Diagnostic Sonography 8th Ed by Sandra Hagen. ALL CHAPTERS 1- 65. TEST BANK

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 01: Foundations of Clinical Sonography Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Historically, the development of ultrasound began shortly after: a. radio communication in World War I. b. sonar in World War II. c. nuclear testing in World War II. d. the launching of Sputnik.

ANS: B World War II brought sonar equipment to the forefront for defense purposes. Ultrasound was influenced by the success of sonar equipment.

PTS: 1 REF: p. 7 OBJ: Detail a timeline for pioneers in the advancement of medical diagnostic ultrasound.

TOP: Historical overview of sound theory and medical ultrasound 2. The early applications of obstetric ultrasound were initiated by: a. Joseph Holmes. b. Ian Donald. c. John Howry. d. William Fry. ANS: B NUR M SINGwas TB.C The early obstetric compound scanner builtOby Tom Brown and Dr. Ian Donald in Scotland in 1957.

PTS: 1 REF: p. 7 OBJ: Detail a timeline for pioneers in the advancement of medical diagnostic ultrasound.

TOP: Historical overview of sound theory and medical ultrasound 3. Visualization of the cardiac structures in the heart was discovered by: a. Joseph Holmes. b. Ian Donald. c. Hertz and Edler. d. George Ludwig.

ANS: C In 1954, echocardiographic techniques were developed in Sweden by Drs. C.H. Hertz and I. Edler.

PTS: 1 REF: p. 7 OBJ: Detail a timeline for pioneers in the advancement of medical diagnostic ultrasound.

TOP: Historical overview of sound theory and medical ultrasound 4. Which one of the following statements about the role of sonographers is false? a. Sonographers perform ultrasound studies and gather diagnostic data independent

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank of the physician. b. Sonographers must possess intellectual curiosity and perseverance. c. Sonographers must have a technical aptitude. d. Sonographers must be able to communicate on different levels.

ANS: A A sonographer performs ultrasound studies gathering diagnostic data under both the direct and the indirect supervision of a physician. They also must assess clinical history and symptoms, interpret laboratory values, and understand other diagnostic examinations.

PTS: 1 REF: p. 5 TOP: Role of the sonographer

OBJ: Describe a career in ultrasound.

5. In soft tissues, the assumed propagation velocity is (in meters per second): a. 1320. b. 1450. c. 1540. d. 1650.

ANS: C In soft tissues, the assumed propagation velocity (speed) is 1540 meters per second.

PTS: 1 REF: p. 9 OBJ: Demonstrate an understanding of the basic principles and terminology of ultrasound.

TOP: Introduction to basic ultrasound principles - Acoustics 6. Diagnostic ultrasound uses the frequencies of: NURSINGTB.COM a. 10 to 15 kHz. b. 1 to 20 kHz. c. 100 to 1000 Hz. d. 1 to 20 MHz. ANS: D Diagnostic application of ultrasound uses frequencies of 1 to 20 million cycles per second (1 to 20 MHz).

PTS: 1 REF: p. 9 OBJ: Demonstrate an understanding of the basic principles and terminology of ultrasound.

TOP: Introduction to basic ultrasound principles - Acoustics 7. The device that converts energy from one form to another is called the: a. digitizer. b. transducer. c. scan converter. d. beam former.

ANS: B Piezoelectric elements (transducers) convert electric energy into ultrasound energy and vice versa.

PTS:

1

REF: p. 12

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Demonstrate an understanding of the basic principles and terminology of ultrasound.

TOP: Introduction to basic ultrasound principles - Acoustics 8. The angle of reflection is equal to the: a. acoustic impedance. b. angle of incidence. c. refraction. d. image resolution.

ANS: B Angle of reflection is the angle between the reflected sound direction and a line perpendicular to the media boundary.

PTS: 1 REF: p. 6 OBJ: Demonstrate an understanding of the basic principles and terminology of ultrasound.

TOP: Historical overview of sound theory and medical ultrasound 9. The display mode that shows time along the horizontal axis and depth along the vertical axis is: a. A mode. b. B mode. c. M-mode. d. real-time.

ANS: C Motion mode (M-mode) displays the depth along the vertical axis versus the time along the horizontal axis.

NURSINGTB.COM

PTS: 1 REF: p. 15 OBJ: Identify ultrasound instruments and discuss their uses.

TOP: Pulse-echo display modes - M-mode 10. Which one of the following statements about the Doppler principle is false? a. Doppler refers to a change in frequency in which the motion of laminar or turbulent flow is detected within a vascular structure. b. The beam should be perpendicular to the flow. c. The Doppler shift is directly proportional to the velocity of the red blood cell. d. If the red blood cell moves away from the transducer, then the fall in frequency is directly proportional to the velocity and direction of the red blood cell movement.

ANS: B The beam should be parallel to the flow to obtain the maximum velocity. The frequency of the Doppler shift is proportional to the cosine of the Doppler angle. At a 90-degree angle (perpendicular to flow), the Doppler shift is zero, regardless of the flow velocity.

PTS: 1 REF: p. 18 |p. 19 OBJ: Discuss three-dimensional and Doppler ultrasound.

TOP: Doppler Ultrasound - Doppler Shift 11. The Fresnel zone is also called the:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

far field. focal point. near zone.

Nyquist limit.

ANS: C The Fresnel or near zone is the field closest to the transducer during the formation of the sound beam.

PTS: 1 REF: p. 18 OBJ: Demonstrate an understanding of the basic principles and terminology of ultrasound.

TOP: System Controls for Image Optimization - Focal Zone 12. The higher the transducer frequency, the: a. shorter the wavelength. b. faster the frame rate. c. deeper the penetration depth. d. slower the frame rate.

ANS: A The higher the frequency, the shorter the wavelength (inversely related).

PTS: 1 REF: p. 18 | p. 22 OBJ: Demonstrate an understanding of the basic principles and terminology of ultrasound.

TOP: Introduction to basic ultrasound principles - Image resolution

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 02: Essentials of Patient Care for the Sonographer Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The most common arrhythmias are: a. supraventricular tachycardia. b. tachycardia and bradycardia. c. heart block. d. asystole.

ANS: B Tachycardia, a heart rate above 100 bpm, and bradycardia, a heart rate below 60 bpm, are the most common cardiac arrhythmias.

PTS: 1 REF: p. 26 TOP: Basic patient care

OBJ: Defined patient-focused care.

2. The normal amount of oxygen in the blood is: a. 90%. b. 85%. c. 80%. d. 75%.

ANS: A A normal reading for a person breathing room air is above 90%.

NURSINGTB.COM

PTS: 1 REF: p. 27 TOP: Basic patient care

OBJ: Define patient-focused care.

3. A shortness of breath or the feeling of not getting enough air, which may leave a person gasping, is called: a. apnea. b. wheezing. c. hyperventilation. d. dyspnea.

ANS: D Dyspnea is defined as a shortness of breath or the feeling of not getting enough air, which may leave a person gasping.

PTS: 1 REF: p. 28 OBJ: Discuss the basic patient care techniques covered in this chapter.

TOP: Basic patient care 4. Which one of the following statements is false regarding the protocol for taking a blood pressure? a. If the patient is sitting, be sure he or she has both feet in the air. b. The brachial artery in the upper arm is the usual site for manually taking a blood

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank pressure. c. Move any clothing out of the way to place the blood pressure cuff properly. d. Place the cuff above the elbow, making sure it is approximately an inch above the elbow.

ANS: A When taking a blood pressure with the patient sitting, ensure that he or she has both feet on the floor.

PTS: 1 REF: p. 28 | p. 29 OBJ: Discuss the basic patient care techniques covered in this chapter.

TOP: Basic patient care 5. Which one of the following statements is false regarding the nasogastric (NG) tube? a. Never pull on the tube when moving the patient. b. Check for leaks in both the NG tube and suction equipment. If found, report them immediately. c. Raise or open the drainage bottle as necessary. d. Never disconnect the tubing.

ANS: C When a patient with an NG tube comes to the ultrasound department, the drainage bottle should never be raised or opened.

PTS: 1 REF: p. 32 OBJ: Discuss the basic patient care techniques covered in this chapter.

TOP: Patients with tubes and tubing

NURSINGTB.COM

6. The basic principles of body mechanics require all of the following except: a. maintain a stable center of gravity by keeping your center of gravity low and your back straight and bending your hips and knees. b. maintain a strong base of support by keeping your feet apart, placing one foot slightly ahead of the other with the toes pointing in the direction of activity. c. when lifting, flex your hips to absorb jolts, and turn with your feet instead of your knees. d. maintain a center of gravity by keeping your back straight and any objects being lifted close to your body.

ANS: C When lifting an object, maintain a strong base of support, flex your knees to absorb jolts, and turn with your feet instead of your hips.

PTS: 1 REF: p. 36 TOP: Patient transfer techniques

OBJ: Describe patient transfer techniques.

7. Which one of the following statements is incorrect regarding hand washing? a. Wash your hands after touching blood, body fluids, or contaminated items—only when gloves are not worn. b. Wash your hands after removing gloves, between patient contacts, and whenever indicated to avoid the transfer of microorganisms to other patients or the

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank environment. c. Washing your hands between tasks and procedures on the same patient may be necessary to prevent cross-contamination of different body sites. d. Use plain soap for routine hand washing and an antimicrobial agent or waterless agent for specific situations (e.g., to control outbreaks, for hyperendemic infections).

ANS: A Wash your hands after touching blood, body fluids, or contaminated items—whether or not gloves are worn.

PTS: 1 REF: p. 39 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

8. Examples of airborne transmission include all of the following except: a. tuberculosis. b. measles. c. chickenpox. d. mumps.

ANS: D Mumps is spread via droplet transmission. Some diseases that are spread by airborne transmission include tuberculosis, measles, chickenpox, and shingles.

PTS: 1 REF: p. 40 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

N R I G B.C M

U Sinclude N T all ofOthe following except: 9. Examples of contact transmission a. flu. b. pertussis. c. impetigo. d. scabies.

ANS: B Pertussis is spread via droplet transmission. Flu, impetigo, scabies, methicillin-resistant Streptococcus aureus (MRSA), pinkeye, wound infections, and hepatitis A are spread through contact.

PTS: 1 REF: p. 40 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

10. According to the National Institutes of Health, hypertension is defined as a blood pressure greater than (in mm Hg): a. 120/80. b. 135/75. c. 140/90. d. 150/100.

ANS: C According to the National Institutes of Health, hypertension is defined as a blood pressure greater than 140/90 mm Hg.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 29 TOP: Basic patient care

OBJ: Define patient-focused care.

11. Vital signs include all of the following except: a. blood pressure. b. pulse rate. c. hematuria. d. respiratory rate.

ANS: C Vital signs include pulse, respiratory rate, blood pressure, and body temperature.

PTS: 1 REF: p. 25 | p. 53 TOP: Basic patient care

OBJ: Define patient-focused care.

12. How many beats per minute (bpm) is the normal adult pulse rate? a. 30 to 50 b. 50 to 75 c. 60 to 100 d. 100 to 120 ANS: C Normal adult pulse rates should be between 60 and 100 bpm with a regular beat.

PTS: 1 REF: p. 25 TOP: Basic patient care

OBJ: Define patient-focused care.

NURSINGTB.COM

13. Breathing that stops spontaneously for any reason is called: a. apnea. b. asthma. c. dyspnea. d. cyanosis.

ANS: A Breathing that stops spontaneously for any reason is called apnea. It may be temporary, starting and stopping at intervals, or prolonged.

PTS: 1 REF: p. 28 TOP: Basic patient care

OBJ: Define patient-focused care.

14. An intravenous (IV) fluid container should always be ________ cm above the level of the patient’s vein. a. 5 to 8 b. 8 to 12 c. 18 to 20 d. 25 to 30 ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank An IV fluid container should always be 18 to 20 cm above the level of the patient’s vein. An IV container too high may cause too rapid a flow rate, and fluid may infiltrate into the surrounding tissues. An IV container too low may cause blood to flow back in the tubing, causing a clot to form or the fluid to stop flowing.

PTS: 1 REF: p. 31 OBJ: Describe how to assist patients with special needs.

TOP: Intravenous therapy 15. When transferring catheterized patients, the urine-collecting bag must be: a. attached to the wheelchair or gurney. b. held below the level of the patient’s bladder. c. emptied before starting the ultrasound examination. d. analyzed for bacterial infection.

ANS: B When transferring catheterized patients, the urine-collecting bag must be held below the level of the patient’s bladder. This level will prevent urine in the bag from being siphoned into the bladder.

PTS: 1 REF: p. 32 | p. 33 TOP: Patients with tubes and tubing

OBJ: Describe patient transfer techniques.

16. Which one of the following is a special safety precaution for oxygen therapy? a. Smoking where oxygen is used is allowed. b. An oxygen cylinder can be placed next to a patient during transport. c. Electrical equipment may next to O anMoxygen cylinder.

NUbe RSplaced INGT B.C d. The tank is secured in the upright position away from any heat source.

ANS: D Securing the tank in the upright position away from any heat source, including electrical equipment, is a special safety precaution for oxygen therapy. Not allowing smoking where oxygen is being used and not placing an oxygen cylinder beside a patient when transporting him or her by stretcher are additional special safety precautions.

PTS: 1 REF: p. 33 OBJ: Describe how to assist patients with special needs.

TOP: Patients with tubes and tubing 17. An artificial opening in the abdominal wall surrounded by a ring of mucosal tissue is called a(n): a. ostomy. b. stoma. c. catheter. d. annula.

ANS: B An artificial opening in the abdominal wall is called a stoma. A stoma appears as a round hole surrounded by a ring of mucosal tissue. This opening may be temporary or permanent, depending of the patient’s condition.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 35 OBJ: Discuss the basic patient care techniques covered in this chapter.

TOP: Patients with tubes and tubing 18. Lifting an object should be done using the muscles of the: a. back. b. legs. c. feet. d. shoulder.

ANS: B Lifting a box or patient should be done using the strong muscles of the legs.

PTS: 1 REF: p. 41 TOP: Patient transfer techniques

OBJ: Describe patient transfer techniques.

19. When transferring a patient from a wheelchair to the examination table, you should: a. bend at the knees and lean forward. b. bend the back and lean backward. c. bend only the knees. d. bend the knees and back.

ANS: A When transferring a patient from a wheelchair to the examination table, you should bend at the knees and lean forward.

N R I G B.C OM Describe patient transfer techniques.

OBJ:

S | Np. 38 T PTS: 1 REF: Up. 37 TOP: Patient transfer techniques

20. Infectious materials include all of the following except: a. blood. b. intact skin. c. synovial fluid. d. cerebrospinal fluid.

ANS: B Infectious materials include blood, synovial fluid, cerebrospinal fluid, semen, vaginal secretions, pericardial and pleural fluids, saliva in dental procedures, and unfixed human tissue or organs.

PTS: 1 REF: p. 39 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

21. The basic infection control guidelines used to reduce the risks of spreading infection are called: a. infection precautions. b. standard precautions. c. environmental controls. d. patient-focused precautions.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B Standard precautions are the basic infection-control guidelines used to reduce the risks of infection spread through droplets, air, and contact.

PTS: 1 REF: p. 39 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

22. Examples of droplet transmission include all of the following except: a. mumps. b. pneumonia. c. strep throat. d. chickenpox.

ANS: D Disease spread through droplet transmission includes mumps, measles, pertussis, pneumonia, strep throat, and specific forms of meningitis. Chickenpox is transferred via the air.

PTS: 1 REF: p. 40 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

23. Which one of the following personal protective equipment (PPE) is applied last? a. Mask b. Gown c. Gloves d. Shoe covers

N R I G B.C M

U S N T O ANS: C Gloves should be the last PPE to be applied. Shoe covers are more commonly used during sterile procedures.

PTS: 1 REF: p. 41 OBJ: Discuss infection control and isolation techniques.

TOP: Infection control

24. The most common nosocomial (hospital-acquired) infection is a(n): a. appendicitis. b. pneumothorax. c. urinary tract infection. d. gastrointestinal infection.

ANS: C The most common nosocomial infections are urinary tract infections, pneumonia, and surgical site infection.

PTS: 1 REF: p. 41 OBJ: Discuss infection control and isolation techniques.

NURSINGTB.COM

TOP: Infection control

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 03: Ergonomics and Musculoskeletal Issues in Sonography Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following is not defined as a Work-Related Musculoskeletal Disorder (WRMSD) injury? a. Restricted work b. Days away from work c. Musculoskeletal symptoms that remain for longer than 3 months d. Musculoskeletal symptoms requiring medical treatment beyond first aid ANS: C WRMSD incidents are defined as injuries that result in restricted work, days away from work, musculoskeletal disorders (MSDs) that remain for 7 days or longer, and MSDs requiring medical treatment beyond first aid.

PTS: 1 REF: p. 56 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: History of OSHA’s Involvement in Sonography 2. Work-related musculoskeletal disorders (MSDs) are injuries of all of the following except: a. bones. b. muscles. c. tendons. d. joints.

N R I G B.C M

U S N T

O

ANS: A Work-related musculoskeletal disorders are injuries of muscles, tendons, and joints that are caused or aggravated by workplace activities.

PTS: 1 REF: p. 63 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Injury Data in Sonography 3. Risk factors for developing musculoskeletal disorders (MSDs) include all of the following except: a. forceful exertions. b. prolonged static postures. c. repetitive motions. d. uniform temperatures.

ANS: D Risk factors for developing an MSD include forceful exertions, awkward postures, and prolonged static postures, as well as repetitive motions, a “pinch” grip, and an exposure to environmental factors such as extreme heat, cold, humidity, or vibrations.

PTS: 1 REF: p. 63 OBJ: Discuss the history of WRMSDs in sonography.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Injury Data in Sonography 4. Which one of the following statements is false? a. Sustained awkward postures can cause imbalances between the muscles that move and the muscles that stabilize. b. Repeatedly rotating the head, neck, and trunk causes one set of muscles to become weaker and longer. c. Asymmetric forces are exerted on the spine, causing misalignment. d. Nerve entrapment syndromes can result from increased muscle and tendon pressure on major nerves that run behind tightened muscles.

ANS: B Repeatedly rotating the head, neck, and trunk causes one set of muscles to become stronger and shorter and the opposing muscles to become weaker and elongated.

PTS: 1 REF: p. 57 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Injury Data in Sonography 5. The type of tendonitis involving the thumb is called: a. carpal tunnel. b. cubital tunnel. c. epicondylitis. d. de Quervain disease.

ANS: D De Quervain disease is a specific type of tendonitis involving the thumb that can result from NURSINGTB.COM gripping the transducer.

PTS: 1 REF: p. 58 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Injury Data in Sonography 6. Inflammation of the shoulder bursa from repeated motion is called: a. rotator cuff injury. b. spinal degeneration. c. bursitis. d. thoracic outlet syndrome.

ANS: C Bursitis involving the shoulder joint is defined as the inflammation of the shoulder bursa from repeated motion.

PTS: 1 REF: p. 58 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Injury Data in Sonography 7. All of the following components are necessary on an ultrasound system to make it ergonomically compatible except: a. fixed control panel.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. adjustable height monitor. c. system easily mobile with brakes. d. thin transducer cables.

ANS: A An ergonomically designed ultrasound system should have a control panel that is height adjustable and swivels.

PTS: 1 REF: p. 58 OBJ: Describe and apply “best practices” in sonography.

TOP: Ergonomics

8. Which one of the following statements is incorrect regarding administrative controls for the sonographer? a. The same type of examination performed throughout the day allows the muscles to become stronger. b. Examination gloves should have textured fingers to prevent the need to grip the transducer too tightly. c. Taking short “mini” breaks during examinations will relax muscles, especially in the shoulder and neck. d. Try to share bedside examinations with other staff members and perform these examinations only when absolutely necessary, not because it is simply more convenient.

ANS: A Patient examinations should be carefully scheduled to prevent repeating the same type of examination back to back. Performing a variety of examinations is important, allowing different muscles to fire. The schedule should be designed to allow enough time between NURSINGTB.COM examinations for muscle recovery.

PTS: 1 REF: p. 59 OBJ: Describe and apply “best practices” in sonography.

TOP: Industry Awareness and Changes 9. All of the following statements contribute to professional controls to prevent injury except: a. minimize sustained bending, twisting, reaching, lifting, and transducer pressure. b. vary scanning techniques and transducer grips. c. maintain equipment height, regardless of the sonographer. d. avoid forward and backward reaches.

ANS: C The ultrasound control panel, display, chairs, and table height should be adjusted to suit each sonographer (user).

PTS: 1 REF: p. 59 OBJ: Describe and apply “best practices” in sonography.

TOP: Industry Awareness and Changes 10. The sonographer should follow all of the following recommendations except: a. use mild transducer pressure when imaging superficial structures. b. grip the transducer tightly when imaging abdominal structures.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. avoid the temptation to be “image-driven,” sacrificing your body for a “pretty picture” that does not affect the diagnosis. d. maintain a firm grip on the transducer, using multiple angulations to obtain the best possible image.

ANS: B When griping the transducer, it is unnecessary to grip the transducer tightly.

PTS: 1 REF: p. 60 OBJ: Describe and apply “best practices” in sonography.

TOP: Work Practice Changes 11. The current term used by the Occupational Safety and Health Administration (OSHA) for ergonomic occupational injuries is: a. overuse syndrome. b. repetitive motion injury. c. musculoskeletal strain injury. d. work-related musculoskeletal disorder.

ANS: D The term work-related musculoskeletal disorder (WRMSD) is currently used by OSHA to label ergonomic occupational injuries.

PTS: 1 REF: p. 56 OBJ: Define OSHA and discuss its role in sonography.

TOP: History of OSHA’s Involvement in Sonography

N R I G B.C M

U Smay N trigger: T O 12. Repeated twisting of the forearm a. epicondylitis. b. tenosynovitis. c. cubital tunnel. d. thoracic outlet syndrome.

ANS: A Epicondylitis is the inflammation of the periosteum in the area of the insertion of the biceps tendon into the distal humerus. This inflammation can be the result of repeated twisting of the forearm.

PTS: 1 REF: p. 58 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Injury Data in Sonography 13. Repeated flexion and extension of the wrist may result in: a. bursitis. b. de Quervain disease. c. rotator cuff injury. d. carpal tunnel syndrome.

ANS: D Carpal tunnel syndrome is the entrapment of the median nerve as a result of repeated flexion and extension of the wrist and mechanical pressure against the wrist.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 58 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Injury Data in Sonography 14. The main cause of shoulder pain associated with scanning is: a. gripping the transducer. b. abduction of the shoulder. c. poor sitting or standing posture. d. mechanical pressure against the shoulder.

ANS: B The main cause of shoulder pain associated with scanning is abduction of the shoulder.

Shoulder abduction must be reduced to 30 degrees or less.

PTS: 1 REF: p. 60 OBJ: Define common types of work-related injury for sonographers and know what causes them.

TOP: Abduction of Your Scanning Arm 15. Approximately how many occupational musculoskeletal disorders are reported annually to OSHA? a. 50,000 b. 100,000 c. 300,000 d. 500,000 ANS: C NURSINGTdisorders B.COMare reported annually to OSHA, which Approximately 300,000 musculoskeletal accounts for 56% of the work-related injuries reported to OSHA. PTS: 1 REF: p. 62 OBJ: Outline the costs of occupational injury to yourself and to your employer.

TOP: Economics of Ergonomics

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 04: Anatomic and Physiologic Relationships within the Abdominopelvic Cavity Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The pancreas is located in which abdominal region? a. Right lumbar b. Left iliac c. Epigastric d. Hypogastric ANS: C The pancreas lies in the epigastrium. The head usually lies below and to the right, the neck lies on the transpyloric plane, and the body and tail lie above and to the left.

PTS: 1 REF: p. 73 OBJ: List the organs located in each major body cavity.

TOP: Abdominal regions 2. Which plane passes through the neck of the pancreas and hilum of the kidneys? a. Subcostal b. Intertubercular c. Midinguinal d. Transpyloric ANS: D NURSINThe GTB.C OM lies below and to the right, the neck The pancreas lies in the epigastrium. head usually lies on the transpyloric plane, and the body and tail lie above and to the left.

PTS: 1 REF: p. 72 OBJ: Describe and locate the abdominal quadrants and regions.

TOP: Abdominal regions 3. The linea alba is found in the: a. abdominal wall. b. external oblique muscle. c. median arcuate ligament. d. crus of the diaphragm.

ANS: A The linea alba is a fibrous band that stretches from the xiphoid to the symphysis pubis. It forms a central anterior attachment for the muscle layers of the abdomen.

PTS: 1 REF: p. 74 | p. 75 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Anatomy and physiology 4. The membrane that covers an internal organ is known as the: a. mesothelium.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. visceral peritoneum. c. greater omentum. d. parietal peritoneum.

ANS: B The peritoneum is a serous membrane lining the walls of the abdominal cavity. The visceral peritoneum covers the internal organs.

PTS: 1 REF: p. 77 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Anatomy and physiology 5. The epiploic foramen is the opening between the: a. right and left crus. b. greater and lesser curvature. c. greater and lesser sac. d. inferior and superior inguinal canal.

ANS: C The right margin of the lesser sac opens into the greater sac through the epiploic foramen.

PTS: 1 REF: p. 78 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Anatomy and physiology 6. The clinical significance of peritoneal recesses is: a. fluid and infection may accumulate in the recesses.

N into RSthe INrecesses.

GTB.COM b. organs may be displaced U c. gallstones may collect in the recesses. d. hydronephrosis may accumulate in the recesses.

ANS: A The omental bursa normally has some small empty spaces known as peritoneal recesses.

Infection and fluid may collect in these spaces.

PTS: 1 REF: p. 79 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Abdominal regions 7. Which muscle is not related to the anterior abdominal wall? a. Rectus abdominis b. External oblique c. Quadratus lumborum d. Transversus ANS: C The anterior abdominal wall is formed by several layers of muscles: rectus abdominis, external oblique, internal oblique, and transversus abdominis. The quadratus lumborum are muscles of the posterior abdominal wall.

PTS:

1

REF: p. 74

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Anatomy and physiology 8. All of the following muscles make up the muscular “sling” in the inferior boundary of the true pelvis except the: a. coccygeus. b. puborectalis. c. levator ani. d. iliacus.

ANS: D The muscular “sling” is made up of the coccygeus and levator ani muscles. The muscles making up the levator ani muscles include the pubococcygeus, puborectalis, and iliococcygeus muscles.

PTS: 1 REF: p. 76 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Anatomy and physiology 9. The space between the right lobe of the liver and the anterior right kidney and colic flexure is: a. pouch of Douglas. b. Morison’s pouch. c. peritoneal recess. d. rectouterine space.

ANS: B N posterior RSINGsubphrenic TB.COMspace between the right lobe of the liver Morison’s pouch is the right U and right kidney and the right colic gutter. It is a frequent location for fluid collection.

PTS: 1 REF: p. 78 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Abdominal regions 10. Vital signs, which are medical measurements to ascertain how the body is functioning, may include all of the following except: a. blood pressure. b. pulse. c. pulmonary function tests. d. temperature.

ANS: C Vital signs are medical measurements that ascertain how the body is functioning. They include body temperature, blood pressure, and the rates and types of pulse and breathing movements.

PTS: 1 REF: p. 65 OBJ: Discuss the body systems and their functions.

TOP: Anatomy and physiology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 11. Which one of the following structures divides the pelvic peritoneal space into the anterior and posterior pouches? a. Bladder b. Rectum c. Uterus d. Ovaries ANS: C The uterus lies anterior to the rectum and posterior to the bladder, dividing the pelvic peritoneal space into the anterior and posterior pouches (cul-de-sacs).

PTS: 1 REF: p. 76 OBJ: Identify and locate the abdominal viscera and other abdominal structures and spaces.

TOP: Abdominal regions 12. An oblique passage through the lower part of the anterior abdominal wall is termed the: a. rectus sheath. b. internal oblique muscle. c. inguinal canal. d. external oblique muscle.

ANS: C The inguinal canal is a passage through the lower anterior abdominal wall. In men, it allows structures to pass to and from the testes to the abdomen. In women, it allows passage of the round ligament from the uterus to the labium major.

PTS: 1 REF: p. 79 NURabdominal SINGTB.C OM and regions.

OBJ: Describe and locate the quadrants TOP: Anatomy and physiology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 05: Comparative Sectional Anatomy of the Abdominopelvic Cavity Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Computed tomography (CT) and ultrasound share terminology describing the body planes.

Identify the plane that divides the body into upper and lower sections. a. Sagittal b. Longitudinal c. Coronal d. Transverse ANS: D The transverse plane divides the body into upper and lower sections on a horizontal plane.

PTS: 1 REF: p. 82 TOP: Planes or Body Sections

OBJ: List the body planes in the abdomen.

2. Choose the definition of a sagittal plane. a. A plane dividing the body or any of its parts into upper and lower portions. b. A lengthwise plane running from front to back dividing the body or any of its parts into right and left sides, or two equal halves. c. A plane parallel to the long axis of the body or part. d. A lengthwise plane running from side to side, dividing the body into anterior and posterior portions.

N R I G B.C M

U S N T O ANS: B The sagittal plane divides the body into equal right and left sides and is not to be confused with the longitudinal plane that divides the body into unequal right and left halves.

PTS: 1 REF: p. 82 TOP: Planes or Body Sections

OBJ: List the body planes in the abdomen.

3. The abdominopelvic cavity has four quadrants and nine regions to help us describe locations of patient symptoms or pathology. Which of the following is the upper horizontal line that joins the lowest point of the costal margin to each side of the body? a. Subcostal plane b. Right upper quadrant c. Transpyloric plane d. Midsagittal plane ANS: A The subcostal plane joins the costal margin on a horizontal line.

PTS: 1 REF: p. 82 OBJ: Know the abdominal quadrants and regions of the body.

TOP: Planes or Body Sections

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. Choose the term that describes the point that lies on the inguinal ligament at the halfway point between the pubic symphysis and the anterior superior iliac spine (ASIS). a. Mid-inguinal point b. Central iliac fossa c. Intertubercular plane d. Hemigastrium ANS: A The mid-inguinal point describes the halfway point between the pubic symphysis and ASIS. PTS: 1 REF: p. 82 OBJ: Know the abdominal quadrants and regions of the body.

TOP: Planes or Body Sections 5. Which of the following lies superior to the level of the caudate lobe on the transverse plane? a. Aorta b. Celiac axis c. Splenic artery d. Hepatic vein ANS: C The splenic artery, splenic vein, and falciform ligament lie superior to the level of the caudate lobe.

PTS: 1 REF: p. 82 | p. 97 OBJ: Define the abdominal structures in the transverse and sagittal planes.

TOP: Sectional Anatomy

NURSINGTB.COM

6. Which of the following lies inferior to the level of the caudate lobe and celiac axis on the transverse plane? a. Splenic vein b. Renal arteries c. Ligamentum venosum d. Hepatic vein ANS: B The left and right renal arteries and veins lie inferior to the caudate lobe and celiac axis as well as the psoas major muscles, portal confluence, and superior mesenteric vein.

PTS: 1 REF: p. 87 OBJ: Define the abdominal structures in the transverse and sagittal planes.

TOP: Sectional Anatomy 7. Choose the structure that divides at the level of the aortic bifurcation. a. Coronary artery b. Hepatic artery c. Celiac axis d. Common iliac arteries ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The common iliac arteries divide at approximately the same level as the aortic bifurcation.

The iliac veins join at the same level.

PTS: 1 REF: p. 89 OBJ: Define the abdominal structures in the transverse and sagittal planes.

TOP: Sectional Anatomy 8. Morison’s pouch is anterior to which organ? a. Pancreas b. Caudate lobe c. Right kidney d. Uterus ANS: C Morison’s pouch lies anterior to the right kidney and posterior to the inferior right lobe of the liver.

PTS: 1 REF: p. 92 OBJ: Define the abdominal structures in the transverse and sagittal planes.

TOP: Sectional Anatomy 9. When imaging on the longitudinal plane at the level of the liver, inferior vena cava, pancreas, and gastroduodenal artery, which of the following enters the left lobe of the liver? a. Portal vein b. Femoral artery c. Iliac vein d. Splenic artery NURSINGTB.COM ANS: A The left portal vein enters the liver at the level of the inferior vena cava, pancreas, and gastroduodenal artery PTS: 1 REF: p. 92 OBJ: Define the abdominal structures in the transverse and sagittal planes.

TOP: Sectional Anatomy 10. Identify the structures imaged at the longitudinal level of the costodiaphragmatic recess superior to the diaphragm. a. Liver and right kidney b. Liver and gallbladder c. Pancreas and gastroduodenal artery d. Portal vein and artery ANS: B The diaphragm, right lobe of the liver, gallbladder, and perirenal fat area as well as the costodiaphragmatic recess superior to the diaphragm are located at the same longitudinal level.

PTS: 1 REF: p. 92 OBJ: Define the abdominal structures in the transverse and sagittal planes.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Sectional Anatomy 11. Both the sagittal and coronal planes divide the body lengthwise. How does the coronal plane divide the body? a. Top to bottom b. Front to back c. Side to side d. Right to left ANS: C The coronal plane divides the body into anterior and posterior sections, while the sagittal plane divides the body into right and left sections.

PTS: 1 REF: p. 82 OBJ: Discuss the difference between a coronal image and a sagittal image.

TOP: Planes or Body Sections 12. Select the description of the midsagittal plane. a. Plane dividing the body into equal right and left halves b. Plane dividing the body into anterior and posterior sections c. Plane dividing the body into upper and lower halves d. Plane running from the left shoulder to the right hip ANS: A The midsagittal plane runs lengthwise from the front to back, dividing the body or any of its parts into equal right and left sides.

N R I G B.C M

S N T O PTS: 1 REF: Up. 82 OBJ: Discuss the difference between a coronal image and a sagittal image.

TOP: Planes or Body Sections 13. An image dividing the right kidney into anterior and posterior sections describes the: a. sagittal plane. b. coronal plane. c. longitudinal plane. d. transverse plane.

ANS: B The coronal plane divides the body or organ into equal or unequal anterior and posterior portions.

PTS: 1 REF: p. 82 | p. 98 OBJ: Discuss the difference between a coronal image and a sagittal image.

TOP: Planes or Body Sections 14. Identify the imaging modality that provides a composite transverse image of the entire body. a. MRI b. MRS c. US d. CT

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: D CT is a composite image of the transverse plane, while most ultrasound images focus on a particular organ.

PTS: 1 REF: p. 82 TOP: Sectional Anatomy

OBJ: Compare and contrast CT to ultrasound.

15. Which of the following modalities uses ionizing radiation from outside the patient? a. MRS b. US c. CT d. MRI ANS: C MRS, MRI, and US do not use ionizing radiation, while CT projects a beam through the patient’s body to a corresponding sensor on the opposite side.

PTS: 1 TOP: Key Pearls

REF: p. 82 | p. 98

OBJ: Compare and contrast CT to ultrasound.

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 06: Basic Ultrasound Imaging: Techniques, Terminology, and Tips Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. An echo-free structure is described as: a. echogenic. b. sonolucent. c. heterogeneous. d. homogeneous.

ANS: B An sonolucent structure is echo-free.

PTS: 1 REF: p. 105 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 2. Select the term that describes a diffuse disease process or metastatic disease. a. Echogenic b. Infiltrating c. Homogeneous d. Shadowing ANS: B A diffuse disease process like fatty infiltration or metastatic disease is described as NURSINGTB.COM infiltrating.

PTS: 1 REF: p. 106 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 3. Which of the following terms describes a simple cyst? a. Echogenic b. Isoechoic c. Anechoic d. Homogeneous ANS: D A simple cyst appears anechoic, with sharp thin margins and posterior acoustic enhancement.

PTS: 1 REF: p. 106 | p. 108 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 4. A dirty shadow is likely the result of: a. air in the duodenum. b. cholelithiasis.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. nephrolithiasis. d. reverberation artifact.

ANS: A Air bubbles in the duodenum may cause a dirty shadow.

PTS: 1 REF: p. 107 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 5. Increased brightness posterior to an anechoic structure is termed: a. shadowing. b. reverberation. c. enhancement. d. refraction.

ANS: C Posterior acoustic enhancement describes an increased brightness posterior to an anechoic structure.

PTS: 1 REF: p. 105 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 6. Which of the following is the opposite of echogenic? a. Isoechoic b. Hypoechoic NURSINGTB.COM c. Hyperechoic d. Sonolucent ANS: D Sonolucent (anechoic) is the opposite of echogenic.

PTS: 1 REF: p. 105 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 7. Choose the term that describes a structure with a uniform texture or composition. a. Homogeneous b. Heterogeneous c. Isoechoic d. Echogenic ANS: A Homogeneous describes a completely uniform texture or composition.

PTS: 1 REF: p. 106 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 8. Heterogeneous describes this type of mass.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Normal thyroid Gallstone Simple cyst Complex mass

ANS: D Heterogeneous describes a complex mass (non-uniform texture of composition).

PTS: 1 REF: p. 105 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 9. Another term for sonolucent is: a. anechoic. b. isoechoic. c. hypoechoic. d. homogeneous.

ANS: A Sonolucent or anechoic: containing few or no echoes.

PTS: 1 REF: p. 105 OBJ: Explain terminology used to describe the results of ultrasound examinations.

TOP: Ultrasound terminology 10. Identify the sonographic characteristic of a cystic mass. a. Decreased through transmission NURSINGTB.COM b. Internal echoes c. Smooth border d. Echogenic ANS: C A cystic mass has a well-defined, smooth border, internally the lesion is anechoic with increased through sound transmission beyond its posterior border.

PTS: 1 REF: p. 107 OBJ: List the criteria for identifying abnormalities.

TOP: Identifying Abnormalities 11. Which of the following vessels lies posterior and inferior to the pancreas? a. Iliac artery and vein b. Superior mesenteric artery c. Subphrenic arteries d. Coronary arteries ANS: B The pancreas lies anterior and superior to the superior mesenteric artery.

PTS: 1 REF: p. 111 OBJ: Identify abdominal sectional anatomy in the transverse and longitudinal planes.

TOP: Figure 6-17A

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

12. Select the vessel that should be included in a transverse view of the liver. a. Inferior mesenteric vein b. Superior vena cava c. Aorta d. Portal vein ANS: D The vascular structures within the liver should be well demonstrated to include the hepatic veins, main portal vein with right and left branches, and inferior vena cava.

PTS: 1 REF: p. 111 OBJ: Identify abdominal sectional anatomy in the transverse and longitudinal planes.

TOP: Transverse Scans 13. Which artery courses along the anterolateral border of the head of the pancreas? a. Superior mesenteric b. Splenic c. Cystic d. Gastroduodenal ANS: D The gastroduodenal artery (GDA) courses along the anterolateral border of the head of the pancreas. The GDA is a branch of the hepatic artery.

PTS: 1 REF: p. 111 OBJ: Identify abdominal sectional anatomy in the transverse and longitudinal planes.

NURSINGTB.COM TOP: Figure 6-17A 14. Identify the shape of a curved array transducer image. a. Octagon b. Square c. Pie d. Annular ANS: C The curved array transducer provides a large pie sector, while the linear array transducer provides a rectangular image of the structure.

PTS: 1 REF: p. 101 OBJ: Describe the scanning techniques used in abdominal scanning.

TOP: Transducer Selection 15. Select the Doppler method most commonly used in the abdomen. a. Continuous Wave b. Directional c. Pulsed Wave d. Color Power ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Pulsed Wave (PW) Doppler is the most common instrumentation used to evaluate the lower velocity abdominal flow patterns.

PTS: 1 REF: p. 116 OBJ: Describe the use of Doppler in the abdomen, including Doppler scanning techniques for abdominal vessels.

TOP: Doppler Scanning Techniques 16. Which one of the following patient preparations is required before an abdominal ultrasound examination? a. Drink 12 ounces of water 1 hour before the examination. b. No preparation is needed. c. Take nothing by mouth for 6 to 8 hours before the examination. d. Take nothing by mouth for 4 to 6 hours before the examination.

ANS: C Nothing by mouth (NPO) for 6 to 8 hours is requested for the patient who is scheduled for an abdominal examination to optimize image quality and diagnosis.

PTS: 1 REF: p. 101 OBJ: Describe the scanning techniques used in abdominal scanning.

TOP: Transverse Scans 17. Flow in the inferior vena cava ___________ in the presence of thrombus. a. decreases b. increases c. remains the same d. stops NURSINGTB.COM ANS: B The flow is increased in the presence of thrombus formation in the inferior vena cava or hepatic vein.

PTS: 1 REF: p. 116 OBJ: Describe the use of Doppler in the abdomen, including Doppler scanning techniques for abdominal vessels.

TOP: Inferior Vena Cava and Hepatic Vein 18. Doppler imaging demonstrates flow toward and away from the transducer. Identify the direction the spectral tracing displays with flow toward the transducer. a. Both sides of the baseline b. Below the baseline c. Above the baseline d. Bidirectionally ANS: C Flow toward the transducer is positive, or above baseline, whereas flow away from the transducer is negative, or below baseline.

PTS: 1 REF: p. 116 OBJ: Describe the use of Doppler in the abdomen, including Doppler scanning techniques for abdominal vessels.

TOP: Doppler Scanning Techniques

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

19. Specific indications for an abdominal ultrasound examination include all of the following except: a. abdominal pain. b. abnormal laboratory values. c. palpable mass. d. nephrolithiasis.

ANS: D Nephrolithiasis is an indication for a renal ultrasound examination.

PTS: 1 REF: p. 104 OBJ: List the criteria for identifying abnormalities.

TOP: Indications for Abdominal Sonography 20. Which one of the following patient positions is best for imaging the spleen? a. Prone b. Right lateral decubitus c. Semi-erect d. Supine ANS: B The best position is the right lateral decubitus when compared with the supine position.

PTS: 1 REF: p. 101 | p. 111 OBJ: Define the criteria for an adequate scan.

TOP: Transverse Scans

N R I G B.C M

U Sbe compared N T with O that of the _____________.

21. The texture of the spleen should a. pancreas b. renal cortex c. left kidney d. renal hilum ANS: C The liver and spleen have similar echo texture and should be compared with each other. The pancreas is hyperechoic to the liver and spleen; the renal cortex is normally hypoechoic to the liver and spleen; the renal hilum is hyperechoic to the liver and spleen.

PTS: 1 REF: p. 111 OBJ: List the criteria for identifying abnormalities.

TOP: Transverse Scans

22. In a transverse image of the lower pole of the kidney, the psoas muscle lies: a. medial. b. lateral. c. inferior. d. anterior.

ANS: A The psoas muscles lie posterior and medial to the kidneys.

PTS:

1

REF: p. 113 | p. 115

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Identify abdominal sectional anatomy in the transverse and longitudinal planes.

TOP: Longitudinal Scans 23. How is the liver oriented on the monitor when scanning on the transverse plane? a. Anterior b. Right c. Left d. Laterally ANS: C All transverse supine scans are oriented with the liver on the left of the monitor; this means that the sonographer will be viewing the body from the feet up to the head (“optimistic view”).

PTS: 1 TOP: Annotation

REF: p. 103

OBJ: State how to properly label a sonogram.

24. Which of the following transducer movements is the best for a majority of breast ultrasound examinations? a. Fan b. Rotate c. Angle d. Slide ANS: A A smaller version of the sweep motion is the “fan” motion, which is used when the transducer is minutely swept, pivoting on a point of interest.

NURSINGTB.COM

PTS: 1 REF: p. 102 | p. 103 OBJ: Define the criteria for an adequate scan.

TOP: Transducer positions

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 07: Imaging and Doppler Artifacts Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Lack of axial and lateral resolution result in: a. echoes originating only from the center of the beam. b. decrease in ultrasound pulse length and width in the scan plane. c. Failure to resolve structures and detail loss. d. beam width artifacts on the scan plane.

ANS: C Axial and lateral (detail) resolutions are artifactual because a failure to resolve means a loss of detail, and two adjacent structures may be visualized as one.

PTS: 1 REF: p. 120 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Propagation 2. Multiple reflections can occur between the transducer and a strong reflector. This is an example of: a. reverberation. b. mirror image. c. speckle tracking. d. refraction.

N R I G B.C M

U S N T O ANS: A The multiple echoes may be sufficiently strong to be detected by the instrument and to cause confusion on the display. The multiple reflections are placed beneath the real reflector at separation intervals equal to the separation between the transducer and the real reflector.

PTS: 1 REF: p. 120 OBJ: Describe how specific artifacts can be recognized.

TOP: Propagation

3. The artifact that shows structures that exist on one side of a strong reflector as being present on the other side as well is known as: a. range ambiguity. b. mirror image. c. refraction. d. speed error.

ANS: B Mirror-image artifacts also a form of reverberation, shows structures that exist on one side of a strong reflector as being present on the other side as well.

PTS: 1 REF: p. 121 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Propagation

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. The reduction in echo amplitude from reflectors that lie behind a strongly reflecting or attenuating structure is: a. enhancement. b. resonance. c. comet tail. d. shadowing.

ANS: D A shadow is present when strongly attenuating or reflecting structure weakens the sound distal to it, causing echoes from the distal region to be weak and thus to appear dark.

PTS: 1 REF: p. 127 OBJ: Describe how specific artifacts can be recognized.

TOP: Attenuation

5. The strengthening of echoes from reflectors that lie behind a weak attenuating structure is: a. aliasing. b. multiple reflection. c. resonance. d. enhancement.

ANS: D Enhancement results in reflectors being placed on the image with amplitudes that are too high.

PTS: 1 REF: p. 128 OBJ: Describe how specific artifacts can be recognized.

TOP: Attenuation

N R I G B.C M

S N study T that O results in the improper representation of 6. Insufficient sampling during U a Doppler information is known as: a. multiple reflection. b. resonance. c. aliasing. d. enhancement.

ANS: C Aliasing in its technical use indicates improper representation of information that has been insufficiently sampled.

PTS: 1 REF: p. 129 OBJ: List ways in which spectral and color Doppler displays can present motion and flow information incorrectly.

TOP: Spectral Doppler 7. The upper limit to the pulsed wave Doppler shift that can be properly detected by pulsed instruments is called: a. aliasing. b. Nyquist limit. c. shadowing. d. speed error.

ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The upper limit to the pulsed wave Doppler shift that can be properly detected by pulsed instruments is called the Nyquist limit. Aliasing occurs when the pulsed wave Doppler shift frequency exceeds one-half of the pulse repetition frequency (PRF).

PTS: 1 REF: p. 129 OBJ: List ways in which spectral and color Doppler displays can present motion and flow information incorrectly.

TOP: Spectral Doppler 8. Artifacts caused by sonographic technique include all of the following except: a. noise. b. banding. c. side lobes. d. breathing.

ANS: C Side lobes are equipment artifacts caused by secondary (weaker) beams of sound traveling out from a single element in different directions of the primary (main) beam.

PTS: 1 REF: p. 123 OBJ: Explain how artifacts can be handled to avoid the pitfalls and misdiagnosis that they can cause.

TOP: Propagation 9. The best example of a mirror-image artifact is seen with the: a. gallbladder and cystic duct. b. pancreas and duodenum. c. uterus and fallopian tube. d. diaphragm and liver. NURSINGTB.COM ANS: D Mirror imaging occurs if a structure has a curved surface. Structures that exist on one side of a strong reflector are present on the other side as well.

PTS: 1 REF: p. 121 | p. 123 OBJ: Explain how artifacts can be handled to avoid the pitfalls and misdiagnosis that they can cause.

TOP: Mirror Image, Shadowing, Clutter, and Noise 10. Which one of the following will reduce or eliminate aliasing? a. Decreasing the Doppler angle b. Decreasing the transducer frequency c. Increasing the depth of the sample volume d. Decreasing the pulse repetition frequency ANS: B Methods of reducing or eliminating aliasing include increasing the pulse repetition frequency, larger Doppler angle, and decrease depth of the sample volume. Decreasing the transducer frequency is another method.

PTS: 1 REF: p. 130 OBJ: List ways in which spectral and color Doppler displays can present motion and flow information incorrectly.

TOP: Spectral Doppler

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

11. Refraction can cause a reflector that is: a. missing. b. not real. c. misplaced. d. of improper brightness.

ANS: C Refraction can cause a reflector to be positioned improperly (lateral) on a sonographic display.

PTS: 1 REF: p. 123 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Propagation 12. Which one of the following artifacts results from constructive and destructive interference of the returning echoes? a. Noise b. Speckle c. Speed error d. Range ambiguity ANS: B Speckle is the interference pattern resulting from constructive and destructive interference of echoes returning simultaneously from many scatterers within the propagating ultrasound pulse at any instant.

N R I G B.C M

S N T O PTS: 1 REF: Up. 121 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Propagation 13. Echoes resulting from grating lobes may be imaged if they fall within a(n) ___________ region. a. complex b. anechoic c. echogenic d. hypoechoic ANS: B If grating lobes encounter a strong reflector (e.g., air), their echoes may well be imaged, particularly if they fall within an anechoic region.

PTS: 1 REF: p. 123 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Propagation 14. Which one of the following structures is most likely to demonstrate strong posterior shadowing? a. Cyst b. Air

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Bone d. Blood vessel ANS: C Calcified plaque, bone, and stones are examples of structures that demonstrate strong posterior shadowing. Air demonstrates a “dirty” shadow posteriorly.

PTS: 1 REF: p. 127 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Attenuation 15. Increased intensity in the focal region of the sound beam is called focal ___________________. a. zones b. intensity c. banding d. attenuation ANS: C Increased intensity in the focal region of the sound beam is called focal banding or focal enhancement.

PTS: 1 REF: p. 128 OBJ: Describe how specific artifacts can be recognized.

TOP: Attenuation

16. Shadowing is reduced by using: a. harmonics imaging.

NURSINGTB.COM b. pixel interpolation. c. three-dimensional imaging. d. spatial compounding.

ANS: D Shadowing is reduced with spatial compounding because several approaches to each anatomic site are used, allowing the beam to “get under” the attenuating structure.

PTS: 1 REF: p. 128 OBJ: Explain how artifacts can be handled to avoid the pitfalls and misdiagnosis that they can cause.

TOP: Attenuation 17. Identify the artifact commonly seen with pulsed wave Doppler imaging. a. Noise b. Aliasing c. Mirror image d. Range ambiguity ANS: B Aliasing is the most common artifact encountered in pulsed wave Doppler ultrasound.

PTS: 1 REF: p. 129 OBJ: List ways in which spectral and color Doppler displays can present motion and flow information incorrectly.

TOP: Spectral Doppler

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

18. Which one of the following eliminates aliasing using the “cut and paste” technique? a. Shifting the baseline b. Decreasing the Doppler angle c. Increasing the transducer frequency d. Increasing the pulse repetition frequency ANS: A Baseline shift is an electronic “cut and paste” technique that moves the misplaced aliasing peaks over their proper location.

PTS: 1 REF: p. 129 OBJ: Explain how artifacts can be handled to avoid the pitfalls and misdiagnosis that they can cause.

TOP: Spectral Doppler 19. Which of the following solutions are common and convenient to aliasing? a. Shifting the baseline and decreasing the pulse repetition frequency b. Decreasing the pulse repetition frequency and increasing the depth of the sample gate c. Shifting the baseline and increasing the pulse repetition frequency d. Increasing the pulse repetition frequency and increasing the depth of the sample gate ANS: C Shifting the baseline and increasing the pulse repetition frequency are common and convenient solutions to aliasing.

N R I G B.C M

S N T O PTS: 1 REF: Up. 129 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Spectral Doppler 20. To decrease internally generated electronic noise in the Doppler signal, the sonographer should decrease the: a. Doppler gain. b. overall gain. c. imaging depth. d. transducer frequency.

ANS: A Internally generated electronic noise appears if the Doppler gain is set too high.

PTS: 1 REF: p. 132 OBJ: Explain how artifacts can be handled to avoid the pitfalls and misdiagnosis that they can cause.

TOP: Spectral Doppler 21. Reverberation artifact displays structures that are: a. not real. b. misplaced. c. improper in shape. d. improper in brightness.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: A Reverberation (multiple reflections) results in the display of additional reflectors that are not real.

PTS: 1 REF: p. 120 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Imaging artifacts 22. Increasing the pulse repetition frequency increases the chances of displaying which one of the following artifacts? a. Speckle b. Aliasing c. Mirror image d. Range ambiguity ANS: D Higher pulse repetition frequencies (PRF) permit higher Doppler shifts to be detected but also increase the chance of the range ambiguity artifact occurring.

PTS: 1 REF: p. 125 | p. 136 OBJ: Explain how artifacts can be handled to avoid the pitfalls and misdiagnosis that they can cause.

TOP: Propagation 23. Cross-talk can produce which one of the following artifacts? a. Noise b. Aliasing c. Mirror image NURSINGTB.COM d. Range ambiguity ANS: C Cross-talk can produce a Doppler mirror-image artifact.

PTS: 1 REF: p. 132 OBJ: List ways in which spectral and color Doppler displays can present motion and flow information incorrectly.

TOP: Spectral Doppler 24. Refraction of the sound beam at a boundary may result in false sonographic ________________. a. brightness b. duplication c. shadowing d. enhancement ANS: C Refraction of the sound beam at a boundary may result in false sonographic shadowing (edge shadowing).

PTS: 1 REF: p. 123 | p. 125 OBJ: Describe how specific artifacts can be recognized.

NURSINGTB.COM

TOP: Propagation

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 25. The width of the pulse determines ______________ resolution. a. temporal b. lateral c. axial d. contrast ANS: B The width of the pulse determines lateral resolution.

PTS: 1 REF: p. 136 OBJ: List ways in which sonographic gray-scale images can present anatomic structures incorrectly.

TOP: Table 7-2

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 08: Vascular System Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The portal veins carry blood from the ______________ to the liver. a. hepatic artery b. intestinal tract c. splenic artery d. peripheral venous system ANS: B The portal veins carry blood from the intestinal tract to the liver by means of its two main branches (right and left portal veins).

PTS: 1 REF: p. 178 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Portal venous system 2. The arterial supply to the gallbladder is via the: a. hepatic artery. b. superior mesenteric artery. c. cystic artery. d. gastroduodenal artery.

ANS: C NURSthe INgallbladder GTB.COvia M the cystic artery.

The right hepatic artery supplies PTS: 1 REF: p. 154 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Sonographic evaluation of the abdominal aorta 3. The portal venous system receives blood from all of the following except the: a. gallbladder. b. pancreas. c. spleen. d. kidneys.

ANS: D The portal venous system receives blood form the gastrointestinal tract, from the lower end of the esophagus to the upper end of the anal canal, and from the pancreas, gallbladder, bile ducts, and spleen.

PTS: 1 REF: pp. 178-179 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Portal venous system 4. What vessel passes anterior to the third part of the duodenum and posterior to the neck of the pancreas?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Superior mesenteric artery Superior mesenteric vein Inferior mesenteric vein Splenic vein

ANS: B The superior mesenteric vein passes anterior to the third part of the duodenum and posterior to the neck of the pancreas, where it joins the splenic vein to form the main portal vein.

PTS: 1 REF: p. 181 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Portal venous system 5. The duodenum and parts of the stomach are supplied by the: a. hepatic artery. b. gastroduodenal artery. c. splenic artery. d. superior mesenteric artery.

ANS: B The gastroduodenal artery (GDA) supplies the duodenum and parts of the stomach and pancreas. Remember that the GDA is located in the anterolateral portion of the pancreatic head.

PTS: 1 REF: p. 153 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Sonographic evaluation of the abdominal aorta

NURSINGTB.COM

6. Which one of the following vessels passes anterior to the uncinate process of the pancreas? a. Hepatic artery b. Portal vein c. Left renal vein d. Superior mesenteric artery ANS: D The superior mesenteric artery courses posterior to the neck of the pancreas and anterior to the uncinate process.

PTS: 1 REF: p. 182 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Sonographic evaluation of the abdominal aorta 7. The distribution of the superior mesenteric artery is to the: a. distal half of the colon and the liver. b. proximal half of the colon and the small intestines. c. small intestine and the proximal half of the colon. d. large intestine and the distal half of the colon.

ANS: B The superior mesenteric artery (SMA) distributes blood to the proximal half of the colon (cecum, ascending colon, and transverse colon) and the small intestines.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 155 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Sonographic evaluation of the abdominal aorta 8. Which one of the following veins begins at the hilum of the spleen joining the short gastric and left gastroepiploic vein? a. Pancreatic b. Portal c. Superior mesenteric d. Splenic ANS: D The splenic vein begins at the hilum of the spleen. It is subsequently joined by the short gastric and left gastroepiploic veins.

PTS: 1 REF: p. 180 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Portal venous system 9. Which one of the following statements is incorrect? a. The portal vein enters the lesser omentum. b. The portal vein is formed anterior to the pancreas. c. The portal vein drains blood out of the gastrointestinal tract. d. The portal vein has an anastomosis with the esophageal veins, rectal venous plexus, and superficial abdominal veins.

N R I G B.C M

U S N T O ANS: B The main portal vein is formed posterior to the pancreas.

PTS: 1 REF: p. 182 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Portal venous system 10. The normal diameter of the aorta is less than ____ millimeters (mm) in men. a. 2 b. 4 c. 10 d. 23 ANS: D The diameter of the abdominal aorta measures less than 23 mm in men and 19 mm in women, with gradual tapering to 10 to 15 mm after it proceeds inferiorly to the bifurcation into the common iliac arteries.

PTS: 1 REF: p. 143 OBJ: Understand the function of the circulatory system.

TOP: Function of the circulatory system 11. The inferior mesenteric artery distributes blood to the:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

left transverse colon, descending colon, sigmoid colon, and rectum. ascending colon, sigmoid colon, and rectum. descending colon. ascending colon and rectum.

ANS: A The inferior mesenteric artery (IMA) has three main branches: left colic, sigmoid, and superior rectal arteries. These branches distribute blood to the transverse colon, descending colon, sigmoid colon, and rectum.

PTS: 1 REF: p. 156 OBJ: Understand the function of the circulatory system.

TOP: Function of the circulatory system 12. The right renal artery passes ____________ to the inferior vena cava (IVC). a. anterior b. posterior c. lateral d. medial ANS: B The right renal artery passes posterior to the IVC and anterior to the spine in a posterior and slightly caudal direction.

PTS: 1 REF: p. 168 | p. 188 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Function of the circulatory system

NURSINGTB.COM

13. The vessel that arises from the anterior aortic wall and takes a parallel course to the aorta is the: a. hepatic artery. b. renal artery. c. superior mesenteric artery. d. inferior mesenteric artery.

ANS: C The superior mesenteric artery (SMA) and the celiac axis arise from the anterior aortic wall; of these, only the SMA takes a parallel course to the aorta.

PTS: 1 REF: p. 155 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Function of the circulatory system 14. Which one of the following vascular structures courses between the aorta and SMA? a. Left renal vein b. Celiac trunk c. Gastroduodenal artery d. Left renal artery ANS: A

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The left renal vein flows from the renal hilum, posterior to the SMA, and anterior to the aorta to enter the lateral wall of the IVC. PTS: 1 REF: p. 176 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Lateral tributaries to the inferior vena cava 15. Where do the renal arteries branch from the lateral wall of the aorta? a. At the level of L4. b. Superior to the SMA. c. Superior to the hepatic arteries. d. Inferior to the SMA. ANS: D Renal arteries arise just inferior to the SMA at the level of the first lumbar vertebra.

PTS: 1 REF: p. 158 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Function of the circulatory system 16. The IVC courses anteriorly to enter the: a. right ventricle. b. left atrium. c. right coronary sinus. d. right atrium.

ANS: D NURSIN Gretroperitoneal B.COM space on the right side of the aorta, The IVC ascends vertically through the T posterior to the liver, and pierces the central tendon of the diaphragm at the level of the eighth thoracic vertebra to enter the right atrium of the heart.

PTS: 1 REF: p. 169 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Inferior vena cava 17. Which vascular structure is used as a landmark in locating the celiac trunk? a. Common bile duct b. Common hepatic artery c. Superior mesenteric artery d. Gastroduodenal artery ANS: C The superior mesenteric artery may be used as a landmark in locating the celiac trunk.

PTS: 1 REF: p. 155 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Sonographic evaluation of the abdominal aorta 18. Which one of the following vascular structures relates to the medial and posterior borders or to the pancreatic body and tail?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Splenic artery Hepatic artery Superior mesenteric artery Splenic vein

ANS: D The splenic vein passes anteriorly to the aorta and IVC and generally relates to the medial and posterior borders of the pancreatic body and tail.

PTS: 1 REF: p. 181 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Inferior vena cava 19. The gastroduodenal artery is a branch of the: a. common hepatic artery. b. left gastric artery. c. splenic artery. d. superior mesenteric artery.

ANS: A The common hepatic artery branches into the gastroduodenal artery and the proper hepatic artery.

PTS: 1 REF: p. 153 OBJ: Describe the anatomy of the arterial system, venous system, and portal venous system.

TOP: Sonographic evaluation of the abdominal aorta

N R I G B.C M

U S N aneurysms T O is: 20. The most common cause of abdominal a. cystic medial necrosis. b. syphilis. c. atheroma. d. arteriosclerosis.

ANS: D Arteriosclerosis and atherosclerosis are the most common causes of abdominal aneurysms.

PTS: 1 REF: p. 161 OBJ: Explain the factors that may cause development of an aneurysm.

TOP: Aorta 21. In patients with massive swelling of the lower trunk and leg edema and a dilated IVC, a(n) _______________ should be suspected. a. rupture b. arteriovenous fistula c. retroperitoneal tumor d. infection ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The development of an arteriovenous fistula may demonstrate clinical symptoms, including low back pain, abdominal pain, progressive cardiac decompensation, dilated IVC, a pulsatile abdominal mass associated with a bruit, and the development of massive swelling of the lower trunk and lower extremities with leg edema.

PTS: 1 REF: p. 168 OBJ: Explain the factors that may cause development of an aneurysm.

TOP: Aorta 22. Choose the tumor that invades the IVC from a connecting vein. a. Islet cell carcinoma b. Renal cell carcinoma c. Venous angioma d. Nephroma ANS: B The sonographer should always look at the cava and renal veins for tumor invasion in the presence of a renal cell carcinoma.

PTS: 1 REF: p. 187 OBJ: Recognize the sonographic findings and pathology found in the vascular structures.

TOP: Abdominal Doppler techniques 23. The clinical signs of leg edema, low back pain, pelvic pain, gastrointestinal complaints, and renal and liver problems may represent: a. abdominal rupture. b. superior mesenteric thrombus.

NURSINGTB.COM c. retroperitoneal tumor. d. IVC thrombosis.

ANS: D The most common origin of pulmonary emboli is venous thrombus from the lower extremity. The patient may have leg edema, lower back pain, pelvic pain, gastrointestinal complaints, and/or renal and liver problems.

PTS: 1 REF: p. 175 OBJ: Recognize the sonographic findings and pathology found in the vascular structures.

TOP: Inferior vena cava 24. Which one of the following statements is false for a patient with renal vein thrombosis? a. Direct visualization of thrombi in the renal vein and IVC is possible. b. Loss of normal renal structure occurs. c. Renal size increases in the acute phase. d. Doppler flow increases in renal vein.

ANS: D Renal vein thrombosis demonstrates a decrease in blood flow or possibly no flow in renal vein.

PTS:

1

REF: p. 177

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the Doppler flow patterns in arterial versus venous structures.

TOP: Inferior vena cava

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 09: Liver Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The liver is suspended from the diaphragm and anterior abdominal wall by the: a. ligamentum teres. b. falciform ligament. c. round ligament. d. triangular ligament.

ANS: B The falciform ligament extends from the umbilicus to the diaphragm.

PTS: 1 REF: p. 193 OBJ: Describe normal anatomy of the liver, including its vascular supply and relational landmarks.

TOP: Anatomy of the liver 2. Fatty infiltration may be observed in all patients except those with: a. diabetes mellitus. b. chronic alcoholism. c. hepatoportal fistula. d. hepatitis.

ANS: C A common cause of fatty infiltration includes alcoholic liver disease, diabetes mellitus, NURSINchronic GTB.C OM and the use of steroids. obesity, pregnancy, severe hepatitis, illness, PTS: 1 REF: p. 215 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 3. Sonographic findings of acute hepatitis include: a. accentuated brightness, more extensive demonstration of portal vein radicles, and an overall decreased echogenicity of liver. b. decreased brightness and echogenicity of liver. c. increased brightness and echogenicity of liver, and no demonstration of portal vein radicles. d. ascites, decreased brightness, and echogenicity.

ANS: A In patients with acute hepatitis, the liver demonstrates accentuated brightness, more extensive demonstration of portal vein radicles, and an overall decrease in parenchyma echogenicity.

PTS: 1 REF: p. 218 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Key Pearls

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

4. Budd-Chiari syndrome is a rare disorder caused by obstruction of the: a. portal veins. b. superior mesenteric vein. c. hepatic veins. d. splenic vein.

ANS: C Budd-Chiari syndrome is an uncommon, often dramatic, illness caused by thrombosis of the hepatic veins or inferior vena cava (IVC).

PTS: 1 REF: p. 229 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 5. Echinococcal cysts have the highest incidence in countries in which: a. fishing is common. b. rock climbing is prevalent. c. poultry is abundant. d. sheep herding is common.

ANS: D Hepatic echinococcosis is an infectious cystic disease common in sheep-herding areas of the world.

PTS: 1 REF: p. 236 N RSINGTB.C OM and differential diagnoses for the OBJ: List the clinical signs,Usonographic features, pathologic findings discussed in this chapter.

TOP: Pathology of the liver 6. The most common benign tumor of the liver is: a. mesenchymal hamartoma. b. adenoma. c. cavernous hemangioma. d. infantile hemangioendothelioma.

ANS: C The cavernous hemangioma is the most common benign tumor of the liver.

PTS: 1 REF: p. 237 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 7. What benign liver tumor has been found in patients with type I glycogen storage disease? a. Lipoma b. Adenoma c. Cavernous hemangioma d. Hamartoma

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B Glycogen storage disease is associated with adenomas, focal nodular hyperplasia, and hepatomegaly.

PTS: 1 REF: p. 239 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 8. Patients who have hepatocellular carcinoma are more likely to have had: a. hemochromatosis. b. adenosis. c. cirrhosis. d. carcinosis.

ANS: C Eighty percent (80%) of patients with preexisting cirrhosis develop hepatocellular carcinoma.

PTS: 1 REF: p. 241 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 9. The most common form of neoplastic involvement of the liver is: a. metastases. b. hepatocellular carcinoma.

NURSINGTB.COM c. hepatoma. d. hamartoma.

ANS: A Metastatic disease is the most common form of neoplastic involvement of the liver. Primary sites include the colon, breast, and lung. Metastasis to the liver occurs as the tumor erodes the wall and travels through the lymphatic system or through the bloodstream to the portal vein or hepatic artery to the liver.

PTS: 1 REF: p. 241 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 10. The fossae of the right portal vein (RPV) and gallbladder are found in the: a. main lobar fissure. b. left intersegmental fissure. c. right intersegmental fissure. d. left lobar fissure.

ANS: A The main lobar fissure is a hyperechoic line extending from the RPV to the neck of the gallbladder. It is used as a landmark leading to the gallbladder fossa.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 193 OBJ: Describe normal anatomy of the liver, including its vascular supply and relational landmarks.

TOP: Sonographic evaluation of the liver 11. In severe hepatocellular destruction, the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are: a. high. b. moderately high. c. moderate. d. mild.

ANS: A In severe hepatocellular destruction, such as acute, viral, or toxic hepatitis, a striking elevation of AST and ALT may be observed. Levels frequently exceed 1000 units.

PTS: 1 REF: p. 200 OBJ: Describe the liver function tests and their relevance to hepatic disease.

TOP: Physiology and laboratory data of the hepatobiliary system 12. Elevation of alkaline phosphatase is associated with: a. biliary obstruction. b. cavernous hemangioma. c. fatty infiltration. d. simple hepatic cysts.

ANS: A NURSIphosphatase M NGTB.CO A significant elevation of alkaline is typically associated with biliary obstruction or the presence of mass lesions in the liver.

PTS: 1 REF: p. 230 OBJ: Describe the liver function tests and their relevance to hepatic disease.

TOP: Physiology and laboratory data of the hepatobiliary system 13. Diminished vascular structures within the liver parenchyma most likely represent: a. obstructive portal disease. b. cirrhosis. c. Budd-Chiari syndrome. d. acute viral hepatitis.

ANS: B Sonographic findings in cirrhosis may include coarse liver texture (fibrosis and nodularity).

Increased attenuation may be present with a decrease in vascular markings.

PTS: 1 REF: p. 218 OBJ: List the clinical signs, sonographic features, and differentials for the pathology discussed in this chapter.

TOP: Pathology of the liver 14. The falciform ligament extends from the umbilicus to the diaphragm in a parasagittal plane containing the:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

ligamentum venosum. ligamentum teres. quadratus ligamentum. ligamentum falciforme.

ANS: B The falciform ligament extends from the umbilicus to the diaphragm in a sagittal plane and contains the ligamentum teres.

PTS: 1 REF: p. 193 OBJ: Describe normal anatomy of the liver, including its vascular supply and relational landmarks.

TOP: Anatomy of the liver 15. Elevation of serum bilirubin results in: a. hepatocellular disease. b. ascites. c. jaundice. d. hemolysis.

ANS: C Elevation of serum bilirubin results in jaundice. Jaundice is a nonspecific finding seen in massive blood breakdown, hepatocellular disease, or biliary obstruction.

PTS: 1 REF: p. 201 OBJ: Describe the liver function tests and their relevance to hepatic disease.

TOP: Physiology and laboratory data of the hepatobiliary system

N R I G B.C M

U S should N T be done O to image the near field of the liver?

16. Which one of the following actions a. Decrease transducer frequency b. Use a sector transducer c. Use a curved array transducer d. Increase the near gain ANS: C Generally, a wider “pie” sector or curved linear array transducer is most appropriate to image the near field of the abdomen optimally.

PTS: 1 REF: p. 205 OBJ: Discuss the sonographic evaluation of the liver in the sagittal, transverse, and lateral decubitus planes.

TOP: Sonographic evaluation of the liver 17. Typical symptoms a patient may have with an abscess formation include all of the following except: a. fever. b. decreased white blood count. c. pain. d. increased white blood count.

ANS: B Clinical symptoms of an abscess include fever, abdominal pain, and an increase in white blood count.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 235 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 18. Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, and an elevated white blood cell count. He states that 3 months earlier, he was kicked in the ribs. An irregular mass showing low-level echoes is found on the sonogram. What is your differential diagnosis? a. Amebic abscess b. Hematoma c. Echinococcal cyst d. Hepatic abscess ANS: C The best diagnosis is an echinococcal cyst. An abscess is a possibility, although with a history of being a sheep herder, echinococcal cyst is more likely. A hematoma does not cause a fever.

PTS: 1 REF: p. 236 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 19. Which one of the following tumors consists of large blood-filled spaces? a. Adenoma NURSINGTB.COM b. Hamartoma c. Ewing angioma d. Cavernous hemangioma ANS: D A hemangioma is a benign tumor consisting of large blood-filled (cystic) spaces. Their sonographic appearance may vary from small to large and hyperechoic to complex.

PTS: 1 REF: p. 237 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 20. Dilated intrahepatic bile ducts may be seen with all of the following except: a. intrahepatic mass in the area of the porta hepatis. b. gallstones in the fundus of the gallbladder. c. obstructive stone in the cystic duct. d. lymphadenopathy in the porta hepatis.

ANS: B Dilated intrahepatic ducts may be seen with gallstones in the neck of the gallbladder, with an intrahepatic mass in the area of the porta hepatis, with an obstructive stone in the cystic duct, and with lymphadenopathy in the porta hepatis.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 231 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 21. Hepatocellular disease can be defined as a process that affects the: a. spherocytes and interferes with liver function. b. phagocytes and does not interfere with liver function. c. phagocytes and interferes with liver function. d. hepatocytes and interferes with liver function.

ANS: D Hepatocellular disease can be defined as a process that affects the hepatocytes and interferes with liver function.

PTS: 1 REF: p. 214 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 22. In glycogen storage disease, type I is the most common and is also known as ____________ disease. a. von Gierke b. von Gussel c. von Gerpe d. von Slurpie NURSINGTB.COM ANS: A The most common type of glycogen storage disease is type I, von Gierke disease, in which abnormal amounts of glycogen are deposited in the liver and kidneys.

PTS: 1 REF: p. 221 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 23. All of the following describe normal portal venous flow except: a. low-flow velocity. b. hepatofugal flow. c. spontaneous flow. d. phasic flow.

ANS: B The portal venous system demonstrates spontaneous, phasic, hepatopetal flow with a low-flow velocity.

PTS: 1 REF: p. 228 OBJ: Describe the normal anatomy of the liver, including its vascular supply and relational landmarks. TOP: Anatomy of the liver

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

24. Which one of the following is noted in type I glycogen storage disease? a. Small liver and hypoechoic parenchyma b. Hyperechoic, attenuating liver and hepatomegaly c. Normal texture and hepatomegaly d. Normal texture and prominent intrahepatic biliary ducts ANS: B Patients with type I glycogen storage disease demonstrate hepatomegaly, increased echogenicity, and attenuation of the liver parenchyma.

PTS: 1 REF: p. 221 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 25. All of the following statements are true about the features most often observed in an extrahepatic mass except: a. internal invagination of the liver capsule. b. formation of a triangular fat wedge. c. discontinuity of the liver capsule. d. anteromedial shift of the IVC. ANS: A Extrahepatic masses demonstrate discontinuity of the liver capsule, formation of a triangular fat wedge, and anteromedial shift of the IVC or anterior displacement of the right kidney.

N R I G B.C M

S N T O PTS: 1 REF: Up. 233 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 26. All of the following statements are true about the features most often observed in an intrahepatic mass except: a. anterior displacement of the right kidney. b. displacement of the hepatic vascular radicles. c. external bulging of the liver capsule. d. posterior shift of the IVC. ANS: A Intrahepatic masses demonstrate displacement of the hepatic vascular radicles, external bulging of the liver capsule, or a posterior shift of the IVC. PTS: 1 REF: p. 233 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 27. The most common site for echinococcal virus growth is in the: a. lungs.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. bones. c. liver. d. brain.

ANS: C After entering the proximal portion of the small intestines in humans, the larvae burrow through the mucosa, entering the portal circulation and traveling to the liver.

PTS: 1 REF: p. 236 |p. 237 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 28. The amebic abscess may reach the liver through the: a. hepatic artery. b. gastroduodenal artery. c. hepatorectal artery. d. portal vein.

ANS: D The infection is primarily a disease of the colon; therefore, the parasites reach the liver via the portal vein.

PTS: 1 REF: p. 236 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver

NURSINGTB.COM

29. What benign liver tumor is located near the free edge of the liver and is solitary, well-circumscribed, and a nonencapsulated multinodular mass? a. Adenoma b. Cavernous hemangioma c. Focal nodular hyperplasia (FHN) d. Lipoma ANS: C FHN generally demonstrates a solitary, well-circumscribed lesion and a nonencapsulated multiodular mass located along the subcapsular area of the liver. Lesions may be multiple and are typically found in women under the age 40 years.

PTS: 1 REF: p. 238 | p. 239 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver 30. Common malignancies affecting the pediatric population include all of the following except: a. neuroblastoma. b. Wilms tumor. c. leukemia. d. hepatoblastoma.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: D Common malignancies affecting the pediatric population include neuroblastoma, Wilms tumor, and leukemia. Hepatoblastoma is a rare hepatic malignant tumor seen in infancy and childhood < 5 years.

PTS: 1 REF: p. 244 OBJ: List the clinical signs, sonographic features, and differential diagnoses for the pathologic findings discussed in this chapter.

TOP: Pathology of the liver

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 10: Gallbladder and the Biliary System Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. In cases of choledocholithiasis, stones tend to lodge in the: a. pancreatic duct. b. common bile duct. c. ampulla of Vater. d. common hepatic duct.

ANS: C In cases of choledocholithiasis, stones tend to lodge in the ampulla of Vater and may project into the duodenum.

PTS: 1 REF: p. 276 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Pathology of the biliary tree 2. The right and left hepatic ducts emerge from the right lobe of the liver in the porta hepatis and unite to form the: a. common hepatic duct. b. cystic duct. c. common bile duct. d. common pancreatic duct.

N R I G B.C M

U S N T O ANS: A The right and left hepatic ducts unite to form the common hepatic duct, which then passes caudally and medially.

PTS: 1 REF: p. 249 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Anatomy of the biliary system 3. The normal diameter of the common hepatic duct is approximately ________ millimeters (mm). a. 2 b. 3 c. 4 d. 5 ANS: C The common hepatic duct is approximately 4 mm in diameter and descends within the edge of the omentum.

PTS: 1 REF: p. 249 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Anatomy of the biliary system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. The hepatic duct is joined by the ______________ to form the ________________. a. pancreatic duct; cystic duct b. cystic duct; common bile duct c. common bile duct; cystic duct d. right hepatic duct; common bile duct ANS: B The common hepatic duct is joined by the cystic duct to form the common bile duct.

PTS: 1 REF: p. 249 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Anatomy of the biliary system 5. In a 50-year-old adult, the normal common bile duct should not measure more than _____ mm. a. 5 b. 6 c. 8 d. 10 ANS: B The normal common bile duct has a diameter of up to 6 mm.

