Principles And Practice Of Radiation Therapy 4th Edition By Charles M. -Test Bank

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Principles And Practice Of Radiation Therapy 4th Edition By Charles M. -Test Bank

Chapter 02: The Ethics and Legal Considerations of Cancer Management

Washington & Leaver: Principles and Practice of Radiation Therapy, 4th Edition

 

MULTIPLE CHOICE

 

  1. What is the study of ethical issues in medicine?
a. Biometrics
b. Bioethics
c. Macro ethics
d. Micro ethics

 

 

ANS:  B

Bioethics is defined as the application of ethics to medicine, nursing, and health care. Biometrics is a branch of biology that studies biological phenomena and observations by means of statistical analysis. Micro ethics consider individuals and internal relations of the specific situations, whereas macro ethics applies to the collective social responsibility and to societal decisions.

 

REF:   p. 25

 

  1. Which of the following is not a sanctionable offence by the American Registry of Radiologic Technologists (ARRT)?
a. Failure to participate in professional activities, share knowledge with colleagues, and investigate new aspects of professional practice
b. Impersonation of a candidate for the examination
c. Failure to perform radiation therapy procedures with reasonable skill and safety
d. Knowingly assisting, aiding, or allowing a person without a current certificate of registration with the ARRT to engage in the practice of radiologic technology, in a jurisdiction that requires such registration

 

 

ANS:  A

Although participation in professional activities, sharing knowledge, and researching new aspects of professional practice result in professional growth and other benefits, failure to be involved in any of these activities is not a sanctionable offense by the ARRT.

 

REF:   pp. 23-24

 

  1. Which of the following is a theory of ethics developed by Immanuel Kant?
a. Virtue ethics
b. Communitarianism
c. Contextual ethics
d. Deontology

 

 

ANS:  D

In its purest form, deontology was developed by Immanuel Kant.

 

REF:   p. 26

 

  1. Who is most closely associated with the stages of grief?
a. Nel Noddings
b. Elisabeth Kübler-Ross
c. John Mill
d. Immanuel Kant

 

 

ANS:  B

In 1969, in her book titled On Death and Dying, Dr. Elisabeth Kübler-Ross described several stages a patient passes through while dealing with grief.

 

REF:   p. 31

 

  1. Which group is responsible for producing the rules of ethics for radiation therapists?
a. American Registry of Radiologic Technologists (ARRT)
b. American Society of Radiologic Technologists (ASRT)
c. American Medical Association (AMA)
d. American Hospital Association (AHA)

 

 

ANS:  A

The rules of ethics are part of the ARRT’s standards of ethics document. The ASRT has a code of ethics for radiation therapists but no rules of ethics. The AMA and AHA do not have any documents specific to radiation therapists.

 

REF:   p. 21

 

  1. Utilitarianism is an example of which broad group of ethical theories?
a. Teleology
b. Deontology
c. Virtue ethics

 

 

ANS:  A

Utilitarianism is one of the two major divisions of teleology (with egoism).

 

REF:   pp. 26-27

 

  1. Jeremy Bentham and John Mill are most closely associated with which ethical theory?
a. Communitarianism
b. Egoism
c. Natural law ethics
d. Utilitarianism

 

 

ANS:  D

Bentham and Mill are typically held to be the founders of utilitarianism as an ethical theory.

 

REF:   pp. 26-27

 

  1. What occurs when the obvious solution to a problem is prohibited by institutional constraints?
a. Ethical dilemma
b. Ethical dilemma of justice
c. Ethical distress
d. Locus of authority

 

 

ANS:  C

Ethical distress occurs when a problem has an obvious solution, but institutional constraints prohibit the application of the solution.

 

REF:   pp. 26-27

 

  1. Allocation of scarce resources is an example of which ethical category?
a. Ethical dilemma
b. Ethical dilemma of justice
c. Ethical distress
d. Locus of authority

 

 

ANS:  B

Ethical dilemmas of justice are problems associated with the distribution of benefits and burdens, such as the allocation of scarce resources.

 

REF:   p. 27

 

  1. Which patient/provider relationship model is best represented by the informed consent process?
a. Engineering
b. Priestly
c. Collegial
d. Contractual
e. Covenant

 

 

ANS:  D

The contractual model is based on a business relationship model and includes a “contract,” such as the informed consent form.

 

REF:   p. 27

 

  1. Which patient/provider relationship model devalues autonomy?
a. Engineering
b. Priestly
c. Collegial
d. Contractual
e. Covenant

 

 

ANS:  B

The priestly model assumes that the caregiver knows what is best for the patient and does not allow for the patient to provide input into the decision-making process.

