Deck 14: Urinary System and Venipuncture

Question 1

What is the total capacity of the average adult bladder?

A) 350 to 500 mL
B) 100 to 250 mL
C) 500 to 750 mL
D) 1000 to 1200 mL

Answer 1

350 to 500 mL

Question 2

Which structure of the kidney is labeled 3?

A) Minor calyx
B) Major calyx
C) Renal pelvis
D) Renal pyramid

Answer 2

Major calyx

Question 3

The suprarenal glands are part of the endocrine system.

Answer 3

False

Question 4

Nonionic contrast agents create a hypertonic condition in the blood plasma as compared with ionic contrast agents.

Question 5

Ionic contrast agents use a parent compound of a carboxyl group (benzoic acid).

Question 6

Which term describes the act of voiding under voluntary control?

A) Urination
B) Urinary release
C) Incontinence
D) Anuria

Question 7

Which structure and/or region of the kidney is labeled 1?

A) Minor calyx
B) Major calyx
C) Renal sinus
D) Medulla

Question 8

Which of the following functions is not performed by the urinary system?

A) Removing nitrogenous wastes
B) Regulating water levels in tissues
C) Regulating the acid-base and electrolyte balance
D) Producing and releasing adrenaline

Question 9

One of the three constricted points along each ureter is the pelvic brim.The location of this constricted point is:

A) where the bladder meets the symphysis pubis.
B) at the level of the ischial spines.
C) where the iliac blood vessels cross over the ureters.
D) where the distal ureters connect to the bladder.

Question 10

The average adult kidney measures ____ in length.

A) 2 to 3 inches (5 to 7 cm)
B) 4 to 5 inches (10 to 13 cm)
C) 6 to 8 inches (15 to 20 cm)
D) 8 to 10 inches (20 to 25 cm)

Question 11

The structural and functional unit of the kidney is:

A) Bowman capsule.
B) the calyx.
C) the nephron.
D) the glomerulus.

Question 12

What structure enables the kidneys to be visualized on plain abdominal radiographs?

A) Adipose capsule
B) Renal pyramids
C) Major and minor calyces
D) High volume of blood within the kidney

Question 13

The glomeruli,glomerular capsule,and proximal and distal convoluted tubules are located in the ____ of the kidney.

A) medulla
B) cortex
C) collecting system
D) fibrous capsule

Question 14

Which structure is labeled 2?

A) Renal pelvis
B) Ureterovesical junction
C) Ureteropelvic junction
D) Pelvic brim

Question 15

The left kidney is generally slightly lower,or more inferior,than the right.

Question 16

Urine will travel from the major calyces to the:

A) renal pelvis.
B) ureter.
C) minor calyces.
D) renal pyramids.

Question 17

The numerous mucosal folds located within the urinary bladder are termed:

A) trigone.
B) mucosa.
C) rugae.
D) vesical mucosa.

Question 18

The term describing the total functioning portions of the kidney is the:

A) renal collecting system.
B) nephron.
C) glomerular capsule.
D) renal parenchyma.

Question 19

Which abdominal muscles run on each side of,and medial and posterior to,the kidneys?

A) Rectus abdominis
B) External obliques
C) Right and left psoas major
D) Erector spinae

Question 20

What is the structure labeled 6?

A) Renal pelvis
B) Ureterovesical junction
C) Renal sinuses
D) Trigone

Question 21

Which component of an ionic contrast media increases its solubility?

A) Cation
B) Anion
C) Benzoic acid
D) Iodine

Question 22

Nonionic contrast agents contain no positively charged cations.

Question 23

Phlebitis is considered to be a systemic contrast media reaction.

Question 24

The American College of Radiology recommends that metformin (a drug used for diabetes mellitus)be withheld for ____ hour(s)following a contrast media procedure.

A) 1
B) 8
C) 24
D) 48

Question 25

Which one of the following drugs is often given before an IVU to reduce the risk of a contrast media reaction?

A) Diazepam
B) Benadryl and prednisone
C) Fluoxetine
D) Verapamil

Question 26

The drug,Lasix,is classified as a:

A) contrast agent.
B) cathartic.
C) diuretic.
D) salicylate.

Question 27

Which of the following is true with nonionic type contrast media?

A) Low osmolality
B) The inability to dissociate into two separate ions
C) Less chance of reaction
D) All of the above

Question 28

Which of the following occurs in many patients and is defined as an expected outcome to the introduction of iodinated contrast media?

A) Moderate itching and sneezing
B) Metallic taste in mouth and a temporary hot flash
C) Mild condition of urticaria (hives)
D) All of the above

Question 29

Extravasation is classified as a local reaction.

Question 30

Which of the following compounds is a common cation (+)found in ionic contrast media?

