RADR 1309 Introduction to Radiography and Patient Care

Correct Answer: D. It must be shaken or mixed prior to use to redistribute the particles within the solution

Explanation of the Correct Answer:

Barium sulfate is classified as a suspension because its solid particles do not dissolve in liquid but are instead dispersed throughout it. Over time, due to gravity, these dense particles will settle to the bottom of the container. This separation means the concentration of barium in the upper portion of the suspension decreases, and if administered without agitation, it could result in uneven contrast distribution during imaging. To ensure diagnostic quality and patient safety, the radiographer must always shake or thoroughly mix the container before use. This redistributes the barium particles evenly within the liquid, ensuring consistent opacity and reliable imaging results.

Why the Other Options Are Incorrect:

A. It must be kept chilled to keep the particles suspended in the liquid

This is incorrect because chilling the suspension does not prevent particle settling. Temperature does not significantly affect the gravitational separation in suspensions. Proper agitation, not cooling, is what redistributes the particles effectively.

B. It must be mixed with distilled water to evenly distribute the particles

This is not accurate because barium sulfate suspensions used in medical imaging are prepared under controlled conditions to achieve specific concentrations and viscosities. Adding water could dilute the suspension, reduce radiopacity, and negatively affect image quality. The product is designed to be used as supplied, with shaking rather than diluting.

C. It has very short shelf-life since the particles will not dissolve in the liquid

While it is true that the particles don’t dissolve, this does not significantly limit the shelf life of the product. Commercially prepared barium sulfate suspensions are stable when stored properly and can be used safely within their labeled expiration date. The key is mixing before use, not worrying about short shelf-life.

Summary:

Barium sulfate remains in suspension rather than dissolving in liquid, causing it to settle over time. The radiographer must shake or mix the product prior to use to ensure even distribution of the contrast agent. This is critical to maintain consistent image quality and diagnostic accuracy.

Correct Answer: D. Fistula

Explanation of the Correct Answer:

D. Fistula:

A fistula is an abnormal or abnormal passageway or connection between two structures in the body that are not normally connected. It can occur between various organs or tissues, such as between the intestines and the skin, the esophagus and the trachea, or the bowel and bladder. Fistulas can be congenital (present at birth) or acquired (due to disease or injury).

Why the Other Options Are Incorrect:

A. Dysphagia:

Dysphagia refers to difficulty or discomfort in swallowing. It is not an abnormal passageway but rather a symptom related to problems in the esophagus or muscles of swallowing.

B. Bolus:

A bolus is a mass of chewed food or medication that is swallowed. It is not an abnormal connection between two structures but refers to the form that food takes when it is being processed by the digestive system.

C. Stricture:

A stricture refers to an abnormal narrowing of a passage or duct, such as the esophagus, intestines, or blood vessels. It is the opposite of a fistula, as it involves constriction rather than an abnormal connection between two structures.

Summary:

A fistula is an abnormal passageway connecting two structures in the body, making it the correct answer. The other terms (dysphagia, bolus, and stricture) refer to different concepts and are not related to abnormal connections between structures.

Correct Answer:

C. Extravasation

Explanation of the Correct Answer:

Extravasation occurs when the contrast media or any fluid intended for injection into a vein leaks into the surrounding tissues instead. This is often caused by improper catheter placement, a tear or puncture in the vein, or pressure during the injection. The contrast media can cause pain, swelling, and potential tissue damage if not recognized and managed quickly.

Why the Other Options Are Incorrect:

A. Absorption

Absorption refers to the process where substances (such as nutrients or medications) are taken up by cells or tissues. This term does not relate to the leakage of contrast media from a blood vessel into surrounding tissues.

B. Resorption

Resorption is the process where the body breaks down and absorbs substances, typically used in the context of bone or tissue breakdown. It is not related to the leakage of contrast media from the vein.

D. Infiltration

Infiltration is a general term that refers to the process of fluid entering tissues. While infiltration can refer to the leakage of fluids like contrast media into tissues, it is often used more broadly and less specifically than extravasation, which is a more precise term used to describe the unintended leakage of intravenous fluids into surrounding tissue.