 

REF:   p. 27

 

  1. Which of the following is not a source from which values are derived?
a. Money
b. Experience
c. Religion
d. Science

 

 

ANS:  A

Although money may factor into many aspects of decisions, values are not derived from money. Values are instead the result of culture, experience, religion, and science.

 

REF:   pp. 27-28

 

  1. Who is most closely associated with clarification of values?
a. Immanuel Kant
b. Louis Rath
c. Elisabeth Kübler-Ross
d. John Mill

 

 

ANS:  B

In 1966, Louis Rath developed a values clarification exercise. The exercise contained a series of questions that helped the participants describe their values.

 

REF:   p. 27

 

  1. Which two ethical principles may clash when dealing with consent?
  2. Beneficence
  3. Nonmaleficence

III. Autonomy

  1. Confidentiality
a. I and III
b. I and IV
c. II and III
d. II and IV

 

 

ANS:  A

The patient may choose (autonomy) a course of action that is considered suboptimal and, therefore, contrary to the caregiver’s obligation to do good (beneficence).

 

REF:   p. 25

 

  1. Which of the following is not a recognized exception to patient confidentiality?
a. Genetic disease
b. Abuse
c. Communicable disease
d. Automobile accident

 

 

ANS:  A

Abuse, communicable disease, and automobile accidents are all acceptable exceptions to patient confidentiality. Genetic disease is not.

 

REF:   p. 25|pp. 30-31

 

  1. What legal document allows the competent adult to provide direction to health care providers regarding their choices under certain circumstances, should the individual no longer be able to make those decisions?
a. Scope of practice
b. Informed consent
c. Durable power of attorney
d. Living will

 

 

ANS:  D

The living will is a legal document created by the patient while competent that outlines what actions should or should not be taken under certain circumstances if he or she is not competent at the time the decision needs to be made. Typically, these decisions are related to the use of artificial life-sustaining measures, such as ventilators and feeding tubes.

 

REF:   p. 34

 

  1. What legal document designates an individual as decision maker for a patient who is no longer capable of making decisions?
a. Scope of practice
b. Informed consent
c. Durable power of attorney
d. Living will

 

 

ANS:  C

Generally speaking, the durable power of attorney for health care is a designee of the patient who accepts or refuses treatment on the patient’s behalf.

 

REF:   p. 34

 

  1. Which law is best described as personal injury law?
a. Civil law
b. Criminal law
c. Constitutional law
d. Tort law

 

 

ANS:  D

A tort is considered a wrongful act against a person or a person’s property. Tort law is also known as personal injury law.

 

REF:   p. 35

 

  1. A civil lawsuit is punishable by which of the following?
a. Loss of property
b. Loss of liberty
c. Loss of life
d. All of the above

 

 

ANS:  A

Violations of civil law, also known as torts or breach of contract, are punishable by loss of property only.

 

REF:   p. 35

 

  1. Which doctrine contends that individuals are responsible for their own negligent conduct?
a. Doctrine of foreseeability
b. Doctrine of personal liability
c. Doctrine of res ipsa loquitur
d. Doctrine of respondeat superior

 

 

ANS:  B

Personal accountability is a fundamental rule of law and states that each person is responsible for his or her own negligent actions.

 

REF:   p. 36

 

  1. A company being punished for the actions of one of its employees is an example of which doctrine?
a. Doctrine of foreseeability
b. Doctrine of personal liability
c. Doctrine of res ipsa loquitur
d. Doctrine of respondeat superior

 

 

ANS:  D

The doctrine of respondeat superior holds the employer liable for the negligence of employees carrying out duties for the employer.

 

REF:   p. 36

 

  1. Risk management programs may include all except which of the following?
a. Malpractice insurance
b. Employee safety
c. Security
d. Fire safety

 

 

ANS:  A

Risk management programs typically focus on the identification, analysis, and evaluation of risks and the selection of the most advantageous method for treating the risks prior to an incident. Malpractice insurance is only used after an incident occurs and is not considered part of the risk management program.

 

REF:   pp. 36-37

 

  1. According to the radiation therapist’s practice standards, a radiation therapist should meet certain levels of which of the following?
a. Clinical performance
b. Quality performance
c. Professional performance
d. All of the above

 

 

ANS:  D

The radiation therapist’s practice standards provide detailed information regarding expectations for clinical, quality, and professional performance.

 

REF:   pp. 32-33

 

  1. Which of the following ethical principles relates to faithfulness or loyalty?
a. Beneficence
b. Maleficence
c. Fidelity
d. Veracity

 

 

ANS:  C

Fidelity or role fidelity is the principle related to faithfulness or loyalty to your role and responsibilities. Beneficence is related to doing good. Maleficence is related to preventing harm. Veracity is related to being truthful.

