ARRT Patient Care and Management 2 — Questions and Answers
Question 1: A patient reports they took metformin before their contrast-enhanced CT. What is the primary concern?
- Risk of nephrotoxicity from contrast
- Risk of lactic acidosis if renal function is compromised (Correct answer)
- Allergic cross-reaction with iodine
- Increased radiation sensitivity
Correct answer: Risk of lactic acidosis if renal function is compromised
Metformin should be withheld before and after iodinated contrast because contrast-induced nephropathy can impair metformin clearance, leading to lactic acidosis.
Question 2: When positioning a combative patient for imaging, the radiologic technologist should FIRST:
- Apply physical restraints immediately
- Administer sedation without physician order
- Communicate calmly and assess the cause of agitation (Correct answer)
- Proceed quickly to minimize exposure time
Correct answer: Communicate calmly and assess the cause of agitation
De-escalation through calm communication and identifying the cause of agitation is the first priority before considering physical or chemical restraints.
Question 3: Which of the following flow rates is appropriate when administering oxygen via nasal cannula to a patient with no known COPD?
- 1-2 L/min
- 2-6 L/min (Correct answer)
- 8-10 L/min
- 12-15 L/min
Correct answer: 2-6 L/min
Nasal cannula delivers 24-44% FiO2 at flow rates of 2-6 L/min for patients without COPD or hypoxic drive concerns.
Question 4: A patient's IV site appears puffy, cool, and pale during contrast injection. The technologist should:
- Slow the injection rate and continue
- Stop the injection immediately and remove the IV (Correct answer)
- Flush with saline and reassess
- Switch to manual injection technique
Correct answer: Stop the injection immediately and remove the IV
These signs indicate extravasation; the injection must be stopped immediately and the IV removed to prevent further contrast infiltration into tissue.
Question 5: Which isolation precaution category requires the technologist to wear a gown, gloves, and eye protection when entering the room?
- Airborne precautions
- Droplet precautions (Correct answer)
- Contact precautions
- Standard precautions only
Correct answer: Droplet precautions
Droplet precautions require a surgical mask, gown, gloves, and eye protection for care activities that may cause splashing or spraying of secretions.
Question 6: A patient undergoing fluoroscopy suddenly states, 'I feel like something terrible is about to happen.' This is MOST likely:
- A vasovagal response
- A classic sign of anaphylaxis prodrome (Correct answer)
- Anxiety from claustrophobia
- A side effect of glucagon administration
Correct answer: A classic sign of anaphylaxis prodrome
A sense of impending doom is a classic prodromal symptom of anaphylaxis and requires immediate cessation of the procedure and emergency response.
Question 7: Which of the following is the MOST important action before transferring a patient with a suspected spinal injury from the stretcher to the imaging table?
- Obtain additional radiographs first
- Ensure adequate personnel and use log-roll technique (Correct answer)
- Have the patient shift themselves slowly
- Remove the cervical collar for comfort
Correct answer: Ensure adequate personnel and use log-roll technique
A minimum of three trained personnel using a log-roll or lift technique maintains spinal alignment and prevents further neurological injury during transfer.
ARRT Patient Care and Management 2
A patient reports they took metformin before their contrast-enhanced CT.
What is the primary concern?