Page 1 of 81
INTERVENTIONAL RADIOLOGY RN EXAM
QUESTIONS EXAM LATEST VERSION QUESTIONS
AND ANSWERS 2026 EDITION
INTERVENTIONAL RADIOLOGY RN EXAM
QUESTIONS WITH RATIONALES
1. A 68-year-old patient with a history of chronic kidney disease and a serum
creatinine of 2.4 mg/dL is scheduled for a diagnostic angiography. Which pre-
procedural intervention should the nurse prioritize to reduce the risk of contrast-
induced nephropathy?
A) Administer intravenous normal saline at 100 mL/hr for 6 hours before the procedure
B) Administer oral N-acetylcysteine 600 mg twice daily starting 24 hours before
C) Hold all antihypertensive medications for 48 hours prior to the procedure
D) Encourage the patient to drink at least 2 liters of clear fluids the night before
Correct Answer: A – Intravenous hydration with normal saline is the most evidence-
based intervention to reduce contrast-induced nephropathy in patients with pre-
existing renal impairment. Oral hydration is insufficient in the peri-procedural period,
and holding antihypertensives may lead to uncontrolled hypertension.
2. The nurse is preparing a patient for a transjugular intrahepatic portosystemic
shunt (TIPS) procedure. Which laboratory value should be reported to the
interventional radiologist immediately because it indicates a significant
contraindication?
A) Serum sodium of 132 mEq/L
B) International normalized ratio (INR) of 2.5
, Page 2 of 81
C) Platelet count of 110,000/μL
D) Serum bilirubin of 6.0 mg/dL
Correct Answer: D – A bilirubin level greater than 5.0 mg/dL is considered a relative
contraindication for TIPS due to the high risk of post-procedural liver failure and
mortality. An INR of 2.5 may be correctable, and mild thrombocytopenia is common in
cirrhosis.
3. A patient with a history of heparin-induced thrombocytopenia (HIT) is scheduled
for an arterial angioplasty. Which anticoagulant should the nurse anticipate will be
ordered for intra-procedural use?
A) Unfractionated heparin administered as a continuous infusion
B) Enoxaparin 40 mg subcutaneously once daily
C) Bivalirudin as a bolus followed by a continuous infusion
D) Warfarin 5 mg orally once daily starting the day before
Correct Answer: C – Bivalirudin is a direct thrombin inhibitor that is safe to use in
patients with HIT. Heparin and enoxaparin are absolutely contraindicated, and warfarin
is not appropriate for intraprocedural anticoagulation.
4. A patient with myasthenia gravis requires moderate sedation for a tunneled
central venous catheter placement. Which sedative agent should the nurse
question if ordered because it may precipitate respiratory failure?
A) Ketamine administered at 0.5 mg/kg intravenously
B) Propofol administered at 20 mg intravenously
C) Midazolam administered at 2 mg intravenously
D) Fentanyl administered at 50 mcg intravenously
Correct Answer: C – Benzodiazepines such as midazolam can exacerbate muscle
weakness in patients with myasthenia gravis and precipitate respiratory failure.
Ketamine and propofol are considered safer alternatives in this patient population.
5. The nurse is assessing a patient scheduled for a transarterial
chemoembolization (TACE) procedure. The patient's albumin level is 2.0 g/dL. What
is the primary concern associated with this laboratory finding?
A) Increased risk of contrast-induced nephropathy
B) Increased risk of bleeding due to impaired clotting factor synthesis
C) Increased risk of chemotherapy drug toxicity due to higher free drug levels
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D) Increased risk of post-embolization syndrome severity
Correct Answer: C – Hypoalbuminemia results in higher levels of free (unbound)
chemotherapeutic agents such as doxorubicin and cisplatin, which significantly
increases the risk of drug toxicity.
6. A patient with hereditary hemorrhagic telangiectasia (HHT) is scheduled for
pulmonary arteriovenous malformation (AVM) embolization. Which pre-procedural
assessment is most critical for the nurse to perform?
A) Review of the patient's platelet count and bleeding time
B) Assessment for a bubble echocardiogram to evaluate for paradoxical embolism risk
C) Evaluation of serum iron and ferritin levels
D) Documentation of the patient's oxygen saturation at rest and with exertion
Correct Answer: B – Patients with HHT have pulmonary AVMs that create right-to-left
shunts, increasing the risk of paradoxical emboli. A baseline bubble study helps guide
management and the procedure itself carries a significant air embolism risk.
7. A patient scheduled for an arteriogram reports a severe allergy to penicillin.
What is the most appropriate nursing action regarding premedication for contrast
media administration?
A) Premedicate with diphenhydramine and prednisone 13 hours, 7 hours, and 1 hour
before the procedure
B) Administer a test dose of iodinated contrast media prior to the procedure
C) Document the allergy and proceed without premedication as there is no cross-
reactivity
D) Substitute gadolinium-based contrast for the iodinated contrast media
Correct Answer: C – Penicillin allergy does not cross-react with iodinated contrast
media. Routine premedication is not indicated for penicillin allergy alone, and test
dosing is not recommended as it does not reliably predict reactions.
