Legal Issues
What is the unauthorized use of an immobilization device?
a. Respondeat Superior
b. Assault
c. False Imprisonment
d. Battery
c. False Imprisonment
An immobilization device is used to reduce motion and increase position accuracy for diagnostic images. False imprisonment occurs when a patient is restrained or believes they are being restrained against their will. In this case, the individual has to be aware of the restraint and be unable to escape. It is prevalent among patients who are unable to cooperate such as pediatric, senile, or intoxicated patients.
Hand washing is involved in which method of infection control?
a. Sterile
b. Chemical
c. Physical
d. Both b & c
d. Both b & c
Hand washing is the singe most important method of preventing the spread of infection. Hand washing removes contaminants and microorganisms. This is both a chemical and physical process, and should be done before and after tending to a patient.
Which one of the following medications should be a patient stop taking 48 hours prior and 48 hours post administration of a water-soluble iodine contrast media?
a. metformin
b. insulin
c. glucagons
d. beta blockers
A. metformin
Metformin is used to treat non-insulin dependent diabetes. It does not interact with iodine contrast agents, however, this medication increases the uptake of glucose in body cells, increases the lactic acid production, and decreases pH in body cells in the presence of iodine.
What are considered serious reactions to contrast media?
Laryngeal edema (Allergic reaction) - Airway obstruction due to swelling of the laryngeal mucosa.
Anaphylactic Shock- A life threatening allergic reaction which causes the body to become hypersensitive. Includes low blood pressure and a rapid heart rate.
Cardiac Arrest (Physiologic Reaction) - A sudden, and sometimes temporary, stoppage of the heart that can lead to permanent organ damage or death.
True or False:
A biohazardous material is waste created in clinical settings or labs that is not contaminated, however hazardous to outsiders.
False, that is defined as medical waste.
Biohazardous waste is infectious waste (such as blood, bodily fluids) contaminated with potentially infectious agents that is a threat to the health of others or the environment.
What is gross negligence?
a. An legal issue only found in criminal cases
b. Loss of limb or loss of life.
c. An action or event that demonstrates reckless disregard for life or limb
d. A case that has an injured indiviudal as a contributing party to the injury
c. An action or event that demonstrates reckless disregard for life or limb
Gross negligence does not have to include an actual loss and is a type of unintentional misconduct (exclusion of reasonable care). This is based on the doctrine of a reasonably prudent person.
With direct transmission, how does the infectious organism spread?
a. From an infected person directly to a susceptible host
b. From a susceptible host directly to a susceptible person
c. In either direction
d. None of the above
b. From a susceptible host directly to a susceptible person
Direct transmission is when an individual infects another by touch or contact such as handholding, sexual contact, coughing, etc. Humans are a favorable host due to the abundance of metabolites and nutrients inside the body.
Which of the following reasons would be valid to perform a single-contrast barium enema?
1. When fistulas are thought to be present.
2. When acute appendicitis or diverticulosis is suspected.
3. When a patient has polyps.
4. When a patient has a family history of colorectal cancer or personal history of rectal bleeding.
a. 1, 2, 3, and 4
b. 1, 2, and 3 only
c. 1 and 2 only
d. 1 and 3 only
e. 2 and 4 only
c. 1 and 2 only
A single contrast barium enema is an imaging method which employs fluoroscopy to examine certain pathologies that may be suspected or present. This exam is similar to a double-contrast enema, however, it uses barium or water-soluble contrast only without using air.
How long can the brain be deprived of oxygen before there cerebral function impairment?
a. 2 to 3 minutes
b. 30 seconds
c. 4 to 6 minutes
d. 60 seconds
c. 4 to 6 minutes
Cerebral brain function is impaired if the brain is deprived of oxygen for more than 4-6 minutes. This is important when initiating CPR and verifying that a patient is in cardiopulmonary distress.
Which of the following are routes of entry for toxic materials?
1. Inhalation
2. Swallowing
3. Absorption through skin
4. Absorption through mucous membranes
a. 1, 2, and 3 only
b. 1, 3, and 4, only
c. 1, 2, 3, and 4
d. 1, 2, and 4 only
c. 1, 2, 3, and 4
Absorption through skin/mucous membranes, inhalation, swallowing are all possible routes of entry for toxic materials.
