Patient Care Chap 11-12 Flashcards

The word ambulatory means that the patient

must be moved by ambulance

must be confined to a wheelchair

can walk

can be moved by stretcher

How does the radiographer communicate with patients who do not speak English?

by rescheduling the patient to go to another hospital

by writing the information on a piece of paper

by slowly enunciating the instructions

through an English-speaking family member

Why is it important for the radiographer to make eye contact with the patient as she describes the pain in her hand?

It helps to expedite the examination.

It provides emotional support for a stressed patient.

It reassures the patient of the radiographer’s technical skills.

It makes the patient feel that what she is saying is important.

Which of the following is undesirable for conducting a clinical history interview?

asking vague questions

asking open-ended questions

repeating information

clarifying terminology

In the process of questioning a patient about the reason for having the requested x-ray examination, the patient becomes irritated and complains that “she is getting pretty tired of saying the same things over and over to all these nurses.” An effective method to deal with this patient’s attitude would be to:

tell her it’s not your fault she is upset and not to take it out on you.

explain that each person asking questions is trying to find additional important information about her condition.

not ask any additional questions, so as not to upset her any more.

call security and have her escorted back to the outpatient center receptionist.

What is the acceptable reaction of the radiographer in dealing with a patient in the beginning stage of denial isolation?

supporting the patient’s feelings by discussing the death of one’s own loved one

attempting to cheer up the patient by telling jokes

offering silence and acceptance of the person, without discussing death

addressing the patient’s feelings about dying

In recording a patient history for the radiologist, you note that the patient has an open sore on her ankle. In your description you indicate that the sore is draining and has a foul odor. This information deals with the _____ of a patient history.

quality

onset

chronology

logic

Most radiologists have one key question they want answered when it relates to any medical imaging examination. That question most likely would be:

What pain level is the patient tolerating?

Is there a reason for coming to the hospital rather than an outpatient clinic?

Can the patient tell you what day it is and what hospital he or she is visiting?

Why is the patient having this examination?

An imaging sciences professional:

relates his or her personal experiences to the patient’s when taking a history.

uses “pet names” such as “dear,” “cutie,” and “honey” in order to encourage the patient to provide more intimate information about his or her condition.

relies exclusively on objective patient data so as not to bias the patient history.

does none of the above.

When questioning patients to obtain an accurate patient history:

keep your questions general in nature so as not to offend the patient.

do not let the patient talk too much, in order to keep the examination moving.

use medical “jargon” to impress the patient with your expertise.

start with open-ended questions and then follow up with more direct inquiries.

Touch is commonly used to express concern and support for patients.

true

false

In which age group can you expect the patient to be able to think logically and analyze a situation?

infant

preschooler

schoolchildren

toddler

One patient describes a cough as productive, and another patient describes a cough as nonproductive; under which element of the clinical history do these descriptions fall?

severity

localization

onset

quality

Which of the following describes an undesirable method of questioning that provides information that may direct the answer toward a suspected symptom or complaint?

leading question

nonverbal communication

facilitation

palpation

Which term describes gentle touching to determine the precise location of a symptom or complaint?

nonverbal communication

facilitation

quality

palpation

In which of the following ways does the radiographer use leading questions?

They should be avoided.

They should be used for filling in details.

They should be used to verify information.

They should be used to help the patient focus on the complaint.

Which of the following includes the tone of voice, the speed of speech, and the position of the speaker’s extremities and torso?

quality

palpation

facilitation

nonverbal communication

How should radiographers handle patients who are combative as a result of their frustration?

talk sternly to the patient about the behavior

refer the patient back to the physician

ask a family member to calm the patient down

acknowledge the anger and help overcome it

As you prepare to take a PA chest radiograph on a patient who is suspected of having a lung collapse, you note that the patient has an extremely difficult time taking in a deep inspiration. An imaging sciences professional would:

make no mention of the breathing pattern, as it has no relationship to a lung collapse.

work very quickly and not bother with any additional patient history.

call inhalation therapy to measure the inspiration with a spirometer.

record the depth of inspiration as an item of subjective data.

As a patient begins to explain his reasons for coming to the clinic for an x-ray examination, he begins to use medical terms to describe his conditions. His information appears to be accurate medically and helps clarify his symptoms. To deal with this patient you should:

politely listen, record his comments, and repeat his statements to clarify.

determine if he knows what he is talking about by quizzing him on basic anatomy.

ask him if he is a doctor and tell the radiologist.

disregard his information and record your impressions of his symptoms.