Summary:

The correct term for the leakage of contrast media into the tissues surrounding the vein during an IV injection is extravasation. It's important to recognize and address this situation quickly to prevent tissue damage and further complications.

Correct Answer: C) Give explanations to the patient in precise medical terms

Explanation of the Correct Answer:

It would be inappropriate for a technologist to give explanations to the patient in precise medical terms because most patients may not understand complex medical terminology. The role of the technologist is to gather relevant information in a way that is clear and understandable for the patient, avoiding overly technical or clinical language. Instead, the technologist should use simple, non-technical language to ensure the patient is comfortable and fully understands the questions being asked.

Why the Other Options Are Correct:

A) Repeat the patient's comments regarding the symptoms

Repeating the patient's comments is a common and effective way of confirming and clarifying symptoms. It shows that the technologist is listening actively and helps ensure accuracy in the history-taking process.

B) Use silence to allow the patient to recall information

Using silence is a useful technique in communication. It gives the patient time to think and recall additional information about their symptoms, allowing for a more complete history.

D) Ask the patient probing questions regarding his or her symptoms

It is appropriate for the technologist to ask probing questions to gather more detailed information about the patient's symptoms. However, the questions should be asked in a sensitive and non-judgmental manner to avoid making the patient feel uncomfortable.

Summary:

When obtaining a patient's clinical history, it's crucial to communicate clearly and in a way the patient can understand. Using precise medical terms may confuse the patient, so it's best to avoid that in favor of simpler language. Repeating the patient's statements, using silence, and asking probing questions are effective communication strategies.

Correct Answer:

D. another radiographic technologist

Explanation of the Correct Answer:

The radiographic technologist (often another technologist working with the primary one) is most likely to place the image receptor (IR) for a surgical image of the abdominal area. The radiographic technologist is responsible for the imaging aspect of the procedure, including positioning the IR correctly to capture the required images while maintaining a sterile field and ensuring the patient's safety. In many surgical settings, another technologist or assistant may help with handling the equipment and positioning the IR in collaboration with the primary radiographer.

Why the Other Options Are Incorrect:

A. Anesthesiologist

The anesthesiologist is responsible for administering anesthesia and monitoring the patient's vital signs during surgery. They are not involved in placing the IR or any imaging duties in the operating room.

B. Circulating nurse

The circulating nurse manages the sterile environment, provides assistance with non-sterile tasks, and helps with equipment and supplies. While they may assist the radiographer by bringing supplies or positioning the patient, they are not typically responsible for placing the IR during a surgical procedure.

C. Surgeon

The surgeon is the medical professional performing the surgery. While they may guide the positioning of the patient for imaging or request specific images, they are not responsible for placing the IR. The surgeon’s focus is on the surgical procedure itself, not on imaging tasks.

Summary:

In a surgical setting, it is most likely that another radiographic technologist will place the image receptor (IR) for a surgical image of the abdominal area, ensuring proper imaging while maintaining a sterile environment.

Correct Answer

B. the patient's birth date.

Explanation of the Correct Answer

While the patient's name and/or identification number, right- or left-side markers, and date of the examination are all crucial for identifying the radiographic image and ensuring it is correctly associated with the patient, the patient's birth date is not required on the radiographic image itself for medicolegal purposes. The birth date may be included in the patient's medical records or on paperwork related to the examination, but it is not typically necessary to be shown on the actual image to ensure its validity in legal matters.

Why the Other Options Are Correct

A. The patient's name and/or identification number – This is essential for ensuring proper identification of the patient in legal contexts. The radiographic images must be clearly linked to the correct patient to avoid misidentification and ensure patient safety.

C. A right- or left-side marker – A right- or left-side marker is vital for ensuring the correct orientation of the image. It helps to distinguish between the patient's left and right side, which is crucial for accurate interpretation and for avoiding confusion in cases where the image might be reviewed later.

D. The date of the examination – The date the image was taken is important for medicolegal reasons, as it provides a clear timeline of when the examination occurred. This is crucial for proper record-keeping and for maintaining the integrity of the medical history.

Summary

For medicolegal reasons, the patient's birth date is not required on the radiographic image, while the patient's name and/or identification number, a right- or left-side marker, and the date of the examination are all essential for proper identification, legal purposes, and accurate interpretation. Therefore, the correct answer is B. the patient's birth date.

