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

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

 

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Chapter 05: Detection and Diagnosis

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

 

MULTIPLE CHOICE

 

1. A subjective indication of a disease or a change in condition as perceived by the patient is a ________.

a.	sign
b.	symptom
c.	syndrome
d.	screening

 

 

ANS:  B

A symptom is a “subjective indication of a disease or a change in condition as perceived by a patient.” A sign is an objective finding by the examiner. A syndrome is a set of signs and symptoms arising from a common cause.

 

REF:   p. 88

 

2. Making a fist and pounding gently onto the posterior abdomen, over a kidney area, is an example of which of the following physician’s exam?

a.	Percussion
b.	Auscultation
c.	Palpation
d.	Inspection

 

 

ANS:  A

Percussion differs from palpation in that it is the act of striking or tapping the patient gently. Pounding one’s fist gently over one’s kidney area would not produce pain. If that patient has an underlying kidney infection, percussion could cause more severe pain.

 

REF:   p. 91

 

3. Which of the following is not considered one of the four senses?

a.	Sight
b.	Touch
c.	Taste
d.	Smell

 

 

ANS:  C

The four senses are sight, touch, hearing, and smell. The sense of smell is one of the most valuable tools in assessing a patient. Examples related to smell consist of breath, sputum, vomitus, feces, urine, and pus.

 

REF:   pp. 90-91

 

4. The chance of developing invasive breast cancer at some time in a woman’s life is approximately 1 out of every ______ women.

a.	5
b.	7
c.	8
d.	10

 

 

ANS:  C

Breast cancer is the most common cancer among American women, except for skin cancer. The chance of developing invasive breast cancer at some time in a woman’s life is 1 in 8 (20%).

 

REF:   p. 98

 

5. Which of the following is a normal white blood count?

a.	3.9 to 5.4 million/mm3
b.	3,900 to 10,800/mm3
c.	12 to 16 million/mm3
d.	150,000 to 425.000/mm3

 

 

ANS:  B

Normal ranges for white blood cells are 3,900 to 10,800/mm³.

 

REF:   p. 101, table 5-8

 

6. Examples of facilitating verbal responses include all except which of the following?

a.	“I understand.”
b.	“This is just part of the aging process.”
c.	“How much did it hurt?”
d.	“I see you are very angry.”

 

 

ANS:  B

Some of the verbal responses that can facilitate the interview are minimal responses, reflecting feelings, and seeking clarification. Responses that may hinder the interview are the use of social clichés, imposition of the interviewer’s own values, and devaluing or minimizing the patient’s feelings or responses. In addition, the interviewer should present himself or herself as unhurried, interested, and sympathetic to the patient.

 

REF:   p. 90, table 5-2

 

7. In the TNM staging system, what does the “T” indicate?

a.	Metastases
b.	Nodal status
c.	Primary tumor
d.	Grade of the tumor

 

 

ANS:  C

In the TNM clinical classification (Table 5-10), T indicates the primary tumor, size, and extent; N indicates the involved region lymph nodes that are assessable; and M indicates distant metastasis.

 

REF:   p. 103, table 5-9

 

8. What was the leading site of new cancer cases in females in 2013?

a.	Lung
b.	Colon
c.	Cervix
d.	Breast

 

 

ANS:  D

The American Cancer Society, Inc., Surveillance Research, 2013, indicates that breast cancer is still the estimated leading site of new cancers in women. The estimated leading cause of death is cancer of the lung and bronchus.

 

REF:   p. 90

 

9. Most screening studies can be grouped into which of the following major categories?
10. Laboratory studies
11. Imaging studies

III.  Vital signs

1. Observation

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

 

 

ANS:  A

Most screening studies can be grouped into two major categories: (1) laboratory studies and (2) medical imaging. Observation and vital signs fall under the physical examination information that the physician may be gathering to detect variations of the normal state of the patient. Specific screening is performed for patients who are symptomatic, undergoing treatment, or being followed.

 

REF:   pp. 93-94

 

10. What is the leading site of cancer resulting in deaths in males and females from studies in 2013?

a.	Lung and bronchus
b.	Colon and rectum
c.	Brain
d.	Head and neck

 

 

ANS:  A

The leading site of cancer resulting in deaths for 2013, according to the American Cancer Society, was lung and bronchus.

 

REF:   p. 88, call out

 

11. The American Cancer Society strongly recommends mass screening for all except which of the following?

a.	Breast cancer
b.	Lung cancer
c.	Prostate cancer
d.	Colorectal cancer

 

 

ANS:  B

At present, no organization recommends testing for early lung cancer detection in asymptomatic individuals at risk for lung cancer. However, the growth of spiral computed tomography (CT) to test for lung cancer detection of former and current smokers led the American Cancer Society to update its 2001 narrative on lung cancer testing, emphasizing the importance of decisions among individuals at risk seeking testing.

 

REF:   pp. 93-96|p. 99

 

12. Which of the following statements are incorrect?

a.	Ultrasonography uses high-frequency sound waves.
b.	CT scans have a higher resolution than radiographs.
c.	Magnetic resonance imaging (MRI) scans use ionizing radiation.
d.	Most invasive procedures provide some risk to the patient.

 

 

ANS:  C

Unlike CT, the MRI scanner does not use ionizing radiation to produce an image. The MRI creates images of the body by using a combination of radiofrequency waves and a strong magnetic field. Ultrasonography images are produced by high-frequency sound waves, and any invasive procedure would put a patient at some risk.