A) Diatrizoate
B) Iodine
C) Meglumine
D) Benzoic acid

Question 31

The normal creatinine level (diagnostic indication of kidney function)for an adult is _____ mg/dL.

A) 0.1 to 0.5
B) 0.6 to 1.5
C) 3 to 4.5 m
D) 6 to 7.5

Question 32

Nonionic contrast agents may increase the severity of side effects as compared with ionic contrast agents.

Question 33

Normal BUN (blood urea nitrogen)levels in adults should not exceed ____ mg per 100 mL.

A) 1.5
B) 5
C) 10
D) 25

Question 34

A loss of consciousness caused by reduced cerebral blood flow is termed:

A) syncope.
B) brachycardia.
C) hypotension.
D) angioedema.

Question 35

A medical emergency must be declared if the patient experiences a moderate contrast media reaction.

Question 36

If a patient experiences tachycardia (>100 heartbeats/min)following a contrast media injection,he or she is experiencing a(n)____ reaction.

A) mild
B) moderate
C) severe
D) vasovagal

Question 37

If a patient experiences laryngeal swelling following a contrast media injection,he or she is experiencing a ____ reaction.

A) mild
B) moderate
C) severe
D) local

Question 38

A vasovagal contrast media reaction can be a life-threatening condition.

Question 39

Which of the following symptoms is classified as a mild reaction?

A) Itching
B) Hypotension
C) Extravasation
D) Angioedema

Question 40

What is the primary purpose of the premedication procedure before an iodinated contrast media study?

A) Reduces anxiety
B) Permits greater contrast enhancement of kidneys during an intravenous urography (IVU)
C) Reduces the severity of a possible contrast media reaction
D) Decreases blood pressure

Question 41

What is the recommended treatment protocol for extravasation?

A) Give the patient diphenhydramine (Benadryl).
B) Elevate the limb and apply cold compress.
C) Increase IV fluids.
D) Give the patient Lasix.

Question 42

Patchy,blunting of the calyces is a radiographic sign of:

A) polycystic kidney disease.
B) renal hypertension.
C) chronic pyelonephritis.
D) ectopic kidney.

Question 43

Which term describes the leakage of contrast media from a vein into the surrounding tissues of the arm?

A) Extravasation
B) Filtration
C) Exudation
D) Micturition

Question 44

If available,the technologist should use a central line catheter to introduce contrast agents into the patient.

Question 45

The bevel of the needle must be facing downward during the actual puncture into a vein.

Question 46

Over-the-needle catheters are often used for drip infusion studies.

Question 47

Which of the following conditions is considered a moderate level reaction requiring treatment?

A) Nausea and vomiting
B) Syncope
C) Tachycardia
D) None of the above

Question 48

What is the correct course of action for the technologist when,during an injection of contrast media,a patient experiences a side effect of mild hot flashes and some metallic taste in his mouth?

A) Call for a physician to complete the injection.
B) Stop the injection of contrast media immediately.
C) Stop the injection but continue the normal imaging sequence.
D) Reassure the patient and continue the injection and imaging sequence, while carefully observing the patient for a possible more severe reaction to follow.

Question 49

Which of the following symptoms is considered a severe reaction to contrast media and is a life-threatening condition requiring life-saving measures?

A) Tachycardia (rapid heartbeat)
B) Excessive urticaria (hives)
C) Extravasation at the injection site
D) Cardiac arrhythmias

Question 50

Venipuncture procedures may be performed by a technologist only if a physician is present in the room or is in an adjoining room.

Question 51

The rapid introduction of contrast agents into the vascular system is termed:

A) rapid-fire injection.
B) rapid-drip infusion.
C) bolus injection.
D) IV infusion.

Question 52

Patients (or legal guardian)must sign an informed consent form before a venipuncture procedure.

Question 53

In preparation for a venipuncture,a tourniquet should be applied ____ above or proximal to the site of injection.

A) 1 to 2 inches (2.5 to 5 cm)
B) 3 to 4 inches (8 to 10 cm)
C) 6 to 7 inches (15 to 18 cm)
D) 8 to 10 inches (20 to 25 cm)

Question 54

Which of the following is considered as a contraindication for an IVU procedure?

A) Hypertension
B) Anuria
C) Hematuria
D) All of the above

Question 55

Which of the following veins is not normally used during venipuncture?

A) Median cubital
B) Axillary
C) Cephalic
D) Basilic

Question 56

Which of the following conditions is considered to be higher risk for a contrast media reaction?

A) Hematuria
B) Congestive heart failure
C) Urinary tract infection
D) Renal calculi

Question 57

Which level of severity is the reaction of giant hives?