PTS: 1 REF: p. 249 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Anatomy of the biliary system

N R I G B.C M

U Swith N the T anterior O wall of the inferior vena cava (IVC).

6. The distal duct lies ___________ a. parallel b. perpendicular c. lateral d. horizontal ANS: A The distal common bile duct lies parallel with the anterior wall of the IVC. PTS: 1 REF: p. 249 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Anatomy of the biliary system 7. The cystic duct connects the _________ of the gallbladder with the common hepatic duct to form the ___________. a. fundus; common hepatic duct (CHD) b. fundus; common bile duct (CBD) c. neck; CBD d. body; CHD ANS: C The cystic duct is about 4 cm long and connects the neck of the gallbladder with the CHD to form the CBD.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 250 OBJ: Describe the internal, surface, and relational anatomies of the gallbladder.

TOP: Anatomy of the biliary system 8. A Phrygian cap of the gallbladder is: a. partial septation. b. calcification of the gallbladder wall. c. septations within the organ. d. folding of the gallblabber fundus.

ANS: D The folding of the gallbladder fundus is termed a Phrygian cap.

PTS: 1 REF: p. 250 |p. 252 OBJ: Describe the internal, surface, and relational anatomies of the gallbladder.

TOP: Anatomy of the biliary system 9. Which one of the following is a function of the gallbladder? a. Storage for extra cholesterol b. Storage for enzymes c. Reservoir for bile d. Reservoir for biliary salts ANS: C The gallbladder serves as a reservoir for bile, which is drained from the hepatic ducts in the liver.

N R I GTB.C OM Explain the function of the gallbladder.

OBJ:

S N PTS: 1 REF: Up. 248 TOP: Anatomy of the biliary system

10. A gallbladder with a small outpuch at the neck is called a: a. Murphy pouch. b. Phyrgian cap. c. Hartmann pouch. d. Murphy sign.

ANS: C The gallbladder may fold on itself at the neck, forming a Hartmann pouch.

PTS: 1 REF: p. 250 OBJ: Describe the internal, surface, and relational anatomies of the gallbladder.

TOP: Anatomy of the biliary system 11. The bright linear echo within the liver connecting the neck of the gallbladder and the right or main portal vein is called the: a. right lobar fissure. b. main lobar fissure. c. ligamentum teres. d. left lobar fissure.

ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The main lobar fissure is a sonographic landmark leading to the gallbladder fossa. It is a bright linear echo connecting the right portal vein to the neck of the gallbladder.

PTS: 1 REF: p. 255 OBJ: Describe the sonographic pattern of the gallbladder, cystic duct, hepatic ducts, and common bile duct. TOP: Sonographic evaluation of the biliary system 12. Gas-forming bacteria in the gallbladder appear on ultrasound as a: a. dilated round shape. b. nonshadowing echogenic mass. c. localized dilation. d. bright echo with a ring down or comet-tail artifact.

ANS: D Emphysematous cholecystitis is gas-forming bacteria in the gallbladder, which appear on ultrasound as a bright echo in the area of the gallbladder with a ring down or comet-tail artifact.

PTS: 1 REF: p. 258 | p. 262 | p. 263 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 13. A positive Murphy sign is a clinical finding associated with: a. cholelithiasis. b. cholecystitis. c. porcelain gallbladder. NURSINGTB.COM d. adenomyomatosis.

ANS: B A presenting sign of cholecystitis is acute right-upper quadrant pain upon palpation of the gallbladder (positive Murphy sign).

PTS: 1 REF: p. 260 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 14. Classic symptoms of gallbladder disease include all of the following except: a. hematuria. b. right upper quadrant pain. c. right shoulder pain. d. nausea and vomiting.

ANS: A The most common symptom of gallbladder disease is right upper quadrant pain, usually after ingesting a fatty meal. Other symptoms include nausea and vomiting, right shoulder blade pain, and epigastric pain.

PTS:

1

REF: p. 257

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 15. Thickening of the gallbladder wall may be caused by all of the following except: a. hepatitis. b. pancreatitis. c. adenomyomatosis. d. cholecystitis.

ANS: B A thickening of the gallbladder wall may be caused by cholecystitis, acquired immunodeficiency syndrome, cholangiopathy, sclerosing cholangitis, ascites, right-sided heart failure, renal failure, severe hypoalbuminemia states, and nonfasting state.

PTS: 1 REF: p. 259 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 16. Which one of the following describes the most common sonographic appearance of gallbladder carcinoma? a. “Comet tail” shadowing posterior to a hypoechoic focus b. Irregular echogenic mass projecting from the gallbladder wall c. Shadowing posterior to mobile echogenic mass d. Comet tail shadowing posterior to a hyperechoic focus

N R I G B.C M

U S N T O ANS: B The sonographic appearance of gallbladder carcinoma is described as a heterogeneous, solid, immobile mass projecting into the gallbladder from a thickened gallbladder wall.

PTS: 1 REF: p. 271 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 17. The common bile duct is joined by the main pancreatic duct. Together they open through the _____________________ into the duodenal wall. a. ampulla of Oddi b. ampulla of Water c. ampulla of Vater d. ampulla of Santorini ANS: C The pancreatic duct (Wirsung duct) and the common bile duct join and enter through the ampulla of Vater into the duodenum.

PTS: 1 REF: p. 249 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Anatomy of the biliary system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

18. A fusiform dilation of the common bile duct is known as: a. a choledochal cyst. b. adenomyomatosis. c. cholangitis. d. a Phrygian cap.

ANS: A Choledochal cysts are classified as one of the following: (1) localized cystic dilation of the common bile duct; (2) diverticulum from the common bile duct; (3) dilation of the entire common bile duct and common hepatic duct; and (4) invagination of the common bile duct into the duodenum.

PTS: 1 REF: p. 272 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Pathology of the biliary tree 19. Inflammation of the gallbladder is known as: a. cholecystitis. b. choledocholithiasis. c. cholesterosis. d. adenomyomatosis.

ANS: A Cholecystitis is the inflammation of the gallbladder that may have several forms—acute or chronic, acalculous, emphysematous, or gangrenous.

N R I G B.C M

S N T O PTS: 1 REF: Up. 260 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 20. A condition causing RUQ pain in which small polypoid masses arise from the gallbladder wall demonstrating “comet tail” artifact is: a. choledocholithiasis. b. cholesterosis. c. adenomyomatosis. d. pruritus.

ANS: C An immobile echogenic focus (i) protruding from the gallbladder wall demonstrating a “comet tail” artifact describes adenomyomatosis.

PTS: 1 REF: p. 267 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Sonographic evaluation of the biliary system 21. The sonographic appearance of cholelithiasis is best described as: a. nonshadowing, mobile, hyperechoic focus.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. mobile, hyperechoic focus demonstrating posterior shadowing. c. immobile, echogenic focus demonstrating a comet-tail artifact. d. mobile, hypoechoic focus demonstrating posterior shadowing.

ANS: B A gallstone generally appears as mobile hyperechoic intraluminal focus (i) demonstrating posterior acoustic shadowing. Gallstones are typically mobile.

PTS: 1 REF: p. 265 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Sonographic evaluation of the biliary system 22. The most common cause of biliary ductal obstruction is the presence of a ductal: a. cyst. b. tumor. c. stone. d. stricture.

ANS: B The most common cause of biliary ductal obstruction is the presence of a ductal tumor or thrombus in the ductal system.

PTS: 1 REF: p. 283 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the biliary tree

NURSINGTB.COM

23. A thick calcified gallbladder wall describes which one of the following conditions? a. Wall-echo-shadow (WES) sign b. Gangrenous gallbladder c. Porcelain gallbladder d. Emphysematous gallbladder ANS: C A porcelain gallbladder is associated with gallstones and demonstrates a thick, hyperechoic (calcified) gallbladder wall with posterior acoustic shadowing. WES sign demonstrates a gallbladder wall and then a hyperechoic focus with posterior shadowing.

PTS: 1 REF: p. 258 | p. 265 | p. 267 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 24. Which one of the following best describes nonshadowing, low-amplitude echoes in a dependent gallbladder? a. Cholelithiasis b. Porcelain gallbladder c. Cholecystitis d. Sludge

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: D Sludge is described as low-level internal echoes that are gravity dependent.

PTS: 1 REF: p. 257 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 25. The valves of Heister are tiny valves found within the: a. cystic duct. b. common bile duct. c. pancreatic duct. d. common hepatic duct.

ANS: A The valves of Heister are tiny valves located within the cystic duct of the gallbladder.

PTS: 1 REF: p. 255 OBJ: Differentiate the sectional anatomy of the hepatobiliary system and adjacent structures.

TOP: Sonographic evaluation of the biliary system 26. All of the following sonographic appearances are found in cases of gallbladder carcinoma except: a. pericholecystic fluid. b. wall thickening. c. cholelithiasis. d. intraluminal wall mass.NURSINGTB.COM ANS: A Sonographic findings in cases of gallbladder carcinoma generally demonstrate a thickening of the gallbladder wall with a globe-shaped heterogeneous mass projecting into the lumen of the gallbladder. Between 80% and 90% of patients have associated gallstones.

PTS: 1 REF: p. 267 | p. 271 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the gallbladder and biliary system 27. The physiologic effect of a fatty meal includes all of the following except: a. stimulation of cholecystokinin (CCK). b. contraction of the gallbladder. c. decreased bile flow to the liver. d. relaxation of the sphincter of Oddi.

ANS: C After a fatty meal, CCK stimulation causes the contraction of the gallbladder; the sphincter of Oddi relaxes with the outpouring of bile into the duodenum, increasing bile flow from the liver..

PTS:

1

REF: p. 250

OBJ: Explain the function of the gallbladder.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Sonographic evaluation of the biliary system 28. Patients positive for AIDS are at risk for developing: a. hepatitis. b. cholangitis. c. pancreatitis. d. nephritis.

ANS: B AIDS patients are at risk for developing cholangitis.

PTS: 1 REF: p. 278 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the biliary tree 29. Air within the biliary tree, secondary to common bile duct stents, is called: a. pneumobilia. b. hemobilia. c. pneumothorax. d. cholangitis.

ANS: A Pneumobilia is air within the biliary tree, secondary to biliary intervention, biliary-enteric anastamoses, or common bile duct stents.

PTS: 1 REF: p. 278 NURSINappearances GTB.COMof the gallbladder and biliary system OBJ: Differentiate the sonographic pathologic features discussed in this chapter.

TOP: Pathology of the biliary tree 30. The most common tumor sites that can spread carcinoma to the biliary tree include all of the following except: a. colon. b. breast. c. melanoma. d. kidney.

ANS: D Metastatic carcinoma in the gallbladder occurs secondary to melanoma, colon, or breast carcinoma.

PTS: 1 REF: p. 281 OBJ: Differentiate the sonographic appearances of the gallbladder and biliary system pathologic features discussed in this chapter.

TOP: Pathology of the biliary tree

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 11: Spleen Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following statements about the spleen is false? a. The spleen lies inferior to the diaphragm. b. The normal adult spleen measures approximately 7 cm in width. c. The spleen is located within the retroperitoneum. d. The spleen lies posterior to the hypochondrium.

ANS: C The spleen is an intraperitoneal structure covered with peritoneum except at the hilum.

PTS: 1 REF: p. 284 | p. 285 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Anatomy of the spleen 2. Lymph nodes emerge from the splenic hilum and course along the: a. renal vein. b. splenic artery. c. renal artery. d. splenic vein.

ANS: B Lymph nodes emerge from the splenic hilum, course along the splenic artery, and drain into NURSINGTB.COM the celiac nodes.

PTS: 1 REF: p. 286 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Anatomy of the spleen 3. Splenomegaly may result from all of the following except: a. trauma. b. congestion. c. subphrenic abscess. d. collagen vascular disease.

ANS: C A left subphrenic abscess could displace the spleen but would not enlarge it. Causes for splenomegaly include collagen vascular disease, hematopoiesis, hemolytic anemia, infection, neoplasm, storage disease, and trauma.

PTS: 1 REF: p. 294 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the spleen 4. An abnormal decrease in platelets may be the result of a(n): a. infection.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. bone marrow disorder. c. internal hemorrhage. d. allergic reaction.

ANS: C Thrombocytopenia is an abnormal decrease in platelets, which may be the result of internal bleeding.

PTS: 1 REF: p. 289 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Physiology and laboratory data of the spleen 5. The normal sonographic appearance of the splenic parenchyma is: a. homogeneous and similar to the liver. b. heterogeneous. c. hyperechoic compared with the liver. d. hypoechoic compared with the kidney.

ANS: A The sonographic appearance of the splenic parenchyma should demonstrate a fine, homogeneous, low-level echo pattern similar to that of the normal liver.

PTS: 1 REF: p. 290 OBJ: Describe the normal sonographic pattern of the spleen.

TOP: Sonographic evaluation of the spleen

N R I G B.C M

U anemia, S N Tthe spleen O generally appears: 6. In the early stages of sickle cell a. atrophied. b. heterogeneous. c. enlarged. d. hyperechoic.

ANS: C In the early stages of sickle cell anemia, the spleen generally appears enlarged with significant congestion of the red pulp. Later, the spleen undergoes progressive infarction and fibrosis, which causes it to decrease in size.

PTS: 1 REF: p. 295 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the spleen 7. Which one of the following statements describes the correct anatomic location of structures adjacent to the spleen? a. The diaphragm is anterior, lateral, and inferior to the spleen. b. The fundus of the stomach and lesser sac are medial and posterior to the splenic hilum. c. The left kidney lies inferior and medial to the spleen. d. The right adrenal and kidney lie superior to the spleen.

ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The medial surface of the spleen is related to the left kidney, tail of the pancreas, stomach, and splenic flexure. The left kidney is also inferior to the spleen.

PTS: 1 REF: p. 285 |p. 287 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Anatomy of the spleen 8. All of the following are functions of the spleen except: a. production of plasma cells. b. production of lymphocytes. c. destruction of red blood cells. d. destruction of white blood cells.

ANS: C Production of lymphocytes and plasma cells, destruction of white blood cells, and disposal of abnormal erythrocytes are functions of the spleen.

PTS: 1 REF: p. 289 OBJ: Discuss the size and primary functions of the spleen.

TOP: Physiology and laboratory data of the spleen 9. Splenic infarction is most commonly the result of: a. cardiac emboli. b. splenomegaly. c. splenic trauma. d. pneumonia.

N R I G B.C M

U S N T O ANS: A A splenic infarction results from the occlusion of the major splenic artery or its branches. It is almost always the result of emboli that arise in the heart.

PTS: 1 REF: p. 299 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the spleen 10. The spleen is variable in size and is considered to be all of the following except: a. tetrahedral. b. pentagonal. c. triangular. d. orange segment.

ANS: B The spleen is of variable size and shape (e.g., orange segment, tetrahedral, triangular) but is generally considered to be ovoid with smooth, even borders and a convex superior and concave inferior surface.

PTS: 1 REF: p. 285 OBJ: Discuss the size and primary functions of the spleen.

TOP: Anatomy of the spleen

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 11. When accessory spleens are present, they are usually located: a. at the inferior margin of the spleen. b. on the posterior aspect of the spleen. c. near the hilum of the spleen. d. near the kidney.

ANS: C The most common location of an accessory spleen is in the splenic hilum along the splenic vessels and ligaments. The location of an accessory spleen has been reported anywhere from the diaphragm and scrotum.

PTS: 1 REF: p. 287 | p. 288 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Anatomy of the spleen 12. The splenic vein courses along the posterior border of the: a. spleen. b. kidney. c. pancreas. d. adrenal gland.

ANS: C The splenic vein travels along the posterior border of the pancreatic body and tail.

PTS: 1 REF: p. 286 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Anatomy of the spleen

NURSINGTB.COM

13. The spleen has two components joined at the hilum; they are the ______________ and ______________ components. a. anterior; posterior b. superomedial; inferolateral c. superior; inferior d. superolateral; inferomedial ANS: B The spleen has two components joined at the hilum: they are the superomedial and inferolateral components.

PTS: 1 REF: p. 290 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Physiology and laboratory data of the spleen 14. Which one of the following may cause a splenic rupture? a. Complicated cyst b. Infarction c. Metastatic tumor d. Hemangioma ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Complications of a hemangioma may include splenic rupture when the tumor increases in size.

PTS: 1 REF: p. 302 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the spleen 15. Primary tumors that may metastasize to the spleen originate from all of the following structures except the: a. kidney. b. ovary. c. stomach. d. brain.

ANS: D Primary tumors that may metastasize to the spleen originate from the breast, lung, ovary, stomach, colon, kidney, prostate, and melanoma.

PTS: 1 REF: p. 303 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Pathology of the spleen 16. The best patient position to evaluate the spleen is: a. supine. b. left lateral decubitus. c. left posterior oblique. d. right decubitus.

NURSINGTB.COM ANS: D To evaluate the spleen, the patient should be rotated into a steep right decubitus position to permit better transducer contact between the ribs without as much bowel interference.

PTS: 1 REF: p. 291 OBJ: Describe the normal sonographic pattern of the spleen.

TOP: Sonographic evaluation of the spleen 17. Other areas that should be examined when ruling out a splenic rupture include all of the following except the: a. liver and lesser sac. b. pericardium. c. pelvis. d. renal gutter.

ANS: B The pericardium is located in the pleural cavity. The liver, lesser sac, pelvis, and renal gutter are potential spaces for fluid collection.

PTS: 1 REF: p. 300 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Scanning techniques

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

18. What sonographic signs are present in the patient with histoplasmosis? a. Atrophy b. Cystic masses c. Adenomas d. Bright echoes ANS: D Histoplasmosis and tuberculosis are the most common causes of granulocytopoiesis. The sonographic appearance of granulomatosis disease includes bright echogenic lesions with or without shadowing in the splenic parenchyma.

PTS: 1 REF: p. 296 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Pathology of the spleen 19. Which one of the following is the most common clinical presentation in patients with a splenic hamartoma? a. Asymptomatic b. Epigastric pain c. Abdominal pain d. Right upper quadrant pain.

ANS: A Patients demonstrating a splenic hamartoma are generally asymptomatic.

PTS: 1 REF: p. 302 NURS INGTand B.C OM OBJ: Explain the sonographic findings differential diagnoses for the pathologies discussed in this chapter.

TOP: Pathology of the spleen 20. A spleen that has migrated from its normal location is termed a(n): a. accessory spleen. b. wandering spleen. c. ectopic spleen. d. splenomegaly.

ANS: B A “wandering” spleen has migrated from its normal position in the left upper quadrant.

PTS: 1 REF: p. 292 OBJ: List the normal anatomy and relational landmarks of the spleen.

TOP: Anatomy of the spleen 21. The major function of the spleen is: a. hematopoiesis. b. to fight infection. c. to manufacture leukocytes. d. to filter the peripheral blood.

ANS: D The major function of the spleen is to filter the peripheral blood.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 288 OBJ: Discuss the size and primary functions of the spleen.

TOP: Physiology and laboratory data of the spleen 22. In the adult, splenomegaly is diagnosed when the length of the spleen exceeds _____ centimeters (cm). a. 11 b. 12 c. 13 d. 14 ANS: C In the adult, splenomegaly is diagnosed when the length of the spleen exceeds 13 cm.

PTS: 1 REF: p. 290 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the spleen 23. Atrophy of the spleen may be found in all of the following except: a. normal individuals. b. wasting diseases. c. sickle cell anemia. d. cirrhosis.

ANS: D Atrophy of the spleen may occur in normal individuals, wasting diseases, sickle cell anemia, NURSINGTB.COM and chronic hemolytic anemia.

PTS: 1 REF: p. 292 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the spleen 24. A chronic disease of unknown causes that involves all bone marrow elements is: a. thalassemia. b. polycythemia vera. c. leukemia. d. Hodgkin disease.

ANS: B Polycythemia vera is a chronic disease of unknown causes that involves all bone marrow elements. It is characterized by an increase in red blood cell mass and hemoglobin concentration. Infarcts and thromboses are common.

PTS: 1 REF: p. 296 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Pathology of the spleen 25. Massive splenomegaly is most likely the result of: a. infection.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. leukemia. c. myelofibrosis. d. portal hypertension.

ANS: C Massive enlargement of the spleen is most likely a result of myelofibrosis.

PTS: 1 REF: p. 294 OBJ: Explain the sonographic findings and differential diagnoses for the pathologies discussed in this chapter.

TOP: Table 11-4

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 12: Pancreas Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The majority of the pancreas lies within which abdominal cavity? a. Perineum b. Intraperitoneum c. Retroperitoneum d. Pericardium ANS: C The pancreas is located in the retroperitoneal cavity.

PTS: 1 REF: p. 306 | p. 334 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 2. The pancreas is found behind the ___________ omental sac. a. greater b. inferior c. superior d. lesser ANS: D The pancreas lies behind (posterior to) the lesser omental sac.

NURSINGTB.COM

PTS: 1 REF: p. 334 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 3. Which one of the following statements is false? a. The head of the pancreas is anterior to the inferior vena cava (IVC). b. The head of the pancreas is superior to the caudate lobe. c. The uncinate process is posterior to the superior mesenteric vein. d. The gastroduodenal artery is the anterolateral border of the head.

ANS: B The head of the pancreas lies inferior to the caudate lobe of the liver and the main portal vein.

PTS: 1 REF: p. 306 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 4. The head of the pancreas lies: a. anterior to the liver. b. posterior to the aorta. c. medial to the duodenum.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. lateral to the inferior vena cava.

ANS: C The head of the pancreas lies medial to the duodenum (in the C-loop of the duodenum).

PTS: 1 REF: p. 306 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 5. The head of the pancreas is inferior to the _____________ of the liver. a. right lobe b. caudate lobe c. right lateral fissure d. left lateral fissure ANS: B The head of the pancreas is inferior to the caudate lobe of the liver and the main portal vein.

PTS: 1 REF: p. 306 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 6. The ___________ passes through a groove posterior to the pancreatic head. a. common bile duct b. gastroduodenal artery c. hepatic duct d. superior mesenteric vein

NURSINGTB.COM

ANS: A The common bile duct passes through the first part of the duodenum and courses through the groove posterior to the pancreatic head.

PTS: 1 REF: p. 306 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 7. Which one of the following structures is located in the anterolateral border of the pancreas? a. Common bile duct b. Gastroduodenal artery c. Hepatic duct d. Superior mesenteric vein ANS: B The gastroduodenal artery is located along the anterolateral border of the pancreas as it travels a short distance along the anterior aspect of the pancreatic head just to the right of the neck before it divides into the superior pancreaticoduodenal artery branches.

PTS: 1 REF: p. 308 | p. 310 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. The tail of the pancreas is located: a. posterior to the left kidney, near the splenic hilum. b. anterior to the left kidney, near the splenic hilum. c. posterior to the right kidney, near the liver hilum. d. anterior to the right kidney, near the liver hilum.

ANS: B The tail of the pancreas lies anterior to the left kidney and posterior to the left colic flexure and transverse colon, near the splenic hilum.

PTS: 1 REF: p. 308 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 9. The primary pancreatic duct is the duct of ______________. a. Santorini b. Ampulla c. Vater d. Wirsung ANS: D The duct of Wirsung is a primary duct of the pancreas. It extends the entire length of the gland.

PTS: 1 REF: p. 308 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas

NURSINGTB.COM

10. An older man with a history of alcoholism is recently diagnosed with acute pancreatitis. His hematocrit and hypotension levels are decreased. Your differential diagnosis should include: a. hemorrhagic pancreatitis. b. cholecystitis. c. pseudocyst. d. chronic pancreatitis.

ANS: A Hemorrhagic pancreatitis may demonstrate symptoms that include a decrease in hematocrit and serum calcium levels, severe (intense) abdominal pain radiating to the back, and hypotension. Nearly one half of these patients have sudden necrotizing destruction of the pancreas after an alcohol binge or an excessively large meal.

PTS: 1 REF: p. 325 | p. 328 OBJ: Describe the laboratory tests used to detect pancreatic disease.

TOP: Pathology of the pancreas 11. Which one of the following veins courses in a sagittal plane and passes posterior to the neck of the pancreas? a. Splenic b. Superior mesenteric c. Inferior mesenteric

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Main portal ANS: B The superior mesenteric vein passes anterior to the third part of the duodenum and posterior to the neck of the pancreas.

PTS: 1 REF: pp. 308-310 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 12. A patient with painless jaundice, weight loss, and a decrease in appetite should be evaluated for: a. cholecystitis. b. adenocarcinoma of the pancreas. c. pancreatitis. d. pancreatic pseudocyst.

ANS: B Clinical findings of adenocarcinoma of the pancreas include weight loss, decreased appetite, nausea and vomiting, stool changes, pain radiating to the back, painless jaundice, and metastases.

PTS: 1 REF: pp. 329-332 OBJ: Define the clinical signs and symptoms of pancreatic disease.

TOP: Pathology of the pancreas 13. The duct of Santorini is a(n): NURgallbladder.

SINGTB.COM a. small accessory duct to the b. accessory duct to the cystic duct. c. accessory duct to the pancreas. d. small opening in the duodenum.

ANS: C The duct of Santorini is a secondary duct that drains the uppermost anterior pancreatic head.

PTS: 1 REF: p. 310 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 14. The normal dimension of the pancreatic head is usually less than ___________. a. 3 mm b. 2-3 cm c. 2 cm d. 1 cm ANS: B The head of the pancreas is the thickest part of the gland, measuring 2 to 3 cm.

PTS: 1 REF: p. 315 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

15. The normal size of the pancreatic duct at the pancreatic head is less than _____ mm. a. 1 b. 3 c. 5 d. 6 ANS: B The duct should measure less than 2 to 3 mm with tapering as it reaches the tail.

PTS: 1 REF: p. 310 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 16. A serum ____________ level of twice normal usually indicates acute pancreatitis. a. lipase b. amylase c. alkaline phosphatase d. aspartate aminotransferase (AST) ANS: B A serum amylase level of twice normal usually indicates acute pancreatitis. Lipase levels also increase with acute pancreatitis.

PTS: 1 REF: p. 313 OBJ: Describe the laboratory tests used to detect pancreatic disease.

TOP: Table 12-5

NURSINGTB.COM

17. What are the microscopic collections of cells within the tissues of the pancreas called: a. Glucagon cells b. Islets of Langerhans c. Insulin d. Amylase cells ANS: B Islets of Langerhans are specialized cells that produce insulin (alpha cells), glycogen (beta cells), and somatostatin (smallest delta cells).

PTS: 1 REF: p. 313 OBJ: Name the exocrine and endocrine functions of the pancreas.

TOP: Anatomy of the pancreas 18. The splenic vein courses along the ____________________ of the pancreas. a. anterior border b. superior border c. posteromedial border d. inferior posterior border ANS: C The splenic vein courses across the posteromedial surface of the pancreas to join the main portal vein.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 309 | p. 319 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 19. If the celiac axis is well visualized, the sonographer should move the transducer in the __________ direction to image the pancreas. a. superior b. anterior c. inferior d. posterior ANS: C The celiac axis serves as the superior border of the pancreas; therefore, the sonographer should move inferiorly to image the pancreas.

PTS: 1 REF: p. 310 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Sonographic evaluation of the pancreas 20. The splenic artery is considered to be along the _________________ border of the pancreas. a. superior b. lateral c. posterior d. inferior ANS: A NURSINcourse GTB.C OMthe superior border of the pancreas.

The splenic artery follows a tortuous along PTS: 1 REF: p. 309 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Sonographic evaluation of the pancreas 21. The main pancreatic duct joins the __________ before entering the second part of the duodenum. a. common bile duct b. duct of Santolina c. cystic duct d. accessory duct ANS: A The duct of Wirsung enters the medial aspect of the second part of the duodenum with the common bile duct at the ampulla of Vater.

PTS: 1 REF: p. 310 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 22. Clinical signs and symptoms in acute pancreatitis include all of the following except: a. severe abdominal pain radiating to the back.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. severe abdominal pain radiating to the right shoulder. c. elevated amylase. d. nausea and vomiting.

ANS: B Clinical signs and symptoms of acute pancreatitis include sudden onset of moderate-to-severe abdominal pain radiating to the back, nausea and vomiting, history of gallstones or alcoholism, mild fever, increase in pancreatic enzymes (amylase and lipase), leukocytes, and abdominal bloating.

PTS: 1 REF: p. 328 OBJ: Define the clinical signs and symptoms of pancreatic disease.

TOP: Table 12.5 23. A most common cause of acute pancreatitis in the United States is: a. colitis. b. alcohol intake. c. biliary tract disease. d. pancreatic malignancy.

ANS: C The most common cause of acute pancreatitis is gallstone(s) and biliary tract disease.

Alcohol abuse is the second most common cause.

PTS: 1 REF: pp. 320-321 OBJ: Define the clinical signs and symptoms of pancreatic disease.

TOP: Physiology and laboratory data of the pancreas

NURSINGTB.COM

24. The exocrine function of the pancreas is performed by the: a. islets of Langerhans. b. Cooper ligaments. c. acini cells. d. fat between the lobules.

ANS: C The acini cells of the pancreas can produce up to 2 L of pancreatic juice per day, which is considered an exocrine function.

PTS: 1 REF: p. 312 OBJ: Name the exocrine and endocrine functions of the pancreas.

TOP: Physiology and laboratory data of the pancreas 25. What vessel runs posterior to the neck of the pancreas and anterior to the uncinate process? a. Splenic vein b. Superior mesenteric vein c. Gastroduodenal artery d. Hepatic artery ANS: B The superior mesenteric vein crosses anterior to the uncinate process and posterior to the neck and body of the pancreas.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 308 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Anatomy of the pancreas 26. The persistence of the dorsal and ventral pancreas with the head encircling the duodenum is called: a. hypoplasia. b. cystic fibrosis. c. agenesis. d. annular pancreas.

ANS: D Annular pancreas is a rare anomaly in which the head of the pancreas surrounds the second part of the duodenum. This condition is more common in men and may be associated with a complete or partial atresia of the duodenum.

PTS: 1 REF: p. 311 OBJ: Name the congenital anomalies of the pancreas.

TOP: Anatomy of the pancreas 27. A condition that causes increased secretion of thick mucus by the exocrine glands is: a. cystic fibrosis. b. fibrocystic disease of the pancreas. c. diabetes. d. cystic mucosal disease.

N R I G B.C M

U S N T O ANS: A Cystic fibrosis is a hereditary disease that causes excessive production of thick mucus by the endocrine glands.

PTS: 1 REF: p. 328 OBJ: Define the clinical signs and symptoms of pancreatic disease.

TOP: Physiology and laboratory data of the pancreas 28. Gallstones are present in 40% to 60% of patients with: a. chronic pancreatitis. b. annular pancreas. c. cystic fibrosis. d. acute pancreatitis.

ANS: D Gallstones are present in 40% to 60% of patients with acute pancreatitis. Of the patients with gallstones, 5% develop acute pancreatitis.

PTS: 1 REF: p. 321 OBJ: List the sonographic findings and differential diagnoses of the following diseases: pancreatitis, pancreatic cyst, and pancreatic tumors.

TOP: Physiology and laboratory data of the pancreas

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 29. A common course of enzyme destruction via the pancreas is fluid accumulation in the: a. greater omentum. b. lesser omentum. c. lesser sac. d. greater sac.

ANS: C The common course is for fluid to break through the pancreatic connective tissue layer and the thin posterior layer of the peritoneum and enter the lesser sac.

PTS: 1 REF: p. 321 OBJ: Describe the normal anatomy and relational landmarks of the pancreas.

TOP: Sonographic evaluation of the pancreas 30. In cases of acute pancreatitis, the parenchyma of the pancreas generally appears: a. homogeneous. b. echogenic. c. calcified. d. hypoechoic.

ANS: D Early stages of acute pancreatitis may appear sonographically normal. When swelling of the pancreas occurs, the pancreas is hypoechoic to anechoic and is less echogenic because of the increased prominence of lobulation and congested vessels.

PTS: 1 REF: p. 321 OBJ: List the sonographic findings and differential diagnoses of the following diseases: N and RSpancreatic INGTB.C OM pancreatitis, pancreatic cyst, U tumors.

TOP: Pathology of the pancreas

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 13: Gastrointestinal Tract Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The mesentery projects from the parietal peritoneum attaching to the: a. large intestine. b. duodenum. c. stomach. d. small intestine.

ANS: D

The coiled small intestine attaches to the peritoneum via a projection of the mesentery.

PTS: 1 REF: p. 338 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Anatomy of the gastrointestinal tract 2. Which one of the following structures is often visualized on a sagittal ultrasound as a

“bull’s-eye” or target pattern anterior to the aorta and posterior to the left lobe of the liver? a. Pancreatic duct b. Common bile duct c. Ligamentum teres d. Gastroesophageal junction ANS: D

The gastroesophageal junction sagittal NUisRseen INonGthe B.C Mscan to the left of the midline as a S T O “bull’s-eye” or target pattern anterior to the aorta, posterior to the left lobe of the liver, and inferior to the hemidiaphragm.

PTS: 1 REF: p. 342 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Sonographic evaluation of the gastrointestinal tract 3. Which one of the following statements about gastric carcinoma is false? a. Gastric carcinoma is the fourth leading cause of death. b. Of the malignant tumors of the stomach, 90% are carcinomas. c. One half of these malignant tumors occur in the pylorus. d. One fourth of these malignant tumors occur in the body and fundus.

ANS: A

Gastric carcinoma is the sixth leading cause of death. Of the malignant tumors of the stomach, 90% are carcinomas. One half of these malignant tumors occur in the pylorus, and one fourth of these develop in the body or fundus of the stomach.

PTS: 1 REF: p. 347 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 4. All of the following are sonographic characteristics of lymphoma of the stomach except: a. relatively large and hypoechoic appearance.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. significant thickening of the gastric walls. c. relatively large and poorly echogenic appearance. d. spoke-wheel pattern.

ANS: C

Lymphoma of the stomach occurs in 3% of all stomach tumors. Sonographic findings include a large hypoechoic echogenic mass, thickening of the gastric walls, and spoke-wheel pattern within the mass.

PTS: 1 REF: p. 347 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Figure 13-22A and B 5. Small bowel obstruction is associated with: a. dilation of the bowel loops distal to the site of the obstruction. b. dilation of the bowel loops proximal to the site of the obstruction. c. collapsed bowel loops proximal to the site of the obstruction. d. polypoid masses throughout the obstruction.

ANS: B

A small bowel obstruction is associated with dilation of the bowel loops distal to the site of the obstruction.

PTS: 1 REF: p. 348 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Key Pearls 6. Acute appendicitis may be seen on a transverse sonogram as a ___________ mass.

NURSINGTB.COM a. hypoechoic b. hyperechoic c. target-shaped d. anechoic ANS: C

The target-shaped lesion consists of a hypoechoic fluid-distended lumen, a hyperechoic inner ring representing mainly the mucosa and submucosa, and an outer hypoechoic ring representing the muscularis externa.

PTS: 1 REF: p. 350 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 7. The ___________ has a target shape and is located in the midline anterior to the pancreas

body. a. fundus b. body c. gastric antrum d. pyloric canal ANS: C

The antrum of the stomach is located anterior to the pancreas body and has a target shape.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 342 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Sonographic evaluation of the gastrointestinal tract 8. Sonographic findings of Crohn disease may include all the following except: a. symmetrically swollen bowel pattern. b. uniformly increased wall thickness. c. matted-loop pattern. d. calcification.

ANS: D

The sonographic findings in Crohn disease include a symmetric swollen bowel target pattern and increased wall thickness involving all layers. A matted loop pattern is found in the late stages.

PTS: 1 REF: p. 353 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 9. The “keyboard” sign is seen in the: a. colon. b. duodenum. c. appendix. d. stomach.

ANS: B

The “keyboard” sign is seen in the duodenum and jejunum. It represents the valvulae conniventes.

N R I G B.C M

U S N T

O

PTS: 1 REF: p. 344 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Sonographic evaluation of the gastrointestinal tract 10. The appendix is located at: a. iliac crest. b. Mubarney’s point. c. McBurney’s sign. d. McBurney’s point.

ANS: D

The appendix is located at the McBurney’s point. The McBurney’s point is located approximately at the midpoint between the right anterosuperior iliac spine and the umbilicus.

The McBurney’s sign is localized pain over the McBurney’s point.

PTS: 1 REF: p. 344 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Sonographic evaluation of the gastrointestinal tract 11. Which one of the following is an embryologic mistake? a. Duplication cyst b. Gastric bezoar c. Polyp

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Leiomyoma ANS: A

A duplication cyst is an embryologic mistake usually found on the greater curvature of the stomach. It occurs more often in female infants.

PTS: 1 REF: p. 345 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Pathology of the gastrointestinal tract 12. Metastatic disease to the stomach may be secondary to all of the following except: a. breast. b. lung. c. prostate. d. melanoma.

ANS: C

Metastatic disease to the stomach is rare; it may be secondary to breast, lung, or melanoma.

PTS: 1 REF: p. 348 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 13. The maximum outer diameter of the normal appendix can measure up to _____ millimeters

(mm). a. 3 b. 4 c. 5 d. 6

NURSINGTB.COM

ANS: D

The maximum outer diameter of the normal appendix can measure up to 6 mm.

PTS: 1 REF: p. 350 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Pathology of the gastrointestinal tract 14. A diverticulum is most common in the: a. stomach. b. small intestines. c. colon. d. ileum.

ANS: C

A diverticulum is a pouchlike herniation through the muscular wall of a tubular organ that occurs in the stomach, in the small intestines, and, most commonly, in the colon.

PTS: 1 REF: p. 352 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 15. Which one of the following statements about Crohn disease is false? a. Crohn disease is regional enteritis.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. The reaction involves only the mesothelium of the bowel wall. c. Clinical symptoms include diarrhea, fever, and right lower quadrant pain. d. Crohn disease affects the terminal ileum or the colon or both.

ANS: B

The reaction involves the entire thickness of the bowel wall.

PTS: 1 REF: p. 353 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 16. The most common tumor of the gastrointestinal tract in children under 10 years of age is: a. lymphoma. b. polyp. c. leiomyoma. d. fecalith.

ANS: A

Lymphoma is the most common tumor of the gastrointestinal tract in children under 10 years of age.

PTS: 1 REF: p. 354 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 17. The colon is divided into segments called: a. villi. b. valvulae conniventes.

NURSINGTB.COM c. haustra. d. rugae.

ANS: C

The colon is divided into segments called haustra.

PTS: 1 REF: p. 338 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Anatomy of the gastrointestinal tract 18. The celiac axis, superior mesenteric artery, and __________ artery supply both the small and

large intestines. a. lumbar b. inferior mesenteric c. splenic d. renal ANS: B

The celiac axis, superior mesenteric artery, and inferior mesenteric artery supply both the small and large intestines. The splenic artery is a branch of the celiac axis.

PTS: 1 REF: p. 339 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Anatomy of the gastrointestinal tract

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 19. Which one of the following divisions of the duodenum courses to the level of the gallbladder

neck? a. First part b. Second part c. Third part d. Fourth part ANS: A

The first part or superior portion of the duodenum begins at the pylorus and terminates at the neck of the gallbladder.

PTS: 1 REF: p. 338 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Anatomy of the gastrointestinal tract 20. The entrance of the esophagus into the stomach is through the ___________ orifice. a. esophageal b. diaphragmatic c. thoracic d. cardiac ANS: D

The entrance of the esophagus into the stomach is through the cardiac orifice.

PTS: 1 REF: p. 337 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Anatomy of the gastrointestinal tract

N R I G B.C M

U S isNsupported T Oby all of the following ligaments except the: 21. The greater curvature of the stomach a. greater omentum. b. gastrohepatic ligament. c. gastrophrenic ligament. d. gastrosplenic ligament.

ANS: B

The greater curvature of the stomach is supported by the greater omentum and the gastrosplenic, gastrophrenic, and lienorenal ligaments. The gastrohepatic ligament supports the lesser curvature of the stomach.

PTS: 1 REF: p. 337 OBJ: Describe the anatomy and relational landmarks of the gastrointestinal system.

TOP: Anatomy of the gastrointestinal tract 22. The progression of acute appendicitis to frank perforation is more rapid in: a. preschool children. b. elementary school children. c. adults. d. senior citizens.

ANS: A

The rate of perforation in preschool children can be as high as 70%, compared with 30% for elementary school children and 21% to 22% for adults.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 349 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 23. Symptoms of appendiceal mucoceles may include all of the following except: a. asymptomatic. b. urinary symptoms. c. bloating. d. sepsis.

ANS: C

Symptoms of appendiceal mucoceles may include right iliac fossa mass, sepsis, and urinary symptoms; 25% are asymptomatic. Bloating is specific to patients with pseudomyxoma peritonei.

PTS: 1 REF: p. 352 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 24. Gastrointestinal leiomyosarcomas most commonly occur in the: a. duodenum. b. jejunum. c. ileum. d. ascending colon.

ANS: C

Approximately 35% to 55% of these tumors are found in the ileum; 30% to 45% are found in NURfound B.C SINGinTthe OM the jejunum, and 10% to 30% are duodenum.

PTS: 1 REF: p. 355 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract 25. The pseudokidney sign may be seen in: a. chronic appendicitis. b. Meckel diverticulum. c. gastric bezoar. d. gastric carcinoma.

ANS: D

In gastric carcinoma, the sonographer should look for the target or pseudokidney sign.

PTS: 1 REF: pp. 346-347 OBJ: Differentiate the sonographic appearances of the pathologic features covered in this chapter.

TOP: Pathology of the gastrointestinal tract

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 14: Peritoneal Cavity and Abdominal Wall Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Collections in the right posterior subphrenic space cannot extend between the bare area of the

liver and the: a. right kidney. b. diaphragm. c. right pleural space. d. coronary ligament.

ANS: B

Collections in the right posterior subphrenic space cannot extend between the bare area of the liver and the diaphragm because of the coronary ligament.

PTS: 1 REF: p. 374 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 2. Anterior displacement of the kidney and ureter suggests a mass in the: a. intraperitoneum. b. subcapsular space. c. retroperitoneum. d. interperitoneum.

ANS: C

NURSINGTB.COM

A mass is confirmed to be in the retroperitoneum with the anterior displacement of the kidneys and ureters.

PTS: 1 REF: p. 369 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 3. Which one of the following structures is found on the right side of the liver to form the

subphrenic and subhepatic spaces? a. Tendons b. Fibers c. Falciform ligament d. Peritoneal ligaments ANS: D

The peritoneal cavity is made up of multiple peritoneal ligaments and folds that connect the viscera to each other and to the abdominopelvic cavity.

PTS: 1 REF: p. 357 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. The left lateral extension of the greater omentum that connects the gastric greater curvature to

the superior splenic hilum is called the ______________ ligament. a. splenorenal b. gastrosplenic c. falciform d. gastrorenal ANS: B

The gastrosplenic ligament is the left lateral extension of the greater omentum that connects the gastric greater curvature to the superior splenic hilum and forms a portion of the left lateral border of the lesser sac.

PTS: 1 REF: p. 360 OBJ: List the peritoneal and retroperitoneal organs.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 5. Which one of the following ligaments forms the posterior portion of the left lateral border of

the lesser sac and separates the lesser sac from the renosplenic recess? a. Gastrosplenic b. Falciform c. Splenorenal d. Costophrenic ANS: C

The splenorenal ligament forms the posterior portion of the left lateral border of the lesser sac and separates the lesser sac from the renosplenic recess.

PTS: 1 REF: pp. 360-361 OBJ: List the peritoneal and retroperitoneal organs.

TOP: Anatomy and sonographic the peritoneal N evaluation R I Gof B.C M cavity and abdominal wall

U S N T

O

6. The lesser sac is located: a. superior to the pancreas. b. anterior to the stomach. c. superior to the stomach. d. anterior to the pancreas.

ANS: D

The lesser sac lies anterior to the pancreas and posterior to the stomach.

PTS: 1 REF: p. 358 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 7. Inflammatory or malignant ascites demonstrate all of the following characteristics except: a. anechoic patterns with smooth borders. b. matting of bowel loops. c. fine or coarse internal echoes. d. loculations.

ANS: A

Inflammatory or malignant ascites is demonstrated as coarse internal echoes, irregular walls, loculations, and matting or clumping of the bowel.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 365 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Pathology of the peritoneal cavity 8. What lesion may mimic a gas-containing abscess? a. Fibroid b. Teratoma c. Lipoma d. Hemangioma ANS: B

A teratoma may mimic the pattern of a gas-containing abscess, but clinical history and radiograph examinations exclude this tumor from the diagnosis.

PTS: 1 REF: p. 365 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the peritoneal cavity 9. Differential diagnosis of a lesser-sac abscess should include all of the following except a: a. pseudocyst. b. gastric outlet obstruction. c. fluid-filled stomach. d. pancreatic carcinoma.

ANS: D

Differential diagnosis of a lesser sac abscess should include a pseudocyst, pancreatic abscess, gastric outlet obstruction, and fluid-filled stomach.

N R I G B.C M

U S N T O PTS: 1 REF: p. 366 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the peritoneal cavity 10. The most common primary lesions to develop peritoneal metastasis originate in the: a. kidneys, testicles, and uterus. b. stomach, pancreas, and colon. c. ovaries, stomach, and colon. d. pancreas, biliary tract, and kidneys.

ANS: C

Peritoneal metastases develop from cellular implantation across the peritoneal cavity. The most common primary sites are the ovaries, stomach, and colon. Other less common sites are the pancreas, biliary tract, kidneys, testicles, and uterus.

PTS: 1 REF: p. 369 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the mesentery, omentum, and peritoneum 11. The most common site(s) for abdominal abscess formation is(are) the: a. appendix. b. retrovesical space. c. hepatic recesses and perihepatic spaces. d. portal vein.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C

The hepatic recesses and perihepatic spaces are the most common sites for abscess formation.

PTS: 1 REF: p. 368 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Pathology of the peritoneal cavity 12. Generalized ascites, inflammatory fluid from acute abdominal processes can be found in

which area? a. Lesser sac b. Hepatorenal recess c. Greater sac d. Retroperitioneal ANS: B

Generalized ascites, inflammatory fluid from acute cholecystitis, fluid resulting from pancreatic autolysis, or blood from a ruptured hepatic neoplasm or ectopic gestation may contribute to the formation of hepatorenal fluid collections.

PTS: 1 REF: pp. 364-365 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the peritoneal cavity 13. An extrahepatic loculated fluid collection that may develop because of a spontaneous rupture

of the biliary tree is called: a. biloma. b. bilitis. c. cholangitis. d. choledochitis.

NURSINGTB.COM

ANS: A

Bilomas are extrahepatic loculated collections of bile that may develop because of iatrogenic, traumatic, or spontaneous rupture of the biliary tree.

PTS: 1 REF: p. 367 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the peritoneal cavity 14. A cystic mass between the umbilicus and the bladder is called a: a. seroma. b. urachal cyst. c. uroma. d. urinoma.

ANS: B

A urachal cyst appears as a cystic mass between the umbilicus and bladder. It may be small or large, multiseptated, and even external to the upper abdomen.

PTS: 1 REF: p. 369 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the mesentery, omentum, and peritoneum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 15. Which one of the following lies freely over the intestines similar to an apron? a. Mesentery b. Peritoneum c. Greater omentum d. Lesser omentum ANS: C

The greater omentum is an apronlike fold of peritoneum that hangs from the greater curvature of the stomach.

PTS: 1 REF: p. 359 OBJ: List the peritoneal and retroperitoneal organs.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 16. Fluid collects in the most ________ areas of the abdomen and pelvis. a. lateral b. posterior c. inferior d. dependent ANS: D

Fluid collection sites depend on the patient’s position. Fluid collects in the dependent (lowest) areas of the abdomen and pelvis.

PTS: 1 REF: p. 359 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Pathology of the peritoneal cavity 17. A double layer of peritoneum, the liver N extending R I Gfrom B.C M to the lesser curvature of the stomach,

is called the: a. greater omentum. b. mesentery. c. lesser omentum. d. peritoneum.

U S N T

O

ANS: C

A double layer of peritoneum, extending from the liver to the lesser curvature of the stomach, is called the lesser omentum. This structure acts as a sling for the stomach, suspending it from the liver.

PTS: 1 REF: p. 359 OBJ: List the peritoneal and retroperitoneal organs.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 18. Clinical signs and symptoms of infection include all of the following except: a. chills. b. weakness. c. localized tenderness. d. elevated liver function tests.

ANS: D

Clinical symptoms include fever of unknown origin, chills, weakness, swelling or tenderness (generalized or localized), elevated white blood count, general sepsis, and normal liver function tests.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 365 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the peritoneal cavity 19. The splenorenal ligament _________the left kidney. a. passes inferior to b. separates c. overlies d. encompasses ANS: C

The splenorenal ligament is formed by the posterior reflection of the peritoneum of the spleen and passes inferiorly to overlie the left kidney.

PTS: 1 REF: p. 360 OBJ: List the peritoneal and retroperitoneal organs.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 20. A smooth membrane that lines the entire abdominal cavity and is reflected over the contained

organs is the: a. perineum. b. mesentery. c. peritoneum. d. retroperitoneum.

ANS: C

The peritoneum is a smooth membrane that lines the entire abdominal cavity and is reflected over the contained organs. N R I G B.C M

U S N T

O

PTS: 1 REF: p. 357 OBJ: List the peritoneal and retroperitoneal organs.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 21. Which one of the following hernia locations typically contains fat? a. Epigastric b. Umbilicus c. Inguinal d. Rectus abdominis ANS: A

Epigastric hernias are found in the widest part of the linea alba between the xiphoid and umbilicus. This hernia is usually filled with fat.

PTS: 1 REF: p. 373 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the mesentery, omentum, and peritoneum 22. A lymphocele may be defined as a: a. walled-off collection of extravasated urine. b. lymph-filled space without a distinct epithelial lining. c. complex irregular mass. d. cystic space anterior to the aorta.

ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank A lymphocele is a fluid collection that occurs after surgery in the pelvis, retroperitoneum, or recess cavities and is a lymph-filled space without a distinct epithelial lining.

PTS: 1 REF: p. 371 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Pathology of the abdominal wall 23. The superior portion of the subhepatic space is called: a. the bare area of the liver. b. Morison’s pouch. c. the anterior pararenal space. d. the subphrenic space.

ANS: B

The superior portion of the subhepatic space is called Morison’s pouch.

PTS: 1 REF: p. 360 OBJ: Compare and contrast the different locations of fluid and their sonographic findings.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 24. The ___________________ is able to adhere to diseased organs. a. lesser omentum b. peritoneum c. mesentery d. greater omentum ANS: D

The greater omentum is able to adhere to diseased organs, which helps prevent further spread N “walling RSINGitToff” B.C OMthe rest of the body. of infected fluid by essentially U from PTS: 1 REF: p. 359 OBJ: Discuss the pathologic and sonographic findings of the peritoneal cavity, mesentery, omentum, and peritoneum.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall 25. On ultrasound, a discrete linear echogenicity in the deepest layer of the anterior abdominal

wall is the: a. linea alba. b. rectus sheath. c. peritoneal line. d. subcutaneous fat.

ANS: C

The peritoneal line is seen sonographically as a discrete linear echogenicity in the deepest layer of the anterior abdominal wall.

PTS: 1 REF: p. 363 OBJ: Describe the normal anatomy of the abdominal wall.

TOP: Anatomy and sonographic evaluation of the peritoneal cavity and abdominal wall

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 15: Urinary System Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. A congenital obstruction found in utero and in infants is called a(n): a. ureteropelvic junction (UPJ) obstruction. b. ureterocele. c. bladder diverticulum. d. posterior urethral valve.

ANS: A

A congenital obstruction of the ureteropelvic junction can be seen in utero and in infants.

PTS: 1 REF: p. 416 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Sonographic evaluation of the urinary system 2. Parapelvic cysts are located in the: a. renal sinus. b. renal cortex. c. lower pole. d. pararenal space.

ANS: A

A parapelvic cyst (renal sinus cyst) is found in the renal sinus but does not communicate with the renal collecting system. N R I G B.C M

U S N T

O

PTS: 1 REF: p. 393 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Pathology of the urinary system 3. The most common solid renal mass found in childhood is: a. renal cell carcinoma. b. angiomyolipoma. c. Wilms’ tumor. d. Von Hippel-Lindau tumor.

ANS: C

The nephroblastoma or Wilms’ tumor is the most common solid renal mass of childhood, peaking at 2 years of age. Wilms’ tumor can reoccur.

PTS: 1 REF: p. 407 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Pathology of the urinary system 4. The sonographic appearance of tuberous sclerosis may be difficult to differentiate from: a. medullary sponge kidney. b. nephrocalcinosis. c. hydronephrosis. d. autosomal dominant polycystic kidney disease.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

ANS: D

The sonographic appearance of tuberous sclerosis may be difficult to differentiate from autosomal dominant polycystic kidney disease.

PTS: 1 REF: p. 400 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 5. In cases of nephrocalcinosis, calcium deposits are usually located in the: a. cortex. b. renal sinus. c. medulla. d. renal hilum.

ANS: C

Nephrocalcinosis, or parenchymal calcification, involves diffuse foci of calcium deposits, usually located in the medulla but infrequently seen in the renal cortex. Both kidneys are affected.

PTS: 1 REF: pp. 421-422 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the urinary system 6. Fusion of the lower pole of the kidneys is called a: a. cross-renal ectopia. b. pelvic kidney. c. supernumerary kidney.

NURSINGTB.COM d. horseshoe kidney.

ANS: D

A horseshoe kidney typically demonstrates fusion of the lower poles. It is commonly associated with improper ascent and malrotation. Inferior poles lie medial, with the isthmus crossing anterior to the aorta.

PTS: 1 REF: p. 389 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy and physiology 7. The most echogenic portion(s) of the kidney is(are) the: a. cortex. b. sinus. c. medullary pyramids. d. parenchyma.

ANS: B

The renal sinus is the most echogenic portion of the normal kidney. It includes the calyces, renal pelvis, renal vessels, fat, nerves, and lymphatic channels.

PTS: 1 REF: p. 379 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Sonographic evaluation of the urinary system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. A cystlike enlargement of the distal end of the ureter is called a: a. ureterocele. b. diverticulum. c. urachal cyst. d. cystitis.

ANS: A

A ureterocele is a cyst-like enlargement of the lower end of the ureter. It can be congenital or acquired and may cause obstruction or infection.

PTS: 1 REF: p. 391 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Sonographic evaluation of the urinary system 9. Which one of the following describes the sonographic appearance of chronic pyelonephritis? a. Echogenic cortex b. Hypoechoic enlarged kidney c. Inability to distinguish the cortex from the medullary regions d. Echogenic foci in the medullary regions ANS: C

In chronic renal disease, including chronic pyelonephritis, the kidneys appear diffusely enlarged with a loss of normal anatomy.

PTS: 1 REF: p. 422 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Pathology of the urinary system

N R I G B.C M

U S ofNtheTkidneyOis called a(n): 10. A cortical bulge in the lateral border a. junctional parenchymal defect. b. dromedary hump. c. extrarenal pelvis. d. column of Bertin.

ANS: B

A dromedary hump is a cortical bulge in the lateral border of the kidney and is more common in the left kidney.

PTS: 1 REF: p. 385 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Sonographic evaluation of the urinary system 11. A dilated renal pelvis without ureteral dilation is observed in patients with: a. hydronephrosis. b. posterior urethral valve obstruction. c. ureteropelvic junction obstruction. d. ureterocele.

ANS: C

Dilation of the kidney or ureter or both occurs superior to the obstruction.

PTS: 1 REF: p. 416 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Sonographic evaluation of the urinary system 12. Which one of the following clinical findings is the most likely reason for a renal artery

Doppler examination? a. Hypertension b. Oliguria c. Hematuria d. Severe flank pain ANS: D

Renal artery stenosis (RAS) is the most common correctable cause of hypertension.

PTS: 1 REF: p. 422 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Sonographic evaluation of the urinary system 13. A posttransplant perinephric fluid collection includes all of the following except: a. ureterocele. b. hematoma. c. urinoma. d. lymphocele.

ANS: A

Perinephric fluid collections include hematoma, abscess, lymphocele, or urinoma.

PTS: 1 REF: pp. 420-421 OBJ: Discuss the role and limitations of sonography in postrenal transplant patients.

TOP: Box 15-10

NURSINGTB.COM

14. A renal sonogram is performed. The finding of hypoechoic areas adjacent to the renal sinus is

most consistent with: a. bifid renal pelvis. b. medullary pyramids. c. column of Bertin. d. junctional parenchymal defect.

ANS: B

The renal medulla consists of hypoechoic pyramids disbursed in uniform distribution and separated by bands of intervening parenchyma that extend toward the renal sinus.

PTS: 1 REF: p. 384 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Sonographic evaluation of the urinary system 15. Papillary necrosis may develop within ________ after renal transplantation. a. 4 to 8 weeks b. 12 to 18 hours c. days to years d. weeks or months ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Necrosis may develop within weeks or months after renal transplantation, especially in patients previously treated for rejection and those with cadaveric kidney.

PTS: 1 REF: p. 412 OBJ: Discuss the role and limitations of sonography in postrenal transplant patients.

TOP: Pathology of the urinary system 16. A common finding in people over 50 years of age is: a. renal calculi. b. renal cyst. c. multicystic disease. d. hypernephroma.

ANS: B

Approximately 50% of patients over the age of 50 years have a simple renal cyst.

PTS: 1 REF: p. 393 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 17. Identify the type of hydronephrosis demonstrating dilatation of the renal pelvis with thinning

of the renal cortex. a. Grade 0 b. Grade 3 c. Grade 4 d. Grade 6 ANS: C

N R I G B.C M

U S N byT prominent O dilation of the collecting system, Grade 4 hydronephrosis is characterized thinning of the renal parenchyma, and a lack of differentiation between the collecting system and the renal parenchyma.

PTS: 1 REF: p. 416 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 18. Renal vein thrombosis may be visualized in patients with: a. pyelonephritis. b. renal calculi. c. renal cell carcinoma. d. angiomyolipoma.

ANS: C

Renal cell carcinoma may demonstrate renal vein thrombosis or tumor extension into the renal vein and inferior vena cava (IVC).

PTS: 1 REF: pp. 395-407 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Box 15-5 19. Ureteral jets are not visualized in patients with: a. renal cell carcinoma.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. obstruction. c. duplex collecting system. d. acute focal bacterial nephritis.

ANS: B

Complete obstruction demonstrates an absence of the respective ureteral jet; partial obstruction may show a low-level jet on the side of the obstruction or an asymmetry of the ureteral jets or both.

PTS: 1 REF: p. 418 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Pathology of the urinary system 20. The process of disposing metabolic wastes is called: a. urea. b. excretion. c. deamination. d. urination.

ANS: B

Metabolic wastes must be excreted quickly to prevent toxic concentrations of homeostasis (maintenance of normal body physiologic stability).

PTS: 1 REF: p. 378 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 21. Which one of the following is present in urine whenever extensive damage or destruction of

N R I GTB.COM

U S N the functioning erythrocytes occurs? a. Protein b. Creatinine c. Hemoglobin d. Albumin ANS: C

Hemoglobin is present in urine whenever extensive damage or destruction of the functioning erythrocytes occurs. This condition injures the kidney and can cause acute renal failure.

PTS: 1 REF: p. 378 OBJ: Describe the clinical signs and symptoms of urinary tract problems and the laboratory tests that are used to evaluate them.

TOP: Physiology and laboratory data of the urinary system 22. The kidneys are located in the: a. peritoneal cavity. b. retroperitoneal cavity. c. perirenal cavity. d. perirenal space.

ANS: B

The urinary system is located in the retroperitoneal cavity.

PTS: 1

REF: p. 375 | p. 376

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Sonographic evaluation of the urinary system 23. The left kidney is in contact with the: a. spleen, pancreas, and gallbladder. b. spleen, gallbladder, and duodenum. c. pancreas, colon, and porta hepatis. d. spleen, stomach, and pancreas.

ANS: D

The left adrenal gland, spleen, stomach, and pancreas lie anterior to the left kidney. The diaphragm, psoas muscle, and quadratus lumborum muscle lie posterior to the left kidney.

PTS: 1 REF: p. 376 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 24. The right kidney is in contact with the: a. spleen, colon, and adrenal gland. b. liver, colon, and adrenal gland. c. liver, pancreas, and gallbladder. d. liver, gallbladder, and splenic flexure.

ANS: B

The right adrenal gland and second part of the duodenum lie anterior to the right kidney. The diaphragm, psoas muscle, and quadratus lumborum muscle lie posterior to the right kidney.

PTS: 1 REF: p. 376 NURlocation, B.COand M sonographic appearance of the urinary SINGTfunction, OBJ: Discuss the normal anatomic system organs.

TOP: Anatomy of the urinary system 25. Outside the renal capsule is the: a. perinephric fat. b. paranephric space. c. renal fascia. d. renal medulla.

ANS: A

Outside of the fibrous capsule is a covering of perinephric fat.

PTS: 1 REF: p. 376 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 26. A triangular-shaped defect located anteriorly in the upper pole of the kidney most likely

represents a(n): a. renal tumor. b. artifact from rib. c. IVC compression. d. junctional parenchymal defect.

ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank A junctional parenchymal defect is a triangular-shaped echogenic area in the upper pole of the renal parenchyma.

PTS: 1 REF: p. 385 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Sonographic evaluation of the urinary system 27. The left renal vein courses: a. posterior to the IVC. b. anterior to the IVC. c. anterior to the aorta. d. anterior to the superior mesenteric artery.

ANS: C

The left renal vein flows from the renal sinus, anterior to the aorta, and posterior to the superior mesenteric artery to join the IVC. PTS: 1 REF: p. 377 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 28. The vessel seen posterior to the IVC on the sagittal scan represents the: a. right adrenal artery. b. right renal artery. c. left renal artery. d. left renal vein.

ANS: B

N R I G B.C M

S N T O coursing posterior to the IVC in the The right renal artery is seen asUa circular structure sagittal plane.

PTS: 1 REF: p. 381 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 29. Which of the following is an indirect, sonographic sign of renal function? a. Obstructive uropathy b. Cyst formation c. Ureteral jets d. Angiomyolipoma ANS: C

The way to confirm a complete collecting system is to demonstrate two ureteral jets entering the bladder on the same side. Identify ureteral jets as flashes of Doppler color entering the bladder from the lateral posterior border and coursing superior and medial.

PTS: 1 REF: p. 388 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 30. A potential space located between the liver and right kidney is: a. Morison’s pouch.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Douglas’ pouch. c. cul-de-sac. d. Winhauer space.

ANS: A

Morison’s pouch is located in the right posterior subhepatic space anterior to the right kidney and posterior to the right lobe of the liver.

PTS: 1 REF: p. 376 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 31. Renal cell carcinoma commonly invades the IVC via the: a. renal vein. b. renal artery. c. portal vein. d. splenic vein.

ANS: A

Renal cell carcinoma may invade the renal vein and IVC with a tumor or thrombosis.

PTS: 1 REF: p. 404 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the urinary system 32. Pyonephrosis refers to the presence of: a. blood in a dilated collecting system. b. pus in a dilated collecting system.

N RSINGTB.COM c. urine in a dilated collectingUsystem. d. a perinephric abscess.

ANS: B

Pyonephrosis occurs when pus is found in the obstructed renal system.

PTS: 1 REF: p. 420 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Pathology of the urinary system 33. An extremely large echogenic renal sinus that appears to engulf the entire renal parenchymal

outline suggests: a. hydronephrosis. b. lipomatosis. c. hypernephroma. d. nephrocalcinosis.

ANS: B

In sinus lipomatosis, the abundant fibrous tissue may cause enlargement of the sinus region with an increase in echogenicity.

PTS: 1 REF: p. 385 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Sonographic evaluation of the urinary system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 34. Dilation of the renal pelvis may be caused by all of the following except: a. oliguria. b. reflux. c. pregnancy. d. distended urinary bladder.

ANS: A

Dilation of the renal pelvis may be caused by polyuria, distended bladder, reflux, pregnancy, and atrophy after obstruction.

PTS: 1 REF: p. 418 OBJ: Discuss normal physiology of the urinary system.

TOP: Sonographic evaluation of the urinary system 35. A common benign vascular fatty tumor of the kidney is called a(n): a. angiomyolipoma. b. hypernephroma. c. neuroblastoma. d. lymphoma.

ANS: A

An angiomyolipoma is the most common benign renal tumor. It is composed of fat, muscle, and blood vessels.

PTS: 1 REF: p. 409 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Pathology of the urinary system 36. All of the following statements about theGkidneys are true except: N R I B.C M U S N T O a. the kidneys are intraperitoneal in location. b. the average adult kidneys measure approximately 9 to 12 cm in length. c. the kidneys move with respiration. d. the anteroposterior thickness of the normal adult kidney is approximately 4 to 5

cm.

ANS: A

The kidneys are located in the retroperitoneal cavity.

PTS: 1 REF: p. 376 OBJ: Discuss the normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Anatomy of the urinary system 37. Hydronephrosis may be best demonstrated sonographically by which one of the following

patterns? a. Distorted shape of the kidney outline b. Multiple cystic masses throughout the renal parenchyma c. Fluid-filled pelvocaliceal collecting system d. Hyperechoic pelvocaliceal collecting system ANS: C

Hydronephrosis demonstrates a fluid-filled renal collecting system.

PTS: 1

REF: p. 397

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 38. Autosomal dominant polycystic kidney disease may be characterized by all of the following

statements except: a. the disease is latent until the fourth or fifth decade of life. b. the severity of the disease varies, depending on the genotype. c. the disease may be associated with cysts in the liver, pancreas, and spleen. d. the kidneys are small and extremely echogenic.

ANS: D

The kidneys become enlarged with multiple cysts.

PTS: 1 REF: p. 401 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 39. Which one of the following statements about the kidneys is false? a. The kidneys are rigidly fixed on the abdominal wall. b. The kidneys consist of an internal medullary and external cortical substance. c. The kidneys rest on the psoas and quadratus lumborum muscles. d. Renal pyramids are found within the medullary region.

ANS: A

The kidneys are located in the retroperitoneum, not on the abdominal wall or rigidly fixed.

PTS: 1 REF: p. 376 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system NURSINevaluation GTB.CO organs.

TOP: Sonographic ofM the urinary system 40. The most common location of renal ectopia is the: a. pelvis. b. intrathoracic. c. epigastric region. d. retroperitoneum.

ANS: A

The pelvic kidney, also called the sacral kidney, is the most common renal ectopia and should not be misdiagnosed as a pelvic tumor.

PTS: 1 REF: p. 388 OBJ: Discuss normal anatomic location, function, and sonographic appearance of the urinary system organs.

TOP: Sonographic evaluation of the urinary system 41. Which one of the following disorders does not produce a complex sonographic pattern? a. Infected cyst b. Hemorrhagic cyst c. Hematoma d. Congenital simple cyst ANS: D

The sonographic criteria of a simple cyst include anechoic properties (without internal echoes), thin smooth walls, and posterior acoustic enhancement.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 398 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 42. The normal bladder wall should be smooth and thin and measure between ____________

millimeters (mm). a. 2 to 4 b. 3 to 6 c. 5 to 7 d. 5 to 10 ANS: B

Depending on the level of bladder distention, the normal bladder wall may measure 3 to 6 mm.

PTS: 1 REF: p. 392 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Sonographic evaluation of the urinary system 43. Which one of the following describes a bladder diverticulum? a. Cystic enlargement of the bladder orifice b. Echogenic mass of the bladder wall c. Herniation of the bladder wall d. Focal thickening of the bladder wall ANS: C

A bladder diverticulum is defined as a herniation of the bladder wall.

NURSINGTB.COM

PTS: 1 REF: p. 427 OBJ: Identify and define the sonographic appearance of pathologies included in this chapter.

TOP: Pathology of the urinary system 44. In the adult, a postvoid residual of less than _____ ml of urine is considered normal. a. 35 b. 50 c. 20 d. 25 ANS: C

A postvoid residual of less than 20 ml of urine is considered normal in the adult.

PTS: 1 REF: p. 393 OBJ: Discuss normal physiology of the urinary system.

TOP: Sonographic evaluation of the urinary system 45. Choose the cause of renal artery stenosis that accounts for two thirds of all cases in young

patients. a. Hydronephrosis b. Parapelvic cyst c. Atherosclerosis d. Fibromuscular dysplasia ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Fibromuscular dysplasia accounts for approximately two thirds of renal artery stenosis cases in young patients. Atherosclerosis is associated with hypertension, which is more common in older patients, and accounts for one third of cases of RAS. PTS: 1 REF: p. 422 OBJ: Define and discuss the pathologies discussed in this chapter.

TOP: Pathology of the urinary system

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 16: Retroperitoneum Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The retroperitoneal space is the area between the: a. anterior portion of the parietal peritoneum and the posterior abdominal wall

muscles. b. posterior portion of the parietal peritoneum and the posterior abdominal wall

muscles. c. anterior portion of the parietal peritoneum and the anterior abdominal wall

muscles. d. posterior portion of the visceral peritoneum.

ANS: B

The retroperitoneal space is the area between the posterior portion of the parietal peritoneum and the posterior abdominal wall muscles. It extends from the diaphragm to the pelvis.

PTS: 1 REF: p. 432 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

2. The iliopsoas muscle, ureter, and branches of the inferior vena cava, aorta, and their

lymphatics is in the: a. perirenal space. b. anterior pararenal space. c. retrofascial space. d. posterior pararenal space.NURSINGTB.COM ANS: D

The posterior pararenal space is located between the posterior renal fascia and the transversalis fascia. It communicates with the peritoneal fat, lateral to the lateroconal fascia, and includes the iliopsoas muscle, ureter, and branches of the inferior vena cava, aorta, and their lymphatics.

PTS: 1 REF: p. 432 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

3. All of the following structures are located in the retroperitoneum except the: a. kidney. b. aorta. c. psoas muscle. d. spleen.

ANS: D

The spleen is an intraperitoneal structure.

PTS: 1 REF: p. 433 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

4. Adrenal hemorrhages are more common in: a. older adults.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. young adults. c. neonates. d. toddlers.

ANS: C

Adrenal hemorrhages are more common in neonates who experience a traumatic delivery with stress, asphyxia, and septicemia. Adrenal hemorrhages are rare in adults.

PTS: 1 REF: p. 442 |p. 443 OBJ: Describe the sonographic appearance and clinical findings of adrenal tumors, retroperitoneal fibrosis and retroperitoneal fluid collections.

TOP: Pathology of the retroperitoneum 5. Para-aortic lymphadenopathy generally displaces the kidney: a. anteriorly. b. posteriorly. c. medially. d. laterally.

ANS: D

Para-aortic lymphadenopathy generally displaces the kidney laterally.

PTS: 1 REF: p. 439 OBJ: Explain the role that sonography plays in the evaluation of para-aortic nodes, and describe the sonographic techniques used to visualize them.

TOP: Sonographic evaluation of the retroperitoneum 6. The length of the normal adult adrenal gland is usually smaller than: NURSINGTB.COM a. 2 cm. b. 2 mm. c. 3 cm. d. 3 mm.

ANS: C

The normal adult adrenal gland measures 3 to 6 cm in length, 3 to 6 mm in thickness, and 2 to 4 cm in width.

PTS: 1 REF: p. 434 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

7. Which one of the following is the most common primary adrenal tumor? a. Cyst b. Adenoma c. Carcinoma d. Pheochromocytoma ANS: B

Benign nonfunctioning adenoma is the most common primary adrenal tumor.

PTS: 1 REF: p. 443 OBJ: Describe the sonographic appearance and clinical findings of adrenal tumors, retroperitoneal fibrosis and retroperitoneal fluid collections.

TOP: Pathology of the retroperitoneum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

8. Which one of the following demonstrates an excessive secretion of epinephrine? a. Adrenal cyst b. Adrenal adenoma c. Medulla tumor d. Neuroblastoma ANS: C

Tumors of the adrenal medulla secrete excessive amounts of epinephrine.

PTS: 1 REF: p. 445 OBJ: List the adrenal gland hormones and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Table 16-1 9. Which one of the following syndromes is a result of excessive secretion of cortisol? a. Conn b. Addison c. Cushing d. Waterhouse-Friderichsen ANS: C

Cushing syndrome is caused by excessive excretion of cortisol.

PTS: 1 REF: p. 442 OBJ: List the adrenal gland hormones and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Pathology of the retroperitoneum 10. What adrenal tumor demonstrates intermittent hypertension and severe headaches?

NURSINGTB.COM a. Neuroblastoma b. Adenoma c. Myolipoma d. Pheochromocytoma ANS: D

A pheochromocytoma is a benign adrenal tumor that secretes epinephrine and norepinephrine in excessive quantities. Clinical symptoms include intermittent hypertension, severe headaches, heart palpitations, and excessive perspiration.

PTS: 1 REF: p. 445 OBJ: List the adrenal gland hormones and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Pathology of the retroperitoneum 11. The most common adrenal tumor in infancy is the: a. adenoma. b. pheochromocytoma. c. neuroblastoma. d. liposarcoma.

ANS: C

The neuroblastoma is the most common malignancy of the adrenal glands in children and the most common tumor in infancy, representing 30% of all neonatal tumors.

PTS: 1

REF: p. 445

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: List the adrenal gland hormones and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Pathology of the retroperitoneum 12. The most common primary retroperitoneal tumor is: a. lymphoma. b. fibrosarcoma. c. germ cell tumor. d. leiomyosarcoma.

ANS: A

Lymphoma is the most common primary retroperitoneal tumor, followed by leiomyosarcoma.

PTS: 1 REF: p. 446 OBJ: Describe the sonographic appearance and clinical findings of adrenal tumors, retroperitoneal fibrosis and retroperitoneal fluid collections.

TOP: Pathology of the retroperitoneum 13. A urinoma may be defined as a: a. walled-off collection of extravasated urine. b. lymph-filled space without a distinct epithelial lining. c. heterogeneous irregular mass. d. cystic space anterior to the aorta.

ANS: A

A urinoma is a walled-off collection of extravasated urine that spontaneously develops after trauma, surgery, or a subacute or chronic urinary tract obstruction.

PTS: 1 REF: p. 447 Nappearance URSINGand TB.C OMfindings of adrenal tumors, retroperitoneal OBJ: Describe the sonographic clinical fibrosis and retroperitoneal fluid collections.

TOP: Pathology of the retroperitoneum 14. The “sandwich” sign represents: a. the complex appearance of adrenal hemorrhage. b. enlarged lymph nodes anterior and posterior to the mesenteric vessels. c. enlarged lymph nodes in the renal hilar area. d. the image of the left adrenal gland between the crus of the diaphragm and the left

kidney.

ANS: B

The “sandwich” sign represents enlarged lymph nodes (or tumor) anterior and posterior to the mesenteric vessels.

PTS: 1 REF: p. 439 OBJ: Explain the role that sonography plays in the evaluation of para-aortic nodes, and describe the sonographic techniques used to visualize them.

TOP: Sonographic evaluation of the retroperitoneum 15. Which of the following muscles lie posterior to the kidneys? a. Psoas and iliopsoas b. Psoas and quadratus lumborum c. Obturator internus and piriformis

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Iliopsoas and levator ani ANS: B

The kidney is anterolateral to the psoas muscle and anterior to the quadratus lumborum.

PTS: 1 REF: p. 434 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

16. The left adrenal gland lies lateral to the: a. crus of the diaphragm. b. tail of the pancreas. c. stomach. d. IVC. ANS: A

The left adrenal gland lies lateral and slightly posterolateral to the aorta and lateral to the crus of the diaphragm.

PTS: 1 REF: p. 434 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

17. The area between the bladder and rectum is called the _____________ space. a. rectovesical b. presacral c. bilateral pararectal d. iliac ANS: A

NURbetween B.C The rectovesical space is located bladder SINGTthe OM and the rectum.

PTS: 1 REF: p. 436 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

18. Which one of the following syndromes demonstrates a decrease in adrenal function? a. Adrenogenital b. Addison c. Conn d. Cushing ANS: B

Addison syndrome is characterized by atrophy of the adrenal cortex with decreased production of cortisol and sometimes aldosterone.

PTS: 1 REF: p. 442 OBJ: Identify the adrenal gland hormones, and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Physiology and laboratory data of the retroperitoneum 19. The right adrenal gland lies posterior to the: a. crus of the diaphragm. b. IVC. c. right kidney. d. liver.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

ANS: B

The medial portion of the right adrenal gland is immediately posterior to the IVC (above the level of the portal vein and lateral to the crus of the diaphragm).

PTS: 1 REF: p. 434 TOP: Anatomy of the retroperitoneum

OBJ: Identify the retroperitoneal anatomy.

20. Which one of the following structures is not located in the anterior pararenal space? a. Duodenal sweep b. Adrenal gland c. Ascending colon d. Pancreas ANS: B

The adrenal gland is located in the perirenal space. The pancreas, duodenum, and ascending and transverse colon are the structures included in the anterior pararenal space.

PTS: 1 REF: p. 433 TOP: Anatomy and physiology

OBJ: Discuss the retroperitoneal anatomy.

21. Which one of the following statements about the adrenal medulla is true? a. The medulla is the outer portion of the adrenal gland. b. The medulla secretes a large range of steroids. c. The medulla is not essential to life. d. The medulla secretes estrogen.

