Question 1

Patchy blunting of the calyces is a radiographic sign of:

Accepted Answer

Patchy blunting of the calyces is a radiographic sign of chronic pyelonephritis, which is a chronic inflammation of the renal pelvis and calyces often caused by recurrent urinary tract infections. The other options are not typically associated with this radiographic finding.

Question 2

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?

Accepted Answer

Both radionuclide scans and sonography can be used to demonstrate vesicourethral reflux without the use of iodinated contrast media. Radionuclide scans use a small amount of radioactive material to produce images, while sonography uses sound waves to create images. CT and MRI both use iodinated contrast media and would not be the best choice for a patient who is highly sensitive to it.

Question 3

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

Accepted Answer

The answer of With automatic exposure control (AEC), which ionization...

Question 4

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?

Accepted Answer

Placing the patient in a Trendelenburg position (where the body is laid flat on the back with the feet higher than the head) is a safer alternative to ureteric compression after abdominal surgery, as it uses gravity to enhance pelvicalyceal filling without applying direct pressure to the surgical site.

Question 5

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?

Accepted Answer

Elevating the limb and placing a cold compress over the injection site will help reduce swelling and alleviate the patient's discomfort. Diphenhydramine (Benadryl) is an antihistamine that is usually given to treat allergic reactions, but in this case, it may not be necessary as there is no indication that the patient is experiencing an allergic reaction. Placing ice directly over the injection site can cause skin damage and is not recommended. Flexing and extending the elbow will not help alleviate the patient's discomfort and may cause further damage to the vein.

Question 6

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

Accepted Answer

The axillary vein is not normally used for venipuncture as it is located in the armpit and difficult to access. The median cubital, cephalic, and basilic veins are commonly used for venipuncture as they are located in the antecubital fossa and easily accessible.

Question 7

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?

Accepted Answer

A nephrogram taken during an IVU demonstrates the contrast-enhanced calyces, which indicates that the contrast has reached the kidneys. However, the poorly visualized renal parenchyma suggests that the contrast has not had enough time to be filtered into the kidneys and into the renal tubules. This is most likely due to the exposure not being taken soon enough following the injection.

Question 8

Where is the central ray (CR) centered for a nephrotomogram of the kidneys?

Accepted Answer

The central ray (CR) for a nephrotomogram of the kidneys is centered midway between the iliac crest and the xiphoid process. This allows for visualization of the kidneys without superimposition of other structures such as the liver or bowel.

Question 9

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?

Accepted Answer

The AP erect, prevoiding and voiding positions are best for demonstrating an enlarged prostate gland because they allow for the assessment of the bladder's shape and the presence of any post-void residual urine, which can be indicative of benign prostatic hyperplasia (BPH).

Question 10

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?

Accepted Answer

Decreasing rotation will align the right kidney more parallel to the film, reducing foreshortening and moving it away from the spine.

Question 11

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

Accepted Answer

During an IVU, the most commonly selected veins for venipuncture are the basilic, cephalic, and median cubital veins. The axillary vein is not typically used for venipuncture during an IVU.

Question 12

Ureteric compression is contraindicated for patients with a history of:

Accepted Answer

Ureteric compression can worsen an existing abdominal mass or cause complications, so it is contraindicated for patients with this condition. It is important to prioritize patient safety and avoid any potential harm. The other options (hematuria, hypertension, flank pain) do not necessarily contraindicate ureteric compression, and may be managed with other interventions.

Question 13

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

Accepted Answer

Nephroptosis, also known as floating kidney, is best demonstrated when the patient is in an erect position. This position allows gravity to affect the kidney, which can then descend abnormally if nephroptosis is present.

Question 14

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

Accepted Answer

The 30° RPO (Right Posterior Oblique) position is typically used in a voiding cystourethrogram for male patients to best visualize the urethra and bladder during the voiding phase.

Question 15

How is contrast media normally introduced during a retrograde cystogram?

Accepted Answer

The answer of How is contrast media normally introduced during...

Question 16

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?

Accepted Answer

Insufficient CR angulation causes the floor of the bladder to be superimposed over the symphysis pubis, resulting in an unclear or distorted image. Adequate CR angulation is necessary to clearly visualize the entire area of interest.

Question 17

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

Accepted Answer

The most common size needle used for bolus injection of contrast agents for adult patients is 18 to 22 gauge. This size allows for swift injection without causing significant discomfort to the patient. Choice A (23 to 25) may be too small for rapid flow rates, while choice B (14 to 16) is typically reserved for larger procedures such as drainage or biopsy. Choice D (28) is too small for bolus injections.

Question 18

What is the recommended position for a male retrograde urethrogram?

Accepted Answer

The recommended position for a male retrograde urethrogram is 30° RPO. This position allows for the urethra to be visualized in a more open position, making it easier to see any obstructions or abnormalities. The 45° RPO position is also commonly used but the 30° RPO is the more preferred position. The lateral position may not offer as clear visualization of the urethra as the angled oblique positions. The 2° LAO position is not recommended for this exam.

Question 19

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?

Accepted Answer

Shortening the time between exposures during an Intravenous Urography (IVU) for a patient with renal hypertension can help in obtaining the necessary diagnostic information more quickly and efficiently, reducing the potential strain on the patient's kidneys.

Question 20

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

Accepted Answer

The correct placement for a tourniquet when preparing for a venipuncture is 3 to 4 inches (7.5 to 10 cm) above or proximal to the site of injection. This distance is optimal for restricting blood flow and enlarging the veins without causing undue discomfort or damage to the patient.

Quiz 14: Urinary System and Venipuncture