Which of the following conditions must be met in order to prove malpractice in a court of law?
a. The standard of care was not met, and violated. The injury was caused by the defendant and was a result of negligence.
b. The injury was caused by the person who is being sued as a result of negligence.
c. The standard of care was not met and violated by the person being sued.
d. The injury was a result of negligence.
d. The standard of care was not met, and violated. The injury was caused by the defendant and was a result of negligence.
Malpractice is defined as the unacceptable, negligent, or illegal activity/treatment by a healthcare professional. There are four conditions needed to establish malpractice: the establishment of standard of care, proof that the standard of care was violated by a healthcare professional, proof that the loss or injury was a result of the healthcare professional who is being sued, and proof that the loss of injury occurred and is a result of the negligence.
Where is the reservoir of infection located?
a. Only on surfaces that are already contaminated
b. Only on patients who must be isolated
c. Anywhere organisms can thrive
d. On all surfaces
c. Anywhere organisms can thrive
The reservoir serves as the location where the infectious organisms live and can transmit disease. Animals and inanimate objects serve as reservoirs.
A contrast media overdose:
a. May occur only in infants during a procedure who have a history of cardiac, renal, or hepatic failure.
b. May occur if the patient injected contrast media prior to the exam.
c. Contrast media overdoses do not occur because it is not a drug.
d. May occur in patients (infants or adults) who have cardiac, hepatic, or renal failure.
d. May occur in patients (infants or adults) who have cardiac, hepatic, or renal failure.
Overdose is a complication of using contrast media for an exam. It differs from an anaphylactic or cardiovascular reaction since it negatively impacts patients who already encounter renal, hepatic, or cardiac failure.
You are with a patient and notice the patient's skin is turning cyanotic. This means:
a. The patient is having a seizure
b. The skin is turning white.
c. The skin is turning yellow.
d. The skin is turning blue.
d. The skin is turning blue.
Bluish discoloration of the skin caused by low levels of oxygen in the red blood cells and/or problems getting oxygenated blood to the body.
Each hospital has written instructions for the handling of biohazardous materials, the safe uses of these products, cleanup, and disposal. They are called:
a. OSHA Standard Precautions
b. Biohazardous Warning System Labels
c. Material Data Safety Sheets
d. CDC Hazardous Waste Management
c. Material Data Safety Sheets or MSDS
The MSDS provides information regarding handling precautions of biohazardous and toxic material, safe uses of products, and cleanup and proper disposal of these materials.
Respondeat superior means:
a. "The thing speaks for itself"
b. The reasonable person should make the choice
c. "Let the master answer"
d. Violations of criminal law
c. "Let the master answer"
In this legal theory, the physician or the healthcare facility is responsible for the negligent acts caused by its employees.
Any area that was in contact with and touched by bodily fluids:
a. Must be covered and not used for the remainder of the day.
b. Must be reported to risk management if there was blood present.
c. Must be collected and sent back to the patient's nurse for testing.
d. Must be washed completely.
d. Must be washed completely.
Standard precautions are used as barriers to prevent contact with bodily fluids, blood, non-intact skin, and mucous membranes. This system assumes all bodily fluids are infectious and all patients are infected.
During venipuncture, air must not be injected because:
a. It would inhibit the iodine
b. It would not be seen on fluoroscopic imaging
c. All exams require air injection during venipuncture
d. An air embolus would create and could be fatal to the patient
d. An air embolus would create and could be fatal to the patient
During a procedure that involves performing venipuncture, it is important to push the contrast agent or medication through the needle before injecting into the vein so air cannot be injected. An air embolus blocks blood supply caused by air bubbles in a vein or artery.
Which of the following actions should be done when handling a patient who begins to experience a violent seizure?
a. If possible, attempt to prevent the patient from injury
b. Restrain the patient as soon as possible
c. Ensure the patient has an open airway by placing his or her hands in the patients mouth
d. All of the above
a. If possible, attempt to prevent the patient from injury
The only task is to prevent the patient from experiencing a possible injury from a seizure. After the seizure is over, it is important to make sure the patient has an open airway to clear any fluids coming from their mouth.
