DAVIES SPI: I. Patient Care, Safety, and
Communication (5% of ARDMS)
During performance of an obstetric ultrasound exam, you adjust the system parameters
to improve the image. Which of the following parameters would increase acoustic
exposure?
A. Increase receiver gain
B. Increase TGC
C. Increase frequency
D. Increase transmit power
E. Increase frame averaging (persistence) - ✔️✔️D. Increase transmit power
<The transmit power is the only control listed that will affect the exposure of the patient
to acoustic power. Gain, TGC, and frame averaging (persistence) do not affect sound
transmission and therefore do not affect exposure. Increasing frequency will not
increase exposure>
What should you do to avoid nosocomial and cross-infection with sonographic probes?
A. Probe cleaning should always precede high-level disinfection
B. Covering a probe with a condom is a sufficient barrier to infection for intracavitary
probes
C. Disinfection using a germicide compatible with the transducer is indicated when the
probe is in contact with mucous membranes
D. Alcohol soak of each probe should occur between patients
E. A and C - ✔️✔️E. A and C
<Alone, covering the probe with a condom is insufficient. Proper cleaning of the probe
both before and after the procedure is required. Alcohol wipes are not recommended by
manufacturers as they will degrade the transducer surface over time>
What does the mechanical index indicate on an ultrasound system?
A. The maximum temperature increase in tissue
B. The minimum temperature increase in tissue
C. Acoustic power in milliwatts
D. The likelihood of cavitation during an ultrasound exam
E. Minutes of exposure time before tissue heating is too great - ✔️✔️D. The likelihood
of cavitation during an ultrasound exam
<Mechanical index is derived from the peak rarefactional pressure and the ultrasound
frequency, parameters shown to be associated with onset of cavitation>
, Which of the following occurs when you use the maximum system gain?
A. Increased tissue heating
B. Increased risk of cavitation
C. Fluid Particle streaming
D. Increased sound absorption
E. None of the above - ✔️✔️E. None of the above
When scanning with pulsed-wave Doppler, you would affect the acoustic exposure by
changing which of the following?
A. Doppler gain
B. High pass filter
C. Pulse repetition frequency
D. Baseline position
E. Doppler angle - ✔️✔️C. Pulse repetition frequency
<The PRF is the number of pulses per second transmitted by the transducer, which
varies with the velocity setting on the spectral display. Increasing PRF has the potential
to increase the acoustic exposure>
Which of the follow would most likely have the highest SPTA value?
A. CW Doppler
B. B-mode real-time scanners
C. Static B-mode scanners
D. PW Doppler
E. Fetal monitor Doppler - ✔️✔️D. PW Doppler
You are performing a sonographic examination and notice that the thermal index (TI) is
greater than 1. Any increase in temperature would be greatest in
A. Liver
B. Lung
C. Kidney
D. Bone
E. Bladder - ✔️✔️B. Bone
What action below would be most in keeping with the ALARA principle while performing
a diagnostic ultrasound examination?
A. Allow multiple students to scan an obstetric patient because the fetus is in a good
position for imaging
Communication (5% of ARDMS)
During performance of an obstetric ultrasound exam, you adjust the system parameters
to improve the image. Which of the following parameters would increase acoustic
exposure?
A. Increase receiver gain
B. Increase TGC
C. Increase frequency
D. Increase transmit power
E. Increase frame averaging (persistence) - ✔️✔️D. Increase transmit power
<The transmit power is the only control listed that will affect the exposure of the patient
to acoustic power. Gain, TGC, and frame averaging (persistence) do not affect sound
transmission and therefore do not affect exposure. Increasing frequency will not
increase exposure>
What should you do to avoid nosocomial and cross-infection with sonographic probes?
A. Probe cleaning should always precede high-level disinfection
B. Covering a probe with a condom is a sufficient barrier to infection for intracavitary
probes
C. Disinfection using a germicide compatible with the transducer is indicated when the
probe is in contact with mucous membranes
D. Alcohol soak of each probe should occur between patients
E. A and C - ✔️✔️E. A and C
<Alone, covering the probe with a condom is insufficient. Proper cleaning of the probe
both before and after the procedure is required. Alcohol wipes are not recommended by
manufacturers as they will degrade the transducer surface over time>
What does the mechanical index indicate on an ultrasound system?
A. The maximum temperature increase in tissue
B. The minimum temperature increase in tissue
C. Acoustic power in milliwatts
D. The likelihood of cavitation during an ultrasound exam
E. Minutes of exposure time before tissue heating is too great - ✔️✔️D. The likelihood
of cavitation during an ultrasound exam
<Mechanical index is derived from the peak rarefactional pressure and the ultrasound
frequency, parameters shown to be associated with onset of cavitation>
, Which of the following occurs when you use the maximum system gain?
A. Increased tissue heating
B. Increased risk of cavitation
C. Fluid Particle streaming
D. Increased sound absorption
E. None of the above - ✔️✔️E. None of the above
When scanning with pulsed-wave Doppler, you would affect the acoustic exposure by
changing which of the following?
A. Doppler gain
B. High pass filter
C. Pulse repetition frequency
D. Baseline position
E. Doppler angle - ✔️✔️C. Pulse repetition frequency
<The PRF is the number of pulses per second transmitted by the transducer, which
varies with the velocity setting on the spectral display. Increasing PRF has the potential
to increase the acoustic exposure>
Which of the follow would most likely have the highest SPTA value?
A. CW Doppler
B. B-mode real-time scanners
C. Static B-mode scanners
D. PW Doppler
E. Fetal monitor Doppler - ✔️✔️D. PW Doppler
You are performing a sonographic examination and notice that the thermal index (TI) is
greater than 1. Any increase in temperature would be greatest in
A. Liver
B. Lung
C. Kidney
D. Bone
E. Bladder - ✔️✔️B. Bone
What action below would be most in keeping with the ALARA principle while performing
a diagnostic ultrasound examination?
A. Allow multiple students to scan an obstetric patient because the fetus is in a good
position for imaging