The lowest level of Maslow’s hierarchy of needs is:

self-actualization

physiologic needs

love and belonging

self-esteem

According to Maslow’s hierarchy of needs, what is the reason patients may behave abnormally during their hospital stay?

They cannot understand what is happening.

Their physiologic needs aren’t being met.

They are missing their sense of love and belonging.

Questions about the diagnosis of an examination from a patient or visitor are best answered by

suggesting that the question is inappropriate

explaining that only a radiologist can read radiographs

providing the best diagnosis available

explaining that the results are not available yet

Aging is a natural part of living. As you work with older patients it is important to empathize with their condition and understand the physiologic changes of the aging process. These changes may include:
1. always feeling cold.
2. a heightened state of mental alertness and memory.
3. a greater awareness of their surroundings.
4. a loss of tactile sensation in fingertips.
5. a greater likelihood of skin damage during movement and transport.
6. less flexibility and joint mobility.

1, 3, 4, and 6 only

1, 4, 5, and 6 only

2, 3, and 5 only

4, 5, and 6 only

When the radiographer asks a patient how many days the person has had a fever, what part of the clinical history is being assessed?
chronology
localization
quality
onset

Touch can be an effective communication strategy when dealing with patients for medical examinations. As you ask a patient to turn on his or her side for an oblique projection, you gently touch his or her hip or shoulder to guide them into the correct position. This would be a type of touch for:

emotional support.

emphasis.

expression.

palpation.

When asking about a patient’s pain, it is effective to:

ask the patient if the pain is in his or her abdomen.

assure the patient that questions about pain offer little insight into the patient's condition.

ask the patient to point to or touch the area that hurts, and record that area on the requisition.

ask the patient if the pain runs down his or her leg.

Which of the following statements is FALSE?

Non–English-speaking patients typically understand simple phrases and commands such as "Yes," "No," and "Stop."

Pediatric patients always require special attention.

To minimize feelings of alienation, it is useful to treat geriatric patients as adolescents in order to make them understand your instructions.

Dealing with mentally impaired patients often requires the technologist use a strong yet reassuring tone of voice.

Which of the following is (are) desirable method(s) of conducting a clinical history interview?

subjectiveness

a and b

defining and specifying terms

positive nonverbal communication

Objective data regarding a patient’s history:

consist of a patient’s vital signs.

are more important than subjective data.

are an effective way to explain the patient’s pain level.

deal with a patient’s feelings.

When family members accompany the patient to the radiology department, both the family members and the patient are treated with professional courtesy and respect.

false

true

When radiographing a very young child or a mentally impaired patient:

try and get a family member to be a part of the examination for communication and reassurance.

ask the patient if he or she has ever had this type of procedure before

work silently in order to avoid questions and alarming the patient.

speak loudly and take charge of the examination from the beginning.

Of the changes that occur in geriatric patients that are especially important when patients are undergoing radiologic examinations, which of the following may produce patient paranoia about potential falls with potential for permanent loss of mobility?

atrophied muscle mass

osteoporotic loss of bone mass

arthritis

decreased muscle strength

How does the radiographer respond to questions from patients or visitors regarding the results of their x-rays?

They should be told that the radiologist will provide them with the information.

They should be instructed to call their physician for the results.

The diagnosis should be shared only with the patient.

They should be informed that the results will be ready by the end of the week.

When dealing with a, terminally ill patient, which of the following would seem most appropriate?

Joyously moving around the room trying to cheer him up

Telling the patient he might as well face reality

Politely working in silence as necessary and attending to his physical needs

All of the above

The highest level of Maslow’s hierarchy of needs is

physiologic

self-actualization

self-esteem

belonging

Which of the following is (are) usually included as part of the chronology of a clinical history?

duration

frequency

onset

all of the above

A patient’s vital signs are as follows: heart rate, 95; blood pressure, 120/75; temperature, 99.2º F. This information is considered:

subjective data

clinical history

chief complaint

objective data

Which of the following characterize(s) the development of an infant?

Preferring to be wrapped tightly in a blanket

Preferring to be held in a familiar position

Preferring to hear a calm, soothing voice

a and b

all of the above

Which of the following is not one of the sacred seven of medical histories?

Chronology

Onset

Severity

Birth date

The dying patient who wants to stay alive long enough to see his son graduate from college would be in what stage of the dying process?

