and water characterized by deterioration of the articular cartilage. Once
(B) Betadine solution the subchondral bone is exposed, friction between adjacent
(C) One part bleach to ten parts water bone occurs, and new bone formation begins. This bone tissue
(D) One part alcohol to ten parts water forms spurs, which get progressively larger and function to
——————————————————————— decrease joint space and restrict movement. Osteoarthritis is a
—— noninflammatory disorder. Rheumatoid arthritis is an
The CDC considers all body substances to be potential inflammatory disorder. (Tortora & Grabowski, p 267)
sources of infection. It lists several precautionary measures
that should be taken when dealing with body substances. 32. Skin discoloration due to cyanosis may be observed in the
Gloves must be used when wiping up bloodspills, and the area 1. gums.
should be disinfected with a solution of one part bleach to ten 2. nailbeds.
parts water. (Adler & Carlton, p 214) 3. thorax.
(A) 1 only
27. The medical term for congenital clubfoot is (B) 1 and 2 only
(A) coxa plana. (C) 3 only
(B) osteochondritis. (D) 1, 2, and 3
(C) talipes. ———————————————————————
(D) muscular dystrophy. ——
——————————————————————— Cyanosis is a condition resulting from a deficiency of oxygen
—— circulating inthe blood. It is characterized by bluish
Talipes is the term used to describe congenital clubfoot. There discoloration of the gums, nailbeds, and earlobes, and around
are several types of talipes, generally characterized by a the mouth. Cyanosis may be accompanied by labored
deformed talus and a shortened Achilles tendon, giving the foot breathing or other types of respiratory distress. (Torres, p 137)
a clubfoot appearance. Osteochondritis (Osgood-Schlatter
disease) is a painful incomplete separation of the tibial 33. In which of the following situations should a radiographer
tuberosity from the tibial shaft. It is often seen in active wear protective eye gear (goggles)?
adolescent boys. Coxa plana (Legg-Calv‚-Perthes disease) is 1. When performing an upper gastrointestinal
ischemic necrosis leading to flattening of the femoral head. radiography examination
Muscular dystrophy is a congenital disorder characterized by 2. When assisting the radiologist during an angiogram
wasting of skeletal muscles. (Ballinger & Frank, vol 1, p 259) 3. When assisting the radiologist in a biopsy /
aspiration procedure
28. A vasodilator would most likely be used for (A) 1 and 2 only
(A) angina. (B) 1 and 3 only
(B) cardiac arrest. (C) 2 and 3 only
(C) bradycardia. (D) 1, 2, and 3
(D) antihistamine. ———————————————————————
——————————————————————— ——
—— It is recommended that a radiographer wear protective eye
Anginal pain, caused by constriction of blood vessels, may be gear (goggles) during any procedure in which there might be
relieved with the administration of a vasodilator such as splattering of blood or body fluids. This includes both
nitroglycerin. Bradycardia (abnormally slow heartbeat) and angiography and biopsy / aspiration procedures. This would
cardiac arrest are treated with vasoconstrictors such as not be expected during a routine upper gastrointestinal
dopamine or epinephrine to increase blood pressure. examination. (Torres, p 57)
Antihistamines such as diphenhydramine (Benadryl) are used
to treat allergic reactions and anaphylactic shock. (Adler & 34.Which of the following statements are true regarding the
Carlton, p 292) proper care of a patient with a tracheostomy?
1. Employ sterile technique if you must touch a
29. The medical abbreviation meaning "every hour" is tracheostomy for any reason.
(A) tid. 2. Before you suction a tracheostomy, the patient
(B) qid. should be well aerated.
(C) qh. 3. Never suction for longer than 15 s, permitting the
(D) pc. patient to rest in between.
——————————————————————— (A) 1 and 2 only
—— (B) 1 and 3 only
The abbreviation for every hour is qh. The abbreviation tid (C) 2 and 3 only
means three times a day, and qid means four times a day. (D) 1, 2, and 3
After meals is abbreviated pc. (Taber's, p 2480) ———————————————————————
——
30. Of the four stages of infection, which is the stage during All of the statements in the question are true regarding the
which the infection is most communicable? proper care of a patient with a tracheostomy. If a tracheostomy
(A) Latent period needs to be touched for any reason, sterile technique should
(B) Incubation period be employed to avoid the possibility of infection. Patients with
(C) Disease phase tracheostomies require frequent suction. This is usually not
(D) Convalescent phase performed by the technologist, but radiographers may be
——————————————————————— called upon to assist with suctioning, especially for patients
—— who must be in the radiology department for lengthy
Of the four stages of infection, the stage during which the procedures. Patients who are to be suctioned should be
infection is most communicable is the disease phase. In the aerated beforehand (that is, oxygen should be administered
initial phase, the latent period, the infection is introduced and prior to suctioning). It is also important that patients be
lies dormant. As soon as the microbes begin to shed, the permitted to rest during suctioning. Never suction for longer
infection becomes communicable. The microbes reproduce than 15 s; check breath sounds with a stethoscope to ensure
(during the incubation period), and during the actual disease that the airway is clear. It is the radiographer's responsibility to
period, signs and symptoms of the infection may begin. The check the work area and ensure that the suction is working and
infection is most active and communicable at this point. As the that ample ancillary supplies (suction kit, catheters, tubing) are
patient fights off the infection, and the symptoms regress, the available.(Adler & Carlton, p 235)
convalescent (recovery) phase occurs. (Torres, p 47)
35.Blood pressure is measured in units of
31. All of the following statements regarding osteoarthritis are (A) mmHg.
true except (B) beats per minute.
(A) Osteoarthritis is a progressive disorder. (C) ºF.
(B) Osteoarthritis is an inflammatory disorder. (D) L/min.
(C) Osteoarthritis involves deterioration of the articular ———————————————————————
cartilage. ——
(D) Osteoarthritis involves the formation of bony spurs. Blood pressure is measured in millimeters of mercury, or

4
Property of Hamilcar Eldo B. Chanjueco
mmHg. Heart rate, or pulse, is measured in units of beats per The normal blood pressure range for men and women is 110 to
minute. Temperature is measured in degrees Fahrenheit, or 140 mmHg systolic reading (top number) and 60 to 80 mmHg
ºF. Oxygen delivery is measured in units of liters per minute, or diastolic reading (bottom number). Systolic pressure is the
L/min. Table 1-1 outlines the normal ranges for vital signs in contraction phase of the left ventricle, and diastolic pressure is
healthy adults. (Torres, p 137) the relaxation phase in the heart cycle. (Torres, p 139)
40. A patient is usually required to drink a barium sulfate
TABLE 1-1. NORMAL RANGES FOR VITAL SIGNS IN suspension in order to demonstrate which of the following
ADULTS structure(s)?
Blood Pressure 110-140 1. Pylorus
mm Hg/ 2. Sigmoid
60-90 3. Duodenum
mm Hg (A) 1 and 2 only
Pulse 60-100 (B) 1 and 3 only
beats per minute (C) 2 and 3 only
Temperature 97.7- (D) 3 only
99.5ºF ———————————————————————
Respiration 12-20 ——
breaths per minute Oral administration of barium sulfate is used to demonstrate
the upper digestive systemthe esophagus, fundus, body and
pylorus of the stomachand barium progression through the
36. The medical term for nosebleed is small bowel. The large bowel, including the sigmoid colon, is
(A) vertigo. usually demonstrated via rectal administration of barium.
(B) epistaxis. (Gurley & Callaway, pp 125-126)
(C) urticaria.
(D) aura. 41. The pulse can be detected only by the use of a
——————————————————————— stethoscope in which of the following locations?
—— (A) Wrist
The medical term for nosebleed is epistaxis. Vertigo refers to a (B) Apex of the heart
feeling of "whirling" or a sensation that the room is spinning. (C) Groin
Some possible causes of vertigo include inner ear infection (D) Neck
and acoustic neuroma. Urticaria is a vascular reaction resulting ———————————————————————
in dilated capillaries and edema and causing the patient to ——
break out in hives. An aura may be classified as either a As blood pulsates through the arteries, a throb can be
feeling or a motor response (such as flashing lights, tasting detected. This throb or pulse can be readily palpated at
metal, smelling coffee) that precedes an episode such as a locations where the arteries are superficial (examples are the
seizure or a migraine headache. (Adler & Carlton, p 274) wrist, groin, neck, and posterior surface of the knee). The
apical pulse can be detected only with a stethoscope. (Torres,
37. In reviewing a patient's blood chemistry, which of the p 133)
following blood urea nitrogen (BUN) ranges is considered
normal? 42.The condition that allows blood to shunt between the right
(A) 0.6 to 1.5 mg/100 mL and left ventricles is called
(B) 4.5 to 6 mg/100 mL (A) patent ductus arteriosus.
(C) 8 to 25 mg/100 mL (B) coarctation of the aorta.
(D) Up to 50 mg/100 mL (C) atrial septal defect.
——————————————————————— (D) ventricular septal defect.
—— ———————————————————————
The BUN level indicates the quantity of nitrogen in the blood in ——
the form of urea. The normal concentration is 8 to 25 mm/100 Ventricular septal defect is a congenital heart condition
mL. BUN and creatinine blood chemistry levels should be characterized by a hole in the interventricular septum, which
checkedprior to beginning an intravenous pyelogram. An allows oxygenated and unoxygenated blood to mix. Some
increase in the BUN level often indicates decreased renal interventricular septal defects are small and close
function. Increased BUN and/or creatinine levels may forecast spontaneously; others require surgery. Coarctation of the aorta
an increased possibility of contrast media-induced renal effects is a narrowing or constriction of the aorta. Atrial septal defect is
and poor visualization of the renal collecting systems. The a small hole (the remnant of the fetal foramen ovale) in the
normal creatinine range is 0.6 to 1.5 mg/mL. (Ballinger & interatrial septum. It usually closes spontaneously in the first
Frank, vol 2, p 176) months of life; if it persists or is unusually large, surgical repair
is necessary. The ductus arteriosus is a short fetal blood
38. Which of the following body fluids is (are) potential vessel connecting the aorta and pulmonary artery that usually
carrier(s) of HIV? closes within 10 to 15 h after birth. A patent ductus arteriosus
1. Semen is one that persists and requires surgical closure. (Taber's, p
2. Vaginal secretions 2323)
3. Blood
(A) 1 only 43. Guidelines for cleaning contaminated objects or surfaces
(B) 1 and 3 only include
(C) 2 and 3 only 1. Clean from the most contaminated to the least
(D) 1, 2, and 3 contaminated area
——————————————————————— 2. Clean in a circular motion, starting from the center
—— and working outward
Blood and all other body fluids are carriers of HIV in infected 3. Clean from the top down
individuals. Standard precautions are taken to avoid contact (A) 1 only
with any blood or body fluids. However, HIV cannot be (B) 1 and 2 only
transmitted via inanimate objects, such as drinking fountains (C) 1 and 3 only
and glassware. (Torres, p 51) (D) 1, 2, and 3
———————————————————————
39. Blood pressure may be expressed as 120/95. What does ——
95 represent? Because hospitals are the refuge of the sick, they can also be
1. The phase of relaxation of the cardiac muscle places of disease transmission unless proper infection control
tissue guidelines are followed. When cleaning contaminated objects
2. The phase of contraction of the cardiac muscle or surfaces such as the radiographic table, it is important to
tissue clean from the most contaminated to the least contaminated
3. A higher-than-average diastolic pressure area and from the top down. Soiled gowns and linens should
(A) 1 only be folded from the outside in and properly disposed of. When
(B) 2 only the patient's skin is being prepared for surgery, it is often
(C) 1 and 3 only cleaned in circular motion, starting from the center and working
(D) 2 and 3 only outward; however, this motion is not used for objects or
——————————————————————— surfaces. (Torres, p 58)
——

