RCIS QUESTIONS AND ANSWERS
You have just completed an echocardiogram. Your patient asks you to interpret the results of his
diagnostic examination. Your response as a healthcare professional should be to:
a. Say you don't know how to interpret results
b. Explain that the physician will interpret it and report the results
c. Explain that the final results are inconclusive
d. Honestly interpret it to the best of your ability - correct answers:ANSWER b. Explain that the physician
will interpret it and report the results. One of the 10 principles of professional conduct adopted by the
ARRT is "Radiologic Technologists shall not diagnose, but in recognition of their responsibility to the
patient, they shall provide the physician with all information they have relative to radiologic diagnosis for
patient management." We do not possess all the information or training necessary to diagnose the
patient. Diagnosis, pathology and treatment are the physician's final responsibility. We can often
reinforce his comments, clarify things and respond to our patient's questions, but always with the
qualification that the physician has the final say. See: Torres, chapter on "The Radiologic Technologist and
professionalism"
Prior to any cardiac invasive procedure the ultimate responsibility for obtaining informed consent lies
with the:
a. Patient's primary care physician (GP)
b. The operating physician (Cardiologist)
c Circulating nurse assigned to the case
d. Patient and his/her family - correct answers:ANSWER b. The operating physician (Cardiologist). The
ultimate responsibility for obtaining permission is the operating physician's, usually the operating
cardiologist. The cath lab staff are responsible for checking that the consent is on the chart, properly
signed, and that the information on the form is correct. See: Allmers, Review for Surgical Tech. Exam,
chapter on "Fundamentals"
A recommended position for a patient in acute pulmonary edema is:
a. Prone position, to encourage maximum rest, thus decreasing respiratory and cardiac rates
b. Sitting up position to facilitate breathing and decrease venous return
c. Trendelenburg position, to drain blood from leg veins into the heart .
d. Recovery position, lateral with upper leg flexed and forward, and upper hand across the chest with
back of hand held supporting his cheek. - correct answers:ANSWER b. Sitting up position to facilitate
,breathing and decrease venous return. A patient with dyspnea is usually uncomfortable in a lying supine
position (orthopnea). This is because gravity increases fluid in the lungs which increases edema in CHF
patients. They often have less difficulty breathing when placed in either a semi- sitting (mid- Fowler's)
position 30o, sitting (high- Fowler's) position 45o, or reverse Trendelenburg position (body tilted head
up). See: Medical Dictionary
When charting in the medical record you should:
a. Avoid generalizations like "appears, inadvertently, seems to..."
b. Avoid writing with fountain pens with liquid ink
c. Avoid documenting routine safety measures
d. Chart care as you are planning it, not after it is given - correct answers:ANSWER a. Avoid
generalizations like "appears, inadvertently, seems to..." Kern says: "Information in the medical record
should reflect only accurate facts regarding the particular patient. Avoid generalizations and speculating
by charting only what you see, hear, feel, and smell. Do not use words such as inadvertently,
unfortunately, appears, resembles, and the like.... Chart after the delivery of care, not before. Never
make an entry in anticipation of something to be done...The chart note should identify precautionary or
protective measures that have been taken for the safety of the patient, including the use of side rails and
restraints." Charting should always be done with a permanent ink pen, although especially runny ink may
smear. See: Kern, chapter on "Documentation in the Cardiac Catheterization Laboratory"
To be legally valid, what is the LATEST that the patient should sign the informed consent form?
a. Before administration of preoperative medications (such as demerol)
b. Before administration of conscious sedation (such as Versed)
c Before any invasive incisions or percutaneous punctures are made d. Before any interventions are
made (PTCA, Stent...) - correct answers:ANSWER a. Before administration of preoperative medications.