ANS: C

NURisSnot INessential GTB.Cto The medulla of the adrenal gland OMlife and can be removed surgically without causing untreatable damage.

PTS: 1 REF: p. 438 OBJ: Identify the retroperitoneal anatomy.

TOP: Physiology and laboratory data of the retroperitoneum 22. Which one of the following statements describes adrenal cysts? a. Male patients are affected more than female patients. b. Patients are typically asymptomatic. c. Adrenal cysts are a common finding. d. Adrenal cysts are usually bilateral.

ANS: B

Adrenal cysts are uncommon, typically unilateral lesions that affect female patients more than male patients (3:1). Adrenal cysts generally produce no clinical symptoms.

PTS: 1 REF: p. 442 OBJ: Describe the sonographic appearance and clinical findings of adrenal tumors, retroperitoneal fibrosis and retroperitoneal fluid collections.

TOP: Pathology of the retroperitoneum 23. Excessive secretion of aldosterone occurs in ____________ syndrome. a. Addison b. Cushing c. Waterhouse-Friderichsen

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Conn ANS: D

Conn syndrome is caused by the excessive secretion of aldosterone.

PTS: 1 REF: p. 442 OBJ: Identify the adrenal gland hormones, and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Pathology of the retroperitoneum 24. Metastases to the adrenal gland are most commonly caused by primary carcinoma of the

__________, __________, and __________. a. breast; liver; kidney b. lung; breast; stomach c. lung; breast; liver d. kidney; colon; liver ANS: B

Metastases to the adrenal gland are most commonly caused by primary carcinoma of the lung (33%), breast (30%), stomach, colon, and kidney.

PTS: 1 REF: p. 444 | p. 445 OBJ: Describe the sonographic appearance and clinical findings of adrenal tumors, retroperitoneal fibrosis and retroperitoneal fluid collections.

TOP: Pathology of the retroperitoneum 25. Adrenal insufficiency is typically caused by: a. adrenal adenoma. b. adrenal cyst.

NURSINGTB.COM c. lymphadenopathy. d. metastatic lesions.

ANS: D

Metastases to the adrenal gland typically cause adrenal insufficiency.

PTS: 1 REF: p. 442 OBJ: Identify the adrenal gland hormones, and describe the syndromes associated with hypersecretion and hyposecretion.

TOP: Pathology of the retroperitoneum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 17: Abdominal Applications of Ultrasound Contrast Agents Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Most of the research and development of ultrasound contrast agents (UCAs) has centered on

creating agents that can: a. enhance the detection of stationary blood. b. be administered by intra-arterial injection. c. be administered intravenously. d. enhance the detection of tumors in solid organs.

ANS: C

Most of the work toward the development of UCAs has centered on developing agents that can be administered by intravenous injection.

PTS: 1 REF: p. 450 OBJ: Describe the properties that an ultrasound contrast agent must have to be clinically accepted.

TOP: Ultrasound contrast agents 2. Vascular ultrasound agents enhance Doppler flow signals by: a. increasing the velocity of blood flow. b. adding more and better acoustic scatterers to the bloodstream. c. increasing the number of red blood cells in the vessel being evaluated. d. decreasing the speed of sound through tissues.

ANS: B

NURSINGTB.COM

Vascular contrast agents enhance Doppler (color and spectrum) flow signals by adding more and better acoustic scatterers to the bloodstream.

PTS: 1 REF: p. 451 OBJ: Describe the difference between tissue-specific ultrasound contrast agents and vascular agents.

TOP: Ultrasound contrast agents 3. For a vascular ultrasound contrast agent to be clinically useful, it should: a. be nontoxic. b. have microbubbles that are small enough to traverse the pulmonary capillary beds. c. be stable enough to provide multiple recirculations. d. have all of the above characteristics.

ANS: D

For a contrast agent to be clinically useful, it should be nontoxic, have microbubbles that are small enough to traverse the pulmonary capillary beds, and be stable enough to provide multiple recirculations.

PTS: 1 REF: p. 452 OBJ: Describe the properties that an ultrasound contrast agent must have to be clinically accepted.

TOP: Types of ultrasound contrast agents 4. Depending on the clinical application, vascular UCAs may be administered via: a. intravenous bolus injection.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. oral ingestion. c. intravenous infusion. d. albumin.

ANS: C

Intravenous infusion resulting in contrast enhancement lasts longer than a bolus injection: 12 minutes for intravenous infusion compared with 2 minutes for a bolus injection.

PTS: 1 REF: p. 452 OBJ: Describe the difference between tissue-specific ultrasound contrast agents and vascular agents.

TOP: Types of ultrasound contrast agents 5. The microbubbles of tissue-specific UCAs are: a. significantly larger than red blood cells. b. significantly larger than liver cells (hepatocytes). c. taken up by or have an affinity for specific tissues. d. toxic to the targeted tissue.

ANS: C

Microbubbles are removed from the blood pool and taken up by or have an affinity for specific tissues.

PTS: 1 REF: p. 453 OBJ: Describe the difference between tissue-specific ultrasound contrast agents and vascular agents.

TOP: Types of ultrasound contrast agents 6. When insonating microbubble-based UCAs, the acoustic pressure present within the acoustic

field: NURSINGTB.COM a. has no effect on microbubbles. b. can have a detrimental effect on the contrast microbubbles. c. usually results in increasing the microbubble size. d. usually results in the creation of more microbubbles.

ANS: B

A significant amount of microbubbles can be destroyed by the acoustic pressure, even though the actual pressure contained within the ultrasound field is relatively low.

PTS: 1 REF: p. 454 OBJ: Describe the properties that an ultrasound contrast agent must have to be clinically accepted.

TOP: Ultrasound equipment modifications 7. Ultrasound contrast agents have shown the potential to improve the accuracy of hepatic

sonography including: a. enhanced detection of hepatic masses. b. enhanced characterization of hepatic masses. c. improved detection of intrahepatic and extrahepatic blood flow. d. All of the above are characteristics ANS: D

UCAs have shown the potential to improve hepatic sonography including enhancing the detection and characterization of hepatic masses and improving the detection of intrahepatic and extrahepatic blood flow.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 456 OBJ: Describe the hepatic applications of contrast agents.

TOP: Clinical applications

8. Which of the following vessels are the first to demonstrate contrast enhancement in the liver? a. Hepatic veins b. Hepatic arteries c. Right portal veins d. Left portal veins ANS: B

The first vessels to demonstrate contrast enhancement in the liver are the hepatic arteries.

PTS: 1 REF: p. 457 OBJ: Describe the hepatic applications of contrast agents.

TOP: Figure 17-8

9. The first ultrasound contrast agent to receive FDA approval was used in: a. biopsy procedures. b. vascular sonography. c. echocardiography. d. general sonography.

ANS: C

In 1994, the first ultrasound contrast agent was approved for use in echocardiography.

PTS: 1 REF: p. 452 OBJ: Describe the properties that an ultrasound contrast agent must have to be clinically accepted.

TOP: Types of ultrasound agents

NURSINGTB.COM

10. Evaluation of a patient with known cirrhosis often demonstrates a(n): a. reduced portal venous flow with an increase in hepatic artery flow. b. increase in portal venous flow with an increase in hepatic artery flow. c. reduced portal venous flow with a reduction in hepatic artery flow. d. increase in portal venous flow with a reduction in hepatic artery flow.

ANS: A

In patients with cirrhosis, portal venous flow is often reduced and a compensatory increase in hepatic artery flow occurs.

PTS: 1 REF: p. 456 OBJ: Describe the hepatic applications of contrast agents.

TOP: Clinical applications

11. In harmonic-imaging mode, the echoes from the oscillating microbubbles have a: a. low signal-to-noise ratio. b. low transducer frequency. c. equal signal-to-noise ratio. d. high signal-to-noise ratio.

ANS: D

Harmonic-imaging mode has a high signal-to-noise ratio; therefore, regions with microbubbles are easier to appreciate visually.

PTS: 1

REF: p. 454

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe how contrast harmonic imaging improves the clinical capabilities of ultrasound contrast agents.

TOP: Ultrasound equipment modifications 12. The mechanical index (MI) uses: a. low acoustic output power. b. low transducer frequency. c. an increase of dynamic range. d. high acoustic output power.

ANS: A

A low acoustic output power is defined by the MI. Low MI is a useful technique for a variety of contrast-enhanced sonographic applications.

PTS: 1 REF: p. 454 OBJ: Describe how contrast harmonic imaging improves the clinical capabilities of ultrasound contrast agents.

TOP: Ultrasound equipment modifications 13. The detection of flow in the hepatic capillaries is identified in the ___________ phase. a. arterial b. early vascular c. portal venous d. late vascular ANS: D

The detection of flow in the hepatic capillaries is identified in the late vascular phase as parenchymal blush.

PTS: 1 REF: p. 456 NURSIofNG TB.Cagents.

OM OBJ: Describe the hepatic applications contrast

TOP: Clinical applications

14. When using ultrasound contrast agents, a lesion that gets progressively echogenic over time is

most likely: a. focal nodular hyperplasia. b. hemangioma. c. hepatocellular carcinoma. d. adenoma.

ANS: B

SonoVue used in a study of an atypical hemangioma demonstrated progressive echogenicity over time (late vascular phase).

PTS: 1 REF: p. 456 OBJ: Describe the hepatic applications of contrast agents.

TOP: Clinical applications

15. Hepatic cavernous hemangiomas demonstrate only peripheral enhancement during the: a. arterial phase. b. portal venous phase. c. late vascular phase. d. None of the above ANS: A

In the arterial phase, cavernous hemangiomas demonstrate only peripheral enhancement.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 456 | p. 457 OBJ: Describe the hepatic applications of contrast agents.

TOP: Clinical applications

16. Several reports have described the contrast-enhanced sonographic appearance of

hepatocellular carcinoma as having intense enhancement in the _____________ phase. a. late vascular b. portal venous c. early arterial d. late arterial ANS: C

Hepatocellular carcinoma demonstrates intense enhancement in the early arterial phase with relatively rapid washout of contrast in the portal venous phase.

PTS: 1 REF: p. 457 OBJ: Describe the hepatic applications of contrast agents.

TOP: Clinical applications

17. In the early arterial phase, using tissue-specific contrast agents, focal nodular hyperplasia can

have a similar appearance to a: a. hepatic cyst. b. hemangioma. c. hepatocellular carcinoma (HCC). d. hepatic abscess.

ANS: C

HCC lesions can have a similar appearance to focal nodular hyperplasia (FNH) in the early arterial phase. In delayed phase appears hypoechoic, whereas FNH appears NUimaging, RSINGHCC TB.COM isoechoic to the normal liver parenchyma.

PTS: 1 REF: p. 459 OBJ: Describe the hepatic applications of contrast agents.

TOP: Clinical applications

18. The rupture of microbubbles results in random: a. tissue enhancement. b. Doppler shifts. c. wall definition. d. enhanced time.

ANS: B

The rupture of microbubbles results in random Doppler shifts appearing as transient mosaic colors on a color Doppler display.

PTS: 1 REF: p. 453 OBJ: Describe the properties that an ultrasound contrast agent must have to be clinically accepted.

TOP: Types of contrast agents 19. Tissue-specific ultrasound contrast agents can be considered to be: a. molecular-imaging agents. b. first-generation contrast agents. c. mechanical-imaging agents. d. oral-contrast agents.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

ANS: A

Because these agents target tissue-specific types of tissue and their behavior is predictable, they can be considered molecular-imaging agents.

PTS: 1 REF: p. 453 OBJ: Describe the difference between tissue-specific ultrasound contrast agents and vascular agents.

TOP: Types of contrast agents 20. Induced acoustic-emission effects are independent of: a. Doppler shifts. b. microbubble size. c. contrast motion. d. All of the above ANS: C

It is important to remember that acoustic-emission effects are independent of contrast motion.

They can result from oscillation and eventual rupture of stationary contrast microbubbles.

PTS: 1 REF: p. 453 OBJ: Describe the difference between tissue-specific ultrasound contrast agents and vascular agents.

TOP: Types of contrast agents 21. To aid in contrast-enhanced imaging equipment, manufacturers have begun to incorporate

__________ into their systems to reduce microbubble destruction. a. harmonic imaging. b. MI. c. intermittent imaging capabilities.

NURSINGTB.COM d. frame one imaging.

ANS: C

Equipment manufacturers have begun to incorporate intermittent imaging capabilities into their systems to provide an additional option to the user seeking to reduce microbubble destruction.

PTS: 1 REF: p. 455 OBJ: Describe how contrast harmonic imaging improves the clinical capabilities of ultrasound contrast agents.

TOP: Ultrasound equipment modifications 22. When the microbubble is destroyed: a. vessels are easier to detect with color Doppler. b. contrast enhancement is no longer provided. c. contrast enhancement is increased. d. vessels are easier to detect with gray-scale harmonic imaging.

ANS: B

Once the microbubble is destroyed, contrast enhancement is no longer provided, which reduces the clinical utility and duration of contrast enhancement.

PTS: 1 REF: p. 454 OBJ: List the current limitations of ultrasound imaging that may be overcome by the use of ultrasound contrast agents.

TOP: Types of ultrasound contrast agents

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 18: Ultrasound-Guided Interventional Techniques Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The primary advantage of an ultrasound-guided procedure is: a. marks the spot for biopsies or fluid taps. b. provides for continuous real-time visualization of the biopsy needle. c. drains abscess collections. d. places drainage tubes.

ANS: B

The main advantage of using ultrasound for guidance is to have the continuous real-time visualization of the biopsy, which allows for the adjustment of the needle as needed during the procedure.

PTS: 1 REF: p. 497 OBJ: Describe the advantages of ultrasound-guided procedures.

TOP: Ultrasound-guided procedures 2. The common indication for a biopsy is to: a. confirm a malignancy in a mass. b. define the amount of fluid in a mass. c. define the size of the drainage tube needed to drain the mass. d. confirm whether the mass is a simple cyst.

ANS: A

NURSINGTB.COM

The common indication for a biopsy is to confirm a malignancy in a mass.

PTS: 1 REF: p. 469 OBJ: Discuss the indications and contraindications for the procedures discussed in this chapter.

TOP: Indications for biopsy 3. Contraindications for a biopsy include all of the following except: a. uncorrectable bleeding disorder. b. lack of a safe needle path. c. dehydration. d. uncooperative patient.

ANS: C

Contraindications for a biopsy include an uncorrectable bleeding disorder, a lack of a safe needle pass, and an uncooperative patient.

PTS: 1 REF: p. 469 | p. 470 OBJ: Discuss the indications and contraindications for the procedures discussed in this chapter.

TOP: Contraindications for biopsy 4. The test used to evaluate the effects of heparin, aspirin, and antihistamines on the

blood-clotting process is: a. Coumadin. b. PTT.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. AFP. d. PSA. ANS: B

PTT (partial thromboplastin time) can be used to evaluate the effects of heparin, aspirin, and antihistamines on the blood-clotting process. It evaluates factors found in the intrinsic and common pathways.

PTS: 1 REF: p. 470 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Laboratory tests 5. The national patient safety standards mandate that a “time-out” be performed before

beginning any procedure, which means all of the following except the: a. patient’s name is recited by a team member. b. patient’s name is recited by the patient. c. patient’s identification number is confirmed. d. type and location of the procedure are confirmed.

ANS: A

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) mandates a “time-out” before any procedure. A “time-out” includes the patient reciting her or his full name, and the patient’s identification number is confirmed along with the type and location of the procedure.

PTS: 1 REF: p. 481 OBJ: Describe the benefits of sonographer involvement in procedures.

TOP: Ultrasound biopsy techniques N R I G B.C M

U S N T

O

6. Postbiopsy complications may include all of the following except: a. pain or discomfort. b. vasovagal reactions. c. hematomas. d. heart failure.

ANS: D

Postbiopsy complaints may include pain, vasovagal reaction, hematoma, hemorrhage, and infection.

PTS: 1 REF: p. 476 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Biopsy complications 7. A higher percentage of positive cells are observed in the _____________ of a thyroid mass. a. center b. complex portion c. anechoic portion d. small calcifications ANS: D

The sonographer should look for small calcifications in a thyroid mass; a higher percentage of positive cells are observed.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 492 OBJ: Describe the benefits of sonographer involvement in procedures.

TOP: Biopsies and procedures by organ 8. The best ways to recognize the tip of the needle with ultrasound include all of the following

except: a. the needle tip appears as an echogenic dot. b. the needle tip appears as a hypoechoic area. c. the needle tip may be seen as it advances into the area. d. the needle tip may be seen with a small amount of saline injection.

ANS: B

The needle tip should appear as an echogenic dot. The needle may be seen moving with advancement or with a small amount of saline injection.

PTS: 1 REF: p. 487 | p. 488 OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Ultrasound guidance methods 9. In a renal transplant procedure, which part of the kidney is typically biopsied? a. Lower pole b. Mid-lower pole c. Mid-upper pole d. Upper pole ANS: D

Typically, the upper pole of a transplant kidney is biopsied to avoid possible lacerations of the N R I G B.COM main renal vessels and ureter. U S N T PTS: 1 REF: p. 490 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Biopsies and procedures by organ 10. Advantages of using ultrasound guidance include all of the following except: a. lack of radiation. b. reduced risk of complications. c. variable patient positions. d. fixed angles when using needle guides.

ANS: D

The main advantage of using ultrasound for guidance is to have continuous real-time visualization of the biopsy needle, which allows adjustment of the needle as needed during the procedure.

PTS: 1 REF: p. 497 OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Ultrasound-guided procedures 11. Limitations of ultrasound guidance include all of the following except: a. bowel gas. b. isoechoic masses.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. inexperienced ultrasound personnel. d. shorter procedure times.

ANS: D

Shorter procedure times are an advantage of using ultrasound guidance.

PTS: 1 REF: p. 469 | p. 476 OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Ultrasound-guided procedures 12. The international normalized ratio (INR) was developed because of the variable results of

_________ among laboratories. a. PT b. AFP c. PTT d. PSA ANS: A

A standard method was developed called the INR because of the variability of PT results among laboratories.

PTS: 1 REF: p. 470 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Contraindications for biopsy 13. What needle gauge is typically used in a fine-needle aspiration? a. 14 to 20 b. 20 to 25 NURSINGTB.COM c. 16 to 18 d. 10 to 23 ANS: B

Fine-needle aspiration (FNA) is performed using a 20- to 25-gauge needle, preferably with a cutting tip, such as a Franseen needle.

PTS: 1 REF: p. 471 OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Types of procedures 14. Which type of biopsy uses an automatic spring-loaded device to provide tissue for analysis? a. Fine-needle aspiration b. Free-hand biopsy c. Core biopsy d. Needle-guided biopsy ANS: C

A core biopsy utilizes an automated, spring-loaded device, termed a biopsy gun, provides tissue for histologic analysis.

PTS: 1 REF: p. 471 OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Types of procedures

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 15. The role of the cytopathology team is to: a. ensure enough diagnostic tissue is obtained. b. increase the percentage of successful biopsies. c. minimize the number of core samples. d. provides all of the above roles.

ANS: D

The role of the cytopathology team is described by all of the above.

PTS: 1 REF: p. 474 |p. 475 OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Cytopathology 16. The wait time after discontinuing the use of aspirin is: a. 4 to 6 hours. b. 3 to 4 days. c. 5 to 7 days. d. 1 to 2 days.

ANS: C

The wait time for discontinuing aspirin is 5 to 7 days; for heparin, the wait time is 4 to 6 days; and for Coumadin, the wait time is 3 to 4 days.

PTS: 1 REF: p. 470 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Contraindications for biopsy 17. A preprocedural image should document the patient’s name and the: NURSINGinitials.

TB.COM a. date, needle path, and sonographer’s b. time, date, and needle path. c. time, date, and examination description. d. date, needle depth, and needle position.

ANS: B

The preprocedural image should document the patient’s name and the time, date, and demonstration of the needle path.

PTS: 1 REF: p. 481 OBJ: Describe the benefits of sonographer involvement in procedures.

TOP: Ultrasound biopsy techniques 18. The most common organ biopsied is the: a. kidney. b. liver. c. thyroid. d. lung.

ANS: B

The liver is the most common organ biopsied for either specific areas or masses or for diffuse parenchymal disease.

PTS: 1 REF: p. 488 | p. 489 OBJ: Discuss the indications and contraindications for the procedures discussed in this chapter.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Biopsies and procedures by organ 19. Renal parenchymal biopsies are most commonly requested for patients with: a. hypertension. b. diabetes mellitus. c. proteinuria. d. pyelonephritis.

ANS: C

Renal biopsies are requested for patients with proteinuria, nephrotic syndrome, and renal failure.

PTS: 1 REF: p. 490 OBJ: Discuss the indications and contraindications for the procedures discussed in this chapter.

TOP: Biopsies and procedures by organ 20. In a renal parenchymal biopsy, which part of the kidney is typically biopsied? a. Lower pole b. Mid-lower pole c. Mid-upper pole d. Upper pole ANS: A

Typically, the lower pole is biopsied because it lies more posterior than the other poles.

PTS: 1 REF: p. 490 OBJ: Describe the benefits of sonographer involvement in procedures.

TOP: Interventional sonography

NURSINGTB.COM

21. A specific complication of a renal biopsy is: a. infection. b. hypertension. c. hematuria. d. hypotension.

ANS: C

Specific complications of a renal biopsy include hematuria and a perinephric hematoma.

PTS: 1 REF: p. 490 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Biopsies and procedures by organ 22. In which of the following positions is a patient placed for a thoracentesis? a. Prone b. Supine c. Sitting d. Decubitus ANS: C

The patient should be scanned in the same position that the procedure will be performed, which is usually upright (sitting).

PTS: 1

REF: p. 494

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Discuss the advantages and disadvantages of free-hand and needle-guided techniques.

TOP: Fluid collections and abscesses 23. Biopsies of the spleen carry an increased risk for: a. capsule rupture. b. pneumothorax. c. hemorrhage. d. infection.

ANS: C

The spleen is a highly vascular structure; therefore, it has an increased risk for hemorrhage.

PTS: 1 REF: p. 476 OBJ: List the potential complications of ultrasound-guided interventional techniques.

TOP: Fluid collections and abscesses 24. The _______________ patient position is most commonly used in a prostate biopsy. a. supine b. prone c. left lateral decubitus d. semi-erect ANS: C

Typically, the left lateral decubitus patient position is used in a prostate biopsy.

PTS: 1 REF: p. 492 | p. 493 OBJ: Describe the benefits of sonographer involvement in procedures.

TOP: Biopsies and procedures by organ

NURSINGTB.COM

25. Which one of the following laboratory tests could indicate a liver lesion? a. Prothrombin time b. Alpha-fetoprotein (AFP) c. Partial thromboplastin time d. Liver-specific antigen ANS: B

The alpha-fetoprotein blood test measures the level of AFP in the bloodstream; an elevated level could indicate a liver lesion.

PTS: 1 REF: p. 470 OBJ: Discuss the indications and contraindications for the procedures discussed in this chapter.

TOP: Laboratory tests

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 19: Emergent Ultrasound Procedures Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. People frequently go to the emergency department for all of the following reasons except: a. chest pain. b. ear pain. c. flank pain. d. respiratory distress.

ANS: B

The reasons people frequently give for visiting the emergency department include problems in the gastrointestinal, genitourinary, respiratory, nervous, and cardiac systems, as well as for orthopedic conditions, lacerations, and fractures.

PTS: 1 REF: p. 499 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Introduction 2. The complications of peritoneal lavage include all of the following except: a. bowel perforation. b. bladder penetration. c. vascular laceration. d. pneumothorax.

ANS: D

NURSINGTB.COM

Peritoneal lavage carries a risk of organ injury, bowel perforation, bladder penetration, vascular lacerations, and wound complications.

PTS: 1 REF: p. 500 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Assessment of abdominal trauma 3. In the trauma setting, the most common finding of free fluid in the abdomen or pelvis is: a. hemoperitoneum. b. ascites. c. bowel. d. urine.

ANS: A

In the trauma setting, free fluid usually represents hemoperitoneum.

PTS: 1 REF: p. 501 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Focused assessment with sonography for trauma 4. The sonographic findings in aortic dissection include all of the following except:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

echogenic membrane. enlarged aorta. moving echogenic flap. laminar blood flow pattern.

ANS: D

Sonographic findings in aortic dissection include the presence of an echogenic membrane (false lumen), visualization of the flap at the site of dissection, decreased or reversed blood flow in the false lumen, and generally a preexisting aneurysm.

PTS: 1 REF: p. 510 | p. 511 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Chest pain 5. Types of abdominal hernias include all of the following except: a. reducible hernia. b. carcerated hernia. c. incarcerated hernia. d. strangulated hernia.

ANS: B

Abdominal wall hernias are classified as reducible, incarcerated, or strangulated.

PTS: 1 REF: p. 513 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Paraumbilical hernia

NURSINGTB.COM

6. The most common sonographic finding of a hernia is: a. peristalsis of the bowel both during and after a Valsalva maneuver. b. positive Murphy’s sign. c. negative McBurney’s sign. d. positive strangulation sign.

ANS: A

Sonography allows real-time visualization of bowel peristalsis both during and after a Valsalva maneuver.

PTS: 1 REF: p. 513 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Paraumbilical hernia 7. The traditional modality of choice for evaluating urolithiasis is: a. noncontrast abdominal computed tomography (CT) scan. b. abdominal x-ray examination. c. renal ultrasound. d. intravenous urography.

ANS: D

The most sensitive and specific modality for evaluating the presence of stones is the intravenous urogram and the helical CT scan.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 511 OBJ: Identify the modalities commonly used to evaluate flank pain.

TOP: Flank pain 8. For years, which one of the following techniques has been used as a surgical tool for the

diagnosis of hemoperitoneum? a. Paracentesis b. Peritoneal lavage c. Laparoscopy d. Focused assessment with sonography for trauma (FAST) ANS: B

Since 1965, the peritoneal lavage has been used as a surgical tool for the diagnosis of hemoperitoneum.

PTS: 1 REF: pp. 500-501 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Assessment of abdominal trauma 9. Posttrauma, the most common location for fluid to accumulate is in the ___________. a. Morison’s pouch b. pouch of Douglas c. paracolic gutters d. subphrenic space ANS: A

N R I G B.C M

S NforTfluid toOaccumulate is in the subhepatic space, Posttrauma, the most common U location (Morison’s pouch), regardless of the site of injury. The next most common site is in the pelvis.

PTS: 1 REF: p. 504 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Focused assessment with sonography for trauma 10. The initial survey of a FAST scan is directed to the: a. paracolic gutter. b. subhepatic space. c. posterior cul-de-sac. d. pericardium.

ANS: D

The initial survey of a FAST scan is directed to the pericardium via a subcostal approach angling cranially to look for pericardial effusion.

PTS: 1 REF: p. 501 OBJ: Describe the protocol for FAST. TOP: Focused assessment with sonography for trauma 11. Torsion of the spermatic cord occurs as a result of which one of the following? a. Inflammation of the testis b. Abnormal size of the testis

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Abnormal mobility of the testis d. Inflammation of the epididymis ANS: C

Torsion of the spermatic cord occurs as a result of abnormal mobility of the testis within the scrotum.

PTS: 1 REF: p. 515 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Scrotal trauma and torsion 12. In the early stages of testicular torsion, the echogenicity of the testis appears _____________. a. normal b. complex c. hypoechoic d. hyperechoic ANS: A

In the early stage of torsion, the echogenicity of the testis appears normal and homogeneous.

PTS: 1 REF: p. 515 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Scrotal trauma and torsion 13. One of the most common conditions that necessitates emergent surgery is: a. acute cholelithiasis.

NURSINGTB.COM b. urolithiasis. c. acute appendicitis. d. acute pancreatitis.

ANS: C

Acute appendicitis is one of the most common reasons for emergent surgery.

PTS: 1 REF: p. 512 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Right lower quadrant pain 14. Sonographic findings of acute cholecystitis include all of the following except: a. thickened gallbladder wall. b. small gallbladder. c. pericholecystic fluid. d. immobile gallstone.

ANS: B

Sonographic findings in acute cholecystitis may include a thickened gallbladder wall, a very dilated gallbladder, pericholecystic fluid, an immobile gallstone, sludge, and a positive Murphy’s sign.

PTS: 1 REF: p. 506 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Right upper quadrant pain 15. Sonographic findings in acute pancreatitis may include which one of the following? a. Atrophy b. Microcalcifications c. Hyperechoic parenchyma d. Normal-parenchyma texture ANS: D

Acute pancreatitis may demonstrate normal parenchymal texture. It also may appear enlarged and hypoechoic, and the borders may appear irregular.

PTS: 1 REF: p. 507 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Epigastric pain 16. Midepigastric pain radiating to the back is most characteristic of: a. acute cholecystitis. b. urolithiasis. c. acute pancreatitis. d. acute appendicitis.

ANS: C

Midepigastric pain radiating to the back is characteristic of acute pancreatitis.

PTS: 1 REF: p. 507 Nfindings B.C URSINforGT OM right upper quadrant pain, free fluid in OBJ: Describe the sonographic aortic dissection, the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Epigastric pain 17. The most common cause of acute cholecystitis is: a. acute pancreatitis. b. chronic pyelonephritis. c. cholelithiasis. d. obstruction of the cystic duct.

ANS: D

The most common cause of acute cholecystitis is a cystic duct obstruction, generally by a gallstone.

PTS: 1 REF: p. 506 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Right upper quadrant pain 18. Stones as small as _____ millimeters (mm) may be visualized with ultrasound. a. 1 b. 2 c. 0.5 d. 1.5

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C

Stones as small as 0.5 mm may be visualized with ultrasound.

PTS: 1 REF: p. 512 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Flank pain 19. Approximately 70% of aortic dissections occur in the: a. aortic arch. b. ascending aorta. c. descending aorta. d. abdominal aorta.

ANS: B

Approximately 70% of aortic dissections occur in the ascending aorta, 20% in the abdominal aorta, and 10% to 20% in the aortic arch.

PTS: 1 REF: p. 510 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Chest pain 20. Which one of the following is nearly always associated with aortic dissection? a. Trauma b. Pregnancy c. Hypertension d. Coarctation of the aorta N R I G B.C M

U S N T

O

ANS: C

Systemic hypertension is associated with aortic dissection in 70% to 90% of patients.

PTS: 1 REF: p. 510 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Box 19-3 21. A pseudodissection demonstrates which one of the following? a. Intimal flap b. Turbulent blood flow pattern c. Decrease in blood flow d. False lumen ANS: B

A pseudodissection on color flow demonstrates a turbulent blood flow pattern, indicating a hypoechoic thrombus near the aortic margin. No intimal flap is observed.

PTS: 1 REF: p. 511 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Chest pain 22. Paraumbilical hernia occurs more often in which one of the following?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Infants Female adults Male adults Children

ANS: B

Paraumbilical hernias occur more often in female adults.

PTS: 1 REF: p. 513 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Right lower quadrant pain 23. A hernia in the bowel that cannot be reduced is a(n) ______________ hernia. a. reducible b. carcerated c. incarcerated d. strangulated ANS: C

In an incarcerated hernia the visceral contents cannot be reduced; it represents an imprisonment of the bowel.

PTS: 1 REF: p. 513 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Right lower quadrant pain

NURSI GTB.COM 24. A hernia with vascular compromise isN ________________. a. carcerated b. incarcerated c. strangulated d. torsioned ANS: C

A strangulated hernia is an incarcerated hernia with vascular compromise.

PTS: 1 REF: p. 513 OBJ: Describe the sonographic findings for aortic dissection, right upper quadrant pain, free fluid in the abdominopelvic region, acute pelvic pain, and scrotal trauma and torsion.

TOP: Right lower quadrant pain 25. In reproductive-age women, free fluid isolated to the posterior cul-de-sac is likely which one

of the following? a. Ascites b. Hemoperitoneum c. Abscess d. Physiologic ANS: D

Isolated free fluid in the pelvis of a reproductive woman is likely physiologic in nature.

PTS: 1

REF: p. 506

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the protocol for focused assessment with sonography for trauma (FAST).

TOP: Focused assessment with sonography for trauma

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 20: Sonographic Techniques in the Transplant Patient Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Select the group that maintains a centralized computer network system for all organ procurement organizations and transplant centers. a. UNOS b. NASH c. PBC d. MELD ANS: A The United Network for Organ Sharing (UNOS) maintains a centralized computer networking system for all organ procurement organizations and transplant centers while seeking to be fair and effective in selecting transplant candidates.

PTS: 1 REF: p. 520 OBJ: Understand the complexity of and criteria for receiving a transplant.

TOP: Who needs a transplant?

2. Which of the following scoring methods helps determine the urgency of a liver transplant in children 12 and under? a. MELD b. PELD c. UNOS NURSINGTB.COM d. WHO ANS: B The Model for End-Stage Liver Disease (MELD) scale for adults and Pediatric End-Stage Liver Disease (PELD) for children under 12 years of age help determine the urgency of a liver transplant.

PTS: 1 REF: p. 521 OBJ: Understand the complexity of and criteria for receiving a transplant.

TOP: History and criteria for liver transplantation 3. What is the most common cause of renal transplants? a. Chronic infection b. Glomerulonephritis c. Renal failure d. Acute nephrolithiasis ANS: C The most common cause for needing a renal transplant is chronic end-stage renal disease or renal failure. An uncommon transplant indication is acute renal failure.

PTS: 1 REF: p. 521 OBJ: Understand the complexity of and criteria for receiving a transplant.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: History and criteria for renal transplant 4. Which intervention is used in hopes to cure type 1 diabetes. a. Insulin injections b. Islet cell grafting c. Pancreatic transplant d. Renal transplant ANS: C Patients receive a pancreas transplant in hopes to cure type 1 diabetes. Type 2 diabetes patients are not a consideration for pancreas transplant.

PTS: 1 REF: p. 522 OBJ: Understand the complexity of and criteria for receiving a transplant.

TOP: History and criteria for pancreatic transplantation 5. Which of the following vessels is anastomosed with the new liver during a liver transplant procedure? a. IVC b. Cystic artery c. SMA d. Aorta ANS: A The IVC, hepatic, and portal vessels all require anastomosis during a liver transplant procedure.

N R I G B.C M

S N T O PTS: 1 REF: Up. 523 OBJ: Gain knowledge of surgical techniques of liver, renal, and pancreatic transplants.

TOP: Liver transplant 6. When is the baseline liver sonogram performed after a liver transplant procedure? a. Within 1 day after surgery b. Day 0 or immediately after surgery c. 7 days after surgery d. 3 days after surgery ANS: B The transplanted liver has a baseline examination immediately after surgery (day 0 examination) with follow-up examinations on days 1 and 7.

PTS: 1 REF: p. 525 OBJ: Identify the necessary imaging protocol needed for imaging the transplanted organ.

TOP: Liver transplant 7. Which of the following best indicates the presence of an arteriovenous fistula (AVF)? a. Flow aliasing b. Absence of color flow c. Low resistive index (RI) d. Focal cystic areas

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C A low RI can be a strong indicator of a proximal stenosis the sonographer may not be able to otherwise identify or a presence of an arteriovenous fistula (AVF). A high RI may indicate rejection or hepatic venous congestion.

PTS: 1 REF: p. 525 OBJ: Recognize and define normal sonographic features of the transplant patient.

TOP: Liver transplant 8. Identify the normal resistive index (RI) in the hepatic artery of a transplant patient. a.

0.20 b. ± 0.80 c. 0.30 to 0.45 d. 0.50 to 0.70 ANS: D The normal resistive index (RI) in the hepatic artery is in the range of 0.50 to 0.70.

PTS: 1 REF: p. 526 OBJ: Recognize and define normal sonographic features of the transplant patient.

TOP: Liver transplant 9. What is the most common cause of liver transplant failure? a. Rejection b. Infection c. Abscesses d. Vascular compromise NURSINGTB.COM ANS: A Rejection is the most common cause of liver transplant failure.

PTS: 1 REF: p. 529 OBJ: Identify and describe immediate complications after transplantation, and those that occur within the months and years to follow.

TOP: Pathology of the liver 10. What technique parameter helps spread out the waveform during a spectral Doppler study of a renal allograft? a. Overall gain b. Sweep speed c. Angle correct d. Scale ANS: B Increasing the sweep speed of the spectral Doppler tracing spreads out the waveform, allowing for an increase in measurement accuracy.

PTS: 1 REF: p. 548 OBJ: Identify the necessary imaging protocol needed for imaging the transplanted organ.

TOP: Renal transplant

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

11. Choose the normal resistive index (RI) range in the arcuate artery of a transplanted kidney. a. 250 cm/sec b. 3.0 c. 0.60 to 0.70 d. > 0.90 ANS: C The RA velocities should be below 250 cm/sec, with a renal to iliac artery ratio of less than 3.0. A normal RI in the arcuate artery is in the range of 0.60 to 0.70, with borderline values between 0.70 and 0.80.

PTS: 1 REF: pp. 550-551 OBJ: Recognize and define normal sonographic features of the transplant patient.

TOP: Renal transplant 12. More than ________ of renal transplants develop an infection in the first year. a. one third b. 50% c. one in five d. 80% ANS: D More than 80% of renal transplant recipients develop at least one infection within the first year. These can include pneumonia, wound infections, or urinary tract infections.

PTS: 1 REF: p. 555 N immediate RSINGTcomplications B.COM after transplantation, and those that OBJ: Identify and describeU occur within the months and years to follow.

TOP: Pathology of the renal transplant 13. Select the renal transplant complication that occurs within the first week of transplantation. a. Renal vein thrombosis b. Chronic renal failure c. Urinary obstruction d. Renal artery stenosis ANS: A Urinary obstruction occurs within the first 6 months, renal vein thrombosis occurs within the first week, and renal artery stenosis occurs within the first year of transplantation.

PTS: 1 REF: p. 557 OBJ: Identify and describe immediate complications after transplantation, and those that occur within the months and years to follow.

TOP: Pathology of the renal transplant 14. How would you determine stenosis in a transplanted kidney? a. Take a blood pressure b. Perform a resistive index c. Do a gain study

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Check bladder wall thickness ANS: B Performing a resistive index (RI) helps determine rejection status of a transplanted kidney.

Blood flow velocities exceeding 250 cm/sec and an RA to iliac artery ratio above 3.0 strongly suggest stenosis.

PTS: 1 REF: p. 558 OBJ: Identify and describe immediate complications after transplantation, and those that occur within the months and years to follow.

TOP: Pathology of the renal transplant 15. Choose the indicator of a proximal stenosis in an intraparenchymal artery in the transplanted pancreas. a. Pulsatile flow b. High pulsatility index c. Low resistive index (RI) d. Normal color flow ANS: C A low RI is a strong indicator of a proximal stenosis; a high RI may indicate rejection or venous congestion. Accurate stenosis measurements require angle correction when evaluating the pancreatic artery with spectral Doppler. Also, include spectral Doppler with velocity measurements in the distal, mid-, and proximal pancreatic artery and at the anastomosis between the iliac artery and pancreatic artery.

PTS: 1 REF: p. 558 N immediate RSINGTcomplications B.COM after transplantation, and those that OBJ: Identify and describeU occur within the months and years to follow.

TOP: Pancreatic transplant 16. Which of the following is a rare complication that results from hyperacute rejection of post-transplant pancreas patient? a. Acute pancreatitis b. Infection and abscess c. Pancreatic venous thrombosis d. Thrombosis and graft loss ANS: D A rare complication, hyperacute rejection, occurs immediately postoperative, causing thrombosis and graft loss. Acute rejection usually occurs 1 to 3 weeks following transplantation. Pancreatitis is the second most common complication occurring within the first 4 weeks of transplantation.

PTS: 1 REF: pp. 570-571 OBJ: Identify and describe immediate complications after transplantation, and those that occur within the months and years to follow.

TOP: Pancreatic transplant 17. What is the first step to formally become an organ donor?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Register as an organ donor Develop an organ donation protocol Perform above-average sonographic examinations Talk to your family

ANS: A If you are interested in more information about becoming an organ donor or would like to share with others, please visit: donatelife.net.

PTS: 1 REF: p. 577 OBJ: Understand how you can help donate life.

TOP: Learn how you can donate life

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 21: Breast Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The breast is sonographically divided into three layers. Which one of the following is incorrect? a. Skin, nipple, subareolar b. Pectoralis major c. Subcutaneous region d. Parenchyma ANS: B Sonographically, the breast is divided into the subcutaneous, mammary, and retromammary layers. The pectoralis major muscle is posterior to the breast layers.

PTS: 1 REF: p. 583 OBJ: Describe the breast anatomy and sonographic layers.

TOP: Anatomy of the breast 2. The functional portion of the breast consists of _________ lobes. a. 3 to 5 b. 5 to 10 c. 15 to 20 d. 25 to 30

N R I G B.C M

U S N T O ANS: C The functional portion of the breast consists of 15 to 20 lobes.

PTS: 1 REF: p. 583 OBJ: Describe the breast anatomy and sonographic layers.

TOP: Anatomy of the breast 3. Which one of the following form(s) a fibrous “skeleton” that is responsible for maintaining the shape of the breast? a. Acini b. Cooper’s ligaments c. Pectoralis major muscle d. Glandular layer of the breast ANS: B Cooper’s ligaments are the connective tissue septa in the breast that form a fibrous “skeleton” that is responsible for maintaining the shape and structure of the breast.

PTS: 1 REF: p. 584 OBJ: Describe the breast anatomy and sonographic layers.

TOP: Anatomy of the breast 4. As a woman ages, the glandular breast tissue is replaced with:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

fat. cysts. fibrous tissue.

Cooper’s ligaments.

ANS: A As a woman ages, the glandular breast tissue undergoes cell death and is replaced by fatty tissue.

PTS: 1 REF: p. 586 OBJ: Describe the breast anatomy and sonographic layers.

TOP: Anatomy of the breast 5. Cooper’s ligaments are best characterized as which one of the following? a. Low reflectivity in the retromammary layer b. High reflectivity in the retromammary layer c. Echogenic line interfaces in the subcutaneous layer d. Homogeneous reflections in the parenchyma ANS: C Cooper’s ligaments appear echogenic and are dispersed in a linear pattern within the subcutaneous layer.

PTS: 1 REF: p. 585 OBJ: Describe the breast anatomy and sonographic layers.

TOP: Anatomy of the breast

N R I G B.C M

U S N T imaged O as which one of the following?

6. The retromammary layer is sonographically a. Hyperechoic b. Dense c. Hypoechoic d. High reflectivity ANS: C The retromammary layer appears hypoechoic, similar to the subcutaneous layer.

PTS: 1 REF: p. 583 OBJ: Describe the breast anatomy and sonographic layers.

TOP: Sonographic characteristics 7. The most important signs to look for in determining a cystic lesion of the breast include all of the following except: a. well-defined borders. b. good through transmission. c. anechoic. d. disruption of architecture.

ANS: D A simple cyst should demonstrate no internal echoes (anechoic) or smooth borders and demonstrate posterior acoustic enhancement.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 601 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Sonographic evaluation of the breast 8. Clinical findings of lumpy, painful, tender breasts that vary with monthly cycles usually represent which one of the following? a. Carcinoma b. Fibrocystic disease c. Cysts d. Adenomas ANS: B Symptoms of fibrocystic disease include breast lumps and pain that fluctuates with every monthly cycle.

PTS: 1 REF: p. 605 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Pathology 9. The most common solid benign tumor of the breast is which one of the following? a. Fibrocystic disease b. Fibroadenoma c. Papilloma d. Lipoma ANS: B The fibroadenoma is the most common solid benign tumor of the breast. It occurs primarily NURSINGTB.COM in young women.

PTS: 1 REF: p. 606 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Pathology 10. Select the sonographic characteristic of a fibroadenoma. a. Poorly defined border b. Uniform, low-level homogeneous echoes c. Increased through transmission d. Disruption of architecture ANS: B Sonographic characteristics of a fibroadenoma include smooth, rounded margins and low-level homogeneous echoes. In addition, sonography may demonstrate immediate posterior acoustic enhancement.

PTS: 1 REF: p. 606 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Pathology 11. Lymphatic drainage from all parts of the breast generally flows to the ________ lymph nodes.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

interpectoral axillary supraclavicular internal mammary

ANS: B Lymphatic drainage from all parts of the breast generally flows to the axillary lymph nodes.

PTS: 1 REF: p. 588 OBJ: Describe breast anatomy and sonographic layers.

TOP: Anatomy of the breast 12. The most common malignant neoplasm of the breast is which one of the following? a. Lobular carcinoma in situ b. Invasive ductal carcinoma (IDC) c. Invasive lobular carcinoma d. Ductal carcinoma in situ ANS: B IDC accounts for nearly 80% of breast cancers.

PTS: 1 REF: p. 608 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Pathology 13. Characteristic findings of breast carcinoma include all of the following except: a. attenuation of sound.

NURSINGTB.COM b. irregular margins. c. strong posterior margin. d. inhomogeneous low-level internal echo pattern with calcifications.

ANS: C Characteristics of breast cancer include irregular margins; a taller-than-wide mass; and strongly attenuating, rigid, noncompressible, and disrupted architecture.

PTS: 1 REF: p. 610 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Pathology 14. Skin dimpling may be caused by which one of the following? a. Old age b. Retraction of tissue secondary to tumor infiltration c. Enlarged ducts d. Thrombosis of arterial vessels ANS: B As malignant masses enlarge, they may cause retracting of the nipple or a dimpling of the skin as the spiculations pull on the Cooper’s ligaments.

PTS: 1 REF: p. 591 | p. 605 OBJ: Identify the sonographic characteristics associated with benign and malignant breast

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank masses.

TOP: Pathology

15. The most common clinical sign of breast carcinoma is which one of the following? a. Skin dimpling b. Skin discoloration c. Palpable lump d. Pain ANS: C A palpable lump is the most common clinical symptom of breast cancer.

PTS: 1 REF: p. 591 OBJ: Summarize the indications for the use of ultrasound in breast imaging.

TOP: Breast evaluation overview 16. The primary purpose of breast screening examinations is to: a. evaluate the retromammary region. b. provide a baseline study for fibrocystic disease. c. provide for early detection of breast carcinoma. d. evaluate dense breast parenchyma.

ANS: C The primary purpose of breast screening examinations is the detection and diagnosis of breast cancer at its earliest and most curable stage.

PTS: 1 REF: p. 591 OBJ: Explain the difference between breast screening and breast imaging.

NURSINGTB.COM TOP: Breast evaluation overview 17. The midportion of the right medial and left lateral breast would be annotated as which one of the following? a. 3:00 b. 6:00 c. 9:00 d. 12:00 ANS: A The midportion of the right medial and left lateral breast would be annotated as 3:00.

PTS: 1 REF: p. 599 OBJ: Know how to use methods of identifying and labeling breast anatomy and masses.

TOP: Sonographic evaluation of the breast 18. A normal extension of breast tissue into the axillary region is called ______________. a. lobar neoplasm b. tail of Spence c. peau d’orange d. terminal ductal lobular unit ANS: B A normal extension of breast tissue into the axillary region is called the tail of Spence.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 582 OBJ: Describe breast anatomy and sonographic layers.

TOP: Anatomy of the breast 19. Which one of the following arteries is responsible for supplying blood to more than half of the breast? a. Intercostal b. Thoracodorsal c. Internal mammary d. Lateral thoracic ANS: C More than one half of the breast—mainly the central and medial portions—is supplied by the anterior perforating branches of the internal mammary artery.

PTS: 1 REF: p. 586 OBJ: Describe breast anatomy and sonographic layers.

TOP: Anatomy of the breast 20. A condition of the male breast in which the ductal elements hypertrophy is called ______________. a. mastitis b. galactocele c. gynecomastia d. Paget’s disease

N R I G B.C M

U S N T O ANS: C Gynecomastia is a condition in which the ductal elements hypertrophy.

PTS: 1 REF: p. 588 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Anatomy of the breast 21. Characteristics of possible breast cancer include all of the following except: a. irregular or spiculated mammographic mass, and solid on ultrasound. b. clustered pleomorphic microcalcifications on mammogram, with or without any abnormality on ultrasound. c. focal distortion on mammogram, and a correlating area of distortion on breast ultrasound. d. a smooth low-density mass on mammogram, and solid lesion that has not changed in over 3 years on ultrasound.

ANS: D A smooth, low-density mass on mammography and a sonographic finding of a solid lesion that does not change or grow are characteristic of benign lesions. Microcalcifications, focal distortion, and irregular (speculated), high-density masses are signs of breast cancer on mammography. Microcalcifications and focal distortion are often difficult to visualize with ultrasound.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 591 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Sonographic evaluation of the breast 22. Ultrasound is often of benefit in guiding breast procedures for all of the following except: a. cyst aspiration. b. fine-needle aspiration cytology (FNAC). c. drainage procedures. d. large-core needle biopsy of microcalcifications.

ANS: D Stereotactic guidance is still the preferred method for evaluation of clustered pleomorphic microcalcifications, which are difficult to see by ultrasound.

PTS: 1 REF: p. 613 OBJ: Discuss ultrasound-guided interventional techniques.

TOP: Breast evaluation overview 23. Which one of the following statements is false? a. Breast ultrasound is the imaging tool of choice to evaluate a breast mass in a teenage girl. b. Ultrasound of the breast is the primary imaging tool of choice in evaluating a breast mass in a pregnant woman. c. Breast ultrasound is the primary imaging tool of choice in screening a 45-year-old woman for any evidence of possible breast cancer. d. In the case of a benign fibroadenoma, the sonographic features of a smooth, sharply circumscribed hypoechoic with homogeneous echogenicity and a NURSINGmass TB.C OM mild posterior acoustic enhancement will usually be seen.

ANS: C Screening mammography is the gold standard for breast cancer screening.

PTS: 1 REF: p. 591 OBJ: Summarize the indications for the use of ultrasound in breast imaging.

TOP: Breast evaluation overview 24. Ultrasound of the breast is often performed as an adjunctive imaging tool in all of the following situations except: a. to assess a smooth mammographic mass as cystic or solid. b. to further evaluate a palpable breast lump in a patient with very dense breast tissue and a negative mammogram. c. to further evaluate a palpable breast lump in a patient with breast implants. d. to further evaluate an asymptomatic patient with large fatty replaced breasts and a negative mammogram.

ANS: D Ultrasound is used to further evaluate symptomatic patients with a negative mammogram.

PTS: 1 REF: p. 595 OBJ: Summarize the indications for the use of ultrasound in breast imaging.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Sonographic evaluation of the breast 25. In the case of a mammographic mass that is highly suggestive of malignancy, the correlating sonographic mass will likely show which one of the following features? a. Irregular margin and taller than wide b. Anechoic c. Irregular margin and wider than tall d. Posterior acoustic enhancement ANS: A Sonographic characteristics of a malignant mass include indistinct walls, taller than wide, hypoechoic, rigid, and strongly attenuating structure.

PTS: 1 REF: p. 602 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Figure 21-39 26. In the case of a smooth mammographic mass that is highly suggestive as cystic, the correlating sonographic mass will likely show which one of the following features? a. Irregular margin b. Anechoic and posterior acoustic enhancement c. Taller than wide d. Echogenic and posterior acoustic enhancement ANS: B A cystic structure demonstrates no internal echoes (anechoic) with good posterior acoustic enhancement.

NURSINGTB.COM

PTS: 1 REF: p. 602 OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.

TOP: Sonographic evaluation of the breast 27. The advantages of breast ultrasound over mammography in evaluating the breast include all of the following except: a. limited radiation exposure to the patient. b. differentiation of cystic versus solid smooth masses. c. more comfortable examination for the patient. d. better visualization of juxtathoracic deep tissues.

ANS: A The patient is exposed to no radiation with ultrasound.

PTS: 1 REF: p. 596 OBJ: Summarize the indications for the use of ultrasound in breast imaging.

TOP: Sonographic evaluation of the breast 28. The advantages of breast ultrasound over mammography in evaluating the breast include which one of the following? a. Can better visualize those often-obscure signs of breast cancer such as microcalcifications

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Can better visualize microcystic adenosis with layering milk of calcium and sclerosing adenosis, as well as variants of benign fibrocystic conditions that contain small calcifications as the principle mammographic finding that can be easily overlooked on routine mammographic images c. Can better discriminate Cooper’s ligaments within lumen of the small ducts of the terminal ductal lobular units (TDLUs) d. Can better evaluate those hard-to-reach places, such as parasternal tissues and axilla, not well seen on mammography ANS: D Ultrasound can evaluate the parasternal tissues, axilla, and juxtathoracic deep tissues better than mammography.

PTS: 1 REF: p. 586 OBJ: Summarize the indications for the use of ultrasound in breast imaging.

TOP: Sonographic evaluation of the breast

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 22: Thyroid and Parathyroid Glands Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The thyroid is an endocrine gland that regulates metabolic function through the production of

all of the following hormones except: a. thyroxine. b. triiodothyronine. c. thyrocalcitonin. d. thyroliberin.

ANS: D

Thyroid hormones include thyroxine (T4), triiodothyronine (T3), and thyrocalcitonin (calcitonin).

PTS: 1 REF: p. 618 OBJ: Discuss the laboratory values and clinical findings of the thyroid and parathyroid glands.

TOP: Introduction 2. The thyroid gland consists of ________ lobes. a. three b. four c. two d. six ANS: C

NURSINGTB.COM

The thyroid gland consists of the right and left lobes connected across the midline by the thin bridge of thyroid tissue called the isthmus.

PTS: 1 REF: p. 619 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Anatomy of the thyroid gland 3. The approximate dimensions of the thyroid gland are: a. 5 cm length, 2 cm width, 2 cm depth. b. 4 cm length, 5 cm width, 2 cm depth. c. 3 cm length, 5 cm width, 2 cm depth. d. 6 cm length, 3 cm width, 3 cm depth.

ANS: A

The normal adult thyroid measures 4 to 6 cm in length, 1.5 to 2.0 cm in width, and 2 to 3 cm in depth (anteroposterior diameter).

PTS: 1 REF: p. 620 OBJ: Describe the texture patterns and size of the normal thyroid and parathyroid glands.

TOP: Anatomy of the thyroid gland 4. The lobes of the thyroid gland are connected by: a. ismal tissue. b. the isthmus.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. island tissue. d. parathyroid tissue.

ANS: B

A thin bridge of thyroid tissue connects the two thyroid lobes and is called the isthmus.

PTS: 1 REF: p. 619 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Anatomy of the thyroid gland 5. All of the following structures form neighboring structures for the thyroid gland except the: a. longus colli muscle. b. parotid muscle. c. strap muscles. d. sternocleidomastoid muscle.

ANS: B

The strap muscles lie anterior to the thyroid, and the sternocleidomastoid muscle lies anterior and lateral to the thyroid. The longus colli muscle is posterior and lateral to each thyroid gland.

PTS: 1 REF: p. 620 OBJ: Define the relational anatomy of the thyroid and parathyroid glands.

TOP: Anatomy of the thyroid gland 6. The pyramid lobe of the thyroid gland extends from the __________________. a. superior right lobe b. inferior left lobe NURSINGTB.COM c. superior isthmus d. inferior right lobe ANS: C

A pyramid lobe extends from the superior isthmus in 15% to 30% of patients.

PTS: 1 REF: p. 619 OBJ: Describe the texture patterns and size of the normal thyroid and parathyroid glands.

TOP: Sonographic evaluation of the thyroid 7. Which one of the following structures lies medial to the left thyroid lobe? a. Larynx b. Jugular vein c. Strap muscles d. Longus colli muscle ANS: A

The larynx, trachea, inferior constrictor of the pharynx, and esophagus are located medial to the left thyroid lobe.

PTS: 1 REF: p. 620 OBJ: Define the relational anatomy of the thyroid and parathyroid glands.

TOP: Sonographic evaluation of the thyroid 8. The thyroid gland develops at the floor of which structure?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Primitive pharynx Trachea precursor Maxilla Nasopharynx

ANS: A

The thyroid gland develops at the floor of the primitive pharynx at the same location of the base of the tongue. The developing thyroid gland migrates inferiorly along the anterior neck region to the lower neck anteriorly to the trachea.

PTS: 1 REF: p. 619 OBJ: Discuss the embryology that affect the thyroid gland and parathyroid glands.

TOP: Embryology of the thyroid gland 9. The most common cause of thyroid disorders worldwide is which one of the following? a. Hypothyroidism b. Iron deficiency c. Iodine deficiency d. Autoimmune process ANS: C

The most common cause of thyroid disorders worldwide is iodine deficiency, which leads to goiter formation and hypothyroidism.

PTS: 1 REF: p. 626 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Pathology of the thyroid gland

N R I G B.C M

N T O include all of the following except: 10. Common disorders associated U withShyperthyroidism a. toxic adenoma. b. toxic multinodular goiter. c. Grave’s disease. d. acute thyroiditis.

ANS: D

Toxic adenoma, toxic multinodular goiter, and Grave’s disease account for 99% of patients with hyperthyroidism.

PTS: 1 REF: p. 622 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Thyroid physiology and laboratory data 11. Which one of the following sonographic features of a thyroid adenoma is the most common? a. Complex echo pattern b. Hyperechoic mass c. Hypoechoic peripheral halo d. Irregular margins ANS: C

Adenomas have a broad spectrum of ultrasound appearances with a relatively consistent hypoechoic peripheral halo.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 628 OBJ: Differentiate the sonographic features of the pathologic conditions found in the thyroid and parathyroid glands. TOP: Pathology of the thyroid gland 12. The parathyroid glands produce a hormone that affects the: a. liver, colon, and kidneys. b. kidneys, bones, and gastrointestinal tract. c. gastrointestinal tract, breast, and scrotum. d. kidneys, heart, and colon.

ANS: B

Parathyroid glands produce parathyroid hormone (PTH), which acts on the bone, kidney, and intestine to enhance calcium absorption.

PTS: 1 REF: p. 635 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Parathyroid physiology and laboratory data 13. The normal parathyroid glands are located on the ____________ and the ____________

surface of the thyroid gland. a. posterior; lateral b. anterior; lateral c. anterior; medial d. posterior; medial ANS: D

The parathyroid glands are normally located on the posteromedial surface of the thyroid gland.

N R I G B.C M

U S N T

O

PTS: 1 REF: p. 634 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Parathyroid physiology and laboratory data 14. Usually _______ parathyroid glands exist. a. two b. three c. four d. five ANS: C

Generally, four parathyroid glands exist. Typically paired, they lie posterior to the superior and inferior poles of the thyroid gland.

PTS: 1 REF: p. 634 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Parathyroid physiology and laboratory data 15. A solitary thyroid nodule in the presence of ipsilateral lymphadenopathy suggests which one

of the following? a. Adenoma b. Grave’s disease c. Follicular carcinoma

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Hashimoto’s thyroiditis ANS: C

A solitary thyroid nodule in the presence of ipsilateral lymphadenopathy suggests a follicular carcinoma.

PTS: 1 REF: p. 628 | p. 629 OBJ: Differentiate the sonographic features of the pathologic conditions found in the thyroid and parathyroid glands. TOP: Pathology of the thyroid gland 16. The most common cause of primary hyperparathyroidism is which one of the following? a. Thyroid adenoma b. Parathyroid adenoma c. Parathyroid cyst d. Parathyroid hemorrhagic cyst ANS: B

Parathyroid adenoma is the most common cause of primary hyperparathyroidism (80% of patients).

PTS: 1 REF: p. 636 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Parathyroid physiology and laboratory data 17. A ___________ is a palpable anterior midline mass between the hyoid bone and the isthmus

of the thyroid gland. a. carotid aneurysm b. parathyroid adenoma c. thyroglossal duct cyst d. brachial cleft cyst

NURSINGTB.COM

ANS: C

A thyroglossal duct cyst is a congenital anomaly that appears in the midline of the neck, anterior to the trachea.

PTS: 1 REF: p. 638 OBJ: Discuss the embryology that affect the thyroid gland and parathyroid glands.

TOP: Miscellaneous neck masses 18. Which one of the following structures lies posterolateral to the thyroid gland? a. Esophagus b. Sternocleidomastoid muscle c. Longus colli muscle d. Omohyoid muscle ANS: C

Structures lying posterolateral to the thyroid gland include the carotid sheath (carotid artery, internal jugular vein, and vagus nerve) and the longus colli muscle.

PTS: 1 REF: p. 620 OBJ: Define the relational anatomy of the thyroid and parathyroid glands.

TOP: Anatomy of the thyroid gland

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 19. Hyperfunction of all parathyroid glands with no apparent cause occurs with which one of the

following? a. Primary hyperplasia of the parathyroid glands b. Secondary hyperplasia of the thyroid gland c. Primary hyperparathyroidism d. Secondary hyperplasia of the parathyroid glands ANS: A

Primary hyperplasia is defined as hypofunction of primary hyperplasia of the parathyroid glands.

PTS: 1 REF: p. 638 OBJ: Describe the normal anatomy and physiology of thyroid and parathyroid glands.

TOP: Parathyroid physiology and laboratory data 20. Increased vascularity with color Doppler, termed the thyroid inferno, is observed in

___________________. a. Hashimoto’s disease b. Graves’ disease c. de Quervain thyroiditis d. papillary carcinoma ANS: B

The overactivity of the thyroid gland in Graves’ disease is manifested in the color Doppler image. This increase in vascular flow is termed the thyroid inferno.

PTS: 1 REF: p. 633 OBJ: Differentiate the sonographic ofB.C the pathologic NURfeatures GT M conditions found in the thyroid and SIofNthe parathyroid glands. TOP: Pathology thyroidO gland 21. The most common cause of thyroid malignancy is _____________ carcinoma. a. papillary b. medullary c. anaplastic d. follicular ANS: A

Approximately 90% of thyroid malignancies are papillary carcinomas and are found more often in women and metastasizes to the cervical nodes in approximately 20% of patients.

PTS: 1 REF: p. 629 OBJ: Differentiate the sonographic features of the pathologic conditions found in the thyroid and parathyroid glands. TOP: Pathology of the thyroid gland 22. An abnormal lymph node demonstrates which one of the following? a. Homogeneous texture b. Central echogenic complex c. Oval contour d. Round contour ANS: D

The more round the lymph node, the more likely it is malignant.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 640 OBJ: Differentiate the sonographic features of the pathologic conditions found in the thyroid and parathyroid glands. TOP: Pathology of the thyroid gland 23. A cystic formation located lateral to the thyroid gland in the neck is typically which one of the

following? a. Thyroglossal duct cyst b. Branchial cleft cyst c. Cystic hygroma d. Sublingual cyst ANS: B

Typically, a branchial cleft cyst is located lateral to the thyroid. A cystic hygroma comes from the posterior occiput and is frequently observed in the lateral neck.

PTS: 1 REF: p. 638 OBJ: Differentiate the sonographic features of the pathologic conditions found in the thyroid and parathyroid glands. TOP: Miscellaneous neck masses

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 23: Scrotum Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The diameter of a varicocele measures more than _____ millimeters (mm). a. 2 b. 3 c. 4 d. 5 ANS: A

A varicocele measures more than 2 mm in diameter.

PTS: 1 REF: p. 658 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 2. The testes are covered by a fibrous capsule formed by the: a. tunica albuginea. b. Cowper’s fascia. c. cremaster muscle. d. dartos muscle.

ANS: A

The testis is completely covered by a dense, fibrous tissue termed the tunica albuginea.

N R INGTB.COM

U S PTS: 1 REF: p. 643 TOP: Anatomy of the scrotum

OBJ: Identify the normal anatomy of the scrotum.

3. The testes measure: a. 6 cm long, 3 cm in diameter (anteroposteriorly [AP]), 3 cm wide. b. 5 cm long, 2 cm in diameter (AP), 2 cm wide. c. 2 cm long, 5 cm in diameter (AP), 5 cm wide. d. 4 cm long, 3 cm in diameter (AP), 3 cm wide.

ANS: D

The adult testes measure 3 to 5 cm long, 2 to 4 cm in width, and 3 cm in diameter (AP).

PTS: 1 REF: p. 643 TOP: Anatomy of the scrotum

OBJ: Identify the normal anatomy of the scrotum.

4. Sonographic characteristics of the normal testis include a(n): a. inhomogeneous pattern with dense internal echoes. b. homogeneous pattern with low-level internal echoes. c. homogeneous pattern with medium-level echoes. d. inhomogeneous pattern with medium-level echoes.

ANS: C

The testis appears as a smooth, homogeneous, medium-gray structure with a fine echo texture.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 665 TOP: Scrotal pathology

OBJ: Identify the normal anatomy of the scrotum.

5. A linear stripe of variable thickness and echogenicity running through the testis in a

craniocaudal direction represents the: a. Cowper’s fascia. b. mediastinum testis. c. epithelial layer. d. dartos muscle.

ANS: B

The mediastinum testis appears as a bright hyperechoic line that courses craniocaudal within the testis.

PTS: 1 REF: p. 644 TOP: Anatomy of the scrotum

OBJ: Identify the normal anatomy of the scrotum.

6. The epididymis courses ________________ to the testis. a. anterior and inferior b. anterior and superior c. posterior and inferior d. superior and posterolaterally ANS: D

The epididymis is a 6- to 7-cm tubular structure beginning superiorly and coursing posterolaterally to the testis. It is divided into the head, body, and tail.

PTS: 1 REF: p.N 643R I GOBJ: Identify the normal anatomy of the scrotum.

B.C OM TOP: Anatomy of the scrotum U S N T 7. Which one of the following facts about an undescended testis is false? a. The testis originates in the retroperitoneum at the level of the fetal kidney. b. All undescended testes are found in the inguinal canal. c. An associated risk for testicular malignancy can develop. d. An increased incidence of infertility exists.

ANS: B

Approximately 80% of undescended testes are located in the inguinal canal. They may also be found in the abdomen or in other ectopic locations.

PTS: 1 REF: p. 665 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Anatomy of the scrotum 8. The most common cause of acute scrotal pain in the adolescent is: a. a varicocele. b. epididymitis. c. testicular torsion. d. an inguinal hernia.

ANS: C

Testicular torsion is the most common cause of acute scrotal pain in the adolescent.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 655 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 9. Common causes of a hydrocele include all of the following except: a. trauma. b. microlithiasis. c. epididymo-orchitis. d. testicular torsion.

ANS: B

Hydroceles may by idiopathic but are commonly associated with epididymo-orchitis, testicular torsion, trauma, or the development of a neoplasm.

PTS: 1 REF: p. 660 OBJ: Describe patient positioning, scanning protocol, and technical considerations for an ultrasound examination of the scrotum.

TOP: Patient position and scanning protocol 10. Which one of the following statements about varicoceles is false? a. Varicoceles refer to dilated, serpiginous, and elongated veins of the pampiniform

plexus. b. Varicoceles are more common on the right side of the scrotum. c. Primary varicoceles result from incompetent valves in the spermatic vein. d. Secondary varicoceles develop from compression of the spermatic vein.

ANS: B

Varicoceles are more commonly found on the left side of the scrotum due to venous drainage NURSINGTB.COM into the left renal vein.

PTS: 1 REF: p. 657 OBJ: Describe patient positioning, scanning protocol, and technical considerations for an ultrasound examination of the scrotum.

TOP: Patient position and scanning protocol 11. A spermatocele is always located in which portion of the epididymis? a. Head b. Neck c. Body d. Tail ANS: A

Spermatoceles are cystic dilations of the efferent ductules of the epididymis and are always located in the epididymal head.

PTS: 1 REF: p. 651 OBJ: Describe patient positioning, scanning protocol, and technical considerations for an ultrasound examination of the scrotum.

TOP: Patient position and scanning protocol 12. A common cause of acute scrotal pain in adults is: a. an epididymal cyst. b. epididymo-orchitis. c. a spermatocele.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. testicular torsion.

ANS: B

Epididymo-orchitis represents the most common cause of acute scrotal pain in adults.

PTS: 1 REF: pp. 652-653 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 13. Which one of the following almost always transpires secondary to epididymitis? a. Orchitis b. Hydrocele c. Spermatocele d. Varicocele ANS: A

Orchitis almost always transpires secondary to epididymitis.

PTS: 1 REF: p. 653 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 14. Tubular ectasia of the rete testis is associated with a(n): a. hydrocele. b. varicocele. c. epididymal cyst. d. inguinal hernia.

ANS: C

NURSINGTB.COM

Tubular ectasia of the rete testis is associated with the presence of a spermatocele, an epididymal or testicular cyst orother epididymal obstruction on the ipsilateral side.

PTS: 1 REF: p. 661 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Tubular ectasia of the rete testis 15. A seminoma of the testicle generally appears on ultrasound as a(n) _____________ mass. a. hypoechoic b. complex c. hyperechoic d. anechoic ANS: A

A seminoma tends to be a homogeneous, hypoechoic mass with smooth borders.

PTS: 1 REF: p. 663 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 16. Epididymo-orchitis most commonly results from a: a. trauma. b. virus. c. bladder infection.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. sexually transmitted disease.

ANS: C

Epididymo-orchitis most commonly results from the spread of a lower urinary tract infection via the spermatic cord. Less common causes include mumps, syphilis, tuberculosis, viruses, trauma, and chemical causes.

PTS: 1 REF: p. 652 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 17. A clinical history of a vasectomy is associated with: a. testicular torsion. b. sperm granulomas. c. microlithiasis. d. varicoceles.

ANS: B

Sperm granulomas are most frequently observed in patients with a history of a vasectomy.

PTS: 1 REF: p. 660 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 18. The primary source of blood flow to the testicles is via the _____________ arteries. a. renal b. internal iliac c. testicular NURSINGTB.COM d. centripetal ANS: C

The testicular arteries are the primary source of blood flow to the testicles.

PTS: 1 REF: p. 644 TOP: Vascular supply

OBJ: Explain the vascular supply to the scrotal contents.

19. Intratesticular cysts have an association with: a. spermatoceles. b. germ cell tumors. c. hydroceles. d. microlithiasis.

ANS: A

Intratesticular cysts are found in men older than 40 years of age and have an association with extratesticular spermatoceles.

PTS: 1 REF: p. 661 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 20. Microlithiasis of the testis is associated with a(n): a. hydrocele. b. inguinal hernia.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. spermatocele. d. malignant neoplasm.

ANS: D

Microlithiasis is associated with malignancy, varicocele, undescended testis, Klinefelter syndrome, infertility, and testicular atrophy.

PTS: 1 REF: p. 661 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 21. Follow-up examination of patients with microlithiasis is recommended: a. semiannually. b. annually. c. every 5 years. d. Follow-up is not recommended.

ANS: B

Follow-up examination is recommended annually.

PTS: 1 REF: p. 661 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Scrotal pathology 22. Attached at the superior pole of the testis between the epididymis and the testis is which one

of the following? a. Rete testis b. Mediastinum testis c. Appendix testis d. Spermatocele

NURSINGTB.COM

ANS: C

The appendix of the testis is attached at the superior pole of the testis between the epididymis and testis.

PTS: 1 REF: p. 643 TOP: Anatomy of the scrotum

OBJ: Identify the normal anatomy of the scrotum.

23. A hydrocele develops between the: a. visceral and parietal layers of the tunica albuginea. b. tunica albuginea and tunica vaginalis. c. parietal and visceral layers of the tunica vaginalis. d. scrotum and tunica albuginea.

ANS: C

A hydrocele develops between the visceral and parietal layers of the tunica vaginalis.

PTS: 1 REF: p. 644 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Anatomy of the scrotum 24. The rete testis is located: a. at the hilum of the testis.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. in the epididymis. c. at the superior pole of the testis. d. at the inferior pole of the testis.

ANS: A

The rete testis is located at the hilum of the testis where the mediastinum resides.

PTS: 1 REF: p. 661 TOP: Anatomy of the scrotum

OBJ: Identify the normal anatomy of the scrotum.

25. Compared with the testis, the epididymis typically appears: a. anechoic. b. hyperechoic. c. hypoechoic. d. homogenous.

ANS: C

The epididymis appears isoechoic to hypoechoic, compared with the normal testis. It also displays a coarser texture than the testis.

PTS: 1 REF: p. 643 OBJ: Describe the ultrasound characteristics of scrotal pathologic conditions.

TOP: Sonographic characteristics

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 24: Musculoskeletal System Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. A bursa provides which one of the following functions? a. Fluid protection to areas that are subject to friction b. Support to muscles c. Support to tendons d. Nerve bundles to the ligaments ANS: A

A bursa is a small sac containing thick fluid that lies between two moving surfaces (usually tendon and bone). It aids in relieving friction.

PTS: 1 REF: p. 668 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology 2. The crass position is used to evaluate which one of the following structures? a. Knee b. Wrist c. Ankle d. Shoulder ANS: D

The crass position is used to N evaluate R ItheGsupraspinatus B.C M tendon of the shoulder.

U S N T

O

PTS: 1 REF: p. 678 OBJ: Summarize the basic sonographic examinations of the shoulder, wrist, knee, ankle, and foot.

TOP: Scanning techniques 3. A Baker’s cyst is an example of: a. communicating bursa. b. communicating tendon. c. fatty pockets. d. joint effusion.

ANS: A

A Baker’s cyst has a connecting neck to the bursa contained in the knee joint.

PTS: 1 REF: p. 673 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Pathology 4. Which one of the following imaging artifacts depends on the angle of incidence? a. Reverberation b. Anisotropy c. Shadowing d. Mirror image

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B

Anisotropy occurs when the sound beam misses the transducer on the return because of the curve of the structure.

PTS: 1 REF: p. 673 OBJ: Summarize the basic sonographic examinations of the shoulder, wrist, knee, ankle, and foot.

TOP: Imaging artifacts 5. Which one of the following imaging artifacts bends the sound beam to an oblique path? a. Reverberation b. Anisotropy c. Refractile shadowing d. Time of flight ANS: C

Refractile shadowing results in a change in the direction of the sound beam, which causes a hypoechoic band posterior to the structure (edge artifact) to be most commonly seen with a complete tendon tear.

PTS: 1 REF: p. 675 OBJ: Summarize the basic sonographic examinations of the shoulder, wrist, knee, ankle, and foot.

TOP: Imaging artifacts 6. Infringement of the median nerve in the wrist results in: a. arthritis. b. bursitis. c. impingement syndrome. d. carpal tunnel syndrome. N R I G B.C M

U S N T

O

ANS: D

Carpal tunnel syndrome is primarily entrapment or compressed neuropathy of the median nerve.

PTS: 1 REF: p. 687 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Pathology 7. The tendon responsible for dorsal and plantar flexion of the foot is the _____________

tendon. a. biceps b. patellar c. Achilles d. semimembranous ANS: C

The Achilles tendon helps move the foot downward and pushes off when walking and rising up on the toes.

PTS: 1 REF: p. 681 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. Which one of the following types of tendinitis causes pain over the lateral wrist or thumb side

of the wrist? a. Tenosynovitis b. de Quervain tendinitis c. Synovial tendinitis d. Carpal tunnel syndrome ANS: B

De Quervain tendinitis results in pain over the thumb side of the wrist, caused by the continuous use of the hand in a grasping fashion.

PTS: 1 REF: p. 685 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Pathology 9. A complete tear of a muscle with a straightforward appearance of a retracted hyperechoic

muscle surrounded by a hematoma is known as the _________________ sign. a. McBurney’s b. clapper-in-the-bell c. gastrocnemius d. sandwich ANS: B

Clapper-in-the-bell sign describes a complete tear of a muscle with a straightforward appearance of a retracted hyperechoic muscle surrounded by a hematoma.

PTS: 1 REF: p. 686 OBJ: Distinguish normal anatomy common pathologic conditions.

NURfrom SINGTB.COM TOP: Pathology 10. Which one of the following structures is a bandlike flat tendon connecting muscle to bone? a. Ligament b. Aponeurosis c. Synovial sheath d. Pinnate ANS: B

Aponeurosis is a bandlike flat tendon connecting muscle to bone.

PTS: 1 REF: p. 668 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology 11. Support and strength of a joint result, in part, from which one of the following structures? a. Muscle b. Bursa c. Cartilage d. Ligament ANS: D

A ligament is a fibrous band of tissue connecting bone or cartilage to bone that aids in stabilizing a joint.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 668 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology 12. When compared with muscle, a normal nerve is ________________. a. hyperechoic b. isoechoic c. hypoechoic d. unable to be visualized on ultrasound ANS: A

A normal nerve appears hyperechoic when compared with a muscle and hypoechoic when compared with a tendon.

PTS: 1 REF: p. 672 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Sonographic characteristics 13. Important artifacts in musculoskeletal ultrasound include all of the following except: a. reverberation. b. refractile shadowing. c. mirror image. d. anisotropy.

ANS: C

Important artifacts in musculoskeletal ultrasound include reverberation, refractile shadowing, anisotropy, and time-of-flight artifact.

NURSINGTB.COM

PTS: 1 REF: p. 673 OBJ: Know the advantages and disadvantages of sonographic artifacts in musculoskeletal imaging.

TOP: Imaging artifacts 14. The Achilles tendon is at an increased risk for injury because of ________________. a. its vulnerable location b. no surrounding muscle c. its limited blood supply d. its large size ANS: C

A limited blood supply increases the risk for injury to the Achilles tendon and slows the healing process.

PTS: 1 REF: p. 681 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology 15. Indications for wrist sonography include all of the following except: a. pain and swelling. b. Thompson sign. c. trauma. d. Tinel’s sign.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B

A Thompson test (pointing toes down while squeezing the calf) is used to evaluate the integrity of the Achilles tendon.