Denial

Depression

Anger

Bargaining

On a patient’s examination requisition for a KUB, you notice that the history recorded by ER states “R/O appendicitis.” In an effort to gain more precise information about the patient’s condition, questions to ask that would be important to this examination (KUB) would be:
1. “How would you describe the pain?”
2. “Have you had previous appendix surgery?”
3. “Do you know if ER called in a sonographer?”
4. “Can you touch the area that specifically hurts?”
5. “Are you sure it’s not your kidneys?”
6. “Does the pain appear to be in your appendix?”

1 only

1, 3, 4, and 6 only

2, 3, 5, and 6 only

1 and 4 only

Which of the following stages of dying is described as the realization that life will be interrupted before everything the dying patient has planned has been accomplished?

anger

bargaining

depression

denial

Which of the following is considered to be the first stage of acceptance of dying for a terminally ill patient?

frustration

denial and isolation

shock

anger

According to Elisabeth Kübler-Ross, the customary stages of the dying or grieving process in the typical sequence are:

denial and isolation, anger, depression, bargaining, acceptance.

anger, denial, bargaining, depression, acceptance.

denial and isolation, anger, bargaining, depression, acceptance.

acceptance, denial, depression, anger, bargaining.

When working with an elderly patient:

give the patient breathing instructions while you’re positioning him or her, in order to hasten the procedure.

write down your instructions first for the patient to read.

assume the patient can see and hear you clearly, and move quickly and deliberately in order to get done.

speak slowly and clearly, and ask for understanding and feedback.

It would be professionally appropriate for the imaging professional to:

touch the patient with varying degrees of pressure to measure the patient’s pain tolerance over the area of interest.

aggressively palpate the patient on the regions that do not hurt to isolate the area of interest.

ask the patient to give you a general idea of the area of concern before the examination is started.

gently touch the patient to clarify the location of his or her pain.

The patient describes her chest pain by saying, “It feels like someone is standing on my chest.” This information is considered:

subjective data

objective data

chronology

none of the above

In preparing to radiograph a patient who has come to medical imaging with a complaint of abdominal pain, you begin to question the patient as part of the history. A good initial question to ask the patient would be:

“Your request states that you have stomach pain, is that correct?”

“Have you seen your doctor about the pain?”

“Did you have any problem with parking here at the hospital?”

“Can you tell me about the nature of your pain?”

Adolescents’ special needs revolve around their modest feelings about their bodies. Therefore radiographers need to do which of the following?

respect the patient’s wishes to keep fully covered

have a radiologist ask about the LMP

proceed with the exam regardless of the patient’s concerns

ignore professional recommendations for patient prep

In Maslow’s hierarchy of needs, a patient cannot satisfy the need for love and belonging before satisfying the need for safety and security.

false

true

Which of the following affects communication?

Perception

Emotions

Values

All of the above

An important piece of information regarding a patient’s need for medical care is sought by physicians and medical professionals. Many times, patients are vague about their pain or reason for seeing the doctor. It is important to discover the patient’s _____ for seeking medical care.

insurance incentive

chief complaint

tolerance

pain threshold

In determining a patient’s description of his or her pain, a good question to ask would be:

“When did the pain first happen?”

“If the pain comes and goes, how often does it occur and what is the time span between occurrences?”

“How would you describe the pain?”

all of the above questions.

As you perform a STAT skull series on a patient from the ER, you notice that the patient has a large swelling over his left temporal region. The patient requisition states that the patient had trauma, and nothing else is provided. An imaging sciences professional would:

give the patient an ice pack to lessen the swelling before the exposure is taken.

call the ER nurse to ask if he or she saw the swelling and recorded it in the patient’s electronic medical record (EMR).

record the swelling on the requisition and ask the patient what kind of injury he experienced.

ask the ER nurse to come to the x-ray room for a more accurate patient history.

Which of the following is the professional way to greet the patient?

Mrs. Jones

Robin Jones

R. Jones

all of the above

Which of the following would you not want to discuss with a patient?

weather

ability to walk

hobbies

medical chart

The patient must perceive the radiographer as genuine, respectful, and empathic to establish an open dialog.

true

false

When taking a patient history, it is important to:

maintain a polite and professional demeanor when gathering information.

remain very impersonal and show little emotion or empathy toward the patient.

call the patient by his or her first name to establish instant credibility.

memorize the patient’s comments to relay them to the radiologist later.

In determining the severity of a patient’s ankle injury, which of the following questions would be appropriate?

“Have you previously injured your ankle?”

“How did the injury happen?”

“When did the injury happen?”

“Can you put any weight on the injured ankle?”