5
Property of Hamilcar Eldo B. Chanjueco
44. Which of the following must be included in the patient's (A) 1 and 2 only
medical record or chart? (B) 1 and 3 only
1. Diagnostic and therapeutic orders (C) 2 and 3 only
2. Medical history (D) 1, 2, and 3
3. Informed consent ———————————————————————
(A) 1 and 2 only ——
(B) 1 and 3 only A stethoscope and a sphygmomanometer are used together to
(C) 2 and 3 only measure blood pressure. The first sound heard is the systolic
(D) 1, 2, and 3 pressure, and the normal range is 110 to 140 mmHg. When
——————————————————————— the sound is no longer heard, the diastolic pressure is
—— recorded. The normal diastolic range is 60 to 90 mmHg.
The Joint Commission on the Accreditation of Healthcare Elevated blood pressure is called hypertension. Hypotension,
Organizations (JCAHO) is the organization that accredits or low blood pressure, is not of concern unless it is caused by
health-care organizations in the United States. The JCAHO injury or disease; in that case, it can result in shock. A pulse
sets forth certain standards for medical records. In keeping oximeter is used to measure a patient's pulse rate and oxygen
with those standards, all diagnostic and therapeutic orders saturation level. (Adler & Carlton, p 181)
must appear on the patient's medical record or chart.
Additionally, patient identification information, medical history, 49.When caring for a patient with an IV, the radiographer
consent forms and any diagnostic and therapeutic reports should keep the medication
should also be part of the patient's permanent record. The (A) 18 to 20 in above the level of the vein.
patient's chart is a means of communication between various (B) 18 to 20 in below the level of the vein.
health-care providers. (Torres, p 14) (C) 28 to 30 in above the level of the vein.
(D) 28 to 30 in below the level of the vein.
45. The mechanical device used to correct an ineffectual ———————————————————————
cardiac rhythm is a ——
(A) defibrillator. It is generally recommended that the IV bottle be kept 18 to 20
(B) cardiac monitor. in above the level of the vein. If the bottle is too high, the
(C) crash cart. pressure of the IV fluid can cause it to pass through the vein
(D) resuscitation bag. into surrounding tissues, causing a painful and potentially
——————————————————————— harmful condition. If the IV bottle is too low, blood may return
—— through the needle into the tubing, form a clot, and obstruct the
The mechanical device used to correct an ineffectual cardiac flow of IV fluid. (Torres, p 293)
ventricular rhythm is a defibrillator. The two paddles attached
to the unit are placed on a patient's chest and used to 50. Forms of intentional misconduct include
introduce an electric current in an effort to correct the 1. slander.
dysrhythmia. Automatic Implantable Cardioverter Defibrillators 2. invasion of privacy.
(AICD) are fairly new devices that are implanted in the body 3. negligence.
and which deliver a small shock to the heart if a life-threatening (A) 1 only
dysrhythmia occurs. A cardiac monitor is used to display, and (B) 2 only
sometime record, electrocardiogram (ECG) readings and some (C) 1 and 2 only
pressure readings. The crash cart is a supply cart with various (D) 1, 2, and 3
medications and equipment necessary for treating a patient ———————————————————————
who is suffering from a myocardial infarction or some other ——
serious medical emergency. It is periodically checked and Verbal defamation of another, or slander, is a type of
restocked. A resuscitation bag is used for ventilation, as during intentional misconduct. Invasion of privacy (that is, public
cardiopulmonary resuscitation. (Tortora & Grabowski, p 691) discussion of privileged and confidential information) is
intentional misconduct. However, if a radiographer leaves a
46. Protective or "reverse" isolation is required in which of the weak patient standing alone in order to check films or get
following conditions? supplies, and that patient falls and sustains an injury, that
1. Tuberculosis would be considered unintentional misconduct or negligence.
2. Burns (Saia, p 8)
3. Leukemia
(A) 1 only 51. Rapid onset of severe respiratory or cardiovascular
(B) 1 and 2 only symptoms after ingestion or injection of a drug, vaccine,
(C) 2 and 3 only contrast agent, or food, or after an insect bite, best describes
(D) 1, 2, and 3 (A) asthma.
——————————————————————— (B) anaphylaxis.
—— (C) myocardial infarction.
Protective or "reverse" isolation is used to keep the susceptible (D) rhinitis.
patient from becoming infected. Patients who have suffered ———————————————————————
burns have lost a very important means of protection, their ——
skin, and therefore have increased susceptibility to bacterial Anaphylaxis is an acute reaction characterized by the sudden
invasion. Patients whose immune systems are depressed have onset of urticaria, respiratory distress, vascular collapse, or
lost the ability to combat infection, and hence are more systemic shock, sometimes leading to death. It is caused by
susceptible to infection. Active tuberculosis requires airborne ingestion or injection of a sensitizing agent such as a drug,
precautions, not protective isolation. (Ehrlich et al, pp 163-165) vaccine, contrast agent, or food, or by an insect bite. Asthma
and rhinitis are examples of allergic reactions. Myocardial
47. When performing cardiopulmonary resuscitation (CPR) on Infarction (MI) is caused by partial or complete occlusion of a
an infant, it is required that the number of compressions per coronary artery. (Torres, p 155)
minute, compared to that for an adult,
(A) remain the same. 52. Which statement(s) would be true regarding tracheostomy
(B) double. patients?
(C) decrease. 1. Tracheostomy patients have difficulty speaking.
(D) increase. 2. A routine chest x-ray requires the tracheostomy
——————————————————————— tubing to be rotated out of view.
—— 3. Audible rattling sounds indicate a need for
The respiratory rate of an infant is much faster than that of an suction.
adult; therefore, the number of compressions per minute is
also greater. Infant CPR requires 5 compressions to 1 breath. (A) 1 only
There should be at least 100 compressions per minute. (Adler (B) 1 and 2 only
& Carlton, p 273) (C) 1 and 3 only
(D) 1, 2, and 3
48.Which of the following medical equipment is used to ———————————————————————
determine blood pressure? ——
1. Pulse oximeter The tracheostomy patient will have difficulty speaking as a
2. Stethoscope result of the redirection of the air past the vocal cords. Gurgling
3. Sphygmomanometer or rattling sounds coming from the trachea indicate an excess

6
Property of Hamilcar Eldo B. Chanjueco
accumulation of secretions, requiring suction with sterile (A) 1 only
catheters. Any rotation or movement of the tracheostomy tube (B) 1 and 2 only
may cause the tube to become dislodged, and an obstructed (C) 1 and 3 only
airway could result. (Torres, p 228) (D) 1, 2, and 3
———————————————————————
53. Chest drainage systems should always be kept ——
(A) above the patient's chest. The radiographer must be aware that the patient's condition
(B) at the level of the patient's chest. has a significant impact on motion control. The patient may
(C) below the level of the patient's chest. wish to be very cooperative, but conditions beyond his or her
(D) none of the above; the position of the chest drainage control may exist. Patients often exhibit uncontrolled motion
system is not important. following a traumatic injury. Medication can worsen the
——————————————————————— condition. Traumatized patients are often more sensitive and
—— likely to feel chilled. Peristalsis is another type of involuntary
The chest drainage system unit should always be kept below motion. (Adler & Carlton, pp 158-160)
the level of the patient's chest. Chest tubes are used to remove
air, blood, or fluid from the pleural cavity. By draining fluid from 58. A nosocomial infection is a(n)
the pleural cavity, a collapsed lung, or atelectasis, may be (A) infection acquired at a large gathering.
relieved. By relieving the pressure from air in the pleural cavity, (B) upper respiratory infection.
a pneumothorax may be reduced. Radiographers must take (C) infection acquired in a hospital.
care that the tubes of the chest drainage unit do not kink and (D) type of rhinitis.
do not get caught on intravenous poles or radiographic ———————————————————————
equipment. It is imperative that the unit remain below the level ——
of the chest. The chest drainage system has several Nosocomial diseases are those acquired in hospitals,
components. One component is a chamber that collects the especially by patients whose resistance to infection has been
draining fluid. Another component is the suction control diminished by their illness. Cleanliness is essential to decrease
chamber. A third component is the water seal chamber, which the number of nosocomial infections. The x-ray table must be
prevents air from the atmosphere from entering the system. cleaned and the pillowcase changed between patients. The
The last component is the water seal venting chamber, which most common nosocomial infection is the urinary tract infection
allows air to leave the system, thus preventing pressure (UTI). (Gurley & Callaway, pp 178-179)
buildup. In order for the unit to work properly, it must remain
below the level of the chest. (Adler & Carlton, p 236) 59. All of the following statements are true regarding the
administration of a barium enema to a patient with a
54.Which of the following may be used to effectively reduce the colostomy, except
viscosity of contrast media? (A) The dressing should be removed and disposed of.
(A) Warming (B) The drainage pouch should be retained unless a fresh one
(B) Refrigeration can be provided.
(C) Storage at normal room temperature (C) The colostomy tip or catheter should be selected by the
(D) Storage in a cool, dry place radiologist.
——————————————————————— (D) The patient should not be permitted to insert the
—— colostomy tip.
Iodinated contrast material can become somewhat viscous ———————————————————————
(thick and sticky) at normal room temperatures. This makes ——
injection much more difficult. Warming the contrast medium to When preparing a colostomy patientfor a barium enema, the
body temperature serves to reduce viscosity. This may be dressing should be removed and disposed of. The drainage
achieved by placing the vial in warm water or putting it into a pouch may be retained for reuse unless the patient indicates
special warming oven. (Adler & Carlton, p 322) that she or he has a fresh pouch or, if the department stocks
them, the radiographer offers to provide one. The choice of
55. Which of the following is (are) symptom(s) of shock? colostomy tip or catheter should be discussed with the
1. Pallor and weakness radiologist. If a catheter is selected, the inflation cuff must be
2. Increased pulse rate large enough to prevent barium from leaking, yet small enough
3. Fever so that the stoma area is not damaged. It is always a good
(A) 1 only idea to ask the patient if he or she would prefer to insert the
(B) 1 and 2 only colostomy tip. Patients are often used to caring for their stoma,
(C) 1 and 3 only and they may be more comfortable if they have control of the
(D) 1, 2, and 3 situation. (Torres, p 209)
———————————————————————
—— 60. The patient is placed in the lithotomy position for which of
A patient who is going into shock may exhibit pallor and the following procedures?
weakness, a significant drop in blood pressure, and an (A) Myelography
increased pulse rate. The patient may also experience (B) Venography
apprehension and restlessness and may have cool, clammy (C) T-tube cholangiography
skin. A radiographer recognizing these symptoms should call (D) Hysterosalpingography
them to the physician's attention immediately. Fever is not ———————————————————————
associated with shock. (Ehrlich et al, p 239) ——
The lithotomy position is generally employed for
56. A patient in a recumbent position with the head lower than hysterosalpingography. The lithotomy position requires that the
the feet is said to be in which of the following positions? patient lie on the back with buttocks at the edge of the table.
(A) Trendelenburg The hips are flexed, the knees are flexed and resting on leg
(B) Fowler's supports, and the feet rest in stirrups. (Adler & Carlton, p 221)
(C) Sims
(D) Stenver's 61. The act of inspiration will cause elevation of the
——————————————————————— 1. sternum.
—— 2. ribs.
The patient is said to be in the Trendelenburg position when 3. diaphragm.
the head is positioned lower than the feet. This position is (A) 1 only
helpful in several radiographic procedures, such as separating (B) 1 and 2 only
redundant bowel loops and demonstration of hiatal hernias. It (C) 2 and 3 only
is also used in treating shock. In Fowler's position, the head is (D) 1, 2, and 3
higher than the feet. The Sims position is the left posterior ———————————————————————
oblique (LPO) position with the right leg flexed up for insertion ——
of the enema tip. Stenver's is a radiographic position for The diaphragm is the major muscle of respiration. Upon
mastoids. (Taber's, p 2234) inspiration / inhalation, the diaphragm and abdominal viscera
are depressed, enabling the filling and expansion of the lungs,
57. Involuntary patient motion can be caused by accompanied by upward movement of the sternum and ribs.
1. post-traumatic shock. During expiration / exhalation, air leaves the lungs and they
2. medication. deflate, while the diaphragm relaxes and moves to a more
3. the temperature of the room. superior position along with the abdominal viscera. As the