PTS: 1 REF: p. 681 OBJ: Summarize the basic sonographic examinations of the shoulder, wrist, knee, ankle, and foot.

TOP: Clinical findings 16. Acute rotator cuff tear may be caused by all of the following except: a. years of playing tennis. b. biceps tendon rupture. c. falls. d. shoulder dislocation.

ANS: A

A rotator cuff tear after years of playing tennis is an accumulative or chronic injury.

PTS: 1 REF: p. 683 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Pathology 17. The proximal portion of the muscle is considered the ______________. a. insertion b. anastomosis c. origin d. bifurcation ANS: C

N R I G B.C M

U Sis Nconsidered T Othe origin.

The proximal portion of the muscle PTS: 1 REF: p. 670 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology 18. A hypoechoic halo around a tendon represents which one of the following? a. Partial tear b. Tendonitis c. Normal synovial sheath d. Abnormal synovial sheath ANS: C

The normal synovial sheath appears as a hypoechoic halo around the tendon.

PTS: 1 REF: p. 685 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Sonographic characteristics 19. Tendinitis is seen more often in the shoulder, wrist, and _____________. a. elbow b. knee c. hip d. fingers

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: A

Tendinitis is seen more often in the shoulder, wrist, elbow, and heel.

PTS: 1 REF: p. 585 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Pathology 20. The easiest tendon to image in the adult shoulder is the __________________. a. supraspinatus b. biceps c. infraspinatus d. subscapularis ANS: B

The biceps tendon is one of the easiest structures to image in the adult shoulder.

PTS: 1 REF: p. 676 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Sonographic characteristics 21. The most common site of an Achilles tendon tear is __________________. a. proximal b. medial c. lateral d. distal ANS: D

The most common site of an Achilles tear is approximately 2 to 6 cm from the calcaneus in N R INGTB.C OM the distal portion of the tendon.UAnSAchilles tear is thought to be the result of the decreased blood flow in this area.

PTS: 1 REF: p. 681 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Pathology 22. The largest tendon of the body is the ___________________. a. biceps b. Achilles c. supraspinatus d. trapezius ANS: B

The Achilles tendon is the largest tendon in the body.

PTS: 1 REF: p. 681 OBJ: Identify the normal anatomic locations and functions of the tendon, ligament, muscle, nerve, and bursa.

TOP: Anatomy and physiology 23. Patients with carpal tunnel syndrome typically have a positive ____________ sign. a. Phalen’s b. Homen c. Thompson

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Murphy ANS: A

Patients with carpal tunnel syndrome typically have a positive Phalen’s sign.

PTS: 1 REF: p. 687 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Clinical findings 24. Sonographic appearance of the normal muscle appears _________________. a. hyperechoic b. complex c. homogeneous d. heterogeneous ANS: C

The muscle appears homogeneous with multiple fine parallel echoes.

PTS: 1 REF: p. 670 OBJ: Distinguish normal anatomy from common pathologic conditions.

TOP: Sonographic characteristics 25. The posterior glenoid labrum is a good landmark to help locate which one of the following

structures? a. Biceps tendon b. Infraspinatus tendon c. Supraspinatus tendon d. Deltoid muscle ANS: B

NURSINGTB.COM

The infraspinatus tendon is located anterior to the posterior labrum.

PTS: 1 REF: p. 678 OBJ: Summarize the basic sonographic examinations of the shoulder, wrist, knee, ankle, and foot.

TOP: Scanning techniques

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 25: Neonatal and Pediatric Abdomen Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. What percentage of liver tumors in children are benign? a. 10% b. 30% c. 40% d. 75% ANS: C

Approximately 40% of the liver tumors in children are benign, with hemangiomas the most common. Infantile hepatic vascular tumors (infantile hemangioendotheliomas) are the most common benign liver tumors, making up a third of childhood hepatic tumors, and account for 12% of all childhood hepatic neoplasms. Mesenchymal hamartoma, adenoma, and focal nodular hyperplasia make up roughly half of all benign liver tumors.

PTS: 1 REF: p. 705 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Hepatobiliary, pancreatic & splenic pathology 2. When bowel prolapses into the distal bowel and is propelled in an antegrade fashion, this

condition is known as which one of the following? a. Hypertrophic pyloric stenosis b. Intussusception NURSINGTB.COM c. Projectile vomiting d. Appendicitis ANS: B

Intussusception is the telescoping of the bowel in which the distal bowel is propelled in an antegrade fashion.

PTS: 1 REF: p. 710 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 3. Hypertrophic pyloric stenosis most commonly occurs in all of the following patient

populations except: a. in male patients. b. in female patients. c. infants between 2 and 6 weeks of age. d. infants with bile-free projectile vomiting.

ANS: B

Hypertrophied pyloric stenosis appears more commonly in male infants, 2 to 6 weeks of age.

Clinical symptoms include projectile vomiting, weight loss, and dehydration.

PTS: 1 REF: p. 712 OBJ: List the more common acquired and hereditary diseases and how pediatric sonography can monitor the associated chronic or malignant processes.

TOP: Gastrointestinal pathology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

4. Which of the following is least commonly associated with vomiting in the infant? a. pylorospasm. b. hiatal hernia. c. malrotation of the bowel. d. appendicolith.

ANS: D

Pylorospasm, hiatal hernia, and malrotation of the bowel may cause vomiting. An appendicolith does not necessarily cause vomiting.

PTS: 1 REF: p. 713 OBJ: List the more common acquired and hereditary diseases and how pediatric sonography can monitor the associated chronic or malignant processes.

TOP: Gastrointestinal pathology 5. Hepatoblastoma has been associated with which one of the following? a. Meige syndrome b. Choledochal cyst c. Precocious puberty d. Intussusception ANS: C

Hepatoblastoma has been associated with precocious puberty and with the Beckwith-Wiedemann syndrome.

PTS: 1 REF: p. 704 OBJ: List the common primary hepatic tumors in children.

TOP: Hepatobiliary, pancreatic & splenic pathology

NURSINGTB.COM

6. The mean portal vein measurement in children younger than 10 years of age is ______

millimeters (mm). a. 5 b. 7.5 c. 8.5 d. 10 ANS: C

The mean portal vein measurement is 8.5 mm in children younger than 10 years of age and 10 mm in patients between 10 and 20 years of age.

PTS: 1 REF: p. 695 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Box 25-2 7. In patients with appendicitis, the outer diameter should measure at greater than _____ mm. a. 6 b. 2 c. 3 d. 5 ANS: A

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank An outer diameter measurement greater than 6 mm with compression is consistent with appendicitis in both children and adults.

PTS: 1 REF: p. 708 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 8. Findings that may indicate appendicitis include all of the following except: a. free peritoneal fluid. b. loculated fluid in the lower abdomen. c. appendicolith. d. Meckel diverticulum.

ANS: D

Findings that may indicate appendicitis include free peritoneal fluid or loculated fluid collection in the lower abdomen, appendicolith, and, occasionally, a right hydronephrosis resulting from inflammation of the ureter.

PTS: 1 REF: p. 710 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 9. A pitfall in diagnosing appendicitis may be which one of the following? a. Enlarged lymph nodes b. Dilated antrum c. Hydronephrosis d. Hydrops ANS: A

NURSINGTB.COM

Enlarged lymph nodes may be a pitfall in diagnosing appendicitis with ultrasound.

PTS: 1 REF: p. 710 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 10. Children with intussusception may exhibit all of the following clinical presentations except: a. colicky abdominal pain b. vomiting c. bloody stools d. tenderness over McBurney’s point ANS: D

Tenderness over McBurney’s point is a clinical sign of appendicitis.

PTS: 1 REF: p. 708 OBJ: List the most common gastrointestinal surgical conditions in the pediatric population.

TOP: Gastrointestinal pathology 11. Sonographic characteristics associated with the bowel include all of the following signs

except: a. croissant b. doughnut

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. target d. pseudokidney ANS: A

Target, doughnut, sandwich, and pseudokidney signs are all descriptions of the sonographic appearance of the bowel.

PTS: 1 REF: p. 711 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 12. The length of the pediatric gallbladder should not exceed which one of the following? a. 5 cm b. 8 cm c. 10 cm d. Length of the kidney ANS: D

The pediatric gallbladder should not exceed the length of the kidney or 7 cm long.

PTS: 1 REF: p. 695 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Box 25-2 13. Preparation for a biliary sonographic examination of a 2-year-old child is nothing by mouth

(nil per os; NPO) for ____ hours. a. 4 b. 5 NURSINGTB.COM c. 6 d. 8 ANS: A

Preparation for a biliary sonography examination of a 2-year-old child is NPO for 4 hours.

PTS: 1 REF: p. 693 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Box 25-1 14. An abdominal ultrasound may be ordered in the neonate when jaundice persists beyond

______________. a. 5 days b. 2 months c. 2 weeks d. 5 weeks ANS: C

If jaundice persists beyond 2 weeks after delivery, an abdominal ultrasound may be ordered to rule out hepatitis, biliary atresia, and a choledochal cyst.

PTS: 1 REF: pp. 699-700 OBJ: List the causes of jaundice in the neonatal and pediatric patients.

TOP: Hepatobiliary, pancreatic & splenic pathology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 15. Which one of the following is the most likely condition to lead to cirrhosis in neonatal

patients? a. Jaundice b. Hepatitis c. Choledochal cyst d. Biliary atresia ANS: D

Biliary atresia is the most likely condition to lead to cirrhosis.

PTS: 1 REF: p. 699 OBJ: Distinguish obstructive from non-obstructive jaundice.

TOP: Hepatobiliary, pancreatic & splenic pathology 16. The most common causes of prolonged neonatal jaundice include all of the following except: a. hepatoblastoma. b. choledochal cyst. c. hepatitis. d. biliary atresia.

ANS: A

The three most common causes of prolonged neonatal jaundice are choledochal cyst, hepatitis, and biliary atresia.

PTS: 1 REF: p. 701 OBJ: List the causes of jaundice in the neonatal and pediatric patients.

TOP: Table 24-4

N R I G B.C M

U S Ncyst T is: O 17. The most common type of choledochal a. diverticula of the common bile duct (CBD). b. fusiform dilation of the CBD. c. dilation of intrahepatic ducts. d. dilation of the intraduodenal portion of the CBD. ANS: B

The fusiform dilation of the CBD is the most common type of choledochal cyst.

PTS: 1 REF: p. 702 OBJ: List the causes of jaundice in the neonatal and pediatric patients.

TOP: Hepatobiliary, pancreatic & splenic pathology 18. Which one of the following is considered to be the infantile form of hepatocellular carcinoma? a. Neuroblastoma b. Wilms’ tumor c. Hepatoblastoma d. Both A and B ANS: C

The hepatoblastoma is sometimes considered the infantile form of hepatocellular carcinoma.

PTS: 1 REF: p. 704 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Hepatobiliary, pancreatic & splenic pathology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

19. The pylorus muscle connects the __________________ with the duodenum. a. body of the stomach b. antrum of the stomach c. lesser curvature of the stomach d. fundus of the stomach ANS: B

The pylorus muscle connects the antrum of the stomach with the duodenum.

PTS: 1 REF: p. 714 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Figure 25-5 20. An overdistended stomach ____________ displaces the pylorus. a. anteriorly b. posteriorly c. laterally d. medially ANS: B

An overdistended stomach posteriorly displaces the pylorus.

PTS: 1 REF: p. 715 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 21. Identify the most common acute abdominal disorder in early childhood.

NURSINGTB.COM a. Hypertrophied pyloric stenosis b. Appendicitis c. Intussusception d. Biliary atresia ANS: C

The most common acute abdominal disorder in early childhood is intussusception.

Appendicitis is the most common acute abdominal inflammation.

PTS: 1 REF: p. 710 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Gastrointestinal pathology 22. In older children, the common bile duct should not exceed _____ mm. a. 2 b. 3 c. 4 d. 5 ANS: C

In older children, the common bile duct should not exceed 4 mm.

PTS: 1 REF: p. 695 OBJ: Describe the sonographic appearances of the pathologic conditions discussed in this chapter.

TOP: Box 25-2

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

23. Choose the percentage of normal-term infants with elevated unconjugated bilirubin levels. a. 20% b. 40% c. 60% d. 80% ANS: C

Unconjugated hyperbilirubin occurs in approximately 60% of normal-term infants and in 80% of preterm infants.

PTS: 1 REF: p. 699 OBJ: List the causes of jaundice in the neonatal and pediatric patients.

TOP: Hepatobiliary, pancreatic & splenic pathology

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 26: Neonatal and Pediatric Adrenal and Urinary System Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following conditions may occur when the fetus is stressed during a difficult

delivery or during a hypoxia insult? a. Renal hemorrhage b. Acute renal failure c. Adrenal hemorrhage d. Urinary obstruction ANS: C

Difficult delivery and hypoxia at delivery can predispose the neonate to adrenal hemorrhage.

PTS: 1 REF: p. 733 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 2. Which one of the following structures lies at the bases of the medullary pyramids and appears

as echogenic structures? a. Arcuate arteries b. Ectopic ureterocele c. Posterior urethral valves d. Renal cortex ANS: A

NURSINGTB.COM

The arcuate arteries are hyperechoic structures located at the base of the medullary pyramids.

PTS: 1 REF: p. 723 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 3. Which one of the following structures is thin in the neonate with echogenicity similar to or

slightly greater than the normal liver parenchyma? a. Medullary pyramids b. Cortex c. Arcuate arteries d. Renal pelvis ANS: B

The cortex in the neonate is quite thin with echogenicity equal to or slightly greater than the normal liver.

PTS: 1 REF: p. 723 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 4. Which one of the following conditions is the most common cause of renal cystic disease in the

neonate? a. Medullary cystic disease

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Parapelvic cysts c. Multicystic dysplastic kidney (MCDK) disease d. Polycystic kidney disease (PKD) ANS: C

MCDK disease is the most common cause of renal cystic disease in the neonate. It is associated with hydronephrosis, abdominal mass, and contralateral ureteropelvic junction (UPJ) obstruction.

PTS: 1 REF: p. 729 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 5. Which one of the following malignant renal tumors is most frequently seen in the neonate and

infant? a. Congenital mesoblastic nephroma b. Neuroblastoma c. Wilms’ tumor d. Renal cell carcinoma ANS: C

Wilms’ tumor (nephroblastoma) is the most common renal tumor in young children.

PTS: 1 REF: p. 737 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 6. Conditions in the newborn commonly associated with renal abnormalities include all of the

following except: a. hematuria. b. vomiting. c. oliguria. d. hypertension.

NURSINGTB.COM

ANS: B

Symptoms of renal abnormalities in the newborn may include flank pain, decreased urine output, palpable abdominal mass, fever, and hypertension.

PTS: 1 REF: p. 721 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Introduction 7. Which one of the following structures should not be mistaken for dilated calyces or cysts in

the infant? a. Renal cortex b. Arcuate arteries c. Renal vein d. Medullary pyramids ANS: D

The medullary pyramids are large hypoechoic structures in infants that should not be mistaken for cysts or obstructions.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 723 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 8. The best way to demonstrate the dilated ureter at the ureteropelvic junction is with a

___________ scan. a. longitudinal b. anterior c. upright d. posterior ANS: A

The best way to demonstrate the dilated ureters at the ureteropelvic junction is with a longitudinal scan plane.

PTS: 1 REF: p. 727 OBJ: Discuss the sonographic approach to imaging neonatal and pediatric kidneys, as well as the adrenal glands.

TOP: Renal, adrenal, and bladder pathology 9. Conditions that may lead to adrenal hemorrhage include all of the following except: a. difficult delivery. b. large fetus. c. neonatal hypoxia. d. hydronephrosis.

ANS: D

Difficult delivery, the large fetus, maternal diabetes mellitus, stress, and hypoxia may lead to NURSINGTB.COM adrenal hemorrhage.

PTS: 1 REF: p. 733 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 10. If the ipsilateral renal is absent or ectopic in location, then the adrenal gland: a. is larger in size. b. remains in the renal fossa. c. demonstrates a hyperechoic echo pattern. d. is absent or ectopic in location.

ANS: B

The adrenal gland remains in the renal fossa but may have an altered configuration if the ipsilateral kidney is absent or ectopic.

PTS: 1 REF: p. 724 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 11. Which one of the following statements regarding ectopic ureteroceles is incorrect? a. They are more commonly found in male patients. b. They are found more often on the left side. c. They result from an ectopic insertion of the distal ureter.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. They cause cystic dilation of the distal ureter.

ANS: A

Ectopic ureteroceles are more commonly found in female patients, more often on the left side, and are the result of an ectopic insertion and cystic dilation of the distal ureter.

PTS: 1 REF: p. 727 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 12. Which one of the following genitourinary problems is commonly associated with the

prune-belly syndrome? a. Small bladder b. Ureteral reflux c. Chronic pyelonephritis d. Multicystic dysplastic kidney ANS: B

Ureteral reflux is a common genitourinary problem associated with the prune-belly syndrome.

PTS: 1 REF: p. 728 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 13. Renal vein thrombosis is more prevalent in infants of _________ mothers. a. hypertensive b. obese c. diabetic NURSINGTB.COM d. hypotensive ANS: C

Renal vein thrombosis is more prevalent in infants of diabetic mothers and occurs more commonly in infants who are dehydrated or septic.

PTS: 1 REF: p. 732 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 14. Sonographic signs of renal vein thrombosis in the neonate include all of the following except: a. renal enlargement. b. adrenal hemorrhage. c. homogeneous echogenicity. d. venous calcification.

ANS: C

Initial thrombosis shows an enlarged kidney has a nonspecific disordered heterogeneous internal echogenicity. There may be coexistent adrenal hemorrhage, particularly on the left side where the adrenal vein drains directly into the renal vein. Calcification within the involved veins may eventually result.

PTS: 1 REF: p. 732 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Renal, adrenal, and bladder pathology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

15. Neuroblastoma is typically a malignant tumor of the _____________________. a. kidney b. adrenal gland c. liver d. pancreas ANS: B

The neuroblastoma is a malignant tumor of the adrenal medulla. Tumors have been found in the neck, mediastinum, retroperitoneum, and pelvis.

PTS: 1 REF: p. 735 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 16. Sonographic findings in adrenal hemorrhage in the neonate include all of the following

conditions except: a. blunting of the superior pole of the underlying kidney. b. ovoid enlargement of the adrenal gland. c. irregular-shaped small gland. d. complex echo texture.

ANS: C

Sonographic findings in adrenal hemorrhage include ovoid enlargement of the adrenal gland, blunting of the superior pole of the underlying kidney, and variable echo texture according to the age of the hemorrhage.

PTS: 1 REF: p.N 733R I G B.C M U and S sonographic N T O OBJ: Distinguish normal anatomic findings from abnormal findings.

TOP: Renal, adrenal, and bladder pathology 17. Differential considerations for hydronephrosis include all of the following except: a. extrarenal pelvis. b. functional dilation. c. parapelvic cysts. d. renal vein thrombosis.

ANS: D

Differential considerations for hydronephrosis include extrarenal pelvis, functional dilation, multicystic dysplastic kidney disease, and parapelvic cysts.

PTS: 1 REF: p. 726 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 18. The most common cause of bladder outlet obstruction in the male neonate is which one of the

following? a. Ureteropelvic junction obstruction b. Ureteral orifice obstruction c. Posterior urethral valve obstruction d. Bladder tumor

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C

Posterior urethral valve obstruction is the most common cause of bladder outlet obstruction in the male neonate.

PTS: 1 REF: p. 728 OBJ: List and discuss the pathologic conditions covered in this chapter.

TOP: Renal, adrenal, and bladder pathology 19. The normal renal length in the pediatric patient varies with ___________. a. age b. weight c. gender d. ethnicity ANS: A

The normal renal length in the pediatric patient varies with age.

PTS: 1 REF: p. 724 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 20. The left adrenal gland: a. extends lateral to the kidney. b. lies immediately inferior to the upper pole of the kidney. c. extends medial to the kidney. d. is ovoid in shape in the longitudinal plane.

ANS: C

N R I G B.C M

S N T kidney.

O The left adrenal gland extends U medial to the

PTS: 1 REF: p. 724 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 21. The adrenal medulla in the neonate appears: a. as a hypoechoic central focus. b. as an echogenic stripe. c. isoechoic to the adrenal cortex. d. relatively thick.

ANS: B

The adrenal medulla appears as an echogenic stripe.

PTS: 1 REF: p. 724 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 22. Which of the following conditions demonstrates a pelvocaliceal dilation without ureteral

dilation? a. Posterior urethral valve obstruction b. Bladder outlet obstruction c. Ureteropelvic junction obstruction

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Multicystic dysplastic kidney disease ANS: C

Ureteropelvic junction obstruction demonstrates a pelvocaliceal dilation without ureteral dilation.

PTS: 1 REF: p. 727 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Normal anatomy and sonographic findings 23. Bilateral renal enlargement is seen with which one of the following conditions? a. Nephroblastoma b. Prune-belly syndrome c. Ureteropelvic junction obstruction d. Autosomal recessive polycystic kidney disease (ARPKD) ANS: D

The most striking feature of ARPKD is bilateral renal enlargement with diffuse increased echogenicity and a loss of definition of the renal sinus, medulla, and cortex.

PTS: 1 REF: p. 731 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Renal, adrenal, and bladder pathology 24. During which of the following age ranges does the incidence of Wilms’ tumor peak? a. 1 to 3 years b. 2 to 5 years c. 3 to 6 years NURSINGTB.COM d. 4 to 6 years ANS: B

Wilms’ tumor is the most common intra-abdominal malignant renal tumor in young children.

The incidence of this tumor peaks between 2 to 5 years of age.

PTS: 1 REF: p. 737 OBJ: Distinguish normal anatomic and sonographic findings from abnormal findings.

TOP: Renal, adrenal, and bladder pathology

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 27: Neonatal and Infant Head Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Dysgenesis of the fourth ventricle results in which one of the following malformations? a. Corpus callosum b. Cystic dilation of the lateral ventricle c. Holoprosencephaly d. Dandy-Walker ANS: D

Dandy-Walker syndrome is a group of congenital brain anomalies involving the disruption in development of the cerebellar vermis and roof of the fourth ventricle.

PTS: 1 REF: p. 764 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Congenital brain malformations 2. What is the name of the structure that forms between the corpus callosum and the anterior

horn or lateral ventricle? a. Septum pellucidum b. Massa intermedia c. Fourth ventricle d. Lateral ventricle ANS: A

NURSINGTB.COM

The cavum septum pellucidum (CSP) lies anterior to the corpus callosum and separates the bodies and frontal horns of the lateral ventricle.

PTS: 1 REF: p. 743 OBJ: Recognize normal neuroanatomic activity as it pertains to ultrasound examination of the neonate.

TOP: Normal anatomy and sonographic findings 3. Cyclopia is associated with which one of the following? a. Holoprosencephaly b. Hydrocephalus c. Hydranencephaly d. Dandy-Walker malformation ANS: A

The abnormalities found in holoprosencephaly include cyclopia, cebocephaly, ethmocephaly, median cleft, and holotelencephaly.

PTS: 1 REF: p. 766 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Congenital brain malformations 4. Bilateral occlusion of the carotid arteries may result in __________________. a. hydrocephalus b. hydranencephaly

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. holoprosencephaly d. intraventricular hemorrhage ANS: B

Hydranencephaly is believed to be the result of the bilateral occlusion of the carotid arteries during fetal development, but any number of intracranial destructive processes may be the cause.

PTS: 1 REF: p. 767 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Congenital brain malformations 5. Which three mechanisms account for the development of hydrocephalus? a. Outflow obstruction, increased absorption, and overproduction of cerebrospinal

fluid (CSF). b. Inflow obstruction, decreased absorption, and underproduction of cerebrospinal fluid (CSF). c. Inflow obstruction, increased absorption, and overproduction of cerebrospinal fluid (CSF). d. Outflow obstruction, decreased absorption, and overproduction of cerebrospinal fluid (CSF).

ANS: D

Hydrocephalus results from outflow obstruction, decreased absorption, or an overproduction of cerebrospinal fluid.

PTS: 1 REF: p. 752 OBJ: Discuss the sonographicN findings in neonatal brain imaging.

URSINGTB.COM TOP: Hydrocephalus (Ventriculomegaly) 6. The junction of the anterior, occipital, and temporal horns is called the ________________. a. cistern b. brainstem c. choroid plexus d. atrium (trigone) ANS: D

The atrium or trigone of the lateral ventricle is the site at which the anterior, occipital, and temporal horns join.

PTS: 1 REF: p. 741 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 7. The most important cause of abnormal neurodevelopment sequelae in premature infants is

which one of the following? a. Hydrocephalus b. Choroid plexus cyst c. White matter necrosis d. Alobar holoprosencephaly ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank White matter necrosis is probably the most important cause of abnormal neurodevelopment sequelae in premature infants.

PTS: 1 REF: p. 760 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Acquired brain lesions 8. The part of the brain that connects the forebrain and the spinal cord is which one of the

following? a. Cerebellum b. Trigone c. Cerebrum d. Brainstem ANS: D

The brainstem consists of the midbrain, pons, and medulla oblongata. It connects the forebrain to the spinal cord.

PTS: 1 REF: p. 744 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 9. The portion of the brain that forms the lateral borders of the frontal horns of the lateral

ventricles and lies anterior to the lateral ventricles and thalamus is which one of the following? a. Caudate nucleus b. Cisterna c. Corpus callosum NURSINGTB.COM d. Fontanelle ANS: A

The caudate nucleus forms the lateral borders of the frontal horns of the lateral ventricles and lies anterior to the lateral ventricles and thalamus.

PTS: 1 REF: p. 744 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 10. A thin, triangular space filled with CSF that lies between the anterior horn of the lateral

ventricles is: a. interhemispheric fissure. b. cavum septi pellucidi. c. trigone. d. caudate nucleus.

ANS: B

Cavum septi pellucidi are thin, triangular spaces filled with CSF that lie between the anterior horns of the lateral ventricles and form the floor of the corpus callosum.

PTS: 1 REF: p. 743 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

11. The portion of the brain that lies posterior to the cranial fossa under the tentorium is called

which one of the following? a. Cerebellum b. Corpus callosum c. Lower recess d. Cavum septum pellucidum ANS: A

The cerebellum lies posterior to the pons and medulla oblongata in the posterior cranial fossa under the tentorium cerebelli.

PTS: 1 REF: p. 745 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 12. Sonography of the neonatal brain is evaluated through which one of the following? a. Inferior temporal lobe b. Anterior fontanelle c. Superior temporal lobe d. Posterior fontanelle ANS: B

Sonography of the neonatal brain is evaluated through the anterior fontanelle in multiple planes to study the supratentorial and infratentorial compartments.

PTS: 1 REF: p. 746 OBJ: Describe the coronal, sagittal, view M studies.

N R andI mastoid G B.C

U S N T

O

TOP: Examination preparation

13. A mass of special cells located in the atrium of the lateral ventricles is which one of the

following? a. Corpus callosum b. Caudate nucleus c. Choroid plexus d. Cisterna ANS: C

The choroid plexus is a mass of special cells located in the atrium of the lateral ventricles and is an important part of CSF production.

PTS: 1 REF: p. 742 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 14. The periventricular tissue, which may bleed easily before 32 weeks’ gestation, is the

____________________. a. caudate nucleus b. corpus callosum c. brainstem d. germinal matrix ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Increased capillary fragility of the germinal matrix explains the high frequency of periventricular bleed.

PTS: 1 REF: p. 756 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Acquired brain lesions 15. Identify the structure that separates the two cerebral hemispheres. a. Tentorium b. Corpus callosum c. Lateral ventricles d. Interhemispheric fissure ANS: D

The interhemispheric fissure is the area in which the falx cerebri sits and separates the two cerebral hemispheres.

PTS: 1 REF: p. 743 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 16. The two ovoid brain structures located on either side of the third ventricle superior to the

brainstem make up the ________________. a. thalami b. choroid plexus c. gyri d. fontanelle ANS: A

NURSINGTB.COM

The two thalami are ovoid brain structures located midbrain and situated on either side of the third ventricle and superior to the brainstem.

PTS: 1 REF: p. 744 OBJ: Recognize normal neuroanatomic activity as it pertains to ultrasound examination of the neonate.

TOP: Anatomy and physiology 17. The brain coverings are known as which one of the following? a. Subependymomas b. Meninges c. Parenchyma d. Ependyma ANS: B

The meninges are three membranes enclosing the brain and spinal cord.

PTS: 1 REF: p. 741 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 18. Which of the following structures produces 40% of the cerebrospinal fluid? a. Extracellular fluid b. Choroid plexus

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Corpus callosum d. Cerebrum ANS: B

Approximately 40% of CSF is produced by the choroid plexus of the lateral, third, and fourth ventricles. The remainder is produced by the extracellular fluid movement from blood through the brain and into the ventricles.

PTS: 1 REF: p. 742 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 19. The largest subarachnoid space demonstrated sonographically is ________________. a. suprasellar cistern b. pontine cistern c. quadrigeminal cistern d. cisterna magna ANS: D

The cisterna magna is one of the largest subarachnoid cisterns.

PTS: 1 REF: p. 742 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 20. Convolutions on the surface of the brain are called which one of the following? a. Sulci b. Fissures NURSINGTB.COM c. Gyri d. Lobes ANS: C

The gyri are convolutions on the surface of the brain caused by infolding of the cortex. Sulci are grooves or depressions on the suface of the brain separating the gyri.

PTS: 1 REF: p. 743 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 21. The most common cause of congenital hydrocephalus is which one of the following? a. Papilloma of the choroid plexus b. Aqueductal stenosis c. Overproduction of CSF d. Agenesis of the corpus callosum ANS: B

Aqueductal stenosis is the most common cause of congenital hydrocephalus.

PTS: 1 REF: p. 753 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Hydrocephalus (Ventriculomegaly)

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 22. Acute neonatal brain hemorrhage appears ____________________ when compared to the

choroid plexus. a. echolucent b. hypoechoic c. echogenic d. complex ANS: C

In the acute stage hemorrhage will have an echogenicity equal to or greater than the choroid plexus; these GM-IVHs are easily detected with ultrasound as echogenic structures because fluid and clotted blood have higher acoustic impedance than the brain parenchyma and the CSF. Acute hemorrhage appears more echogenic than chronic hemorrhage.

PTS: 1 REF: p. 756 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Acquired brain lesions 23. Periventricular leukomalacia is defined as which one of the following? a. White matter necrosis b. Focal brain necrosis c. Thickened ependyma d. An epidural hemorrhage ANS: A

Periventricular leukomalacia is defined as multifocal white matter necrosis and is a frequent ischemic lesion in the premature brain.

PTS: 1 REF: p.N 760R I G B.C M U S inNneonatal T brain O imaging.

OBJ: Discuss the sonographic findings TOP: Acquired brain lesions 24. Which of the following brain structures are part of the hindbrain? a. Cerebral hemispheres, thalamus, and hypothalamus b. Spinal cord, cisterna magna, and nerve roots c. Mastoid fontanel, temporal lobe, and lateral ventricle d. Pons, cerebellum, and medulla oblongata ANS: D

The rhombencephalon is located in the hindbrain. The cerebral hemispheres, thalamus, and hypothalamus are part of the brainstem, while the pons, cerebellum, and medulla oblongata are part of the hindbrain.

PTS: 1 REF: pp. 744-745 OBJ: Recognize normal neuroanatomy as it pertains to the ultrasound examination of the preterm and full-term neonate.

TOP: Normal anatomy and sonographic findings 25. Which one of the following is most likely the result of a germinal matrix hemorrhage? a. Cerebral cyst b. Subependymal cyst c. Subarachnoid cyst d. Periventricular leukomalacia

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B

Subependymal cysts occur at the site of a previous bleed in the germinal matrix.

PTS: 1 REF: p. 756 OBJ: Discuss the sonographic findings in neonatal brain imaging.

TOP: Acquired brain lesions

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 28: Infant and Pediatric Hip Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The hip bones are the fusion of three separate bones. Which one of the following bones does

not belong in this group? a. Ilium b. Femur c. Ischium d. Pubis ANS: B

The hip bones are the fusion of the ilium, ischium, and pubis.

PTS: 1 REF: p. 774 OBJ: Discuss the anatomy of the neonatal hip.

TOP: Normal anatomy and sonographic findings 2. The femur is surrounded by all of the following structures except: a. bursa. b. muscles. c. ligaments. d. tendons.

ANS: A

The femur is surrounded by muscles, ligaments, and tendons.

NURSINGTB.COM

PTS: 1 REF: p. 774 OBJ: Discuss the anatomy of the neonatal hip.

TOP: Normal anatomy and sonographic findings 3. Which movement does the psoas major, iliacus, and rectus femoris provide? a. stabilization b. rotation c. adduction d. flexion ANS: D

The primary flexors of the hip are the psoas major, iliacus, and rectus femoris. Extension is limited to 20 degrees and is brought about by the hamstrings and gluteus maximus.

PTS: 1 REF: p. 776 OBJ: Describe normal movements of the hip.

TOP: Normal anatomy and sonographic findings 4. Bending the hip backward is called: a. adduction. b. flexion. c. extension. d. abduction.

ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Flexion is the bending forward, and extension is the bending backward. Adduction is a sideways movement, and abduction is the combination of a sideways and outward movement.

PTS: 1 REF: p. 776 OBJ: Describe normal movements of the hip.

TOP: Normal anatomy and sonographic findings 5. The articulation of the head of the femur with the acetabulum of the hip bone forms the

_______________. a. hip joint b. femoral triangle c. iliofemoral ligament d. ligament teres ANS: A

The hip joint is formed by the articulation of the head of the femur with the acetabulum of the hip bone.

PTS: 1 REF: p. 775 OBJ: Discuss the anatomy of the neonatal hip.

TOP: Normal anatomy and sonographic findings 6. The ligament in the shape of an inverted y or V passing from the anteroinferior iliac spine to

each end of the intertrochanteric line is the _______________ ligament. a. iliofemoral b. obturator c. femoral d. gluteal ANS: A

N R I G B.C M

UtheShipNjoint T is theOiliofemoral ligament, which is in the shape The most important ligament of of an inverted y or V. PTS: 1 REF: p. 776 OBJ: Discuss the anatomy of the neonatal hip.

TOP: Normal anatomy and sonographic findings 7. When a person crosses his or her legs in a sitting position, which one of the following muscle

groups is used? a. Adductor b. Abductor c. Flexion d. Extension ANS: A

The adductor muscle group is used when crossing the legs (moving inward).

PTS: 1 REF: p. 776 OBJ: Describe normal movements of the hip.

TOP: Normal anatomy and sonographic findings 8. In the coronal neutral view, the sonographic finding of a frankly dislocated hip is which one

of the following? a. The femoral head rests against the bony acetabulum. b. The femoral head migrates laterally and superiorly with decreased coverage of the femoral head.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. The acetabular roof is irregular and angled. d. The labrum may be deformed.

ANS: D

In the coronal neutral view, the labrum may be deformed when visualizing a frankly dislocated hip.

PTS: 1 REF: p. 781 OBJ: Describe the sonographic evaluation of the neonatal hip for the development and displacement of the hip.

TOP: Developmental displacement of the hip 9. In the “push-pull” maneuver, which one of the following findings is seen in the normal hip in

the coronal neutral view? a. The femoral head is never seen over the posterior lip of the acetabulum. b. The femoral head remains in place in the acetabulum. c. The femoral head appears over the posterior lip of the triradiate cartilage as the femur is pushed. d. The femoral head migrates laterally and posteriorly.

ANS: A

In the normal hip, the femoral head is never seen over the posterior lip of the acetabulum.

PTS: 1 REF: p. 786 OBJ: Describe the sonographic appearance of the neonatal hip.

TOP: Dynamic Harcke technique 10. Indications for sonography of the neonatal hip include all of the following except: a. to rule out hip dysplasia.

NURSINGTB.COM b. sacral dimple. c. breech birth. d. abnormal hip examination.

ANS: B

A sacral dimple is an indication for a sonographic evaluation of the neonatal spine. Breech birth, especially female infants, should be routinely screened for hip dysplasia.

PTS: 1 REF: p. 778 OBJ: Describe the sonographic evaluation of the neonatal hip, including technique and protocol.

TOP: Developmental displacement of the hip 11. The hip of a normal infant has a Graf alpha angle of ____________ degrees. a. less than 43 b. less than 60 c. between 43 and 60 d. less than 77 ANS: B

Classified as a type I hip, a normal hip has a Graf alpha angle of less than 60 degrees.

PTS: 1 REF: p. 784 OBJ: Describe the sonographic evaluation of the neonatal hip for the development and displacement of the hip.

TOP: Box 28-3

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 12. The coronal neutral view of the subluxed infant hip demonstrates which one of the following? a. Irregular and angled acetabular roof b. Deformed labrum c. Femoral head gradually migrating superiorly and laterally with decreased coverage

of the femoral head d. Femoral head resting against the bony acetabulum ANS: C

The coronal neutral view of the subluxed infant hip demonstrates the femoral head gradually migrating superiorly and laterally with decreased coverage of the femoral head.

PTS: 1 REF: p. 781 OBJ: Describe the sonographic evaluation of the neonatal hip for the development and displacement of the hip.

TOP: Sonographic characteristics 13. Which one of the following hips gives the appearance of a “ball on a spoon” in the

mid-acetabulum in the coronal flexion view? a. Subluxed b. Dislocated c. Frankly dislocated d. Normal ANS: D

A normal hip demonstrates a “ball on a spoon” in the mid-acetabulum in the coronal flexion view.

PTS: 1 REF: p. 781 OBJ: Describe the sonographic neonatal hip for the development and displacement Nevaluation INGofTthe B.C URSfindings OM of the hip.

TOP: Coronal of hip displacement 14. Which one of the following describes the femoral head completely out of the acetabulum? a. Normal hip with abduction b. Dislocated hip c. Hip fracture d. Hip dysplasia ANS: B

In Frank dislocation, the femoral head is completely out of the acetabulum.

PTS: 1 REF: p. 786 OBJ: Describe the sonographic evaluation of the neonatal hip for the development and displacement of the hip.

TOP: Transverse findings of hip displacement 15. Sonographic examination of the infant hip is performed with a(n) _______________

transducer. a. linear array b. curvilinear c. endocavity d. vector array ANS: A

A 7.5 MHz linear transducer is used to sonographically examine the infant hip.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: pp. 778-779 OBJ: Describe the sonographic evaluation of the neonatal hip, including technique and protocol.

TOP: Joint effusions of the hip 16. The sonographic protocol of the basic hip anatomy is imaged in _____ different views. a. two b. three c. four d. five ANS: C

Protocol of the infant hip includes four different views: coronal neutral, coronal flexion, transverse neutral, and transverse flexion.

PTS: 1 REF: p. 779 OBJ: Describe the sonographic evaluation of the neonatal hip, including technique and protocol.

TOP: Sonographic protocol 17. A type IV hip has an alpha angle of _______________ degrees and a beta angle of

_______________ degrees. a. less than 60; greater than 40 b. less than 43; greater than 77 c. less than 43; immeasurable d. immeasurable; less than 60 ANS: C

A type IV hip demonstrates an alpha angle of less than 43 degrees and a beta angle of NURSINGTB.COM immeasurable degrees.

PTS: 1 REF: p. 784 OBJ: Describe the sonographic evaluation of the neonatal hip for the development and displacement of the hip.

TOP: Table 28-1 18. The alpha angle is the angle between the ___________ and the ______________. a. baseline; acetabulum roof line b. baseline; inclination line c. acetabulum roof line; inclination line d. baseline; acetabular labrum ANS: A

The alpha angle is the angle between the baseline and the acetabulum roof line.

PTS: 1 REF: p. 783 OBJ: Describe the sonographic evaluation of the neonatal hip, including technique and protocol.

TOP: Box 28-3 19. In the ____________ maneuver, down and outward pressure is applied with the patient lying

in a supine position with the hip adducted and flexed 90 degrees. a. Galeazzi b. push-and-pull c. Barlow

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Ortolani ANS: C

In the Barlow maneuver, down and outward pressure is applied with the patient lying in a supine position with the hip adducted and flexed 90 degrees.

PTS: 1 REF: p. 778 TOP: The Barlow Maneuver

OBJ: Define the Barlow and Ortolani maneuvers.

20. Select the maneuver that induces a “clunk” as the femoral head returns to the acetabulum. a. Adduction b. Barlow c. Rotation d. Ortolani ANS: D

The Barlow (adduction) and Ortolani (abduction) maneuvers provide stress in opposite directions. In cases of developmental displacement of the hip (DDH), the return of the femoral head into the acetabulum results in a “clunk.”

PTS: 1 REF: p. 778 TOP: The Ortolani Maneuver

OBJ: Define the Barlow and Ortolani maneuvers.

21. The gluteus maximus muscle is also known as a(n) ______________ muscle. a. hamstring b. extensor c. abductor d. adductor N R I G B.C M

U S N T

O

ANS: B

The gluteus maximus is a powerful extensor of the hip and is the cover for the upper part of the hip joint. The gluteus medius and gluteus minimus pass from the outer surface of the hip bone to the greater trochanter. Together they act as abductors of the hip joint.

PTS: 1 REF: p. 776 TOP: Supporting ligaments and muscles

OBJ: Discuss the anatomy of the neonatal hip.

22. Choose the diagnostic criteria for subluxation. a. Femoral head coverage between 54% and 56% b. Femoral head coverage lower than 45% c. Normal femoral head coverage d. Femoral head coverage lower than 39% ANS: D

Normally, the mean femoral head coverage is between 54% and 56% (in females and males, respectively), with a lower limit of 45%. Fifty percent is considered the limit between normal and potentially abnormal. Subluxation is reached when femoral head coverage is lower than 39%, and dislocation less than 10%.

PTS: 1 REF: p. 786 OBJ: Differentiate between subluxation of the hip and dislocation of the hip.

TOP: Static head coverage

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

23. Which one of the following is moving sideways outward? a. Flexion b. Adduction c. Abduction d. Extension ANS: C

Abduction is moving sideways outward.

PTS: 1 REF: p. 776 TOP: Movements of the hip

OBJ: Describe the normal movements of the hip.

24. The physical signs of the development of a displacement of the hip include all of the

following except: a. prominence of trochanter. b. extreme abduction. c. shortening of the femur. d. asymmetry of skinfolds.

ANS: B

Physical signs of the development of a displacement of the hip include limited abduction, prominence of trochanter, shortening of the femur, and asymmetry of skinfolds.

PTS: 1 REF: p. 777 OBJ: Describe the sonographic evaluation of the neonatal hip, including technique and protocol.

TOP: Clinical examination

N R I G B.C M

U Susing N T O harness, the hip should be positioned in 25. With treatment of hip displacement the Pavlik flexion with adduction and ____________ rotation. a. neutral b. internal c. external d. either neutral or internal ANS: C

With treatment of hip displacement using the Pavlik harness, the hip should be positioned in flexion with adduction and external rotation.

PTS: 1 REF: p. 787 OBJ: Describe the sonographic evaluation of the neonatal hip, including technique and protocol.

TOP: Treatment and sonographic follow-up

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 29: The Neonatal and Infant Spine Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Failure of the neural tube to fold and fuse in the midline results in a ___________. a. myelomeningocele b. hydromyelia c. diastematomyelia d. tethered cord ANS: A

If the neural tube fails to fold and fuse in the midline, defects such as myelomeningoceles occur.

PTS: 1 REF: p. 793 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Embryogenesis 2. The spinal cord in the younger child ends at the upper border of the _______ lumbar vertebra. a. first b. second c. third d. fourth ANS: C

In young children, the spinalN cord is I longGand ends M at the upper border of the third lumbar RS B.C U N T O vertebra.

PTS: 1 REF: p. 794 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 3. The spinal cord tapers off into which one of the following? a. Filum terminals b. Conus medullaris c. Median fissure d. Median sulcus ANS: B

Inferiorly, the cord tapers off into the conus medullaris.

PTS: 1 REF: p. 796 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 4. The spinal cord is surrounded by three meninges, which include all of the following except: a. dura mater. b. subdural mater. c. arachnoid mater. d. pia mater.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

ANS: B

The three meninges surrounding the spinal cord are the dura mater, arachnoid mater, and pia mater.

PTS: 1 REF: p. 796 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 5. Sonography is able to image the spinal cord because the: a. ossification of the posterior spinal elements is incomplete. b. ossification of the anterior body of the spine is incomplete. c. dura mater is less dense during neonatal growth. d. cerebrospinal fluid is an excellent window.

ANS: A

Incomplete ossification of the posterior spinal elements allows sonography to provide a broad panoramic view of the neonatal spinal canal.

PTS: 1 REF: p. 797 OBJ: Describe the sonographic techniques to image the neonatal spinal column.

TOP: Sonographic evaluation of the neonatal & infant spine 6. An anechoic mass in the cauda equina region is most likely which one of the following? a. Lipoma b. Hydromyelia c. Meningocele d. Cyst of the spinal cord ANS: D

NURSINGTB.COM

An anechoic mass in the cauda equina region is most likely a cyst of the spinal cord.

PTS: 1 REF: p. 797 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Figure 29-10 7. Pathologic fixation of the spinal cord in an abnormal caudal location is known as which one

of the following? a. Lipoma b. Tethered cord c. Diastematomyelia d. Hydromyelia ANS: B

The tethered spinal cord is a pathologic fixation of the spinal cord in an abnormal caudal location.

PTS: 1 REF: p. 800 OBJ: Describe how to determine the level of the lumbar vertebrae in the sonographic examination.

TOP: Pathology of the neonatal & infant spine 8. Dilation of the central canal of the spinal cord is ________________. a. meningocele

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. hydromyelia c. myeloschisis d. diastematomyelia ANS: B

Hydromyelia is dilation of the central canal of the spinal cord.

PTS: 1 REF: p. 801 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Pathology of the neonatal & infant spine 9. Indications for spinal sonography include all of the following abnormalities except: a. back mass. b. midline cutaneous deformities. c. large collections of hair on the back. d. shortening of the femur.

ANS: D

Shortening of the femur is an indication of hip displacement.

PTS: 1 REF: p. 800 OBJ: Describe the sonographic techniques to image the neonatal spinal column.

TOP: Introduction 10. A dimple may indicate a spinal abnormality if it is more than _____ from the anus. a. 1 cm b. 1 inch c. 2 cm NURSINGTB.COM d. 2 inches ANS: B

It is not uncommon for the buttocks to contain a shallow dimple near the anus. It may become indicative of a spinal abnormality if it is more than 1 inch from the anus.

PTS: 1 REF: p. 792 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Introduction 11. The lumbar peduncles are strong and directed ___________. a. medially b. laterally c. anteriorly d. posteriorly ANS: D

The lumbar peduncle is strong and directed posteriorly.

PTS: 1 REF: p. 793 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 12. A severe form of spinal bifida is called ___________________. a. aperta

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. occulta c. tethered spinal cord d. terminals ANS: A

The severity of the spinal defects ranges from mild spina bifida occulta to severe spina bifida aperta.

PTS: 1 REF: p. 792 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Introduction 13. The most important determination in ruling out tethered spinal cord is determining which one

of the following? a. Skin surface of the lumbar spine b. Oscillations of the spinal cord c. Vertebral level of the tip of the cornus medullaris d. Vertebral level of the tip of the cauda equina ANS: C

In excluding an occult tethered spinal cord, determining the vertebral level of the tip of the cornus medullaris receives the most attention.

PTS: 1 REF: p. 799 OBJ: Describe how to determine the level of the lumbar vertebrae in the sonographic examination.

TOP: Sonographic evaluation of the neonatal & infant spine 14. Spina bifida with a portion of the spinal cord and membranes protruding is called

_____________. a. hydromyelia b. meningocele c. tethered cord d. myelomeningocele

NURSINGTB.COM

ANS: D

Spina bifida with a portion of the spinal cord and membranes protruding is called a myelomeningocele.

PTS: 1 REF: p. 804 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Pathology of the neonatal & infant spine 15. The sacrum consists of _____ fused bones. a. three b. four c. five d. six ANS: C

The sacrum consists of five fused bones.

PTS: 1 REF: p. 793 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings

16. Which of the following structures are responsible for one fourth of the vertebral column’s

length? a. Vertebral bodies b. Intervertebral discs c. Vertebral lemma d. Spinal muscles ANS: B

The intervertebral discs are responsible for one fourth of the vertebral column’s length.

PTS: 1 REF: p. 794 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 17. The vascular membrane that closely covers the spinal cord is the ___________. a. dura mater b. pia mater c. arachnoid mater d. gray matter ANS: B

The pia mater is the vascular membrane that closely covers the spinal cord.

PTS: 1 REF: p. 797 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings

NURSINGTB.COM

18. Identify the spinal structure that images as a hypoechoic structures located directly over the

spinal canal. a. Posterior dorsal spinal elements b. Dura mater c. Posterior spinous processes d. Coccyx ANS: C

When imaging from the posterior approach, the anterior vertebral bodies appear echogenic and lie posterior to the hypoechoic spinal canal. The cartilaginous posterior spinous processes appear as a hypoechoic structure anterior to the spinal canal.

PTS: 1 REF: p. 793 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 19. A transverse projection across the midline from the lowest palpable rib is _____. a. L1 b. L2 c. L3 d. T12 ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank A transverse projection across the midline from the lowest palpable rib is L2.

PTS: 1 REF: p. 799 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Sonographic evaluation of the neonatal & infant spine 20. The neonatal coccyx should not be mistaken for a ______________. a. cyst b. fluid collection c. lipoma d. cyst or fluid collection ANS: D

The neonatal coccyx is usually of low echogenicity and should not be mistaken for a cyst or fluid collection.

PTS: 1 REF: p. 804 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Pathology of the neonatal & infant spine 21. Hemangiomas over the back have a high association with which one of the following

abnormalities? a. Tethered spinal cord b. Hydromyelia c. Spina bifida occulta d. Myeloschisis ANS: A

NURSINGTB.COM

Hemangiomas over the back have a high association with a tethered spinal cord.

PTS: 1 REF: p. 800 OBJ: List the common pathologic conditions of the spinal cord and their sonographic appearances.

TOP: Pathology of the neonatal & infant spine 22. How many lumbar vertebrae are in the vertebral column? a. 4 b. 5 c. 7 d. 12 ANS: B

The vertebral column consists of 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal vertebrae.

PTS: 1 REF: p. 793 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings 23. A transverse projection across the midline from the palpated apex of the iliac crest is often at

the level of ________. a. L3

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. L4 c. L5 d. S2 ANS: C

A transverse projection across the midline from the palpated apex of the iliac crest is often L5.

PTS: 1 REF: p. 799 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Sonographic evaluation of the neonatal & infant spine 24. The lower nerve roots together are called which one of the following? a. Spinal nerves b. Cauda equina c. Filum terminale d. Posterior root ganglion ANS: B

The lower nerve roots together are called the cauda equina.

PTS: 1 REF: p. 796 OBJ: Describe the sonographic appearances of the normal anatomy of the spinal cord, the dura, the nerve roots, and the cauda equina.

TOP: Normal anatomy and sonographic findings

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 30: Anatomic and Physiologic Relationships within the Thoracic Cavity Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The tricuspid valve opens when the: a. right ventricle pressure drops below the right atrial pressure. b. papillary muscle contracts. c. velocity of blood flow in the right ventricle exceeds the velocity of flow in the

right atrium. d. pulmonic valve opens.

ANS: A

The tricuspid valve opens when the right ventricle pressure drops below the right atrial pressure.

PTS: 1 REF: p. 819 TOP: The heart and great vessels

OBJ: Define the relational landmarks of the heart.

2. Two pulmonary veins enter posteriorly in which one of the following? a. Left atrium b. Right atrium c. Left ventricle d. Right ventricle ANS: A

Two pulmonary veins enter posteriorly NURSINon GTeither B.Cside OM of the left atrium.

PTS: 1 REF: p. 814 TOP: The heart and great vessels

OBJ: Define the relational landmarks of the heart.

3. The mitral valve separates which of the following sets of structures? a. Right and left atria b. Left atrium and left ventricle c. Right atrium and right ventricle d. Right and left ventricles ANS: B

The mitral valve separates the left atrium from the left ventricle.

PTS: 1 REF: p. 816 TOP: The heart and great vessels

OBJ: Define the relational landmarks of the heart.

4. The base of the heart is formed by the ______________. a. left atrium b. right atrium c. left ventricle d. right ventricle ANS: A

The base of the heart is formed by the left atrium.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 811 TOP: The heart and great vessels

OBJ: Define the relational landmarks of the heart.

5. The apex of the heart is formed by the _____________. a. left atrium b. right atrium c. left ventricle d. right ventricle ANS: C

The apex of the heart is formed by the left ventricle.

PTS: 1 REF: p. 811 TOP: The heart and great vessels

OBJ: Define the relational landmarks of the heart.

6. Which of the following has a slight bulge seen at the aortic valve cusps? a. Coronary sinus b. Crista supraventricularis c. Sinus of Valsalva d. Recess of the oblique sinus ANS: C

The aortic valve lies at the root of the aorta and has right, left, and posterior (or noncoronary) cusps. The wall of the aorta bulges slightly at each cusp to form the sinus of Valsalva.

PTS: 1 REF: p. 817 TOP: The heart and great vessels

OBJ: Describe the landmarks of the thoracic cavity.

NURSINGTB.COM

7. The _____________ is the pleural reflection between the costal and diaphragmatic portions of

the parietal pleura. a. costal pleura b. costophrenic sinus c. mediastinal pleura d. diaphragmatic pleura ANS: B

The costophrenic sinus is the pleural reflection between the costal and diaphragmatic portions of the parietal pleura.

PTS: 1 REF: p. 810 TOP: The thorax and the thoracic cavity

OBJ: Define the relational landmarks of the heart.

8. The most posterior chamber to the left of the sternum is the ___________. a. right atrium b. left atrium c. right ventricle d. left ventricle ANS: B

The left atrium is the most posterior chamber to the left of the sternum.

PTS: 1

REF: p. 811

OBJ: Define the relational landmarks of the heart.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Heart and great vessels 9. The right border of the heart is formed by the ______________. a. right atrium b. right ventricle c. superior vena cava d. pulmonary trunk ANS: A

The right atrium forms the right border of the heart.

PTS: 1 REF: p. 813 TOP: Heart and great vessels

OBJ: Define the relational landmarks of the heart.

10. The pericardial sac protects the heart from: a. friction. b. diaphragmatic motion. c. hernia invasion. d. tumor.

ANS: A

The pericardial sac protects the heart against friction.

PTS: 1 REF: p. 812 TOP: Heart and great vessels

OBJ: Discuss the functions of the pericardial sac.

11. Select the structure that the medial wall of the right atrium contains. a. Interventricular septum NURSINGTB.COM b. Interatrial septum c. Right upper pulmonary vein d. Right lower pulmonary vein ANS: B

The medial wall of the right atrium is formed by the interatrial septum.

PTS: 1 REF: p. 813 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Heart and great vessels 12. The inferior vena cava is guarded by a fold of tissue called the _____ valve, whereas the

coronary sinus is guarded by the _____ valve. a. eustachian; coronary b. thebesian; eustachian c. eustachian; thebesian d. eustachian; atrial ANS: C

The inferior vena cava is guarded by a fold of tissue called the eustachian valve, whereas the coronary sinus is guarded by the thebesian valve.

PTS: 1 REF: p. 813 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Heart and great vessels

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

13. The roof of the right ventricle is occupied by the _______________, which lies between the

tricuspid and pulmonary orifices. a. coronary sinus orifice b. right atrial appendage c. fossa ovalis d. crista supraventricularis ANS: D

The roof of the right ventricle is occupied by the crista supraventricularis, which lies between the tricuspid and pulmonary orifices.

PTS: 1 REF: p. 813 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Heart and great vessels 14. The outflow tract of the right ventricle is also called the _______________. a. infundibulum b. conus arteriosus c. crista terminalis d. right atrial appendage ANS: A

The outflow tract of the right ventricle is also called the infundibulum.

PTS: 1 REF: p. 814 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Heart and great vessels

NURSINGTB.COM

15. Which valve prevents retrograde flow between the aorta and left ventricle? a. Mitral b. Tricuspid c. Semilunar d. Atrioventricular ANS: C

The semilunar valves prevent the reverse flow of blood from the aorta into the left ventricle.

PTS: 1 REF: p. 819 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: The cardiac cycle 16. The wall of the aorta bulges slightly at each semilunar cusp to form which one of the

following? a. Coronary arteries b. Sinus of Valsalva c. Chordae tendinae d. Arantius nodule ANS: B

The wall of the aorta bulges slightly at each cusp to form the sinus of Valsalva.

PTS: 1

REF: p. 823

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Heart and great vessels 17. The forceful contraction of the cardiac chambers is ___________, and the relaxed phase of the

cycle is ___________. a. diastole; systole b. up slope; down slope c. systole; dicrotic d. systole; diastole ANS: D

The forceful contraction of the cardiac chambers is systole, and the relaxed phase of the cycle is diastole.

PTS: 1 REF: p. 819 TOP: The cardiac cycle

OBJ: Define the relational landmarks of the heart.

18. Defects in the valves may cause turbulence or regurgitation on auscultation, which is called

_____________. a. stenosis b. murmur c. arrhythmia d. insufficiency ANS: B

Defects in the valves can cause excessive turbulence or regurgitation of the blood. These abnormal sounds are called murmurs or clicks.

N R INGTB.COM

U S PTS: 1 REF: p. 821 TOP: Auscultation of the heart valves

OBJ: Define the relational landmarks of the heart.

19. The superior vena cava (SVC) enters the right atrium __________. a. posteriorly b. anteriorly c. medially d. ventrally ANS: C

The SVC enters the right atrium medially.

PTS: 1 REF: p. 813 TOP: Heart and great vessels

OBJ: Define the relational landmarks of the heart.

20. Approximately how many beats per minute is the normal adult heart rate? a. 50 b. 70 c. 90 d. 100 ANS: B

The normal adult heart usually beats in sinus rhythm at 70 times per minute.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 819 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: The cardiac cycle 21. Most coronary venous drainage is into the ________________. a. coronary veins b. coronary sinus c. thespian veins d. atrial sinus ANS: B

The coronary sinus drains the blood supply from the heart wall.

PTS: 1 REF: p. 813 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Heart and great vessels 22. Which one of the following structures initiates the normal cardiac impulse? a. Atrioventricular node b. Bundle of His c. Sinoatrial node d. Purkinje fibers ANS: C

The sinoatrial node initiates the normal cardiac impulse and is often called the pacemaker of the heart.

PTS: 1 REF: p. 819 NURSIof M NGtheTB.C OBJ: Describe the anatomic landmarks cardiacOchambers, valves, and interventricular septum.

TOP: The electrical conduction system 23. Atrial contraction follows the _________ on an electrocardiogram (ECG). a. T wave b. P wave c. QRS complex d. S wave ANS: B

Atrial contraction follows the P wave on an ECG. PTS: 1 REF: p. 819 OBJ: Describe the anatomic landmarks of the cardiac chambers, valves, and interventricular septum.

TOP: Electrocardiography 24. The greatest muscle mass in the heart is found in which one of the following structures? a. Right atrium b. Left ventricle c. Right ventricle d. Left atrium ANS: B

The left ventricle has the greatest muscle mass because it must pump blood to all of the body.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 823 TOP: Heart and great vessels

OBJ: Differentiate the three layers of the heart wall.

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 31: Understanding Hemodynamics Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Choose the term that describes the left atrial pressure. a. Pulmonary capillary wedge b. Left atrial systolic pressure ANS: A

PCW stands for pulmonary capillary wedge and is a substitute for left atrial pressure. The PCW is obtained using a Swan-Ganz catheter primarily in intensive care settings.

PTS: 1 REF: p. 825 OBJ: State basic knowledge of the cardiac cycle, normal intracardiac pressures and volumes, cardiac output, stroke volume and its mechanics. TOP: The cardiac cycle 2. Identify the definition for cardiac output. a. The amount of blood pumped by each ventricle in one minute. b. The volume of blood ejected by the ventricles with each contraction. c. The degree of muscle fiber stretching before contraction. d. Aortic arterial pressure and vascular resistance to overcome.

ANS: A

Cardiac output refers to the amount of blood pumped by each ventricle in one minute. Stroke volume (SV) is the volume of blood ejected by the ventricles with each contraction. Any effect on SV or heart rate (HR) Preload is the degree that the NUaffects RSINthe GTcardiac B.COoutput.

M muscle fiber stretches prior to contraction (end-diastole). Afterload refers to the aortic arterial pressure and vascular resistance the ventricle must overcome to eject blood or any resistance against which the ventricles must pump in order to eject its volume.

PTS: 1 REF: p. 825 OBJ: State basic knowledge of the cardiac cycle, normal intracardiac pressures and volumes, cardiac output, stroke volume and its mechanics. TOP: The cardiac cycle 3. How is the volume of blood ejected by the ventricles with each contraction described? a. Cardiac output b. Afterload c. Stroke volume d. Resting load ANS: C

Stroke volume (SV) is the volume of blood ejected by the ventricles with each contraction.

PTS: 1 REF: p. 825 OBJ: State basic knowledge of the cardiac cycle, normal intracardiac pressures and volumes, cardiac output, stroke volume and its mechanics. TOP: The cardiac cycle 4. How would you explain the difference between laminar and parabolic flow? a. Laminar flow all has multiple speeds, while parabolic flow is considered turbulent. b. Laminar flow overlays normal flow, while parabolic flow is fast in the central

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank portion. c. Laminar flow is similar to venous waveforms, while parabolic flow has a pulsatile pattern. d. Laminar flow all has the same velocity, while parabolic flow has slow flow at the outer areas.

ANS: D

Most of the flow is traveling at the same velocity with laminar flow. As the shape of the surface blood travels through changes, so does the flow velocity profile. This change in shape or additional forces continues and the flow will vary so that it appears more parabolic with varying flow velocities. The flow velocities will be highest toward the middle of the vessel or area and slowest along the walls or edges of the surface the blood travels through.

PTS: 1 REF: p. 826 OBJ: Understand the fundamental concepts of hemodynamics as applied to ultrasound.

TOP: Blood flow velocity profiles 5. How would you create a positive shift spectral tracing when imaging the carotid artery? a. Ensure flow is toward the transducer. b. Angle the region of interest to the right. c. Invert the image and spectral tracing. d. Keep the region of interest at 90 degrees.

ANS: A

Keep in mind that the Doppler shift is relative to the position of the transducer. Blood flow moving away from the transducer has a lower frequency and is negative because of the movement away from the transducer, while blood flow moving toward the transducer has a higher frequency and is positive because flowOisMmoving toward the transducer.

NUR SINGthe TB.C PTS: 1 REF: p. 826 OBJ: Understand the fundamental concepts of hemodynamics as applied to ultrasound.

TOP: Blood flow velocity profiles 6. How would you identify flow that exceeds the Nyquist limit? a. Inability to obtain flow. b. The presence of aliasing. c. Flow away from the transducer. d. Vertical lines on the spectral tracing.

ANS: B

The Nyquist limit equals the pulse repetition frequency (PRF) divided by 2 (1/2 the PRF). The PRF is changed based on the depth of the sample volume as a longer distance from the transducer to the sample site requires more time for the pulses to be transmitted and received.

PTS: 1 REF: p. 827 OBJ: Understand the fundamental concepts of hemodynamics as applied to ultrasound.

TOP: Doppler Basics 7. Color Doppler imaging is a nonqualitative imaging method that assigns a color to blood

____________. a. shifts b. baseline

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. velocities d. intensity ANS: C

Color flow Doppler is a pulsed wave technique with multiple gates for averaging flow velocities and then assigning a color.

PTS: 1 REF: p. 828 OBJ: Understand the fundamental concepts of hemodynamics as applied to ultrasound.

TOP: Doppler Basics 8. What type of Doppler imaging has no specific pulse duration or sample volume area? a. Strain imaging b. Color Doppler c. Pulsed wave d. Continuous wave ANS: D

Continuous wave (CW) Doppler delivers continuous pulses out and back; it constantly transmits and receives, with no specific pulse duration or sample volume area.

PTS: 1 REF: p. 829 OBJ: Understand the fundamental concepts of hemodynamics as applied to ultrasound.

TOP: Doppler Basics 9. How are flow velocities changed to pressure gradients? a. Using the Bernoulli equation. b. Calculating the Nyquist limit.

N R I G B.COM c. Applying Poselli’s law. U S N T d. Multiplying the velocity by four.

ANS: A

A simplified version of the original Bernoulli equation for calculating a peak pressure gradient squares the Doppler velocity and multiplies by 4 (4V2). Anytime there is a spectral display of Doppler velocities using this simplified calculation can turn velocities into pressure gradients.

PTS: 1 REF: pp. 829-830 OBJ: Demonstrate knowledge of how to apply Doppler ultrasound to calculate pressures, velocities, and output.

TOP: Quantification of intracardiac pressures with ultrasound 10. The RA pressure (RAP) is estimated by ultrasound from the size and collapsibility of the

_______________________. a. superior vena cava (SVC) b. inferior vena cava (IVC) c. coronary sinus (CS) d. right ventricular outflow (RVO) ANS: B

The RA pressure (RAP) is estimated by ultrasound from the size and collapsibility of the inferior vena cava (IVC).

PTS: 1 REF: p. 830 OBJ: Demonstrate knowledge of how to apply Doppler ultrasound to calculate pressures, velocities,

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank and output.

TOP: Quantification of intracardiac pressures with ultrasound

11. Select the normal right atrial pressure (RAP) with the size of the collapsed inferior vena cava

at 2 centimeters (cm). a. 15 mm Hg b. 120 mm Hg c. 3 mm Hg d. 45 mm Hg ANS: C

If the IVC is normally sized (2.1 cm) and collapses with respiration, generally the RAP is estimated at 3 mm Hg (ASE GL). If the IVC is dilated (>2.1 cm) and does not collapse with respiration, the RAP is generally estimated at 15 mm Hg. PTS: 1 REF: p. 830 OBJ: Demonstrate knowledge of how to apply Doppler ultrasound to calculate pressures, velocities, and output.

TOP: Quantification of intracardiac pressures with ultrasound 12. Choose the number of images needed to calculate the cardiac output and stroke volume by

ultrasound. a. Four b. Six c. Three d. Two ANS: D

To calculate the cardiac output and stroke volume, you must have two images: the radius of the outflow tract (generally aNzoomed 2D image the left ventricular outflow tract [LVOT]) RSIN GT B.CofOM U and a PW spectral Doppler image in the LVOT. PTS: 1 REF: p. 830 OBJ: Demonstrate knowledge of how to apply Doppler ultrasound to calculate pressures, velocities, and output.

TOP: Quantification of intracardiac pressures with ultrasound 13. What is the equation to calculate the stroke volume? a. VTILVOT  CSALVOT b. r2 c. SV  HR d. 4 (4V2) ANS: A

We know that CO = SV  HR; one needs to know how to calculate SV ultrasound (SV = VTILVOT  CSALVOT). SV is the product of the velocity time integral (VTI) of the LVOT and the cross-sectional area (CSA) of the LVOT. The CSA is the radius of the LVOT in centimeters, squared and multiplied by pi (CSA = r2).

PTS: 1 REF: p. 830 OBJ: Demonstrate knowledge of how to apply Doppler ultrasound to calculate pressures, velocities, and output.

TOP: Quantification of intracardiac pressures with ultrasound

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 32: Introduction to Echocardiographic Techniques, Terminology, and Tips Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following echocardiographic modes was called the ice pick view? a. A-mode b. M-mode c. B-mode d. Doppler ANS: B

The M-mode technique was limited in that it provided only a one-dimensional or ice pick view of the heart.

PTS: 1 REF: pp. 839-840 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: The echocardiographic examination 2. Which one of the following patient positions is best suited for echocardiographic

examination? a. Prone b. Supine c. Left lateral semidecubitus d. Right lateral decubitus ANS: C

NURSINGTB.COM

The left lateral semidecubitus position allows the heart to move away from the sternum and closer to the chest wall.

PTS: 1 REF: p. 833 OBJ: Explain the transducer selection and patient position for a cardiac examination.

TOP: Two-dimensional echocardiography 3. The cardiac window for the parasternal view is best found in the ______________ approach. a. right parasternal border b. left parasternal border c. suprasternal d. infrahepatic ANS: B

The parasternal approach is accomplished by placing the long axis of the transducer to the left of the sternum in approximately the fourth intercostal space.

PTS: 1 REF: p. 839 OBJ: Explain the transducer selection and patient position for a cardiac examination.

TOP: Two-dimensional echocardiography 4. The brightest returning echo signal in the heart is from which one of the following areas? a. Anterior wall of the heart b. Anterior leaflet of mitral valve

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Aortic leaflet d. Pericardium ANS: D

The bright echo reflection is from the pericardium.

PTS: 1 REF: p. 839 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Two-dimensional echocardiography 5. Which one of the following techniques may alleviate lung interference? a. Scan the patient while erect. b. Ask the patient to exhale. c. Scan the patient while supine. d. Ask the patient to inhale.

ANS: B

If too much lung interference clouds the study, then the patient should exhale for as long as possible.

PTS: 1 REF: p. 833 OBJ: Explain the transducer selection and patient position for a cardiac examination.

TOP: Two-dimensional echocardiography 6. Which one of the following imaging planes is used in echocardiography? a. Apical b. Subcostal c. Short-axis NURSINGTB.COM d. Parasternal ANS: C

Imaging planes used in echocardiography include long-axis, short-axis, and four-chamber planes. Apical, subcostal, parasternal, and suprasternal are transducer locations.

PTS: 1 REF: p. 834 OBJ: Define the imaging planes used in echocardiography.

TOP: The echocardiographic examination 7. As diastole begins, the anterior leaflet mitral valve (ALMV) executes a rapid anterior motion,

coming to a peak at point _____. a. F b. E c. D d. A ANS: B

As diastole begins, the ALMV executes a rapid anterior motion, coming to a peak at point E. PTS: 1 REF: p. 859 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: M-mode imaging of the cardiac structures

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. As the left atrium contracts, the mitral valve opens in a shorter anterior excursion and

terminates at point ______. a. B b. E c. A d. C ANS: C

As the left atrium contracts, the mitral valve opens in a shorter anterior excursion and terminates at point A. PTS: 1 REF: p. 859 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: M-mode imaging of the cardiac structures 9. The mitral valve coincides with the onset of the QRS systolic component at point _____. a. B b. A c. E d. C ANS: D

Point C coincides with the onset of the QRS systolic component.

PTS: 1 REF: p. 859 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: M-mode imaging of the cardiac structures

N RSINGTB.COM

U 10. As the left atrium contracts, the: a. mitral valve opens. b. tricuspid valve opens. c. mitral valve closes. d. tricuspid valve closes.

ANS: A

As the left atrium contracts, the mitral valve opens.

PTS: 1 REF: p. 859 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Anatomy and physiology 11. Which one of the following cardiac chambers is posterior to the aorta in the parasternal

long-axis view? a. Left ventricle b. Right atrium c. Right ventricle d. Left atrium ANS: D

The left atrium is the cardiac chamber that lies posterior to the aorta in the long-axis parasternal view.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 839 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: The echocardiographic examination 12. Which one of the following statements about Doppler is false? a. The best quality Doppler signals are obtained when the sample volume is parallel

to the direction of flow. b. The key is to produce a spectral signal to show a well-defined velocity envelope

along with a clear window. c. Displaying an electrocardiogram (ECG) on the Doppler tracing is not necessary. d. Flow toward the transducer is above the baseline.

ANS: C

A simultaneous ECG should be displayed to help time the cardiac cycle.

PTS: 1 REF: p. 835 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Doppler applications and technique 13. Velocities that exceed the Nyquist limit are known to produce which one of the following

artifacts? a. Aliasing b. Side lobe artifact c. Axial artifact d. Mirror-image artifact ANS: A

Velocities that exceed the Nyquist known M to produce aliasing.

N R limit I Gare B.C

U S N T

O

PTS: 1 REF: p. 836 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Doppler applications and technique 14. Choose the graphic display used to display blood flow. a. Nyquist limit b. Spectral waveform c. Color Doppler imaging d. Turbulence shift ANS: B

Spectral waveform displays the flow patterns obtained via the Doppler.

PTS: 1 REF: p. 837 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Imaging modalities 15. Generally, the optimal view to evaluate the pulmonary valve is _____________. a. apical b. subcostal c. suprasternal d. parasternal ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The optimal view to evaluate the pulmonary valve is generally a high parasternal short-axis view with a slight angulation of the beam toward the left shoulder.

PTS: 1 REF: p. 861 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Doppler applications and technique 16. The best window to record images and Doppler signals from the arch of the aorta is which one

of the following imaging planes? a. Suprasternal b. Long-axis c. Short-axis d. Apical ANS: A

The suprasternal plane is the best window to view the aortic arch, brachiocephalic, right pulmonary artery, left atrium, and left main branches.

PTS: 1 REF: p. 857 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: The echocardiographic examination 17. Why is it beneficial to narrow the color Doppler sector during the echocardiographic

examination? a. Increases the 2D detail b. Focuses the receive beam c. Increases the frame rate d. Turquoise speckle artifacts NURSINGTB.COM ANS: C

The color Doppler sector should be long, spanning the entire cardiac image from top to bottom to increase the frame rate (FR) to 17 Hz. PTS: 1 REF: p. 838 | p. 857 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: The echocardiographic examination 18. If the cardiac sonographer is in the parasternal long-axis view to visualize the ALMV, the

transducer should be angled _________ to record the tricuspid valve. a. superiorly b. medially c. inferiorly d. laterally ANS: B

The tricuspid valve can be visualized in the parasternal long-axis view with the transducer angled medially.

PTS: 1 REF: p. 861 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Scanning techniques M-mode imaging of the cardiac structures

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

19. The best window used to record the inferior vena cava and hepatic veins draining into the

right atrium is the ______________ imaging plane. a. apical b. long-axis c. subcostal d. suprasternal ANS: C

The subcostal window is used to visualize the inferior vena cava, hepatic veins, right and left ventricle inflow, and right ventricle outflow.

PTS: 1 REF: p. 839 OBJ: Define the imaging planes used in echocardiography.

TOP: The echocardiographic examination 20. Which one of the following imaging planes transects the heart perpendicular to the dorsal and

ventral surfaces of the body? a. Apical window b. Long-axis c. Suprasternal window d. Short-axis ANS: D

The short-axis plane transects the heart perpendicular to the dorsal and ventral surfaces of the body.

PTS: 1 REF: p.N 834R I G B.C M Sin Nechocardiography.

T O OBJ: Define the imaging planesU used TOP: Two-dimensional echocardiography 21. Which one of the following techniques has the ability to record maximum velocities without

exceeding the Nyquist limit? a. Spectral analysis b. Color-flow Doppler c. Continuous-wave Doppler d. Pulse-wave Doppler ANS: C

Continuous-wave Doppler has the ability to record maximum velocities without aliasing.

PTS: 1 REF: p. 837 OBJ: Describe a normal cardiac examination using two-dimensional, color flow, Doppler, and M-mode imaging modes.

TOP: Doppler applications and technique 22. The mid-parasternal short-axis view is useful in recording which one of the following? a. Mobility and thickness of tricuspid and aortic valves b. Flow from the right ventricle outflow tract and pulmonary arteries c. Typical sausage-shaped right ventricular outflow tract and pulmonary artery

draped anterior to circular aorta d. Continuity of the interventricular septum with the anterior wall of the aorta

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B

The parasternal short-axis view is useful in recording flow from the right ventricle outflow tract and pulmonary arteries.

PTS: 1 REF: p. 845 OBJ: Define suprasternal, apical, and parasternal views.

TOP: The echocardiographic examination 23. The cardiac sonographer should palpate the patient’s chest to detect the point of maximal

impulse when using the _________________ view. a. suprasternal b. subcostal c. parasternal d. apical ANS: D

The cardiac sonographer should palpate the patient’s chest to detect the point of maximal impulse when using the apical view.

PTS: 1 REF: p. 845 OBJ: Define suprasternal, apical, and parasternal views.

TOP: Two-dimensional echocardiography 24. If a four-chambered view is unobtainable, which one of the following alternate views may be

used? a. Suprasternal b. Subcostal c. Parasternal d. Short-axis ANS: B

NURSINGTB.COM

The subcostal four-chamber view may serve as an alternate view if the apical four-chamber view is unobtainable.

PTS: 1 REF: pp. 848-849 OBJ: Define suprasternal, apical, and parasternal views.

TOP: The echocardiographic examination 25. Which one of the following views is usually good for assessing the presence of pericardial

effusion? a. Parasternal b. Suprasternal c. Apical d. Subcostal ANS: D

The subcostal view is usually good for assessing the presence of pericardial effusion, because it surrounds the anterior segment of the right side of the heart.

PTS: 1 REF: p. 855 OBJ: Define suprasternal, apical, and parasternal views.

TOP: The echocardiographic examination

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 33: Introduction To Clinical Echocardiography: Left-Sided Valvular Heart Disease Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Choose the pathology that demonstrates systolic retrograde flow from the left ventricle to the

left atrium. a. Mitral regurgitation b. Aortic stenosis c. Tricuspid regurgitation d. Pulmonary hypertension ANS: A

Mitral regurgitation is systolic retrograde flow from the left ventricle into the left atrium. This condition occurs secondary to the reduction or elimination of the normal systolic coaptation between the anterior and posterior mitral leaflets.