If you come into contact and touch a hazardous material, what should you do first?
a. Rinse immediately with warm water for 3 minutes.
b. Rinse immediately with cool water for 5 minutes.
c. Rinse immediately with cool water for 3 minutes.
d. Use hand sanitizer to wipe off the hazardous material from your skin.
b. Rinse immediately with cool water for 5 minutes.
It is important to rinse the affected area with cool water for 5 minutes to prevent potentially serious corrosive injury from a hazardous or toxic material.
Which of the following statements are true in regards to radiographic images?
1. Anatomic marking placed on the image after the exposure may not be legally admissible.
2. Images are usually retained 5-7 years after the date of the last radiographic exam in the patients EMR.
3. Breast imaging and black lung imaging are kept in the patients chart for a lifetime span.
4. Images can be erased from a file if the patient wants them to be removed.
5. Images on minors are usually retained for 5-7 years after the minor is 18 or 21 depending on the state.
a. 1, 3, 4, and 5 only
b. 1, 2, 4, and 5 only
c. 1, 2, 3, and 5 only
d. 1, 2, 3, and 4 only
c. 1, 2, 3, and 5 only
Radiographic images are legal documents and should have the proper annotations. The image should correctly identify the patient, have a left or right lead marker attached (and correctly placed to not cover anatomy) and date the image was taken. Any changes to the image after the exposure may not be legally admissible. Image retention varies depending on state laws, however 5-7 years is considered the standard. Images such as mammograms or black lung demonstrations are not taken out of the patient's file.
What is the difference between a biological vector and a mechanical vector?
A biological vector (such as a tick or mosquito) carries pathogens that survive within their bodies and be delivered to new hosts, typically by biting.
Mechanical vectors such as flies can obtain infectious agents outside of their bodies and spread them through physical contact.
Which of the following is true regarding an IV catheter?
1. It is used for small injections
2. It is more flexible than a hypodermic needle or butterfly
3. Is only used for chemotherapy
4. A combination unit with a needle inside a flexible plastic catheter.
5. May contain contrast medium connected to the syringe.
a. 1, 3, 5 only
b. 1, 3, 4, 5 only
c. 2, 4, 5 only
d. 2, 3, 5 only
e. 3, 4, 5 only
c. 2, 4, 5 only
An IV catheter has two components, a needle inside a plastic catheter. Both are inserted into the vein with the needle going in first. The catheter is pushed in, and once in place, the needle is then withdrawn. The catheter is sometimes connected to a syringe that contains contrast medium. It is more flexible than a butterfly or hypodermic needle. An IV catheter also allows an attachment to the IV tubing leading to a bag or bottle which is utilized when a serious reaction to contrast agents occurs.
Which of the following conditions includes the following symptoms: weakness, intense hunger, shaky, excessive sweating.
a. Hypovolemic Shock
b. Hyperglycemia
c. Vasogenic Shock
d. Hypoglycemia
d. Hypoglycemia
Hypoglycemia occurs with excess insulin in the body. The brain needs glucose for metabolism. Symptoms include weakness, hunger, shaky feeling, and excessive sweating. Some patients may have glucose tablets with them to ingest when they experience hypoglycemia. If they don't, they should ingest carbohydrates such as orange juice with sugar, a soda, or a candy bar. The process takes about 10 to 15 minutes to take effect after consuming carbohydrates.
What should you do when handling chemicals?
1. Read the container multiple times prior to using the contents to verify you are using the correct material.
2. Remaining chemical material can be poured in the sink after use.
3. Never mix chemicals together unless it can be verified to be mixed safely.
4. All chemicals can be stored in one area regardless of what the bottle states.
5. If the chemical comes into contact with the eyes, rinse for at least 15 minutes.
a. 1, 2, 3, 5 only
b. 1, 3, 4, 5, only
c. 3, 4, and 5 only
d. 1, 3, and 5 only
d. 1, 3, and 5 only
Chemical material that is irritating or flammable can not be poured into a sink and must be properly disposed of. Chemicals contain labels that show where and how they should be stored (ie room temperature). Chemicals can be used if the container is clearly labeled and has been correctly identified multiple times prior to use. Safely use chemicals to avoid a spill or contact with yourself. If a spill occurs, follow written procedures for proper clean up. Always follow up with a supervisor or medical follow-up and incident report.