Deck 14: Urinary System and Venipuncture

Question 1

Which component of an ionic contrast media increases its solubility?

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

Answer 1

Cation

Question 2

Which structure is labeled 2?

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

Answer 2

Renal pelvis

Question 3

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

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

Answer 3

Meglumine

Question 4

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 5

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 6

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 7

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 8

Urine will travel from the major calyces to the:

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

Question 9

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

Question 10

Which structure of the kidney is labeled 3?

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

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

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 13

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

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

Question 14

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 15

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

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

Question 16

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 17

The average adult kidney measures ____ in length.

A)2 to 3 inches (5 to 7 cm)
B)4 to 5 inches (10 to 12 cm)
C)6 to 8 inches (15 to 20 cm)
D)8 to 10 inches (20 to 25 cm)

Question 18

What is the structure labeled 6?

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

Question 19

Which term describes the act of voiding under voluntary control?

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

Question 20

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 21

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
D)6 to 7.5

Question 22

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 23

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 24

The drug Lasix is classified as a:

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

Question 25

What is the recommended treatment protocol for extravasation?

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

Question 26

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 27

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 28

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

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

Question 29

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

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

Question 30

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 31

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

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

Question 32

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

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

Question 33

Which of the following symptoms is classified as "mild" during a systematic contrast media reaction?

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

Question 34

A region or area of subcutaneous swelling caused by allergic reaction to foods or drugs is termed:

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

Question 35

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 36

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

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

Question 37

Which level of contrast media reaction has occurred when the patient develops moderate urticaria?

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

Question 38

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 39

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 40

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 41

Patchy blunting of the calyces is a radiographic sign of:

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

Question 42

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 43

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 44

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 45

A patient, during an injection of contrast media, complains about pain at the injection site.The radiographer notices a moderate degree of swelling beneath the skin.The radiographer stops the injection and suspects that the needle has slipped out of the vein.What should the radiographer do after removing the needle to alleviate the patient's discomfort?

A)Give the patient diphenhydramine (Benadryl).
B)Elevate the limb and place a cold compress over the injection site.
C)Place ice over the injection site.
D)Flex and extend the elbow to increase absorption of contrast media into the soft tissues.

Question 46

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

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

Question 47

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 48

Where is the central ray (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 49

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 50

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 51

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

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

Question 52

Ureteric compression is contraindicated for patients with a history of:

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

Question 53

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 54

A male patient comes to radiology for a voiding cystourethrogram.Which of the following projections and/or positions would be performed for this procedure?

A)30° RPO
B)Erect lateral
C)Recumbent lateral
D)Erect PA

Question 55

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 56

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 57

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 58

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 59

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 60

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 (7.5 to 10 cm)
C)6 to 7 inches (15 to 18 cm)
D)8 to 10 inches (20 to 25 cm)

Question 61

Select the correct pathologic indication for each statement or description.(Select each choice only once.)

Age-associated enlargement of the prostate gland

A)Horseshoe kidney
B)Ectopic kidney
C)Vesicocolonic fistula
D)Staghorn kidney stone
E)Urinary incontinence
F)BPH (benign prostatic hyperplasia)

Question 62

Select the correct pathologic indication for each statement or description.(Select each choice only once.)

Large stone that grows and completely fills the renal pelvis

A)Horseshoe kidney
B)Ectopic kidney
C)Vesicocolonic fistula
D)Staghorn kidney stone
E)Urinary incontinence
F)BPH (benign prostatic hyperplasia)

Question 63

Select the correct pathologic term for each definition.(Use each selection only once.)

Excretion of diminished amounts of urine

A)Anuria
B)Oliguria or hypouresis
C)Polyuria
D)Hematuria
E)Renal agenesis
F)Micturition

Question 64

A patient with a possible ureteric stone comes from the emergency department (ED) for an IVU.She has a blood urea nitrogen (BUN) level of 50.Which of the following imaging modalities is recommended for this patient?

A)IVU using ionic contrast media
B)Sonography
C)CT
D)MRI

Question 65

Select the correct pathologic term for each definition.(Use each selection only once.)

Complete cessation of urinary secretion

A)Anuria
B)Oliguria or hypouresis
C)Polyuria
D)Hematuria
E)Renal agenesis
F)Micturition

Question 66

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

Question 67

Select the correct pathologic indication for each statement or description.(Select each choice only once.)

Fusion of the kidneys during development of the fetus

A)Horseshoe kidney
B)Ectopic kidney
C)Vesicocolonic fistula
D)Staghorn kidney stone
E)Urinary incontinence
F)BPH (benign prostatic hyperplasia)

Question 68

Select the correct pathologic term for each definition.(Use each selection only once.)

Passage of a large volume of urine

A)Anuria
B)Oliguria or hypouresis
C)Polyuria
D)Hematuria
E)Renal agenesis
F)Micturition

Question 69

Select the correct pathologic indication for each statement or description.(Select each choice only once.)

Constant or frequent involuntary passage of urine

A)Horseshoe kidney
B)Ectopic kidney
C)Vesicocolonic fistula
D)Staghorn kidney stone
E)Urinary incontinence
F)BPH (benign prostatic hyperplasia)

Question 70

Select the correct pathologic indication for each statement or description.(Select each choice only once.)

Normal kidney that fails to ascend into the abdomen but remains in the pelvis

A)Horseshoe kidney
B)Ectopic kidney
C)Vesicocolonic fistula
D)Staghorn kidney stone
E)Urinary incontinence
F)BPH (benign prostatic hyperplasia)

Question 71

The suprarenal glands are part of the endocrine system.

Question 72

A patient experiences a hot flash after the injection of an iodinated contrast media.What should be the next action taken by the technologist?

A)Call a code emergency.
B)Comfort the patient; this is a common side effect.
C)Give the patient diphenhydramine (Benadryl).
D)Get medical assistance.

Question 73

A patient comes to radiology for an IVU.His laboratory report indicates a creatinine level of 0.7 mg/dL.What should be the technologist's next step?

A)Proceed with the study.
B)Notify the radiologist of an elevated creatinine level.
C)Notify the referring physician of an elevated creatinine level.
D)Escort the patient to the emergency department (ED) right away.

Question 74

Select the correct pathologic term for each definition.(Use each selection only once.)

Blood in the urine

A)Anuria
B)Oliguria or hypouresis
C)Polyuria
D)Hematuria
E)Renal agenesis
F)Micturition

Question 75

Select the correct pathologic indication for each statement or description.(Select each choice only once.)

Artificial opening between the urinary bladder and aspects of the large intestine

A)Horseshoe kidney
B)Ectopic kidney
C)Vesicocolonic fistula
D)Staghorn kidney stone
E)Urinary incontinence
F)BPH (benign prostatic hyperplasia)

Question 76

Select the correct pathologic term for each definition.(Use each selection only once.)

Act of voiding

A)Anuria
B)Oliguria or hypouresis
C)Polyuria
D)Hematuria
E)Renal agenesis
F)Micturition

Question 77

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

Question 78

Select the correct pathologic term for each definition.(Use each selection only once.)

Absence of a functioning kidney

A)Anuria
B)Oliguria or hypouresis
C)Polyuria
D)Hematuria
E)Renal agenesis
F)Micturition

Question 79

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

Question 80

During an IVU, the patient develops severe urticaria.What should be the next action taken by the technologist?

A)Call a code emergency.
B)Comfort the patient; this is a common side effect.
C)Give the patient diphenhydramine (Benadryl).
D)Get medical assistance.