PTS: 1 REF: p. 863 OBJ: Define the characteristics and causes of mitral regurgitation.

TOP: Mitral valve disease 2. What type of Carpentier’s mitral regurgitation demonstrates excessive leaflet motion due to

mitral prolapse? a. Type I b. Type II c. Type III d. Type IV

NURSINGTB.COM

ANS: B

Carpentier’s classification is a method to describe functional mitral regurgitation with three specific types: Type I shows normal leaflet motion with the MR due to annular dilation, perforation, or cleft; Type II shows excessive leaflet motion due to mitral valve prolapse or chordal rupture; and Type III shows restricted leaflet motion due to rheumatic heart disease or dilated cardiomyopathy.

PTS: 1 REF: p. 864 OBJ: Define the characteristics and causes of mitral regurgitation.

TOP: Mitral valve disease 3. Which of the following do you need to calculate a PISA of the mitral valve? a. Qualitative color Doppler b. Hemispheric flow divergence area c. Peak velocity of the MR jet d. Baseline color measurement ANS: C

Use the following steps to calculate EROA and PISA. 1.

Center the mitral valve and apply color flow Doppler. Use the apical 4 CV view that shows convergence zone optimally.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 2.

3.

4.

5.

Zoom in on flow convergence area on the ventricular side of the MV; adjust the Nyquist limit to obtain a hemispheric flow convergence area.

Measure the distance between the edge of the hemisphere where CFD abruptly changes colors to the valve orifice; this is the radius of the hemisphere “r.”

Obtain CW signal of MR jet and measure the peak velocity; this is the MR peak velocity.

Calculate EROA using the formula = 2  r2  Va/MR peak velocity.

PTS: 1 REF: p. 865 TOP: Mitral valve disease

OBJ: Know how to calculate the PISA method.

4. Choose the most common cause of mitral stenosis. a. Age-related changes b. Flail anterior leaflet c. Congenital stenosis d. Rheumatic fever ANS: D

The two common causes of mitral stenosis are rheumatic fever and degenerative mitral stenosis. The most frequent valvular complication of rheumatic fever is the development of mitral stenosis.

PTS: 1 REF: p. 867 TOP: Mitral valve disease

OBJ: Describe the common causes of mitral stenosis.

5. Identify the mitral valve area that results in an increase in left atrial pressure and dyspnea.

NURSINGTB.COM a. 1.5 cm2 2 b. 4 to 6 cm c. 3.0 cm2 d. 8010 cm2 ANS: A

The normal mitral valve area is 4 to 6 cm2. Patient symptoms are related to increased left atrial pressure and dyspnea and usually occur when the mitral valve area is less than 1.5 m2.

PTS: 1 REF: p. 868 TOP: Mitral valve disease

OBJ: Describe the common causes of mitral stenosis.

6. Identify the genetic cause for aortic insufficiency. a. Edward syndrome b. Marfan’s syndrome c. Down syndrome d. VACTERAL ANS: B

The development of aortic regurgitation may be the result of multiple causes: congenital malformation of the aortic valve, rheumatic disease, dilated aortic root, Marfan’s syndrome, endocarditis, aortic dissection, prosthetic valve dysfunction, or degenerative or calcified aortic valve.

PTS: 1

REF: p. 872

OBJ: Explain the causes of aortic regurgitation.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Aortic valve disease 7. A patient with a history of infective endocarditis is at risk for: a. left ventricular myopathy. b. abdominal aortic dissection. c. aortic regurgitation. d. late closure of the MV. ANS: C

Acute aortic regurgitation demonstrates a sudden large regurgitant volume on the left ventricle causing early closure of the mitral valve. This may be secondary to aortic dissection, infective endocarditis, or post-surgical prosthetic valve implantation.

PTS: 1 REF: p. 864 | p. 872 OBJ: List the echocardiographic features of acute versus chronic aortic regurgitation.

TOP: Aortic valve disease 8. An increase in left ventricular end-diastolic volume raises suspicion for: a. acute mitral valve flail leaflet. b. dilated cardiomyopathy. c. viral induced valve calcification. d. chronic aortic regurgitation.

ANS: D

Patients with chronic aortic regurgitation show an increase in the left ventricular end-diastolic volume, an increase in chamber compliance, eccentric and concentric hypertrophy, and pressure overload of the left ventricle.

N R I G B.C M

U S N T O PTS: 1 REF: p. 872 OBJ: List the echocardiographic features of acute versus chronic aortic regurgitation.

TOP: Aortic valve disease 9. Rheumatic heart disease may cause which of the following affects on the aortic valve? a. Fibrosis b. Thinning c. Flail leaflet d. Increased mobility ANS: A

Rheumatic heart disease may affect the heart valves, which causes thickening and fibrosis that leads to aortic stenosis. This is characterized by commissural fusion and thickening of the leaflet edges that is sometimes associated with leaflet retraction, aortic regurgitation, and mitral leaflet involvement.

PTS: 1 REF: p. 876 OBJ: State the three types of aortic stenosis and their echocardiographic features.

TOP: Aortic valve disease 10. Choose the least common type of aortic stenosis. a. Subvalvular b. Supravalvular c. Valvular

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Paravalvular ANS: B

There are three types of aortic stenosis: supravalvular, subvalvular, and valvular.

Supravalvular aortic stenosis is uncommon and is seen more in the pediatric population. The most common type is valvular aortic stenosis.

PTS: 1 REF: p. 875 OBJ: State the three types of aortic stenosis and their echocardiographic features.

TOP: Aortic valve disease 11. Which of the following will you need to calculate the simplified continuity equation for the

aortic valve area? a. RVOT length b. RA/RV ratio c. LVOT diameter d. RA contractibility ANS: C

Measurement of the aortic valve area is independent of flow rate influence. This measurement is obtained from the continuity equation. Therefore, in order to calculate the aortic valve area with the continuity equation, you need: (1) LVOT diameter, (2) LVOT VTI, and (3) aortic jet VTI. PTS: 1 REF: p. 879 TOP: Aortic valve disease

OBJ: Explain how to calculate the aortic valve area.

12. The 50% expansion of the aorta thatI involves the three vessel wall layers defines a(n): N R G B.C M U S N T O a. fistula. b. dissection. c. tear. d. aneurysm.

ANS: D

The definition of an aneurysm implies there has been 50% expansion of all three layers of the vessel wall in diameter.

PTS: 1 REF: p. 881 TOP: Aortic abnormalities

OBJ: Define the definition of an aortic aneurysm.

13. Select the definition of a pseudoaneurysm. a. A break in the aortic wall with periaortic blood collection b. Reduction of AVA of 0.1 cm2/yr c. Flow from the ventricle to atrium d. Degeneration of the aortic wall ANS: A

A pseudoaneurysm is the loss of integrity of the aortic wall with a blood collection outside the aorta.

PTS: 1 REF: p. 882 OBJ: State the difference between a true aneurysm and a pseudoaneurysm.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Aortic abnormalities 14. A tear in the aortic intima is a(n): a. dissection. b. pseudoaneurysm. c. partial aneurysm. d. valvular dilatation.

ANS: A

The dissection is a tear in the aortic intima that leads to a false lumen with blood between the intima and media and/or adventitia.

PTS: 1 REF: p. 882 OBJ: Describe the echocardiographic findings in aortic dissection.

TOP: Aortic abnormalities

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 34: Introduction to Clinical Echocardiography: Pericardial Disease, Cardiomyopathies, and Tumors Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. What is the normal thickness of the pericardial layers? a. 1 to 2 mm b. 5 to 6 mm c. 15 to 20 mm d. 0.5 to 2.0 cm ANS: A

The visceral and parietal layers are separated by 15 to 50 ml of serous fluid. Their normal thickness is 1 to 2 mm, and the thickness is abnormal if it is greater than 4 mm.

PTS: 1 REF: p. 887 OBJ: Identify the echocardiographic distinction between pericardial effusion and pleural effusion.

TOP: Pericardial disease 2. What defines a pericardial effusion? a. Serous fluid less than 15 ml between the visceral and parietal pericardium b. An echo-free space between the visceral and parietal pericardium c. Maintenance of less than 25 ml through the entire cardiac cycle d. Fluid within the lung base on a transesophageal image ANS: B

NURSINGTB.COM

The pericardial effusion is recognized as an echo-free space between the visceral and parietal pericardium. The effusion maintains at greater than 25 ml through the entire cardiac cycle.

PTS: 1 REF: p. 888 OBJ: Identify the echocardiographic distinction between pericardial effusion and pleural effusion.

TOP: Pericardial disease 3. At what location does the pericardial effusion begin? a. Anterior b. Apical c. Posterior d. Lateral ANS: C

This fluid usually accumulates posterior to the heart as this is the most dependent surface. As the effusion increases, it extends laterally and then may surround the apex and the anterior surface of the heart.

PTS: 1 REF: p. 888 OBJ: Identify the echocardiographic distinction between pericardial effusion and pleural effusion.

TOP: Pericardial disease 4. Fluid found anterior to the descending aorta is a: a. pleural effusion.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. malignant effusion. c. hemorrhagic effusion. d. pericardial effusion.

ANS: D

The pericardial effusion is always is found anterior to the descending aorta, while the pleural effusion is posterior to the descending aorta. Recall that the pericardium reflects off the aorta at this junction.

PTS: 1 REF: p. 888 OBJ: Identify the echocardiographic distinction between pericardial effusion and pleural effusion.

TOP: Pericardial disease 5. Pericardial fat is found __________ to the heart. a. anterior b. posterior c. lateral d. superior ANS: A

If there is only an echo-free space anterior to the right ventricle, the consideration of pericardial fat should be made.

PTS: 1 REF: p. 888 OBJ: Identify the echocardiographic distinction between pericardial effusion and pleural effusion.

TOP: Pericardial disease 6. Which of the following is an echocardiographic finding of cardiac tamponade?

N R I G B.COM a. Small pericardial effusion U S N T b. Right atrial systolic collapse c. Collapsed inferior vena cava d. Right ventricular enlargement ANS: B

Echocardiographic findings are quite specific for tamponade: moderate to large pericardial effusion; right atrial systolic collapse; right ventricle diastolic collapse; reciprocal respiratory changes in ventricular volumes; and a dilated inferior vena cava with lack of respiratory changes.

PTS: 1 REF: p. 889 TOP: Cardiac tamponade

OBJ: Describe the echo findings in cardiac tamponade.

7. Choose the Doppler finding affected by cardiac tamponade. a. Early left atrial emptying b. Premature ventricular contractions c. Left ventricular diastolic filling d. Systolic changes in the right ventricle ANS: C

Doppler findings will show a respiratory variation in the right ventricular (>40% variation) and left ventricular (greater than 25% variation) diastolic filling.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 889 | p. 891 OBJ: Describe the echo findings in cardiac tamponade.

TOP: Cardiac tamponade

8. Choose the echocardiographic sign of constrictive pericarditis. a. Biatrial enlargement b. Decreased motion of the ventricular septum c. Thinning of the pericardial layer d. Septal thinning ANS: A

On echo there may be thickening of the pericardial layer with increased echogenicity. There may be normal left ventricular size and systolic function. There is biatrial enlargement. The septum is quite abnormal; there may be an abrupt posterior motion of the ventricular septum in early diastole, a flat motion in middle diastole, an abrupt anterior motion following atrial contraction, or a septal “bounce” demonstrating an exaggerated interventricular dependence.

PTS: 1 REF: p. 891 OBJ: Define the echo findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

TOP: Constrictive pericarditis 9. Identify the mitral inflow Doppler pattern demonstrated with constrictive pericarditis. a. Shortened isovolumic contraction time b. Early diastolic filling velocity c. Pulmonary venous hum d. Systolic flow reversal ANS: B

The Doppler finding of the mitral pattern demonstrates increased early diastolic filling NURinflow SINGleading TB.CtoOaMshort filling time. There may be dynamic velocity followed by rapid deceleration, changes with respiration: early diastolic mitral inflow reduced with the onset of inspiration; the isovolumic relaxation time shortens and returns to normal with expiration. The pulmonary venous flow may show respiratory changes. The diastolic flow reversal is augmented in expiration in the hepatic vein flow.

PTS: 1 REF: p. 891 OBJ: Define the echo findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

TOP: Constrictive pericarditis 10. Which of the following is a cause for dilated cardiomyopathy? a. Gram-positive sepsis b. Carbon dioxide exposure c. Legionella infection d. Premature ventricular contractions ANS: C

Legionella infection, gram-negative sepsis, and carbon monoxide exposure are a few causes of dilated cardiomyopathy.

PTS: 1 REF: p. 893 OBJ: Define the echo findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

TOP: Cardiomyopathies

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 11. Identify one of the echocardiographic findings with congestive cardiomyopathy. a. Increased wall thickness b. Right ventricular thrombus c. Tricuspid regurgitation d. Left ventricular dilation ANS: D

A few of the echocardiographic findings of congestive cardiomyopathy include left ventricular dilation, normal to reduced wall thickness, left ventricular thrombus, and mitral regurgitation.

PTS: 1 REF: p. 892 OBJ: Define the echo findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

TOP: Cardiomyopathies 12. What is the tricuspid annular plane systolic excursion (TAPSE) in a patient with dilated

cardiomyopathy? a. <15 mm b. <800 mm c. 0.5 to 2.0 cm d. 25 mm ANS: A

Measurement of TAPSE (tricuspid annular plane systolic excursion) of <15 mm indicates abnormal movement of the right ventricular free wall.

PTS: 1 REF: p. 894 OBJ: Define the echo findingsNin dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

URSINGTB.COM TOP: Cardiomyopathies 13. Which of the following is an echocardiographic finding of tamponade? a. Increased respiratory changes of the LV b. Moderate to large pericardial effusion c. Collapsed inferior vena cava d. Right atrial diastolic dilatation ANS: B

Echocardiographic findings are quite specific for tamponade: moderate to large pericardial effusion; right atrial systolic collapse; right ventricle diastolic collapse; reciprocal respiratory changes in ventricular volumes; and a dilated inferior vena cava with lack of respiratory changes.

PTS: 1 REF: p. 889 OBJ: Define the echo findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

TOP: Cardiomyopathies 14. What is the result of chronic pericardial disease? a. Ventricular systolic dysfunction b. Increased atrial filling c. Constrictive pericarditis d. High systemic output

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C

A thickened and inelastic pericardium is a result of chronic pericardial disease, which in turn limits the ventricular filling, leading to chronic biventricular diastolic dysfunction, right-sided heart failure, and low systemic output. This condition is secondary to long-standing pericardial inflammation with pericardial scarring, thickening, fibrosis, and calcification.

PTS: 1 REF: p. 891 OBJ: Define the echo findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy.

TOP: Cardiomyopathies 15. Name the artifact that can mimic an intracardiac mass. a. Enhancement b. Lateral beam c. Ghosting d. Beam-width ANS: D

The sonographer should ensure the cardiac mass is not due to an ultrasound artifact caused by beam-width, electrical inference, or side lobe artifact.

PTS: 1 REF: p. 903 OBJ: Recognize the echocardiographic findings of tumors, thrombus, vegetations and normal variants.

TOP: Cardiac masses 16. Where would metastasis from renal adenocarcinoma be located in the heart? a. Right atrium b. Left atrium c. Right ventricle NURSINGTB.COM d. Left ventricle ANS: A

Adenocarcinoma of the kidney may travel through the renal vein into the inferior vena cava and into the right atrium.

PTS: 1 REF: p. 903 OBJ: Recognize the echocardiographic findings of tumors, thrombus, vegetations and normal variants.

TOP: Cardiac masses 17. Which of the following increases the risk for left ventricular thrombus? a. Ejection fraction of more than 20% b. Low velocity flow and blood stasis c. Apical kinesis without flow d. Right ventricular aneurysm ANS: B

Predisposing conditions for left ventricular thrombus include blood stasis with low velocity flow, ventricular aneurysm, dilated cardiomyopathy with “swirling” blood flow, or pseudoaneurysm. If apical akinesis is present with a left ventricular aneurysm and a low ejection fraction less than 20%, caution should be made to clearly identify the apex of the heart to rule out thrombus.

PTS: 1

REF: p. 907

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Recognize the echocardiographic findings of tumors, thrombus, vegetations and normal variants.

TOP: Cardiac masses

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 35: Fetal Echocardiography: Beyond the Four Chambers Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. In the four-chamber view at 18 weeks of gestation, the ventricles should each measure

approximately _______ millimeters (mm). a. 2 b. 4 c. 6 d. 8 ANS: C

The ventricles should each measure 6 mm at 18 weeks of gestation.

PTS: 1 REF: p. 920 OBJ: Describe the normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus 2. Which one of the following abnormalities is communication between the right and left atrium

that persists after birth? a. Patent ductus arteriosus b. Ventricular septal defect c. Persistent ductus venosus d. Atrial septal defect ANS: D

NURSINGTB.COM

The failure of the foramen ovale to close after birth causes an atrial septal defect.

PTS: 1 REF: p. 918 TOP: Fetal circulation

OBJ: Discuss fetal circulation.

3. Which one of the following structures forms in the wall of the sinus venosus near its opening

into the right atrium? a. Sinoatrial node b. Atrioventricular node c. Purkinje fiber node d. Moderator band ANS: A

A sinoatrial node forms in the wall of the sinus venosus near its opening into the right atrium.

PTS: 1 REF: p. 913 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 4. The ______________ is the first part of the atrial septum to grow from the dorsal wall of the

primitive atrium. It fuses with the endocardial cushions. a. septum primum b. fossa ovale c. septum secundum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. fossa ovalis ANS: A

The septum primum is the first part of the atrial septum to grow from the dorsal wall of the primitive atrium.

PTS: 1 REF: p. 912 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 5. The embryonic vascular system begins during the _____ week. a. second b. third c. fourth d. fifth ANS: B

The vascular system begins during the third week in the wall of the yolk sac, connecting stalk, and chorion.

PTS: 1 REF: p. 911 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 6. The cardinal vein returns blood from which one of the following? a. Embryo b. Yolk sac c. Placenta NURSINGTB.COM d. Heart ANS: A

The cardinal vein returns blood from the embryo.

PTS: 1 REF: p. 911 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 7. The primitive cardiovascular system is formed by blood vessels including all of the following

structures except the: a. yolk sac. b. chorion. c. connecting stalk. d. amnion.

ANS: D

Blood vessels from the embryo join those on the yolk sac, chorion, and connecting stalk to form a primitive cardiovascular system.

PTS: 1 REF: p. 911 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 8. The caudal region of the primitive heart is called the ___________________.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

primitive atrium truncus arteriosus sinus venosus primitive ventricle

ANS: C

The sinus venosus is the caudal region of the primitive heart.

PTS: 1 REF: p. 912 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 9. The division of the heart into four chambers occurs during the _____ and _____ weeks of

fetal development. a. third; fourth b. fourth; fifth c. fifth; sixth d. sixth; seventh ANS: B

The division of the heart into four chambers occurs during the fourth and fifth weeks of fetal development.

PTS: 1 REF: p. 912 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 10. The right ventricle is formed from which one of the following structures?

NURSINGTB.COM a. Primitive vein b. Septum primum c. Bulbus cordis d. Septum secundum ANS: C

The right ventricle is formed from the bulbus cordis.

PTS: 1 REF: p. 912 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system 11. Normal interventricular septal thickness during the third trimester should not exceed _______

mm. a. 2 b. 4 c. 6 d. 8 ANS: B

Normal interventricular septal thickness during the third trimester should not exceed 4 mm.

PTS: 1 REF: p. 922 OBJ: Describe normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

12. Blood flow in the fetus communicates between the aorta and pulmonary arteries via which

one of the following? a. Fossa ovalis b. Ductus venosus c. Ductus arteriosus d. Pulmonary veins ANS: C

Blood flow in the fetus communicates between the aorta and pulmonary artery via the ductus arteriosus.

PTS: 1 REF: p. 913 TOP: Fetal circulation

OBJ: Discuss fetal circulation.

13. The _____________ forms the floor of the fossa ovale. a. bulbus cordis b. septum primum c. annulus d. sinoatrial node ANS: B

The septum primum forms the floor of the fossa ovalis.

PTS: 1 REF: p. 914 OBJ: Understand the embryologic development of the fetal heart.

TOP: Embryology of the cardiovascular system

N R I G B.C M

U S N T than the O left heart.

14. In utero, the right heart is ______________ a. much larger b. slightly larger c. slightly smaller d. much smaller ANS: B

In utero, the right heart is slightly larger than the left heart.

PTS: 1 REF: p. 918 TOP: Fetal circulation

OBJ: Discuss fetal circulation.

15. In utero, the foramen ovale opens toward which one of the following? a. Right atrium b. Left atrium c. Right ventricle d. Left ventricle ANS: B

In utero, the foramen ovale opens toward the left atrium.

PTS: 1 REF: p. 918 TOP: Fetal circulation

OBJ: Discuss fetal circulation.

16. The tricuspid valve is normally located ___________ the mitral valve.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

slightly superior to slightly inferior to at the same level as slightly ventral to

ANS: B

Normally, the tricuspid valve is located slightly inferior to the mitral valve.

PTS: 1 REF: p. 919 OBJ: Describe normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus 17. In the four-chamber view, all pulmonary veins are imaged except which one of the following

veins? a. Left lower b. Right lower c. Left upper d. Right upper ANS: B

The right lower vein is not imaged in the four-chamber view.

PTS: 1 REF: p. 919 OBJ: Describe normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus 18. The four pulmonary veins bring blood from the lungs back into the ___________ wall of the

___________ atrium. a. medial; left b. posterior; left c. medial; right d. posterior; right

NURSINGTB.COM

ANS: B

The four pulmonary veins bring blood from the lungs back into the posterior wall of the left atrium.

PTS: 1 REF: p. 926 OBJ: Describe normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus 19. Which one of the following is between the left atrium and the left ventricle? a. Tricuspid valve b. Foramen ovale c. Mitral valve d. Atrioventricular node ANS: C

The mitral valve is an atrioventricular valve between the left atrium and left ventricle.

PTS: 1 REF: p. 926 OBJ: Describe normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

20. A gestational age of 20 weeks would show a normal aortic measurement of ______ mm. a. 2 b. 4 c. 6 d. 8 ANS: B

A gestational age of 20 weeks would show a normal aortic measurement of 4 mm.

PTS: 1 REF: p. 922 OBJ: Describe normal anatomy seen in the views discussed in this chapter.

TOP: Echocardiographic evaluation of the fetus 21. Fetal tachycardia is defined as a heart rate over _____ beats per minute. a. 160 b. 180 c. 200 d. 220 ANS: C

A fetal heart rate over 200 bpm is termed tachycardia.

PTS: 1 REF: p. 914 TOP: Fetal circulation

OBJ: Discuss fetal circulation.

22. Fetal risk factors for congenital heart disease include all of the following abnormalities except: a. an abnormal heart rate.

NURSINGTB.COM b. abnormal amniotic fluid collections. c. extracardiac abnormalities. d. a sibling with a cardiac abnormality.

ANS: D

A sibling with a cardiac abnormality is a familial risk factor.

PTS: 1 REF: p. 915 OBJ: Explain how to sonographically evaluate the fetal heart with two-dimensional, M-mode, pulsed Doppler, and color-flow Doppler imaging.

TOP: Risk factors indicating fetal echocardiography 23. Which one of the following types of imaging is used to evaluate cardiac motion? a. M-mode b. B-mode c. Pulse Doppler d. Color Doppler ANS: A

Motion mode (M-mode) is used to evaluate cardiac motion.

PTS: 1 REF: p. 916 OBJ: Explain how to sonographically evaluate the fetal heart with two-dimensional, M-mode, pulsed Doppler, and color-flow Doppler imaging.

TOP: Beyond the four-chamber view

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

24. In fetal echocardiography, the normal peak systolic measurement of the mitral valve is

___________ centimeters per second (cm/sec). a. 45-65-87 b. 40-60-77 c. 25-55-80 d. 40-60-100 ANS: B

The normal peak systolic measurement of the mitral valve is 40-60-77 cm/sec.

PTS: 1 REF: p. 917 OBJ: Explain how to sonographically evaluate the fetal heart with two-dimensional, M-mode, pulsed Doppler, and color-flow Doppler imaging.

TOP: Embryology of the cardiovascular system

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 36: Fetal Echocardiography: Congenital Heart Disease Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. A(n) __________________ defect occurs when the endocardial cushion fails to fuse in the

center of the heart. a. atrioventricular septal b. muscular c. perimembranous d. supracristal ANS: A

The failure of the endocardial cushion to fuse is termed an incomplete atrioventricular septal defect.

PTS: 1 REF: p. 936 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Septal defects 2. In which one of the following conditions do the atria beat more than 400 beats per minute

(bpm), whereas the ventricular rate is 120 to 200 bpm? a. Atrioventricular block b. Ventricular fibrillation c. Atrial flutter NURSINGTB.COM d. Atrial fibrillation ANS: D

In atrial fibrillation, the atria beat more than 400 bpm, whereas the ventricular rate is 120 to 200 bpm.

PTS: 1 REF: p. 959 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Septal defects 3. In which of the following congenital heart lesions does only one great artery arise from the

base of the heart? a. A single ventricle b. A single atrium c. Transposition d. Truncus arteriosus ANS: D

Truncus arteriosus is a congenital heart lesion in which only one great artery arises from the base of the heart.

PTS: 1 REF: p. 951 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Prenatal evaluation of congenital heart disease

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

4. A disease of the myocardial muscle layer of the heart that causes the heart to dilate secondary

to regurgitation and also affects cardiac function is which one of the following? a. Critical aortic stenosis b. Cardiomyopathy c. Coarctation d. Pericardial effusion ANS: B

Cardiomyopathy involves a disease of the myocardial tissue in the heart.

PTS: 1 REF: p. 929 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Prenatal evaluation of congenital heart disease 5. A large ventricular and atrial septal defect with a single, undivided, free-floating leaflet that

stretches across both ventricles is called a _________________________. a. partial atrioventricular septal defect b. cleft mitral valve c. complete atrioventricular septal defect d. muscular septal defect ANS: C

A complete atrioventricular septal defect has a single, undivided, free-floating leaflet that stretches across both ventricles.

PTS: 1 REF: pp. 936-937 OBJ: Discuss the echocardiographic for septalMdefects, ventricular inflow and outflow tract NURSfindings Icardiac NGTB.C O complex cardiac abnormalities, and disturbances, great vessel abnormalities, tumors, dysrhythmias.

TOP: Septal defects 6. A discrete or long-segment narrowing in the aortic arch, usually at the level of the left

subclavian artery near the insertion of the ductus arteriosus, is called which one of the following? a. Coarctation of the aorta b. Hypoplasia of the aorta c. Aortic atresia d. Hypoplastic left heart ANS: A

Coarctation of the aorta is a discrete or long-segment narrowing in the aortic arch, usually at the level of the left subclavian artery near the insertion of the ductus arteriosus.

PTS: 1 REF: p. 952 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Great vessel abnormalities 7. Which one of the following abnormalities is a fetal cardiac arrhythmia caused by extra

systoles and ectopic beats? a. Ventricular exstrophy b. Premature atrial and ventricular contractions c. Heart block

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Bradycardia ANS: B

The atrium and ventricle may both experience extra systoles and ectopic beats, giving rise to a complex echo pattern with premature atrial and ventricular contractions.

PTS: 1 REF: pp. 958-959 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Complex cardiac abnormalities 8. Failure of the leaflets to close completely, allowing blood to leak backward into the left

atrium, is called ___________ regurgitation. a. tricuspid b. aortic c. pulmonic d. mitral ANS: D

Mitral regurgitation occurs when the mitral leaflet is deformed and unable to close properly, allowing blood to leak backward into the left atrium.

PTS: 1 REF: p. 945 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Left ventricular inflow disturbance 9. Which one of the following anomalies demonstrates an abnormal thickening and closure of

the aortic leaflets, causing the left ventricle to “balloon” from increased pressure? It leads to NUR SINGTB.COM heart failure and, if severe, fetal demise. a. Critical aortic stenosis b. Bicuspid aortic valve c. Supravalvular aortic stenosis d. Subvalvular aortic stenosis ANS: A

Critical aortic stenosis demonstrates an abnormal thickening and closure of the aortic leaflets, causing the left ventricle to “balloon” from increased pressure.

PTS: 1 REF: p. 946 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Left ventricular inflow disturbance 10. A benign tumor of the heart associated with tuberous sclerosis is which one of the following? a. Teratoma b. Sarcoma c. Rhabdomyoma d. Myxoma ANS: C

A rhabdomyoma is a benign tumor of the heart associated with tuberous sclerosis.

PTS: 1

REF: p. 953

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Cardiac tumors 11. Which one of the following conditions occurs when a membrane covers the left ventricular

outflow tract? a. Subvalvular aortic stenosis b. Supravalvular aortic stenosis c. Aortic stenosis d. A bicuspid aortic valve ANS: A

Subvalvular aortic stenosis occurs when a membrane covers the left ventricular outflow tract.

PTS: 1 REF: p. 946 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Left ventricular outflow tract disturbance 12. Which one of the following congenital lesions of the heart is the most common? a. Pulmonary stenosis b. Ventricular septal defect c. Coarctation of the aorta d. Secundum atrial septal defect ANS: B

A ventricular septal defect is the most common congenital lesion of the heart, accounting for approximately 30% of all structural heart defects.

PTS: 1 REF: p. 928 NURSIN GTB.C M OBJ: Discuss the pathologic conditions discussed in O this chapter.

TOP: Introduction 13. The highest rate of associated cardiac abnormalities is shown in fetuses with which one of the

following chromosome anomalies? a. Trisomy 13 b. Trisomy 18 c. Trisomy 21 d. Turner syndrome ANS: B

The incidence of cardiac defects in a fetus with trisomy 18 shows the highest rate at more than 90%, followed by trisomy 13 at higher than 80%.

PTS: 1 REF: p. 928 OBJ: List the three factors that contribute to congenital heart disease.

TOP: Table 36-1 14. Congenital mitral stenosis is also called mitral _________________. a. regurgitation b. inflammation c. atresia d. coarctation ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Congenital mitral stenosis is also called mitral atresia.

PTS: 1 REF: p. 945 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Left ventricular inflow disturbance 15. Pericardial effusion is an abnormal collection of fluid surrounding the _______________ of

the heart. a. pericardial layer b. epicardial layer c. myocardial layer d. pleura ANS: B

Pericardial effusion is an abnormal collection of fluid surrounding the epicardial layer of the heart.

PTS: 1 REF: p. 930 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Cardiac enlargement 16. A condition in which the heart is located in the right side of the chest and the cardiac apex

points medially is which one of the following? a. Mesoposition b. Levoposition c. Dextroposition d. Sinus inversus ANS: C

NURSINGTB.COM

Dextroposition is a condition in which the heart is located in the right side of the chest and the cardiac apex points medially.

PTS: 1 REF: p. 929 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Cardiac malposition 17. In which one of the following conditions does the inflow portion of the right ventricle fail to

form? a. Mitral atresia b. Tricuspid atresia c. Truncus arteriosus d. Ebstein anomaly ANS: B

In tricuspid atresia, the inflow portion of the right ventricle fails to form. A membrane or dimple in the floor of the right atrium represents the position in which the tricuspid valve should have originated.

PTS: 1 REF: pp. 938-939 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Right ventricular inflow disturbance

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

18. The most common form of cyanotic heart disease is which one of the following? a. Pentalogy of Cantrell b. Myocarditis c. Single ventricle d. Tetralogy of Fallot ANS: D

Tetralogy of Fallot is the most common form of cyanotic heart disease. The severity of the disease varies.

PTS: 1 REF: p. 941 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Right ventricular inflow disturbance 19. The prognosis for a fetus with tetralogy of Fallot is __________________ surgical

intervention. a. poor without b. good without c. very good with d. poor even with ANS: C

The prognosis for a fetus with tetralogy of Fallot is very good with surgical intervention.

PTS: 1 REF: p. 941 OBJ: Discuss the pathologic conditions discussed in this chapter.

NURSINGTB.COM TOP: Right ventricular outflow disturbance 20. The most common form of right ventricular outflow tract obstruction is which one of the

following? a. Pulmonic stenosis b. Tricuspid stenosis c. Mitral valve stenosis d. Ventricular septal defect ANS: A

Pulmonic stenosis is the most common form of right ventricular outflow tract obstruction.

PTS: 1 REF: p. 942 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Right ventricular outflow disturbance 21. A “parachute” deformity of the valve is demonstrated in the second variety of

_______________________. a. congenital tricuspid stenosis b. congenital mitral stenosis c. mitral atresia d. pulmonic stenosis ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The second variety of congenital mitral stenosis consists of a “parachute” deformity of the valve. This occurs when the normal leaflets are drawn into close apposition by shortened chordae tendinae.

PTS: 1 REF: p. 943 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Left ventricular inflow disturbance 22. The aorta is connected to the right ventricle and the pulmonary artery is connected to the left

ventricle in which one of the following conditions? a. Coarctation of the aorta b. Interrupted aortic arch c. Transposition of the great vessels d. Ductal constriction ANS: C

Transposition of the great arteries is an abnormal condition that exists when the aorta is connected to the right ventricle and the pulmonary artery is connected to the left ventricle.

PTS: 1 REF: p. 949 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Great vessel abnormalities 23. If a rhabdomyoma is suspected, the sonographer should look for associated mass

abnormalities in the fetal head and in which one of the following structure(s)? a. Diaphragm b. Carotid arteries NURSINGTB.COM c. Kidneys d. Liver ANS: C

If a rhabdomyoma is suspected, the sonographer should look for associated mass abnormalities in the fetal head and kidneys.

PTS: 1 REF: p. 953 OBJ: Discuss the pathologic conditions discussed in this chapter.

TOP: Cardiac tumors 24. A congenital anomaly with two atria but only one ventricular chamber is known as

____________________. a. Tetralogy of Fallot b. single ventricle c. cor triatriatum d. ventricular septal defect ANS: B

A single ventricle is a congenital anomaly in which two atria are present but only one ventricular chamber has developed, which receives both the mitral and tricuspid valves.

PTS: 1 REF: p. 954 OBJ: Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias.

TOP: Complex cardiac abnormalities

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 37: Extracranial Cerebrovascular Evaluation Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. One of the warning signs of stroke includes which of the following? a. Severe neck pain b. Loss of smell c. Temporary blindness in one eye d. Unilateral leg pain ANS: C

Warning signs include a sudden numbness or weakness of the face, arm, or leg; sudden confusion; trouble speaking; sudden vision troubles; a loss of balance or coordination; and sudden headache.

PTS: 1 REF: p. 968 OBJ: List the risk factors, signs, and symptoms for stroke and carotid artery disease.

TOP: Carotid disease and stroke risk factors, warning signs, and symptoms 2. A difference of greater than 20 mm Hg pressure between arms suggests disease of the

_____________ artery. a. common carotid b. internal carotid c. vertebral d. subclavian ANS: D

NURSINGTB.COM

A difference of greater than 20 mm Hg pressure between arms suggests disease of the subclavian or innominate artery.

PTS: 1 REF: p. 968 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Technical aspects of carotid duplex imaging 3. An ultrasound finding of the Doppler signal from an external carotid artery (ECA) is which

one of the following waveforms? a. Low-resistance b. High-resistance c. Triphasic d. Parvus tardus ANS: B

The ECA reflects a high-resistance waveform.

PTS: 1 REF: p. 970 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Extracranial arterial hemodynamics 4. An ultrasound characteristic of the normal internal carotid artery (ICA) includes which one of

the following?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Anterior and medial origination at the bifurcation Low-resistance Doppler signal Cervical branches Smaller lumen

ANS: B

An ICA reflects a low-resistance waveform.

PTS: 1 REF: p. 970 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Extracranial arterial hemodynamics 5. Which one of the following is not an ultrasound finding of an ICA occlusion? a. Echogenic material filling the lumen b. Lack of arterial pulsations c. Loss of diastolic flow in the common carotid artery (CCA) d. Reduced diastolic blood flow pattern ANS: D

An occluded ICA does not demonstrate any blood flow.

PTS: 1 REF: pp. 973-974 OBJ: Recognize the pathologic conditions associated with the carotid anatomy.

TOP: Technical aspects of carotid duplex imaging 6. Which one of the following phrases defines a transient ischemic attack (TIA)? a. Permanent loss of vision bilaterally b. Residual neurologic deficit N R I G B.COM c. Duration less than 24 hoursU S N T d. Loss of consciousness ANS: C

A neurologic deficit that lasts less than 24 hours is termed a TIA. PTS: 1 REF: p. 968 OBJ: List the risk factors, signs, and symptoms for stroke and carotid artery disease.

TOP: Carotid disease and stroke risk factors, warning signs, and symptoms 7. Which one of the following should be used to classify a greater than 70% diameter reduction

of the origin of the ICA? a. Peak-systolic velocity less than 140 cm/sec b. Peak-systolic velocity greater than 230 cm/sec c. End-diastolic velocity less than 155 cm/sec d. End-diastolic velocity greater than 155 cm/sec ANS: B

A stenosis of greater than 70% diameter reduction demonstrates a peak-systolic velocity greater than 230 cm/sec.

PTS: 1 REF: p. 976 OBJ: Recognize pathology associated with the carotid anatomy.

TOP: Table 37-1

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. Normal vertebral arteries: a. are asymmetrical. b. are branches of the axillary artery. c. demonstrate a high-resistance Doppler signal. d. demonstrate an alternating blood flow pattern.

ANS: A

Asymmetry of the vertebral arteries is common. Only 25% of patients demonstrate equal vertebral arteries.

PTS: 1 REF: p. 967 OBJ: Distinguish normal from abnormal carotid anatomy.

TOP: Interpretation of carotid duplex imaging 9. Placement of the Doppler sample volume should be parallel to which one of the following? a. Color jet b. Plaque surface c. Vessel walls d. Skin surface ANS: C

Doppler interrogation of the carotid system is performed using a Doppler angle of 60 degrees or less, with the placement of the sample volume parallel to the vessel wall.

PTS: 1 REF: pp. 968-969 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Technical aspects of carotid duplex imaging

N R I G B.C M

U S N T O 10. Fibromuscular dysplasia typically affects which portion of the carotid artery? a. Proximal portion of the common carotid artery b. Midportion of the internal carotid artery c. Midportion of the common carotid artery d. Proximal portion of the internal carotid artery ANS: B

Fibromuscular dysplasia occurs in the renal arteries and the midsegment of the internal carotid artery. It occurs most often in women.

PTS: 1 REF: p. 974 OBJ: Distinguish normal from abnormal carotid anatomy.

TOP: Technical aspects of carotid duplex imaging 11. The innominate artery divides into the ___________ and ___________ arteries. a. right common carotid; right subclavian b. left common carotid; left subclavian c. right subclavian; right vertebral d. left subclavian; left vertebral ANS: A

The innominate artery divides into the right common carotid and the right subclavian arteries.

PTS: 1 REF: p. 966 OBJ: Distinguish normal from abnormal carotid anatomy.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Anatomy for extracranial cerebrovascular imaging 12. The Doppler sample volume should be kept ______________ during a carotid duplex imaging

examination. a. near the deep wall b. near the superficial wall c. large d. small ANS: D

The Doppler sample volume should be small and placed in the center of the artery (or center stream).

PTS: 1 REF: p. 968 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Technical aspects of carotid duplex imaging 13. An abnormal shape of the spectral Doppler waveform from the ICA suggests which one of the

following? a. Contralateral disease b. Arterial branches c. Proximal or distal disease or occlusion d. Venous thrombosis ANS: C

An abnormal shape of the Doppler waveform may indicate more proximal (subclavian) or distal (intracranial) disease.

N R I G B.C M

U S N T O PTS: 1 REF: p. 976 OBJ: Recognize pathology associated with the carotid anatomy.

TOP: Technical aspects of carotid duplex imaging 14. A contralateral ICA occlusion may cause the ipsilateral ICA velocities to be which one of the

following? a. The same b. Reversed c. Increased d. Decreased ANS: C

In the presence of an ICA occlusion, the velocity in the contralateral ICA may be elevated.

PTS: 1 REF: p. 976 OBJ: Recognize pathology associated with the carotid anatomy.

TOP: Interpretation of carotid duplex imaging 15. When determining the ICA:CCA ratio, the CCA velocity should be obtained from which one

of the following areas? a. Proximal segment b. Origin c. Distal segment d. Near the carotid bulb

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

ANS: C

When determining the ICA:CCA ratio, the CCA velocity should be obtained from the distal segment.

PTS: 1 REF: p. 971 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Technical aspects of carotid duplex imaging 16. A characteristic of a subclavian steal is: a. reversal of blood flow in the vertebral artery. b. equal blood pressure bilaterally. c. loss of diastolic flow. d. increased pulsatility.

ANS: A

A subclavian steal is present if the vertebral arterial blood flow reverses direction, secondary to an obstruction of the ipsilateral subclavian or innominate artery.

PTS: 1 REF: p. 977 OBJ: Recognize pathology associated with the carotid anatomy.

TOP: Interpretation of carotid duplex imaging 17. A systolic velocity recorded from the origin of the ICA that is less than 125 cm/sec suggests

which one of the following? a. No plaque b. Stenosis less than 50% diameter reduction c. Stenosis greater than 50% diameter reduction GTB.COM URSINreduction d. Stenosis greater than 80%Ndiameter ANS: B

A systolic velocity from the origin of the ICA less than 140 cm/sec suggests a stenosis less than 50% diameter reduction.

PTS: 1 REF: p. 976 OBJ: Recognize pathology associated with the carotid anatomy.

TOP: Table 37-1 18. Intraoperative carotid duplex imaging identifies which one of the following? a. Contralateral ICA disease b. Abnormal blood flow c. Increased blood pressure d. Need for a carotid shunt ANS: B

Intraoperative carotid duplex imaging identifies abnormal blood flow, disturbed blood flow, and anatomic abnormalities.

PTS: 1 REF: p. 979 OBJ: Distinguish normal from abnormal carotid anatomy.

TOP: Other carotid duplex imaging applications and emerging techniques 19. Transient partial or complete loss of vision is known as which one of the following?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Aphasia Ataxia Vertigo Amaurosis fugax

ANS: D

Amaurosis fugax is a transient partial or complete loss of vision.

PTS: 1 REF: p. 968 OBJ: List the risk factors, signs, and symptoms for stroke and carotid artery disease.

TOP: Carotid disease and stroke risk factors, warning signs, and symptoms 20. The carotid body assists in regulating all of the following except: a. balance. b. heart rate. c. blood pressure. d. respiration.

ANS: A

The carotid body is a small (3 to 5 mm) chemoreceptor that lies within the adventitial layer on the posterior aspect of the carotid bifurcation. The carotid body assists in the regulation of heart rate, blood pressure, and respiration.

PTS: 1 REF: p. 974 OBJ: Distinguish normal from abnormal carotid anatomy.

TOP: Technical aspects of carotid duplex imaging 21. Which one of the following branches of the ECA is the most commonly visualized?

NURSINGTB.COM a. Facial b. Superior thyroid c. Lingual d. Superficial temporal ANS: B

The superior thyroid artery is the first branch of the ECA, and is the most commonly visualized branch during carotid duplex imaging.

PTS: 1 REF: p. 967 OBJ: Distinguish normal from abnormal carotid anatomy.

TOP: Technical aspects of carotid duplex imaging 22. Noise caused by tissue vibration produced by turbulent flow is which one of the following? a. Bruit b. Aliasing c. Reverberation d. Boundary layer separation ANS: A

Noise caused by tissue vibration produced by turbulent flow is termed a bruit.

PTS: 1 REF: p. 968 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Carotid disease and stroke risk factors, warning signs, and symptoms

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

23. A normal flow disturbance along the posterior wall of the bulb is which one of the following? a. Bruit b. Aliasing c. Boundary layer separation d. Jet ANS: C

A boundary layer separation is a normal flow disturbance demonstrating transient reversal of blood flow along the posterior wall of the bulb.

PTS: 1 REF: p. 971 OBJ: Discuss the technical aspects of carotid duplex imaging.

TOP: Technical aspects of carotid duplex imaging

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 38: Intracranial Cerebrovascular Evaluation Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. When performing a transcranial color Doppler (TCD) imaging examination, the best results

are obtained using a _____ transducer. a. 10 kHz b. 7.5 MHz c. 5 MHz d. 2 MHz ANS: D

TCD imaging is performed with a 2.0 to 2.5 MHz phased array transducer.

PTS: 1 REF: p. 987 OBJ: Outline the technical aspects and proper instrumentation control settings used to perform a high quality transcranial Doppler imaging examination.

TOP: Technical aspects of transcranial Doppler imaging 2. The large terminal branch of the internal carotid artery is which one of the following? a. Anterior cerebral artery b. Middle cerebral artery c. Posterior cerebral artery d. Posterior communicating artery ANS: B

NURSINGTB.COM

The middle cerebral artery is the large terminal branch of the internal carotid artery.

PTS: 1 REF: p. 985 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

TOP: Intracranial arterial anatomy 3. The union of the two vertebral arteries forms which one of the following? a. Basilar artery b. Posterior cerebral artery c. Posterior communicating artery d. Anteroinferior cerebellar artery ANS: A

The union of the two vertebral arteries forms the basilar artery.

PTS: 1 REF: p. 985 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

TOP: Intracranial arterial anatomy 4. A _____-degree angle is assumed when performing TCD imaging examinations. a. zero b. 25 c. 45 d. 60

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

ANS: A

It is recommended that routine TCD imaging be performed assuming a zero-degree angle.

PTS: 1 REF: p. 987 OBJ: Outline the technical aspects and proper instrumentation control settings used to perform a high quality transcranial Doppler imaging examination.

TOP: Technical aspects of transcranial Doppler imaging 5. Intracranial arterial velocities __________ with increasing age. a. increase b. decrease c. expand d. do not change ANS: B

Intracranial arterial velocities decrease with increasing age primarily because of changes in cardiac output.

PTS: 1 REF: p. 993 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination. TOP: Anatomy and physiology 6. A _____________ Doppler transducer is used for TCD imaging examinations. a. pulsed wave b. continuous wave c. alternating d. mechanical ANS: A

NURSINGTB.COM

TCD imaging is performed with a 2-MHz phased array transducer.

PTS: 1 REF: p. 987 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

TOP: Interpretation of transcranial Doppler imaging 7. The acoustical intensity should be ___________ to evaluate the carotid siphon using the

transorbital approach. a. increased b. decreased c. not adjusted d. doubled ANS: B

The acoustical power should be decreased significantly before evaluating the orbit (spatial peak temporal average [SPTA] 17 mW/cm2 and mechanical index of 0.28).

PTS: 1 REF: p. 990 OBJ: Outline the technical aspects and proper instrumentation control settings used to perform a high quality transcranial Doppler imaging examination.

TOP: Technical aspects of transcranial Doppler imaging 8. The ________________ artery wraps around the cerebral peduncle.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

middle cerebral anterior cerebral posterior cerebral posterior communicating

ANS: C

The posterior cerebral artery wraps around the cerebral peduncle.

PTS: 1 REF: p. 990 OBJ: Outline the technical aspects and proper instrumentation control settings used to perform a high quality transcranial Doppler imaging examination.

TOP: Technical aspects of transcranial Doppler imaging 9. Most users report ___________ velocities during TCD examinations. a. peak-systolic b. mean c. end-diastolic d. pulsatility ANS: B

The mean velocity is used in TCD examinations.

PTS: 1 REF: p. 994 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

TOP: Technical aspects of transcranial Doppler imaging 10. Which one of the following parameters affects the intracranial velocities proximal to the circle

of Willis? a. Infarction b. Cardiac output c. Blood viscosity d. Intracranial pressure

NURSINGTB.COM

ANS: B

The patient’s age, degree and location of extracranial obstruction, hematocrit, and cardiac output affect the intracranial velocities proximal to the circle of Willis.

PTS: 1 REF: p. 993 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

TOP: Interpretation of transcranial Doppler imaging 11. The interpretation of a TCD imaging examination is made from which one of the following? a. Gray-scale image b. Color display c. Spectral waveforms d. Color bar ANS: C

Spectral waveforms demonstrate focal velocity increase, turbulence, and post-stenotic drop in velocity.

PTS: 1

REF: p. 996

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

TOP: Interpretation of transcranial Doppler imaging 12. During color Doppler transcranial imaging, the middle cerebral artery (MCA) runs parallel to

which one of the following bony landmarks? a. Occipital bone b. Cerebral peduncle c. Sphenoid wing d. Petrous ridge of the temporal bone ANS: C

The MCA courses adjacent to the sphenoid wing.

PTS: 1 REF: p. 989 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

TOP: Technical aspects of transcranial Doppler imaging 13. The anterior cerebral artery (ACA) is normally evaluated from the ____________ approach. a. transtemporal b. suboccipital c. transorbital d. submandibular ANS: A

The transtemporal approach is normally used when evaluating the ACA. PTS: 1 REF: p. 988 NUof RStheIN GTB.C OM waveforms obtained from arteries evaluated OBJ: Describe the characteristics spectral Doppler during a transcranial Doppler examination.

TOP: Interpretation of transcranial Doppler imaging 14. The middle cerebral artery (MCA) is located at a depth of 30-67 millimeters (mm). Select the

mean velocity of the middle cerebral artery. a. 62  12 cm/sec b. 50  11 cm/sec c. 39  10 cm/sec d. 36  15 cm/sec ANS: A

The MCA mean velocity is 62  12 cm/sec, the PCA mean velocity is 39  10 cm/sec, the ACA mean velocity is 50  11 cm/sec, and the PCoA is 36  15 cm/sec.

PTS: 1 REF: p. 989 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

TOP: Technical aspects of transcranial Doppler imaging 15. Blood flow in the ACA is normally ___________ the transducer. a. toward b. away from c. bidirectional to

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. vertical to ANS: B

Blood flow in the ACA normally courses away from the transducer.

PTS: 1 REF: p. 989 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

TOP: Technical aspects of transcranial Doppler imaging 16. A low hematocrit (less than 30%) is associated with _________ intracranial arterial velocities. a. decreased b. increased c. unchanged d. turbulent ANS: B

Intracranial arterial velocities increase in the presence of anemia (hematocrit less than 30%).

PTS: 1 REF: p. 993 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

TOP: Interpretation of transcranial Doppler imaging 17. After evaluating the MCA, the color PRF may need to be __________ to evaluate the

posterior cerebral artery (PCA). a. increased b. decreased NURSINGTB.COM c. unadjusted d. doubled ANS: B

The color PRF may need to be decreased to visualize the PCA because of low flow velocity.

PTS: 1 REF: pp. 989-990 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

TOP: Interpretation of transcranial Doppler imaging 18. A high-resistance Doppler signal is normally characteristic of which one of the following

arteries evaluated during a TCD examination? a. Middle cerebral artery b. Vertebral artery c. Ophthalmic artery d. No artery has a high resistance.

ANS: C

The ophthalmic artery Doppler signal has a high pulsatility because this artery supplies blood to the globe and its structures.

PTS: 1 REF: p. 991 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Interpretation of transcranial Doppler imaging 19. Which one of the following is not a limitation of a TCD examination? a. Poor temporal window b. Anatomic variations c. Pulsed wave Doppler transducer d. Patient movement ANS: C

Limitations of TCD include operator experience, uncooperative patient, anatomic variations, and poor transmission.

PTS: 1 REF: p. 1000 OBJ: Discuss the technical aspects of intracranial color Doppler imaging.

TOP: Normal intracranial velocities 20. The two A1 segments of the ACA are connected by which one of the following? a. A2 segment of the right ACA b. Anterior communicating artery c. A2 segment of the left ACA d. Recurrent artery of Heubner ANS: B

The anterior communicating artery is a short vessel that connects the ACAs at the interhemispheric fissure.

PTS: 1 REF: p. 985 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

NURSINGTB.COM TOP: Intracranial arterial anatomy 21. All of the following parameters affects the intracranial velocities at the level of the circle of

Willis except? a. Vessel diameter b. Turbulence c. Blood viscosity d. Vessel length ANS: B

Vessel diameter, blood viscosity, and turbulence affect the intracranial velocities at the level of the circle of Willis.

PTS: 1 REF: p. 993 OBJ: List the clinical applications of transcranial Doppler imaging and describe expected findings and diagnostic criteria associated with each TOP: Clinical applications 22. Side-to-side differences that occur during a TCD imaging examination should be considered

within normal limits if they are less than _____%. a. 30 b. 50 c. 75 d. 100

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: A

If side-to-side differences occur, a difference of less than 30% should be considered within normal limits.

PTS: 1 REF: p. 994 OBJ: Distinguish normal from abnormal intracranial arterial anatomy.

TOP: Intracranial arterial anatomy 23. Which one of the following windows is used to evaluate the vertebrobasilar system? a. Transtemporal b. Suboccipital c. Transorbital d. Submandibular ANS: B

The suboccipital window is used to evaluate the vertebrobasilar system.

PTS: 1 REF: p. 991 OBJ: Outline the technical aspects and proper instrumentation control settings used to perform a high quality transcranial Doppler imaging examination.

TOP: Technical aspects of transcranial Doppler imaging 24. Blood flow in the MCA is normally __________________. a. toward the transducer b. away from the transducer c. blue on color Doppler d. both away from the transducer and blue on color Doppler ANS: A

NURSINGTB.COM

Blood flow in the MCA is normally toward the transducer.

PTS: 1 REF: p. 989 OBJ: Describe the characteristics of the spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination. TOP: Figure 38-7 25. Identification of normal cranial arteries is based on all of the following except: a. depth of sample volume. b. blood flow direction. c. blood flow velocity. d. adjacent anatomic structures.

ANS: C

Identification of normal cranial arteries is based on the depth of the sample volume, blood flow direction and adjacent anatomic structures, angle of the transducer, traceability of the artery, and spatial relationship.

PTS: 1 REF: pp. 992-993 OBJ: Discuss common errors associated with performing and interpreting a transcranial Doppler imaging examination.

TOP: Interpretation of transcranial Doppler imaging

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 39: Peripheral Arterial Evaluation Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Blood pressure cuffs should have a width ________________ the diameter of the limb. a. 100% less than b. equal to c. 20% less than d. 20% greater than ANS: D

To obtain pressures comparable with direct intra-atrial measurements, the blood pressure cuffs must have a width 20% greater than the limb diameter. Too small a cuff will falsely elevate pressures.

PTS: 1 REF: p. 1010 OBJ: Outline the proper instrument control settings used during arterial duplex imaging.

TOP: Indirect (physiologic) arterial testing 2. The characteristics of a normal Doppler signal obtained during lower-extremity arterial

imaging include all of the following except: a. sharp up slope. b. triphasic and reverse flow component. c. dicrotic notch. d. low velocity forward flow in late diastole.

ANS: C

NURSINGTB.COM

A dicrotic notch is seen on an arterial pulse volume recording.

PTS: 1 REF: p. 1016 OBJ: Describe the characteristics of the arterial Doppler signals obtained during arterial duplex imaging.

TOP: Indirect (physiologic) arterial testing 3. A normal pulse volume waveform contains a(n): a. slow up slope. b. dicrotic notch. c. round peak during systole. d. up slope and down slope with equal times ANS: B

A normal pulse volume waveform contains a rapid rise to a sharp peak during systole and a slower fall during diastole. The down slope of a normal pulse volume waveform contains a dicrotic notch.

PTS: 1 REF: p. 1013 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 4. To obtain arterial Doppler signals during arterial color Doppler imaging, using a(n)

___________ imaging plane is best.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

transverse longitudinal oblique inverted

ANS: B

A longitudinal imaging plane is used to obtain color and spectral Doppler information.

PTS: 1 REF: p. 1022 OBJ: Outline the proper instrument control settings used during arterial duplex imaging.

TOP: Arterial duplex imaging 5. During arterial duplex imaging, Doppler signals are obtained using a ___________ angle. a. zero-degree b. 35-degree c. 60-degree d. direct ANS: C

Doppler waveforms are obtained by maintaining a 60-degree angle to the vessel wall. The CW transducer should insonate at an angle of 45 to 60 degrees to provide optimal Doppler signals.

PTS: 1 REF: p. 1015 | p. 1022 OBJ: Outline the proper instrument control settings used during arterial duplex imaging.

TOP: Arterial duplex imaging 6. Which one of the following statements best describes ultrasound compression therapy of

pseudoaneurysms?

N R INGTB.C OM a. Is the most successful whenUtheSaneurysm is large b. Is the most successful in patients who are receiving anticoagulated therapy c. Takes minimal upper body strength d. Usually requires 30 to 60 minutes to be successful ANS: D

In most patients, at least 30 to 60 minutes are needed to achieve a successful closure of the pseudoaneurysm neck.

PTS: 1 REF: p. 1022 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Arterial duplex imaging 7. Which one of the following is most likely to produce a palpable thrill? a. Pseudoaneurysm b. Common femoral occlusion c. In situ bypass graft d. Dialysis access graft ANS: D

Dialysis access grafts are usually easily identifiable under the surface of the skin and produce a thrill when palpated.

PTS: 1 REF: p. 1019 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Arterial duplex imaging 8. A difference in pressures greater than 20 mm Hg between arms usually indicates disease of

which one of the following arteries? a. Subclavian b. Radial c. Common carotid d. Iliac ANS: A

A difference of pressures greater than 20 mm Hg between arms usually indicates disease of the subclavian artery.

PTS: 1 REF: p. 1011 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 9. Patients complaining of intermittent claudication will have an ankle-brachial index (ABI) of: a. 1. b. 0.45. c. 0.59. d. 0.35.

ANS: C

In absence of arterial occlusion, an ABI of 0.59 plus or minus 0.15 is found in limbs with intermittent claudication.

PTS: 1 REF: p.N 1011 URStoIsegmental NGTB.C OM and pulse volume waveforms in the OBJ: Discuss the changes that occur pressures presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 10. Which one of the following imaging characteristics indicates a significant (greater than 50%

diameter reduction) arterial narrowing during lower-extremity arterial imaging? a. Spectral broadening b. Increase of peak-systolic velocity of greater than 20% when compared with the proximal adjacent area c. Increase of peak-systolic velocity of greater than 100% when compared with the proximal adjacent area d. Loss of blood flow reversal in early diastole ANS: C

A greater than 50% diameter reduction demonstrates an increase of peak-systolic velocity greater than 100% when compared with the proximal adjacent area.

PTS: 1 REF: p. 1018 OBJ: Discuss the imaging characteristics associated with an arterial narrowing.

TOP: Arterial duplex imaging 11. The ABI on the left side is ________ mm Hg.

The following resting segmental pressure measurements (mm Hg) are taken: Right Left

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Upper arm Upper thigh Lower thigh Calf Ankle a. b. c. d.

152 180 100 100 100

110 180 170 158 148

0.50 0.66 1.35 0.97

ANS: D

Left ankle pressure (148) divided by the highest arm pressure (152) equals 0.97 mm Hg. PTS: 1 REF: p. 1011 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 12. The ABI on the right side is ___________ mm Hg.

The following resting segmental pressure measurements (mm Hg) are taken: Right Left Upper arm 152 110 Upper thigh 180 180 Lower thigh 100 170 Calf 100 158 Ankle 100 N R I G B.C M148

U S N T

a. b. c. d.

O

0.50 0.66 0.91 0.97

ANS: B

Right ankle pressure (100) divided by the highest arm pressure (152) equals 0.66 mm Hg. PTS: 1 REF: p. 1011 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 13. The lower limb pressures suggest disease of the ___________________ artery.

The following resting segmental pressure measurements (mm Hg) are taken: Right Left Upper arm 152 110 Upper thigh 180 180 Lower thigh 100 170 Calf 100 158 Ankle 100 148 a. right common femoral

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. right superficial femoral c. right popliteal d. left popliteal ANS: B

The diseased segment is found proximal to the location of the decrease in pressure.

PTS: 1 REF: p. 1011 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 14. The brachial pressure suggests disease of the _______________ artery.

The following resting segmental pressure measurements (mm Hg) are taken: Right Left Upper arm 152 110 Upper thigh 180 180 Lower thigh 100 170 Calf 100 158 Ankle 100 148 a. b. c. d.

innominate right subclavian left subclavian right brachial

ANS: C

NURisS42IN GTHg, B.C The brachial pressure difference mm suggesting an obstruction of the subclavian OM artery on the side with the lowest pressure (left).

PTS: 1 REF: p. 1011 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 15. Most patients describe claudication as which one of the following? a. Pain in the toes b. Pain at rest c. Cramping of the leg muscles d. Extreme leg pain when walking ANS: C

Most patients describe claudication as a cramp or an ache in the leg muscles.

PTS: 1 REF: p. 1010 OBJ: Discuss the imaging characteristics associated with an arterial narrowing.

TOP: Clinical signs and symptoms 16. The profunda femoris artery lies __________ and __________ to the superficial femoral

artery (SFA). a. posterior; medial b. posterior; lateral c. anterior; medial

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. anterior; lateral ANS: B

The profunda femoris artery (deep femoral artery) lies posterior and lateral to the SFA. PTS: 1 REF: p. 1007 OBJ: Describe the anatomy encountered during peripheral arterial testing.

TOP: Anatomy associated with peripheral arterial testing 17. The major branches of the popliteal artery are the _________ and _________ arteries. a. anterior tibial; peroneal b. sural; anterior tibial c. genicular; anterior tibial d. sural; genicular ANS: D

The major branches of the popliteal artery are the sural and genicular arteries. The popliteal artery terminates into the anterior tibial and tibial peroneal trunk.

PTS: 1 REF: p. 1008 OBJ: Describe the anatomy encountered during peripheral arterial testing.

TOP: Anatomy associated with peripheral arterial testing 18. The second main branch of the aortic arch is which one of the following arteries? a. Innominate b. Right common carotid c. Left common carotid d. Left subclavian ANS: C

NURSINGTB.COM

The three main branches of the arch are: (1) innominate artery; (2) left common carotid artery; (3) left subclavian artery.

PTS: 1 REF: p. 1008 OBJ: Describe the anatomy encountered during peripheral arterial testing.

TOP: Anatomy associated with peripheral arterial testing 19. Segmental pressures of the lower extremity tend to ____________ the extent of the disease. a. overestimate b. underestimate c. equal d. underestimate or equal ANS: B

Segmental pressures of the lower extremity tend to underestimate the extent of the disease.

Reasons include (1) the proximal disease may mask distal disease, and (2) calcified vessels may falsely elevate pressures.

PTS: 1 REF: p. 1012 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 20. A toe pressure is considered normal if it is:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

50 mm Hg. 45 mm Hg. less than 64% of brachial pressure.

50 mm Hg and less than 64% of brachial pressure.

ANS: A

A toe pressure is considered normal if it is 50 mm Hg or greater than 64% of the highest brachial pressure.

PTS: 1 REF: p. 1013 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 21. The calf pulse volume waveform normally has greater amplitude than the thigh waveform

because of which one of the following? a. Sequential changes b. Superficial femoral disease c. Cuff artifact d. Intermittent ischemia ANS: C

Cuff artifact causes the normal calf pulse volume waveform to have greater amplitude than in the thigh. If the amplitude of the calf waveform is equal to or smaller than the thigh waveform, then SFA disease should be considered.

PTS: 1 REF: p. 1013 OBJ: Outline the proper instrument control settings used during arterial duplex imaging.

TOP: Indirect (physiologic) arterial N Rtesting I G B.C M

U S N T

O

22. Exercise testing of the lower-extremity arterial system is performed on a treadmill on a

__________ grade. a. 5% to 10% b. 10% to 12% c. 12% to 15% d. 15% to 20% ANS: B

Exercise testing of the lower-extremity arterial system is performed on a treadmill on a 10% to 12% grade at 1.5 to 2 mph.

PTS: 1 REF: p. 1012 OBJ: Outline the proper instrument control settings used during arterial duplex imaging.

TOP: Indirect (physiologic) arterial testing 23. Exercise testing of the lower-extremity arterial system is performed on a treadmill at a speed

of ___________ mph. a. 1 to 2 b. 1.5 to 2 c. 2 to 2.5 d. 2.5 to 3 ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Exercise testing of the lower-extremity arterial system is performed on a treadmill on a 10% to 12% grade at 1.5 to 2 mph.

PTS: 1 REF: p. 1012 OBJ: Outline the proper instrument control settings used during arterial duplex imaging.

TOP: Indirect (physiologic) arterial testing 24. Ankle pressures that fall after exercise and return to baseline in 5 minutes suggest which one

of the following? a. Normal arterial system b. Multisegment arterial disease c. Single-segment occlusive disease d. Lower-extremity amputation ANS: C

Ankle pressures that fall after exercise and return to baseline in 5 minutes suggest single-segment occlusive disease.

PTS: 1 REF: p. 1012 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing 25. In nondiabetic patients, ischemic skin lesions are not likely to heal if ankle systolic pressure is

below __________ mm Hg. a. 55 b. 45 c. 80 d. 30 NURSINGTB.COM ANS: A

Ischemic skin lesions are not likely to heal if ankle systolic pressure is below 55 mm Hg in nondiabetic patients or below 80 mm Hg in patients with diabetes.

PTS: 1 REF: p. 1014 OBJ: Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease.

TOP: Indirect (physiologic) arterial testing

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 40: Peripheral Venous Evaluation Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following veins is difficult to compress during duplex imaging? a. Subclavian b. Brachial c. Popliteal d. Posterior tibial ANS: A The compression technique may be attempted with the subclavian vein.

PTS: 1 REF: p. 1041 OBJ: Outline the proper instrument control settings used during venous duplex imaging.

TOP: Technical aspects of venous duplex imaging 2. The left iliac vein is usually mildly compressed by which one of the following anatomic vessels? a. Aorta b. Right iliac artery c. Left iliac artery d. Right renal artery ANS: B NURSIbeneath M NGTB.C The left common iliac vein crosses the O right iliac artery, causing a mild compression of the vein.

PTS: 1 REF: p. 1027 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 3. Which one of the following is not one of the three factors of the Virchow triad? a. Hypercoagulability b. Stasis c. Lysis d. Vein injury ANS: C The Virchow triangle includes hypercoagulability, venous stasis, and vein wall injury.

PTS: 1 REF: p. 1031 OBJ: List the risk factors and the signs and symptoms of venous disease.

TOP: Venous pathology and treatments 4. The longest vein in the body is which one of the following? a. External iliac b. Superficial femoral

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Popliteal d. Greater saphenous ANS: D The greater saphenous vein is the longest vein in the body.

PTS: 1 REF: p. 1028 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 5. Perforating veins connect the superficial and deep venous systems. Blood flow in the perforating veins is normally from the ___________________ to the _______________. a. superficial system; deep system b. deep system; superficial system c. distal veins; central veins d. central veins; distal veins ANS: A Venous blood flow is normally from the superficial system to the deep system.

PTS: 1 REF: p. 1028 OBJ: Describe the characteristics of venous Doppler signals obtained during venous duplex imaging.

TOP: Anatomy for peripheral venous duplex imaging 6. The characteristics of a normal venous Doppler signal from the lower extremity include all of the following except: a. phasicity.

NURSINGTB.COM b. spontaneity. c. pulsatility. d. augmentation with distal limb compression.

ANS: C Normal venous flow includes spontaneity, respiratory phasicity, augmentation with distal compression, and unidirectional flow pattern.

PTS: 1 REF: p. 1036 OBJ: Describe the imaging characteristics of a normal venous system.

TOP: Interpretation of venous duplex imaging 7. The most important diagnostic criterion during venous duplex imaging is which one of the following? a. Echo-free lumen b. Lumen filled with echogenic material c. Decreased color filling d. Vein response to transducer compression on the skin ANS: D The most significant diagnostic criterion during venous duplex imaging is how the vein responds to transducer pressure.

PTS:

1

REF: p. 1037

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the characteristics of venous Doppler signals obtained during venous duplex imaging.

TOP: Table 40-2 8. The presence of an incompetent venous segment is determined by which one of the following? a. Venous reflux less than 1 second b. Venous reflux on augmentation c. Color Doppler filling of the lumen d. Gray-scale image of valve motion ANS: B The valves are considered incompetent if retrograde (reflux) flow is present with augmentation maneuvers.

PTS: 1 REF: p. 1032 | p. 1041 OBJ: Describe the characteristics of venous Doppler signals obtained during venous duplex imaging.

TOP: Venous reflux imaging 9. The superficial femoral vein is a ______________ vein. a. perforating b. superficial c. deep d. complex ANS: C The superficial femoral vein is a deep vein.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1027 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 10. To obtain venous Doppler signals during venous duplex imaging, using a(n) ___________ imaging plane is best. a. transverse b. longitudinal c. oblique d. inverted ANS: B To obtain venous Doppler signals during venous duplex imaging, using the longitudinal imaging plane is best.

PTS: 1 REF: p. 1036 OBJ: Outline the proper instrument control settings used during venous duplex imaging.

TOP: Technical aspects of venous duplex imaging 11. Risk factors for deep-vein thrombosis (DVT) include all of the following except: a. pregnancy. b. orthopedic surgery. c. Baker cyst.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. oral contraceptive use.

ANS: C A Baker cyst may mimic symptoms of DVT, but it is not a risk factor.

PTS: 1 REF: p. 1031 OBJ: List the risk factors and the signs and symptoms of venous disease.

TOP: Venous pathology and treatments 12. Venous valves are observed in all of the following anatomic structures except: a. greater saphenous vein. b. lesser saphenous vein. c. soleal sinuses. d. gastrocnemius vein.

ANS: C Venous valves are not seen in the inferior vena cava, superior vena cava, innominate vein, or soleal sinuses.

PTS: 1 REF: p. 1028 | p. 1035 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 13. The common femoral vein lies: a. in the Hunter’s canal. b. in the Scarpa triangle. c. in the superficial fascia.

NURSIartery.

NGTB.COM d. lateral to the common femoral ANS: B The common femoral vein lies in the Scarpa triangle, medial to the common femoral artery.

PTS: 1 REF: p. 1027 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 14. Which one of the following veins is shorter on the right side, oriented vertically, and ascends posteriorly and then laterally to its companion artery? a. Right superficial femoral b. Right profunda femoris c. Right popliteal d. Right common iliac vein ANS: D The right common iliac vein is shorter than the left, oriented vertically, and ascends posteriorly and laterally to its companion artery.

PTS: 1 REF: p. 1027 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 15. The basilic vein is a ______________ vein of the ____________ extremity. a. superficial; lower b. superficial; upper c. deep; lower d. deep; upper ANS: B The cephalic and basilic veins are superficial veins of the upper extremity.

PTS: 1 REF: p. 1029 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 16. Angle correction of the Doppler signal is not necessary during a lower-extremity venous duplex examination because of which one of the following reasons? a. Venous velocity is not angle dependent. b. The transverse plane is used in lower-extremity duplex imaging. c. Peak venous velocity does not provide any clinical information in lower-extremity duplex imaging. d. Spectral waveform is not required in a lower-extremity venous duplex examination.

ANS: C Angle correction of the Doppler signal is not necessary during a lower extremity venous duplex examination because peak venous velocity does not provide any clinical information.

PTS: 1 REF: p. 1036 NURSINcontrol GTB.C OM used during venous duplex imaging.

OBJ: Outline the proper instrument settings TOP: Technical aspects of venous duplex imaging 17. Which one of the following perforator veins is from the greater saphenous vein in the distal thigh? a. Hunterian b. Boyd c. Dodd d. Crockett III ANS: C Boyd’s perforators are located around the level of the knee, Dodd’s in the distal thigh, and Hunterian in the proximal thigh.

PTS: 1 REF: p. 1028 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 18. Which one of the following is the primary route of venous drainage in the upper extremity? a. Deep venous system b. Axillary vein c. Superficial venous system d. Mammary vein

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C The superficial venous system is the primary route of drainage in the upper extremity.

PTS: 1 REF: p. 1029 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 19. The femoral vein ascends in which of the following locations? a. Lateral thigh b. Lateral calf c. Medial thigh d. Medial calf ANS: C The femoral vein originates at the popliteal vein ascending in the medial thigh.

PTS: 1 REF: p. 1027 OBJ: Describe the anatomy encountered during a venous duplex imaging examination.

TOP: Anatomy for peripheral venous duplex imaging 20. Adequate pressure has been applied to compress a vein when: a. the patient can no longer tolerate the pressure. b. the companion artery is deformed. c. fifty pounds of pressure is applied. d. the companion artery is enlarged.

ANS: B NURSINbyGthe TB.C OM If the companion artery is deformed compression maneuver, then the sonographer knows adequate pressure has been applied to the vein.

PTS: 1 REF: p. 1033 OBJ: Describe the characteristics of a normal venous system.

TOP: Technical aspects of venous duplex imaging 21. A pulsatile venous signal is normal in all of the following veins except: a. subclavian. b. axillary. c. superior vena cava. d. jugular.

ANS: B Pulsatile signals should be present in the jugular, subclavian, innominate, and superior vena cava veins because of the retrograde transmission of right atrial pressure.

PTS: 1 REF: p. 1036 OBJ: Describe the characteristics of venous Doppler signals obtained during venous duplex imaging.

TOP: Interpretation of venous duplex imaging 22. The compression technique is not used for __________ thrombus. a. partial

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. complete c. chronic d. free-floating ANS: D Compression technique is not performed at the level of the free-floating thrombus.

PTS: 1 REF: p. 1039 OBJ: Describe the imaging characteristics associated with DVT and venous reflux.

TOP: Interpretation of venous duplex imaging 23. A potentially lethal complication of acute DVT is which one of the following? a. Postphlebitic syndrome b. Pulmonary embolism c. Cellulitis d. Venous ulcers ANS: B Pulmonary embolism is a potentially lethal complication of acute DVT. PTS: 1 REF: p. 1031 OBJ: List the risk factors and the signs and symptoms of venous disease.

TOP: Controversies in venous duplex imaging 24. Signs and symptoms of acute DVT include all of the following except: a. leg swelling. b. superficial venous dilation.

NURSINGTB.COM c. palpable subcutaneous cord. d. positive Homans’ sign.

ANS: C A palpable subcutaneous cord is a possible sign of thrombosis of the superficial venous system.

PTS: 1 REF: p. 1031 OBJ: List the risk factors and the signs and symptoms of venous disease.

TOP: Venous pathology and treatments 25. In the presence of incompetent valves, the sudden release of distal augmentation produces which one of the following? a. No blood flow b. Dynamic antegrade blood flow c. Retrograde blood flow d. Minimal antegrade blood flow ANS: C In the presence of incompetent valves, the sudden release of distal augmentation produces retrograde blood flow.

PTS: 1 REF: p. 1041 OBJ: Describe the characteristics of venous Doppler signals obtained during venous

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank duplex imaging.

TOP: Venous reflux imaging

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 41: Normal Anatomy and Physiology of the Female Pelvis Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. What is the physiologic status of prepuberty called? a. Menarche b. Menopause c. Premenarche d. Postmenarche ANS: C Premenarche is the physiologic status of prepuberty, which is the time before the onset of puberty.

PTS: 1 REF: p. 1062 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Physiology 2. Which one of the following arteries sheds blood during menses? a. Radial b. Spiral c. Arcuate d. Vaginal ANS: B N RSINduring GTB.C OM Blood from the spiral arteriesUis shed menses.

PTS: 1 REF: p. 1061 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Pelvic vasculature 3. Which one of the following muscle groups may be seen in the false pelvis along the lateral sidewall of the pelvis? a. Obturator internus b. Iliopsoas c. Rectus sheath d. Psoas major ANS: B The iliopsoas muscles descend inferiorly through the false pelvis on the pelvic sidewalls.

PTS: 1 REF: p. 1054 OBJ: Identify the sonographically significant muscles of the pelvic cavity.

TOP: Figure 41-6 4. Which one of the following ligaments contains the uterine blood vessels and nerves? a. Broad b. Round

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Uterosacral d. Endometrial ANS: A The broad ligaments provide a small amount of support for the uterus and contain the uterine blood vessels and nerves.

PTS: 1 REF: p. 1057 OBJ: Describe the major ligaments of the uterus and ovaries.

TOP: Uterus

5. Which one of the following ligaments occupies the space between the layers of another ligament and occurs in front of and below the fallopian tubes? a. Broad b. Uterosacral c. Round d. Tubal ANS: C The round ligaments are fibrous cords that occur in front of and below the fallopian tubes between the layers of the broad ligaments.

PTS: 1 REF: p. 1057 OBJ: Describe the major ligaments of the uterus and ovaries.

TOP: Uterus

6. Bending forward of the fundus and body of the uterus toward the cervix is called which one of the following positions? a. Retroflexion NURSINGTB.COM b. Anteversion c. Anteflexion d. Retroversion ANS: B Anteversion is the most common uterine position. The fundus and body are bent forward toward the cervix.

PTS: 1 REF: p. 1058 OBJ: Describe the pelvic organs and their functions.

TOP: Uterus

7. The normal size of the menarchal uterus should measure ______ centimeters (cm) long and _____ cm wide. a. 3; 5 b. 2; 3 c. 8; 4 d. 6; 2 ANS: C The menarchal uterus measures 8 to 10 cm long and 3 to 5 cm wide.

PTS: 1 REF: p. 1056 OBJ: Describe the pelvic organs and their functions.