8. The nurse is reviewing a patient's medication list prior to a percutaneous
nephrostomy tube placement. Which medication should be held to reduce the risk
of bleeding complications?
A) Metformin 500 mg twice daily
B) Clopidogrel 75 mg daily
C) Omeprazole 20 mg daily
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D) Amlodipine 10 mg daily
Correct Answer: B – Clopidogrel is an antiplatelet agent that should typically be held
for 5-7 days before invasive procedures to reduce bleeding risk. Metformin is held due to
contrast concerns, not bleeding. Omeprazole and amlodipine do not significantly
increase bleeding risk.
9. A patient with a left ventricular assist device (LVAD) is scheduled for an inferior
vena cava (IVC) filter placement. What is the priority pre-procedural assessment
for the nurse?
A) Verification of the patient's international normalized ratio (INR)
B) Assessment of the mean arterial pressure (MAP) to ensure adequate perfusion
C) Confirmation of the platelet count being above 100,000/μL
D) Evaluation of the patient's baseline oxygen saturation
Correct Answer: B – LVAD patients require a MAP greater than 60-70 mmHg to maintain
adequate end-organ perfusion. This is the priority assessment before any procedure in
this patient population.
10. A patient is scheduled for a percutaneous biliary drainage procedure and has an
INR of 2.8 due to chronic warfarin therapy. Which reversal agent should the nurse
expect to be administered to normalize the INR emergently?
A) Protamine sulfate administered intravenously
B) Vitamin K 10 mg administered slowly intravenously
C) Fresh frozen plasma (FFP) administered intravenously
D) Andexanet alfa administered as a bolus
Correct Answer: C – Fresh frozen plasma provides immediate clotting factors to rapidly
correct an elevated INR. Intravenous vitamin K requires 6-12 hours to take effect, and
protamine is for heparin reversal, not warfarin.
11. The nurse is performing a pre-procedural assessment on a patient scheduled
for a uterine fibroid embolization (UFE). Which finding would be most concerning
and should be reported to the physician immediately?
A) The patient reports mild intermittent pelvic pain
B) The patient's hemoglobin is 10.5 g/dL
C) The patient reports heavy menstrual bleeding and is unsure if she could be pregnant
D) The patient's blood pressure is 138/86 mmHg
INTERVENTIONAL RADIOLOGY RN EXAM
QUESTIONS EXAM LATEST VERSION QUESTIONS
AND ANSWERS 2026 EDITION
INTERVENTIONAL RADIOLOGY RN EXAM
QUESTIONS WITH RATIONALES
1. A 68-year-old patient with a history of chronic kidney disease and a serum
creatinine of 2.4 mg/dL is scheduled for a diagnostic angiography. Which pre-
procedural intervention should the nurse prioritize to reduce the risk of contrast-
induced nephropathy?
A) Administer intravenous normal saline at 100 mL/hr for 6 hours before the procedure
B) Administer oral N-acetylcysteine 600 mg twice daily starting 24 hours before
C) Hold all antihypertensive medications for 48 hours prior to the procedure
D) Encourage the patient to drink at least 2 liters of clear fluids the night before
Correct Answer: A – Intravenous hydration with normal saline is the most evidence-
based intervention to reduce contrast-induced nephropathy in patients with pre-
existing renal impairment. Oral hydration is insufficient in the peri-procedural period,
and holding antihypertensives may lead to uncontrolled hypertension.
2. The nurse is preparing a patient for a transjugular intrahepatic portosystemic
shunt (TIPS) procedure. Which laboratory value should be reported to the
interventional radiologist immediately because it indicates a significant
contraindication?
A) Serum sodium of 132 mEq/L
B) International normalized ratio (INR) of 2.5
, Page 2 of 81
C) Platelet count of 110,000/μL
D) Serum bilirubin of 6.0 mg/dL
Correct Answer: D – A bilirubin level greater than 5.0 mg/dL is considered a relative
contraindication for TIPS due to the high risk of post-procedural liver failure and
mortality. An INR of 2.5 may be correctable, and mild thrombocytopenia is common in
cirrhosis.
3. A patient with a history of heparin-induced thrombocytopenia (HIT) is scheduled
for an arterial angioplasty. Which anticoagulant should the nurse anticipate will be
ordered for intra-procedural use?
A) Unfractionated heparin administered as a continuous infusion
B) Enoxaparin 40 mg subcutaneously once daily
C) Bivalirudin as a bolus followed by a continuous infusion
D) Warfarin 5 mg orally once daily starting the day before
Correct Answer: C – Bivalirudin is a direct thrombin inhibitor that is safe to use in
patients with HIT. Heparin and enoxaparin are absolutely contraindicated, and warfarin
is not appropriate for intraprocedural anticoagulation.