Consent forms must be signed before the administration of preoperative medications. This is to ensure
that the patient fully understands and is informed about the procedure and the risks involved. If his mind
is clouded by preoperative medications such as demerol the consent is not legally valid. See: Allmers,
Review for Surgical Tech. Exam, chapter on "Fundamentals"
A patient's informed consent:
a. Authorizes all routine hospital procedures
b. Protects patient from high risk procedures .c Protects the operating physician and the hospital from
claims of an unauthorized operation
,d. Authorizes the physician to withhold lifesaving measures as he deems appropriate - correct
answers:ANSWER c. Protects the operating physician and the hospital from claims of an unauthorized
operation. An informed consent (operative permit) protects the operating physician and the hospital
from claims of an unauthorized operation. A general consent authorizes the physician and staff to render
treatment and perform procedures which are routine duties normally carried out at the hospital. It also
protects the patient from procedures they have not been informed about. The physician cannot perform
different procedures or withhold lifesaving measures unless it has been approved by the patient. See:
Allmers, Review for Surgical Tech. Exam, chapter on "Fundamentals"
Your patient with hypertension has been noncompliant in taking his antihypertensive medications. He
should be taught that one relatively common complication of uncontrolled hypertension is:
a. Thrombophlebitis
b. Herniation of the aorta
c. Destruction of valves in the venous system
d. Hemorrhaging of blood vessels in the brain - correct answers:ANSWER d. Hemorrhaging of blood
vessels in the brain. "Hemorrhaging and occlusion of blood vessels in the body are relatively common
complications of uncontrolled hypertension and occur in various places in the body, but most often in
the brain (stroke), the eyes, the heart (myocardial infarction) and the kidneys." Just as in coronary
disease we should encourage patients to beware of the symptoms of MI, we should alert hypertensive
patients about the risk of stroke of failing to take their medication. See: Lippincott's State Board Review
for NCLEX-PN.
Your patient is told that he has a poor prognosis, but says he believes there is some mistake. According
to Dr. Elisabeth Kubler- Ross, this patient is most probably in what grief stage?
a. Anger
b. Denial
c. Bargaining
d. Depression - correct answers:ANSWER b. Denial. "When a terminally ill person states that there must
be a mistake or that he is being confused with someone else, he is most probably denying his impending
death. These 5 stages of grief are described by Dr. Elisabeth Kubler- Ross: 1. Denial & disbelief "What!
There must be some mistake" 2. Anger "Why me?" 3. Bargaining "If I'm healed, I promise to..." 4.
Depression "Oh God! Wherefore art thou?" 5. Acceptance "OK. Thy will be done." See: Lippincott's State
Board Review for NCLEX-PN.
Your patient is to receive vein stripping surgery for varicose veins. She asks you how her circulation will
be provided in her leg after surgery with the veins gone? You should base your response on knowledge
that:
, a. Such information should only be provided by the physician
b. New veins develop to replace the removed veins c. Veins deep in the leg take over the work of the
removed veins
d. The end of ligated veins are anastomosed for continuity of veins - correct answers:ANSWER c. Veins
deep in the leg take over the work of the removed veins. When veins are ligated and stripped, the
affected veins are severed and removed. The blood then returns through veins deeper in the leg so that
return circulation continues. New veins do not replace those removed, nor do arteries take over the
functions of veins. Entire veins often are removed and their ends are ligated, such as the saphenous vein
for CABG surgery, without compromise to the patients venous circulation. See: Lippincott's State Board
Review for NCLEX-PN
Which of the following is NOT a predisposing factor for acute MI?
a. Diabetes
b. Hypertension
c. Hyperlipidemia
d. High estrogen levels - correct answers:ANSWER d. High estrogen levels is incorrect. Estrogen, the
female hormone, appears to protect women from heart disease. After menopause, when estrogen levels
fall in women, they begin to develop coronary disease akin to men. Diabetes, hypertension, and
hyperlipidemia (high cholesterol) are all risk factors for atherosclerosis. See: Braunwald, chapter on
"Coronary Risk Factors"
If you suspect that your patient has an organic heart murmur, the cause of such a murmur would
probably be a defect in the:
a. Conduction system
b. Coronary arteries
c. Mixing of blood
d. Action of the heart valves - correct answers:ANSWER d. Action of the heart valves. An organic heart
murmur is caused by a defect in the action of heart valves such as stenosis or leakage (regurgitation or
shunt). A functional heart disorder, in contrast to an organic heart disease, is a disturbance in function
only with no organic cause. A functional heart murmur is often caused by anxiety or exercise. Heart
murmurs are unrelated to oxygenation of blood, the heart's ability to pump, or the capacity of coronary
arteries. See: Lippincott's State Board Review for NCLEX-PN.