NURSINGTB.COM

TOP: Uterus

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. The superficial layer of glands and stroma of the endometrium is called which one of the following? a. Zona basalis b. Zona functionalis c. Zona stromata d. Zona endometria ANS: B The endometrium consists of two layers: the superficial functional layer (zona functionalis) and the deep basal layer (zona basalis).

PTS: 1 REF: p. 1057 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Uterus 9. Which one of the following structures lies above the utero-ovarian ligament, round ligament, and tubo-ovarian vessels? a. Ovary b. Fallopian tube c. Broad ligament d. Uterine artery ANS: B The fallopian tube lies above the utero-ovarian ligament, round ligament, and tubo-ovarian vessels.

PTS: 1 REF: p. 1058 NURSINofGTtheB.C OMand ovaries.

OBJ: Describe the major ligaments uterus

TOP: Uterus

10. The ovary produces two hormones. Estrogen is secreted by __________, whereas progesterone is secreted by the ___________. a. follicles; corpus luteum b. secretory; proliferative c. follicles; corpuscle d. corpus luteum; nabothian ANS: A The ovary produces two hormones. Estrogen is secreted by follicles, whereas progesterone is secreted by the corpus luteum.

PTS: 1 REF: p. 1059 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Ovaries 11. The release of an egg from the ruptured follicle is termed which one of the following? a. Menstruation b. Corpus luteum c. Ovulation d. Follicular-stimulating hormone ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Ovulation is the release of an ovum once a month by one of two ovaries.

PTS: 1 REF: p. 1062 OBJ: Define the function of the corpus luteum.

TOP: Physiology

12. The vagina has two sources of blood supply; they are the: a. ovarian artery and uterine artery. b. uterine artery and vaginal artery. c. internal iliac artery and vaginal artery. d. aorta and external iliac artery.

ANS: B Arterial supply of the vagina is received from the vaginal and uterine arteries.

PTS: 1 REF: p. 1061 OBJ: Describe the pelvic organs and their functions.

TOP: Figure 41-7

13. The ovary receives its primary blood supply from which one of the following arteries? a. Uterine b. Internal iliac c. Ovarian d. External iliac ANS: C The primary blood supply to the ovaries is from the ovarian arteries. The ovarian arteries anastomose with the uterine artery, providing additional blood flow to the ovary.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1060 OBJ: Describe the pelvic organs and their functions.

TOP: Ovaries

14. Which one of the following portions of the fallopian tube is the most coiled? a. Infundibulum b. Ampulla c. Isthmus d. Interstitial ANS: B The ampulla is the longest and most coiled portion of the fallopian tube and is the area in which fertilization most often occurs.

PTS: 1 REF: p. 1059 OBJ: Describe the pelvic organs and their functions.

TOP: Fallopian tubes

15. In postmenopausal patients who are not on hormone replacement therapy, an endometrial thickness of less than ______ millimeters (mm) is considered benign. a. 2 b. 3 c. 5 d. 10 ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The postmenopausal patient who is not taking hormone replacement therapy should have an endometrial thickness of less than 5 mm.

PTS: 1 REF: p. 1063 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Physiology 16. Which one of the following statements is false? a. The ovaries are almond shaped. b. The ovaries are suspended from the anterior aspect of the broad ligaments. c. The ovaries lie in the ovarian fossa. d. The ovaries receive blood from the ovarian and uterine arteries.

ANS: B The ovary is attached at the posterior aspect of the broad ligaments.

PTS: 1 REF: p. 1060 OBJ: Describe the major ligaments of the uterus and ovaries.

TOP: Ovaries

17. The left ovarian vein drains into which one of the following veins? a. Inferior vena cava b. Uterine c. Left renal d. External iliac ANS: C The left ovarian vein drains into the left renal vein. The right ovarian vein drains directly N R I G B.COM into the inferior vena cava. U S N T PTS: 1 REF: p. 1060 OBJ: Describe the pelvic organs and their functions.

TOP: Pelvic vasculature

18. The ovaries are laterally supported by which one of the following ligaments? a. Ovarian b. Broad c. Round d. Suspensory ANS: D The ovaries are laterally supported by the suspensory (infundibulopelvic) ligaments and medially supported by the ovarian ligaments.

PTS: 1 REF: p. 1059 OBJ: Describe the major ligaments of the uterus and ovaries.

19. A mature follicle is known as a __________ follicle. a. Müllerian b. graafian c. corpus luteal d. stimulated

NURSINGTB.COM

TOP: Ovaries

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B A mature follicle is known as a graafian follicle.

PTS: 1 REF: p. 1062 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Physiology 20. A mature follicle typically measures _____ cm right before ovulation. a. 1 b. 1.5 c. 2 d. 3 ANS: C A mature follicle typically measures 2 cm right before ovulation.

PTS: 1 REF: p. 1062 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Physiology 21. The endometrium demonstrates the “three-line” sign in which one of the following phases? a. Menstrual b. Proliferative c. Secretory d. Luteal ANS: B N endometrium RSINGTB.C OM and appears hypoechoic with a In the proliferative phase theU thickens “three-line” (triple-line) sign.

PTS: 1 REF: p. 1063 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Physiology 22. The retrouterine space is also known as which one of the following? a. Anterior cul-de-sac b. Space of Retzius c. Posterior cul-de-sac d. Pouch of Dodd ANS: C The retrouterine space is also known as the posterior cul-de-sac or pouch of Douglas.

PTS: 1 REF: p. 1064 OBJ: Name the major landmarks of the bony pelvis and external genitalia.

TOP: Pelvic recesses and bowel 23. The pelvic recess between the anterior bladder wall and the pubic symphysis is which one of the following? a. Vesicouterine pouch

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Anterior cul-de-sac c. Retrouterine pouch d. Space of Retzius ANS: D The retropubic space (space of Retzius) is located between the anterior bladder wall and the pubic symphysis.

PTS: 1 REF: p. 1064 OBJ: Name the major landmarks of the bony pelvis and external genitalia.

TOP: Pelvic recesses and bowel 24. Abnormally heavy or long menses is termed: a. dysmenorrhea. b. menorrhagia. c. oligomenorrhea. d. amenorrhea.

ANS: B Menorrhagia is used to describe abnormally heavy or long periods and is often associated with uterine fibroids, intrauterine disease, or hormonal imbalances.

PTS: 1 REF: p. 1064 OBJ: Discuss the physiology of the menstrual cycle, and describe hormonal changes that occur during the various ovulatory and endometrial phases.

TOP: Physiology 25. Which one of the following ligaments provides support to the cervix?

NURSINGTB.COM a. Round b. Cardinal c. Suspensory d. Ovarian ANS: B The cervix is the only portion of the uterus that is firmly supported. It is fixed in position by the cardinal and uterosacral ligaments.

PTS: 1 REF: p. 1057 OBJ: Describe the major ligaments of the uterus and ovaries.

NURSINGTB.COM

TOP: Uterus

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 42: Sonographic and Doppler Evaluation of the Female Pelvis Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Depending on the menstrual cycle, the inner lining of the uterine cavity that appears echogenic to hypoechoic on ultrasound is which one of the following structures? a. Myometrium b. Perineum c. Endouterine d. Endometrium ANS: D The endometrium is the inner lining of the uterine cavity that appears echogenic to hypoechoic on ultrasound, depending on the menstrual cycle.

PTS: 1 REF: p. 1082 | p. 1083 OBJ: Describe both the sonographic techniques for evaluating the uterus and adnexal area and the sonographic appearances of each. TOP: Sonographic evaluation of the pelvis 2. Menarche may be defined as which one of the following? a. The state after reaching puberty during which menses occur every 21 to 28 days b. When menses have ceased permanently c. Time before the onset of menses d. Midcycle

N R I G B.C M

U S N T O ANS: A Menarche is the state after reaching puberty in which menses occur every 21 to 28 days.

PTS: 1 REF: p. 1067 OBJ: Demonstrate how to take a patient history specific to a pelvic ultrasound examination.

TOP: Patient preparation and history 3. The Doppler measurement that takes the highest systolic peak minus the highest diastolic peak divided by the highest systolic peak is which one of the following? a. Pulsatility index b. Mean Doppler gradient c. Pourcelot resistive index d. Mean systolic measurement ANS: C The Pourcelot resistive index takes the highest systolic peak minus the highest diastolic peak divided by the highest systolic peak.

PTS: 1 REF: p. 1079 OBJ: Discuss quantitative Doppler measurements.

TOP: Sonographic evaluation of the pelvis 4. Which one of the following are small vessels found along the periphery of the uterus?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Uterine arteries Arcuate vessels Iliac arteries Peripheral vessels

ANS: B The arcuate vessels are found along the periphery of the uterus.

PTS: 1 REF: p. 1080 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 5. The Doppler measurement that uses peak systole minus peak diastole divided by the mean over one cardiac cycle is the ________________ index. a. pulsatility b. resistive c. mean systolic d. mean diastolic ANS: A The pulsatility index uses peak systole minus peak diastole divided by the mean over one cardiac cycle.

PTS: 1 REF: p. 1079 OBJ: Discuss quantitative Doppler measurements.

TOP: Sonographic evaluation of the pelvis

N R I G B.C M

U S thickness N T andOechogenicity with posterior enhancement in 6. The endometrium is at its greatest which one of the following phases? a. Menses b. Proliferative c. Ovulatory d. Luteal ANS: D The endometrium is at its greatest thickness and echogenicity with posterior enhancement during the secretory (luteal) phase.

PTS: 1 REF: p. 1083 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 7. The difference between the peak systole and the peak diastole is the __________. a. LS ratio b. S/D ratio c. D/S ratio d. CI ratio ANS: B The S/D ratio is the difference between the peak systole and the peak diastole.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1079 OBJ: Discuss quantitative Doppler measurements.

TOP: Sonographic evaluation of the pelvis 8. Which one of the following techniques uses a catheter inserted into the endometrial cavity with the insertion of saline or contrast media to fill the endometrial cavity to demonstrate abnormalities within the cavity or uterine tube? a. Transvaginal b. Perineal c. Sonohysterography d. Transendometrography ANS: C Sonohysterography is a technique that uses a catheter inserted into the endometrial cavity with the insertion of saline or contrast media to fill the endometrial cavity to demonstrate abnormalities within the cavity or uterine tube.

PTS: 1 REF: p. 1087 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 9. To image the fundus of the uterus with transvaginal sonography, the transducer should be angled so that the handle is positioned as described in which one of the following? a. Closer to the bed b. Farther from the bed c. Lateral to the patient d. Perpendicular to the patient NURSINGTB.COM ANS: A Advancing the transducer slightly and angling it anteriorly (move handle closer to the bed) is often necessary to visualize the uterine fundus in transvaginal sonography.

PTS: 1 REF: p. 1073 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic technique 10. On the sagittal image with endovaginal sonography, the cervix of an anteverted uterus is seen in the _____________ of the screen, whereas the fundus of the anteverted uterus is found in the _____________ of the screen. a. upper portion; lower portion b. right side; lower portion c. left side; right side d. right side; left side ANS: D On the sagittal image with endovaginal sonography, the cervix of an anteverted uterus is seen in the right side of the screen, whereas the fundus of the anteverted uterus is found in the left side of the screen.

PTS:

1

REF: p. 1072

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic technique 11. The thickness of the endometrium should be measured in which one of the following planes? a. Transverse b. Longitudinal c. Coronal d. Oblique ANS: B The thickness of the endometrium should be measured in the longitudinal plane.

PTS: 1 REF: p. 1076 OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic technique 12. The transvaginal transducer should be soaked in disinfectant between uses for a minimum of _______________. a. 3 to 5 minutes b. 10 to 20 minutes c. 30 to 60 minutes d. 1 to 2 hours ANS: B The transvaginal transducer should be soaked in disinfectant between uses for a minimum of 10 to 20 minutes. The amount of time may differ for products from different manufacturers.

NURorSI NGTB.C OM Extended soaking may damage degrade the transducer.

PTS: 1 REF: p. 1077 OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic technique 13. Symmetrical bilateral pelvic masses are likely to be which one of the following? a. Ovarian cysts b. Uterine fibroids c. Pelvic muscles d. Iliac vessels ANS: C Symmetric bilateral pelvic masses are likely to be pelvic muscles.

PTS: 1 REF: p. 1078 OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic evaluation of the pelvis 14. The middle layer of the uterus is which one of the following? a. Serosa b. Endometrium c. Body

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Myometrium ANS: D The myometrium is the middle layer of the uterus.

PTS: 1 REF: p. 1080 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 15. The thin outer layer of the uterus is separated from the immediate layer by which one of the following? a. Peripheral arteries b. Uterine arteries c. Arcuate vessels d. Radial arteries ANS: C The arcuate vessels separate the thin outer layer from the immediate layer in the uterus.

PTS: 1 REF: p. 1080 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 16. Flexion refers to the axis of the uterine body relative to the ___________. a. fundus b. cervix c. vagina NURSINGTB.COM d. cornua ANS: B Flexion refers to the axis of the uterine body relative to the cervix.

PTS: 1 REF: p. 1081 OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic evaluation of the pelvis 17. In transvaginal scanning, the scanning plane that is 90 degrees from the sagittal plane is the ______________ plane. a. transverse b. parasagittal c. axial d. coronal ANS: D The coronal plane is 90 degrees from the sagittal plane in transvaginal scanning.

PTS: 1 REF: p. 1073 OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic technique 18. Nabothian cysts are found near which one of the following anatomic structures?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Isthmus Vagina Endocervical canal Peritoneum

ANS: C Cervical inclusion cysts known as nabothian cysts are visualized near the endocervical canal.

PTS: 1 REF: p. 1081 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 19. Arcuate artery calcifications may be observed in patients who are _______________. a. pregnant b. perimenopausal c. postmenopausal d. premenopausal ANS: C Calcified arcuate arteries are a normal aging process that may be accelerated in the patient with diabetes.

PTS: 1 REF: p. 1080 | p. 1081 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis

N R I G B.C M

U S N isTthe best O way to measure the cervical-fundal 20. Which one of the following techniques dimension of the uterus? a. Transvaginal b. Translabial c. Transabdominal d. Endorectal ANS: C The transabdominal image is the best way to measure the length of the uterus.

PTS: 1 REF: p. 1068 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 21. Sonohysterography is usually performed on premenopausal women between days ________ of the menstrual cycle. a. 3 and 5 b. 6 and 10 c. 10 and 14 d. 21 and 28 ANS: B Sonohysterography is usually performed on premenopausal women between days 6 and 10 of the menstrual cycle.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1087 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic evaluation of the pelvis 22. Limitations of translabial scanning may be overcome by which one of the following? a. Emptying the patient’s bladder b. Elevating the patient’s head c. Elevating the patient’s hips d. Assuming the left lateral decubitus position ANS: C Elevating the patient’s hips may overcome some limitations in translabial scanning.

PTS: 1 REF: p. 1077 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic techniques 23. After the transducer has been soaked in a glutaraldehyde-type solution, which one of the following is an important step to ensure safe handling? a. Check the cord for damage. b. Wear gloves when handling the transducer. c. Immediately place the transducer into a protective container. d. Thoroughly rinse the transducer with water.

ANS: B When handling glutaraldehyde, the sonographer is required to wear gloves. Some NURuse GTB.C SIofNsafety OM manufacturers recommend the goggles.

PTS: 1 REF: p. 1077 OBJ: Describe both the sonographic techniques for evaluating the uterus and the sonographic appearances of each.

TOP: Sonographic techniques 24. On transabdominal imaging of the female pelvis, the distended urinary bladder: a. is an acoustic window to view the pelvic anatomy. b. serves as a “cystic” reference. c. displaces the bowel into the false pelvis. d. All of the above are correct.

ANS: D The urinary bladder is used as an acoustic window and landmark for visualizing pelvic anatomy, serves as a “cystic” reference, and displaces the bowel into the false pelvis.

PTS: 1 REF: pp. 1068-1069 OBJ: Describe the scan orientations for transabdominal and transvaginal ultrasonography.

TOP: Sonographic techniques

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 43: Pathology of the Uterus Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The clinical signs of a 32-year-old woman with an enlarged uterus on physical examination and a history of cyclic profuse and prolonged bleeding with increasing pain most likely represent which one of the following? a. Early pregnancy b. Leiomyoma c. Ruptured nabothian cyst d. Ruptured follicular cyst ANS: B Clinical signs of uterine leiomyoma include irregular bleeding, menorrhagia, an enlarged uterus, pelvic pain, and bladder symptoms.

PTS: 1 REF: p. 1095 OBJ: Define the pathologic conditions of the uterus discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 2. Which one of the following is the most common site for a leiomyoma to occur? a. Submucosal b. Subserosal c. Pedunculated NURSINGTB.COM d. Intramural ANS: D An intramural (confined to the myometrium) is the most common site of a leiomyoma.

PTS: 1 REF: p. 1095 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 3. Complications in delivery may occur with pregnancy if a fibroid is located in or near which one of the following structures? a. Near the fundus b. Pedunculated off the fundus c. Near the cervix d. Near the ovary ANS: C A fibroid located in the lower uterine segment or cervix may interfere with a normal vaginal delivery.

PTS: 1 REF: p. 1095 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 4. Hydrometra appears sonographically as a(n) ________________________________. a. sonolucent tubular structure in the adnexa b. echogenic thickening of the endometrium c. sonolucent fluid collection in the uterine canal d. sonolucent fluid collection in the uterus, cervix, and vagina ANS: C Fluid accumulation in the uterus is termed hydrometra.

PTS: 1 REF: p. 1090 | p. 1091 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the vagina and cervix 5. A benign invasion of endometrial tissue into the myometrium is known as which one of the following conditions? a. Endometriosis b. Pelvic inflammatory disease (PID) c. Adenomyosis d. Endomyosarcoma ANS: C Adenomyosis is a benign disease, commonly diffuse, with global infiltration of the endometrium.

NURSINGTB.COM

PTS: 1 REF: p. 1099 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 6. Which one of the following conditions is described as a hyperplastic protrusion of the epithelium of the cervix that may be broad based or pedunculated? a. Cervical stenosis b. Pyometrium c. Cervical polyps d. Cervical obstruction ANS: C A cervical polyp is a benign condition arising from the hyperplastic protrusion of the epithelium of the cervix.

PTS: 1 REF: p. 1090 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 7. Which one of the following sonographic characteristics is the most common finding in endometrial carcinoma? a. Abnormal thinning of the endometrial cavity, usually with irregular bleeding in postmenopausal women b. Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women c. Irregular bleeding d. Heavy bleeding with a thickening of the myometrium ANS: B In endometrial carcinoma, the most common sonographic finding is an abnormally thickened endometrium. The most common clinical symptom is irregular uterine bleeding.

PTS: 1 REF: p. 1108 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the endometrium 8. A small percentage of leiomyomas are located in which one of the following structures? a. Body b. Fundus c. Myometrium d. Cervix ANS: D A small percentage of leiomyomas are located in the cervix.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1091 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 9. Which one of the following is most likely the result of an acquired condition with obstruction of the cervical canal? a. Leiomyoma b. Cervical carcinoma c. Cervical stenosis d. Adenomyosis ANS: C An acquired condition with obstruction of the cervical canal is most likely a result of cervical stenosis at the internal or external os. This condition may be a result of radiation therapy, previous cone biopsy, postmenopausal cervical atrophy, chronic infection, or cervical carcinoma.

PTS: 1 REF: p. 1091 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 10. The size and shape of the normal uterus are related to all of the following except: a. family history. b. age. c. hormonal status. d. parity.

ANS: A The size and shape of the normal uterus are related to age, hormonal status, and parity.

PTS: 1 REF: p. 1093 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 11. Which one of the following locations of a fibroid will most likely cause heavy irregular uterine bleeding? a. Subserosal b. Submucosal c. Intramural d. Pedunculated ANS: B A submucosal fibroid displaces or distorts the endometrial canal with subsequent irregular or heavy uterine bleeding.

PTS: 1 REF: p. 1095 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and NURSIand NGsonographic TB.COM findings. describe the causes, clinical signs, TOP: Pathology of the uterus 12. The most common cause of uterine calcification is which one of the following? a. Adenomyosis b. Endometritis c. Arcuate artery calcification d. Myomas ANS: D Myomas are the most common cause of uterine calcifications. A less common cause is arcuate artery calcification, visualized in the periphery of the uterus.

PTS: 1 REF: p. 1099 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 13. On ultrasound, the characteristic appearance of a degenerating leiomyoma is ____________________. a. homogeneous b. heterogeneous c. isoechoic

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. anechoic ANS: B Degenerating leiomyomas demonstrate cystic degeneration and appear complex or heterogeneous.

PTS: 1 REF: p. 1098 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 14. Which one of the following statements about adenomyosis is false? a. Elevated progesterone levels may promote the growth of myometrial islands of endometrium. b. Adenomyosis can be managed with hormone therapy. c. Adenomyosis may cause abnormal uterine bleeding. d. Adenomyosis may cause pelvic pain during menstruation.

ANS: A Elevated estrogen levels may also promote the growth of myometrial islands of endometrial tissue.

PTS: 1 REF: p. 1099 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus

N R I G B.C M

U S N(AVM): T O 15. Uterine arteriovenous malformation a. usually involves the endometrium. b. can be managed with dilation and curettage (D&C). c. usually involves the myometrium. d. is always acquired.

ANS: C Uterine AVM usually involves the myometrium, but rarely the endometrium. The condition is typically acquired but may be congenital. A D&C could lead to catastrophic hemorrhaging.

PTS: 1 REF: p. 1101 OBJ: Identify the role of Doppler in evaluating pathology in the pelvis.

TOP: Pathology of the uterus 16. The endometrium should be measured from ___________ layer to ___________ layer. a. hypoechoic; hypoechoic b. hyperechoic; hyperechoic c. hyperechoic; hypoechoic d. hypoechoic; hyperechoic ANS: B The functionalis layers (hyperechoic or echogenic layers) are only included in the measurement. The hypoechoic basalis layer is not included in the endometrial measurement.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1103 OBJ: Describe how to measure the endometrial thickness and the normal measurements for the various menstrual phases.

TOP: Pathology of the endometrium 17. Endometrial hyperplasia develops from which one of the following? a. Unopposed estrogen stimulation b. Unopposed progesterone stimulation c. Follicular-stimulating hormone d. Endometrial polyp ANS: A Endometrial hyperplasia develops from unopposed estrogen stimulation.

PTS: 1 REF: pp. 1104-1105 OBJ: Define the pathologies discussed in this chapter and describe their causes, clinical signs, and sonographic findings.

TOP: Pathology of the endometrium 18. A 3-day postpartum woman complains of intense pelvic pain. Sonographically, the uterus appears hypoechoic with an irregular endometrium. This condition most likely represents which one of the following? a. Adenomyosis b. Degenerating submucosal leiomyoma c. Endometritis d. Endometrial hyperplasia ANS: C NURisSintense INGTpelvic B.COpain.

M It occurs most often in association with A clinical sign of endometritis PID, postpartum, or instrument invasion. Sonographically, the uterus appears hypoechoic with an irregular endometrium.

PTS: 1 REF: pp. 1106-1107 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the endometrium 19. In postmenopausal patients, an endometrial thickness of less than _____ millimeters (mm) reliably excludes an endometrial abnormality. a. 4 b. 5 c. 8 d. 10 ANS: B In postmenopausal patients, an endometrial thickness of less than 5 mm reliably excludes an endometrial abnormality.

PTS: 1 REF: p. 1108 OBJ: Describe how to measure the endometrial thickness and the normal measurements for the various menstrual phases.

TOP: Pathology of the endometrium

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

20. Only _____% of women with postmenopausal bleeding have endometrial carcinoma. a. 10 b. 25 c. 50 d. 75 ANS: A Although postmenopausal bleeding is the most common clinical sign of endometrial carcinoma, only 10% of women with postmenopausal bleeding have endometrial carcinoma.

PTS: 1 REF: p. 1108 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the endometrium 21. Patients on tamoxifen therapy have an increased risk of which one of the following reactions? a. Endometrial hyperplasia b. Endometrial polyp c. Endometrial carcinoma d. All of the above reactions ANS: D An increased risk of endometrial carcinoma, hyperplasia, and polyp has been reported in patients on tamoxifen therapy.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1108 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the endometrium 22. A 28-year-old woman reports left lower quadrant pain. Her last menstrual period was 2 weeks earlier. Sonographically, the uterine body displays a highly echogenic structure in the endometrial cavity. This appearance most likely represents which one of the following conditions? a. Endometritis b. Calcified submucosal fibroid c. Intrauterine contraceptive device (IUD) d. Calcified arcuate arteries ANS: C Sonographically, an IUD appears as a highly echogenic structure in the endometrium of the uterine body.

PTS: 1 REF: p. 1110 OBJ: Differentiate among the types of intrauterine contraceptive devices, and describe the sonographic appearance of each.

TOP: Intrauterine contraceptive devices 23. Irregular, acyclic bleeding is defined as which one of the following?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Menorrhagia Metrorrhea Dysmenorrhea Amenorrhea

ANS: B Metrorrhea is defined as irregular, acyclic bleeding.

PTS: 1 REF: p. 1100 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the uterus 24. In which of the following structures would a Gartner’s duct cyst be found? a. Fallopian tube b. Ovary c. Cervix d. Vagina ANS: D The Gartner’s duct cyst is the most common cystic lesion of the vagina.

PTS: 1 REF: p. 1090 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the vagina and cervix

N R I G B.C M

U StheNnormal T vaginal O cuff should not exceed _____ 25. In a patient after a hysterectomy, centimeters (cm). a. 1 b. 2 c. 3 d. 4 ANS: B The upper normal limit of a vaginal cuff in a patient after a hysterectomy is 2.1 cm.

PTS: 1 REF: p. 1090 OBJ: Define the pathologic conditions of the pelvic region discussed in this chapter, and describe the causes, clinical signs, and sonographic findings.

TOP: Pathology of the vagina and cervix

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 44: Pathology of the Ovaries Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Theca-lutein cysts are associated with high levels of which one of the following hormones? a. Estrogen b. Progesterone c. Luteinizing hormone d. Human chorionic gonadotropin (hCG) ANS: D Theca-lutein cysts are associated with high levels of hCG. PTS: 1 REF: p. 1120 OBJ: Describe the effects of hormones on the ovarian cycle.

TOP: Benign adnexal cysts 2. A hypoechoic mass adjacent to the ovary is most likely which one of the following masses? a. Teratoma b. Endometrioma c. Paraovarian cyst d. Mucinous cystadenoma ANS: B An endometrioma is a well-defined unilocular or multilocular hypoechoic mass N RSINGechoes).

TB.COM (homogeneous with low-levelUinternal PTS: 1 REF: p. 1123 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Benign adnexal cysts 3. A tumor that may mimic gas or feces in the pelvis is which one of the following masses? a. Leiomyoma b. Lipoma c. Granulosa d. Dermoid ANS: D Echogenic dermoids may often be confused with bowel, because the mass may have characteristics similar to those of bowel tissue.

PTS: 1 REF: p. 1133 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Germ cell tumors 4. The dermoid tumor is typically associated with which one of the following ultrasound signs?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Sandwich Silhouette Tip of the iceberg Mickey Mouse

ANS: C The term, tip of the iceberg sign, refers to a mixture of matted hair and sebum-producing, ill-defined acoustic shadowing that obscures the posterior wall of the lesion.

PTS: 1 REF: p. 1134 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Germ cell tumors 5. Which one of the following cysts occurs when a dominant follicle does not succeed in ovulating but remains active although immature? a. Nabothian b. Corpus luteum c. Follicular d. Paraovarian ANS: C A follicular cyst forms when a mature follicle fails to ovulate or involute.

PTS: 1 REF: p. 1119 OBJ: Define the characteristics of the simple ovarian cyst and a functional ovarian cyst.

TOP: Benign adnexal cysts

N R I G B.C M

U Sfound N during T early O pregnancy is which one of the 6. The most common adnexal mass following cysts? a. Corpus luteal b. Theca-lutein c. Follicular d. Paraovarian ANS: A If the ovum is fertilized, then the corpus luteum continues as the corpus luteum of pregnancy.

PTS: 1 REF: p. 1119 OBJ: Define the characteristics of the simple ovarian cyst and a functional ovarian cyst.

TOP: Benign adnexal cysts 7. A mucinous cystadenoma is all of the following except: a. a large cystic mass with multilocular cystic spaces. b. unilateral. c. the most common cystic tumor. d. thick with irregular walls and septations.

ANS: D A mucinous cystadenoma is demonstrated as a simple or septated, thin-walled multilocular cyst.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1130 OBJ: Differentiate between mucinous and serous types of tumor.

TOP: Epithelial tumors 8. Mucinous cystadenocarcinoma most frequently occurs in women over the age of _______ years. a. 20 b. 30 c. 40 d. 50 ANS: C Mucinous cystadenocarcinoma most frequently occurs in women 40 to 70 years of age and accounts for 5% to 10% of all primary malignant neoplasms.

PTS: 1 REF: p. 1130 OBJ: Differentiate between mucinous and serous types of tumor.

TOP: Epithelial tumors 9. Which one of the following pelvic organs is more commonly involved with metastatic disease? a. Uterus b. Ovaries c. Bladder d. Fallopian tubes

N R I G B.C M

U S N T O ANS: B The ovaries are more involved with metastatic disease than any other pelvic organ.

PTS: 1 REF: p. 1136 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Stromal tumors 10. The normal ovary exhibits which one of the following characteristic appearances? a. Heterogeneous echotexture b. Homogeneous echotexture c. Central hypoechoic medulla d. Both a heterogeneous echotexture and a central hypoechoic medulla ANS: B The normal ovary has a homogeneous echotexture, which may exhibit a central, more echogenic medulla.

PTS: 1 REF: p. 1114 OBJ: Define the characteristics of the simple ovarian cyst and a functional ovarian cyst.

TOP: Anatomy of the ovaries 11. Simple ovarian cysts in postmenopausal women are not likely malignant when measuring less than _____ centimeters (cm).

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

3 4 5 6

ANS: C Simple ovarian cysts in postmenopausal women are not likely malignant when measuring less than 5 cm.

PTS: 1 REF: p. 1123 OBJ: Define the characteristics of the simple ovarian cyst and a functional ovarian cyst.

TOP: Sonographic evaluation of the ovaries 12. Sonographic criteria for a simple ovarian cyst include all of the following except: a. anechoic appearance. b. smooth walls. c. posterior shadowing. d. acoustic enhancement.

ANS: C Sonographic criteria for a simple ovarian cyst include anechoic appearance, smooth thin walls, and posterior acoustic enhancement.

PTS: 1 REF: p. 1116 OBJ: Define the characteristics of the simple ovarian cyst and a functional ovarian cyst.

TOP: Sonographic evaluation of the ovaries

N R I G B.C M

U Sabnormal N T if itsOvolume is _____ the size of the 13. An ovary is generally considered contralateral ovary. a. one half b. twice c. three times d. one quarter ANS: B An ovary is generally considered abnormal if its volume has changed more than 20 ml or is twice the size of the contralateral ovary.

PTS: 1 REF: p. 1126 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, the common solid ovarian mass, an ovarian neoplasm, and a dermoid tumor.

TOP: Sonographic evaluation of ovarian neoplasms 14. Which one of the following statements about polycystic ovarian syndrome (PCOS) is false? a. PCOS includes amenorrhea. b. PCOS includes early pregnancy loss. c. PCOS occurs in the middle-to-late 30s. d. PCOS includes hirsutism.

ANS: C PCOS occurs in the late teens through the 20s.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1121 OBJ: List the characteristics of the ovarian syndromes discussed in this chapter.

TOP: Benign adnexal cysts 15. In PCOS, the ovaries have which one of the following shapes? a. Rounded b. Irregular c. Elongated d. Smooth ANS: A In PCOS, the ovaries have a round shape.

PTS: 1 REF: p. 1121 OBJ: List the characteristics of the ovarian syndromes discussed in this chapter.

TOP: Benign adnexal cysts 16. Paraovarian cysts arise from which one of the following structures? a. Fallopian tube b. Round ligament c. Peritoneum d. Broad ligament ANS: D Paraovarian cysts arise from the broad ligament and are usually of mesothelial or paramesonephric origin.

NURSINGTB.COM

PTS: 1 REF: p. 1122 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Key Pearls 17. A specific diagnosis of a paraovarian cyst is possible only by: a. intervening surgically. b. demonstrating an ipsilateral ovary separate from the cyst. c. demonstrating thin deformable walls. d. demonstrating a lack of peripheral blood flow.

ANS: B A specific diagnosis of paraovarian cyst is possible only by demonstrating an ipsilateral ovary separate from the cyst.

PTS: 1 REF: p. 1122 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Benign adnexal cysts 18. Ovarian carcinoma is classified into four stages. Stage II is limited to which one of the following? a. Pelvis

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. One ovary c. Broad ligament d. Two ovaries ANS: A Stage II is limited to the pelvis.

PTS: 1 REF: p. 1126 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Ovarian carcinoma 19. The most common benign tumor of the ovary is which one of the following masses? a. Serous cystadenoma b. Endometrioma c. Dermoid tumor d. Mucinous cystadenoma ANS: C The most common benign mass of the ovary is a dermoid tumor.

PTS: 1 REF: p. 1132 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Epithelial tumors 20. Which one of the following masses is a rare but benign ovarian neoplasm most often seen in postmenopausal women?

NURSINGTB.COM a. Fibroma b. Thecoma c. Granulosa d. Dysgerminoma ANS: B Thecomas are usually benign and unilateral, making up 1% of ovarian neoplasms with 70% occurring in postmenopausal women.

PTS: 1 REF: p. 1135 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Stromal tumors 21. Functioning endometrial tissue is present outside of the uterus in which one of the following common conditions? a. Adenomyosis b. Endometriosis c. Endometritis d. Hemorrhagic cyst ANS: B Endometriosis is a common condition in which functioning endometrial tissue is present outside of the uterus.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1123 OBJ: Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms.

TOP: Key Pearls 22. The partial or complete rotation of the ovarian pedicle on its axis is defined as which one of the following? a. Hemorrhagic cyst b. Endometrioma c. Paraovarian cyst d. Ovarian torsion ANS: D Ovarian torsion is defined as the partial or complete rotation of the ovarian pedicle on its axis.

PTS: 1 REF: p. 1125 OBJ: Explain the Doppler parameters used in ovarian torsion.

TOP: Ovarian torsion

23. Which one of the following statements about ovarian torsion is false? a. Ovarian torsion is usually associated with a mass. b. Torsion frequently involves the ovary and the fallopian tube. c. The ovary appears enlarged. d. The left ovary is three times more likely to develop torsion than the right.

ANS: D The right ovary is three times more likely to develop torsion than the left.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1125 OBJ: Explain the Doppler parameters used in ovarian torsion.

TOP: Ovarian torsion

24. Which one of the following endocrine disorders is associated with chronic anovulation? a. Polycystic ovarian syndrome b. Endometriosis c. Ovarian hyperstimulation syndrome d. Theca-lutein cysts ANS: A PCOS is an endocrine disorder associated with chronic anovulation.

PTS: 1 REF: p. 1121 OBJ: List the characteristics of the ovarian syndromes discussed in this chapter.

TOP: Benign adnexal cysts

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 45: Pathology of the Adnexa Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. An infection that involves the fallopian tube and the ovary is called which one of the following conditions? a. Pelvic inflammatory disease b. Tubo-ovarian abscess (TOA) c. Pyosalpinx d. Salpingitis ANS: B A TOA involves the fallopian tube and ovary.

PTS: 1 REF: p. 1143 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 2. Risk factors in pelvic inflammatory disease (PID) include all of the following except: a. early sexual contact. b. single sexual partner. c. sexually transmitted disease. d. intrauterine contraceptive device.

ANS: B NURSsexual INGTcontact, B.COmultiple M Risk factors in PID include early sexual partners, sexually transmitted disease, intrauterine device, previous history of PID, and douching.

PTS: 1 REF: p. 1139 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 3. Which one of the following statements about PID is false? a. PID is almost always a bilateral collection of pus and fluid. b. Patients may experience pelvic pain and have a history of infertility. c. PID includes vaginal discharge with bleeding. d. PID confers a decreased risk of ectopic pregnancy.

ANS: D The incidence of ectopic pregnancy is significantly increased with a history of PID. PTS: 1 REF: p. 1140 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 4. Which one of the following statements about the fallopian tube is false? a. The normal lumen is not usually visualized. b. Detection is easier if fluid or pus is in the tube.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. The tube is best seen transabdominally. d. Ascites is helpful to outline the tube.

ANS: C The normal fallopian tube is not well visualized but may be seen on transvaginal sonography near the uterine cornua.

PTS: 1 REF: p. 1141 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 5. Which one of the following is an infection in the fallopian tube? a. Parametritis b. Oophoritis c. Hydrosalpinx d. Salpingitis ANS: D Salpingitis is defined as an infection in the fallopian tube.

PTS: 1 REF: p. 1140 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 6. Early in the disease, the clinical presentation of both PID and endometriosis may mimic which one of the following? a. Para-ovarian cyst NURSINGTB.COM b. Subserosal fibroid c. Functional bowel disease d. Adenomyosis ANS: C Clinical presentation early in both PID and endometriosis is nonspecific and may mimic functional bowel disease.

PTS: 1 REF: p. 1139 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 7. PID is an inclusive term that refers to all of the following pelvic infections except: a. oophoritis. b. endometriosis. c. parametritis. d. myometritis.

ANS: B PID includes oophoritis, parametritis, myometritis, salpingitis, peri-ovarian inflammation, and tubo-ovarian abscess.

PTS: 1 REF: p. 1139 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Pelvic inflammatory disease 8. Which one of the following is the most common cause of PID? a. Intrauterine devices b. Sexually transmitted diseases c. Postsurgical complications d. Endometritis ANS: B Gonorrhea and chlamydia are the most common forms of pelvic infection.

PTS: 1 REF: p. 1139 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 9. Fusion of the inflamed dilated tube and ovary is called which one of the following? a. A tubo-ovarian abscess b. Pyosalpinx c. Pelvic inflammatory disease d. Tubo-ovarian complex ANS: D Tubo-ovarian complex is the fusion of the inflamed dilated tube and ovary.

PTS: 1 REF: pp. 1142-1143 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease

NURSINGTB.COM

10. Which one of the following is an infection within the uterine serosa and broad ligaments? a. PID b. Parametritis c. Myometritis d. Peri-ovarian inflammation ANS: B Parametritis is the infection within the uterine serosa and broad ligaments.

PTS: 1 REF: p. 1139 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 11. Clinical symptoms of PID may include which one of the following? a. Fever b. Dull pelvic aching c. No symptoms d. Fever and dull pelvic aching ANS: D Clinical symptoms may include fever, a dull pelvic ache, painful intercourse, severe pelvic pain, irregular menstrual bleeding, and an increase in the white blood count.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1140 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 12. The differential considerations of a solid-appearing adnexal mass include all of the following except: a. endometrioma. b. hemorrhagic cyst. c. hydrosalpinx. d. pedunculated uterine fibroid.

ANS: C A hydrosalpinx demonstrates an anechoic tubular adnexal mass.

PTS: 1 REF: p. 1142 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 13. The differential considerations of PID may include all of the following except: a. dermoid. b. endometriosis. c. serous cystadenoma. d. ovarian neoplasm.

ANS: C Differential considerations may include dermoid, endometriosis, ovarian neoplasm, hematoma, and ectopic pregnancy.

NURSINGTB.COM

PTS: 1 REF: p. 1140 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 14. Sonographic findings of PID include all of the following except: a. endometritis. b. endometriosis. c. peri-ovarian inflammation. d. salpingitis.

ANS: B Endometriosis is not a risk factor for PID. PTS: 1 REF: p. 1140 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 15. Enlarged ovaries with multiple cysts and indistinct margins describes which of the following conditions? a. Peri-ovarian inflammation b. Tubo-ovarian complex c. Para-ovarian inflammation

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Oophoritis ANS: A Enlarged ovaries with multiple cysts and indistinct margins describe peri-ovarian inflammation.

PTS: 1 REF: p. 1140 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pathology 16. Sexually transmitted PID is spread via which one of the following? a. Bloodstream b. Mucosa c. Serosa d. Fallopian tubes ANS: B Sexually transmitted PID is spread via the mucosa of the pelvic organs.

PTS: 1 REF: p. 1140 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 17. A complex adnexal mass most likely represents which one of the following? a. Salpingitis b. Hydrosalpinx c. Oophoritis NURSINGTB.COM d. Pyosalpinx ANS: D A complex adnexal mass most likely represents pyosalpinx.

PTS: 1 REF: p. 1141 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 18. Perihepatic inflammation ascending from a pelvic infection is called ____________ syndrome. a. Stein-Leventhal b. Fritz-Hugh-Curtis c. Turner’s d. de Quervain’s ANS: B Perihepatic inflammation ascending from a pelvic infection is called Fritz-Hugh-Curtis syndrome.

PTS: 1 REF: p. 1140 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 19. An asymptomatic 32-year-old woman is diagnosed with a left adnexal mass on physical examination. A history of PID has been reported. Transabdominal and transvaginal images demonstrate an anechoic tubular structure in the left lower quadrant. This finding most likely represents which one of the following? a. Iliac vessels b. Hydrosalpinx c. Theca-lutein cysts d. Ectopic pregnancy ANS: B With a history of PID, hydrosalpinx is a likely diagnosis.

PTS: 1 REF: pp. 1140-1141 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 20. A 24-year-old woman has a fever, vaginal discharge, and intense pelvic pain.

Transabdominal and transvaginal images demonstrate a complex multiloculated irregular mass in the pouch of Douglas. This clinical presentation most likely represents which one of the following? a. Ovarian torsion b. A tubo-ovarian abscess c. Degenerating pedunculated fibroid d. Endometrioma ANS: B The clinical presentation represents a pelvic infection, and a tubo-ovarian abscess is the NURSINGTB.COM most likely choice.

PTS: 1 REF: p. 1140 OBJ: List the causes of and risk factors for pelvic inflammatory disease.

TOP: Pelvic inflammatory disease 21. A 25-year-old woman complains of painful menstrual cycles and infertility. Transabdominal and transvaginal images demonstrate a hypoechoic well-defined adnexal mass. Normal ovaries are seen bilaterally. This sonographic appearance most likely represents which one of the following? a. A tubo-ovarian abscess b. Para-ovarian cyst c. Endometrioma d. Hemorrhagic corpus luteum cyst ANS: C An endometrioma is the mostly likely choice because of the patient’s history and the sonographic appearance of the adnexal mass.

PTS: 1 REF: p. 1147 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Endometriosis and endometrioma

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 22. Which one of the following statements about diffuse endometriosis is false? a. It is the most common form of endometriosis. b. Endometriosis is easily diagnosed by sonography. c. Endometriosis leads to the disorganization of pelvic anatomy. d. Its appearance is similar to PID. ANS: B Diffuse endometriosis is difficult to diagnose with sonography.

PTS: 1 REF: p. 1147 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Endometriosis and endometrioma 23. Inflammation of the serous membrane lining the abdominal cavity and covering the viscera is which one of the following? a. Periangitis b. Omentitis c. Peritonitis d. Retroperitonitis ANS: C Peritonitis is the inflammation of the serous membrane lining the abdominal cavity and covering the viscera.

PTS: 1 REF: p. 1143 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease

NURSINGTB.COM

24. A pelvic abscess will likely appear as which one of the following? a. Complex cul-de-sac mass that distorts the pelvic anatomy b. Hypoechoic adnexal mass with a separate normal ovary c. Complex ovarian mass with anechoic cul-de-sac fluid d. Hypoechoic cul-de-sac mass ANS: A A pelvic abscess is usually a complex cul-de-sac mass that distorts the pelvic anatomy.

PTS: 1 REF: p. 1143 OBJ: Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis.

TOP: Pelvic inflammatory disease 25. Which one of the following statements about interventional pelvic sonography is true? a. Is not a valuable diagnostic tool b. Lacks a safe biopsy route c. Decreases patient care d. Decreases patient cost ANS: D Interventional sonography is a valuable diagnostic tool that decreases patient cost and the need for surgical intervention.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1148 OBJ: Discuss the role of ultrasound as a tool in diagnosing PID. TOP: Interventional sonography

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 46: Role of Ultrasound in Evaluating Female Infertility Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following statements about infertility is false? a. Infertility is the inability to conceive within 12 months with regular coitus. b. Infertility affects one in three couples in the United States. c. Infertility in 40% of patients is attributable to men. d. Infertility in 20% of patients is attributable to either the man or the woman or is unexplained.

ANS: B Infertility affects one in seven couples in the United States.

PTS: 1 REF: p. 1151 OBJ: Define infertility, and list its treatment options.

TOP: Introduction

2. When evaluating the patient who is infertile, in addition to assessing structural anatomy, the sonographer should evaluate the: a. endometrium. b. presence of corpus luteal cysts. c. presence of follicular cysts. d. vagina.

ANS: A N RSINthe GTsonographer B.COM has two main objectives: (1) assess When evaluating the infertileUpatient, the structural anatomy; and (2) assess the endometrium.

PTS: 1 REF: p. 1152 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Evaluating the uterus 3. The uterine anomaly most frequently associated with a high incidence of infertility is a ___________ uterus. a. septate b. bicornuate c. didelphys d. T-shaped ANS: A A septate uterus is associated with a high incidence of infertility because of an inadequate blood supply from the septum.

PTS: 1 REF: p. 1152 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Congenital uterine anomalies 4. The triple-line sign is associated with which one of the following structures?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Cervix Vagina Endometrium Uterus

ANS: C The proliferative endometrial phase is seen as the triple-line sign, which consists of hypoechoic mucosa and the echogenic interface where they meet.

PTS: 1 REF: p. 1153 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

TOP: Evaluating the endometrium 5. The fallopian tubes are evaluated by a sonographic and saline examination to determine which one of the following characteristics? a. Size b. Patency c. Length d. Duplication ANS: B Patency of the fallopian tubes is evaluated by a sonographic and saline examination.

PTS: 1 REF: p. 1154 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

TOP: Evaluating the fallopian tubes

N R I G B.C M

S ofN_____ T to O 6. A dominant follicle grows atU a rate _____ millimeters per day (mm/day). a. 0.5; 1 b. 1; 1.5 c. 1; 2 d. 1; 3 ANS: D A dominant follicle grows at a rate of 1 to 3 mm/day until it reaches an average of 22 mm.

PTS: 1 REF: p. 1155 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

TOP: Evaluating the fallopian tubes 7. Patients with polycystic ovarian syndrome may have the clinical triad of all the following characteristics except: a. oligomenorrhea. b. hirsutism. c. bulimia. d. obesity.

ANS: C The clinical triad of polycystic ovarian syndrome includes oligomenorrhea, hirsutism, and obesity.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1155 OBJ: Define infertility, and list its treatment options.

TOP: Evaluating the ovaries 8. Complications associated with assisted reproductive technologies include all of the following except: a. hyperstimulation. b. multiple gestations. c. cervical stenosis. d. ectopic pregnancy.

ANS: C Complications associated with assisted reproductive technologies include hyperstimulation, multiple gestations, and ectopic pregnancy.

PTS: 1 REF: p. 1157 OBJ: List the complications that may occur because of infertility treatments.

TOP: Complications associated with assisted reproductive technology 9. After ovulation, progesterone is secreted by which one of the following? a. Graafian follicle b. Follicular cyst c. Corpus luteum d. Hyperstimulation ANS: C After ovulation, progesterone is secreted by the corpus luteum. The secretion of NURSINphase GTB.C OM progesterone begins in the secretory of the endometrial cycle.

PTS: 1 REF: p. 1153 OBJ: Define infertility, and list its treatment options.

TOP: Evaluating the endometrium 10. Lack of progesterone production is known as which one of the following? a. Secondary infertility b. Luteal phase deficiency c. Polycystic ovarian syndrome d. Ovarian hyperstimulation syndrome ANS: B The lack of progesterone production is known as luteal phase deficiency.

PTS: 1 REF: p. 1153 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Evaluating the endometrium 11. The T-shaped uterus is a congenital anomaly caused by which one of the following? a. In utero exposure to diethylstilbestrol (DES) b. Partial fusion of the müllerian ducts c. Incomplete fusion of the müllerian ducts

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Exposure to radiation ANS: A The T-shaped uterus is a congenital anomaly caused by in utero exposure to DES. PTS: 1 REF: p. 1152 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Congenital uterine anomalies 12. In the luteal phase, the endometrial lining may be thinner than expected from an inadequate level of which of the following? a. Estrogen b. Progesterone c. Luteinizing hormone d. Follicle-stimulating hormone ANS: B If the level of progesterone produced in the luteal phase is inadequate, then the endometrial lining may be thinner than expected on ultrasound.

PTS: 1 REF: p. 1153 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

TOP: Evaluating the endometrium 13. Which one of the following tends to have a narrow base attachment to the endometrium with a vascular pedicle feeding it? a. Endometrial polyp NURSINGTB.COM b. Submucosal fibroid c. Endometrial carcinoma d. Synechiae ANS: A Endometrial polyps tend to have a narrow base attachment (stalk) with a vascular pedicle feeding it.

PTS: 1 REF: p. 1153 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Evaluating the endometrium 14. A hyperechoic linear strand of tissue extending from one wall of the uterine cavity to the other describes which one of the following? a. Adenomyosis b. Decidua basalis c. Uterine synechiae d. Normal proliferative phase ANS: C Uterine synechiae are typically observed on ultrasound as hyperechoic linear strands extending from one wall of the uterine cavity to the other.

PTS:

1

REF: p. 1153

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Evaluating the endometrium 15. A normal endometrial response associated with overstimulation is an increasing thickness between 2 to 3 mm and __________ mm. a. 7 to 10 b. 10 to 20 c. 12 to 14 d. 20 to 25 ANS: C A normal endometrial response associated with overstimulation is an increasing thickness between 2 to 3 mm and 12 to 14 mm.

PTS: 1 REF: p. 1156 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Monitoring the endometrium 16. Producing more luteinizing hormone (LH) than follicle-stimulating hormone (FSH) results in which one of the following conditions? a. Meige syndrome b. Luteal phase deficiency c. Polycystic ovarian syndrome d. Ovarian hyperstimulation syndrome ANS: C Polycystic ovarian syndrome is due to the pituitary gland producing more LH than FSH.

NURSINGTB.COM

PTS: 1 REF: p. 1155 OBJ: State the anatomic variations or pathologic conditions that need to be defined when imaging an infertility patient.

TOP: Evaluating the ovaries 17. Which one of the following is used as a substitute for luteinizing hormone (LH) to trigger ovulation? a. Clomid b. Estradiol c. Progesterone d. Human chorionic gonadotropin (hCG) ANS: D To trigger ovulation, hCG may be administered intramuscularly as a substitute for LH. PTS: 1 REF: p. 1156 OBJ: Define infertility, and list its treatment options.

TOP: Treatment options

18. Which one of the following syndromes demonstrates enlarged ovaries with multiple cysts, abdominal ascites, and pleural effusion? a. Polycystic ovarian b. Fritz-Hugh-Curtis c. Ovarian hyperstimulation

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Stein-Leventhal ANS: C Severe ovarian hyperstimulation syndrome demonstrates enlarged ovaries with multiple cysts, abdominal ascites, and pleural effusion.

PTS: 1 REF: p. 1157 OBJ: List complications that may occur because of infertility treatments.

TOP: Complications associated with assisted reproductive technology 19. Ovarian induction therapy requires documentation of all follicles greater than _____ mm in both longitudinal and transverse planes. a. 5 b. 20 c. 15 d. 17 ANS: B Ovarian induction therapy requires documentation of all follicles greater than 20 mm in both longitudinal and transverse planes.

PTS: 1 REF: p. 1156 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

TOP: Treatment options 20. Which one of the following hormones, along with follicle size determine the approximate time of ovulation?

NURSINGTB.COM a. Follicle-stimulating hormone b. Progesterone c. Human chorionic gonadotropin d. Estradiol ANS: D Follicle size and estradiol levels determine the approximate time of ovulation.

PTS: 1 REF: p. 1156 OBJ: Define infertility, and list its treatment options.

TOP: In vitro fertilization and embryo transfer 21. During in vitro fertilization, the optimal placement of the embryos is considered to be within 2 cm of the apex of which one of the following structures? a. Cervix b. Uterine body c. Uterine fundus d. Cornua ANS: C Optimal placement of the embryos is within 2 cm of the apex of the uterine fundus.

PTS: 1 REF: p. 1157 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Intrauterine insemination 22. Multiple gestations occur in approximately _____% of in vitro fertilization (IVF) pregnancies. a. 15 b. 30 c. 50 d. 75 ANS: B An estimated 30% of IVF pregnancies result in multiple gestation.

PTS: 1 REF: p. 1158 OBJ: List complications that may occur because of infertility treatments.

TOP: Complications associated with assisted reproductive technology 23. Patients who undergo assisted reproductive procedures have an increased risk factor for a(n) ________________ pregnancy. a. molar b. heterotopic c. anembryonic d. monoamniotic and monochorionic ANS: B The incidence of heterotopic pregnancy increases to 1:100 with assisted reproductive technologies.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1158 OBJ: List complications that may occur because of infertility treatments.

TOP: Complications associated with assisted reproductive technology 24. On a baseline pelvic ultrasound, an ovarian cyst greater than ____ mm could interfere with ovarian stimulation and may represent a persistent follicle. a. 5 b. 8 c. 10 d. 15 ANS: D On a baseline pelvic ultrasound, an ovarian cyst greater than 15 mm could interfere with the response of ovarian stimulation and may represent a persistent follicle.

PTS: 1 REF: p. 1156 OBJ: List the female pelvic organs to be imaged in an infertility work-up procedure.

TOP: Treatment options

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 47: Role of Sonography in Obstetrics Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Obstetric (OB) ultrasound allows the clinician to assess all of the following except: a. muscle tone. b. development. c. growth. d. well-being.

ANS: A Assessment of fetal muscle tone is not part of an obstetric ultrasound.

PTS: 1 REF: p. 1161 OBJ: Analyze the differences among standard, specialized, and limited obstetric sonography examinations.

TOP: Indications for obstetric sonography 2. Ultrasound is able to determine all of the following except: a. source of bleeding and status of fetus. b. fetal presentation. c. multiple gestation. d. exact date of delivery.

ANS: D The estimated date of vaginal delivery can be determined, not an exact date.

NURSINGTB.COM

PTS: 1 REF: pp. 1162-1163 OBJ: Describe the steps of the first-, second-, and third-trimester sonography protocols.

TOP: Indications for obstetric sonography 3. Biophysical evaluation for fetal well-being includes all of the following except: a. assessment of amniotic fluid. b. fetal tone. c. muscle tone. d. body and breathing movements.

ANS: C Biophysical evaluation for fetal well-being includes an assessment of the amniotic fluid, body movements, breathing movements, and heart rate patterns.

PTS: 1 REF: p. 1163 OBJ: Describe the biologic effects of diagnostic medical ultrasound energy and related patient safety.

TOP: Indications for obstetric sonography 4. Limited obstetric ultrasound examinations are ordered for which one of the following reasons? a. To answer a specific clinical question b. To determine the fetal gender

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. To screen the fetus for anomalies d. To rule out an ectopic pregnancy ANS: A The limited OB examination is to answer a specific clinical question such as placenta location or fetal position.

PTS: 1 REF: p. 1164 OBJ: List fetal anatomy visualization required as part of the standard second-trimester examination.

TOP: Types of obstetric sonography examinations 5. Which one of the following statements about the gestational sac is false? a. The earliest structure observed with the sac is the yolk sac. b. The earliest structure may be seen with transvaginal ultrasound. c. Blood tests should be positive 7 to 10 hours after conception. d. The placenta is seen as a thickened density along part of the margin of the gestational sac.

ANS: C The blood tests (beta hCG levels) should be positive 7 to 10 days after conception (embryonic age).

PTS: 1 REF: p. 1167 OBJ: Describe the steps of the first-, second-, and third-trimester sonography protocols.

TOP: Sonographic characteristics 6. Which one of the following statements about the embryo heart rate is false?

NURphase, M SING TB.C a. Early in the developmental the heart O rate is greater than 190 bpm. b. Early in the developmental phase, the heart rate is 90 bpm. c. The rate may increase to 170 bpm in the middle of the first trimester. d. The rate is 120 to 140 bpm in the second and third trimesters.

ANS: A The embryo’s heart rate in the early developmental phase is approximately 90 bpm.

PTS: 1 REF: p. 1168 OBJ: Describe the steps of the first-, second-, and third-trimester sonography protocols.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 7. Which one of the following statements about the amniotic fluid development is true? a. The fetal kidneys begin to produce urine in the first trimester. b. In the first trimester, fluid is produced by the placenta. c. The fluid decreases in volume until 34 weeks’ gestation. d. The fetus gains two thirds of its weight during the first two trimesters.

ANS: B In early pregnancy, the amniotic fluid is produced by the placenta.

PTS: 1 REF: p. 1168 OBJ: List fetal anatomy visualization required as part of the standard second-trimester

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank examination.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 8. Which one of the following statements about determining fetal age is false? a. Measure the head circumference at the same level as the biparietal diameter (BPD). b. Measure the abdominal circumference at the level of junction of the umbilical vein and portal sinus. c. Measure the femur length on the femur farthest from the transducer. d. Measure BPD in the axial plane that includes the thalamus and cavum septum pellucidum.

ANS: C The femoral shaft should be measured perpendicular to the sound beam.

PTS: 1 REF: pp. 1168-1169 OBJ: Describe the steps of the first-, second-, and third-trimester sonography protocols.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 9. The dates established by sonography examinations performed in the second trimester typically take precedence over the menstrual age when the discrepancy is greater than _______ days. a. 5 b. 7 c. 10 NURSINGTB.COM d. 15 ANS: C The dates established by sonography examination performed in the second trimester take precedence over the menstrual age when the discrepancy is greater than 10 days.

PTS: 1 REF: p. 1165 OBJ: Recount important questions to ask the patient before beginning the obstetric sonography examination.

TOP: Patient history 10. The most accurate measurement of gestational age during the first trimester is which one of the following? a. Mean sac diameter b. Yolk sac diameter c. Biparietal diameter d. Crown-rump length ANS: D The crown-rump length is the most accurate measurement of gestational age during the first trimester.

PTS: 1 REF: p. 1168 OBJ: Describe the steps of the first-, second-, and third-trimester sonography protocols.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 11. Fetal anatomy may be adequately assessed after ______ weeks’ gestation. a. 14 b. 16 c. 18 d. 21 ANS: C Fetal anatomy may be adequately assessed after 18 weeks’ gestation.

PTS: 1 REF: p. 1169 OBJ: List fetal anatomy visualization required as part of the standard second-trimester examination.

TOP: Types of obstetric sonography examinations 12. On transabdominal imaging, an overdistended bladder may give a false impression of which one of the following? a. Incompetent cervix b. Placenta previa c. Fetal position d. Fetal size ANS: B An overdistended bladder or uterine contraction can give a false impression of placenta previa.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1168 OBJ: Discuss the use of sonography as a diagnostic and screening tool.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 13. In the second trimester, guidelines recommend images of the fetal head including all of the following except: a. Sylvian fissure. b. lateral cerebral ventricles. c. cerebellum. d. midline falx.

ANS: A Images of the fetal head should include the cerebellum, choroid plexus, cisterna magna, lateral cerebral ventricles, midline falx, and cavum septum pellucidi.

PTS: 1 REF: p. 1169 OBJ: List fetal anatomy visualization required as part of the standard second-trimester examination.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 14. The abdominal circumference on a transverse view is measured at the level of all the following structures except: a. portal sinus. b. fetal stomach. c. fetal kidneys. d. umbilical vein.

ANS: C The abdominal circumference is measured where the portal sinus, fetal stomach, and umbilical vein are visible in the transverse plane.

PTS: 1 REF: p. 1169 OBJ: List fetal anatomy visualization required as part of the standard second-trimester examination.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 15. Interval fetal growth may be determined by sonographic measurements a minimum of ______ weeks apart. a. 1 b. 2 c. 3 d. 5 ANS: C Interval fetal growth can be determined with ultrasound examinations a minimum of 3 weeks apart.

NURSINGTB.COM

PTS: 1 REF: p. 1169 OBJ: Describe the steps of the first-, second-, and third-trimester sonography protocols.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations 16. Even with a known menstrual date, conception may occur from day _____ to day _____. a. 1; 15 b. 6; 27 c. 10; 18 d. 15; 27 ANS: B Even with a known menstrual date, conception may occur from day 6 to day 27.

PTS: 1 REF: p. 1165 OBJ: Recount important questions to ask the patient before beginning the obstetric sonography examination.

TOP: Patient history 17. The second trimester is between ___________ gestational weeks. a. 12 and 21 b. 12 and 28 c. 14 and 26

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. 15 and 30 ANS: C The second trimester is between 14 and 26 gestational weeks.

PTS: 1 REF: p. 1165 OBJ: Discuss the use of sonography as a diagnostic and screening tool.

TOP: Patient history 18. The major biologic effects of ultrasound are believed to be which one of the following? a. Thermal b. Production and collapse of gas-filled bubbles c. Cavitation d. All of the above ANS: D The major biologic effects of ultrasound are believed to be thermal (rise of temperature) and cavitation (production and collapse of gas-filled bubbles).

PTS: 1 REF: p. 1166 OBJ: Describe the biologic effects of diagnostic medical ultrasound energy and related patient safety.

TOP: Safety of ultrasound 19. A sonographer can minimize thermal effects by which one of the following? a. Not staying in one spot b. Placing the focus of the beam in the near field c. Scanning over fetal bone NURSINGTB.COM d. Increasing acoustic output ANS: A Sonographers can minimize thermal effects by not staying in one spot, especially over fetal bone for long periods and extending the focus deep into the body.

PTS: 1 REF: p. 1166 OBJ: Describe the biologic effects of diagnostic medical ultrasound energy and related patient safety.

TOP: Safety of ultrasound 20. Which one of the following statements about ultrasound safety is true? a. No potential biologic effects exist. b. The energy produced by ultrasound machines today is lower than that produced by earlier equipment. c. Continual research on the bioeffects of ultrasound is no longer necessary. d. Studies on the bioeffects of ultrasound are not definitive.

ANS: D Studies of the bioeffects of ultrasound are not definitive, and continued research is essential.

In addition, theoretic effects of ultrasound energy exist for the fetus, and potential bioeffects are possible.

PTS: 1 REF: p. 1166 OBJ: Describe the biologic effects of diagnostic medical ultrasound energy and related

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank patient safety.

TOP: Safety of ultrasound

21. When is the nuchal translucency examination performed? a. During the first trimester b. During the second trimester c. During the third trimester d. Throughout pregnancy ANS: A The first-trimester risk assessment examination, nuchal translucency examination, is performed only when women choose first-trimester screening tests for aneuploidy.

PTS: 1 REF: p. 1168 OBJ: Discuss the indications for obstetric examinations.

TOP: Types of obstetric sonography examinations 22. Diagnostic ultrasound has been in use since late in which one of the following decades? a. 1940s b. 1950s c. 1960s d. 1970s ANS: B Diagnostic ultrasound has been in use since the late 1950s.

PTS: 1 REF: p. 1166 OBJ: Describe the biologic effects of diagnostic medical ultrasound energy and related N RSINofGultrasound TB.COM patient safety.

TOP: USafety 23. Fetal sonography with or without Doppler should be performed: a. on all second-trimester pregnancies. b. on all first-trimester pregnancies. c. with a valid medical reason. d. for sex determination.

ANS: C Fetal sonography with or without Doppler should be performed with a valid medical reason.

The lowest exposure settings should be used to obtain necessary diagnostic information.

PTS: 1 REF: p. 1167 OBJ: Describe the biologic effects of diagnostic medical ultrasound energy and related patient safety.

TOP: Safety of ultrasound 24. The purpose for certification in diagnostic sonography is to assure the public that the sonographer has which one of the following? a. Necessary knowledge to perform the examination b. Necessary skills to perform the examination c. Necessary experience to perform the examination d. All of the above ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The purpose for certification in diagnostic sonography is to assure the public that the sonographer has the necessary knowledge, skills, and experience to perform the examination.

PTS: 1 REF: p. 1167 OBJ: Discuss the use of sonography as a diagnostic and screening tool.

TOP: Guidelines for First-Trimester and Standard Second- and Third-Trimester Obstetric Sonography Examinations

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 48: Clinical Ethics for Obstetric Sonography Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following terms means matters that concern right and wrong conduct? a. Morality b. Ethics c. Integrity d. Beneficence ANS: A Morality means matters that concerns right and wrong conduct and good and bad character.

PTS: 1 REF: p. 1171 OBJ: Identify multiple sources of moral beliefs in a pluralistic society.

TOP: Morality and ethics defined 2. Which one of the following terms refers to a person’s capacity to formulate, express, and carry out value-based preferences? a. Primum non-nocere b. Beneficence c. Nonmaleficence d. Autonomy ANS: D NURS INGTB.COfreedom M Autonomy is the self-governing or self-directing to choose and have one’s choices respected.

PTS: 1 REF: p. 1173 OBJ: Identify multiple sources of moral beliefs in a pluralistic society.

TOP: Morality and ethics defined 3. Which one of the following describes the duty of a health care professional to protect the privacy of patient information? a. Integrity b. Morality c. Ethics d. Confidentiality ANS: D Confidentiality is the duty of the health care professional to protect and respect a patient’s privacy.

PTS: 1 REF: p. 1175 OBJ: Identify ethical issues in the confidentiality of findings.

TOP: Confidentiality of findings

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. Which one of the following is the physiologic phenomenon involving the central nervous system processing tissue damage? a. Suffering b. Pain c. Nonmaleficence d. Ethics ANS: B Pain is a physiologic phenomenon involving the central nervous system processing tissue damage.

PTS: 1 REF: p. 1173 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 5. Western medicine uses which one of the following principles to know what is in the clinical interest of the patient? a. Ethics b. Morality c. Primum non-nocere d. Integrity ANS: C Primum non-nocere (“First, do no harm.”) emphasizes choosing a treatment based on the best benefit to the patient.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1172 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: History of medical ethics 6. Which one of the following goals seeks a greater balance of clinical “goods” over clinical “harms?” a. Beneficence b. Fiduciary c. Pain d. Autonomy ANS: A Beneficence is the goal of seeking a greater balance of clinical “goods” over clinical “harms.”

PTS: 1 REF: p. 1173 OBJ: Define the principle of beneficence in clinical ethics.

TOP: Principles of medical ethics 7. Which one of the following is a psychologic phenomenon involving blocked intentions, plans, and projects? a. Pain

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Suffering c. Psychosis d. Addiction ANS: B Suffering is a psychologic phenomenon involving blocked intentions, plans, and projects.

PTS: 1 REF: p. 1173 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 8. Which one of the following terms refers to honesty? a. Ethics b. Morality c. Integrity d. Autonomy ANS: C In terms of honesty, integrity means no difference exists in what a person says and what he or she does.

PTS: 1 REF: p. 1174 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics

N R I G B.C M

U Sdescribes N T theOkind of person we should become and the 9. Which one of the following terms virtues we should cultivate in doing so? a. Ethics b. Integrity c. Morality d. Autonomy ANS: C Morality reflects duties and values, as well as good and bad characters.

PTS: 1 REF: p. 1171 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 10. A code of ethics for sonographers has been adopted by which one of the following organizations? a. American Registry of Diagnostic Medical Sonography b. Joint Review Committee c. Society of Diagnostic Medical Sonography d. American Medical Association ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The Society of Diagnostic Medical Sonography (SDMS) has adopted a code of ethics for medical sonographers.

PTS: 1 REF: p. 1172 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 11. Which one of the following is the discipline that seeks to articulate clear and practical guidelines for conduct and character? a. Autonomy b. Ethics c. Morality d. Justice ANS: B Ethics is a discipline study that seeks to articulate clear, consistent, coherent, and practical guidelines for conduct and character.

PTS: 1 REF: p. 1172 TOP: Morality and ethics defined

OBJ: Differentiate morality from ethics.

12. Which one of the following emphasizes individual rights and autonomy? a. Morality b. Declaration of Helsinki c. Nuremberg Code d. Hippocratic Oath NURSINGTB.COM ANS: C The Nuremberg Code emphasizes individual rights and autonomy, which has become a key element in modern-day ethics.

PTS: 1 REF: p. 1172 OBJ: Define the principle of respect for autonomy in clinical ethics.

TOP: Morality and ethics defined 13. Which one of the following principles directs the sonographer not to cause harm? a. Nuremberg Code b. Autonomy c. Nonmaleficence d. Beneficence ANS: C The nonmaleficence principle directs the sonographer not to cause harm.

PTS: 1 REF: p. 1172 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Morality and ethics defined

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 14. Informed consent is a(n) ______________-based right. a. autonomy b. morality c. beneficence d. nonmaleficence ANS: A Informed consent is an autonomy-based right.

PTS: 1 REF: p. 1173 OBJ: Define the principle of respect for autonomy in clinical ethics.

TOP: Morality and ethics defined 15. Which one of the following is not an ethical issue? a. Nonmedical use of sonography b. Nonmaleficence c. Family traditions d. Primum non-nocere ANS: C Family tradition is a moral issue.

PTS: 1 REF: p. 1171 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Morality and ethics defined

N R I G B.C M

U aSdetailed N Texplanation O of the examination is an example of 16. The sonographer who provides respecting the patient’s ________________. a. morals b. autonomy c. beneficence d. nonmaleficence ANS: B The sonographer who provides a detailed explanation of the examination is an example of respecting the patient’s autonomy.

PTS: 1 REF: pp. 1173-1174 OBJ: Define the principle of respect for autonomy in clinical ethics.

TOP: Principles of medical ethics 17. Adherence to moral and ethical principles is called which one of the following? a. Veracity b. Morality c. Autonomy d. Integrity ANS: D Integrity is the adherence to moral and ethical principles.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1174 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 18. Which one of the following principles requires the sonographer to read current medical literature to stay abreast of new developments related to patient safety? a. Informed consent b. Nonmaleficence c. Autonomy d. Morality ANS: B The principle of nonmaleficence requires the sonographer to read current medical literature to stay abreast of new developments related to medical sonography.

PTS: 1 REF: p. 1173 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 19. Which one of the following principles encourages sonographers to exceed the minimum standards of protocol and seek additional pertinent images as needed? a. Veracity b. Autonomy c. Beneficence d. Justice NURSINGTB.COM ANS: C The principle of beneficence obligates the sonographer to seek the greatest benefit for the patient.

PTS: 1 REF: p. 1173 OBJ: Define the principle of beneficence in clinical ethics.

TOP: Principles of medical ethics 20. Truthfulness with respect to abilities and limitations is an example of which one of the following? a. Integrity b. Justice c. Nonmaleficence d. Veracity ANS: D Truthfulness with respect to abilities and limitations is an example of veracity.

PTS: 1 REF: p. 1174 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

21. The ethical principle(s) that determine(s) the timing of a routine sonographic examination is (are) which of the following? a. Autonomy b. Veracity c. Justice d. Autonomy and justice ANS: D The information obtained from a sonogram enhances a woman’s choices (autonomy).

Failure to provide these choices to some women and not others is an example of injustice.

PTS: 1 REF: p. 1175 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 22. Which one of the following principles is served when protocols are standardized? a. Confidentiality b. Justice c. Morality d. Beneficence ANS: B Justice is the ethical principle that requires fair distribution of benefits and burdens. Men and women with similar symptoms should receive similar tests and interventions.

N R I G B.C M

S N T O PTS: 1 REF: Up. 1175 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics 23. Which one of the following principles describes the right of self-determination? a. Beneficence b. Nonmaleficence c. Autonomy d. Veracity ANS: C Autonomy, or the right to self-determination, is a key ethical principle.

PTS: 1 REF: p. 1173 OBJ: Define the principle of respect for autonomy in clinical ethics.

TOP: Principles of medical ethics 24. Fetal interests in sonography are understood exclusively in terms of ________________. a. justice b. autonomy c. fiduciary d. beneficence

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: D The sonographer has a beneficence-based obligation to the fetal patient (going to term) to protect and promote both fetal interests and those of the child it will become as understood from a rigorous clinical perspective.

PTS: 1 REF: p. 1173 OBJ: Identify beneficence-based obligations to the fetal patient.

TOP: Principles of medical ethics 25. ALARA is an example of which one of the following ethical principles? a. Justice b. Beneficence c. Nonmaleficence d. Veracity ANS: C Ultrasound energy poses a theoretic risk to the fetus. The principle of nonmaleficence requires sonographers to perform all examinations with ALARA (is as low as reasonably achievable).

PTS: 1 REF: p. 1172 OBJ: Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed.

TOP: Principles of medical ethics

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Chapter 49: The Normal First Trimester Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The cavity in which the fetus exists is called the _________ cavity. a. chorionic b. amniotic c. decidual d. embryonic ANS: B The fetus exists in the amniotic cavity.

PTS: 1 REF: p. 1181 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Sonographic technique and evaluation of the first trimester 2. Which one of the following laboratory tests is used to indicate pregnancy when the values are elevated? a. FSH b. LH c. hCG d. HL

N R I G B.C M

U S N T O ANS: C Serum beta hCG is a hormone secreted by the trophoblastic cells of the blastocyst. When pregnancy exists, the levels are elevated.

PTS: 1 REF: pp. 1178-1179 OBJ: Explain the clinical roles of first-trimester maternal serum biochemistry.

TOP: Maternal serum analysis in early pregnancy 3. Maternal serum hCG levels in a normal intrauterine pregnancy at less than 7 weeks should increase by doubling every _______________. a. 24 hours b. 48 hours c. 3.5 days d. 1 week ANS: C The normal IUP at less than 7 weeks demonstrates a doubling of quantitative maternal serum hCG levels every 3.5 days or an increase of 66% within 48 hours.

PTS: 1 REF: p. 1179 OBJ: Explain the clinical roles of first-trimester maternal serum biochemistry.

TOP: Maternal serum analysis in early pregnancy

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. Which of the following ages refers to the length of time calculated from the first day of the last normal menstrual period to the point at which the pregnancy is being assessed? a. Gestational b. Embryonic c. Menstrual d. Either gestational or menstrual ANS: D Either menstrual or gestational age refers to the length of time calculated from the first day of the last normal menstrual period to the point at which the pregnancy is being assessed.

PTS: 1 REF: p. 1178 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Overview of the first trimester 5. Which one of the following terms refers to a multiple pregnancy within one chorionic sac? a. Monoembryonic b. Dichorionic c. Diamniotic d. Monochorionic ANS: D Monochorionic describes a single chorionic sac.

PTS: 1 REF: p. 1191 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Multiple gestations

NURSINGTB.COM

6. The interface between the decidua capsularis and echogenic vascular endometrium is which one of the following? a. Decidua capsularis b. Decidua basalis c. Double decidual sign d. Chorionic cavity ANS: C A reliable sign for an early intrauterine pregnancy is the double decidual sign. This sign demonstrates the interface between the decidua capsularis and the echogenic vascular endometrium.

PTS: 1 REF: p. 1181 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Multiple gestations 7. The beta hCG levels plateau and subsequently decline, whereas the gestational sac continues to grow, after _________ weeks. a. 3 to 5 b. 6 to 8 c. 9 to 10 d. 10 to 12

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C At 9 to 10 weeks, hCG levels plateau and subsequently decline, whereas the gestational sac continues to grow.

PTS: 1 REF: p. 1180 OBJ: Explain the clinical roles of first-trimester maternal serum biochemistry.

TOP: Maternal serum analysis in early pregnancy 8. The fusion of the chorion and amnion occurs between ________ weeks. a. 9 and 10 b. 11 and 12 c. 14 and 15 d. 20 and 21 ANS: C Chorioamniotic fusion occurs at between 14 and 15 weeks of gestation.

PTS: 1 REF: p. 1183 OBJ: Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac. TOP: Sonographic technique and evaluation of the first trimester 9. The embryonic heart begins to beat at __________ days. a. 23 b. 35 c. 43 d. 49

N R I G B.C M

U S N T O ANS: B The embryonic heart begins to beat at 35 days (5 to 5.5 weeks).

PTS: 1 REF: p. 1187 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Sonographic technique and evaluation of the first trimester 10. With transvaginal ultrasound, an abnormal pregnancy is suspected when visualizing the yolk sac fails with a minimum mean sac diameter (MSD) of ______ millimeters (mm). a. 6 b. 8 c. 10 d. 12 ANS: D Failure to visualize a yolk sac with a minimum of 12 mm MSD using transvaginal scanning should suggest an abnormal pregnancy.

PTS: 1 REF: p. 1182 OBJ: Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac. TOP: Sonographic technique and evaluation of the first trimester

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 11. To calculate the mean sac diameter of a gestational sac, which one of the following formulas should be used? a. Length  width  height b. Length + width + height c. (Length  width  height) ÷ 3 d. (Length + width + height) ÷ 3 ANS: D The formula to calculate the MSD of a gestational sac is (length + width + height) ÷ 3.

PTS: 1 REF: p. 1188 OBJ: Describe the sonographic measurements performed in the first trimester and the goals of first-trimester sonography.

TOP: Determination of gestational age 12. Using a transvaginal approach, the first structure visualized within a gestational sac is which one of the following structures? a. Primary yolk sac b. Secondary yolk sac c. Amnion d. Embryo ANS: B The first structure visualized within a gestational sac is the secondary yolk sac.