4. A patient with myasthenia gravis requires moderate sedation for a tunneled
central venous catheter placement. Which sedative agent should the nurse
question if ordered because it may precipitate respiratory failure?
A) Ketamine administered at 0.5 mg/kg intravenously
B) Propofol administered at 20 mg intravenously
C) Midazolam administered at 2 mg intravenously
D) Fentanyl administered at 50 mcg intravenously
Correct Answer: C – Benzodiazepines such as midazolam can exacerbate muscle
weakness in patients with myasthenia gravis and precipitate respiratory failure.
Ketamine and propofol are considered safer alternatives in this patient population.
5. The nurse is assessing a patient scheduled for a transarterial
chemoembolization (TACE) procedure. The patient's albumin level is 2.0 g/dL. What
is the primary concern associated with this laboratory finding?
A) Increased risk of contrast-induced nephropathy
B) Increased risk of bleeding due to impaired clotting factor synthesis
C) Increased risk of chemotherapy drug toxicity due to higher free drug levels
, Page 3 of 81
D) Increased risk of post-embolization syndrome severity
Correct Answer: C – Hypoalbuminemia results in higher levels of free (unbound)
chemotherapeutic agents such as doxorubicin and cisplatin, which significantly
increases the risk of drug toxicity.
6. A patient with hereditary hemorrhagic telangiectasia (HHT) is scheduled for
pulmonary arteriovenous malformation (AVM) embolization. Which pre-procedural
assessment is most critical for the nurse to perform?
A) Review of the patient's platelet count and bleeding time
B) Assessment for a bubble echocardiogram to evaluate for paradoxical embolism risk
C) Evaluation of serum iron and ferritin levels
D) Documentation of the patient's oxygen saturation at rest and with exertion
Correct Answer: B – Patients with HHT have pulmonary AVMs that create right-to-left
shunts, increasing the risk of paradoxical emboli. A baseline bubble study helps guide
management and the procedure itself carries a significant air embolism risk.
7. A patient scheduled for an arteriogram reports a severe allergy to penicillin.
What is the most appropriate nursing action regarding premedication for contrast
media administration?
A) Premedicate with diphenhydramine and prednisone 13 hours, 7 hours, and 1 hour
before the procedure
B) Administer a test dose of iodinated contrast media prior to the procedure
C) Document the allergy and proceed without premedication as there is no cross-
reactivity
D) Substitute gadolinium-based contrast for the iodinated contrast media
Correct Answer: C – Penicillin allergy does not cross-react with iodinated contrast
media. Routine premedication is not indicated for penicillin allergy alone, and test
dosing is not recommended as it does not reliably predict reactions.
8. The nurse is reviewing a patient's medication list prior to a percutaneous
nephrostomy tube placement. Which medication should be held to reduce the risk
of bleeding complications?
A) Metformin 500 mg twice daily
B) Clopidogrel 75 mg daily
C) Omeprazole 20 mg daily
, Page 4 of 81
D) Amlodipine 10 mg daily
Correct Answer: B – Clopidogrel is an antiplatelet agent that should typically be held
for 5-7 days before invasive procedures to reduce bleeding risk. Metformin is held due to
contrast concerns, not bleeding. Omeprazole and amlodipine do not significantly
increase bleeding risk.
9. A patient with a left ventricular assist device (LVAD) is scheduled for an inferior
vena cava (IVC) filter placement. What is the priority pre-procedural assessment
for the nurse?
A) Verification of the patient's international normalized ratio (INR)
B) Assessment of the mean arterial pressure (MAP) to ensure adequate perfusion
C) Confirmation of the platelet count being above 100,000/μL
D) Evaluation of the patient's baseline oxygen saturation
Correct Answer: B – LVAD patients require a MAP greater than 60-70 mmHg to maintain
adequate end-organ perfusion. This is the priority assessment before any procedure in
this patient population.
10. A patient is scheduled for a percutaneous biliary drainage procedure and has an
INR of 2.8 due to chronic warfarin therapy. Which reversal agent should the nurse
expect to be administered to normalize the INR emergently?
A) Protamine sulfate administered intravenously
B) Vitamin K 10 mg administered slowly intravenously
C) Fresh frozen plasma (FFP) administered intravenously
D) Andexanet alfa administered as a bolus
Correct Answer: C – Fresh frozen plasma provides immediate clotting factors to rapidly
correct an elevated INR. Intravenous vitamin K requires 6-12 hours to take effect, and
protamine is for heparin reversal, not warfarin.
11. The nurse is performing a pre-procedural assessment on a patient scheduled
for a uterine fibroid embolization (UFE). Which finding would be most concerning
and should be reported to the physician immediately?
A) The patient reports mild intermittent pelvic pain
B) The patient's hemoglobin is 10.5 g/dL
C) The patient reports heavy menstrual bleeding and is unsure if she could be pregnant
D) The patient's blood pressure is 138/86 mmHg