Correct Answer: B. Viscosity

Explanation of the Correct Answer:

B. Viscosity:

Viscosity refers to the thickness or resistance to flow of a liquid. In the case of contrast media, viscosity determines how thick or thin the contrast agent is. High-viscosity contrast media is thicker and may be more difficult to inject, while low-viscosity media is thinner and easier to inject. Viscosity is a key factor when selecting a contrast medium for different imaging procedures to ensure the correct flow and ease of administration.

Why the Other Options Are Incorrect:

A. Osmolality:

Osmolality refers to the concentration of particles (such as ions or molecules) in a solution. It affects the ability of the contrast media to draw water into or out of tissues, but it does not directly describe the "thickness" or "thinness" of the contrast media. Osmolality is more related to the potential for adverse reactions, especially in the kidneys, rather than its flow characteristics.

C. Iodine concentration:

Iodine concentration refers to the amount of iodine in the contrast media. Higher iodine concentrations generally provide better image quality and enhanced contrast in imaging studies. However, it does not directly describe the "thickness" or "thinness" of the contrast material, as iodine concentration mainly influences radiographic density and contrast.

D. Toxicity:

Toxicity refers to the potential harm a substance may cause to the body. While the toxicity of contrast media is an important consideration in patient safety, it does not describe the flow properties or thickness of the contrast agent.

Summary:

Viscosity is the term that refers to the "thickness" or "thinness" of a contrast media, making B. Viscosity the correct answer.

Correct Answer

C. Chronology

D. Onset

Explanation of the Correct Answer

The Sacred Seven elements of a clinical history are crucial to understanding a patient's symptoms and guiding appropriate imaging. From the patient’s statement:

Onset (D) refers to when the condition began. In this case, the patient stated the pain started during yardwork earlier that afternoon, which directly provides onset information.

Chronology (C) refers to the duration and frequency of the symptoms. The patient explained the pain has been continuous for three hours, which clearly speaks to the chronological pattern of the symptom.

Why the Other Options Are Incorrect

A. Localization – This refers to where the pain or issue is located (e.g., left chest, upper right quadrant), which the patient did not specify.

B. Quality – This describes the nature of the pain (e.g., sharp, dull, throbbing), which was not described by the patient.

E. Aggravating or alleviating factors – This involves what makes the symptom worse or better. Although the pain began during activity, the patient did not indicate that yardwork aggravated it or that anything relieved it.

Summary

The patient provided onset and chronology elements of the Sacred Seven during the interview, making C and D the correct answers.

Correct Answer: C. Perform the exam with an iodine-based contrast media for the gastrointestinal (GI) tract

Explanation of the Correct Answer:

If there is a suspected bowel perforation, barium sulfate is contraindicated because it is not water-soluble and cannot be absorbed by the body. If it leaks into the peritoneal cavity through a perforation, it can cause serious complications, including chemical peritonitis, an intense inflammatory response that may require surgery and can be life-threatening. In such cases, a water-soluble iodine-based contrast agent (such as Gastrografin or Omnipaque) is used instead. These agents are absorbable by body tissues and much safer if leakage occurs.

Why the Other Options Are Incorrect:

A. Perform the exam as usual with no modifications

This is incorrect and potentially dangerous. Proceeding with barium sulfate in the presence of a suspected perforation risks introducing a harmful substance into the abdominal cavity, which could result in severe complications.

B. Perform the exam with a less toxic form of barium sulfate

There is no form of barium sulfate that is safe for use in cases of suspected perforation. All forms remain non-absorbable and toxic outside the GI tract. Modifying the formulation does not eliminate the risk of peritonitis.

D. Do not perform the exam at all since no contrast media could be used

This is incorrect because contrast studies can still be performed—just with the appropriate iodine-based media. The exam is still possible, but only with the necessary precautions and substitution of contrast type.

Summary:

In cases of suspected bowel perforation, barium sulfate must be avoided due to the risk of peritonitis. A water-soluble iodine-based contrast should be used instead, as it is safe for use in situations where leakage from the gastrointestinal tract may occur.