When communicating with a young child as part of a radiographic examination, an effective strategy to communicate would be to:
1. kneel down to the child’s eye level and lower your voice.
2. speak loudly and quickly so the child knows you’re in charge.
3. allow one of the younger radiographers in the department to perform the study.
4. speak exclusively to the parent so the child cooperates.

1 and 3 only

2 and 4 only

1 only

3 only

Man’s first and foremost need is:

nourishment and water.

shelter and protection from outside enemies.

being accepted by peers.

succeeding at job or work.

Which of the following is an example of a negative nonverbal communication technique?

Talking to the patient with your back turned as you record in the chart

Maintaining eye contact

Leaning toward the patient when talking to him or her

Giving a pleasant smile

A patient discusses his condition with the radiologist. After the radiologist leaves the room, the patient begins to cry. The radiographer sits down next to the patient and squeezes the patient’s hand. This is an example of using touch for:

localization

emphasis

palpation

emotional support

Aggravating factors are described as any condition (e.g., heartburn) that is worsened by something (e.g., eating spicy food).

false

true

Professional medical imaging personnel must possess many desirable traits and skills. To succeed in patient interactions as a part of performing examinations, it is important that the radiographer:

reference procedure notes or textbooks often during examinations to reassure the patient that the radiographer is double-checking his or her work for safety reasons.

work efficiently by minimizing small conversations with patients that slow down the procedure.

avoid touching patients for fear of offending them.

do none of the above.

All of the following are forms of subjective patient data EXCEPT:

patient complaints of pain and tenderness in a generalized region of the body.

patient facial expressions.

blood pressure and temperature.

patient mood or demeanor.

Which of the following characterize the development of a toddler (1 to 3 years of age)?
a.
b.
c.
d.

understands simple abstractions

is unable to take the viewpoint of another

is unable to understand more than one word for something

all of the above

During the patient interview, it is important to obtain subjective data only.

true

false

The use of humor during radiographic procedures can be effective with patients, if used professionally and under the right circumstance. An example of correct use of humor would be:

telling the patient you need to repeat the examination because the “mouse on the generator flywheel” didn’t run fast enough to give enough power for the exposure.

making light of the bad weather and how it “brightened your day” to have a job inside.

repeating an ethnic joke you heard on the radio earlier in the day.

commenting on the patient’s tattoo and how funny it looks with the skin stretched from the x-ray positions.

Which of the following clinical history elements is described as defining the precise area for the patient’s complaint?

onset

localization

chronology

aggravating factor

As a patient begins to accept the inevitability of death, he or she may ask to discuss important circumstances that will affect the last moments of life. These concerns may include the administration of CPR techniques, organ donation, internment plans, pain control and sedation, and so on. To formalize these wishes, patients will complete a(n):

will and testimonial.

death directive.

postmortem.

advanced directive.

Good history taking involves the collection of objective and subjective data. All of the following are examples of subjective data EXCEPT the patient’s:

emotions.

speech pattern.

respiratory rate.

ability to follow your instructions.

Why would it be beneficial to sit with the parents and child in the waiting room to get a history of the child and explain the procedure?

It expedites the time spent in the radiography room.

It ensures the technical competence of the staff.

It allows the parents active participation in the exam.

It helps the child become familiar and comfortable with the radiographic staff.

Patients are interviewed by the radiographer.

false

true

A common emotion of most patients entering the hospital is:

insincerity.

fear of the unknown and about their condition.

optimism.

eagerness to meet new people.

When is touching a patient valuable?

for emphasis

for palpation

for emotional support

all of the above

Who is responsible for obtaining the clinical history from the patient for the diagnostic procedure?

the radiologist

the radiographer

the nurse

the emergency department physician

A(n) _____ is someone who has been admitted to the hospital for diagnostic studies or treatment.

intern

medical resident

inpatient

outpatient

A clinical history for an abdominal x-ray should begin with which of the following questions?

“What type of abdominal problems are you having?”

“How long have you been vomiting?”

“When did you have gallbladder surgery?”

“Specifically where is the abdominal pain?”

Radiographers’ professional appearance is a personal choice and does not reflect on their diagnostic abilities.

true

false

Which of the following includes a description of the color, quantity, and consistency of blood or other body substances?

quality

localization

occurrence

chronology

The patient coming to you for an abdominal examination states, “My belly hurts.” A logical question to ask next would be:

“Would you point to the area that hurts for the radiologist when he enters the examination room?”

“Can you touch the area of your belly that hurts?”

“Did you tell the nurse this when you were in the Urgent Care center?”

“Can you draw on a diagram of the human body the area that hurts?”