 

REF:   pp. 25-26

 

  1. The threat of touching or causing harm to an individual is known as which of the following?
a. Assault
b. Battery
c. Libel
d. Slander

 

 

ANS:  A

Assault is the threat of touching in an injurious way. Battery is the actual act of harm. Libel is written defamation of character. Slander is the oral defamation of character.

 

REF:   pp. 35-36

 

Chapter 06: Medical Imaging

Washington & Leaver: Principles and Practice of Radiation Therapy, 4th Edition

 

MULTIPLE CHOICE

 

  1. Therapeutically, x-rays in the 40 to 300 kVp range are used for which of the following?
a. Treatment of skin cancers and other superficial tumors
b. The planning of a patient’s treatment on the simulator
c. Both of the above
d. None of the above

 

 

ANS:  C

Therapeutically, x-rays in the 40 to 300 kVp range are used for two principal purposes: (1) treatment of skin cancers and other superficial tumors and (2) the planning of a patient’s treatment on the simulator.

 

REF:   p. 108

 

  1. Components of a modern x-ray tube include which of the following?
a. Cathode filament
b. Rotating anode
c. Glass envelope
d. All of the above

 

 

ANS:  D

A typical x-ray tube includes all of those components listed. Other components include the protective housing and focusing cup.

 

REF:   pp. 106-108

 

  1. Interactions at the anode that produce x-rays may be described as which of the following?
a. Bremsstrahlung radiation
b. Characteristic radiation
c. Compton scattering
d. All of the above
e. Both a and b

 

 

ANS:  E

X-ray production in the anode occurs by only two methods—Bremsstrahlung and characteristic radiation. Compton scatter, however, is a typical x-ray interaction within the tissues of the human body.

 

REF:   pp. 112-113

 

  1. Beam quality is affected by changes in which of the following?
a. kVp
b. Potential difference in the x-ray tube
c. Voltage
d. All of the above

 

 

ANS:  D

Beam quality is a descriptive term referring to the energy level of the photons in a beam. The energy level is modulated by changing kVp, also known as potential difference or voltage.

 

REF:   p. 113

 

  1. The quantity of photons in an x-ray beam is directly proportional to _____________.
a. kVp
b. anode temperature rating
c. tube current
d. filtration

 

 

ANS:  C

Although there is a relationship between kVp and photon quantity, the relationship is more exponential, not proportional. The anode temperature rating is irrelevant and filtration is indirectly related. As tube current increases, the number of photons in the beam increases in direct proportion.

 

REF:   p. 113

 

  1. Attenuation is the process by which an x-ray beam ___________________.
a. is focused
b. is reduced in intensity
c. diverges
d. exposes a film

 

 

ANS:  B

Attenuation is the process by which an x-ray beam is reduced in intensity—that is, has a reduction in the total number of photons. This may occur through a number of processes, including scatter and absorption.

 

REF:   p. 114

 

  1. Which of the following describes the predominant x-ray interaction in the diagnostic range?
a. Compton scatter
b. Photoelectric absorption
c. Coherent scatter
d. None of the above

 

 

ANS:  A

Compton scatter, or the Compton effect, is the predominant x-ray interaction in the diagnostic energy range.

 

REF:   p. 114

 

  1. Additive pathologies affect tissue density such that the affected anatomy may appear _________ on the radiograph.
a. lighter than normal
b. darker than normal
c. unchanged
d. hypoechoic

 

 

ANS:  A

Additive pathology adds to the tissue’s normal density, therefore increasing its ability to attenuate the x-ray beam. These areas of underexposure appear lighter on the resultant image.

 

REF:   p. 116

 

  1. Destructive pathologies include which of the following?
a. Pleural effusion
b. Atelectasis
c. Edema
d. Necrosis

 

 

ANS:  D

Destructive pathologies decrease the normal density of tissue and result in darker areas on the exposed film. Necrotic areas break down normal tissue, whereas pleural effusion, atelectasis, and edema all add to tissue density.

 

REF:   p. 116

 

  1. Which technical factor has the most effect on radiographic density?
a. mAs
b. kVp
c. Distance
d. All of the above

 

 

ANS:  D

Although mAs is typically modulated to change radiographic density, several factors have an equal or greater effect on density. kVp, distance, and other factors can have a tremendous effect on the image density.

 

REF:   pp. 116-117

 

  1. A quality radiograph taken at 100 cm using 20 mAs could be replicated at 50 cm using which of the following?
a. 15 mAs
b. 10 mAs
c. 7 mAs
d. 5 mAs

 

 

ANS:  D

According to the inverse squares law, if the distance is reduced by a factor of 2, the exposure necessary to produce the same image may be reduced by a factor of 4. Likewise, if distance is doubled, the output of the tube must be quadrupled.

