RADR 1309 Introduction to Radiography and Patient Care

Correct Answer

A. Vasogenic

Explanation of the Correct Answer

Vasogenic shock is a type of distributive shock that results from widespread dilation of blood vessels, leading to a sudden drop in blood pressure and poor perfusion to tissues. It can be caused by conditions like:

Sepsis (septic shock) – where bacterial toxins cause massive vasodilation

Anaphylaxis – a severe allergic reaction that causes histamine release and vessel dilation

Deep anesthesia – which can depress the central nervous system and cause loss of vascular tone

All of these result in vasodilation and blood pooling, which is the hallmark of vasogenic shock.

Why the Other Options Are Incorrect

B. Septic – Septic shock is a specific type of vasogenic (distributive) shock. While sepsis is one cause, this option doesn’t encompass the full list of causes mentioned (deep anesthesia and anaphylaxis).

C. Hypovolemic – This is caused by fluid or blood loss, not by vasodilation. It results in reduced blood volume, not abnormal vessel tone.

D. Neurogenic – This is also a form of distributive shock but is specifically caused by spinal cord or nervous system injury, not sepsis or allergic reactions.

Summary

Shock caused by sepsis, deep anesthesia, or anaphylaxis involves vascular dilation and falls under the category of vasogenic shock, making A. Vasogenic the correct answer.

Correct Answer:

B. Stop the injection

Explanation of the Correct Answer:

When a patient is struggling to breathe or experiencing breathing difficulties during or after the administration of iodinated contrast media, this could be a sign of a severe allergic reaction, such as anaphylaxis. The immediate reaction should be to stop the injection of the contrast media to prevent further exacerbation of the reaction. Stopping the injection helps to limit the exposure to the contrast agent, which could be triggering the allergic response or respiratory distress. Once the injection is stopped, further steps, such as calling for emergency assistance, administering emergency medications (e.g., epinephrine), and closely monitoring the patient, should be taken.

Here's why the other options are less appropriate:

A. Call a code:

While calling a code may be appropriate if the patient’s condition worsens and they lose consciousness or their airway becomes compromised, the first action should always be to stop the contrast injection. You can call a code if the patient's condition deteriorates significantly.

C. Take her vital signs:

While monitoring vital signs is crucial for assessing the severity of the reaction, the first action should be to stop the injection. Taking vital signs may be done shortly after stopping the injection, but it should not delay stopping the contrast infusion, which is the immediate priority.

D. Prepare emergency medications:

Preparing emergency medications (such as epinephrine or antihistamines) is an important part of treating a severe allergic reaction, but it comes after stopping the injection. First, you must stop the administration of the contrast media to halt the potential progression of the reaction.

Summary:

The first response to a patient experiencing breathing difficulties after receiving iodinated contrast media is to stop the injection immediately to prevent further exposure to the contrast media. Following that, further action, such as calling for emergency assistance and administering emergency medications, can be initiated.

Correct Answer:

A) Radionuclides

C) Medical exposures

Explanation of the Correct Answer:

Artificial radiation is radiation that is man-made or the result of human activity.

Radionuclides are artificially created radioactive materials used in various applications, including medical imaging and treatment (such as in nuclear medicine).

Medical exposures refer to radiation used in healthcare for diagnostic or therapeutic purposes, such as X-rays, CT scans, and radiation therapy. These are examples of artificial radiation.

Why the Other Options Are Incorrect:

B) Cosmic radiation

Cosmic radiation is a type of natural radiation that comes from outer space and interacts with the Earth's atmosphere. It is not artificially generated.

D) Naturally occurring radioactive substances present on earth

Naturally occurring radioactive substances are also natural sources of radiation (such as radon or uranium) and are not artificially produced.

Summary:

Artificial radiation includes radionuclides and medical exposures, both of which are intentionally created or used by humans.

Correct Answer

D. 15 degrees

Explanation of the Correct Answer

For intravenous (IV) injections, the needle is typically inserted at a 15-degree angle. This angle allows the needle to enter the vein at a shallow enough depth to avoid puncturing through the vein while still allowing the medication to be delivered directly into the bloodstream. The 15-degree angle is ideal for veins near the skin's surface, making it easier to locate and access the vein with minimal discomfort for the patient.

Why the Other Options Are Incorrect

A. 90 degrees – A 90-degree angle is used for intramuscular injections, not intravenous. In IV injections, this angle would be too steep and could potentially damage the vein.

B. 75 degrees – While this is closer than 90 degrees, it is not the most commonly recommended angle for IV injections, which are usually performed at a 15-degree angle for optimal access to the vein.

C. 45 degrees – A 45-degree angle is more commonly used for subcutaneous injections, not for intravenous access. It is too steep for IV injection, where a shallower angle is generally preferred.

Summary

The needle angle recommended for intravenous injections is typically D. 15 degrees, allowing for optimal access to the vein with minimal risk of vein damage.

Correct Answer

A. Warming

Explanation of the Correct Answer

The viscosity of contrast media refers to its thickness or resistance to flow. Warming the contrast media can effectively reduce its viscosity, making it easier to inject into a patient’s vein or other body cavities. This is particularly important for contrast agents that are thicker or more viscous at lower temperatures, as warming them helps achieve smoother flow and improves ease of administration.

Why the Other Options Are Incorrect

B. Refrigeration – Storing contrast media in a refrigerator increases its viscosity, making it more difficult to inject and potentially leading to complications. It should be kept at an appropriate temperature according to the manufacturer's guidelines, but refrigeration is not helpful in reducing viscosity.

C. Storage at normal room temperature – While normal room temperature is typically the best storage condition for most contrast agents, it does not actively reduce viscosity in the way warming does. Some contrast agents may naturally become less viscous at room temperature, but warming is the more effective method.