 

REF:   pp. 101-102

 

13. One part of the staging by the American Joint Committee on Cancer (AJCC) is called histologic type; this refers to which of the following?

a.	Staging of the cell
b.	Cell type
c.	Differentiation of the cell
d.	Grading of the cell

 

 

ANS:  B

Histologic type indicates the type of cell making up the tumor. Surgical/pathologic staging offers the most accurate information about the tumor and the extent of disease spread. A biopsy is often obtained during surgical staging.

 

REF:   p. 103

 

14. Which of the following are parts of the medical record?
15. Lab results
16. Medical history

III. Simulation and treatment related images

a.	I and II
b.	I and III
c.	II and III
d.	I, II, and III

 

 

ANS:  D

The medical record contains the medical history, results of laboratory tests and medical procedures, progress notes, copies of consent forms, correspondence, and even images produced in the radiation therapy department. Images in the radiation department would include simulation and treatment-related images.

 

REF:   pp. 89-90

 

15. Mass screening is based on all except which of the following?

a.	Specific results obtained
b.	Cost-effectiveness
c.	Risk to the patient
d.	Geographic location

 

 

ANS:  D

Cancer screening is part of the second level of health promotion. The determination to perform mass screening is based on the results obtained, cost-effectiveness, and risk to the patient.

 

REF:   pp. 93-94

 

16. A physician used auscultation, the act of listening to sounds within the body. The instrument often used in this procedure is the ____________.

a.	sphygmomanometer
b.	stethoscope
c.	pulse oximeter
d.	flowmeter

 

 

ANS:  B

With a stethoscope, a physician or nurse performs auscultation to listen to sounds of the lungs, heart, arteries, stomach, and bowel.

 

REF:   p. 91

 

17. Vital signs include all except which of the following?

a.	Temperature
b.	Pulse
c.	Oxygen analysis
d.	Blood pressure

 

 

ANS:  C

Vital signs include temperature, pulse, respirations, blood pressure, and (now by The Joint Commission) pain.

 

REF:   p. 92

 

18. The diastolic norm would be within a range of which of the following?

a.	40 to 50 mm Hg
b.	60 to 80 mm Hg
c.	110 to 140 mm Hg
d.	140 to 160 mm Hg

 

 

ANS:  B

The normal diastolic range for blood pressure is 60 to 80 mm Hg.

 

REF:   p. 92, table 5-4

 

19. Which of the following is an advantage of digital mammography over conventional mammography with x-ray film?
20. Images are displayed on a computer monitor.
21. Images can be manipulated (lightened or darkened) by the radiologist.

III. Images can be stored and retrieved.

a.	I and II
b.	II and III
c.	I and III
d.	I, II, and III

 

 

ANS:  D

Digital mammography can be very advantageous over conventional mammography. Images are displayed on a computer monitor and can be manipulated by the radiologist by lightening or darkening, as well as by zooming in on suspicious areas for more careful inspection. They also can be stored and retrieved electronically, which makes it easier for long-distance consultation.

 

REF:   pp. 95-96

 

20. Which of the following factors would not be observed when assessing respiration?
21. Rate
22. Rhythm

III. Character

a.	I and II
b.	II and III
c.	I and III
d.	I, II, and III

 

 

ANS:  D

All of these factors are observed during the evaluation of respiration. Rate is the breaths per minute, depth refers to shallow or deep breathing, and rhythm refers to the regularity of the breathing.

 

REF:   p. 92

 

21. Which of the following is a more widely accepted procedure for assessing axillary node status once the primary breast tumor has been identified?

a.	Specificity testing
b.	Predictive value testing
c.	Sentinel lymph node
d.	Axillary node surgery

 

 

ANS:  C

The sentinel lymph node procedure focuses on finding lymph nodes that are the first to receive draining fluid from breast tumor and, therefore, the first to collect cancer cells. A blue dye or radioactive substance is injected near the tumor site and is then absorbed locally through the lymph system traveling to the sentinel node(s).

 

REF:   p. 96

 

22. In which of the following modalities might the patient be injected with a radionuclide, making the patient radioactive for an image?

a.	Medical radiography
b.	Nuclear medicine
c.	Ultrasonography
d.	CT

 

 

ANS:  B

Nuclear medicine imaging introduces a special radionuclide (radioactive substance) into the patient. It is a radioisotope that undergoes radioactive decay. After injection into the patient, it follows a specific metabolic pathway in the body. Then the patient undergoes imaging.

 

REF:   pp. 101-102

 

23. An example of an exfoliative cytologic study could be demonstrative in which of the following?
24. Cervix
25. Lung

III. Brain

a.	I and II
b.	II and III
c.	I and III
d.	I, II, and III

 

 

ANS:  A

Exfoliative cells are usually scraped off or sloughed off naturally. They are found in the urine, sputum, feces, and mucus. They are extremely helpful in identifying neoplastic disease, especially in cases of cervical and lung cancer.

 

REF:   p. 102

 

24. Which of the following indicates a hematocrit value within normal limits for a healthy 40-year-old woman?

a.	20%
b.	30%
c.	40%
d.	50%

 

 

ANS:  C

Normal range for women is 37% to 47%. At certain times, women run a slightly lower hematocrit due to the menstrual cycle.

 

REF:   p. 101, table 5-8

 

25. Lymphadenopathy in the axilla area could be an indication of cancer spread from which of the following?

a.	Breast
b.	Larynx
c.	Lung
d.	Thyroid

 

 

ANS:  A

Lymphadenopathy is defined as swelling of any lymph nodes, particularly superficial lymph nodes, which can be palpated by a physician during a physical exam. Lymph node status is the most important prognostic indicator and is a significant aspect of staging.

 

REF:   pp. 95-96