Patient Care: Patient Interactions and Management (14%)

ARRT-T · 42 questions

A patient with widely metastatic cancer stops all disease-directed treatment after a goals-of-care discussion, wants to remain at home, and has pain and breathing comfort needs that could worsen at any hour. The family asks the therapist which service will send a coordinated team to the house for end-of-life comfort care. Which support professional should the therapist name to this family?
A patient's daughter asks the team for his diagnosis and schedule; he is alert and waiting for today's fraction, yet no authorization form on file names her. Which privacy action should the therapist take first before speaking with her?
A patient with widely metastatic disease is nearing the end of life and wants to remain at home. The family needs access to symptom control around the clock, help with personal care, regular nursing visits, and counseling that continues after the death. Which support resource best matches every one of those needs?
During a simulation visit, an adult daughter says her father has authorized her to speak for him and asks for his dose and side-effect details. The chart shows no documented representative, and a colleague is ready to walk her through the plan while the patient rests. Which disclosure decision best follows HIPAA and the Patient Care Partnership before anything is shared?
A patient with advanced pancreatic cancer has left curative treatment and entered hospice care at home. The family tells the visiting nurse that they want someone to help them pray, reconcile with their faith, and find meaning in what is happening. Which hospice team member should visit to address this spiritual need?
A patient scheduled for her fourth treatment tells you the daily trips are no longer worth the discomfort, and her daughter, who drives her, asks you to persuade her to finish the course. The patient is alert and answers for herself. Which response best applies the patient's goals of care?
A patient breathing 2 liters per minute of oxygen through a nasal cannula from a cylinder on a wheeled stand must move from the transport chair to the treatment table. She is unsteady, her oxygen must keep running, and you are the only staff member available. What is the safest action before the transfer?
A patient on 3 liters of nasal cannula oxygen and a pole-mounted infusion pump stands for the first time after a fall and becomes lightheaded. The patient can bear weight with one helper, and the infusion must continue without interruption. What should the helper do first to support the patient while keeping the infusion running?
Before today's fraction, the console record shows the field label and fraction size from an earlier plan, while the current signed prescription lists a different treatment site and dose. The patient is on the table and ready. Which identity, site and prescription verification must happen before beam-on?
Before an afternoon fraction you notice the record shows a plan for the left chest while the skin marks and the immobilization tray match the right chest. Which verification step must happen before the beam is delivered?
A new course of external beam treatment is ready to start, but the signed prescription lists only the total dose and fractionation schedule, and the record-and-verify entry shows a generic anatomic region instead of a specific site. Before the first fraction, which verification step confirms the treatment site?
A patient who needs help standing is being moved from a wheelchair to the treatment couch while wearing a nasal cannula and connected to an infusion pump, and both the pump and the oxygen unit sit on separate rolling poles. The patient can push up with both arms, and a second staff member is available. Which transfer technique keeps the patient and both lines safe during the move to the couch?
During morning setup, a patient who had a near-fall in the waiting area reports lightheadedness every time they stand, and the chart shows a 3 kg weight gain since the last visit. The therapist is about to help the patient onto the treatment couch. What should the therapist do before positioning the patient?
Mid-fraction, the therapists stop the beam when a patient with dementia becomes agitated and starts thrashing their arms. One therapist holds the patient's arms at their sides until a second staff member arrives, and the thermoplastic mask stays secured as always. Which statement correctly distinguishes restraint from immobilization in this setup?
A patient receiving radiation for lung cancer with known bone metastases starts to rise from a waiting-room chair and says the room feels unsteady. The slot is running late, and the patient walks with a cane. What should the therapist do before the patient walks to the couch?
A patient with dementia becomes agitated during setup, tries to sit up, and grabs at the couch rails. To keep her still for the beam, a therapist buckles a soft belt across her chest and thighs and the fraction is finished. The department later reviews the event under its patient safety policy. Which classification applies to what the therapist placed on this patient?
A patient who has completed several weeks of daily treatments sits up from the couch and reports the room spinning. The therapist notes pale skin, a pulse of 104 taken while the patient stands, and that the patient drank very little fluid overnight, while last week's readings were unremarkable. Which measurement sequence should the therapist obtain to assess for an orthostatic blood pressure change?
On the treatment table, a confused patient with brain metastases repeatedly pushes at the headrest and tries to sit up. The physician has ordered padded wrist restraints for the treatment sessions, and the thermoplastic mask is already in place for positioning. Which statement correctly distinguishes the restraint from the immobilization device?
During a CT simulation with iodinated contrast, a patient on the table develops widespread hives, hoarse speech, and audible wheeze within minutes. The treatment team is present and the physician is down the hall. Which action takes priority in managing this allergic reaction?
While covering another treatment room, you notice a coworker open the chart of a patient outside her assignment, saying she recognized the vehicle parked out front and wanted to know the diagnosis. She closes the record and laughs it off, and nothing leaves the department. Which response best applies the ARRT Standards of Ethics to this chart access?
On your lunch break in the department's shared cafeteria, you hear a therapist describe a patient's diagnosis, treatment site, and unusual daily setup to two coworkers from another unit. The therapist mentions no patient name and says that keeps the discussion private. Which response best applies the ARRT Standards of Ethics to this conversation?