According to Maslow's hierarchy of needs, few people completely satisfy the need for:

shelter, peace, and protection.

acceptance by peers.

food, water, and nutrients.

self-fulfillment and self-actualization.

Which of the following permits the patient to begin to work through the various stages that precede dying?

mutual pretense

all of the above

suspicious awareness

open awareness

All of the following are used to provide a better history to the radiologist except:

asking close-ended questions

using probing questions

encouraging elaboration

summarizing the details

A patient who is near death will likely exhibit what signs of impending death?
1. Loss of bowel functions and control
2. State of unconsciousness
3. Unusual high level of alertness and response to conversation
4. A condition of “wasting away” (cachexia)

2 only

3 only

1 and 3 only

1, 2, and 4 only

Objective data are data perceived by the patient only.

true

false

The cadence and rhythm of your speech, often referred to as the “music of speech,” is known as:

nonverbal communication.

paralanguage.

negative therapeutic communication.

therapeutic communication.

When dealing with a patient who has a terminal disease, it is important to:

interact with him or her based on his or her particular stage of death.

not play psychologist and attempt to cure the patient’s depression.

provide for his or her physical needs.

do all of the above.

The primary medical problem as defined by the patient is called:

objective data

subjective data

the chief complaint

the clinical history

Nonverbal communication is not as important as verbal communication with the patient or family members.

true

false

A patient schedules an appointment for a barium enema on Friday at 8 AM. The patient is given the intestinal prep and instructions to follow. The scheduling department instructs the patient to arrive at 7:45 AM in the radiology department. This patient is considered which of the following?

an inpatient

an emergency department patient

an outpatient

What term describes the primary medical problem as defined by the patient?

chief complaint

onset

palpation

nonverbal communication

A dying patient who has asked to see his loved ones and is making preparations to die would be in the _____ stage of dying.

grief

bargaining

anger

preparatory depression

Which of the following statements reflect(s) interactions with substance abuse patients?

The patient should never be let unattended while films are developed.

Restraints may be used for their safety.

The patient may become agitated or violent.

all of the above

Which of the following is (are) part of the sacred seven elements of the patient clinical history?

localization

aggravating factors

all of the above

quality

A 52-year-old female patient arrives for a chest x-ray. She is considered which of the following?

a mature person

an adolescent

middle-aged

a young adult

Why is it important to handle geriatric patients as mature adults rather than “senior citizens”?

to minimize discrimination

to preserve their self-image

to divert their attention from the problem

to eliminate excess anxiety

The primary means of communication with a hearing-impaired patient is through:

continual conversation

a bilingual family member

writing

touch

According to Dr. Eric Cassell, how do radiographers become part of the “healing process”?

by communicating the procedural steps to the patient

by treating the patient’s pathologic condition

by showing interesting in the patient’s well-being

by taking the patient’s pathologic condition

Which method is effective in communicating with a patient?
1. professional appearance
2. touch
3. pantomime techniques

1 only

1 and 2 only

2 and 3 only

1, 2, and 3

Touching the patient’s iliac crest for an abdominal exam is an example of using touch for:

emphasis

emotional support

reassurance

palpation

What is the significance of a good clinical history?

It focuses the radiologist’s attention on a specific area.

It translates the patient’s complaints into medical jargon.

It provides the referring physician’s admitting diagnosis.

It provides general information about the patient’s condition.

It would be inappropriate to:

call the patient by his or her surname (preceded by Mr., Ms., or Mrs.) to establish a professional image.

describe the patient’s symptoms to the radiologist in precise medical terms.

repeat the patient’s comments regarding the symptoms, to keep the examination time short.

ask the patient leading questions regarding his or her symptoms.

Which of the following is the determination of a precise area, usually through gentle palpation or careful wording of questions?

occurrence

quality

chronology

localization

You have received a request to perform a radiographic study on a patient who is clearly intoxicated. In preparing to perform this procedure, you should:

prepare patient restraint devices, including restraint jackets, and tape in order to hold him down during the procedure.

ensure your safety by checking to see that the hospital security officer will stay with the patient during the procedure.

close all the examination room doors to prevent others from hearing the patient’s language.

put on a patient gown in case the patient vomits on you.

All of the following are examples of nonverbal communication except:

using a friendly tone of voice

smiling at the patient

having a puzzled facial expression

asking the patient for a medical history

All of the following are nonverbal communication characteristics EXCEPT your:

amount of eye contact.

tone of voice.

body language.

professional appearance.

When patients are not told of their terminal condition, they fall into which category?

suspicious awareness

closed awareness

mutual pretense

open awareness