7
Property of Hamilcar Eldo B. Chanjueco
diaphragm relaxes and moves up, the sternum and ribs move 66. Which of the following blood pressure measurements
inferiorly. (Ballinger & Frank, vol 1, pp 509-510) indicates shock?
(A) Systolic pressure lower than 60 mmHg
62. Anaphylaxis is the term used to describe (B) Systolic pressure higher than 140 mmHg
(A) an inflammatory reaction. (C) Diastolic pressure higher than 140 mmHg
(B) bronchial asthma. (D) Diastolic pressure lower than 90 mmHg
(C) acute chest pain. ———————————————————————
(D) allergic shock. ——
——————————————————————— Shock is indicated by extremely low blood pressure, that is, a
—— systolic blood pressure reading lower than 60 mmHg (below 90
A severe allergic reaction affecting several tissue functions is mmHg is considered low blood pressure). Normal blood
referred to as anaphylaxis or anaphylactic shock. It is pressure is 110 to 140 mmHg systolic and 60 to 80 mmHg
characterized by dyspnea (difficulty breathing) caused by rapid diastolic. High blood pressure is indicated by systolic pressure
swelling of the respiratory tract and a sharp drop in blood higher than 140 mmHg and diastolic pressure higher than 90
pressure. Individuals who are sensitive to bee stings and mmHg. (Torres, p 153)
certain medications, including iodinated contrast agents, are
candidates for this reaction. (Adler & Carlton, p 267) 67. If the radiographer performed a lumbar spine examination
on a patient who was supposed to have an elbow exam, which
63. Which of the following conditions must be met in order for of the following charges may be brought against the
patient consent to be valid? radiographer?
1. The patient must sign the consent form before (A) Assault
receiving sedation. (B) Battery
2. The physician named on the consent form must (C) False imprisonment
perform the procedure. (D) Defamation
3. All the blanks on the consent form must be filled ———————————————————————
in before the patient signs the form. ——
A radiographer who performs the wrong examination on a
(A) 1 and 2 only patient may be charged with battery. Battery refers to the
(B) 1 and 3 only unlawful laying of hands on a patient. The radiographer could
(C) 2 and 3 only also be charged with battery if a patient was moved about
(D) 1, 2, and 3 roughly or touched in a manner that is inappropriate or without
——————————————————————— the patient's consent. Assault is the threat oftouching or laying
—— hands on someone. If a patient feels threatened by a
All of the statements in the question are true and are practitioner, either because of the tone or pitch of the
necessary in order for patient consent to be valid. The patient practitioner's voice or because the practitioner uses words that
must sign the consent form before receiving sedation. The are threatening, the practitioner can be accused of
physician named on the consent form must perform the assault.False imprisonment may be considered if a patient is
procedure; no other physician should perform it. Also, the ignored after stating that she no longer wishes to continue with
consent form should be complete prior to being signed; there the procedure, or if restraining devices are improperly used or
should be no blank spaces on the consent form when the used without a physician's order. The accusation of defamation
patient signs it. In the case of a minor, a parent or guardian is can be upheld when patient confidentiality is not respected,
required to sign the form. If a patient is not competent, then the and as a result the patient suffers embarrassment or mockery.
legally appointed guardian should sign the consent. Remember (Ehrlich et al, p 57)
that obtaining consent is the physician's responsibility, and so
the explanation of the procedural risks should be performed by 68. Examples of COPD include
the physician, not the radiographer. (Ehrlich, McCloskey & 1. bronchitis.
Daly, pp 54-56) 2. pulmonary emphysema.
3. asthma.
64. The legal doctrine res ipsa locquitur means which of the (A) 1 only
following? (B) 1 and 2 only
(A) Let the master answer. (C) 2 and 3 only
(B) The thing speaks for itself. (D) 1, 2, and 3
(C) A thing or matter settled by justice. ———————————————————————
(D) A matter settled by precedent. ——
——————————————————————— COPD is the abbreviation for chronic obstructive pulmonary
—— disease; it refers to a group of disorders, including bronchitis,
The legal doctrine res ipsa locquitur relates to a thing or matter emphysema, asthma, and bronchiectasis. COPD is irreversible
that speaks for itself. For instance, if a patient went into the and decreases the ability of the lungs to perform their
hospital to have a kidney stone removed and ended up with an ventilation functions. There is often less than half the normal
appendectomy, that speaks for itself, and negligence can be expected maximal breathing capacity. (Taber's, p 608)
proven. Respondeat superior is the phase meaning "let the
master answer" or "the one ruling is responsible." If a 69. The normal average rate of respiration for a healthy adult
radiographer was negligent, there may be an attempt to prove patient is
that the radiologist was responsible, because the radiologist (A) 5 to 7 breaths/min.
oversees the radiographer. Res judicata means a thing or (B) 8 to 12 breaths/min.
matter settled by justice. Stare decisis refers to a matter settled (C) 12 to 20 breaths/min.
by precedent. (Gurley & Callaway, p 194) (D) 20 to 30 breaths/min.
———————————————————————
65. Lyme disease is caused by bacteria carried by deer ticks. ——
The tick bite may cause fever, fatigue, and other associated The normal average rate of respiration for a healthy adult
symptoms. This is an example of transmission of an infection patient is between 12 and 20 breaths/min. For children, the
by rate is higher, averaging between 20 and 30 breaths/min. In
(A) droplet contact. addition to monitoring the respiratory rate, it is also important to
(B) a vehicle. monitor the depth (shallow or labored) and pattern (regularity)
(C) the airborne route. of respiration. A respiratory rate greater than 20 breaths/minin
(D) a vector. an adult would be considered tachypnea. (Adler & Carlton, pp
——————————————————————— 176-177)
—— 70. If extravasation occurs during an intravenous injection of
Lyme disease is a condition that results from the transmission contrast media, correct treatment includes which of the
of an infection by a vector (in this case, a deer tick). Vectors following?
are insects and animals carrying disease. Droplet contact 1. Remove the needle and locate a sturdier vein
involves contact with secretions (from the nose, mouth, or eye) immediately.
that travel via a sneeze or cough. The airborne route involves 2. Apply pressure to the vein until bleeding stops.
evaporated droplets in the air that transfer disease. A vehicle 3. Apply warm, moist heat.
can transmit infection via contaminated water, food, blood, or (A) 1 only
drugs. (Torres, p 46) (B) 1 and 2 only
(C) 2 and 3 only