A) Normal side effect
B) Mild reaction
C) Moderate reaction
D) Severe reaction

Question 58

The technologist should leave a butterfly needle in the vein for the first part of the IVU following injection.

Question 59

The most common size needle used for bolus injection of contrast agents for adult patients is _____ gauge.

A) 23 to 25
B) 14 to 16
C) 18 to 22
D) 28

Question 60

Region or areas of subcutaneous swelling caused by allergic reaction to foods or drugs is termed:

A) oliguria.
B) micturition.
C) syncope.
D) angioedema.

Question 61

With automatic exposure control (AEC),which ionization chamber(s)should be activated for an AP projection taken during an IVU?

A) Left and right upper chambers
B) Center chamber
C) Left chamber
D) Center and right upper chamber

Question 62

If both procedures are ordered on the same day,a barium enema must be performed before an IVU.

Question 63

A radiograph of an AP projection taken during a retrograde cystogram reveals that the floor of the bladder is superimposed over the symphysis pubis.What error led to this radiographic finding?

A) Excessive CR angulation
B) Rotation of the pelvis
C) Insufficient CR angulation
D) Excessive filling of the bladder with contrast media

Question 64

Which one of the following veins is NOT selected for venipuncture during an IVU?

A) Basilic
B) Cephalic
C) Axillary
D) Median cubital

Question 65

What is the recommended position for a male retrograde urethrogram?

A) 30° right posterior oblique (RPO)
B) 45° RPO
C) Lateral
D) 2° left anterior oblique (LAO)

Question 66

A patient comes to radiology for an IVU.During the procedure,the radiologist suspects nephroptosis.Which of the following positions best demonstrates this condition?

A) Erect
B) Prone
C) Supine with ureteric compression
D) RPO and LPO

Question 67

What is the most common exposure angle performed during nephrotomography?

A) 15°
B) 10°
C) 20°
D) 40°

Question 68

A patient comes to radiology for an IVU.The clinical history states that the patient may have an enlarged prostate gland (benign prostatic hyperplasia).Which of the following positions best demonstrates this condition?

A) AP erect, prevoiding and voiding
B) PA prone, CR perpendicular
C) AP supine with a 15° CR caudad angle
D) 30° RPO

Question 69

A patient comes to radiology with a history of vesicourethral reflux.The patient states that she is highly sensitive to iodinated contrast media.Which of the following alternative procedures could be performed to demonstrate this condition?

A) Radionuclide scan
B) Sonography
C) CT
D) MRI (magnetic resonance imaging)

Question 70

A patient comes to radiology for an IVU.He has a clinical history of renal hypertension.How should the IVU procedure be altered for this patient?

A) Keep ureteric compression inflated for all projections.
B) Give the patient a diuretic agent before the procedure.
C) Provide images every 30 minutes after the injection.
D) Shorten the time between exposures.

Question 71

How is contrast media normally introduced during a retrograde cystogram?

A) Intravenously
B) With an injection through the urethra with a large syringe and catheter
C) Gravity flow through a catheter
D) Either B or C

Question 72

CT (computed tomography)of the kidney for renal calculi does not require the use of intravenous contrast media.

Question 73

A patient comes to radiology,after surgery of the abdomen,for an IVU with an order for ureteric compression to enhance pelvicalyceal filling.What should the technologist do?

A) Use mild ureteric compression only.
B) Place the patient into a Trendelenburg position instead of compression.
C) Perform all projections erect.
D) Raise the Foley bag above the tabletop to keep the contrast media in the kidneys longer.

Question 74

Where is the CR centered for a nephrotomogram of the kidneys?

A) At the xiphoid process
B) At the iliac crest
C) Midway between the iliac crest and the xiphoid process
D) Midway between the ASIS and the iliac crest

Question 75

A nephrogram taken during an IVU demonstrates that the renal parenchyma is poorly visualized but the calyces are contrast enhanced.What is the most likely reason for this radiographic outcome?

A) The kV may have been too high.
B) The contrast media was diluted.
C) The patient has hypertension.
D) The exposure was not taken soon enough following the injection.

Question 76

Generally,female patients cannot be shielded during an IVU (except for nephrotomography).

Question 77

If an IVU is performed on a female,a menstrual history must be obtained.

Question 78

A radiograph of a left posterior oblique (LPO)position taken during an IVU reveals that the right kidney is foreshortened and superimposed over the spine.What must the technologist do to correct this error during the repeat exposure?

A) Decrease rotation.
B) Increase rotation.
C) Increase CR angulation.
D) Place the patient in the RPO position to better demonstrate the right kidney.

Question 79

Ultrasound is an effective imaging modality in demonstrating cystitis.

Question 80

Ureteric compression is contraindicated for patients with a history of:

A) hematuria.
B) abdominal mass.
C) hypertension.
D) flank pain.