 

REF:   p. 117

 

  1. Unlike digital radiography, conventional imaging media includes which of the following?
a. Film
b. Screens
c. Cassettes
d. All of the above

 

 

ANS:  D

Digital radiography uses no film, screens, or cassettes. Instead, the x-ray image is captured through a unique process that produces a completely digital image.

 

REF:   pp. 118-119

 

  1. Which of the following is responsible for transforming invisible x-rays into energy and then into visible light?
a. Grids
b. Glass envelop
c. Densitometer
d. Intensifying screens

 

 

ANS:  D

Through the process of phosphorescence, incoming x-rays transmitted through the patient interact with the intensifying screen to form visible light. This process is used to lower the total exposure necessary to produce an image of appropriate density.

 

REF:   p. 120

 

  1. Which of the following is an advantage of the photostimulatable phosphor plate over conventional x-ray image production?
a. Less radiating per exposure
b. Postprocessing manipulation of density and contrast
c. No need for radiographic grids
d. Higher spatial resolution

 

 

ANS:  B

Unlike conventional x-ray imaging, photostimulatable phosphor plates may be modified in terms of contrast and density even after processing. This is advantageous in that images produced with poor technical factors can be remedied with some modification after processing.

 

REF:   pp. 119-120

 

  1. Which of the following imaging receptors do not use light in capturing the latent image?
a. Flat panel detectors (FPDs)
b. TFTs
c. Film and screen

 

 

ANS:  A

FPDs require no visible light for image production. With the direct approach of FPDs, the x-rays passing through the patient are converted directly to an electrical signal that generates the digital image.

 

REF:   p. 119

 

  1. Which of the following may be used to reduce the amount of scatter radiation that reaches the image receptor?
a. Collimation
b. Grids
c. Filtration
d. All of the above
e. Both a and b

 

 

ANS:  E

Two significant means of reducing the amount of scatter radiation that reaches the film are: (1) collimation and (2) grid use. Collimation limits scatter production by minimizing the exposed tissue. Radiographic grids prevent scatter from reaching the film by absorbing the scatter in lead strips.

 

REF:   p. 122

 

  1. Image fusion as used in the production of positron emission tomography (PET) images may fuse together the PET images with the images of what other imaging modality?
a. Ultrasound
b. X-ray
c. Computed tomography (CT)
d. All of the above

 

 

ANS:  C

PET images are fused together with CT or magnetic resonance imaging (MRI) to produce the final images. By combining CT, MRI, or PET images in a way that overlays or electronically registers the information gathered from the same anatomical area, a better understanding of the structure and function of the pathology volume is possible.

 

REF:   p. 127

 

  1. Three-dimensional imaging using voxels is present in ____________.
a. MRI
b. CT
c. both of the above
d. neither of the above

 

 

ANS:  C

A voxel, used in MRI and CT scanning, is a volume element, meaning the voxel represents an entire volume of tissue, not just the surface of a two-dimensional slice.

 

REF:   p. 123

 

  1. In which of the following imaging procedures does an x-ray tube rotate rapidly around the patient?
a. CT
b. MRI
c. Fluoroscopy
d. Mammography

 

 

ANS:  A

During a CT scan, an x-ray tube rapidly rotating around the patient produces several views of the anatomy of concern. These views, or projections, are collected and combined to produce the final composite images.

 

REF:   p. 125

 

  1. Which of the following modalities does not use radiation in image production and acquisition?
a. CT
b. Nuclear medicine
c. MRI
d. Mammography

 

 

ANS:  C

Unlike x-rays, CT scans, and nuclear medicine, all of which use radiation, MRI uses a large magnet and radiofrequency waves to produce an image.

 

REF:   p. 126

 

  1. Because of the mobility of the prostate, which imaging modality is often used at the time of treatment to identify the position of the prostate?
a. Fluoroscopy
b. Ultrasound
c. MRI
d. Nuclear medicine

 

 

ANS:  B

Because the prostate gland moves relative to bony anatomy between the time of initial image acquisition for treatment planning and treatment delivery, real-time imaging, such as ultrasound, is commonly used to accurately localize the target at the time treatment is delivered. Localizing CT and x-ray images work in a similar fashion.

 

REF:   p. 128

 

  1. Who is the discovery of x-rays in 1895 credited to?
a. Wilhelm Conrad Roentgen
b. Theodor Boveri
c. Marie Curie
d. Sir Godfrey Hounsfield

 

 

ANS:  A

Roentgen discovered x-rays in 1895.

 

REF:   p. 107

 

  1. The emission of liberated electrons is the primary purpose of which of the following?
a. Anode
b. Cathode
c. Target
d. Generator

 

 

ANS:  B

It is the purpose of the tungsten cathode to generate the free electrons used in x-ray production.

 

REF:   pp. 109-110

 

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