D. Storage in a cool, dry place – This refers to storage conditions, but it does not specifically address reducing viscosity. While a cool, dry place is important for preserving the quality of the contrast media, it does not impact viscosity reduction.

Summary

To effectively reduce the viscosity of contrast media and make it easier to administer, A. Warming is the correct approach.

Correct Answer:

A) Photodisintegration

Explanation of the Correct Answer:

Photodisintegration is an interaction where a high-energy photon (typically above 7 MeV) interacts directly with the nucleus of an atom, resulting in the emission of a nuclear fragment (such as a proton or neutron). This process occurs when the photon has enough energy to overcome the binding energy of the nucleus and causes it to break up.

Why the Other Options Are Incorrect:

B) Photoelectric interaction

The photoelectric interaction occurs when a low-energy photon (typically below 1 MeV) is absorbed by an atom and ejects an inner shell electron. This does not involve the nucleus or result in the emission of nuclear fragments.

C) Pair production

Pair production occurs when a high-energy photon (typically above 1.022 MeV) interacts near the nucleus and creates an electron-positron pair. This is not the correct process described in the question, as it involves the creation of particles, not the emission of nuclear fragments.

D) Compton scattering

Compton scattering is an interaction where a photon transfers part of its energy to an outer shell electron, causing the electron to be ejected from the atom. The photon is scattered in a different direction, but this does not involve the nucleus or result in the emission of nuclear fragments.

Summary:

When an x-ray photon with energy above 7 MeV interacts directly with the nucleus of an atom and results in the emission of a nuclear fragment, the process is called photodisintegration.

Correct Answer:

A. 0.8-1.2

Explanation of the Correct Answer:

The normal range for the international normalized ratio (INR) for reporting prothrombin time (PT) is typically 0.8-1.2. The INR is a standardized number that helps to measure the time it takes for blood to clot. It is commonly used to monitor patients on anticoagulant therapy, ensuring that the blood's clotting ability remains within a therapeutic range.

Why the Other Options Are Incorrect:

B. 1.5-2.0:

This range is commonly seen for patients who are on anticoagulant therapy, such as warfarin, but it is not considered the normal range. It is a therapeutic range used for patients being treated to reduce the risk of clotting.

C. 2.0-2.5:

This range is also a therapeutic range for patients undergoing anticoagulant therapy, particularly those at risk for thromboembolic events. It is above the normal range of 0.8-1.2.

D. 2.5-5.0:

This is a higher therapeutic range for patients on anticoagulation therapy, especially in cases where a more aggressive anticoagulant effect is desired (e.g., for patients with mechanical heart valves or certain clotting disorders).

Summary:

The normal range for INR is 0.8-1.2. Higher values are seen in patients on anticoagulant therapy, and the therapeutic range depends on the medical condition being treated.

Correct Answer

A. physician intervention.

Explanation of the Correct Answer

An iatrogenic infection refers to an infection that is caused as a result of medical intervention or treatment. This type of infection can occur during a hospital stay, surgery, or any other medical procedure where external factors such as medical instruments, procedures, or medications unintentionally introduce pathogens into the body. For example, infections can arise due to improperly sterilized surgical instruments, failure to follow proper hygiene protocols, or side effects of medications. The word "iatrogenic" comes from the Greek "iatros" (meaning physician) and "genes" (meaning born of or produced by). Therefore, iatrogenic infections are those produced by the physician's actions, such as surgeries, diagnostic tests, or treatments, that unintentionally lead to an infection.

Why the Other Options Are Incorrect

B. Blood-borne pathogens – While blood-borne pathogens can lead to infections, they are not specifically associated with iatrogenic infections. Blood-borne infections are those that are transmitted via blood, such as HIV, Hepatitis B, and Hepatitis C, but this is a broader category of infection, not one tied directly to medical interventions.

C. Chemotherapy – While chemotherapy can lower the immune system and make the patient more susceptible to infections, these infections are not classified as iatrogenic by definition. Chemotherapy-related infections are typically due to the immunocompromised state it causes, not the result of the chemotherapy treatment itself introducing a pathogen.

D. Infected droplets – This refers to infections that are transmitted via droplets, such as respiratory infections like the flu or COVID-19. These are not iatrogenic infections because they are caused by external pathogens (such as viruses) transmitted through the air, rather than as a result of medical intervention.

Summary

An iatrogenic infection is specifically one that arises as a result of physician intervention or medical procedures. It occurs when medical treatments or diagnostic procedures unintentionally cause an infection, such as through improperly sterilized equipment or post-surgical complications. Therefore, the correct answer is A. physician intervention.

Correct Answer: C. Remove air or fluid in the pleural cavity

Explanation of the Correct Answer:

A chest tube is inserted into the pleural cavity, the space between the lungs and the chest wall, to remove air, fluid, or blood that may be causing pressure on the lungs. This is typically done to treat conditions like pneumothorax (air in the pleural space) or pleural effusion (fluid in the pleural space).

Why the Other Options Are Incorrect:

A. Remove bile from the common bile duct

This option is incorrect because a chest tube is not used to remove bile from the common bile duct. Procedures like bile duct drainage or surgery are used for that purpose.

B. Drain urine for measurement

Urine drainage is typically done using a catheter, not a chest tube. A chest tube is specifically for the pleural cavity, not for the urinary system.

D. Remove contrast from large colon

Contrast removal from the large colon is not a function of a chest tube. Procedures involving the large colon, such as colonoscopy or enemas, would be used for this purpose.

Summary:

A chest tube is used to remove air, fluid, or blood from the pleural cavity to alleviate pressure on the lungs, allowing for proper lung expansion and improving breathing function.