PTS: 1 REF: p. 1178 OBJ: Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac. TOP:N Sonographic technique R I G B.C M and evaluation of the first trimester

U S N T

O

13. In the first trimester, herniated bowel will return within the abdominal cavity by the _________ week. a. eighth b. tenth c. twelfth d. fifteenth ANS: C The fetal bowel returns to the abdominal cavity by approximately the eleventh week and should no longer be visualized by the twelfth week.

PTS: 1 REF: p. 1187 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Physiologic herniation of bowel 14. The diameter of the normal yolk sac should never exceed _______ mm. a. 4 b. 6 c. 8 d. 10 ANS: B The normal diameter of the secondary yolk sac should not exceed 5.6 mm in diameter.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1182 OBJ: Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac. TOP: Sonographic technique and evaluation of the first trimester 15. A sonogram at 10 weeks of gestation demonstrates a cystic area within the posterior cranium. This appearance most likely represents which one of the following? a. Abnormal mesencephalon b. Normal rhombencephalon c. Abnormal rhombencephalon d. Normal prosencephalon ANS: B In a 10-week fetus, the normal rhombencephalon routinely images as a cystic area within the posterior cranium.

PTS: 1 REF: p. 1184 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Sonographic technique and evaluation of the first trimester 16. Transvaginal imaging of the female pelvis uses which of the following planes? a. Sagittal and coronal b. Coronal and transverse c. Sagittal and transverse d. Sagittal only

N R I G B.C M

U S N T O ANS: A With transvaginal transducers, the pelvic anatomy is imaged in the sagittal and coronal and semicoronal imaging planes. The coronal image should not be misconstrued as a transverse section.

PTS: 1 REF: p. 1180 OBJ: Describe the sonographic measurements performed in the first trimester and the goals of first-trimester sonography.

TOP: Sonographic technique and evaluation of the first trimester 17. Typically, the yolk sac resorbs and is no longer visible sonographically by _______ weeks. a. 8 b. 10 c. 12 d. 14 ANS: C Typically, the yolk sac resorbs and is no longer sonographically visible by 12 weeks of gestation.

PTS: 1 REF: p. 1182 OBJ: Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac. TOP: Sonographic technique and evaluation of the first trimester

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

18. After fertilization of the ovum, the corpus luteum begins to secrete which of the following hormones? a. Estrogen only b. Progesterone only c. Progesterone with some estrogen d. Estrogen with some progesterone ANS: C The corpus luteum secretes progesterone with some estrogen.

PTS: 1 REF: p. 1178 OBJ: Explain the clinical roles of first-trimester maternal serum biochemistry.

TOP: Overview of the first trimester 19. The blastocyst typically enters the uterus ___________ days after fertilization. a. 1 to 2 b. 2 to 3 c. 4 to 5 d. 7 to 9 ANS: C The blastocyst typically enters the uterus 4 to 5 days after fertilization.

PTS: 1 REF: p. 1178 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Overview of the first trimester

NURSINGTB.COM

20. Implantation of the blastocyst into the uterine decidua is completed within _______ days after fertilization. a. 2 b. 5 c. 10 d. 12 ANS: D Implantation of the blastocyst into the uterine decidua is completed within 12 days after fertilization.

PTS: 1 REF: p. 1178 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Overview of the first trimester 21. In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG level is _________ mega international units per milliliter (mIU/ml). a. 500 b. 1800 c. 2500 d. 3000 ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank In transabdominal scanning, a normal gestational sac can be consistently demonstrated when the beta hCG level is 3000 mIU/ml or greater (Second International Standard).

PTS: 1 REF: p. 1179 OBJ: Explain the clinical roles of first-trimester maternal serum biochemistry.

TOP: Maternal serum analysis in early pregnancy 22. The anechoic center of a 5- to 6-week gestational sac represents which one of the following? a. Amniotic cavity b. Chorionic cavity c. Decidual reaction d. Primary yolk sac ANS: B The anechoic center of a 5- to 6-week gestational sac represents the chorionic cavity.

PTS: 1 REF: p. 1181 OBJ: Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac. TOP: Sonographic technique and evaluation of the first trimester 23. The villi on the myometrial side of the conceptus are known as which one of the following? a. Double decidual sign b. Decidua basalis c. Decidua capsularis d. Chorion laeve ANS: B NUR M SINGTB.C The villi on the myometrial or burrowing side ofOthe conceptus are known as the decidua basalis.

PTS: 1 REF: p. 1181 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Sonographic technique and evaluation of the first trimester 24. In early pregnancy, the gestational sac size grows at a rate of _____ mm/day. a. 0.5 b. 1 c. 2 d. 2.5 ANS: B In early pregnancy, the gestational sac size grows at a rate of 1 mm/day (ranging from 0.7 to 1.5 mm/day).

PTS: 1 REF: p. 1181 OBJ: Describe the early development of the embryo and its sonographic appearances at different gestational ages.

TOP: Sonographic technique and evaluation of the first trimester

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 25. The crown-rump length measurement may be used up through the ______ gestational week. a. tenth b. eleventh c. twelfth d. thirteenth ANS: C The crown-rump length measurement may be used up through the twelfth gestational week.

PTS: 1 REF: p. 1189 OBJ: Describe the sonographic measurements performed in the first trimester and the goals of first-trimester sonography.

TOP: Determination of gestational age

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 50: First-Trimester Complications Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Transvaginally, an embryo with cardiac activity should be identified when the gestational sac

measures ____________ millimeters (mm). a. 5 to 8 b. 8 to 12 c. 10 to 15 d. 16 to 20 ANS: D

When the gestational sac measures 16 to 20 mm or greater, an embryo with cardiac activity should be observed.

PTS: 1 REF: p. 1198 OBJ: Discuss the normal range for fetal cardiac rhythm.

TOP: First-trimester bleeding and sonographic appearances 2. Which one of the following is the most frequent sonographic finding in an ectopic pregnancy? a. Extrauterine gestation with heart motion b. Adnexal mass c. Echogenic free fluid in the Morison’s pouch d. Pseudogestational sac ANS: B

The identification of an adnexal mass isG the most O frequent sonographic finding in an ectopic NUR M SIN TB.C pregnancy.

PTS: 1 REF: p. 1203 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy 3. Which one of the following is the most common pelvic mass seen in a first-trimester

pregnancy? a. Ovarian dermoid b. Ectopic pregnancy c. Fibroid d. Corpus luteum cyst ANS: D

The corpus luteum cyst is by far the most common mass in a first-trimester pregnancy.

PTS: 1 REF: p. 1213 OBJ: Differentiate between a hemorrhagic corpus luteum cyst and a dermoid.

TOP: First-trimester pelvic masses 4. An ovum without an embryo is known as which one of the following? a. Anembryonic pregnancy b. Diamniotic pregnancy c. Ectopic pregnancy

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Pseudogestational sac ANS: A

Anembryonic pregnancy or “blighted ovum” is an intrauterine gestational sac in which an embryo does not develop.

PTS: 1 REF: p. 1195 OBJ: List other types of abnormal pregnancies.

TOP: First-trimester bleeding and sonographic appearances 5. A congenital fissure that remains open past 12 weeks in the wall of the abdomen just to the

right of the umbilical cord is called which one of the following? a. Umbilical hernia b. Gastroschisis c. Omphalocele d. Midgut herniation ANS: B

A congenital fissure that remains open past 12 weeks in the wall of the abdomen just to the right of the umbilical cord is called gastroschisis. Other organs may protrude outside the abdomen from this opening.

PTS: 1 REF: p. 1211 OBJ: Distinguish among normal bowel herniation and gastroschisis and omphalocele.

TOP: Diagnosis of Embryonic Abnormalities in the First Trimester 6. Cranial anatomy is routinely visualized after how many gestational weeks? a. 8 to 10 b. 9 to 11 NURSINGTB.COM c. 10 to 12 d. 12 to 14 ANS: D

Cranial anatomy is routinely visualized after 12 to 14 gestational weeks. Repeating a previous examination should be scheduled at this time to confirm any earlier suspicion of a cranial abnormality.

PTS: 1 REF: p. 1209 OBJ: Describe the cranial abnormalities seen in the first-trimester pregnancy.

TOP: Diagnosis of Embryonic Abnormalities in the First Trimester 7. A partial absence of the cranium is called which one of the following abnormalities? a. Iniencephaly b. Anencephaly c. Acrania d. Osteogenesis imperfecta ANS: C

Acrania is the partial or complete absence of the cranium. It is believed to be a predecessor of anencephaly.

PTS: 1 REF: p. 1209 OBJ: Describe the cranial abnormalities seen in the first-trimester pregnancy.

TOP: Diagnosis of Embryonic Abnormalities in the First Trimester

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

8. Which one of the following abnormalities is most commonly associated with cystic hygroma? a. Spina bifida b. Beckwith-Wiedemann syndrome c. Turner syndrome d. Dandy-Walker malformation ANS: C

Turner syndrome is the most common karyotype abnormality associated with cystic hygroma.

PTS: 1 REF: p. 1212 OBJ: Discuss the sonographic findings with cystic hygroma.

TOP: Diagnosis of Embryonic Abnormalities in the First Trimester 9. Multiple tiny clusters of grapelike echoes within the uterine cavity best describes which one

of the following? a. Pseudogestational sacs b. Ectopic pregnancy c. Incomplete abortion d. Gestational trophoblastic disease ANS: D

On sonography, gestational trophoblastic disease (molar) is characterized by a large uterus filled with a heterogeneous complex pattern (grapelike).

PTS: 1 REF: p. 1199 OBJ: List other types of abnormal pregnancies.

TOP: Diagnosis of Embryonic Abnormalities in the First Trimester

N R I G B.C M

N T sacOand the myometrium represents which one 10. A hemorrhage located betweenUtheSgestational of the following conditions? a. Placenta abruption b. Subchorionic hemorrhage c. Placental hematoma d. Placental lake ANS: B

A hemorrhage located between the gestational sac and the myometrium represents a subchorionic hemorrhage.

PTS: 1 REF: p. 1195 OBJ: List other types of abnormal pregnancies.

TOP: First-trimester bleeding and sonographic appearances 11. Corpus luteum cysts regress and are typically not seen beyond _________ weeks. a. 10 to 12 b. 12 to 14 c. 16 to 18 d. 18 to 20 ANS: C

Corpus luteum cysts regress and are typically not seen beyond 16 to 18 weeks.

PTS: 1

REF: p. 1213

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Differentiate between a hemorrhagic corpus luteum cyst and a dermoid.

TOP: First-trimester pelvic masses 12. An ectopic pregnancy most commonly occurs in which one of the following structures? a. Ovary b. Fallopian tube c. Cornua d. Cervix ANS: B

An ectopic pregnancy occurs in the fallopian tube in approximately 95% of patients.

PTS: 1 REF: p. 1202 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy 13. The increased risk of massive hemorrhage in an ectopic pregnancy is located: a. within the adnexa. b. within the peritoneum. c. near the uterine cornua. d. within the ovary.

ANS: C

When an ectopic pregnancy is located in the interstitial portion of the fallopian tube near the uterine cornua, an increased risk of massive hemorrhage exists, which may lead to hysterectomy or even death.

PTS: 1 REF: p. 1202 NURSINGfindings TB.COinMan ectopic pregnancy.

OBJ: Describe the clinical and sonographic TOP: Ectopic pregnancy 14. Findings in an ectopic pregnancy include all of the following except: a. no evidence of intrauterine pregnancy. b. adnexal mass. c. intraperitoneal fluid. d. normal increase in serum beta hCG levels.

ANS: D

The serum beta hCG levels in an ectopic pregnancy do not increase as they do in a normal pregnancy.

PTS: 1 REF: p. 1204 | p. 1206 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy 15. Which one of the following statements about a pseudogestational sac is false? a. It does not contain a yolk sac. b. It contains low-level internal echoes. c. It is eccentrically located within the endometrium. d. It demonstrates a high resistive spectral waveform.

ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank A pseudogestational sac is centrally located within the endometrium, does not contain a yolk sac, and demonstrates internal echoes and a high resistive spectral waveform.

PTS: 1 REF: p. 1203 OBJ: List other types of abnormal pregnancies.

TOP: First-trimester bleeding and sonographic appearances 16. The best sonographic correlation in the diagnosis of an ectopic pregnancy is the combination

of no intrauterine pregnancy and which one of the following? a. Adnexal mass b. Complex endometrium c. Ovarian mass d. Anechoic cul-de-sac fluid ANS: A

A combination of free fluid and an adnexal mass is the best correlation in the diagnosis of an ectopic pregnancy. Echogenic free fluid correlates with a 92% risk of an ectopic pregnancy.

PTS: 1 REF: p. 1204 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy 17. An increased risk of a complete hysterectomy is present when an ectopic pregnancy is located

in which one of the following structures? a. Peritoneum b. Cervix c. Fallopian tube d. Adnexa ANS: B

NURSINGTB.COM

An increased risk of a complete hysterectomy exists when an ectopic pregnancy is located in the uterine cervix.

PTS: 1 REF: p. 1207 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy 18. The most common cause of vaginal bleeding in the first trimester is which one of the

following? a. Placenta previa b. Subchorionic hemorrhage c. Ectopic pregnancy d. Missed abortion ANS: B

Subchorionic hemorrhage is the most common cause of vaginal bleeding in the first trimester.

PTS: 1 REF: p. 1195 OBJ: Explain the clinical and sonographic findings in ectopic pregnancy.

TOP: Ectopic pregnancy 19. Embryos with heart rates below ______ beats per minute (bpm) generally have a poor

prognosis.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

90 100 105 110

ANS: A

Embryos with cardiac rates of less than 90 bpm have a poor prognosis.

PTS: 1 REF: p. 1201 OBJ: Discuss the normal range for fetal cardiac rhythm.

TOP: Abnormal or Absent Cardiac Activity 20. The most potentially life-threatening ectopic gestation is which one of the following? a. Cervical b. Interstitial c. Ovarian d. Peritoneal ANS: B

The interstitial or cornual pregnancy is potentially the most life-threatening ectopic gestation.

PTS: 1 REF: p. 1202 | p. 1207 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy 21. Nuchal translucency must be measured between _____ weeks and _____ weeks, _____ days. a. 8; 10; 6 b. 10; 12; 6 c. 11; 13; 6 NURSINGTB.COM d. 12; 13; 6 ANS: C

Nuchal translucency must be measured between 11 weeks and 13 weeks, 6 days.

PTS: 1 REF: p. 1208 OBJ: Describe the cranial abnormalities seen in the first-trimester pregnancy.

TOP: Diagnosis of Embryonic Abnormalities in the First Trimester 22. A gestational sac in which the embryo fails to develop is described as which one of the

following? a. Blighted ovum b. Missed abortion c. Anembryonic pregnancy d. Blighted ovum or anembryonic pregnancy ANS: D

By definition, anembryonic pregnancy or blighted ovum demonstrates a gestational sac in which the embryo fails to develop.

PTS: 1 REF: p. 1198 OBJ: List other types of abnormal pregnancies.

TOP: First-trimester bleeding and sonographic appearances 23. The serum level of beta hCG is __________________ with gestational trophoblastic disease. a. dramatically elevated

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. mildly elevated c. mildly decreased d. dramatically decreased ANS: A

The serum level of beta hCG with gestational trophoblastic disease is dramatically elevated, often greater than 100,000 IU/ml.

PTS: 1 REF: p. 1198 OBJ: List other types of abnormal pregnancies.

TOP: First-trimester bleeding and sonographic appearances 24. A heterotopic pregnancy is which one of the following? a. A form of abdominal pregnancy b. Simultaneous intrauterine and extrauterine pregnancies c. Twin intrauterine pregnancy with only one viable embryo d. Bilateral ectopic pregnancies ANS: B

A heterotopic pregnancy is simultaneous intrauterine and extrauterine pregnancies.

PTS: 1 REF: p. 1204 OBJ: Describe the clinical and sonographic findings in an ectopic pregnancy.

TOP: Ectopic pregnancy

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 51: Sonography of the Second and Third Trimesters Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following structures carries oxygenated blood from the umbilical vein to the

inferior vena cava (IVC)? a. Foramen ovale b. Ductus arteriosus c. Ligamentous venous d. Ductus venosus ANS: D

The ductus venosus carries oxygenated blood from the umbilical vein to the IVC, which empties into the right atrium of the heart.

PTS: 1 REF: p. 1237 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: Fetal circulation 2. Which one of the following terms indicates that the fetal head is toward the fundus of the

uterus? a. Vertex b. Cephalic c. Breech d. Fundal ANS: C

NURSINGTB.COM

Breech presentation indicates that the fetal head is visualized in the uterine fundus and the lower extremities or buttocks are found in the lower uterine segment.

PTS: 1 REF: p. 1220 OBJ: Define the terminology specific to fetal presentation.

TOP: Fetal presentation

3. At what gestational week does the volume of amniotic fluid stop increasing? a. 28th b. 30th c. 32nd d. 34th ANS: D

The volume of amniotic fluid increases until 34 weeks of gestation.

PTS: 1 REF: p. 1249 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: The amniotic fluid 4. Which one of the following indicates that the liver is on the right, the stomach is on the left,

and the heart apex is on the left? a. Normal situs b. Situs inversus

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Dextrocardia d. Mesocardia ANS: A

Normal situs is the typical position of the abdominal organs with the liver and IVC on the right, the stomach on the left, and the apex of the heart directed toward the left.

PTS: 1 REF: pp. 1200-1221 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: Situs 5. The widest transverse diameter of the skull and the proper level to measure the biparietal

diameter (BPD) includes which one of the following structures? a. Peduncles b. Fourth ventricle c. Thalamus d. Corpus callosum ANS: C

The cavum septum pellucidum, falx cerebri, thalamus, and ambient cistern are structures located at the level of the widest transverse diameter.

PTS: 1 REF: p. 1224 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters 6. The three vessels found in the umbilical cord are which of the following? a. One artery and two veins N R I G B.COM b. Two arteries and one vein U S N T c. One artery, one vein, and one portal vein d. Hepatic vein, portal vein, and umbilical vein ANS: B

The normal human umbilical cord contains an umbilical vein and two umbilical arteries.

PTS: 1 REF: p. 1247 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: Extrafetal Obstetric Evaluation 7. Normally, the fetal bladder empties at least every ______________. a. 10 minutes b. 15 minutes c. 3 hours d. 60 minutes ANS: D

A fetus bladder generally voids at least once every hour.

PTS: 1 REF: p. 1242 OBJ: Describe normal fetal anatomy visualized in an obstetrical sonography examination and variations that may be significant.

TOP: The urinary system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. Because of the low-density brain tissue, the texture of the brain may appear ______________. a. hyperechoic b. hypoechoic c. inhomogeneous d. echogenic ANS: B

Fetal brain tissue may appear hypoechoic or cystic because of the low-density brain tissue.

PTS: 1 REF: p. 1222 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters 9. The cranial bones ossify by ______ weeks of gestation. a. 12 b. 14 c. 16 d. 18 ANS: A

By 12 weeks of gestation, the cranial bones calcify.

PTS: 1 REF: p. 1221 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: Fetal anatomy of the second and third trimesters 10. The cerebrospinal fluid (CSF) travels from the lateral ventricles to the third ventricle via

N R I GTB.COM

U S N which one of the following structures? a. Foramina of Luschka b. Foramen of Monro c. Aqueduct of Sylvius d. Foramina of Magendie ANS: B

From the lateral ventricle, the CSF travels to the third ventricle through the foramen of Monro.

PTS: 1 REF: p. 1222 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: Fetal anatomy of the second and third trimesters 11. The cavum septum pellucidi is observed anterior to the _______________. a. peduncles b. cerebellum c. thalamus d. corpus callosum ANS: C

In the same scanning plane, the cavum septum pellucidi is observed anterior to the thalamus.

PTS: 1

REF: p. 1224

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters 12. The profile view of the fetal face is important to examine to rule out all of the following

abnormalities except: a. frontal bossing. b. micrognathia. c. cephalocele. d. cleft soft palate.

ANS: D

A profile of the fetal face would not visualize the soft palate to rule out a cleft soft palate.

PTS: 1 REF: pp. 1226-1227 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters 13. Fetal anatomy may be assessed accurately after _________________. a. 16 gestational weeks b. 16 embryonic weeks c. 18 menstrual weeks d. None of the above ANS: C

Fetal anatomy may be accurately assessed after 18 menstrual (gestational) weeks, although structures may be less than optimal with the maternal body habitus, fetal movement or position, and fluid quantity. Structures may be seen earlier in many pregnancies.

N R I G B.C M

U S N T O PTS: 1 REF: p. 1216 OBJ: Specify the equipment and policies required for facilities performing obstetric sonography.

TOP: Introduction | Key Pearls 14. Especially in the third trimester, a fetus in the breech position may demonstrate a cranium

shape of which one of the following? a. Brachycephalic b. Cloverleaf c. Dolichocephalic d. Fetal position does not change the head shape.

ANS: C

With the fetus in a breech presentation (especially in the third trimester), the shape of the head may appear elongated (dolichocephalic).

PTS: 1 REF: p. 1220 OBJ: Define the terminology specific to fetal presentation.

TOP: Initial Steps and Examination Overview 15. In the transverse plane, an abnormal fetal spine may appear splayed in all of the following

configurations except: a. V-shaped. b. Y-shaped. c. C-shaped.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. U-shaped.

ANS: B

The pedicles of the spine appear splayed in a V-, C-, or U-shaped configuration.

PTS: 1 REF: p. 1231 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters 16. When evaluating the fetal spine, aligning the transducer in a(n) ___________ axis to the

spinal elements is important. a. perpendicular b. parallel c. oblique d. coronal ANS: A

When evaluating the fetal spine, aligning the transducer in a perpendicular axis to the spinal elements is important.

PTS: 1 REF: p. 1231 OBJ: Describe the sonographic techniques used to image specific fetal structures.

TOP: Initial Steps and Examination Overview 17. Which one of the following structures shunts blood away from the lungs? a. Pulmonary vein b. Ductus venosus c. Ductus arteriosus NURSINGTB.COM d. Aorta ANS: C

The ductus arteriosus shunts blood away from the lungs.

PTS: 1 REF: p. 1237 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal circulation 18. The presentation of a fetus lying perpendicular to the maternal sagittal axis is in the

____________ position. a. vertex b. oblique c. transverse d. breech ANS: C

The transverse position indicates that the fetus is lying horizontal or perpendicular to the maternal sagittal axis.

PTS: 1 REF: p. 1218 OBJ: Define the terminology specific to fetal presentation.

TOP: Fetal presentation

19. Which one of the following statements about the fetal liver is false? a. The fetal liver is the main storage site for glucose.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. The texture of the fetal liver appears pebble gray. c. The fetal liver is very sensitive to disturbances in growth. d. The right lobe is larger than the left lobe in the fetal liver.

ANS: D

The left lobe of the liver is larger than the right lobe because of the large quantity of oxygenated blood flowing through the left lobe.

PTS: 1 REF: pp. 1238-1239 OBJ: List the components of a standard obstetrics examination in the second and third trimesters, and describe the fetal anatomy recommended for review.

TOP: The Hepatobiliary System and Upper Abdomen 20. Beyond 30 weeks of gestation, a renal pelvis is considered abnormal when measuring greater

than _____ millimeters (mm). a. 4 b. 6 c. 8 d. 10 ANS: D

A renal pelvis that measures greater than 5 mm before 20 weeks, 8 mm between 20 and 30 weeks, and 10 mm beyond 30 weeks of gestation is considered abnormal.

PTS: 1 REF: p. 1240 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: The urinary system

N R I G B.C M

U Sepiphysis N T signifies O a gestational age beyond: 21. Visualization of the distal femoral a. 28 to 30 weeks. b. 31 to 33 weeks. c. 33 to 35 weeks. d. All of the above ANS: C

The distal femoral epiphysis is seen within the cartilage at the knee and signifies a gestational age beyond 33 to 35 weeks.

PTS: 1 REF: p. 1246 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Upper and lower extremities 22. Dilation of the entire ventricular system, including the fourth ventricle, is associated with

which one of the following abnormalities? a. Aqueductal stenosis b. Spinal defects c. Cardiac defects d. Foramen Monro stenosis ANS: B

Dilation of the entire ventricular system, including the fourth ventricle, is associated with spinal defects. Aqueductal stenosis results in excess fluid in the lateral and third ventricles.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1223 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: The cranium 23. The normal atrium of the lateral ventricle measures ______ mm. a. 6.5 b. 8 c. 10 d. 11 ANS: A

The normal atrium of the lateral ventricle measures 6.5 mm and is considered abnormal when it exceeds 10 mm.

PTS: 1 REF: p. 1224 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters 24. The size of the cistern magna is obtained by measuring from the _____________ to the

______________. a. cerebellar lobe; skin line b. vermis; skin line c. cerebellar lobe; occipital bone d. vermis; occipital bone ANS: D

Determining the size of the cistern magna is obtained by measuring from the vermis to the N RSINGTB.COM inner skull table of the occipitalUbone.

PTS: 1 REF: p. 1226 OBJ: Describe the normal anatomy visualized in an obstetric sonography examination and the variations that may be significant.

TOP: Fetal anatomy of the second and third trimesters

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 52: Obstetric Measurements and Gestational Age Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The abdominal circumference (AC) is taken at the ________________________. a. diameter of the fetal abdomen b. level of the stomach, left portal vein, and left umbilical vein c. diameter of the fetal abdomen at the level of the kidneys and diaphragm d. level of the kidneys and bladder ANS: B

The AC is taken at the level of the stomach, left portal vein, and left umbilical vein.

PTS: 1 REF: p. 1260 OBJ: Measure, calculate the biparietal diameter, head circumference, 3D cranium, abdominal circumference, and extremity measurements.

TOP: Abdominal circumference 2. Which one of the following sonographic signs refers to the shape of the cerebellum when a

spinal defect is present? a. Sandwich b. Strawberry c. Banana d. Lemon ANS: C

The banana sign refers to an N abnormally (banana shaped) in the presence RSINGshaped B.Ccerebellum M U T O of spina bifida.

PTS: 1 REF: p. 1266 OBJ: Describe when other measurements should be used to provide additional clinical information.

TOP: Other parameters 3. The biparietal diameter (BPD) is the measurement of the fetal head at the level of which of the

following structures? a. Thalamus and cavum septum pellucidum (CSP) b. Frontal horns and third ventricle c. Peduncles and septum pellucidum d. Thalamus and fourth ventricle ANS: A

The BPD should be measured perpendicular to the fetal skull at the level of the CSP and thalamus.

PTS: 1 REF: p. 1257 OBJ: Measure, calculate the biparietal diameter, head circumference, 3D cranium, abdominal circumference, and extremity measurements.

TOP: Gestational Age Assessment: Second and Third Trimesters 4. The condition that shows the fetal head elongated in the transverse diameter and shortened in

the anteroposterior diameter is known as which one of the following?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Dolichocephaly Elongichocephaly Brachycephaly Minicephaly

ANS: C

A brachycephalic-shaped head is elongated in the transverse diameter and shortened in the anteroposterior diameter.

PTS: 1 REF: p. 1259 OBJ: Measure, calculate the biparietal diameter, head circumference, 3D cranium, abdominal circumference, and extremity measurements.

TOP: Cephalic index 5. Which one of the following measurements is the most accurate for determining gestational

age in the first trimester? a. Crown-rump length (CRL) b. BPD c. MSD d. Yolk sac diameter ANS: A

The proper CRL measurement is the most accurate in estimating gestational age.

PTS: 1 REF: p. 1255 OBJ: Describe how to perform a crown-rump measurement and evaluate growth.

TOP: Crown rump length 6. The plane used for a coronal head circumference (CHC) should include which of the

N R I G B.COM

U S N T following structures? a. CSP and falx cerebri b. Third ventricle and brainstem c. Thalamus and brainstem d. Atrium of the lateral ventricle and thalamus ANS: C

The CHC should include the thalamus and brainstem.

PTS: 1 REF: p. 1260 OBJ: Measure, calculate the biparietal diameter, head circumference, 3D cranium, abdominal circumference, and extremity measurements.

TOP: Gestational Age Assessment: Second and Third Trimesters 7. When measuring the gestational sac, all of the following statements are true except: a. a distended urinary bladder can compress the sac from round to ovoid. b. if the sac is round, one diameter should be measured. c. if the sac is ovoid, measurements cannot be obtained. d. if the sac is ovoid, the anteroposterior and width are measured to obtain mean

diameter.

ANS: C

If the sac is ovoid in shape, two measurements are taken—one transverse and one perpendicular to the length of the sac.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1254 OBJ: Discuss gestational sac growth, take measurements, and assess gestational age.

TOP: Gestational Age Assessment: First Trimester 8. The absence of an embryo in an intrauterine pregnancy of 7 to 8 weeks is consistent with

which one of the following? a. Placenta previa b. Ectopic pregnancy c. Anembryonic pregnancy d. Multiple gestation ANS: C

The absence of an embryo in an intrauterine pregnancy of 7 to 8 menstrual or gestational weeks is consistent with anembryonic pregnancy or blighted ovum.

PTS: 1 REF: p. 1256 OBJ: Describe how to perform a crown-rump measurement and evaluate growth.

TOP: Crown rump length 9. Frontal bones of the cranium that collapse inward describes which one of the following

abnormalities? a. Banana sign b. Lemon sign c. Mickey Mouse sign d. Acrocephaly ANS: B

N R I G B.C M

U Sinward, N T givingO the appearance of a lemon. This The fetal frontal bones can collapse abnormality may be associated with spina bifida.

PTS: 1 REF: p. 1266 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Cerebellum

10. Which one of the following biometric measurements is more useful as a growth parameter? a. BPD b. Head circumference c. CRL d. Abdominal circumference ANS: D

The abdominal circumference (AC) is more useful as a growth parameter than predicting gestational age.

PTS: 1 REF: p. 1260 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Abdominal circumference

11. With normal transvaginal sonography, cardiac activity should be demonstrated when the CRL

exceeds ______ mm. a. 5 b. 6 c. 7

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. 8 ANS: C

Cardiac activity should be seen when the CRL exceeds 7 mm but may be observed with transvaginal sonography at 2-4 mm.

PTS: 1 REF: p. 1256 OBJ: Describe how to perform a crown-rump measurement and evaluate growth.

TOP: Crown rump length 12. Which one of the following measurements is devised to determine the normality of the fetal

head shape? a. Abdominal circumference b. BPD c. Head circumference:abdominal circumference ratio d. Cephalic index ANS: D

The cephalic index is devised to determine the normality of the fetal head shape.

PTS: 1 REF: p. 1259 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Cephalic index

13. Which one of the following fetal measurements is about as accurate as the BPD in

determining gestational age? a. AC b. Head circumference c. Femur length NURSINGTB.COM d. Cephalic index ANS: C

The femur length is about as accurate as the BPD in determining gestational age.

PTS: 1 REF: p. 1261 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Bone lengths

14. The fetal orbits should be measured: a. at the same level as the BPD. b. in a plane slightly caudal to the BPD. c. in a plane slightly cephalic to the BPD. d. in the occipitoanterior position.

ANS: B

The fetal orbits should be measured in a plane slightly caudal to the BPD. The orbits are assessable in every head position except the occipitoanterior position (face looking down).

PTS: 1 REF: p. 1265 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Orbits

15. The fetus is categorized into the small, average, or large growth percentiles in which one of

the following methods? a. Intrauterine growth restriction (IUGR)

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Biophysical profile c. Growth-adjusted sonar age d. Age-range analysis ANS: C

The fetus is categorized into small, average, or large growth percentiles in a method called the growth-adjusted sonar age.

PTS: 1 REF: p. 1258 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Biparietal diameter

16. Which one of the following statements about the femur length measurement is true? a. It is taken from the pointed end to the pointed end. b. It should include the distal femoral epiphysis. c. It includes only the femoral diaphysis. d. It should include the femoral head.

ANS: C

Only the femoral diaphysis is measured for the femur length.

PTS: 1 REF: p. 1261 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Bone lengths

17. All long bones should be measured if the difference between the femur length and all other

biometric parameters is which one of the following? a. Greater than 3 weeks b. Greater than 4 weeks c. Greater than 1 week NURSINGTB.COM d. 2 weeks or greater ANS: D

All fetal long bones should be measured if a 2-week or greater difference is found between the femur length and all other biometric parameters.

PTS: 1 REF: p. 1260 OBJ: Assess fetal parameter measurements and fetal growth.

TOP: Bone lengths

18. Which one of the following statements describes the binocular distance (BD)? a. It includes both orbits at the same time. b. It is the length between the two orbits. c. It is the distance of an orbit. d. It is the depth of both orbits.

ANS: A

The BD includes both orbits at the same time.

PTS: 1 REF: p. 1265 OBJ: Describe when other measurements should be used to provide additional clinical information.

TOP: Orbits 19. Gestational age can best be predicted from which one of the following? a. Interocular distance

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Orbital diameter c. Intraocular distance d. Binocular distance ANS: D

The BD is more strongly related to the BPD and gestational age than the other orbit parameters.

PTS: 1 REF: p. 1265 OBJ: Describe when other measurements should be used to provide additional clinical information.

TOP: Orbits 20. With transvaginal sonography, the earliest appearance of a normal intrauterine gestational sac

should be seen with a serum beta human chorionic gonadotropin (hCG) greater than _____ mega international units per milliliter (mIU/ml). a. 500 b. 1000 c. 1500 d. 2000 ANS: A

A normal intrauterine gestational sac should be seen with a beta hCG level of above 500 mIU/ml when using transvaginal sonography.

PTS: 1 REF: p. 1254 OBJ: Discuss gestational sac growth, take measurements, and assess gestational age.

TOP: Gestational Age Assessment: First Trimester

N R I G B.C M

S Nis T O the ___________ edge of one orbit to the 21. Measurement of the binocular U distance taken from ___________ edge of the contralateral orbit. a. outer; inner b. inner; inner c. outer; outer d. inner; outer ANS: C

Measurement of the binocular distance is taken from the outer edge on one orbit to the outer edge of the contralateral orbit.

PTS: 1 REF: pp. 1265-1266 OBJ: Describe when other measurements should be used to provide additional clinical information.

TOP: Orbits 22. Linear acceleration of the embryonic heart rate correlates well with gestational age up to

_________________ weeks. a. 8 menstrual b. 9 gestational c. 10 menstrual d. 12 conception ANS: B

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Linear acceleration of the embryonic heart rate correlates well with gestational age up to 9.2 weeks.

PTS: 1 REF: p. 1256 OBJ: Assess fetal parameter measurements, proportions, and fetal growth.

TOP: Embryonic heart rate 23. A condition in which the fetus is not growing at a normal rate is which one of the following? a. Growth-adjusted sonar age b. Age-range analysis c. IUGR d. Microcephaly ANS: C

Intrauterine growth restriction (IUGR) is a condition in which the fetus is not growing at a normal rate.

PTS: 1 REF: p. 1260 OBJ: Evaluate the fetal growth series for IUGR and growth disturbances.

TOP: Age range analysis 24. Measurement of the BPD is taken from the __________ edge to the ___________. a. outer; inner edge b. outer; outer edge c. inner; inner edge d. outer; falx multiplied by two ANS: A

N R I G B.C M

S the N outer T edge O to the inner edge or from the leading edge The BPD measurement is takenUfrom to the leading edge.

PTS: 1 REF: p. 1258 OBJ: Measure, calculate the biparietal diameter, head circumference, 3D cranium, abdominal circumference, and extremity measurements.

TOP: Biparietal diameter

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 53: Fetal Growth Assessment by Sonography Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The assessment of the fetus to determine fetal well-being, including an evaluation of a cardiac

nonstress test and the observation of fetal breathing movement, gross fetal body movements, fetal tone, and amniotic fluid volume, is known as which one of the following? a. Apgar score b. Nonstress test c. Biophysical profile d. Reflex index ANS: C

The biophysical profile is the assessment of the fetus to determine fetal well-being, including the evaluation of a cardiac nonstress test and the observation of fetal breathing movement, gross fetal body movements, fetal tone, and amniotic fluid volume.

PTS: 1 REF: p. 1271 OBJ: Describe how to perform a biophysical profile (BPP) on a fetus.

TOP: Tests of fetal well-being 2. Asymmetric intrauterine growth restriction (IUGR) may show all of the following except: a. a placental problem. b. head measurements correlating with dates. c. body disproportionately smaller.

NURSINGTB.COM d. body and head small for dates.

ANS: D

Asymmetric IUGR is characterized by an appropriate biparietal diameter (BPD) and a disproportionally small abdominal circumference (AC).

PTS: 1 REF: pp. 1269-1270 OBJ: Differentiate between symmetric and asymmetric IUGR. TOP: Intrauterine growth restriction 3. The normal amniotic fluid index (AFI) should range between ___________ centimeters (cm). a. 1 and 5 b. 5 and 8 c. 7 and 16 d. 8 and 22 ANS: D

The normal AFI should range between 8 and 22 cm.

PTS: 1 REF: p. 1271 TOP: Amniotic fluid evaluation

OBJ: Describe how to assess amniotic fluid volume.

4. Which one of the following measurements incorporates several fetal growth parameters such

as BPD, head circumference (HC), AC, and femur length (FL)? a. Estimated fetal weight (EFW)

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. IUGR c. Biophysical profile d. Fetal growth chart ANS: A

The EFW is determined by incorporating all BPD, HC, AC, and FL parameters.

PTS: 1 REF: p. 1270 OBJ: Discuss the multiple fetal parameters and calculated ages used to assess the fetal somatic proportions and growth.

TOP: Diagnostic criteria 5. Which is one of the growth problems seen in the fetus of a diabetic mother? a. Small for gestational age b. Macrosomia c. Microsomia d. Symmetric IUGR ANS: B

The frequency of macrosomia in the offspring of mothers with diabetes ranges from 25% to 45%.

PTS: 1 TOP: Macrosomia

REF: p. 1275

OBJ: Analyze the significance of macrosomia in a fetus.

6. Significant maternal risk factors for IUGR include all of the following except: a. history of a fetus with IUGR. b. significant hypotension. c. history of tobacco use.

NURSINGTB.COM d. significant placenta hemorrhage.

ANS: B

Significant maternal risk factors for IUGR include hypertension, history of a fetus with IUGR, history of tobacco use, significant placenta hemorrhage, and uterine anomalies.

PTS: 1 REF: p. 1269 OBJ: Describe how intrauterine growth restriction (IUGR) may be detected by sonography.

TOP: Intrauterine growth restriction 7. Clinical observations for IUGR include all of the following except: a. increased fundal height. b. decreased fetal motion. c. grade 3 placenta before 36 weeks. d. decreased placental thickness.

ANS: A

IUGR may demonstrate a decrease in fundal height, a decrease in fetal motion, grade 3 placenta before 36 weeks, and decreased placental thickness.

PTS: 1 REF: p. 1269 OBJ: Describe how intrauterine growth restriction (IUGR) may be detected by sonography.

TOP: Intrauterine growth restriction 8. Which one of the following statements about IUGR is false?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

The BPD used alone is a poor indicator of IUGR. The HC:AC ratio is useful in determining the type of IUGR. The FL may decrease in size with symmetric IUGR. The FL:AC ratio is a good positive predictive value of IUGR.

ANS: D

The FL:AC ratio has a poor positive predictive value in determining IUGR. PTS: 1 REF: p. 1270 OBJ: Describe how intrauterine growth restriction (IUGR) may be detected by sonography.

TOP: Intrauterine growth restriction 9. Which one of the following statements about amniotic fluid is false? a. Oligohydramnios occurs if the fetus cannot urinate. b. Polyhydramnios develops if the fetus cannot swallow. c. An amniotic fluid pocket greater than 5 cm may represent IUGR. d. Not all oligohydramnios are associated with IUGR. ANS: C

An amniotic fluid pocket less than 1 to 2 cm may represent IUGR. PTS: 1 REF: p. 1272 TOP: Amniotic fluid evaluation

OBJ: Describe how to assess amniotic fluid volume.

10. An increased incidence of morbidity and mortality as the result of head and shoulder injuries

is found in which one of the following? a. Microsomic fetus b. Neural tube fetus NURSINGTB.COM c. Macrosomic fetus d. Fetus with radial dysplasia ANS: C

The macrosomic fetus has an increased incidence of morbidity and mortality as the result of head and shoulder injuries and cord compression.

PTS: 1 TOP: Macrosomia

REF: p. 1275

OBJ: Analyze the significance of macrosomia in a fetus.

11. IUGR is most commonly defined as an estimated fetal weight (EFW) _____________ for a

given gestational age. a. below the 10th percentile b. at or below the 10th percentile c. at or below the 5th percentile d. below the 5th percentile ANS: B

IUGR is most commonly defined as an estimated fetal weight (EFW) at or below the 10th percentile for a given gestational age.

PTS: 1 REF: p. 1268 OBJ: Describe how intrauterine growth restriction (IUGR) may be detected by sonography.

TOP: Intrauterine growth restriction

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 12. Which one of the following is not a parameter of a biophysical profile? a. Nonstress test b. Amniotic fluid volume c. Fetal swallowing d. Fetal breathing movement ANS: C

The five parameters of a biophysical profile include (1) cardiac nonstress test, (2) fetal breathing movements, (3) fetal body movements, (4) fetal tone, and (5) amniotic fluid volume.

PTS: 1 REF: p. 1271 OBJ: Describe how to perform a biophysical profile (BPP) on a fetus.

TOP: Tests of fetal well-being 13. Increased vascular resistance to the fetus is reflected by a(n) ______________. a. decrease in the systolic-to-diastolic (S/D) ratio b. decrease in pulsatility index c. increase in the S/D ratio d. decrease in both the S/D ratio and the pulsatility index ANS: D

Increased vascular resistance to the fetus is reflected by an increase in both the S/D ratio and the pulsatility index.

PTS: 1 REF: p. 1274 OBJ: Discuss quantitative and qualitative Doppler measurements as applied to obstetrics.

TOP: Tests of fetal well-being

N R I G B.C M

U Scan N beTused toOevaluate fetal well-being: 14. An S/D ratio of the umbilical artery a. beginning at 20 weeks of gestation. b. after 25 weeks of gestation. c. after 30 weeks of gestation. d. throughout the pregnancy.

ANS: C

An S/D ratio of the umbilical artery greater than 3 after 30 weeks of gestation is considered abnormal.

PTS: 1 REF: p. 1269 OBJ: Discuss quantitative and qualitative Doppler measurements as applied to obstetrics.

TOP: Tests of fetal well-being 15. Macrosomia is defined as a estimated fetal weight (EFW) or birth weight of which one of the

following? a. EFW above 90% for estimated gestational age b. Birth weight above 3900 grams (g) for birth weight c. EFW at 95% for estimated gestational age d. EFW above 95% for estimated gestational age ANS: A

Macrosomia is defined as a estimated fetal weight (EFW) above 90% for estimated gestational age or birth weight above 4000 g.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 TOP: Macrosomia

REF: p. 1275

OBJ: Analyze the significance of macrosomia in a fetus.

16. The S/D ratio cannot be measured when which one of the following conditions is present? a. Diastolic flow is continuous. b. Systolic flow exceeds 100 cm/sec. c. Acceleration time is decreased. d. Diastolic flow is absent.

ANS: D

The S/D ratio cannot be measured when the diastolic flow is absent.

PTS: 1 REF: p. 1274 OBJ: Discuss quantitative and qualitative Doppler measurements as applied to obstetrics.

TOP: Tests of fetal well-being 17. The single most useful biometric parameter to assess fetal growth is which one of the

following parameters? a. BPD b. Chest circumference c. AC d. FL ANS: C

The AC is the single most useful parameter to assess fetal growth.

PTS: 1 REF: p. 1276 NURSshould INGbe TB.C OM OBJ: List which growth parameters used to assess IUGR. TOP: Diagnostic criteria 18. Calculating a macrosomic index can be performed by subtracting the __________ from the

___________. a. chest circumference; AC b. BPD; chest circumference c. BPD; AC d. chest circumference; BPD ANS: B

Calculating a macrosomic index can be performed by subtracting the BPD from the chest circumference.

PTS: 1 TOP: Macrosomia

REF: p. 1277

OBJ: Analyze the significance of macrosomia in a fetus.

19. The placenta of the macrosomic fetus can become which one of the following? a. Significantly thin b. Significantly calcified c. Extremely small d. Significantly large ANS: D

The placenta of the macrosomic fetus can become significantly large and thick.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 TOP: Macrosomia

REF: p. 1277

OBJ: Analyze the significance of macrosomia in a fetus.

20. Symmetric IUGR is usually the result of which one of the following? a. Second-trimester infection b. Placental insufficiency c. First-trimester insult d. Maternal renal disease ANS: C

Symmetric IUGR is usually the result of first-trimester insult, such as a chromosomal abnormality or infection.

PTS: 1 REF: p. 1269 OBJ: Differentiate between symmetric and asymmetric IUGR. TOP: Intrauterine growth restriction 21. Asymmetric IUGR is usually caused by which one of the following? a. Chromosomal abnormalities b. Maternal malnutrition c. Placental insufficiency d. Fetal alcohol syndrome ANS: C

Asymmetric IUGR is the most common form of IUGR and is usually caused by placental insufficiency.

N R I G B.C M

U S N T O PTS: 1 REF: p. 1269 OBJ: Differentiate between symmetric and asymmetric IUGR. TOP: Intrauterine growth restriction 22. The single most sensitive indicator of IUGR is which one of the following? a. Last menstrual period b. FL c. HC:AC ratio d. AC ANS: D

AC is the single most sensitive indicator of IUGR. PTS: 1 REF: p. 1270 OBJ: Differentiate between symmetric and asymmetric IUGR. TOP: Intrauterine growth restriction 23. Assessing amniotic fluid volume using the sum of four quadrants is called which one of the

following? a. Amniotic fluid index b. Amniotic fluid volume c. Total uterine volume d. Pocket index ANS: A

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The AFI uses the sum of four quadrants to assess the amniotic fluid volume.

PTS: 1 REF: p. 1272 TOP: Amniotic fluid evaluation

OBJ: Describe how to assess amniotic fluid volume.

24. An AFI of 9 cm is considered which one of the following? a. Polyhydramnios b. Oligohydramnios c. Within the lower limits of the normal amniotic fluid volume d. Premature rupture of membranes ANS: C

An AFI of 9 cm is considered to be within the lower limits of the normal amniotic fluid volume (normal range 8 to 22 cm).

PTS: 1 REF: p. 1271 TOP: Amniotic fluid evaluation

OBJ: Describe how to assess amniotic fluid volume.

25. Which one of the following fetal body organs is most severely affected by IUGR? a. Brain b. Liver c. Kidney d. Heart ANS: B

In IUGR, the fetal liver is one of the most severely affected body organs, which therefore alters the AC measurement.

N R I G B.C M

U S N T O PTS: 1 REF: p. 1270 OBJ: Describe how intrauterine growth restriction (IUGR) may be detected by sonography.

TOP: Diagnostic criteria

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 54: Sonography and High-Risk Pregnancy Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The caudal regression syndrome is found most commonly in patients with which one of the

following? a. Systemic lupus erythematosus b. Premature rupture of membranes c. Diabetes d. Hypertension ANS: C

Caudal regression syndrome is seen almost exclusively in patients with diabetes.

PTS: 1 REF: p. 1286 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal diseases of pregnancy 2. The development of conjoined twins occurs when the division of the egg occurs _____ days

after conception. a. 13 b. 3 c. 8 d. 25 ANS: A

NURSINGTB.COM

Conjoined twins may occur when the division of the egg occurs 13 days after conception.

PTS: 1 REF: p. 1292 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Multiple gestation pregnancy 3. Twins that arise from two separately fertilized ova are known as which one of the following? a. Monozygotic b. Monochorionic c. Diamniotic d. Dizygotic ANS: D

Dizygotic twins arise from two separately fertilized ova.

PTS: 1 REF: p. 1291 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Multiple gestation pregnancy 4. Secondary to pregnancy-induced hypertension, the occurrence of a coma or seizures in the

patient during the second and third trimesters represents which one of the following? a. Erythroblastosis fetalis b. Eclampsia c. Hydrops

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Alloimmune thrombocytopenia ANS: B

Eclampsia represents the occurrence of seizures or coma in a preeclamptic patient.

PTS: 1 REF: p. 1287 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal diseases of pregnancy 5. Fetal death that occurs after the fetus has reached a certain growth that is too large to resorb

into the uterus is which one of the following? a. Spalding sign b. Nonimmune hydrops c. Fetus papyraceous d. Stuck twin ANS: C

Fetus papyraceous is a term used to describe a fetus too large for resorption at fetal death. The fetus is significantly flattened from a loss of fluid.

PTS: 1 REF: p. 1293 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Multiple gestation pregnancy 6. Which one of the following complications of pregnancy is characterized by increasing

hypertension, proteinuria, and edema? a. Preeclampsia b. Fetal hydrops NURSINGTB.COM c. Thrombocytopenia d. Diabetes ANS: A

Preeclampsia is a complication of pregnancy characterized by increasing hypertension, proteinuria, and edema.

PTS: 1 REF: p. 1287 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal diseases of pregnancy 7. Which one of the following terms describes a group of conditions in which hydrops is present

in the fetus but is not a result of fetomaternal blood group incompatibility? a. Immune hydrops b. Toxemia c. Hyperemesis gravidarum d. Nonimmune hydrops (NIH) ANS: D

NIH describes a group of conditions in which hydrops is present in the fetus but is not a result of fetomaternal blood group incompatibility.

PTS: 1 REF: p. 1280 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal factors in high-risk pregnancy

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

8. Hypertensive pregnancies may be associated with which one of the following abnormalities? a. Macrosomia b. Small placentas c. Large placentas d. Caudal regression syndrome ANS: B

Hypertensive pregnancies may be associated with small placentas because of the effect of hypertension on the blood vessels.

PTS: 1 REF: p. 1287 OBJ: Discuss the role of sonography in high-risk pregnancies.

TOP: Maternal diseases of pregnancy 9. What sonographic finding(s) confirms the presence of a diamniotic pregnancy? a. Two yolk sacs b. Two fetal poles c. Membrane that separates the fetuses d. Two placentas ANS: C

Documentation of a membrane separating the fetuses confirms the presence of a diamniotic pregnancy.

PTS: 1 REF: p. 1295 OBJ: Discuss the role of sonography in high-risk pregnancies.

TOP: Multiple gestation pregnancy

NURSINGTB.COM

10. Which one of the following is defined as the appearance of overlapping skull bones that

indicates fetal death? a. Fetus papyraceous b. Cranial regression syndrome c. Spalding sign d. Lemon sign ANS: C

The Spalding sign is the appearance of overlapping skull bones, which indicates fetal death.

PTS: 1 REF: p. 1289 OBJ: Discuss the role of sonography in high-risk pregnancies.

TOP: Fetal factors in high-risk pregnancy 11. Sonographic findings of fetal hydrops in an isoimmunized pregnancy include all of the

following except: a. pleural effusion. b. polyhydramnios. c. thinning placenta. d. pericardial effusion.

ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Sonographic findings of fetal hydrops in an isoimmunized pregnancy include scalp edema, pleural effusion, pericardial effusion, polyhydramnios, and a thickened placenta.

PTS: 1 REF: pp. 1280-1281 OBJ: Discuss the role of sonography in high-risk pregnancies.

TOP: Maternal factors in high-risk pregnancy 12. Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate ranging

between ______ and ______ beats per minute (bpm). a. 160; 200 b. 200; 240 c. 210; 250 d. 225; 250 ANS: B

Hydrops caused by fetal tachycardia most commonly demonstrates a heart rate between 200 and 240 bpm.

PTS: 1 REF: p. 1284 OBJ: Discuss the role of sonography in high-risk pregnancies.

TOP: Maternal factors in high-risk pregnancy 13. Maternal obesity has been associated with an increased incidence of which one of the

following abnormalities? a. Biliary atresia b. Hydrocephalus c. Neural tube defects d. Polycystic kidney diseaseNURSINGTB.COM ANS: C

Maternal obesity has been associated with an increased incidence of neural tube defects and may be attributed to a deficiency in the diet.

PTS: 1 REF: p. 1288 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal diseases of pregnancy 14. Caudal regression syndrome is described as which one of the following? a. Lacks the development of caudal nerves b. Lacks the development of the caudal spine and cord c. Is associated with chromosome abnormalities d. Is observed in systemic lupus erythematosus ANS: B

Caudal regression syndrome is the lack of development of the caudal spine and cord. This syndrome is almost exclusively observed in mothers with diabetes.

PTS: 1 REF: p. 1286 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal diseases of pregnancy

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 15. Skeletal and central nervous system congenital anomalies in infants of diabetic mothers

include all of the following except: a. macrocephaly. b. neural tube defects. c. anencephaly. d. caudal regression syndrome.

ANS: A

Skeletal and central nervous system congenital anomalies in infants of diabetic mothers include microcephaly, caudal regression syndrome, neural tube defects, and anencephaly.

PTS: 1 REF: p. 1286 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal diseases of pregnancy 16. Premature labor is defined as the onset of labor before _____ weeks of gestation. a. 37 b. 38 c. 39 d. 40 ANS: A

The onset of labor before 37 weeks of gestation is considered premature labor.

PTS: 1 REF: p. 1288 TOP: Ultrasound in labor and delivery

OBJ: Define high-risk pregnancy.

17. Which one of the following terms a monochorionic twin pregnancy in which one N RisIusedGforB.C M

S Nbody?

T fetus develops without a heart U or upper a. Conjoined twins b. Stuck twin c. Acardiac anomaly d. Twin-to-twin transfusion

O

ANS: C

Acardiac anomaly occurs in a monochorionic twin pregnancy. During this type of pregnancy, one twin develops without a heart and often an upper body is absent.

PTS: 1 REF: p. 1295 OBJ: Describe the maternal and fetal factors for a pregnancy.

TOP: Anomalies specific to twin pregnancies 18. Which one of the following statements about twin-to-twin transfusion syndrome is true? a. The venous blood of one twin is pumped into the arterial system of the other twin. b. The arterial blood of one twin is pumped into the venous system of the other twin. c. This syndrome is a common complication of multiple gestations. d. Twin-to-twin transfusion syndrome occurs between the fetal umbilical cords.

ANS: B

In monozygotic twin pregnancies with a single placenta and arteriovenous shunting within the placenta, the arterial blood of one twin is pumped into the venous system of the other twin.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1294 OBJ: Discuss the role of sonography in high-risk pregnancies.

TOP: Anomalies specific to twin pregnancies 19. Poly-oli sequence is also known as which one of the following? a. Acardiac anomaly b. Twin-to-twin transfusion syndrome c. Spalding sign d. Stuck twin syndrome ANS: D

Poly-oli sequence is also known as stuck twin syndrome.

PTS: 1 REF: p. 1294 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Anomalies specific to twin pregnancies 20. Stuck twin syndrome is usually observed between _____ and _____ weeks of gestation. a. 12; 14 b. 12; 24 c. 16; 20 d. 16; 26 ANS: D

Stuck twin syndrome is usually evident between 16 and 26 weeks of gestation.

PTS: 1 REF: p. 1294 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

NUpregnancies RSINGTB.COM TOP: Anomalies specific to twin 21. A diamniotic and dichorionic twin pregnancy demonstrates which one of the following

sonographic findings? a. Two gestational sacs and one placenta b. Two gestational sacs and two placentas c. One gestational sac and two placentas d. Two gestational sacs and one embryo ANS: B

A diamniotic and dichorionic twin pregnancy demonstrates two gestational sacs and two placentas.

PTS: 1 REF: p. 1291 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Multiple gestation pregnancy 22. Which one of the following is demonstrated if the division of one fertilized egg occurs 4 to 8

days after fertilization? a. Two chorions and two amnions b. One amnion and two chorions c. One chorion and two amnions d. One amnion and one chorion ANS: C

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The division of a fertilized egg 4 to 8 days after fertilization demonstrates one chorion and two amnions.

PTS: 1 REF: p. 1291 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Multiple gestation pregnancy 23. In twin-to-twin transfusion syndrome, which one of the following statements is true? a. Both twins are at risk of dying. b. An arteriovenous shunting within the placenta is demonstrated. c. The recipient twin may demonstrate polyhydramnios. d. All of the above statements are true.

ANS: D

In twin-to-twin transfusion syndrome, both twins are at risk of dying, an arteriovenous shunting is demonstrated within the placenta, and the recipient twin may demonstrate polyhydramnios.

PTS: 1 REF: pp. 1294-1295 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Anomalies specific to twin pregnancies 24. Predictors of discordance in the growth of twins include all except which one of the

following? a. Difference in estimated fetal weight greater than 20% b. Difference in biparietal diameter of 10 mm or greater c. Difference in abdominal circumference of 20 mm or greater d. Difference in femur length NUofR5Smm ING B.COM orTgreater ANS: B

Predictors of discordance in the growth of twins include a difference in biparietal diameter of 6 mm or greater, a difference in estimated fetal weight of greater than 20%, a difference in abdominal circumference of 20 mm or greater, and a difference in femur length of 5 mm or greater.

PTS: 1 REF: p. 1296 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Anomalies specific to twin pregnancies 25. Which one of the following is the most frequent cause of nonimmune hydrops? a. Duodenal atresia b. Congenital nephrotic syndrome c. Umbilical cord anomalies d. Cardiovascular lesions ANS: D

Cardiovascular lesions are the most frequent cause of nonimmune hydrops.

PTS: 1 REF: p. 1283 OBJ: Describe the maternal and fetal factors for a pregnancy that is considered high risk.

TOP: Maternal factors in high-risk pregnancy

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 55: Prenatal Diagnosis of Congenital Anomalies Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Chorionic villus sampling (CVS) may include all of the following advantages except: a. it is performed in the first trimester. b. the results are available within 48 hours. c. the results are available within 1 week. d. early results allow more options for parents.

ANS: B

Advantages of CVS include the following: (1) It is performed in the first trimester; (2) the results are available in 1 week; and (3) early results allow more options for the parents.

PTS: 1 REF: p. 1299 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 2. Cordocentesis is more commonly used for which one of the following procedures? a. Chromosomal analysis b. Analysis of fetal lung maturity c. Cardiovascular analysis d. Guidance for transfusions to treat fetal isoimmunization ANS: D

Cordocentesis is more commonly NURused INfor GTguidance B.COMfor transfusions to treat fetal S isoimmunization. It can also be used for chromosomal analysis.

PTS: 1 REF: p. 1302 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 3. Amniocentesis may be used for all of the following except: a. analysis of fetal chromosomes. b. prediction of Rh isoimmunization. c. documentation of lung maturity. d. prediction of cardiac abnormalities.

ANS: D

Amniotic fluid studies are performed to determine karyotype, lung maturity, and Rh condition.

PTS: 1 REF: p. 1300 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 4. Reasons to perform an amniocentesis include all of the following except: a. maternal age. b. multiple gestations. c. previous child with chromosomal abnormality.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. abnormal alpha-fetoprotein (AFP) level.

ANS: B

Amniocentesis may be offered when the maternal AFP level is elevated and ultrasound reveals no explanation. Multiple gestation may increase maternal serum alpha-fetoprotein (MSAFP), but it is not a reason for an amniocentesis.

PTS: 1 REF: p. 1300 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 5. Sonographic findings that may suggest a chromosomal anomaly include all of the following

except: a. reduced movement. b. hand clenching. c. thickened nuchal fold. d. omphalocele.

ANS: A

Physical features that may suggest a chromosomal anomaly include hand clenching, hypoplasia of the fifth middle phalanx, choroid plexus cysts, ventriculomegaly, thickened nuchal fold, cardiac anomalies, omphalocele, spina bifida, and foot anomalies.

PTS: 1 REF: p. 1300 OBJ: Describe the sonographic features of chromosomal anomalies.

TOP: Genetic testing 6. AFP is found in all of the following fetal structures except the: NURSINGTB.COM a. spine. b. liver and gastrointestinal tract. c. brain. d. kidneys.

ANS: C

AFP is produced by the liver and found in the fetal spine, gastrointestinal tract, liver, and kidneys.

PTS: 1 REF: p. 1302 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 7. High levels of AFP indicate all of the following except: a. anencephaly. b. Down syndrome. c. open spina bifida. d. gastroschisis.

ANS: B

Increased levels of AFP may indicate neural tube defects, abdominal wall defects, open spina bifida, gastrointestinal obstruction, renal anomalies, hydrops, liver disease, and multiple gestations. Down syndrome demonstrates a decrease in AFP levels.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1302 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 8. The quadruple screen evaluates all of the following markers except: a. AFP. b. human chorionic gonadotropin (hCG). c. unconjugated estriol. d. fetal lung maturity.

ANS: D

This biochemical screening test combines three serum markers: (1) AFP, (2) hCG, and (3) unconjugated estriol.

PTS: 1 REF: p. 1304 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Genetic testing 9. An abnormality in the number of chromosomes is called which one of the following? a. Aneuploidy b. X-linked disorder c. Multifactorial d. Mosaicism ANS: A

Aneuploidy is an abnormal number of chromosomes.

PTS: 1 REF: p. 1304 Discuss how anomalies are transmitted genetically.

NURSINGOBJ: TB.COM TOP: Medical genetics 10. Anencephaly is an example of which one of the following conditions? a. Aneuploidy b. X-linked disorder c. Multifactorial d. Mosaicism ANS: C

Anencephaly is an example of a multifactorial condition.

PTS: 1 REF: p. 1305 OBJ: Describe the sonographic features of chromosomal anomalies.

TOP: Medical genetics 11. An early noninvasive means of assessing the risk of aneuploidy is which one of the following? a. Facial analysis b. Nuchal translucency c. Fetal position d. Biophysical profile ANS: B

A thickened nuchal translucency is associated with chromosomal abnormalities. An abnormal fluid collection behind the fetal neck has been associated with aneuploidy.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1305 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Chromosomal abnormalities 12. The sonographic findings of increased nuchal thickening, shortened femurs, cardiac

anomalies, and pyelectasis may be seen in which one of the following? a. Trisomy 13 b. Trisomy 18 c. Trisomy 21 d. Turner syndrome ANS: C

The sonographic features of trisomy 21 may include nuchal thickness, heart defects, duodenal atresia, shortened femurs, mild pyelectasis, mild ventriculomegaly, and echogenic bowel.

PTS: 1 REF: p. 1306 OBJ: Describe the sonographic features of chromosomal anomalies.

TOP: Chromosomal abnormalities 13. The sonographic findings of cranial anomalies, choroid plexus cysts, facial abnormalities, and

rocker bottom feet may be seen in which one of the following? a. Trisomy 13 b. Trisomy 18 c. Trisomy 21 d. Turner syndrome ANS: B

The sonographic features of trisomy mayB.C includeMcardiac anomalies, choroid plexus cysts, NURSI18NG T O cleft lip and palate, omphalocele, and clenched hands, micrognathia, talipes, renal anomalies, cerebellar hypoplasia.

PTS: 1 REF: pp. 1307-1308 OBJ: Describe the sonographic features of chromosomal anomalies.

TOP: Chromosomal abnormalities 14. Holoprosencephaly and proboscis are most likely to be found in a fetus with which one of the

following? a. Trisomy 13 b. Trisomy 18 c. Trisomy 21 d. Turner syndrome ANS: A

Holoprosencephaly is a common finding in fetuses with trisomy 13.

PTS: 1 REF: p. 1308 OBJ: Describe the sonographic features of chromosomal anomalies.

TOP: Chromosomal abnormalities 15. A large cystic hygroma, hydrops, and coarctation of the aorta may be seen in a fetus with

which one of the following? a. Trisomy 13

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Trisomy 18 c. Trisomy 21 d. Turner syndrome ANS: D

Sonographic features of Turner syndrome may include cystic hygroma, heart defects, hydrops, and renal anomalies.

PTS: 1 REF: p. 1304 OBJ: Describe the sonographic features of chromosomal anomalies.

TOP: Chromosomal abnormalities 16. Pregnancy-associated plasma protein A (PAPP-A) levels: a. peak from 16 to 20 weeks of gestation. b. increase throughout pregnancy. c. decline after 24 weeks of gestation. d. peak from 15 to 18 weeks of gestation.

ANS: B

PAPP-A levels increase in maternal serum throughout pregnancy.

PTS: 1 REF: p. 1304 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: First-trimester screening 17. AFP is produced in early gestation by which one of the following structures? a. Liver b. Brain NURSINGTB.COM c. Yolk sac d. Placenta ANS: C

AFP is a major protein in fetal serum and is produced by the yolk sac in early gestation. Later, the liver produces AFP. PTS: 1 REF: p. 1302 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Maternal serum markers 18. A common reason for an elevated level of maternal serum AFP (MSAFP) is which one of the

following? a. Neural tube defect b. Abdominal wall defect c. Chromosomal abnormality d. Incorrect dates ANS: D

Incorrect dates are the most common reason for an elevated level of MSAFP. PTS: 1 REF: pp. 1302-1303 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Maternal serum markers

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 19. The most common aneuploid condition is which one of the following? a. Trisomy 13 b. Trisomy 18 c. Trisomy 21 d. Turner syndrome ANS: C

Trisomy 21 is the most common aneuploid condition.

PTS: 1 REF: p. 1305 TOP: Chromosomal abnormalities

OBJ: Discuss how anomalies are transmitted genetically.

20. The optimal collection site in an amniocentesis includes all of the following except: a. away from the maternal midline. b. away from the fetus. c. away from the umbilical cord. d. away from the central portion of the placenta.

ANS: A

The optimal collection site in amniocentesis should be near the maternal midline to avoid the peripheral vessels, away from the umbilical cord and fetus, and away from the central portion of the placenta.

PTS: 1 REF: p. 1300 OBJ: Describe the ultrasound technique of amniocentesis.

TOP: Genetic testing

21. MSAFP levels increase with advancing gestational age and peak at _____ weeks of gestation. a. 14 to 16 NURSINGTB.COM b. 15 to 18 c. 18 to 20 d. 16 to 20 ANS: B

MSAFP levels increase with advancing gestational age and peak at 15 to 18 weeks of gestation.

PTS: 1 REF: p. 1302 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Maternal serum markers 22. Beta–hCG can be assessed in maternal serum in the first trimester to evaluate for an increased

risk of which one of the following anomalies? a. Triploidy b. Turner syndrome c. Down syndrome d. Meckel-Gruber syndrome ANS: C

Beta–hCG can be assessed in maternal serum in the first trimester to evaluate for an increased risk of Down syndrome.

PTS: 1

REF: p. 1304

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Maternal serum markers 23. After amniocentesis, the sonographer should demonstrate and document which one of the

following? a. Amniotic fluid volume b. Cervical length c. Placenta location d. Fetal cardiac activity ANS: D

After amniocentesis, the sonographer should demonstrate and document fetal cardiac activity.

If the placenta has been transversed, then the site should be evaluated for hemorrhage.

PTS: 1 REF: p. 1301 OBJ: Describe the ultrasound technique of amniocentesis.

TOP: Genetic testing

24. Continuous monitoring during an amniocentesis with ultrasound is invaluable in patients with

which one of the following abnormalities? a. Posterior placenta location b. Polyhydramnios c. Placenta previa d. Premature rupture of membranes ANS: D

Continuous monitoring during an amniocentesis with ultrasound is invaluable in the patient with premature rupture of membranes, oligohydramnios, anterior placenta location, or increased fetal activity.

N R I G B.C M

U S N T

O

PTS: 1 REF: p. 1301 OBJ: Describe the ultrasound technique of amniocentesis.

TOP: Genetic testing

25. Low AFP levels have been found in which one of the following? a. Fetus older than expected b. Anencephaly c. Fetus younger than expected d. Omphalocele ANS: C

Low AFP levels have been found with chromosomal abnormalities, in fetuses younger than expected, and when fetal death, spontaneous abortion, and hydatidiform mole have occurred.

PTS: 1 REF: p. 1303 OBJ: Describe the methods of genetic testing, including maternal serum markers, CVS, and amniocentesis.

TOP: Maternal serum markers

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 56: Placenta Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The fetal membranes comprise all of the following except the: a. chorion. b. amnion. c. blastocyst. d. yolk sac.

ANS: C

The chorion, amnion, yolk sac, and allantois constitute the embryonic or fetal membranes.

PTS: 1 REF: p. 1316 TOP: Embryogenesis

OBJ: Describe the embryogenesis of the placenta.

2. The chorionic plate is related to which one of the following? a. Maternal surface of the fetus b. Fetal surface of the placenta c. Allantois of the yolk stalk d. Cotyledons and intervillous spaces ANS: B

The fetal surface, which is contiguous with the surrounding chorion, is related to the chorionic plate.

NURSINGTB.COM OBJ: Describe the embryogenesis of the placenta.

PTS: 1 REF: p. 1319 TOP: Embryogenesis

3. The decidual reaction that changes in the endometrium opposite the site of implantation is

which one of the following? a. Decidua basalis b. Decidua capsularis c. Decidua frondosum d. Decidua vera ANS: D

Decidua vera (parietalis) is a reaction that changes in the endometrium opposite the site of implantation.

PTS: 1 REF: p. 1315 TOP: Embryogenesis

OBJ: Describe the embryogenesis of the placenta.

4. The major functioning unit(s) of the placenta is(are) which of the following? a. Chorionic villi b. Yolk sac c. Amnion d. Cotyledons ANS: A

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The chorionic villi are the major functioning units of the placenta.

PTS: 1 REF: p. 1315 TOP: Embryogenesis

OBJ: List the functions of the placenta.

5. The placenta performs all of the following functions except: a. protection. b. absorption. c. nutrition. d. respiration.

ANS: B

Functions of the placenta include protection, nutrition, respiration, and excretion.

PTS: 1 REF: p. 1315 TOP: Embryogenesis

OBJ: List the functions of the placenta.

6. The velamentous placenta refers to a(n): a. insertion of the umbilical cord at the margin of the placenta. b. insertion of the umbilical cord near the edge of the placenta. c. arteriovenous anastomosis of the vessels within the placenta. d. membranous insertion of the cord.

ANS: D

The velamentous placenta refers to a membranous insertion of the umbilical cord.

PTS: 1 REF: p. 1316 OBJ: Identify the placental position and describe its importance.

NURSINGTB.COM TOP: Cordal attachments 7. By 9 weeks, the yolk sac should measure ____________ millimeters (mm) in diameter. a. less than 5 b. greater than 5 c. less than 2 d. greater than 2 ANS: A

The yolk sac has diminished to less than 5 mm in diameter by 9 weeks.

PTS: 1 REF: p. 1317 TOP: Embryogenesis

OBJ: Describe the embryogenesis of the placenta.

8. Fusion of the amnion and chorion usually occurs by _______ weeks of gestation. a. 12 b. 14 c. 16 d. 20 ANS: C

The amnion fuses with the chorion by 16 weeks of gestation.

PTS: 1 REF: p. 1317 TOP: Embryogenesis

OBJ: Describe embryogenesis of the placenta.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

9. A marginal or an eccentric insertion of the umbilical cord into the placenta is which one of the

following? a. Velamentous placenta b. Vasa previa c. Battledore placenta d. Placenta accreta ANS: C

A battledore placenta refers to the insertion of the umbilical cord at the margin of the placenta.

PTS: 1 REF: p. 1316 OBJ: Identify the placental position and describe its importance.

TOP: Cordal attachments 10. The primary cause of placentomegaly is which one of the following abnormalities? a. Intrauterine growth restriction (IUGR) b. Battledore placenta c. Maternal diabetes d. Intrauterine infection ANS: C

Maternal diabetes and Rh incompatibility are the primary causes of placentomegaly.

PTS: 1 REF: p. 1323 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Abnormalities of the placenta

N R I G B.C M

Udeposition S N Tis which O one of the following?

11. The most common site of fibrin a. Along the subchorionic area b. Along the retroplacental area c. Within the chorioangioma d. Within the hydatidiform mole ANS: A

Deposits of fibrin may be found in the intervillous spaces posterior to the chorionic plate (subchorionic).

PTS: 1 REF: p. 1323 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Evaluation of the placenta after delivery 12. Complications of placenta previa include all of the following except: a. premature delivery. b. maternal hemorrhage. c. postpartum hemorrhage. d. succenturiate placenta.

ANS: D

Complications of placenta previa may include premature delivery, maternal hemorrhage, increased risk of placental invasion, increased risk of postpartum hemorrhage, and IUGR. PTS: 1

REF: p. 1324

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Identify the placental position and describe its importance.

TOP: Abnormalities of the placenta 13. Severe blood loss may occur with placenta ____________. a. percreta b. increta c. accreta d. excreta ANS: A

Severe blood loss may occur with placenta percreta.

PTS: 1 REF: p. 1326 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Table 56-2 14. The presence of one or more accessory lobes connected to the body of the placenta by blood

vessels is a ______________ placenta. a. circumvallate b. succenturiate c. circummarginate d. battledore ANS: B

The presence of one or more accessory lobes connected to the body of the placenta by blood vessels is a succenturiate placenta.

PTS: 1 REF: p. 1326 NURSINand GTtheB.C OMsignificance of placental pathologic OBJ: Describe the sonographic findings clinical conditions.

TOP: Abnormalities of the placenta 15. Which one of the following statements about a placental abruption is false? a. Bleeding in the decidua basalis occurs with separation. b. Placental abruption may be a retroplacental or marginal abruption. c. The bleed may lead to a chorioangioma. d. Preterm labor may result.

ANS: C

Placental abruption may demonstrate a hematoma but does not lead to a chorioangioma.

PTS: 1 REF: p. 1328 TOP: Placental abruption

OBJ: Recognize placental abruption on ultrasound.

16. An example of a low-pressure bleed is which one of the following? a. Marginal abruption b. Retroplacental abruption c. Decompression of the uterus d. Trauma to the uterus ANS: A

Marginal abruption results from tears of the marginal veins and represents a low-pressure bleed.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1328 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Placental abruption 17. The maternal side of the placenta is the decidua ______________. a. frondosum b. capsularis c. basalis d. parietalis ANS: C

The maternal portion of the placenta is the decidua basalis formed by the endometrium.

PTS: 1 REF: p. 1315 TOP: Embryogenesis

OBJ: Describe the embryogenesis of the placenta.

18. The chorion around the gestational sac on the opposite side of implantation is the chorion

_______________. a. frondosum b. laeve c. capsularis d. vera ANS: B

The chorion around the gestational sac on the opposite side of implantation is the chorion laeve.

PTS: 1 REF: p. 1315 Describe the embryogenesis of the placenta.

NURSINGOBJ: TB.COM TOP: Embryogenesis 19. A marginal placenta previa demonstrates which one of the following? a. The edge of the placenta is near the internal cervical os. b. The placenta is in the right lateral position. c. The placenta touches but does not cross the internal cervical os. d. The placenta partially covers the internal cervical os.

ANS: C

A marginal placenta previa touches but does not cross the internal cervical os.

PTS: 1 REF: pp. 1323-1324 OBJ: Identify the placental position and describe its importance.

TOP: Abnormalities of the placenta 20. Which one of the following abnormalities might demonstrate a small placenta? a. Maternal anemia b. Rh sensitivity c. Maternal diabetes d. Aneuploidy ANS: D

IUGR, intrauterine infection, and aneuploidy may demonstrate a small placenta.

PTS: 1

REF: p. 1319

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Sonographic evaluation of the normal placenta 21. Which one of the following occurs when the intramembranous vessels course across the

internal cervical os? a. Placenta previa b. Battledore placenta c. Vasa previa d. Velamentous placenta ANS: C

Vasa previa occurs when large fetal vessels run in the fetal membranes course across the cervical os, placing them at risk of rupture and life-threatening hemorrhage.

PTS: 1 REF: p. 1325 OBJ: Identify the placental position and describe its importance.

TOP: Abnormalities of the placenta 22. The growth of the chorionic villi superficially into the myometrium describes which one of

the following? a. Succenturiate placenta b. Placenta accreta c. Placental migration d. Placenta increta ANS: B

Placenta accreta is the growth of chorionic villi superficially into the myometrium. The placental villi are anchored toNmuscle rather than R Ifibers G B.C M the intervening decidual cells.

U S N T

O

PTS: 1 REF: pp. 1325-1326 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Abnormalities of the placenta 23. The attachment of the placental membranes to the fetal surface of the placenta describes

which one of the following? a. Circummarginate placenta b. Succenturiate placenta c. Battledore placenta d. Placenta accreta ANS: A

A circummarginate or circumvallate placenta is the attachment of the placental membranes to the fetal surface of the placenta rather than the underlying villous placental margin.

PTS: 1 REF: p. 1327 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Abnormalities of the placenta 24. A circumscribed complex mass protruding from the fetal surface of the placenta is

demonstrated on ultrasound. This appearance most likely represents which one of the following? a. Succenturiate placenta

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Abruptio placenta c. Circumvallate placenta d. Chorioangioma ANS: D

On ultrasound, a chorioangioma appears as a solid or complex circumscribed mass protruding from the fetal surface of the placenta.

PTS: 1 REF: p. 1330 OBJ: Describe the sonographic findings and the clinical significance of placental pathologic conditions.

TOP: Abnormalities of the placenta

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 57: Umbilical Cord Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following umbilical cord entanglements in the fetus is the most common? a. Nuchal cord b. True knot c. False knot d. Hematoma ANS: A

Nuchal cord is the most common cord entanglement in the fetus.