8
Property of Hamilcar Eldo B. Chanjueco
(D) 1, 2, and 3 Three times a day is indicated by the abbreviation tid. The
——————————————————————— abbreviation qid means four times a day. Every hour is
—— represented by qh, and pc means after meals. (Taber's, p
Extravasation of contrast media into surrounding tissue is 2480)
potentially very painful. If it does occur, the needle should be
removed and the extravasation cared for immediately (before 76. All of the following rules regarding proper handwashing
looking for another vein). Pressure should be applied to the technique are correct except
vein until bleeding stops. Application of warm, moist heat to the (A) Keep hands and forearms lower than elbows.
affected area helps relieve pain. (Adler & Carlton, p 300) (B) Use paper towels to turn water on.
(C) Avoid using hand lotions whenever possible.
71. A small bottle containing a single dose of medication is (D) Carefully wash all surfaces and between fingers.
termed ———————————————————————
(A) an ampule. ——
(B) a vial. Frequent and correct handwashing is an essential part of
(C) a bolus. medical asepsis; it isthe best method for avoiding the spread of
(D) a carafe. microorganisms. If the faucet cannot be operated with the knee
——————————————————————— or a foot pedal, it should be opened and closed using paper
—— towels. Care should be taken to wash all surfaces of the hand
Injectable medications are available in two different kinds of and between the fingers thoroughly. The hands and forearms
containers. An ampule is a small container that usually holds a should always be kept below the elbows. Hand lotions should
single dose of medication. A vial is a larger container that holds be used frequently to keep hands from chapping. Unbroken
several doses of the medication. The term bolus is used to skin prevents the entry of microorganisms; dry, cracked skin
describe an amount of fluid to be injected. A carafe is a breaks down that defense and permits the entry of
narrow-mouthed container; it is not likely to be used for microorganisms. (Ehrlich et al, pp 153-155)
medical purposes. (Adler & Carlton, pp 294-295)
77.Conditions in which there is a lack of normal bone
72. Physical changes characteristic of gerontologic patients calcification include
usually include 1. rickets.
1. loss of bone calcium. 2. osteomalacia.
2. loss of hearing. 3. osteoarthritis.
3. loss of mental alertness. (A) 1 only
(A) 1 only (B) 1 and 2 only
(B) 1 and 2 only (C) 2 and 3 only
(C) 1 and 3 only (D) 1, 2, and 3
(D) 1, 2, and 3 ———————————————————————
——————————————————————— ——
—— Rickets and osteomalacia are disorders in which there is
Gerontology, or geriatrics, is the study of the elderly. While softening of bone. Rickets results from a deficiency of vitamin
bone demineralization and loss of muscle mass occur to a D and usually is found affecting the growing bones of young
greater or lesser degree in most elderly individuals, the children. The body's weight on the soft bones of the legs
radiographer must not assume that all gerontologic patients results in bowed and misshapen legs. Osteomalacia is an adult
are hard of hearing, clumsy, or not mentally alert. Today many condition in which new bone fails to calcify. It is a painful
elderly people remain very active, staying mentally and condition and can result in easily fractured bones, especially in
physically agile well into their so-called golden years.The the lower extremities. Osteoarthritis is often seen in the elderly
radiographer must keep this in mind as he or she provides and is characterized by degeneration of articular cartilage in
age-specific care to the gerontologic patient. (Torres, p 181) adjacent bones. The resulting rubbing of bone against bone
results in pain and deterioration. (Tortora & Grabowski, p 181)
73. Medication can be administered by which of the following
routes? 78.All of the following statements regarding handwashing and
1. Orally skin care are correct except
2. Intravenously (A) Hands should be washed after each patient examination.
3. Intramuscularly (B) Faucets should be opened and closed with paper towels.
(A) 1 and 2 only (C) Hands should be smooth and free from chapping.
(B) 1 and 3 only (D) Any cracks or abrasions should be left uncovered to
(C) 2 and 3 only facilitate healing.
(D) 1, 2, and 3 ———————————————————————
——————————————————————— ——
—— In the practice of aseptic technique, handwashing is the most
Medications are commonly administered orally (by mouth). important precaution. The radiographer'shands should be
They may also be administered directly into a vein thoroughly washed with warm, soapy running water after each
(intravenously), into a muscle (intramuscularly), or under the patient examination. To avoid contamination of, or
skin (subcutaneously). (Ehrlich, McCloskey & Daly, pp 192- contamination by, the faucets, they should be opened and
193) closed using paper towels. Care should be taken to avoid
chapped handsby the use of hand cream. Skin function is a
74. The condition of slow heart rate, below 60 beats per minute major factor in protecting bodies from the invasion of bacteria
(bpm), is termed and infection. Any cuts, abrasions, or other breaks in the
(A) hyperthermia. continuity of this protective barrier should be protected from
(B) hypotension. bacterial invasion with a bandage. (Torres, p 54)
(C) hypoxia.
(D) bradycardia. 79. While performing mobile radiography on a patient, you note
——————————————————————— that the requisition is for a chest film to check placement of a
—— Swan-Ganz catheter. A Swan-Ganz catheter is a(n)
The condition in which a patient's heart rate slows to below 60 (A) pacemaker.
bpm is bradycardia.Hyperthermia is the condition in which the (B) chest tube.
patient's temperature is well above the normal average range (C) intravenous catheter.
(97.7 to 99.5ºF). Hypotension occurs if the blood pressure (D) urinary catheter.
drops below thenormal ranges (110 to 140/60 to 90 mmHg). ———————————————————————
Hypoxia is a condition in which there is decreased oxygen ——
supply to body tissues. (Adler & Carlton, p 181) A Swan-Ganz catheter is a specific type of intravenous
catheter used to measure the pumping ability of the heart, to
75. The medical abbreviation meaning "three times a day" is obtain pressure readings, and to introduce medications and
(A) tid. intravenous fluids. Apacemaker is a device that is inserted
(B) qid. under the patient's skin to regulate heart rate. Pacemakers
(C) qh. may be permanent or temporary. Chest tubes are used to
(D) pc. remove fluid or air from the pleural cavity. Any of these items
——————————————————————— may be identified on a chest radiograph, provided the cassette
—— is properly positioned and the correct exposure factors are

9
Property of Hamilcar Eldo B. Chanjueco
employed. If the physician is interested in assessing the proper (B) 2 only
placement of a Swan-Ganz catheter, the lungs may have to be (C) 1 and 3 only
slightly overexposed in order to clearly delineate the proper (D) 2 and 3 only
placement of the tip of the Swan-Ganz catheter, which will ———————————————————————
overlap the denser cardiac silhouette. A urinary catheter will ——
not appear on a chest radiograph. (Adler & Carlton, p 246) When performing bedside radiography in a contact isolation
room, the radiographer should wear a gown, gloves, mask, and
80. Factors that are important to evaluate when selecting cap. The cassettes are prepared for the examination by placing
contrast media include a pillowcase over them to protect them from contamination.
1. miscibility. Whenever possible, one person should manipulate the mobile
2. potential toxicity. unit and remain "clean" while the other handles the patient.
3. viscosity. The mobile unit should be cleaned with a disinfectant upon
(A) 1 and 2 only exiting the patient's room, not prior to entering. (Torres, pp 61-
(B) 2 and 3 only 66)
(C) 1 and 3 only
(D) 1, 2, and 3 85. A patient developed hives several minutes after injection of
——————————————————————— an iodinated contrast medium. What type of drug should be
—— readily available?
All three factors are important considerations. Miscibility (A) Analgesic
describes the ability of a contrast medium to mix with blood as (B) Antihistamine
it is injected into the bloodstream. Potential toxicity has always (C) Anti-inflammatory
been an important consideration, as side effects from contrast (D) Antibiotic
media can be life-threatening. The new nonionic contrast ———————————————————————
media have considerably lower toxicity than the ionic ——
compounds. Viscosity is a term that denotes the degree of Then a contrast medium is injected, histamines are produced
stickiness or gumminess of the contrast medium. A contrast to protect the body from the foreign substance. An
medium with higher viscosity can offer considerable resistance antihistamine [such as diphenhydramine (Benadryl)] blocks the
upon injection. (Torres, p 266) action of the histamine and reduces the body's inflammatory
response to the contrast medium. An analgesic (such as
aspirin) relieves pain. An anti-inflammatory drug (such as
81. Which of the following sites are commonly used for an ibuprofen) suppresses the inflammation of tissue. Antibiotics
intravenous injection? (such as penicillin) help fight bacterial infections. (Torres, p
1. Antecubital vein 261)
2. Basilic vein
3. Popliteal vein 86. An intravenous urogram requires the patient to remain in
(A) 1 and 2 one position for an extended period of time. What can be done
(B) 1 and 3 to make the patient as comfortable as possible?
(C) 2 and 3 1. Place a pillow under the patient's head.
(D) 1, 2, and 3 2. Place a support cushion under the patient's knees
——————————————————————— to relieve back strain.
—— 3. Place a radiopaque pad on the entire table prior to
Either the antecubital vein or the basilic vein, both found in the the start of the examination.
elbow region, may be used for an intravenous injection. Other (A) 1 only
veins in the area include the cephalic and accessory veins. (B) 1 and 2 only
The popliteal vein, found in the area of the knee, is not (C) 1 and 3 only
commonly used for an intravenous injection. (Adler & Carlton, (D) 1, 2, and 3
p 300) ———————————————————————
——
82. A diuretic is used to It is important to make the patient as comfortable as possible
(A) induce vomiting. during lengthy radiographic examinations; as comfort
(B) stimulate defecation. increases, so does cooperation. Place pillows under the
(C) promote elimination of urine. patient's head and knees (this reduces back strain). A
(D) inhibit coughing. radiolucent pad will increase the patient's tolerance of the
——————————————————————— uncomfortable radiographic table and will not interfere with the
—— examination. (Ballinger & Frank, vol 2, p 41)
Diuretics are used to promote urine elimination in individuals
whose tissues are retaining excessive fluid. Emetics induce 87. You have encountered a person who is apparently
vomiting, and cathartics stimulate defecation. Antitussives are unconscious. Although you open his airway, there is no rise
used to inhibit coughing. (Torres, p 257) and fall of the chest, and you can hear no breath sounds. You
should
83. With a patient suffering abdominal pain, it is frequently (A) begin mouth-to-mouth rescue breathing, giving two full
helpful to breaths.
1. elevate the head slightly with a pillow. (B) proceed with the Heimlich maneuver.
2. perform the exam in the Trendelenburg position. (C) begin external chest compressions at a rate of 80 to 100
3. place a support under the knees. per minute.
(A) 1 and 2 only (D) begin external chest compressions at a rate of at least 100
(B) 1 and 3 only per minute.
(C) 2 and 3 only ———————————————————————
(D) 1, 2, and 3 ——
——————————————————————— The victim's airway should first be opened. This is
—— accomplished by tilting back the head and lifting the chin.
Strain on the abdominal muscles may be minimized by placing However, if the victim may have suffered a spinal cord injury,
a pillow under the patient's head and a support under the the spine should not be moved and the airway should be
patient's knees. The pillow also relieves neck strain, reduces opened using the jaw-thrust method. The rescuer next listens
the chance of aspiration in the nauseated patient, and allows for breathing sounds and watches for the rise and fall of the
the patient to observe his or her surroundings. The chest to indicate breathing. If there is no breathing, the rescuer
Trendelenburg position causes the diaphragm to assume a pinches the victim's nose and delivers two full breaths via
higher position and can cause a patient to become short of mouth-to-mouth rescue breathing. If rise and fall of the chest is
breath. (Ehrlich, McCloskey & Daly, pp 93-94) still not present, the Heimlich maneuver is instituted. If
ventilation does not take place during the two full breaths, the
84. The radiographer must perform which of the following victim's circulation is checked next (using the carotid artery). If
procedures prior to entering a contact isolation room with a there is no pulse, external chest compressions are begun at a
mobile x-ray unit? rate of 80 to 100/min for adults and at least 100/min for infants.
1. Put on gown and gloves only. (Taber's, pp 1868-1869)
2. Put on gown, gloves, mask, and cap.
3. Clean the mobile x-ray unit. 88. You and a fellow radiographer have received an
(A) 1 only unconscious patient from a motor vehicle accident. As you

10
Property of Hamilcar Eldo B. Chanjueco
perform the examination, it is important that you to clean equipment and to remove microorganisms from areas
1. refer to the patient by name. such as radiographic tables. Antiseptics are also used to stop
2. make only those statements that you would make the growth of microorganisms, but they are often applied to the
with a conscious patient. skin, not to radiographic equipment. Antifungal medications
3. reassure the patient about what you are doing. can be administered systemically or topically to treat or prevent
(A) 1 only fungal infections. Antibacterial medications (bacteriostatics)
(B) 1 and 2 only can also be administered systemically or externally.
(C) 2 and 3 only Tetracycline is a systemic antibacterial medication. (Ehrlich et
(D) 1, 2, and 3 al, p 153)
———————————————————————
—— 93. Which of the following drugs is considered a
An unconscious patient is frequently able to hear and bronchodilator?
understand all that is going on, even though he or she is (A) Epinephrine
unable to respond. Therefore, while performing the exam, the (B) Lidocaine
radiographer should always refer to the patient by name and (C) Nitroglycerin
take care to continually explain what is being done and (D) Verapamil
reassure the patient. (Adler & Carlton, p 126) ———————————————————————
——
89. Following a barium enema (BE) examination, the patient Epinephrine (Adrenalin) is a bronchodilator. Bronchodilators
should be given which of the following instructions? may be administered in a spray mister, such as for asthma, or
1. Increase fluid and fiber intake for several days. by injection to relieve severe bronchospasm. Lidocaine
2. Changes in stool color will occur until all barium (Xylocaine) is an antiarrhythmic used to prevent or treat
has been evacuated. cardiac arrhythmias (dysrhythmia). Nitroglycerin and verapamil
3. Contact a physician if no bowel movement occurs are vasodilators. Vasodilators permit increased blood flow by
in 24 h relaxing the walls of the blood vessels. (Adler & Carlton, p 291)
(A) 1 only
(B) 2 only 94. The usual patient preparation for an upper GI exam is
(C) 1 and 3 only (A) NPO 8 h before the exam.
(D) 1, 2, and 3 (B) light breakfast only on the morning of the exam.
——————————————————————— (C) clear fluids only on the morning of the exam.
—— (D) 2 oz castor oil and enemas until clear.
Physicians often prescribe a mild laxative to aid in the ———————————————————————
elimination of barium sulfate. If a laxative is not given, the ——
patient should be instructed to increase dietary fluid and fiber In order to obtain a diagnostic examination of the stomach, it
and to monitor bowel movements (the patient should have at must first be empty. The usual preparation is NPO (nothing by
least one within 24 h). Patients should also be aware of the mouth) after midnight (approximately 8 h before the exam).
white-colored appearance of their stool that will be present until Any material in the stomach can simulate the appearance of
all barium is expelled. (Torres, p 208) disease. (Torres, p 211)

90.The advantages of using nonionic, water-soluble contrast 95. A patient suffering from orthopnea would experience the
media include least discomfort in which body position?
1. cost-containment benefits. (A) Fowler's
2. low toxicity. (B) Trendelenburg
3. fewer adverse reactions. (C) Recumbent
(A) 1 only (D) Erect
(B) 1 and 2 only ———————————————————————
(C) 2 and 3 only ——
(D) 1, 2, and 3 Orthopnea is a respiratory condition in which the patient has
——————————————————————— difficulty breathing (dyspnea) in any position other than erect.
—— The patient is usually comfortable in the erect, standing, or
The relatively low-osmolality and nonionic, water-soluble seated position. The Trendelenburg position places the
contrast media available to radiology departments have patient's head lowerthan the rest of the body. Fowler's position
outstanding advantages, especially for patients with a history is a semierect position, and the recumbent position is lying
of allergic reaction. They were originally used for intrathecal down. (Ehrlich et al, p 127)
injections (myelography), but they were quickly accepted for
intravascular injections as well. Side effects and allergic 96. When a patient arrives in the radiology department with a
reactions are less likely and less severe with these media. urinary Foley catheter bag, it is important to
Their one very significant disadvantage is their high cost (A) place the drainage bag above the level of the bladder.
compared to ionic contrast media. (Adler & Carlton, p 328) (B) place the drainage bag at the same level as the bladder.
(C) place the drainage bag below the level of the bladder.
91. All of the following statements regarding oxygen delivery (D) clamp the Foley catheter.
are true, except ———————————————————————
(A) Oxygen is classified as a drug and must be prescribed by a ——
physician. When caring for a patient with an indwelling Foley catheter,
(B) Rate of delivery and mode of delivery must be part of a place the drainage bag and tubing below the level of the
physician order for oxygen. bladder to maintain the gravity flow of urine. Placement of the
(C) Oxygen may be ordered continuously or as needed by the tubing or bag above or level with the bladder will allow
patient. backflow of urine into the bladder. This reflux of urine can
(D) None of the above; they are all true. increase the chance of urinary tract infection (UTI). (Adler &
——————————————————————— Carlton, p 238)
——
None of the statements in the question is false; all aretrue. 97. Symptoms of shock include
Oxygen is classified as a drug and must be prescribed by a 1. rise in blood pressure.
physician. The rate and mode of delivery of oxygen must be 2. increase in pulse rate.
specified in the physician's orders. It can be ordered to be 3. restlessness and apprehension.
delivered continuously or as needed. (Adler & Carlton, pp 184- (A) 1 only
186) (B) 1 and 2 only
(C) 2 and 3 only
92. Hypochlorite bleach (Clorox) and Lysol are examples of (D) 1, 2, and 3
(A) antiseptics. ———————————————————————
(B) bacteriostatics. ——
(C) antifungal agents. Shock occurs when the blood pressure is insufficient to provide
(D) disinfectants. adequate circulation of oxygenated blood to all body tissues.
——————————————————————— There are several types of shock. Symptoms common to all
—— types of shock include a drop in blood pressure (and therefore
Hypochlorite bleach (Clorox) and Lysol are examples of an inability to provide oxygenated blood to body tissues), an
disinfectants. Disinfectants are used in radiology departments increased pulse rate, and restlessness and apprehension.

11
Property of Hamilcar Eldo B. Chanjueco
(Ehrlich et al, p 239) decrease under different circumstances? A radiographer
should explore this with a patient and document the
98. A quantity of medication introduced intravenously over a information on the requisition for the radiologist. (Adler &
period of time is termed Carlton, p 137)
(A) an intravenous push.
(B) an infusion. 103. In which of the following conditions is a double-contrast
(C) a bolus. barium enema (BE) essential for demonstration of the
(D) parenteral. condition?
——————————————————————— 1. Polyps
—— 2. Colitis
Quantities of medication can be dispensed intravenously over 3. Diverticulosis
a period of time via an IV infusion. A special infusion pump (A) 1 only
may be used to precisely regulate the quantity received by the (B) 1 and 2 only
patient. An intravenous push refers to a rapid injection; the (C) 1 and 3 only
term bolus refers to the quantity of material being injected. The (D) 1, 2, and 3
term parenteral refers to administration of medication by any ———————————————————————
route other than orally. (Adler & Carlton, pp 301-302) ——
Double-contrast studies of the large bowel are particularly
99. For which of the following radiographic examinations is a useful for demonstration of the bowel wall, and anything
consent form usually required? projecting from it, as in diverticulosis. Polyps are projections of
1. Angiogram the bowel wall mucous membrane into the bowel lumen. Colitis
2. GI series is inflammation of the large bowel, often associated with
3. Skeletal survey ulcerations of the mucosal wall. A single-contrast study would
(A) 1 only most likely obliterate these mucosal conditions, but coating the
(B) 1 and 2 only bowel mucosa with barium and subsequent filling the bowel
(C) 1 and 3 only with air (double contrast) provides optimal delineation.
(D) 1, 2, and 3 (Ballinger & Frank, vol 2, p 128)
———————————————————————
—— 104. Which of the following is a vasopressor and may be used
Although patient consent for all routine procedures is implied for an anaphylactic reaction or cardiac arrest?
upon admission to the hospital, specific informed consent (A) Nitroglycerin
forms are required for procedures that involve significant risk. (B) Epinephrine
Routine procedures such as GI series and skeletal surveys do (C) Hydrocortisone
not involve significant patient risk, but invasive procedures (D) Digitoxin
such as angiography do, and thereforea consent form must be ———————————————————————
signed for such procedures. A family member may sign for a ——
patient who is incompetent or too ill to sign. (Ehrlich et al, p Epinephrine (Adrenalin) is the vasopressor used to treat an
125) anaphylactic reaction or cardiac arrest. Nitroglycerin is a
vasodilator. Hydrocortisone is a steroid that may be used to
100. What is the most common means of spreading infection? treat bronchial asthma, allergic reactions, and inflammatory
(A) Improperly disposed of contaminated waste reactions. Digitoxin is used to treat cardiac fibrillation. (Ehrlich
(B) Instruments that are improperly sterilized et al, pp 186-187)
(C) Soiled linen
(D) Human hands 105. Nitroglycerin is used
——————————————————————— (A) to relieve pain from angina pectoris.
—— (B) to prevent a heart attack.
Microorganisms are most commonly spread from one person (C) as a vasoconstrictor.
to another by human hands and can be prevented from (D) to increase blood pressure.
spreading by handwashing. Contaminated waste products, ———————————————————————
soiled linen, and improperly sterilized instruments are all ways ——
in which microorganisms can travel. Not every patient will Angina pectoris is a crushing chest pain caused by acirculatory
come into contact with these items. However, the health-care disturbance of the coronary arteries. Nitroglycerin is used to
worker is in constant contactwith the patient and is therefore a dilate blood vessels (vasodilation) and decrease blood
constant threat for the spread of infection. (Torres, p 54) pressure in the treatment of pain from angina pectoris.
Nitroglycerin is usually given sublingually, and thus is absorbed
101. An ambulatory patient is one who directly into the bloodstream. (Adler & Carlton, p 292)
(A) is able to walk.
(B) is unable to walk. 106. The chemical agent alcohol can be used effectively as
(C) has difficulty breathing. a(n)
(D) arrives by ambulance. (A) antiseptic.
——————————————————————— (B) germicide.
—— (C) disinfectant.
An ambulatory patient is one who is able to walk with minimal (D) antibiotic.
or no assistance. Outpatients are usually ambulatory, as are ———————————————————————
many inpatients. Patients who are not ambulatory are usually ——
transported to the radiology department via stretcher. (Adler & Some chemical agents used in health-care facilities function to
Carlton, p 161) kill pathogenic microorganisms, while others function to inhibit
the growth / spread of pathogenic microorganisms. Germicides
102. When a radiographer is obtaining a patient history, both and disinfectants are used to kill pathogenic microorganisms,
subjective and objective data should be obtained. An example whereas antiseptics (like alcohol) are used to stop their
of subjective data is growth / spread. Sterilization is another associated term; it
(A) The patient appears to have a productive cough. refers to the killing of all microorganisms and their spores.
(B) The patient has a blood pressure of 130/95. (Ballinger & Frank, vol 1, p 15)
(C) The patient states that he experiences extreme pain in
the upright position. 107. The pain experienced by an individual whose coronary
(D) The patient has a palpable mass in the right upper arteries are not conveying sufficient blood to the heart is called
quadrant of the left breast. (A) tachycardia.
——————————————————————— (B) bradycardia.
—— (C) angina pectoris.
Obtaining a complete and accurate history from the patient for (D) syncope.
the radiologist is an important aspect of a radiographer's job. ———————————————————————
Both subjective and objective data should be collected. ——
Objective data include signs and symptoms that can be An individual whose coronary arteries are not carrying enough
observed, such as a cough, a lump, or elevated blood blood to the heart muscle (myocardium), as a result of partial
pressure. Subjective data relate to what the patient feels, and or complete blockage of a cardiac vessel, experiences
to what extent. A patient may experience pain, but is it mild or crushing pain in the chest, frequently radiating to the left jaw
severe? Is it localized or general? Does the pain increase or and arm. This is termed angina pectoris. It may be relieved by

12
Property of Hamilcar Eldo B. Chanjueco
the drug nitroglycerin, which dilates the coronary arteries, thus
facilitating circulation. Tachycardia refers to rapid heart rate, 113. A radiologic technologist can be found guilty of a tort in
and bradycardia to slow heart rate. Syncope is fainting. (Adler which of the following situations?
& Carlton, p 292) 1. Failure to shield a patient of childbearing age from
unnecessary radiation
108. Where is the "sterile corridor" located? 2. Performing an examination on a patient who has
(A) Just outside the surgical suite refused the examination
(B) Immediately inside each operating room door 3. Discussing a patient's condition with a third party
(C) Between the draped patient and the instrument table (A) 1 only
(D) At the foot end of the draped patient (B) 1 and 2 only
——————————————————————— (C) 2 and 3 only
—— (D) 1, 2, and 3
When radiographs in the surgical suite are required, the ———————————————————————
radiographer is responsible for ensuring that surgical asepsis is ——
maintained. This requires proper dress, cleanliness of A tort is an intentional or unintentional act that involves
equipment, and restricted access to certain areas. An example personal injury or damage to a patient. Allowing a patient to
of a restricted area is the "sterile corridor," which is located beexposed to unnecessary radiation, either by neglecting to
between the draped patient and the instrument table and is shield the patient or by performing an unwanted, examination,
occupied only by the surgeon and the instrument nurse. would be considered a tort, and the radiographer would be
(Ehrlich, McCloskey & Daly, p 171) legally accountable. Discussing a patient's condition with a
third party would undoubtedly be considered a serious
109. You receive an ambulatory patient for a GI series. As the intentional tort. (Torres, p 12)
patient is seated on the x-ray table, he feels faint. You should
1. Lay the patient down on the x-ray table. 114. A patient whose systolic blood pressure is less than 90
2. Elevate the patient's legs or place the table slightly mmHg is usually considered
Trendelenburg. (A) hypertensive.
3. Leave quickly and call for help. (B) hypotensive.
(A) 1 only (C) average / normal.
(B) 1 and 2 only (D) baseline.
(C) 1 and 3 only ———————————————————————
(D) 1, 2, and 3 ——
——————————————————————— Systolic blood pressure describes the pressure during
—— contraction ofthe heart. It is expressed as the top number when
A patient who has been NPO since midnight or who is anxious, recording blood pressure. Diastolic blood pressure is the
frightened, or in pain may suffer an episode of reading during relaxation of the heart and is placed on the
syncope(fainting) on exertion. The patient should be helped to bottom when recording blood pressure. A patient is considered
a recumbent position with feet elevated, in order to increase hypertensive when systolic pressure is consistently above 140
blood flow to the head. A patient who feels faint should never mmHg, and hypotensive when the systolic pressure is lower
be left alone. (Adler & Carlton, pp 274-275) than 90 mmHg. (Adler & Carlton, p 181)

110.An MRI procedure is contraindicated for a patient having 115. A patient experiencing an episode of syncope should be
(A) herniated disc. placed in which of the following positions?
(B) aneurysm clips. (A) Dorsal recumbent with head elevated
(C) dental fillings. (B) Dorsal recumbent with feet elevated
(D) subdural bleeding. (C) Lateral recumbent
——————————————————————— (D) Seated with feet supported
—— ———————————————————————
The presence of aneurysm clips is contraindication for MRI; ——
even slight shift can cause damage. MRI can be performed for Syncope, or fainting, is the result of a drop in blood pressure
herniated disc and subdural bleeding. Dental fillings do not caused by insufficient blood (oxygen) flow to the brain. The
contraindicate MRI. (Ehrlich, McCloskey & Daly, p 192) patient should be helped into a dorsal recumbent position with
feet elevated in order to facilitate blood flow to the brain.
111. Symptoms associated with a respiratory reaction to (Ehrlich et al, p 239)
contrast media include
1. sneezing. 116. According to the Centers for Disease Control and
2. dyspnea. Prevention (CDC), which of the following body fluids should be
3. asthma attack. treated as if they contained pathogenic microorganisms?
(A) 1 and 2 only 1. Any fluid containing blood
(B) 1 and 3 only 2. Cerebrospinal fluid
(C) 2 and 3 only 3. Synovial fluid
(D) 1, 2, and 3 (A) 1 only
——————————————————————— (B) 1 and 2 only
—— (C) 2 and 3 only
All of these symptoms are related to a respiratory reaction. (D) 1, 2, and 3
There may also be hoarseness, wheezing, or cyanosis. The ———————————————————————
patient who has received contrast media should be watched ——
closely. If any symptoms arise, the radiologist should be The CDC has issued recommendations for handling blood and
notified immediately. (Adler & Carlton, p 328) other body fluids for the protection of health-care workers.
According to the CDC, all human blood and certain human
112. All drug packages must provide certain information body fluids must be treated as though they harbored
required by the U.S. Food and Drug Administration. Some of pathogenic microorganisms. This describes Standard
the information that must be provided includes Precautions. The body fluids identified by the CDC are as
1. the generic name. follows:
2. contraindications. Blood and/or any fluid containing blood
3. the usual dose. Amniotic fluid
(A) 1 only Cerebrospinal fluid
(B) 1 and 2 only Pericardial fluid
(C) 1 and 3 only Pleural fluid
(D) 1, 2, and 3 Saliva from dental procedures
——————————————————————— Seminal fluid Synovial fluid Vaginal fluid Any
—— unidentifiable body fluid
The U.S. Food and Drug Administration mandates that certain (Torres, p 51)
information be included in every drug package. Some of the
information that drug companies are required to provide is 117. Which of the following legal phrases defines a
trade and generic names, indications and contraindications, circumstance in which both the health-care provider's and the
usual dose, chemical composition and strength, and any patient's actions contributed to an injurious outcome?
reported side effects. (Ehrlich, McCloskey & Daly, p 184) (A) Intentional misconduct

13
Property of Hamilcar Eldo B. Chanjueco
(B) Contributory negligence 2. tell them it will not hurt.
(C) Gross negligence 3. be cheerful and unhurried.
(D) None of the above (A) 1 only
——————————————————————— (B) 1 and 3 only
—— (C) 2 and 3 only
A circumstance in which both the health-care provider's and (D) 1, 2, and 3
the patient's actions contribute to an injurious outcome is ———————————————————————
termed contributory negligence. An example would be a patient ——
who fails to follow the physician's orders or show up for follow- Children are often fearfulof leaving familiar surroundings, and
up care, and then sues when the condition causes permanent being able to take along a familiar toy is helpful. A calm and
damage. Another example would be a patient who deliberately cheerful radiographer can be reassuring to the anxious child.
gives false information about the ingestion of drugs, leading to Honesty is essential, and false reassurances, such as telling
adverse effects from medications administered. Most states do the child it will not hurt, not only do more harm than good, but
not completely dismiss injury if there has been negligence on also focus the child's attention on pain. (Ehrlich et al, p 71)
the part of the health-care institution, even if the patient's
actions contributed substantially to the injury. Rather, 122. Because of medicolegal considerations, radiographic
comparative negligence is applied, with the percentage of the images are required to include all the following information,
injury due to the patient's actions is compared with the total except
amount of injury. A jury may decide that a doctor was negligent (A) the patient's name and/or identification number.
in his actions, but because the patient lied about using an (B) the patient's birth date.
illegal street drug that contributed to the injurious outcome, the (C) a right or left side marker.
patient is 80 percent responsible for her condition. The party (D) the date of the examination.
suing may be awarded $100,000 for injuries, but would actually ———————————————————————
receive only $20,000. Gross negligence occurs when there is ——
willful or deliberate neglect of the patient. Assault, battery, Every radiographic image must include (1) the patient's name
invasion of privacy, false imprisonment, and defamation of or ID number; (2) the side marker, right or left; (3) the date of
character all fall under the category of intentional misconduct. the examination; and (4) the identity of the institution or office.
(Ehrlich, McCloskey, & Daly, p 57) Additional information may be included: the patient's birth date
or age, the attending physician, and the time of day. When
118. Which of the following patient rights is violated by multiple exams (e.g., chest exams or small bowel images) of a
discussing privileged patient information with an individual who patient are made on the same day, it becomes crucial that the
is not involved with the patient's care? time the radiographs were taken be included on the film. This
1. The right to considerate and respectful care allows the physician to track the patient's progress. (Ballinger &
2. The right to privacy Frank, vol 1, pp 22-23)
3. The right to continuity of care
(A) 1 only 123. The least toxic contrast medium listed below is
(B) 2 only (A) barium sulfate.
(C) 1 and 3 only (B) metrizamide.
(D) 2 and 3 only (C) ethiodized oil.
——————————————————————— (D) meglumine diatrizoate.
—— ———————————————————————
The patient's right to privacy refers to the patient's modesty ——
and dignity being respected. It also refers to the professional The inert characteristics of barium sulfate render it the least
health-care worker's obligation to respect the confidentiality of toxic contrast medium. Iodinated contrast media are absorbed
privileged information. Communication of privileged information by the body, whereas barium sulfate is not. Metrizamide,
to anyone but health-care workers involved with the patient's ethiodized oil, and meglumine diatrizoate are iodinated
care is inexcusable. (Gurley & Callaway, p 187) contrast media that could cause anaphylactic shock and death
in the allergic patient. (Torres, p 200)
119. Possible side effects of an iodinated contrast medium that
is administered intravenously include all of the following except 124. A drug's chemical name is called its
(A) a warm feeling. (A) generic name.
(B) altered taste. (B) trade name.
(C) nausea. (C) brand name.
(D) hypotension. (D) proprietary name.
——————————————————————— ———————————————————————
—— ——
Nonionic, low-osmolality iodinated contrast agents are A drug's generic name identifies its chemical family. A
associated with far fewer side effects and reactions than ionic, particular generic drug can be manufactured by several
higher-osmolality contrast agents. A side effect is an effect that different companies and be given different trade names (brand
is unintended but possibly expected and fundamentally not or proprietary names). For example, the drug with the chemical
harmful. An adverse reaction is a harmful unintended effect. / generic name acetaminophen is known by the trade or brand
Possible side effects of iodinated contrast agents include a name Tylenol. Drugs can be classified by either their generic
warm, flushed feeling, a metallic taste in the mouth, nausea, name or their trade name. (Ehrlich et al, p 184)
headache, and pain at the injection site. Adverse reactions
include itching, anxiety, rash or hives, vomiting, sneezing, 125. Anaphylactic shock manifests early symptoms that
dyspnea and hypotension. (Adler & Carlton, p 328) include
1. dysphagia.
120. Which of the following conditions describes a patient who 2. itching of palms and soles.
is unable to breathe easily while in the recumbent position? 3. constriction of the throat.
(A) Dyspnea (A) 1 only
(B) Apnea (B) 2 only
(C) Orthopnea (C) 2 and 3 only
(D) Oligopnea (D) 1, 2, and 3
——————————————————————— ———————————————————————
—— ——
A patient with orthopnea is unable to breathe while lying down. Adverse reactions to the intravascular administration of
When the body is recumbent, the diaphragm and abdominal iodinated contrast are not uncommon, and although the risk of
viscera move to a more superior position. It is therefore more a life-threatening reaction is relatively low, the radiographer
difficult to breathe deeply. Patients with orthopnea must be must be alert to recognize the situation and deal with it
examined in an erect or semierect position. Dyspnea refers to effectively should a serious reaction occur. A minor reaction is
difficulty breathing in any body position. Apnea describes characterized by flushed appearance and nausea, and
cessation of breathing for short intervals. Oligopnea is occasionally by vomiting and a few hives. Early symptoms of a
infrequent breathingas slow as 6 to 10 respirations per possible anaphylactic reaction include constriction of the
minute. (Ehrlich, McCloskey & Daly, p 127) throat, possibly because of laryngeal edema, dysphagia
(difficulty swallowing), and itching of the palms and soles. The
121. When radiographing young children, it is helpful to radiographer must maintain the patient's airway, summon the
1. let them bring a toy. radiologist, and call a "code." (Adler & Carlton, p 267)