Your patient reports having had an illnesses which predisposed her to having a heart murmur. What
childhood disease was this:
You have just completed an echocardiogram. Your patient asks you to interpret the results of his
diagnostic examination. Your response as a healthcare professional should be to:
a. Say you don't know how to interpret results
b. Explain that the physician will interpret it and report the results
c. Explain that the final results are inconclusive
d. Honestly interpret it to the best of your ability - correct answers:ANSWER b. Explain that the physician
will interpret it and report the results. One of the 10 principles of professional conduct adopted by the
ARRT is "Radiologic Technologists shall not diagnose, but in recognition of their responsibility to the
patient, they shall provide the physician with all information they have relative to radiologic diagnosis for
patient management." We do not possess all the information or training necessary to diagnose the
patient. Diagnosis, pathology and treatment are the physician's final responsibility. We can often
reinforce his comments, clarify things and respond to our patient's questions, but always with the
qualification that the physician has the final say. See: Torres, chapter on "The Radiologic Technologist and
professionalism"
Prior to any cardiac invasive procedure the ultimate responsibility for obtaining informed consent lies
with the:
a. Patient's primary care physician (GP)
b. The operating physician (Cardiologist)
c Circulating nurse assigned to the case
d. Patient and his/her family - correct answers:ANSWER b. The operating physician (Cardiologist). The
ultimate responsibility for obtaining permission is the operating physician's, usually the operating
cardiologist. The cath lab staff are responsible for checking that the consent is on the chart, properly
signed, and that the information on the form is correct. See: Allmers, Review for Surgical Tech. Exam,
chapter on "Fundamentals"
A recommended position for a patient in acute pulmonary edema is:
a. Prone position, to encourage maximum rest, thus decreasing respiratory and cardiac rates
b. Sitting up position to facilitate breathing and decrease venous return
c. Trendelenburg position, to drain blood from leg veins into the heart .
d. Recovery position, lateral with upper leg flexed and forward, and upper hand across the chest with
back of hand held supporting his cheek. - correct answers:ANSWER b. Sitting up position to facilitate
,breathing and decrease venous return. A patient with dyspnea is usually uncomfortable in a lying supine
position (orthopnea). This is because gravity increases fluid in the lungs which increases edema in CHF
patients. They often have less difficulty breathing when placed in either a semi- sitting (mid- Fowler's)
position 30o, sitting (high- Fowler's) position 45o, or reverse Trendelenburg position (body tilted head
up). See: Medical Dictionary
When charting in the medical record you should:
a. Avoid generalizations like "appears, inadvertently, seems to..."
b. Avoid writing with fountain pens with liquid ink
c. Avoid documenting routine safety measures
d. Chart care as you are planning it, not after it is given - correct answers:ANSWER a. Avoid
generalizations like "appears, inadvertently, seems to..." Kern says: "Information in the medical record
should reflect only accurate facts regarding the particular patient. Avoid generalizations and speculating
by charting only what you see, hear, feel, and smell. Do not use words such as inadvertently,
unfortunately, appears, resembles, and the like.... Chart after the delivery of care, not before. Never
make an entry in anticipation of something to be done...The chart note should identify precautionary or
protective measures that have been taken for the safety of the patient, including the use of side rails and
restraints." Charting should always be done with a permanent ink pen, although especially runny ink may
smear. See: Kern, chapter on "Documentation in the Cardiac Catheterization Laboratory"
To be legally valid, what is the LATEST that the patient should sign the informed consent form?
a. Before administration of preoperative medications (such as demerol)
b. Before administration of conscious sedation (such as Versed)
c Before any invasive incisions or percutaneous punctures are made d. Before any interventions are
made (PTCA, Stent...) - correct answers:ANSWER a. Before administration of preoperative medications.