While a planning CT is running with IV contrast, a patient develops widespread hives, a hoarse voice, and an oxygen saturation of 89% two minutes after the injection starts; the line is still infusing, the emergency cart is in the room, and the physician is down the hall. Which response best manages the reaction and communicates the critical findings?
A patient's sibling waits at the counter and asks how the daily treatments and the skin reaction are going, saying the patient has already told them everything. You must reply in a way that follows the ARRT Standards of Ethics and protects the patient's privacy. Which response best applies the confidentiality principle of the ARRT Standards of Ethics?
During a head and neck setup, a patient suddenly reports an itchy throat and chest tightness, and the therapist hears stridor with each breath. The therapist has stopped the beam and entered the vault alone. Which response best manages this suspected anaphylactic reaction?
During a teaching visit, a patient with limited English proficiency must learn positioning, skin care, and what erythema means before starting daily treatments. The patient's teenage child offers to translate. The therapist wants a reliable check that the instructions landed. Which communication approach best confirms the patient understands the medical terms and instructions?
A patient with a documented MRSA lesion on the forearm finishes a fraction in a shared treatment room. In ten minutes that same couch, arm board and accessories will hold the next patient, who will be positioned by hand. Which infection control step breaks the chain of transmission before that setup?
A patient with limited health literacy is starting a course of breast radiotherapy and nods politely whenever staff walk through the daily routine. Before the first fraction, the therapist needs solid evidence that the patient has actually processed the routine rather than just agreeing to it. Which communication method best verifies the patient's understanding?
A patient whose first language differs from the one used by every staff member is about to begin a planning session while a teenage relative translates your explanation of the word 'isocenter.' You need certainty that the patient understands the term before the session starts. Which method best confirms the patient's own understanding of the explanation?
A patient on contact precautions for a resistant skin organism finishes treatment and leaves drainage on the couch pad, mask, and headrest. The same accessories are needed for the next patient in fifteen minutes. Which infection-control steps should the therapist take to break the chain of infection at the treatment unit?
A patient with confirmed Clostridioides difficile infection has an episode of watery diarrhea that soils the treatment couch and floor partway through a fraction, and another patient is due in that same room shortly. Which pair of actions breaks the chain of C. difficile transmission before that next setup?
A bottle of a chemical used in your department breaks open on the floor, and the label is soaked and unreadable. Two therapists are about to start cleaning it up with absorbent pads. Which source of hazard information should guide their actions before cleanup begins?
During a CT simulation education visit, a patient asks whether the scan itself is the treatment, why the same position and immobilization must be repeated later, and whether the metal implant in the hip must be removed. Which explanation addresses the scan purpose, the daily setup, and the hip implant together?
A patient with a dental implant and a fear of tight spaces arrives for a head-and-neck CT simulation with a thermoplastic mask. The patient asks whether the scanner's magnet could disturb the implant and whether the scan itself is the day treatment begins. Which explanation best prepares this patient for the simulation?
While casting a block, a small splash of molten Cerrobend hardens on the workbench; nobody is burned, but the pot's label is scorched and unreadable. Which document should guide the cleanup and the protective clothing used before the residue is removed?
A patient with stainless steel surgical plates in his shoulder grows anxious during the planning visit. He asks why the CT simulation lasts longer than a routine scan, why small marks were drawn on his skin, and why he must lie in exactly the same position each day. Which explanation correctly addresses the implant, skin marks, and positioning concerns during the CT simulation?
A student in the mold room is told to help skim dross from the pot while Cerrobend is molten. The alloy contains lead and cadmium, the splash hazard reaches the eyes and forearms, and printed safety data sheets are kept at the workbench. Which SDS section should the student use to select the eye and skin protection for this task?
A patient with a documented prior iodinated contrast reaction of hives, facial swelling, and wheeze needs a contrast-enhanced CT of the chest, and kidney function is normal. Which contrast administration plan addresses both the prior reaction and the imaging requirement?
A patient arrives for a contrast-enhanced CT of the chest. The intake form records moderate hives and wheezing after iodinated contrast two years ago, normal kidney function today, and clear breathing between events. Emergency drugs and airway equipment are in the room, but the schedule is tight. Which contrast management approach best fits this patient's risk profile?
A patient in week 2 of a three-week palliative course says the knee cushion and arm cradle used at simulation are uncomfortable, so they have been lying without them. They insist the skin marks still line up, so the setup is fine. Which counseling point best reinforces daily setup reproducibility?
During a contrast-enhanced CT simulation, a patient with an IV in the hand reports sudden burning at the wrist, and the power injector stops as a firm swelling rises along the forearm. The scan can be repeated later. Which immediate response to contrast extravasation should the therapist carry out at the bedside?
A head-and-neck patient at fraction 15 says the thermoplastic mask feels tighter than it did at simulation, has been scrubbing the drawn skin marks in the shower, and applies moisturizer over them each evening. Which guidance should you reinforce before today's set-up?
A patient midway through a chest treatment course tells you one of the alignment marks has faded and that she has been adding her own dot at home so she can line up more easily. She asks whether that helps the team. Which instruction about the faded mark and her own dot keeps her daily setup consistent?