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Property of Hamilcar Eldo B. Chanjueco
 3. disinfectants.
126. According to the CDC (Centers for Disease Control and (A) 1 only
Prevention), all of the following precaution guidelines are true, (B) 1 and 2 only
except (C) 2 and 3 only
(A) Airborne precautions require that the patient wear a mask. (D) 1, 2, and 3
(B) Masks are indicated when caring for patients on MRSA ———————————————————————
precautions. ——
(C) Patients under MRSA precautions require a negative- Some chemical agents used in health-care facilities function to
pressure room. kill pathogenic microorganisms, while others function to inhibit
(D) Gloves are indicated when caring for a patient on droplet the growth / spread of pathogenic microorganisms. Germicides
precautions. and disinfectants are used to kill pathogenic microorganisms,
——————————————————————— whereas antiseptics (like alcohol) are used to stop their
—— growth / spread. Sterilization is another associated term; it
Category-specific isolations have been replaced by refers to the killing of all microorganisms and their spores.
transmission-based precautions: airborne, droplet, and (Ballinger & Frank, vol 1, p 15)
contact. Under these guidelines, some conditions or diseases
can fall into more than one category. Airborne precautions are 130. Which of the following parenteral routes is most often
employed with patients suspected or known to be infected with used for administration of contrast agents in the radiology
the tubercle bacillus (TB), chickenpox (varicella), or measles department?
(rubeola). Airborne precautions require that the patient wear a (A) Subcutaneous
mask to avoid the spread of bronchial secretions or other (B) Intravenous
pathogens during coughing. If the patient is unable or unwilling (C) Intramuscular
to wear amask, the radiographer must wear one. The (D) Intradermal
radiographer should wear gloves, but a gown is required only if ———————————————————————
flagrant contamination is likely. Patients under airborne ——
precautions require a private, specially ventilated (negative- A parental route of drug administration is one that bypasses
pressure) room. A private room is also indicated for all patients the digestive system. In radiography, the intravenous method
on droplet precautions, i.e., with diseases transmitted via large is most commonly used to administer contrast agents. The four
droplets expelled from the patient while speaking, sneezing, or parenteral routes require different needle placements: under
coughing. The pathogenic droplets can infect others when they the skin (subcutaneous), through the skin and into the muscle
come in contact with mouth or nasal mucosa or conjunctiva. (intramuscular), between the layers of the skin (intradermal),
Rubella ("German measles"), mumps, and influenza are and into the vein (intravenous). (Adler & Carlton, p 300)
among the diseases spread by droplet contact; a private room
is required for the patient, and health-care practitioners should 131. Chemical substances that are used to kill pathogenic
use gown and gloves. Any diseases spread by direct or close bacteria are called
contact, such as MRSA (methicillin-resistant Staphylococcus 1. antiseptics.
aureus), conjunctivitis, and hepatitis A, require contact 2. germicides.
precautions. Contact precautions require a private patient room 3. disinfectants.
and the use of gloves, mask, and gown for anyone coming in (A) 1 only
direct contact with the infected individual or his or her (B) 1 and 2 only
environment. (Adler & Carlton, p 215) (C) 2 and 3 only
(D) 1, 2, and 3
127. Examples of nasogastric tubes include ———————————————————————
1. Swan-Ganz. ——
2. Salem-sump. Some chemical agents used in health-care facilities function to
3. Levin. kill pathogenic microorganisms, while others function to inhibit
(A) 1 and 2 only the growth / spread of pathogenic microorganisms. Germicides
(B) 1 and 3 only and disinfectants are used to kill pathogenic microorganisms,
(C) 2 and 3 only whereas antiseptics (like alcohol) are used to stop their
(D) 1, 2, and 3 growth / spread. Sterilization is another associated term; it
——————————————————————— refers to the killing of all microorganisms and their spores.
—— (Ballinger & Frank, vol 1, p 15)
The Levin and Salem-sump tubes are nasogastric (NG) tubes
used for gastric decompression. The Salem-sump tube is 132. Which of the following diastolic pressure readings might
radiopaque and has a double lumen. One lumen is for gastric indicate hypertension?
air compression, and the other is for removal of fluids. The (A) 50 mmHg
Levin tube is a single-lumen tube that is used to prevent (B) 70 mmHg
accumulation of intestinal liquids and gas during and following (C) 90 mmHg
intestinal surgery. The Swan-Ganz intravenous catheter is (D) 110 mmHg
advanced to the pulmonary artery and used to measure ———————————————————————
various heart pressures. (Adler & Carlton, p 246) ——
The diastolic number is the bottom number in a blood pressure
128. Which of the following imaging procedures do not require reading. The normal range for diastolic pressure is 60 to 90
the use of ionizing radiation to produce an image? mmHg. A diastolic pressure reading of 110 mmHg might
1. Ultrasound indicate hypertension. A diastolic pressure of 50 mmHg might
2. Computed axial tomography indicate shock. The systolic number is the top number in a
3. Magnetic resonance imaging blood pressure reading. The normal systolic pressure range is
(A) 1 and 2 only 110 to 140 mmHg. (Torres, p 139)
(B) 1 and 3 only
(C) 2 and 3 only 133. During a grand mal seizure, the patient should be
(D) 1, 2, and 3 (A) protected from injury.
——————————————————————— (B) placed in a semiupright position to prevent aspiration of
—— vomitus.
Both ultrasound and magnetic resonance imaging do not (C) allowed to thrash freely.
require the use of ionizing radiation to produce an image. (D) given a sedative to reduce jerky body movements and
Computed axial tomography does require ionizing radiation to reduce the possibility of injury.
produce an image. Ultrasound requires the use of high- ———————————————————————
frequency sound waves to produce images of soft tissue ——
structures and certain blood vessels within the body. Magnetic When a patient is experiencing a seizure, he or she should be
resonance imaging relies on the use of a very powerful magnet protected from striking any hard surfaces or falling. The patient
and specially designed coils that are sensitive to radio-wave exhibits uncontrollable body movements. Any attempt to place
signals to produce the image. (Torres, pp 310, 313) the patient in a semierect position or to administer a sedative
would prove futile. Following the seizure, it is important to
129. Chemical substances that inhibit the growth of pathogenic place the patient on his or her side to prevent aspiration of any
microorganisms without necessarily killing them are called vomitus or oral secretions. (Torres, p 167)
1. antiseptics.
2. germicides. 134. An inanimate object that has been in contact with an