Consent forms must be signed before the administration of preoperative medications. This is to ensure
that the patient fully understands and is informed about the procedure and the risks involved. If his mind
is clouded by preoperative medications such as demerol the consent is not legally valid. See: Allmers,
Review for Surgical Tech. Exam, chapter on "Fundamentals"
A patient's informed consent:
a. Authorizes all routine hospital procedures
b. Protects patient from high risk procedures .c Protects the operating physician and the hospital from
claims of an unauthorized operation
,d. Authorizes the physician to withhold lifesaving measures as he deems appropriate - correct
answers:ANSWER c. Protects the operating physician and the hospital from claims of an unauthorized
operation. An informed consent (operative permit) protects the operating physician and the hospital
from claims of an unauthorized operation. A general consent authorizes the physician and staff to render
treatment and perform procedures which are routine duties normally carried out at the hospital. It also
protects the patient from procedures they have not been informed about. The physician cannot perform
different procedures or withhold lifesaving measures unless it has been approved by the patient. See:
Allmers, Review for Surgical Tech. Exam, chapter on "Fundamentals"
Your patient with hypertension has been noncompliant in taking his antihypertensive medications. He
should be taught that one relatively common complication of uncontrolled hypertension is:
a. Thrombophlebitis
b. Herniation of the aorta
c. Destruction of valves in the venous system
d. Hemorrhaging of blood vessels in the brain - correct answers:ANSWER d. Hemorrhaging of blood
vessels in the brain. "Hemorrhaging and occlusion of blood vessels in the body are relatively common
complications of uncontrolled hypertension and occur in various places in the body, but most often in
the brain (stroke), the eyes, the heart (myocardial infarction) and the kidneys." Just as in coronary
disease we should encourage patients to beware of the symptoms of MI, we should alert hypertensive
patients about the risk of stroke of failing to take their medication. See: Lippincott's State Board Review
for NCLEX-PN.
Your patient is told that he has a poor prognosis, but says he believes there is some mistake. According
to Dr. Elisabeth Kubler- Ross, this patient is most probably in what grief stage?
a. Anger
b. Denial
c. Bargaining
d. Depression - correct answers:ANSWER b. Denial. "When a terminally ill person states that there must
be a mistake or that he is being confused with someone else, he is most probably denying his impending
death. These 5 stages of grief are described by Dr. Elisabeth Kubler- Ross: 1. Denial & disbelief "What!
There must be some mistake" 2. Anger "Why me?" 3. Bargaining "If I'm healed, I promise to..." 4.
Depression "Oh God! Wherefore art thou?" 5. Acceptance "OK. Thy will be done." See: Lippincott's State
Board Review for NCLEX-PN.
Your patient is to receive vein stripping surgery for varicose veins. She asks you how her circulation will
be provided in her leg after surgery with the veins gone? You should base your response on knowledge
that:
, a. Such information should only be provided by the physician
b. New veins develop to replace the removed veins c. Veins deep in the leg take over the work of the
removed veins
d. The end of ligated veins are anastomosed for continuity of veins - correct answers:ANSWER c. Veins
deep in the leg take over the work of the removed veins. When veins are ligated and stripped, the
affected veins are severed and removed. The blood then returns through veins deeper in the leg so that
return circulation continues. New veins do not replace those removed, nor do arteries take over the
functions of veins. Entire veins often are removed and their ends are ligated, such as the saphenous vein
for CABG surgery, without compromise to the patients venous circulation. See: Lippincott's State Board
Review for NCLEX-PN
Which of the following is NOT a predisposing factor for acute MI?
a. Diabetes
b. Hypertension
c. Hyperlipidemia
d. High estrogen levels - correct answers:ANSWER d. High estrogen levels is incorrect. Estrogen, the
female hormone, appears to protect women from heart disease. After menopause, when estrogen levels
fall in women, they begin to develop coronary disease akin to men. Diabetes, hypertension, and
hyperlipidemia (high cholesterol) are all risk factors for atherosclerosis. See: Braunwald, chapter on
"Coronary Risk Factors"
If you suspect that your patient has an organic heart murmur, the cause of such a murmur would
probably be a defect in the:
a. Conduction system
b. Coronary arteries
c. Mixing of blood
d. Action of the heart valves - correct answers:ANSWER d. Action of the heart valves. An organic heart
murmur is caused by a defect in the action of heart valves such as stenosis or leakage (regurgitation or
shunt). A functional heart disorder, in contrast to an organic heart disease, is a disturbance in function
only with no organic cause. A functional heart murmur is often caused by anxiety or exercise. Heart
murmurs are unrelated to oxygenation of blood, the heart's ability to pump, or the capacity of coronary
arteries. See: Lippincott's State Board Review for NCLEX-PN.
Your patient reports having had an illnesses which predisposed her to having a heart murmur. What
childhood disease was this:
