SP16:Patient Care

Question 1

Which of the following concerning an IV drip should a technologist monitor while a patient is under his or her care?
(a)Height of the infused substance

(b) Kinks in tubing
(c) Pain and swelling
(d) All of the above

Answer 1

(d) While a technologist has care of a patient, he or she is responsible to be alert for and take steps to avoid problems with IV lines, catheter bags, etc.

Question 2

Ambulatory means:
(a)Emergent

(b) Able to walk
(c) Bedridden
(d) In a wheelchair

Answer 2

(b) Ambulatory means able to walk.

Question 3

Which of the following is not a method for decreasing the spread of HIV?
(a)Using a protective gown and gloves

(b) Using disposable needles only once
(c) Obtaining a detailed sexual history
(d) Using a protective face mask

Answer 3

(c) Protective barriers are a part of universal precautions set out by the Centers for Disease Control and Prevention and include gowns, gloves, and masks as necessary, There is a minute risk of spread of HIV via contact with tears, feces, nasal secretions, sputum, urine, and vomit, unless there is visible blood in them. However, in some cases, it may be necessary for technologists to use gowns or masks to protect their mucous membranes and skin if there will be exposure to other body fluids or those listed above when they contain blood. Obtaining a sexual history may be relevant for the physician but does not help a technologist control disease spread.

Question 4

If bleeding occurs during withdrawal of a needle following injection, one should:
(a)Apply a tourniquet

(b) Apply pressure
(c) Alert a physician
(d) Apply ice

Answer 4

(b) Bleeding following an IV injection is halted by applying pressure. In cases of severe or prolonged bleeding, a physician should be alerted.

Question 5

NPO means:
(a)No preparation for exam.

(b) Nothing by mouth.
(c) Patient may drink water but should not eat.
(d) None of the above.

Answer 5

(b) NPO stands for nil per os, which means nothing by mouth.

Question 6

Which of the following should be considered when using patient restraint devices?
(a)Restricted circulation

(b) Attenuation
(c) Comfort
(d) All of the above
(e) (a) and (c) only

Answer 6

(d) Patient restraint devices should not restrict circulation and patient comfort is important. Buckles on straps, etc. may produce attenuation artifacts.

Question 7

A patient who is aphasic cannot:
(a)Walk

(b) Breathe while lying flat
(c) Sit up
(d) Talk

Answer 7

(d) Aphasia refers to difficulty with or complete inability to use or comprehend words.

Question 8

If several patients receiving a dose of radiopharmaceutical from the same vial experience an adverse reaction, this is likely a(n):
(a)Anaphylactic reaction

(b) Allergic reaction
(c) Pyrogenic reaction
(d) Radiation sickness

Answer 8

(c) Anaphylactic reaction is a systemic allergic reaction caused by a second exposure to an antigen, so this is unlikely to occur in multiple patients. Another type of allergic reaction (which may be mild) would also not likely be present in multiple patients. The dose necessary to cause radiation sickness would be much higher than that likely to be contained in the vial. A pyrogenic reaction is one causing fever and could be the result of pyrogens (microbial or nonmicrobial substances that produce increases in body temperature) in the prepared radiopharmaceutical and therefore could affect all patients receiving doses withdrawn from that vial.

Question 9

Which of the following tests does not require the patient to be NPO for some time period prior to scanning?
(a)Hepatobiliary imaging

(b) Gastrointestinal bleeding study
(c) Exercise-redistribution myocardial scan with 201Tl
(d) Schilling test

Answer 9

(b) A gastrointestinal bleeding study does not require that the patient be NPO prior to exam, but this is part of the preparation for all of the other choices.

Question 10

Of the following types of disease transmission, for which does the Centers for Disease Control recommend wearing a bio-safety mask?
(a)Airborne

(b) Contact
(c) Droplet
(d) (a) and (c) only
(e) All of the above

Answer 10

(d) The Centers for Disease Control and Prevention recommends the healthcare professional treating patients for whom droplet and airborne precautions are needed use masks when treating the patients, put such patients in private rooms, and that the patient wear a mask when being transported or treated outside his or her room.

Question 11

The standard precautions re commended by the Centers for Disease Control are designed for use:
(a)With patients presenting a risk for contact transmission

(b) With all patients who present in the healthcare setting
(c) With patients presenting a risk for airborne transmission
(d) With patients presenting a risk droplet transmission

Answer 11

(b) Standard precautions (now known as universal precautions) apply to all patients regardless of their infection status and include the use of gloves, handwashing, barrier protection (depending on the anticipated exposure), and safe injection procedure.

Question 12

A nosocomial infection is:
(a)In the nasal passage

(b) Transmitted by coughing or sneezing
(c) Acquired while in the hospital
(d) Always less serious in nature

Answer 12

(c) Nosocomial refers to being acquired in a hospital.

Question 13

Before any procedure has begun on a patient, his or her identity should be checked:
(a)According to the accompanying chart/medical record

(b) Verbally with the patient if possible
(c) On the wrist band
(d) By all of the above methods

Answer 13

(d) Patient identity should always be ascertained before performing any patient procedure. Identification bands, charts, and verbal communication should all agree with the identity of the patient before proceeding.

Question 14

If a patient is having seizures, the technologist should:
(a)Try to restrict the patients’ movements

(b) Try to grasp the patient’s tongue
(c) Start CPR
(d) Clear the area around the patient to minimize the risk of injury
(e) All of the above

Answer 14

(d) Regardless of the seizure type, patients should not be restricted and nothing should be inserted into their mouth as this will increase the risk of injury. Removing objects that could potentially injure the patient and prevention of injury is a priority for the healthcare provider during the seizure. It is not necessary to start CPR in cases of seizure (unless, of course, the seizure is provoked by a stroke or other serious medical condition and the patient’s heartbeat and breathing cease).

Question 15

Infectious waste disposal involves:
(a)Leakproof containers

(b) Puncture-resistant containers
(c) The universal symbol for biohazard
(d) All of the above
(e) (a) and (b) only

Answer 15

(d) Infectious waste should be disposed of using the universal biohazard symbol, which is recognized by the World Health Organization and numerous national agencies. Sharps should be disposed of using puncture-resistant containers, and all containers and bags should be leakproof.

Question 16

Gloves should be worn anytime there is contact with:
(a)Blood and body fluids

(b) Broken skin
(c) Mucous membranes
(d) All of the above
(e) (a) and (b) only

Answer 16

(d) While nasal secretions do not require universal precautions, vaginal secretions do, and the vaginal lining is a mucous membrane. Hence, mucous membranes are included in the correct answers. In practice, nuclear medicine technologists rarely have contact with mucous membranes.

Question 17

According to the standard precautions issued by the Centers for Disease Control, when should gloves be changed?
(a)Between procedures on two different patients

(b) Between procedures on the same patient
(c) Every half hour
(d) All of the above
(e) (a) and (b) only
(f) (a) and (c) only

Answer 17

(e) The Centers for Disease Control and Prevention recommends changing gloves between patients and between procedures on a single patient if moving from a contaminated area to a clean area. There is no specific frequency recommendation.

Question 18

According to the Centers for Disease Control, handwashing should be performed:
(a)Before contact with a patient

(b) After contact with a patient
(c) After contact with a patient if gloves were worn
(d) All of the above
(e) (a) and (b) only

Answer 18

(d) The Centers for Disease Control and Prevention recommends handwashing or another method of hand hygiene, before and after direct contact with a patient and after gloves are removed, in addition to other circumstances.

Question 19

Which of the following statements is not true regarding sharp instruments?
(a)Reusable instruments should be cleaned, disinfected, and sterilized before reuse.

(b) Nonreusable sharp instruments should be recapped before disposal into a biohazard container.
(c) Single-use needles should be disposed using puncture-resistant containers.
(d) None of the above.

Answer 19

(b) Single-use sharps should not be recapped before disposal as the proper disposal container is puncture resistant and recapping will increase the risk of puncturing the skin of the user.

Question 20

A nursing mother who undergoes a lung perfusion exam utilizing 4 mCi of 99mTc MAA should:
(a)Continue nursing as usual

(b) Interrupt breast-feeding for 12.6 h
(c) Interrupt breast-feeding for 36 h
(d) Discontinue breast-feeding

Answer 20

(b) The International Commission on Radiological Protection recommends delaying breast-feeding for 12 h after 99mTc-labeled radiopharmaceuticals except for labeled red blood cells, phosphonates, and DTPA for which 4 h of interruption is recommended. Three weeks is recommended after 201Tl-, 67Ga-, and 125I-labeled compounds. It is recommended that breast-feeding be completely discontinued after 131I therapy.

Question 21

Patients who receive an injection of an investigational radiopharmaceutical must:
(a)Have their urine collected and stored until it decays to background

(b) Sign a patient informed consent form
(c) Have made a living will
(d) Be inpatients

Answer 21

(b) While some investigational radiopharmaceutical use will require that the patient is hospitalized and some could theoretically require storage of urine until decay, the only statement that is true regarding all uses of investigational drugs is that patients must given informed consent.

Question 22

Which of the following is true concerning radioactivity and pregnancy?
(a)Radioiodine will cross the placenta.

(b) Hydration and frequent voiding will reduce the fetal absorbed dose.
(c) The NRC total dose allowed to an embryo/fetus from occupational exposure is 0.5 rem.
(d) All of the above.

Answer 22

(d) The use of radiopharmaceuticals is not encouraged during pregnancy. Iodine, and therefore radioiodine, crosses the placenta from the mother to the child, and therefore, radioiodine therapy can damage the baby’s thyroid. Women are advised to delay pregnancy for a year following radioiodine therapy. The international Atomic Energy Agency recommends lower doses followed by hydration and frequent voiding to reduce fetal exposure for pregnant women who have undergone examinations using radiopharmaceuticals. Hydration without frequent voiding will increase the dose to the fetus. The total dose equivalent allowed to the fetus from occupational exposure of the mother is 0.5 rem.