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Property of Hamilcar Eldo B. Chanjueco
infectious microorganism is termed a patients) or other pathogens during coughing. If the patient is
(A) vector. unable or unwilling to wear a mask, the radiographer must
(B) fomite. wear one. The radiographer should wear gloves, but a gown is
(C) host. required only if flagrant contamination is likely. Patients
(D) reservoir. infected with diseases calling for airborne precautions require a
——————————————————————— private, specially ventilated (negative-pressure) room. A private
—— room is also indicated for all patients on droplet precautions,
A fomite is an inanimate object that has been in contact with an i.e., with diseases that are transmitted via large droplets
infectious microorganism. A reservoir is a site where an expelled from the patient while speaking, sneezing, or
infectious organism can remain alive and from which coughing. The pathogenic droplets can infect others when they
transmission can occur. Although an inanimate object can be a come in contact with the mouth or nasal mucosa or
reservoir for infection, living objects (such as humans) can also conjunctiva. Rubella ("German measles"), mumps, and
be reservoirs. For infection to spread, there must be a host influenza are among the diseases spread by droplet contact; a
environment. Although an inanimate object may serve as a private room is required for the patient, and health-care
temporary host where microbes can grow, microbes flourish on practitioners must use gown and gloves.(Adler & Carlton, p
and in the human host, where there are plenty of body fluids 115)
and tissues to nourish and feed the microbes. A vector is an
animal host of an infectious organism that transmits the 139. In classifying intravenous contrast agents, the total
infection via bite or sting. (Torres, p 46) number of dissolved particles in solution per kilogram of water
defines
135. Log rolling is a method of moving patients with suspected (A) osmolality.
(A) head injury. (B) toxicity.
(B) spinal injury. (C) viscosity.
(C) bowel obstruction. (D) miscibility.
(D) extremity fracture. ———————————————————————
——————————————————————— ——
—— In classifying contrast agents, the total number of dissolved
Patients arriving from the emergency department (ED) with particles in solution per kilogram of water defines the
suspected spinal injury should not be moved. AP and osmolality of the contrast agent. The toxicity defines how
horizontal lateral projections of the suspected area should be noxious or harmful a contrast agent is. Contrast agents with
evaluated and a decision made about the advisability of further low osmolality have been found to cause less tissue toxicity
films. For a lateral projection, the patient should be moved than the ionic intravenous contrast agents. The viscosity
along one plane, that is, rolled like a log. It is imperative that defines the thickness or concentration of the contrast agent.
twisting motions be avoided. (Torres, pp 78-79) The viscosity of a contrast agent can affect the injection rate. A
thicker, or more viscous, contrast agent will be more difficult to
136. A patient who is diaphoretic has inject (more pressure is needed to push the contrast agent
(A) pale, cool, clammy skin. through the syringe and needle or the angiocatheter). The
(B) hot, dry skin. miscibility of a contrast agent refers to its ability to mix with
(C) dilated pupils. body fluids, such as blood. Miscibility is an important
(D) warm, moist skin. consideration in preventing thrombosis formation. It is
——————————————————————— generally preferable to use a contrast agent with low osmolality
—— and low toxicity because such an agent is safer for the patient
Observation is an important part of the evaluation of acutely ill and less likely to cause any untoward reactions. When ionic
patients. The patient who is diaphoretic is "in a cold sweat," and nonionic contrast agents are compared, a nonionic
with pale, cool, moist skin. Hot, dry skin accompanies fever. contrast agent has a lower osmolality. To further understand
Warm, moist skin may be a result of anxiety or simply of being osmolality, remember that wheneverintravenous contrast
in a warm room. The pupils dilate in dimly illuminated places in media are introduced, there is a notable shift in fluid and ions.
order to allow more light into the eyes. (Ehrlich, McCloskey & This shift is caused by an inflow of water from interstitial
Daly, p 120) regions into the vascular compartment, which increases the
blood volume and cardiac output. Consequently, there will be a
137. Ingestion of a gas-producing powder or crystals is usually decrease in systemic arterial pressure and peripheral vascular
preliminary to which of the following examinations? resistance with peripheral vasodilation. Additionally, the
1. Oral cholecystogram pulmonary pressure and heart rate increase. When the effects
2. Double-contrast GI of osmolality on the patient are understood, it becomes clear
3. Intravenous urogram that an elderly patient or one with cardiac disease or impaired
(A) 1 only circulation would greatly benefit from the use of an agent with
(B) 2 only lower osmolality. (Adler & Carlton, p 320)
(C) 1 and 2 only
(D) 2 and 3 only 140.Which of the following radiographic procedures requires
——————————————————————— an intrathecal injection?
—— (A) Intravenous pyelogram
A double-contrast GI requires that the patient ingest gas- (B) Myelogram
producing powder, crystals, pills, or beverage followed by a (C) Lymphangiogram
small amount of high-density barium. The patient may then be (D) Computed tomography (CT)
asked to roll in the recumbent position in order to coat the ———————————————————————
gastric mucosa, while the carbon dioxide expands. This ——
procedure provides optimal visualization of the gastric walls. A myelogram, or radiographic examination of the spinal canal,
An oral cholecystogram can be performed approximately 3 h requires an intrathecal (intraspinal) injection. Intrathecal
after ingestion of special ipodate calcium granules. An administration of contrast medium is usually at the level of L2/3
intravenous urogram (IVU) requires an IV injection of iodinated or L3/4. An intravenous pyelogram is performed with an
contrast medium. (Ballinger & Frank, vol 2, p 99) injection of contrast medium into the venous system. A
lymphangiogram requires that contrast medium be delivered
138. Diseases whose mode of transmission is through the air into the lymphatic vessels. A CT scan may or may not require
include the use of an intravenous injection. (Torres, p 306)
1. tuberculosis.
2. mumps. 141. Which of the following is a violation of correct sterile
3. rubella. techniques?
(A) 1 only (A) Gowns are considered sterile in the front down to the waist,
(B) 1 and 2 only including the arms.
(C) 1 and 3 only (B) Sterile gloves must be kept above the waist level.
(D) 1, 2, and 3 (C) Persons in sterile dress should pass each other face to
——————————————————————— face.
—— (D) A sterile field should not be left unattended.
Diseases that are transmitted through the air include TB, ———————————————————————
rubella ("German measles"), mumps, and influenza. Airborne ——
precautions require the patient to wear a mask to avoid the Persons in sterile dress should not pass each other face to
spread of acid-fast bacilli (in the bronchial secretions of TB face. Rather, they should pass each other back to back, to

16
Property of Hamilcar Eldo B. Chanjueco
avoid contaminating each other. Gowns are considered sterile ——
in the front down to the waist, including the arms. Sterile gloves Barium can dry and harden in the large bowel, causing
must be kept above the waist level. If the hands are symptoms ranging from mild constipation to bowel obstruction.
accidentally lowered or placed behind the back, they are no It is thereforeessential that the radiographer provide clear
longer sterile. A sterile field should not be leftunattended. instructions, especially to outpatients, on follow-up care, along
Sterile fields should be set up immediately prior to a procedure, with the rationale for this care. In order to avoid the possibility
and should be covered with a sterile drape if a few moments of fecal impaction, the patient should drink plenty of fluids for
are to elapse before the procedure can begin. A sterile field the nextfew days and take a mild laxative such as milk of
should be constantly monitored to be certain that it has not magnesia. (Torres, pp 211-212)
been contaminated. (Adler & Carlton, p 234)
146. If an emergency trauma patient experiences
142. Which of the following statements are true regarding a hemorrhaging from a leg injury, the radiographer should
two-member team performing mobile radiography on a patient 1. apply pressure to the bleeding site.
with MRSA (methicillin-resistant Staphyloccus aureus) 2. call the emergency department for assistance.
precautions? 3. apply a pressure bandage and complete the
1. One radiographer remains "clean"that is, he or examination.
she has no physical contact with the patient. (A) 1 and 2 only
2. The radiographer who positions the mobile unit (B) 1 and 3 only
also makes the exposure. (C) 2 and 3 only
3. The radiographer who positions the cassette also (D) 1, 2, and 3
retrieves the cassette and removes it from its ———————————————————————
plastic protective cover. ——
It is unlikely that the radiographer will be faced with a wound
(A) 1 and 2 only hemorrhage, because bleeding from wounds is controlled
(B) 1 and 3 only before the patient is seen for x-ray examination. However, if a
(C) 2 and 3 only patient does experience hemorrhaging from a wound, you
(D) 1, 2, and 3 should apply pressure to the bleeding site and call for
——————————————————————— assistance. Delay can lead to serious blood loss. (Adler &
—— Carlton, p 275)
When a two-member team of radiographers is performing
mobile radiography on a patient with contact precautions, such 147. To reduce the back strain associated with transferring
as an MRSA patient, one radiographer remains "clean"that is, patients from stretcher to x-ray table, the radiographer should
he or she has no physical contact with the patient. The clean (A) pull the patient.
radiographer will position the mobile unit and make the (B) push the patient.
exposure. The other member of the team will position the (C) hold the patient away from his or her body and lift.
cassette and retrieve the cassette. As the two radiographers (D) bend at the waist and pull.
fold down the cassette's protective plastic cover, the clean ———————————————————————
radiographer will remove the cassette from the plastic. Both ——
radiographers should be protected with gowns, gloves, and When transferring patients from stretcher to x-ray table, there
masks if the patient is on contact precautions. Additionally, are several rules that will reduce back strain. Pull, do not push,
after the exam is completed, the mobile unit should be cleaned the patient; pushing increases friction and makes the transfer
with a disinfectant. Conditions requiring the use of contact more difficult. Do not bend at the waist and pull; use
precautions also include hepatitis A and varicella. (Torres, pp yourbiceps for pulling the patient. Draw the patient as close to
61-66) you as possible and then lift if necessary. (Torres, p 74)

143.The condition in which pulmonary alveoli lose their 148. The Heimlich maneuver is used if a patient is
elasticity and become permanently inflated, causing the patient (A) in cardiac arrest.
to consciously exhale, is (B) choking.
(A) bronchial asthma. (C) having a seizure.
(B) bronchitis. (D) suffering from hiccups.
(C) emphysema. ———————————————————————
(D) tuberculosis. ——
——————————————————————— The Heimlich maneuver is used when a person is choking. If
—— you suspect that an individual is choking, be certain that the
Emphysema is a progressive disorder caused by long-term airway is indeed obstructed before attempting the Heimlich
irritation of the bronchial passages, such as by air pollution or maneuver. A person with a completely obstructed airway will
cigarette smoking. Emphysema patients are unable to exhale not be able to speak or cough. If the person cannot speak or
normally because of the loss of elasticity of alveolar walls. If cough, then the airway is obstructed, and the Heimlich
emphysema patients receive oxygen, it is usually administered maneuver should be performed. The proper method is to stand
at a very slow heart rate, because their respirations are behind the choking victim with one hand in a fist, thumb side in,
controlled by the level of carbon dioxide in the blood. (Tortora midway between the navel and the xiphoid tip. Place the other
& Grabowski, p 844) hand over the closed fist with the palm open and apply
pressure in and up. Repeat the thrust several times, until the
144. An informed consent is required before performing which object is dislodged. For an infant, the procedure is modified.
of the following exams? Four back blows are given, midway between the scapulae,
(A) Upper GI using the heel of the hand. If the object is not dislodged, the
(B) Lower GI baby is turned over (being very careful to support the baby's
(C) Sialogram head and spine), and four chests thrusts are performed just
(D) Renal arteriogram below the nipple line, using several fingers. (Adler & Carlton,
——————————————————————— pp 268-269)
——
Informed consent is required before any examination that 149. Abnormal accumulation of air in pulmonary tissues,
involves greater-than-usual risk. Routine procedures such as resulting in overdistention of the alveolar spaces, is
sialography and upper and lower GI series are examples of (A) emphysema.
lower-risk procedures, for which the consent given on (B) empyema.
admission to the hospital is sufficient. (Adler & Carlton, p 366) (C) pneumothorax.
(D) pneumoconiosis.
145. What instructions might a patient receive upon completing ———————————————————————
a barium enema (BE) examination? ——
1. Drink plenty of fluids. Overdistention of the alveoli with air is emphysema. The
2. Take a mild laxative. condition is often a result of many years of smoking and is
3. Withhold fluids for 6 h. characterized by dyspnea, especially when recumbent.
(A) 1 and 2 only Empyema is pus in the thoracic cavity; pneumothorax is air or
(B) 2 and 3 only gas in the pleural cavity. Pneumoconiosis is a condition of the
(C) 2 only lungs characterized by particulate matter having been
(D) 3 only deposited in lung tissue; it sometimes results in emphysema.
——————————————————————— (Tortora & Grabowski, p 844)

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Property of Hamilcar Eldo B. Chanjueco
150. A diabetic patient who is prepared for a fasting
radiographic exam is susceptible to a hypoglycemic reaction.
This is characterized by
1. shaking and nervousness.
2. cold, clammy skin.
3. cyanosis
(A) 1 only
(B) 2 only
(C) 1 and 2 only
(D) 1, 2, and 3
———————————————————————
——
Hypoglycemic reactions can be very severe and should be
treated with an immediate dose of sugar (e.g., in juice). Early
symptoms of an insulin reaction are shaking, nervousness,
dizziness, cold and clammy skin, blurred vision, and slurred
speech. Convulsions and coma may result if the patient is not
treated. Cyanosis is the lack of oxygenated blood, which is a
symptom of shock. (Torres, p 158)

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Property of Hamilcar Eldo B. Chanjueco