PTS: 1 REF: p. 1340 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord knots 2. If a single umbilical artery is seen, the sonographer should search for which one of the

following? a. Neural tube defect b. Esophageal atresia c. Genitourinary defect d. Abdominal wall defect ANS: C

If a single umbilical artery isNseen, RSthe INsonographer GTB.COMshould search for genitourinary, U cardiovascular, facial, and musculoskeletal malformations. Abnormalities are seen in 25% to 50% of infants with a single umbilical artery.

PTS: 1 REF: p. 1342 OBJ: Predict obstetric problems that may be associated with abnormal umbilical cord dimensions.

TOP: Single umbilical artery 3. ____________ of the cord may be formed when a loop of cord is slipped over the fetal head

or shoulders during delivery. a. Hemangioma b. False knots c. Hematoma d. True knots ANS: D

True knots of the cord may be formed when a loop of cord is slipped over the fetal head or shoulders during delivery.

PTS: 1 REF: p. 1340 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord knots 4. Which one of the following occurs when the cord inserts into the membranes before it enters

the placenta?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Prolapse Velamentous insertion Battledore placenta Vasa previa

ANS: B

Velamentous cord insertion occurs when the cord inserts into the membranes rather than inserting into the placenta.

PTS: 1 REF: p. 1340 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord insertion abnormalities 5. Cord prolapse problems can be produced during all of the following obstetric procedures

except: a. velamentous cord insertion. b. artificial rupture of membranes. c. disengaging the head. d. version and extraction.

ANS: A

One third of cord prolapse problems are produced during obstetric procedures; these include artificial rupture of the membranes, disengaging the head, version, and extraction and flexion of an extended head. A velamentous cord insertion is not an obstetric procedure.

PTS: 1 REF: p. 1342 OBJ: Predict obstetric problems that may be associated with abnormal umbilical cord dimensions.

TOP: Vasa previa and prolapseNof R the I cordG B.C M

U S N T

O

6. Which one of the following problems may lead to inadequate fetal descent? a. Long cord b. Twisted cord c. Short cord d. Ruptured cord ANS: C

Short cord length predisposes the fetus to inadequate descent, cord compression, fetal distress, and oligohydramnios.

PTS: 1 REF: p. 1337 OBJ: Predict obstetric problems that may be associated with abnormal umbilical cord dimensions.

TOP: Key Pearls 7. After birth, the ductus venosus turns into which one of the following? a. Ductus arteriosus b. Ligamentum venosum c. Falciform ligament d. Coronary ligament ANS: B

The ductus venosus is patent during fetal life until shortly after birth, with transformation into the ligamentum venosum.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1337 OBJ: Describe the development and normal anatomy of the umbilical cord.

TOP: Development and anatomy of the umbilical cord 8. Thrombosis of the umbilical vessels is most common in which one of the following? a. Right umbilical artery b. Left umbilical artery c. Umbilical vein d. Hypogastric arteries ANS: C

Thrombosis of the umbilical vessels primarily occurs in the umbilical vein.

PTS: 1 REF: p. 1339 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord masses 9. All of the following statements are correct about a true knot of the cord except: a. It is associated with long cords. b. It has been associated with polyhydramnios. c. Color Doppler is useful to record flow. d. It has been associated with monoamniotic twin gestation.

ANS: D

True knots of the cord have been associated with long cord length, polyhydramnios, intrauterine growth restriction (IUGR), and monoamniotic twins. The mortality rate is 8% to 11%.

NURSINGTB.COM

PTS: 1 REF: p. 1340 OBJ: Predict obstetric problems that may be associated with abnormal umbilical cord dimensions.

TOP: Abnormal umbilical cord dimensions 10. The presence of umbilical vessels crossing the internal os of the cervix is called which one of

the following? a. Placenta previa b. Cord prolapse c. Vasa previa d. Velamentous cord ANS: C

The presence of umbilical vessels crossing the internal os of the cervix is called vasa previa.

PTS: 1 REF: p. 1342 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Vasa previa and prolapse of the cord 11. The umbilical cord is formed by the fusion of which of the following? a. Amnion and yolk sac b. Yolk stalk and allantoic ducts c. Yolk sac and allantoic ducts d. Allantoic ducts and chorion

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B

The umbilical cord is formed by the fusion of the yolk stalk and allantoic ducts.

PTS: 1 REF: p. 1333 OBJ: Describe the development and normal anatomy of the umbilical cord.

TOP: Development and anatomy of the umbilical cord 12. In the first trimester, the length of the umbilical cord is approximately the same size as which

one of the following? a. Mean (gestational) sac diameter b. Biparietal diameter c. Crown-rump length d. Femur length ANS: C

In the first trimester, the length of the umbilical cord is approximately the same size as the crown-rump length.

PTS: 1 REF: pp. 1336-1337 OBJ: Describe the development and normal anatomy of the umbilical cord.

TOP: Abnormal umbilical cord dimensions 13. The normal length of the umbilical cord measures __________ centimeters (cm). a. 20 to 35 b. 40 to 60 c. 30 to 50 d. 60 to 90 ANS: B

NURSINGTB.COM

The normal length of the umbilical cord measures 40 to 60 cm and is unreliably measured with ultrasound.

PTS: 1 REF: p. 1337 OBJ: Describe the development and normal anatomy of the umbilical cord.

TOP: Development and anatomy of the umbilical cord 14. A cystic mass in the umbilical cord is usually which one of the following? a. Allantoic in origin b. An omphalocele c. A false knot of the cord d. A true knot of the cord ANS: A

A cystic mass in the umbilical cord is usually allantoic or omphalomesenteric (yolk stalk) in origin.

PTS: 1 REF: p. 1338 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord masses 15. Velamentous umbilical cord insertion is associated with all of the following except: a. preterm labor.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. abnormal fetal heart rate. c. low Apgar scores. d. macrosomia.

ANS: D

Velamentous umbilical cord insertion is associated with a high risk of low birth weight, small gestational age, preterm delivery, low Apgar scores, and abnormal intrapartum fetal heart rate problems.

PTS: 1 REF: pp. 1341-1342 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord insertion abnormalities 16. Which one of the following statements about a single umbilical artery is false? a. The incidence of IUGR is increased. b. The right umbilical artery is absent more often than the left umbilical artery. c. An increase in prenatal mortality is present. d. The incidence of chromosomal abnormalities is increased.

ANS: B

The left umbilical artery is absent more often than the right umbilical artery.

PTS: 1 REF: p. 1342 OBJ: Describe the development and normal anatomy of the umbilical cord.

TOP: Single umbilical artery 17. A dilated intraabdominal, extrahepatic portion of the umbilical vein is called which one of the

following?

N R I G B.COM a. Varix of the umbilical veinU S N T b. Persistent right portal vein c. Thrombosis of the umbilical vein d. Aneurysm of the umbilical vein ANS: A

An umbilical varix appears as a dilated intraabdominal, extrahepatic portion of the umbilical vein on ultrasound.

PTS: 1 REF: p. 1343 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Varix of the umbilical vein 18. Conditions predisposing a fetus to cord prolapse include all of the following except: a. velamentous cord. b. premature rupture of membranes. c. polyhydramnios. d. normal fetal presentation.

ANS: D

Conditions predisposing a fetus to cord prolapse include a velamentous cord, premature rupture of membranes, polyhydramnios, abnormal fetal presentation, and vasa previa.

PTS: 1 REF: p. 1342 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank significance.

TOP: Vasa previa and prolapse of the cord

19. A short cord measures less than _____ cm. a. 25 b. 30 c. 35 d. 40 ANS: C

A short cord measures less than 35 cm in length.

PTS: 1 REF: p. 1337 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Abnormal umbilical cord dimensions 20. Which one of the following statements about the umbilical cord is false? a. The chorion covers the cord and blends with the fetal skin at the umbilicus. b. The umbilical vein carries oxygenated blood to the fetus. c. One umbilical vein and two umbilical arteries make up the umbilical cord. d. The umbilical cord is the essential link from the mother to the fetus.

ANS: A

The amnion covers the cord and blends with the fetal skin at the umbilicus.

PTS: 1 REF: p. 1333 OBJ: Describe the development and normal anatomy of the umbilical cord.

TOP: Development and anatomy of the umbilical cord

NURall B.C M SIlayers NGTof 21. A paraumbilical defect involving theO abdominal wall is called which one of the following? a. Omphalocele b. Umbilical herniation c. Gastroschisis d. Amniotic band syndrome ANS: C

A paraumbilical defect (usually on the right) involving all layers of the abdominal wall is called gastroschisis.

PTS: 1 REF: p. 1338 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord masses 22. Coiling of the umbilical cord: a. is abnormal. b. is not related to fetal activity. c. has a higher incidence of fetal anomalies when the cord is twisted toward the right. d. is insignificant.

ANS: C

Coiling of the umbilical cord is normal and related to fetal activity. A fetus with a right twist in the cord has a higher incidence of fetal anomalies.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1337 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Abnormal umbilical cord dimensions 23. False knots of the umbilical cord: a. are associated with short cord length. b. occur when the blood vessels are longer than the cord. c. are loops of cord slipped over the fetal head. d. are umbilical hernias.

ANS: B

A false knot occurs when the blood vessels are longer than the cord.

PTS: 1 REF: p. 1340 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Umbilical cord knots 24. A long umbilical cord measures greater than _____ cm. a. 60 b. 80 c. 100 d. 120 ANS: B

A long umbilical cord measures greater than 80 cm.

PTS: 1 REF: p. 1337 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical NURSIumbilical M significance.

TOP: Abnormal cordOdimensions NGTB.C 25. A hypoplastic umbilical artery is defined as a three-vessel cord when the artery-to-artery

difference is greater than ______. a. 25% b. 30% c. 50% d. 75% ANS: C

A three-vessel cord showing an artery-to-artery difference of more than 50% is defined as a hypoplastic umbilical artery.

PTS: 1 REF: p. 1342 OBJ: Discuss the umbilical cord disorders presented in this chapter, including the cause and clinical significance.

TOP: Single umbilical artery

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 58: Amniotic Fluid and Fetal Membranes Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The multiple fibrous strands of amnion that develop in utero and may entangle fetal parts to

cause amputations or malformation of the fetus are described as which of the following? a. Uterine synechiae b. Amniotic bands c. Amniotic sheets d. Entangled sheets ANS: B

Amniotic bands are multiple fibrous strands of amnion that develop in utero and may entangle fetal parts to cause amputations or malformation of the fetus.

PTS: 1 REF: p. 1356 OBJ: Describe the significance of amniotic band syndrome.

TOP: Fetal membranes

2. Which one of the following is produced by the umbilical cord and membranes and the fetal

lungs, skin, and kidneys? a. Amniotic fluid b. Chorion frondosum c. Decidua basalis d. Vernix caseosa ANS: A

NURSINGTB.COM

The amniotic fluid is produced by the umbilical cord and membranes and the fetal lungs, skin, and kidneys.

PTS: 1 REF: p. 1362 TOP: Amniotic fluid

OBJ: Describe the production of amniotic fluid.

3. Which one of the following structures forms early in gestation and surrounds the embryo? a. Chorionic cavity b. Chorion frondosum c. Amniotic cavity d. Fetal cavity ANS: C

The amniotic cavity forms early in gestation and is filled with amniotic fluid that completely surrounds and protects the embryo.

PTS: 1 REF: p. 1346 TOP: Amniotic fluid

OBJ: List the functions of amniotic fluid.

4. The fetal production of urine and the ability to swallow begin during which of the following

weeks of gestation? a. 6 to 9 b. 8 to 11 c. 10 to 13

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. 9 to 15 ANS: B

Fetal production of urine and the ability to swallow begin between 8 and 11 weeks of gestation.

PTS: 1 REF: p. 1347 TOP: Amniotic fluid

OBJ: Describe the production of amniotic fluid.

5. The amount of amniotic fluid is regulated by all of the following except the: a. production of the fluid. b. removal of the fluid by swallowing. c. fluid exchange within the heart. d. membranes and cord.

ANS: C

The amount of amniotic fluid is regulated by the production of fluid and the removal of fluid by swallowing, by exchange within the lungs, and by the membranous cord.

PTS: 1 REF: p. 1347 TOP: Amniotic fluid

OBJ: Describe the production of amniotic fluid.

6. Which one of the following statements about the amniotic fluid volume (AFV) is false? a. The amniotic fluid increases in the early second trimester by 25 milliliters (ml). b. The amniotic fluid increases in the third trimester by 50 ml. c. The amniotic fluid increases in the late second trimester by 50 ml. d. The amniotic fluid in the third trimester does not change significantly.

ANS: B

NURSINGTB.COM

The AFV in the third trimester does not change significantly.

PTS: 1 REF: p. 1347 TOP: Abnormal amniotic fluid volumes

OBJ: Describe the methods for assessing the AFV.

7. Signs of polyhydramnios include all of the following sonographic demonstrations except: a. appearance of a free-floating fetus within the amniotic cavity. b. accentuated fetal anatomy as increased amniotic fluid improves image resolution. c. amniotic fluid index (AFI) greater than 20 centimeters (cm). d. AFI greater than 15 cm.

ANS: D

Sonographic signs of polyhydramnios include the appearance of a free-floating fetus within the amniotic cavity, an accentuated fetal anatomy as increased amniotic fluid improves image resolution, a freely moving fetus, and an AFI greater than 20 cm (greater than 20 cm = mild; greater than 24 cm = moderate; greater than 25 cm = severe).

PTS: 1 REF: p. 1352 OBJ: Determine the abnormal volumes of amniotic fluid.

TOP: Abnormal amniotic fluid volumes 8. Maternal conditions associated with polyhydramnios include all of the following except: a. diabetes mellitus.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. fetal macrosomia. c. tetralogy of Fallot. d. Rh isoimmunization.

ANS: C

Maternal conditions associated with polyhydramnios include diabetes mellitus, fetal macrosomia, and Rh isoimmunization. The most common cause is diabetes mellitus.

PTS: 1 REF: p. 1351 OBJ: Determine the abnormal volumes of amniotic fluid.

TOP: Abnormal amniotic fluid volumes 9. Oligohydramnios is associated with all of the following except: a. renal agenesis. b. gastrointestinal disorders. c. premature rupture of the intrauterine membranes (PROM). d. postdate pregnancy.

ANS: B

Oligohydramnios is associated with intrauterine growth restriction (IUGR), renal anomalies, PROM, postdate pregnancy, and chromosomal abnormalities. Gastrointestinal disorders are generally associated with polyhydramnios.

PTS: 1 REF: p. 1353 OBJ: Determine the abnormal volumes of amniotic fluid.

TOP: Abnormal amniotic fluid volumes 10. Syndactylism is most likely the result of which one of the following?

NURSINGTB.COM a. Synechiae b. Uterine sheets c. Amniotic bands d. Subchorionic hemorrhage ANS: C

Amniotic bands may cause various fetal malformations of the limbs, craniofacial region, and trunk.

PTS: 1 REF: p. 1356 OBJ: Describe the significance of amniotic band syndrome.

TOP: Fetal membranes

11. What is the suspected cause of amniotic sheets? a. Synechiae b. Amniotic bands c. Subchorionic hemorrhage d. Demise twin pregnancy ANS: A

Amniotic sheets are believed to be caused by synechiae or uterine scars.

PTS: 1 REF: p. 1358 OBJ: Differentiate amniotic band syndrome from amniotic sheets with sonography.

TOP: Fetal membranes

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 12. Which one of the following methods is used for visual assessment of the AFV? a. AFI b. Single-pocket assessment c. Subjective assessment of fluid d. Three-dimensional (3-D) determination ANS: C

With subjective assessment of the AFV, the sonographer surveys the uterine cavity to determine a visual assessment of the AFV. PTS: 1 REF: p. 1348 TOP: Characteristics of amniotic fluid

OBJ: Describe the methods for assessing the AFV.

13. Select the structure that is the major source of amniotic fluid production in early pregnancy. a. Yolk sac b. Amniotic membranes c. Yolk stalk d. Chorionic villi ANS: B

Early in gestation, the major source of amniotic fluid is produced by the amniotic membranes.

PTS: 1 REF: p. 1347 TOP: Amniotic fluid

OBJ: Describe the production of amniotic fluid.

14. Twin pregnancies have a ________________ median AFI than a singleton pregnancy. a. slightly higher b. similar NURSINGTB.COM c. significantly lower d. slightly lower ANS: D

Twin pregnancies have a slightly lower median AFI than a singleton pregnancy.

PTS: 1 REF: p. 1350 OBJ: Determine the abnormal volumes of amniotic fluid.

TOP: Amniotic fluid

15. Which one of the following is not a function of the amniotic fluid? a. Allowing the fetus to move freely b. Maintaining intrauterine temperature c. Developing fetal swallowing d. Protecting the fetus from injury ANS: C

Functions of the amniotic fluid include allowing symmetric growth, preventing adherence of the amnion to the embryo, allowing the fetus to move freely, maintaining intrauterine temperature, and protecting the fetus from injury.

PTS: 1 REF: p. 1347 TOP: Amniotic fluid

OBJ: List the functions of amniotic fluid.

16. Amniotic fluid may appear generous during ______ weeks of gestation.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

12 to 15 15 to 20 20 to 30 36 to 40

ANS: C

From 20 to 30 weeks of gestation, amniotic fluid may appear rather generous, although this typically represents a normal amniotic fluid variant.

PTS: 1 REF: p. 1347 TOP: Characteristics of amniotic fluid

OBJ: List the functions of amniotic fluid.

17. Which one of the following techniques is both valid and reproducible in assessing the AFV? a. AFI b. Single-pocket assessment c. Maximum vertical pocket d. 3-D determination ANS: A

Of all the techniques used to assess the AFV, the AFI is the only one that is both valid and reproducible.

PTS: 1 REF: p. 1349 TOP: Characteristics of amniotic fluid

OBJ: Describe the methods for assessing the AFV.

18. Congenital anomalies associated with polyhydramnios include all of the following except: a. cystic hygroma. b. coarctation of the aorta. N R I G B.C M U S N T O c. anencephaly. d. infantile polycystic kidney disease.

ANS: D

Infantile polycystic kidney disease is associated with oligohydramnios.

PTS: 1 REF: p. 1352 OBJ: Determine the abnormal volumes of amniotic fluid.

TOP: Characteristics of amniotic fluid 19. Persistent oligohydramnios in the second trimester, regardless of the cause, carries a(n): a. poor prognosis. b. average prognosis. c. good prognosis. d. prognosis that depends on the underlying cause.

ANS: A

Persistent oligohydramnios in the second trimester, regardless of the cause, carries a poor prognosis.

PTS: 1 REF: p. 1353 OBJ: Determine the abnormal volumes of amniotic fluid.

TOP: Characteristics of amniotic fluid

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 20. Scars within the uterus, secondary to previous gynecologic surgery, are called which one of

the following? a. Adenomyosis b. Amniotic bands c. Synechiae d. Uterine polyps ANS: C

Synechiae are scars within the uterus, secondary to previous gynecologic surgery.

PTS: 1 REF: p. 1358 OBJ: Describe the significance of amniotic band syndrome.

TOP: Fetal membranes

21. The amniotic fluid generally appears anechoic on ultrasound. Occasionally, however, mobile

particles are observed that are most likely which one of the following? a. Sludge b. Debris c. Vernix caseosa d. Hemorrhage ANS: C

Vernix caseosa is fatty material found on fetal skin and is commonly demonstrated on ultrasound as mobile particles within the amniotic fluid. Other considerations include intra-amniotic blood, intrauterine meconium passage, and amniotic sludge.

PTS: 1 REF: p. 1347 TOP: Characteristics of amniotic fluid

OBJ: List the functions of amniotic fluid.

N R I G B.C M

U Smethod N Tof assessing O the AFV, a pocket 22. Using the maximum vertical depth ______________________________. a. less than 3 cm indicates oligohydramnios b. greater than 7 cm indicates polyhydramnios c. between 1 and 7 cm is considered normal d. between 2 and 8 cm is considered normal ANS: D

A pocket between 2 and 8 cm is considered normal when assessing the AFV using the maximum depth method.

PTS: 1 REF: p. 1350 TOP: Characteristics of amniotic fluid

OBJ: Describe the methods for assessing the AFV.

23. Polyhydramnios is defined as an AFV greater than _______ ml. a. 1500 b. 1750 c. 2000 d. 2250 ANS: C

Polyhydramnios is defined as an AFV greater than 2000 ml.

PTS: 1

REF: p. 1350

OBJ: Describe the methods for assessing the AFV.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Characteristics of amniotic fluid 24. The AFI may be approximated by multiplying the largest pocket of amniotic fluid by

____________. a. two b. three c. four d. five ANS: B

As a general rule, the AFI may be approximated by multiplying the largest pocket of amniotic fluid by three.

PTS: 1 REF: p. 1350 OBJ: Describe methods for assessing amniotic fluid volume.

TOP: Characteristics of amniotic fluid 25. Nonanomalous conditions causing oligohydramnios include all of the following except: a. dysplastic kidney. b. PROM. c. IUGR. d. postdate pregnancy.

ANS: A

Dysplastic kidney is a fetal anomalous condition causing oligohydramnios. Nonanomalous conditions include PROM, IUGR, postdate pregnancy, and chorionic villi sampling.

PTS: 1 REF: p.N 1353 URSIof NGamniotic TB.Cfluid.

OM OBJ: Determine the abnormal volumes

NURSINGTB.COM

TOP: Box 58-3

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 59: Fetal Face and Neck Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following statements about the fetal face is false? a. The fetal profile is well imaged with transvaginal sonography beginning late in the

first trimester to early in the second trimester. b. The modified coronal view is best to image a cleft lip and palate. c. The maxilla and orbits are well imaged in a true sagittal plane. d. The longitudinal view demonstrates the nasal bones, soft tissue, and mandible.

ANS: C

The maxilla and orbits are well imaged in the coronal plane.

PTS: 1 REF: p. 1368 OBJ: Describe how to evaluate the fetal face and neck for normal features.

TOP: Sonographic evaluation of the fetal face 2. Which one of the following imaging planes is best for imaging the cleft lip and palate? a. Transverse b. Longitudinal c. Transverse oblique d. Modified coronal ANS: D

The modified coronal view isNbest the cleft R forI imaging G B.C M lip and palate.

U S N T

O

PTS: 1 REF: p. 1368 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Sonographic evaluation of the fetal face 3. Extensive facial screening may be hindered by all of the following except: a. bone shadowing. b. poor fetal positioning. c. polyhydramnios. d. maternal obesity.

ANS: C

Polyhydramnios aids in facial screening.

PTS: 1 REF: p. 1367 OBJ: Describe how to evaluate the fetal face and neck for normal features.

TOP: Sonographic evaluation of the fetal face 4. Craniosynostosis may be defined as which one of the following? a. Wide cranial sutures b. Overlapping cranial sutures c. Protrusion of the meninges outside the sutures d. Premature closure of the cranial sutures

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: D

Craniosynostosis may be defined as the premature closure of the cranial sutures.

PTS: 1 REF: p. 1369 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 5. Which one of the following results from a malformation of the lymphatic system? a. Teratoma b. Goiter c. Cystic hygroma d. Brachial cleft cyst ANS: C

Fetal cystic hygroma results from a malformation of the lymphatic system, which leads to single-loculated or multiloculated lymph-filled cavities around the neck.

PTS: 1 REF: p. 1380 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormal fetal development 6. Which one of the following statements about the facial profile is incorrect? a. The facial profile appears as a curvilinear surface with a differentiation of the

forehead, nose, lips, and chin. b. The facial profile demonstrates a cloverleaf skull shape. c. The facial profile has frontal bossing, which is described as a lemon-shaped skull

or an absent depressed nasal bridge. d. The facial profile has a strawberry-shaped cranium, N R I G B.C M which is described as a

U S N T

bulging of the occipital bones.

O

ANS: D

The facial profile has a strawberry-shaped cranium, which is a bulging of the frontal bones and wide occiput.

PTS: 1 REF: pp. 1369-1370 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 7. Evaluation of the nasal triad should include all of the following except: a. nostril symmetry. b. nostril length. c. nasal septum integrity. d. continuity of the upper lip to exclude cleft lip and palate.

ANS: B

An evaluation of the nasal triad includes nostril symmetry, nasal septum integrity, and a continuity of the upper lip to exclude a cleft lip and palate.

PTS: 1 REF: p. 1377 OBJ: Describe how to evaluate the fetal face and neck for normal features.

TOP: Sonographic evaluation of the fetal face

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 8. Which one of the following statements about cleft lip and palate is false? a. A medial cleft lip is caused by an incomplete merging of the two medial nasal

prominences in the midline. b. An oblique facial cleft is the failure of the maxillary prominence to merge with the

lateral nasal swelling; the nasolacrimal duct is exposed. c. A complete bilateral cleft lip and palate is a small gap in the left upper lip on the

modified coronal view; the nose is flattened and widened. d. A unilateral complete cleft lip and palate is an incomplete fusion of the maxillary

prominence to the medial prominence on one side; the modified coronal view is used.

ANS: C

A complete bilateral cleft lip and palate is a large gap in the upper lip on the modified coronal view; the nose is flattened and widened.

PTS: 1 REF: p. 1379 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 9. Which one of the following statements about an epignathus is false? a. An epignathus is a teratoma located in the oropharynx. b. The mass may be highly complex and contain solid, cystic, or calcified

components. c. Swallowing is not impaired in fetuses with epignathus. d. A small stomach may be present.

ANS: C

Swallowing may be impairedNin fetuses with an epignathus.

UR SING TB.C OM PTS: 1 REF: p. 1380 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 10. The most common neck mass is which one of the following? a. Cystic hygroma colli b. Cervical meningomyelocele c. Hemangioma d. Goiter ANS: A

The most common neck mass is the cystic hygroma colli (lymphatic obstruction).

PTS: 1 REF: p. 1380 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 11. What is the most common neck mass in the fetus? a. Teratoma b. Brachial cleft cyst c. Cervical meningomyelocele d. Cystic hygroma

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: D

The most common neck mass is cystic hygroma colli (lymphatic obstruction). Rarer lesions include cervical meningomyelocele, hemangiomas, teratomas, goiter, sarcoma, and metastatic adenopathy. Branchial cleft cysts are prenatally detectable.

PTS: 1 REF: p. 1380 TOP: Abnormalities of the neck

OBJ: Discuss basic embryology of the face.

12. The bridge of the nose originates from the ____________ prominence. a. frontal b. medial nasal c. maxillary d. optic ANS: A

The nose is formed in three parts. The bridge of the nose originates from the frontal prominence.

PTS: 1 REF: p. 1367 OBJ: Discuss the embryologic development of the face.

TOP: Embryology of the fetal face and neck 13. Proboscis suggests which one of the following abnormalities? a. Trisomy 18 b. Cephalocele c. Holoprosencephaly d. Pierre Robin syndrome ANS: C

N R I G B.C M

U S holoprosencephaly.

N T O Orbital fusion or proboscis suggests PTS: 1 REF: p. 1367 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Sonographic evaluation of the fetal face 14. The optimal gestational age for measuring the nuchal translucency is _______ weeks. a. 10 through 12 b. 11 through 13 c. 14 through 16 d. 18 through 20 ANS: B

The optimal gestational age for measurement of nuchal translucency is between 11 and 13 weeks, 6 days.

PTS: 1 REF: p. 1370 OBJ: Describe how to evaluate the fetal face and neck for normal features.

TOP: Abnormalities of the face and neck 15. The most common congenital anomaly of the face is which one of the following? a. Macroglossia b. Micrognathia c. Hypotelorism

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Cleft lip ANS: D

The cleft lip with or without a cleft palate represents the most common congenital anomaly of the face.

PTS: 1 REF: p. 1377 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the nose, maxilla, lips, and palate 16. Differential considerations for cystic hygroma include all of the following except: a. goiter. b. nuchal edema. c. brachial cleft cyst. d. thyroglossal duct cyst.

ANS: A

Differential considerations for cystic hygroma include meningomyelocele, encephalocele, nuchal edema, brachial cleft cyst, cystic teratoma, and thyroglossal cyst.

PTS: 1 REF: p. 1382 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the neck 17. Which one of the following terms describes a small chin? a. Microglossia b. Micrognathia c. Microphthalmia NURSINGTB.COM d. Microrhinia ANS: B

Micrognathia means a small chin.

PTS: 1 REF: p. 1372 OBJ: Discuss basic embryology of the face.

TOP: Abnormalities of the face and neck 18. Which one of the following statements about facial anomalies is correct? a. Fetal facial anomalies are homogeneous. b. Hemangiomas do not occur in the face and neck. c. Facial anomalies occur as isolated defects or as part of a syndrome. d. Doppler evaluation of facial masses is discouraged because of possible bioeffects

to the fetus.

ANS: C

Facial anomalies occur as isolated defects or as part of a syndrome.

PTS: 1 REF: p. 1367 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Sonographic evaluation of the fetal face 19. An elongated forehead in the sagittal plane and triangular in shape in the axial plane describes

which one of the following abnormalities? a. Trigonocephaly

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Otocephaly c. Strabismus d. Microcephaly ANS: A

Trigonocephaly may cause the forehead to have an elongated appearance in the sagittal plane and a triangular appearance in the axial plane.

PTS: 1 REF: p. 1370 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 20. Ear malformation may be observed in which one of the following? a. Pierre Robin syndrome b. Goldstein syndrome c. Beckwith-Wiedemann syndrome d. Goldenhar syndrome ANS: D

Goldenhar syndrome may demonstrate abnormal ears, anophthalmia, and hemifacial microsomia.

PTS: 1 REF: p. 1373 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the face and neck 21. Cleft lip with or without cleft palate is seen more frequently in which one of the following

groups? a. Caucasians b. African Americans c. Asians d. Native Americans

NURSINGTB.COM

ANS: D

Cleft lip with or without cleft palate is seen in 1 in 150 to 200 births in Native Americans; in 1 in 350 births in Asians; in 1 in 600 births in Caucasians; and in 1 in 3000 births in African Americans.

PTS: 1 REF: p. 1377 TOP: Lip and palate

OBJ: Discuss basic embryology of the face.

22. Which one of the following statements about a fetal goiter is incorrect? a. A fetal goiter appears symmetric. b. A fetal goiter appears heterogeneous. c. A mass arises from the anterior neck. d. A fetal goiter is associated with maternal thyroid disease.

ANS: B

A fetal goiter appears as a bilobed, solid, and homogenous mass arising from the anterior fetal neck. It is associated with maternal thyroid disease.

PTS: 1

REF: pp. 1382-1383

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the nose, maxilla, lips, and palate 23. Congenital anomalies of the face occur in 1 in ______ births. a. 2000 b. 1500 c. 600 d. 1200 ANS: C

Congenital anomalies of the face occur in 1 out of 600 births.

PTS: 1 TOP: Introduction

REF: p. 1364

OBJ: Discuss basic embryology of the face.

24. An isolated unilateral cleft lip defect commonly originates: a. in the midline. b. on the left side of the face. c. on the right side of the face. d. in the mouth.

ANS: B

An isolated unilateral cleft lip commonly originates on the left side of the face.

PTS: 1 REF: p. 1377 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Lip and palate

NURSINabout GTB.C M 25. Which one of the following statements neckOteratomas is incorrect? a. They are usually unilateral. b. They may demonstrate a complex appearance. c. They are usually located posteriorly. d. Color Doppler may be helpful in diagnosis.

ANS: C

Neck teratomas are usually located anteriorly.

PTS: 1 REF: p. 1383 OBJ: Describe the sonographic findings of abnormalities of the fetal face and neck.

TOP: Abnormalities of the neck

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 60: Fetal Neural Axis Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following neural tube defects is characterized by a lack of development of

the cerebral and cerebellar hemispheres and cranial vault and is an abnormality that is incompatible with life? a. Acrania b. Cephalocele c. Dandy-Walker malformation d. Anencephaly ANS: D

Anencephaly is a neural tube defect characterized by a lack of development of the cerebral and cerebellar hemispheres and cranial vault. This abnormality is incompatible with life.

PTS: 1 REF: p. 1386 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Anencephaly 2. Which one of the following central nervous anomalies demonstrates splaying of the cerebellar

hemispheres on ultrasound? a. Hydranencephaly b. Cephalocele c. Vein of Galen malformation NURSINGTB.COM d. Dandy-Walker malformation ANS: D

Dandy-Walker malformation demonstrates a splaying of the cerebellar hemispheres and posterior fossa cyst on ultrasound.

PTS: 1 REF: p. 1387 | p. 1394 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Dandy-Walker malformation 3. A condition in which a complete or partial absence of the cranial bones is demonstrated is

which one of the following? a. Cebocephaly b. Acrania c. Holoprosencephaly d. Hydranencephaly ANS: B

Acrania is a lethal anomaly that exhibits an absence of the cranial bones with the presence of a complete, although abnormal, development of the cerebral hemispheres.

PTS: 1 REF: p. 1388 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Acrania

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. Anomalies associated with anencephaly include all of the following except: a. cleft lip. b. holoprosencephaly. c. polyhydramnios. d. spina bifida.

ANS: B

Anomalies associated with anencephaly include polyhydramnios, coexisting spina bifida, cleft lip and palate, hydronephrosis, diaphragmatic hernia, cardiac defects, omphalocele, gastrointestinal defects, and talipes.

PTS: 1 REF: pp. 1387-1388 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Anencephaly 5. Which one of the following is the most severe form of holoprosencephaly and is characterized

by a single common ventricle and malformed brain? a. Alobar b. Cephalocele c. Anencephaly d. Acrania ANS: A

Three forms of holoprosencephaly exist. The most severe form is classified as alobar.

PTS: 1 REF: p. 1394 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Holoprosencephaly N R I G B.C M

U S N T

O

6. Which one of the following anomalies may be characterized by the presence of colpocephaly? a. Agenesis of the corpus callosum b. Arnold-Chiari malformation c. Dandy-Walker malformation d. Holoprosencephaly ANS: A

Agenesis of the corpus callosum demonstrates dilated occipital horns (colpocephaly), giving the lateral ventricles a teardrop appearance on ultrasound.

PTS: 1 REF: p. 1398 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Agenesis of the corpus collosum 7. The absence of the cavum septi pellucidi is a distinguishing characteristic of which one of the

following fetal anomalies? a. Craniostenosis b. Schizencephaly c. Dandy-Walker malformation d. Agenesis of the corpus callosum ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank An absence of the cavum septi pellucidi is a distinguishing characteristic of agenesis of the corpus callosum.

PTS: 1 REF: p. 1386 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Agenesis of the corpus collosum 8. Which one of the following defects is associated with Meckel-Gruber syndrome? a. Anencephaly b. Arachnoid cyst c. Encephalocele d. Hydranencephaly ANS: C

Meckel-Gruber syndrome is characterized by an encephalocele, polydactyly, and polycystic kidneys. Anencephaly may result from a syndrome such as Meckel-Gruber.

PTS: 1 REF: p. 1389 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Cephalocele 9. Facial anomalies in holoprosencephaly may represent all of the following except: a. hypotelorism. b. cyclopia. c. hypertelorism. d. flattened nose with a single nostril.

ANS: C

N R I G B.C M

U S Nmay T include O cyclopia, hypotelorism, an absent nose, Facial anomalies in holoprosencephaly and a flattened nose with a single nostril and proboscis.

PTS: 1 REF: p. 1396 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Holoprosencephaly 10. Which of the following signs are characteristic of the Arnold-Chiari malformation? a. Banana- and lemon-shaped b. Strawberry- and banana-shaped c. Lemon- and strawberry-shaped d. Cloverleaf- and banana-shaped ANS: A

Arnold-Chiari malformation demonstrates a banana-shaped cerebellum and scalloping frontal bones producing a lemon-shaped head.

PTS: 1 REF: p. 1391 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Spina bifida 11. Which one of the following anomalies is characterized by the presence of a posterior fossa

cyst and a splaying of the cerebellar hemispheres? a. Agenesis of the corpus callosum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Arachnoid cyst c. Dandy-Walker malformation d. Encephalocele ANS: C

Sonographic features in Dandy-Walker malformation include posterior fossa cyst, a splaying of the cerebellar hemispheres, and a complete or partial agenesis of the cerebellar vermis.

PTS: 1 REF: p. 1387 | p. 1394 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Dandy-Walker malformation 12. Which one of the following abnormalities is described as the congenital absence of the

cerebral hemispheres resulting from an occlusion of the internal carotid arteries? a. Hydranencephaly b. Hydrocephalus c. Agenesis of the corpus callosum d. Holoprosencephaly ANS: A

Hydranencephaly is the destruction of the cerebral hemispheres by the occlusion of the internal carotid arteries.

PTS: 1 REF: p. 1401 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Hydranencephaly 13. Ventriculomegaly is defined as lateral ventricular enlargement measuring greater than ____

millimeters (mm). a. 5 b. 7 c. 10 d. 13

NURSINGTB.COM

ANS: C

Ventriculomegaly is defined as lateral ventricular enlargement measuring greater than 10 mm.

PTS: 1 REF: p. 1403 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Ventriculomegaly (Hydrocephalus) 14. An open spinal defect characterized by a protrusion of meninges and spinal cord through the

defect, usually within a meningeal sac, is called which one of the following? a. Meningocele b. Spina bifida occulta c. Meningomyelocele d. Arnold-Chiari syndrome ANS: C

Meningomyelocele is an open spinal defect characterized by the protrusion of meninges and spinal cord through the defect, usually within the meningeal sac.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1391 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Cephalocele 15. Conditions commonly associated with fetal hydrocephalus include all of the following except: a. choroid plexus cyst. b. Dandy-Walker malformation. c. meningomyelocele. d. agenesis of the corpus callosum.

ANS: A

Common causes of hydrocephalus include spina bifida, encephalocele, Dandy-Walker malformation, agenesis of the corpus callosum, holoprosencephaly, and aqueductal stenosis.

PTS: 1 REF: p. 1403 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Spina bifida, encephalocele, Dandy-Walker malformation, agenesis of the corpus callosum, holoprosencephaly, and aqueductal stenosis.

16. Ventriculomegaly coupled with an enlargement of the fetal head is called which one of the

following? a. Hydrocephalus b. Hydranencephaly c. Hydronephrosis d. Dandy-Walker malformation ANS: A

Hydrocephalus is defined as ventriculomegaly in the neonate; cerebrospinal fluid abnormally N RSINGTresulting B.COMin compression and frequently the accumulates within the cerebralUventricles, destruction of brain tissue.

PTS: 1 REF: p. 1402 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Ventriculomegaly (Hydrocephalus) 17. Which one of the following abnormalities is the most common open neural tube defect? a. Anencephaly b. Acrania c. Encephalocele d. Cephalocele ANS: A

Anencephaly is the most common open neural tube defect.

PTS: 1 REF: p. 1386 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Anencephaly 18. Which one of the following fetal head anomalies is characterized by the presence of a single

primitive ventricle? a. Arachnoid cyst b. Dandy-Walker malformation

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. Holoprosencephaly d. Schizencephaly ANS: C

Alobar holoprosencephaly is characterized by singular monoventricle brain tissue that is small and may have a cup, ball, or pancake configuration.

PTS: 1 REF: p. 1395 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Table 60-1 19. A vein of Galen malformation is which one of the following abnormalities? a. An aneurysm of the Galen vein b. A rare arteriovenous malformation c. A sporadic event d. All of the above ANS: D

A vein of Galen malformation or aneurysm of the vein of Galen is a sporadic event, demonstrating an enlarged vein communicating with a normal-appearing artery.

PTS: 1 REF: p. 1399 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Vein of Galen aneurysm 20. A form of holoprosencephaly characterized by a common ventricle, hypotelorism, and a nose

with a single nostril is which one of the following? a. Lissencephaly NURSINGTB.COM b. Cebocephaly c. Ethmocephaly d. Porencephaly ANS: B

Cebocephaly is a form of holoprosencephaly characterized by a common ventricle, hypotelorism, and a nose with a single nostril.

PTS: 1 REF: p. 1396 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Holoprosencephaly 21. Which one of the following statements about anencephaly is incorrect? a. The incidence of anencephaly varies with geographic location. b. Anencephaly is a lethal disorder. c. Anencephaly has a male prevalence. d. Anencephaly is caused by the failure of closure of the neural tube at the cranial

end.

ANS: C

Anencephaly has a female prevalence of 4:1 over males.

PTS: 1 REF: p. 1386 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Anencephaly

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

22. Which one of the following statements about microcephaly is incorrect? a. Microcephaly is an abnormally large head. b. The prognosis for fetuses with microcephaly is always poor. c. Microcephaly does not affect the head circumference. d. Microcephaly may manifest later in pregnancy.

ANS: A

Microcephaly is an abnormally small head that falls two standard deviations below the mean.

PTS: 1 REF: p. 1404 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Microcephaly 23. The differential considerations of anencephaly include all of the following except: a. arachnoid cyst. b. microcephaly. c. acrania. d. cephalocele.

ANS: A

The differential considerations of anencephaly include microcephaly, acrania, and cephalocele.

PTS: 1 REF: p. 1387 OBJ: Recognize the sonographic appearance of fetal head and spine anomalies.

TOP: Anencephaly

N R I G B.C M

U S N T O the herniation of the meninges and brain 24. Which one of the following terms is used to describe through a calvarium defect? a. Dandy-Walker malformation b. Encephalocele c. Cranial meningocele d. Cebocephaly ANS: B

Encephalocele is the term used to describe the herniation of the meninges and brain through a calvarium defect.

PTS: 1 REF: p. 1405 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Cephalocele 25. Differential considerations of Dandy-Walker malformation should include which one of the

following? a. Ventriculomegaly b. Arachnoid cyst c. Cystic hygroma d. Nuchal edema ANS: B

Differential consideration of Dandy-Walker malformation should include an arachnoid cyst.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1387 OBJ: Discuss the anomalies that can occur in the fetal head and spine.

TOP: Dandy-Walker malformation

NURSINGTB.COM

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 61: Fetal Thorax Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following abnormalities refers to a fetus with a significantly narrow

diameter of the chest? a. Bronchopulmonary sequestration b. Asphyxiating thoracic dystrophy c. Congenital bronchial atresia d. Lymphangiectasia ANS: B

Asphyxiating thoracic dystrophy refers to a fetus with a significantly narrow chest diameter.

PTS: 1 REF: p. 1407 OBJ: Describe the development of the thoracic cavity.

TOP: Normal sonographic characteristics 2. The most important determinant for fetal viability is which one of the following? a. Pulmonary hypoplasia b. Bronchopulmonary sequestration c. Pulmonary development d. Bronchial atresia ANS: C

The adequacy of pulmonary development is probably the single most important determination for fetal viability.

NURSINGTB.COM PTS: 1 REF: p. 1406 TOP: Embryology of the thoracic cavity

OBJ: Describe the development of the thoracic cavity.

3. Sonographic evaluation of the normal fetal thorax should include all of the following except: a. size. b. shape. c. chest circumference/abdominal circumference ratio. d. symmetry.

ANS: C

Sonographic evaluation of the chest should include chest size, shape, and symmetry.

PTS: 1 REF: p. 1407 OBJ: List the normal sonographic features of the thorax and diaphragm.

TOP: Normal sonographic characteristics 4. Chest circumference measurements are made in the transverse plane at the level of which one

of the following? a. Diaphragm b. Four-chamber view of the heart c. Short axis of the heart d. Mediastinum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: B

Chest circumference measurements are made in the transverse plane at the level of the four chambers of the heart.

PTS: 1 REF: p. 1407 OBJ: List the normal sonographic features of the thorax and diaphragm.

TOP: Normal sonographic characteristics 5. Which one of the following statements about fetal breathing is false? a. Fetal breathing is most prominent in the second and third trimesters. b. The mature fetus spends one third of its time breathing. c. Breathing is present if the fetal chest or abdomen makes seesaw movements for 20

seconds. d. Breathing is absent if no fetal activity is noted during a 2-minute period.

ANS: D

Breathing is absent if no fetal activity is noted during a 20-minute period.

PTS: 1 REF: p. 1408 OBJ: Describe the development of the thoracic cavity.

TOP: Normal sonographic characteristics 6. The average cardiac axis is ______ degrees. a. 23 b. 30 c. 45 d. 50 ANS: C

N R I G B.C M

S 22 N toT75 degrees O with an average of 45 degrees.

The normal cardiac axis rangesUfrom PTS: 1 REF: p. 1408 OBJ: Describe the development of the thoracic cavity.

TOP: Abnormalities of the thoracic cavity 7. Common abnormalities associated with pulmonary hypoplasia include all of the following

except: a. renal agenesis. b. premature rupture of membranes (PROM). c. macrosomia. d. posterior urethral valve syndrome.

ANS: C

Kidney abnormalities, chromosomal abnormalities, posterior urethral valve syndrome, intrauterine growth restriction (IUGR), diaphragmatic hernia, and PROM are associated with pulmonary hypoplasia.

PTS: 1 REF: p. 1410 OBJ: Describe the development and consequences of pulmonary hypoplasia.

TOP: Abnormalities of the thoracic cavity 8. Sonographic findings in cystic adenomatoid malformation include all of the following except: a. cystic adenomatoid malformation may occur below the diaphragm. b. cystic adenomatoid malformation may be an echogenic mass in type II cystic

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank adenomatoid malformation. c. cystic adenomatoid malformation may be a large cyst in type I cystic adenomatoid malformation. d. cystic adenomatoid malformation is associated with polyhydramnios.

ANS: A

Cystic adenomatoid malformation is a mass within the lung. Type II may demonstrate an echogenic chest mass because of multiple small-sized (less than 1 cm) cysts.

PTS: 1 REF: p. 1413 OBJ: Differentiate between solid and cystic lesions of the lung.

TOP: Abnormalities of the thoracic cavity 9. Diaphragmatic hernias may occur anteriorly and medially in the diaphragm through the

foramen of ______________. a. Luschka b. Bochdalek c. Morgagni d. Monro ANS: C

Diaphragmatic hernias may occur anteriorly and medially in the diaphragm through the foramen of Morgagni and may communicate with the pericardial sac.

PTS: 1 REF: p. 1414 OBJ: Discuss the sonographic findings in a diaphragmatic hernia.

TOP: Abnormalities of the diaphragm

N R I G B.C M

U cysts S Ndetected T prenatally O 10. Which one of the following lung is the most common? a. Cystic adenomatoid malformation b. Bronchogenic cyst c. Pleural effusion d. Lymphangiectasia ANS: B

The bronchogenic cyst is the most common lung cyst detected prenatally.

PTS: 1 REF: p. 1410 OBJ: Differentiate between solid and cystic lesions of the lung.

TOP: Abnormalities of the thoracic cavity 11. The severity of pulmonary hypoplasia depends on which one of the following? a. When it occurs during pregnancy b. Fetal breathing movements c. Amniotic fluid volume d. Systolic/diastolic ratio of the umbilical artery ANS: A

The severity of pulmonary hypoplasia depends on when it occurs during pregnancy, as well as its duration.

PTS: 1 REF: p. 1409 OBJ: Describe the development and consequences of pulmonary hypoplasia.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Abnormalities of the thoracic cavity 12. The supernumerary lobe of the lung is called which one of the following? a. Pulmonary hypoplasia b. Succenturiate lobe c. Anomalous lobe d. Pulmonary sequestration ANS: D

Pulmonary sequestration is a supernumerary lobe of the lung and is separated from the normal tracheobronchial tree.

PTS: 1 REF: p. 1412 OBJ: Describe the development of the thoracic cavity.

TOP: Abnormalities of the thoracic cavity 13. Normal sonographic appearances of the fetal chest include all of the following except: a. ribs form the lateral margin of the chest. b. clavicles form the upper margin of the chest. c. lungs serve as the medial borders for the heart. d. thoracic cavity is symmetric and bell shaped.

ANS: C

The lungs serve as the lateral borders of the heart and lie superior to the diaphragm.

PTS: 1 REF: pp. 1406-1407 OBJ: List the normal sonographic features of the thorax and diaphragm.

TOP: Normal sonographic characteristics

N R I G B.C M

S N T as which O one of the following?

14. The normal fetal lungs appear U on ultrasound a. Heterogeneous with moderate echogenicity b. Homogeneous and hyperechoic c. Heterogeneous and hypoechoic d. Homogeneous with moderate echogenicity ANS: D

The normal fetal lungs appear homogeneous with moderate echogenicity on ultrasound.

PTS: 1 REF: p. 1407 OBJ: List the normal sonographic features of the thorax and diaphragm.

TOP: Normal sonographic characteristics 15. Which one of the following statements about the fetal thorax is false? a. The majority of the heart is positioned in the midline and left chest. b. The apex of the heart should be directed toward the spleen. c. The central portion of the thorax is occupied by the heart. d. The base of the heart lies horizontal to the diaphragm.

ANS: C

The central portion of the thorax is occupied by the mediastinum.

PTS: 1 REF: p. 1407 OBJ: List the normal sonographic features of the thorax and diaphragm.

TOP: Normal sonographic characteristics

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

16. When fetal pleural effusion is encountered, a careful search of the _________ should be

attempted. a. urinary bladder b. diaphragm c. long bones d. facial profile ANS: B

Once a pleural effusion is demonstrated, a careful search of the lung, heart, and diaphragm should be attempted to rule out associated abnormalities.

PTS: 1 REF: p. 1411 OBJ: Differentiate between solid and cystic lesions of the lung.

TOP: Abnormalities of the thoracic cavity 17. Sonographic findings in sequestration include all of the following except: a. sequestration appears as an echogenic mass that resembles lung tissue. b. sequestration is seen with normal intra-thoracic anatomy. c. sequestration commonly occurs below the diaphragm. d. sequestration is associated with hydrops.

ANS: C

Sequestration rarely occurs below the diaphragm.

PTS: 1 REF: p. 1412 OBJ: Differentiate between solid and cystic lesions of the lung.

TOP: Abnormalities of the thoracic cavity

NURSINGTB.COM

18. Congenital bronchial atresia is found most commonly in the __________ lobe. a. left lower b. left upper c. right lower d. right upper ANS: B

Congenital bronchial atresia is most commonly found in the left upper lobe.

PTS: 1 REF: p. 1413 OBJ: List the normal sonographic features of the thorax and diaphragm.

TOP: Abnormalities of the thoracic cavity 19. The most common type of diaphragmatic defect occurs: a. posteriorly and laterally. b. posteriorly and medially. c. anteriorly and laterally. d. anteriorly and medially.

ANS: A

The most common type of diaphragmatic defect occurs posteriorly and laterally.

PTS: 1 REF: p. 1414 OBJ: Discuss the sonographic findings in a diaphragmatic hernia.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank TOP: Abnormalities of the diaphragm 20. Herniation through the foramen of Bochdalek is usually found on which one of the following

portions of the diaphragm? a. Anterior b. Right c. Medial d. Left ANS: D

Herniation through the foramen of Bochdalek is usually found on the left portion of the diaphragm.

PTS: 1 REF: p. 1414 OBJ: Discuss the sonographic findings in a diaphragmatic hernia.

TOP: Abnormalities of the diaphragm 21. Abnormalities within the thoracic cavity include all of the following except: a. pleural effusion. b. pulmonary sequestration. c. brachial cleft cyst. d. cystic adenomatoid malformation.

ANS: C

Brachial cleft cyst is submandibular in location.

PTS: 1 REF: p. 1408 OBJ: List the normal sonographic features of the thorax and diaphragm.

NURcavity SINGTB.COM TOP: Abnormalities of the thoracic 22. Which one of the following does not describe sonographic features of a right-sided

diaphragmatic hernia? a. The liver is seen in the chest. b. A collapsed bowel may be present. c. The stomach lies superior to the diaphragm. d. The heart is deviated far to the left.

ANS: C

In right-sided herniation, the stomach appears abnormal and is located slightly to the right but inferior to the diaphragm.

PTS: 1 REF: p. 1416 OBJ: Discuss the sonographic findings in a diaphragmatic hernia.

TOP: Abnormalities of the diaphragm 23. The mortality rate at birth for the fetus with a diaphragmatic hernia is ____________. a. low b. mild c. moderate d. high ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank Because of pulmonary hypoplasia and secondary to pulmonary insufficiency, the mortality rate at birth for a fetus with a diaphragmatic hernia is high.

PTS: 1 REF: p. 1417 OBJ: Discuss the sonographic findings in a diaphragmatic hernia.

TOP: Abnormalities of the diaphragm 24. Diaphragmatic hernia is frequently associated with all of the following except: a. facial cleft. b. talipes. c. cardiac defect. d. vertebral defect.

ANS: B

Diaphragmatic hernia is frequently associated with facial cleft, cardiac defect, vertebral defect, pulmonary hypoplasia, and central nervous system and renal abnormalities.

PTS: 1 REF: pp. 1416-1417 OBJ: Discuss the sonographic findings in a diaphragmatic hernia.

TOP: Abnormalities of the diaphragm 25. The presence of a pleural effusion may cause which one of the following to occur? a. Enlargement of the heart b. Enhancement of the diaphragm c. A shift of mediastinal structures d. A bronchogenic cyst ANS: C

N R I G B.C M

U SmayNcause T a shift O of mediastinal structures, compression of The presence of a pleural effusion the heart, and inversion of the diaphragm.

PTS: 1 REF: p. 1410 OBJ: Differentiate between solid and cystic lesions of the lung.

TOP: Abnormalities of the thoracic cavity

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 62: Fetal Anterior Abdominal Wall Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. The rupture of the amnion that leads to entrapment or entanglement of the fetal parts by the

“sticky” chorion is called which one of the following? a. Beckwith-Wiedemann syndrome b. Amniotic band syndrome c. Pentalogy of Cantrell d. Gastroschisis ANS: B

Amniotic band syndrome is a result of an amnion rupture that leads to the entanglement of the fetal parts by the “sticky” chorion.

PTS: 1 REF: p. 1427 OBJ: Explain the sonographic findings in a fetus with amniotic band syndrome.

TOP: Abnormalities of the anterior abdominal wall 2. A defect in the lower abdominal wall and anterior wall of the urinary bladder is which one of

the following? a. Cloacal exstrophy b. Amniotic band syndrome c. Umbilical hernia d. Ectopic bladder ANS: A

NURSINGTB.COM

Cloacal exstrophy is a defect in the lower abdominal wall and anterior wall of the urinary bladder.

PTS: 1 REF: p. 1429 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 3. An anomaly with large cranial defects, facial cleft, large body-wall defects, and limb

abnormalities is called which one of the following? a. Pentalogy of Cantrell b. Beckwith-Wiedemann syndrome c. Dandy-Walker malformation d. Limb–body wall complex ANS: D

Limb–body wall complex is an anomaly with large cranial defects, facial cleft, large body-wall defects, and limb abnormalities.

PTS: 1 REF: p. 1431 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Key Pearls

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 4. Evaluation of the fetal abdominal wall that demonstrates evisceration of the bowel to the right

of the umbilical cord is most representative of which one of the following? a. Gastroschisis b. Omphalocele c. Limb–body wall defect d. Umbilical hernia ANS: A

A gastroschisis is an opening in the layers of the abdominal wall with evisceration of the bowel that is nearly always to the right of the umbilical cord.

PTS: 1 REF: p. 1426 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 5. If omphalocele and scoliosis are found in the fetus, which one of the following conditions

should be considered? a. Pentalogy of Cantrell b. Skeletal dysplasia c. Limb–body wall complex d. Amniotic band syndrome ANS: C

When scoliosis is found with an omphalocele, limb–body wall complex should be considered.

PTS: 1 REF: p. 1423 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior wall M N Rabdominal I G B.C

U S N T

O

6. If a low omphalocele is found in the fetus, other anomalies may include all of the following

except: a. bladder or cloacal exstrophy. b. anal atresia. c. esophageal atresia. d. spina bifida.

ANS: C

Anomalies associated with a low omphalocele include bladder or cloacal exstrophy, anal atresia, spina bifida, and lower limb defects.

PTS: 1 REF: p. 1426 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 7. Beckwith-Wiedemann syndrome includes all of the following except: a. organomegaly. b. macroglossia. c. omphalocele. d. gastroschisis.

ANS: D

Beckwith-Wiedemann syndrome includes organomegaly, macroglossia, and omphalocele.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

PTS: 1 REF: p. 1429 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 8. A gastroschisis is a consequence of atrophy of which one of the following vessels? a. Right umbilical vein b. Left umbilical vein c. Right umbilical artery d. Left umbilical artery ANS: A

A gastroschisis is thought to be a consequence of atrophy of the right umbilical vein or a disruption of the omphalomesenteric artery.

PTS: 1 REF: p. 1426 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 9. Bladder exstrophy is characterized by a defect in the lower abdominal wall and anterior wall

of the urinary bladder. This abnormality may be accompanied by all of the following except: a. omphalocele. b. inguinal hernia. c. gastroschisis. d. undescended testes.

ANS: C

Bladder exstrophy may be accompanied by an omphalocele, an inguinal hernia, undescended NURSINGTB.COM testes, and anal disorders.

PTS: 1 REF: p. 1429 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 10. Which of the following types of anterior abdominal wall defects are the most common? a. Gastroschisis, inguinal hernia, and ectopia cordis b. Omphalocele, ectopia cordis, and umbilical hernia c. Gastroschisis, umbilical hernia, and omphalocele d. Omphalocele, gastroschisis, and limb–body wall complex ANS: C

A gastroschisis, an omphalocele, and an umbilical hernia are the most common anterior abdominal wall defects.

PTS: 1 REF: p. 1420 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 11. A critical part of the process of closing the abdominal wall is which one of the following? a. Herniation of the midgut b. Embryonic folding c. Shortening of the neural tube

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Expansion of the amniotic cavity ANS: B

Folding helps the embryo to transform itself into a cylindrical shape. This transformation is a critical part of the process of closing the abdominal wall.

PTS: 1 REF: p. 1419 OBJ: Describe the embryology of the abdominal wall.

TOP: Abnormalities of the anterior abdominal wall 12. The normal embryologic herniation of the bowel permits which one of the following? a. Expansion of the thorax b. Development of the intra-abdominal organs c. Development of the umbilical cord d. Development of the diaphragm ANS: B

The normal embryologic herniation of the bowel permits the development of the intra-abdominal organs.

PTS: 1 REF: p. 1421 OBJ: Describe the embryology of the abdominal wall.

TOP: Embryology of the abdominal wall 13. Which one of the following statements about an omphalocele is correct? a. The herniation is covered by a membrane that consists of amnion and chorion. b. An omphalocele that contains only bowel has a higher risk for chromosomal

abnormalities. c. The maternal serum alpha-fetoprotein (MSAFP) level will be significantly

elevated.

N R I G B.C M

U S Ndefect T located O to the right of the umbilicus. d. An omphalocele is a periumbilical ANS: B

Omphaloceles that contain only bowel have a higher risk for chromosomal abnormalities.

PTS: 1 REF: p. 1422 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 14. A 19-week fetus with elevated MSAFP shows herniated, free-floating bowel loops, which

most likely represent a(n) __________________. a. omphalocele b. umbilical hernia c. gastroschisis d. jejunoileal atresia ANS: C

A gastroschisis causes a significant elevation of MSAFP. The demonstration of herniated, free-floating bowel loops along with the elevated MSAFP most likely represents a gastroschisis.

PTS: 1 REF: p. 1426 OBJ: List the sonographic findings for an omphalocele and a gastroschisis.

TOP: Abnormalities of the anterior abdominal wall

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 15. The five defects of pentalogy of Cantrell include which of the following? a. Omphalocele, ectopic lung, proximal sternum defect, diaphragmatic hernia, and

anterior pericardium b. Gastroschisis, ectopic heart, proximal sternum defect, diaphragmatic hernia, and

anterior pericardium c. Omphalocele, ectopic heart, distal sternum defect, diaphragmatic hernia, and

diaphragmatic pericardium d. Gastroschisis, ectopic lung, distal sternum defect, diaphragmatic hernia, and

diaphragmatic pericardium.

ANS: C

Pentalogy of Cantrell is a rare anomaly that demonstrates five defects: (1) omphalocele, (2) ectopia cordis, (3) distal sternum defect (cleft), (4) diaphragmatic hernia, and (5) diaphragmatic pericardium.

PTS: 1 REF: p. 1421 OBJ: Identify the fetal anomalies in Pentalogy of Cantrell.

TOP: Abnormalities of the anterior abdominal wall 16. Which one of the following statements about a gastroschisis is false? a. Gastroschisis is found more frequently in males. b. Gastroschisis is located next to the normal cord insertion. c. MSAFP levels are significantly elevated. d. Small bowel is not always found in the herniation.

ANS: D

Small bowel is always found in the herniation of a gastroschisis.

NURSINGTB.COM

PTS: 1 REF: p. 1426 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 17. The prognosis for an infant with an uncomplicated gastroschisis is which one of the

following? a. Excellent b. Moderate c. Poor d. Extremely poor ANS: A

The prognosis for an infant with an uncomplicated gastroschisis is excellent.

PTS: 1 REF: p. 1427 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 18. The most dramatic finding in ectopia cordis is which one of the following? a. Cleft lip and palate b. Umbilical vein separate from the umbilical arteries c. Heart outside of the thoracic cavity d. Omphalocele

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank ANS: C

The most dramatic finding in ectopia cordis is the presence of the heart outside of the thoracic cavity. A portion or all of the heart may protrude through the defect in the sternum.

PTS: 1 REF: p. 1430 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormal fetal development 19. A high or superumbilical omphalocele is usually the primary finding in which one of the

following conditions? a. Limb–body wall complex b. Beckwith-Wiedemann syndrome c. Meckel-Gruber syndrome d. Pentalogy of Cantrell ANS: D

A high or superumbilical omphalocele is usually the primary finding in pentalogy of Cantrell.

PTS: 1 REF: p. 1430 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 20. Limb–body wall defects are more common: a. on the right side than the left side. b. on the left side than the right side. c. in females. d. anteriorly than posteriorly.

ANS: B

NURSINGTB.COM

Limb–body wall defects are three times more common on the left side than on the right side.

PTS: 1 REF: p. 1431 OBJ: Define and describe the anterior abdominal wall abnormalities discussed in this chapter.

TOP: Abnormalities of the anterior abdominal wall 21. Common anomalies coexisting with a gastroschisis include which one of the following? a. Cleft lip b. Renal agenesis c. Cardiac defects d. None of the above ANS: D

Coexisting anomalies are rare with a gastroschisis.

PTS: 1 REF: p. 1427 OBJ: List the sonographic findings for an omphalocele and a gastroschisis.

TOP: Abnormalities of the anterior abdominal wall 22. Notably dilated, free-floating bowel loops may suggest which one of the following? a. Infarction b. Amniotic band syndrome c. Intrauterine growth restriction

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Hydrops ANS: A

Notably dilated, free-floating bowel loops may suggest infarction.

PTS: 1 REF: p. 1427 OBJ: List the sonographic findings for an omphalocele and a gastroschisis.

TOP: Abnormal fetal development 23. The herniation of an omphalocele is covered by a membrane that consists of the __________

and __________. a. amnion; chorion b. amnion; peritoneum c. chorion; Wharton’s jelly d. amnion; Wharton’s jelly ANS: B

The herniation of an omphalocele is covered by a membrane that consists of the amnion and peritoneum.

PTS: 1 REF: p. 1423 OBJ: List the sonographic findings for an omphalocele and a gastroschisis.

TOP: Abnormalities of the anterior abdominal wall 24. The umbilical vein drains all of the following except the: a. placenta. b. body stalk. c. yolk sac.

N R I G B.COM d. evolving abdominal wall. U S N T ANS: C

The umbilical vein drains the placenta, body stalk, and evolving abdominal wall.

PTS: 1 REF: p. 1420 OBJ: Describe the embryology of the abdominal wall.

TOP: Embryology of the abdominal wall 25. The hepatic bud enlarges and the right umbilical vein atrophies during the _____ gestational

week. a. sixth b. seventh c. eighth d. ninth ANS: B

The hepatic bud enlarges and the right umbilical vein atrophies during the seventh gestational week.

PTS: 1 REF: p. 1420 OBJ: Describe the embryology of the abdominal wall.

TOP: Embryology of the abdominal wall

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 63: Fetal Abdomen Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. A fetus with partial situs inversus demonstrates which of the following abnormalities? a. Stomach is on the right, and the heart is on the left. b. Stomach is on the left, and the heart is on the left. c. Gallbladder is on the right, and the spleen is on the left. d. Stomach is on the left, and the gallbladder is on the right.

ANS: A

In partial situs inversus, only the heart or the abdominal organs are reversed.

PTS: 1 REF: p. 1439 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the hepatobiliary system 2. In a transverse image, evidence of the “double bubble” sign in a fetus with trisomy 21

represents which one of the following conditions? a. Jejunoileal stenosis b. Meconium ileus c. Multicystic dysplastic kidney d. Duodenal atresia ANS: D

Approximately 30% of fetuses trisomy 21 demonstrate duodenal atresia. Duodenal NUwith RSI GTB.C M N O atresia appears as two anechoic adjacent structures and is called the “double bubble” sign.

PTS: 1 REF: p. 1443 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the gastrointestinal tract 3. A fetus with dilated loops of echogenic bowel should be evaluated for all of the following

except: a. cystic fibrosis. b. meconium peritonitis. c. duodenal atresia. d. bowel obstruction.

ANS: C

A fetus with bowel obstruction, meconium peritonitis, and cystic fibrosis may demonstrate dilated loops of echogenic bowel.

PTS: 1 REF: p. 1444 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the hepatobiliary system 4. The spleen is visualized on a transverse plane, just _________________. a. anterior to the liver b. posterior to the liver

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. posterior and left of the stomach d. anterior and left of the stomach ANS: C

The spleen is visualized on a transverse plane, just posterior and to the left of the stomach.

PTS: 1 REF: p. 1438 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Sonographic evaluation of the abdominal cavity 5. Causes of echogenic areas in the fetal abdomen may be all of the following except: a. peritoneal calcification. b. meconium peritonitis. c. duodenal atresia. d. hydrometrocolpos.

ANS: C

Duodenal atresia typically demonstrates adjacent anechoic structures.

PTS: 1 REF: p. 1446 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Sonographic evaluation of the abdominal cavity 6. A cystic growth of the common bile duct is ______________. a. choledochal cyst b. cholelithiasis c. pseudocyst d. biliary atresia ANS: A

NURSINGTB.COM

A cystic growth of the common bile duct describes a choledochal cyst.

PTS: 1 REF: p. 1441 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the hepatobiliary system 7. Haustral folds can be found within which one of the following structures? a. Small bowel b. Colon c. Liver d. Stomach ANS: B

Haustral folds are found in the colon.

PTS: 1 REF: p. 1437 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Sonographic evaluation of the abdominal cavity 8. Choose the remnant of the proximal yolk stalk. a. Choledochal cyst b. Meconium peritonitis c. Meckel diverticulum

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Urachal cyst ANS: C

Meckel diverticulum is a remnant of the proximal part of the yolk sac that fails to degenerate and disappear during the early fetal period.

PTS: 1 REF: p. 1435 OBJ: Describe the development of the digestive system and list the unique features of the fetal abdomen.

TOP: Embryology of the digestive system 9. A sonographic demonstration of the normal esophagus in the second and third trimesters

appears as a _________________. a. multilayered pattern b. hockey stick pattern c. Mickey Mouse configuration d. double bubble pattern ANS: A

The normal esophagus appears as two or more parallel echogenic lines (multilayered pattern).

PTS: 1 REF: p. 1436 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Sonographic evaluation of the abdominal cavity 10. Which one of the following malformations of the midgut is most common? a. Umbilical hernia b. Meckel diverticulum c. Omphalocele NURSINGTB.COM d. Gastroschisis ANS: B

Meckel diverticulum is the most common malformation of the midgut.

PTS: 1 REF: p. 1435 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Embryology of the digestive system 11. The distinction of the large bowel from the small bowel is possible as early as ____ weeks’

gestation. a. 16 b. 20 c. 24 d. 28 ANS: B

The distinction of the large bowel from the small bowel is possible as early as 20 weeks’ gestation.

PTS: 1 REF: p. 1437 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Sonographic evaluation of the abdominal cavity 12. Which one of the following statements about the fetal stomach is incorrect?

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. b. c. d.

Most fetuses greater than 14 to 16 weeks demonstrate fluid in their stomach.

A significant variation in the size of the stomach may be seen.

Echogenic debris may be seen in the dependent portion of the stomach.

An esophageal anomaly is the most common cause of nonvisualization of the stomach.

ANS: D

An esophageal anomaly is the least common cause of nonvisualization of the fetal stomach.

PTS: 1 REF: p. 1436 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Sonographic evaluation of the abdominal cavity 13. A transposition of the liver and stomach, an absence of the gallbladder, multiple spleens, and

a disruption of the inferior vena cava describes which one of the following conditions? a. Asplenia b. Pentalogy of Cantrell c. Polysplenia d. Bisplenia ANS: C

Polysplenia (more than one spleen) demonstrates the transposition of the liver and stomach, an absence of the gallbladder, multiple spleens, and a disruption of the inferior vena cava.

Cardiac malformation is seen in 90% of fetuses.

PTS: 1 REF: p. 1439 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

Abnormalities of the hepatobiliary system N R I GTOP: B.C M

U S N T

O

14. A sonolucent band identified near the fetal anterior abdominal wall represents which one of

the following? a. Fetal hydrops b. Pseudoascites c. Ascites d. Amniotic band syndrome ANS: B

A sonolucent band identified near the fetal anterior abdominal wall represents pseudoascites.

The band results from normal musculature surrounding the abdominal wall.

PTS: 1 REF: p. 1441 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Abnormalities of the hepatobiliary system 15. The most reliable criterion for diagnosing dilated bowel is which one of the following? a. Bowel diameter b. Double bubble sign c. Polyhydramnios d. Megacolon ANS: A

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank The most reliable criterion for diagnosing dilated bowel is an increase in bowel diameter, rather than its sonographic appearance.

PTS: 1 REF: p. 1442 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Abnormalities of the gastrointestinal tract 16. Causes of the double bubble sign include all of the following except: a. diaphragmatic hernia. b. annular pancreas. c. choledochal cyst. d. duodenal stenosis.

ANS: C

A choledochal cyst may mimic the double bubble sign but is not a cause.

PTS: 1 REF: p. 1443 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the gastrointestinal tract 17. Coexisting anomalies of fetuses with esophageal atresia include all of the following except: a. vertebral defects. b. renal anomalies. c. cardiac defects. d. ascites.

ANS: D

Coexisting anomalies of fetuses include vertebral anomalies (V), anal atresia (A), cardiac N RSIN G B.COM atresia (E), renal agenesis (R), and limb defects (C), tracheoesophagealUfistula (T),Tesophageal abnormalities (L), which form the mnemonic, VACTERL. Ascites is not considered an anomaly.

PTS: 1 REF: p. 1443 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the gastrointestinal tract 18. The derivatives of the hindgut include all of the following except: a. descending colon. b. sigmoid colon. c. cecum. d. urethra.

ANS: C

The cecum is a derivative of the midgut.

PTS: 1 REF: p. 1435 OBJ: Describe the development of the digestive system and list the unique features of the fetal abdomen.

TOP: Embryology of the digestive system 19. The normal diameter of the fetal small bowel is less than or equal to ____ millimeters (mm). a. 3 b. 4

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. 5 d. 6 ANS: C

The normal diameter of the fetal small bowel is less than or equal to 5 mm.

PTS: 1 REF: p. 1437 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Sonographic evaluation of the abdominal cavity 20. The sonographic criteria for choledochal cyst include all of the following except: a. close proximity of the cyst to the neck of the gallbladder. b. decreased size of a cyst and gallbladder on serial examinations. c. ovoid right upper-quadrant cyst with an entering bile duct. d. absence of peristalsis within the cyst.

ANS: B

The choledochal cyst and gallbladder increase in size on serial examinations.

PTS: 1 REF: p. 1441 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the hepatobiliary system 21. Peritoneal calcifications noted in a fetus at 30 weeks’ gestation may represent which one of

the following? a. Echogenic meconium b. Cholelithiasis c. Anorectal atresia d. Meconium peritonitis

NURSINGTB.COM

ANS: D

Peritoneal calcifications may represent meconium peritonitis or hydrometrocolpos.

PTS: 1 REF: p. 1446 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Box 63-5 22. VACTERL is a group of anomalies associated with which one of the following? a. Duodenal atresia b. Esophageal atresia c. Jejunoileal atresia d. Anorectal atresia ANS: B

VACTERL is associated with esophageal atresia.

PTS: 1 REF: p. 1443 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the gastrointestinal tract 23. Which one of the following statements about the fetal liver is incorrect? a. The fetal liver is large compared with other intraabdominal organs. b. The hepatic veins and fissures are formed by the end of the first trimester.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. The right lobe is larger than the left lobe. d. The liver occupies most of the upper abdomen.

ANS: C

The left lobe is larger than the right lobe, secondary to the greater supply of oxygenated blood.

PTS: 1 REF: p. 1437 OBJ: Describe the normal development of the stomach and the importance of its sonographic visualization.

TOP: Sonographic evaluation of the abdominal cavity 24. Which one of the following describes total situs inversus? a. Heart is on the right, the liver is on the left, and the gallbladder on the right. b. Heart is on the right, the liver is on the left, and the spleen is on the right. c. Spleen is on the right, the heart is on the left, and the gallbladder is on the left. d. Liver is on the right, the spleen is on the left, and the heart is on the right.

ANS: B

The heart and abdominal organs are completely reversed in total situs inversus.

PTS: 1 REF: p. 1439 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the hepatobiliary system 25. A complex disorder of the bowel and genitourinary tract is called which one of the following

abnormalities? a. Hirschsprung disease b. Jejunoileal atresia c. Anorectal atresia d. Meconium peritonitis

NURSINGTB.COM

ANS: C

Anorectal atresia is a complex disorder of the bowel and genitourinary tract.

PTS: 1 REF: p. 1446 OBJ: Define abnormalities of the fetal gastrointestinal tract and hepatobiliary system and describe their sonographic findings.

TOP: Abnormalities of the gastrointestinal tract

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 64: Fetal Urogenital System Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Kidneys should be sonographically documented in all fetuses beginning at ______ weeks’

gestation. a. 12 b. 15 c. 18 d. 20 ANS: C

Beginning at 18 weeks’ gestation, kidneys should be sonographically documented in all fetuses.

PTS: 1 REF: p. 1453 OBJ: Describe the sonographic appearance of the fetal kidneys and bladder.

TOP: Sonographic evaluation of the urogenital system 2. Protrusion of the posterior wall of the urinary bladder, which contains the trigone of the

bladder and the ureteric orifices, is called which one of the following? a. Limb–body wall syndrome b. Prune belly syndrome c. Cryptorchidism d. Exstrophy of the bladder ANS: D

NURSINGTB.COM

Exstrophy of the bladder is characterized by the protrusion of the posterior wall of the urinary bladder, which contains the trigone of the bladder and the ureteric orifices.

PTS: 1 REF: p. 1460 OBJ: Discuss the development of the urogenital and genital systems.

TOP: Abnormalities of the urinary tract 3. A condition in which both ovarian and testicular tissues are present is ______________. a. cryptorchidism b. hermaphroditism c. hydrometrocolpos d. hypospadias ANS: B

Hermaphroditism is a rare condition in which both ovarian and testicular tissues are present.

PTS: 1 REF: p. 1475 OBJ: Identify congenital malformations of the genital system.

TOP: Congenital malformations of the genital system 4. Sonographic findings in complete renal agenesis include all of the following except: a. oligohydramnios. b. absence of urine in the fetal bladder.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. dilated fetal bladder. d. small thorax.

ANS: C

In bilateral (complete) renal agenesis, the kidneys and bladder are not sonographically visualized.

PTS: 1 REF: p. 1460 TOP: Abnormalities of the urinary tract

OBJ: Detail the complications of renal agenesis.

5. Renal agenesis, oligohydramnios, pulmonary hypoplasia, abnormal facies, and malformed

hands and feet may be found in which one of the following conditions? a. Potter syndrome b. Infantile polycystic disease c. Meckel-Gruber syndrome d. Beckwith-Wiedemann syndrome ANS: A

Renal agenesis, oligohydramnios, pulmonary hypoplasia, abnormal facies, and malformed hands and feet may be found in Potter syndrome.

PTS: 1 REF: p. 1458 OBJ: Discuss the development of the urogenital and genital systems.

TOP: Renal agenesis 6. Which one of the following characteristics of multicystic dysplastic kidney disease is most

common? a. Distinct renal pelvis NURSINGTB.COM b. Multiple noncommunicating cysts of variable size c. Large kidneys with hyperechoic parenchyma d. Oligohydramnios ANS: B

Multiple noncommunicating cysts of variable sizes make up the most common characteristic of multicystic dysplastic renal disease.

PTS: 1 REF: p. 1463 TOP: Renal cystic disease

OBJ: Differentiate renal cystic disease.

7. Which one of the following sites of hydronephrosis in the neonate is the most common? a. Ureterovesical junction b. Level of the urethra c. Ureteropelvic junction (UPJ) d. Junction of the pyramids and the major capsule ANS: C

The UPJ obstruction is the most common reason for hydronephrosis in the neonate.

PTS: 1 REF: p. 1467 OBJ: Distinguish between the different types of urinary obstruction.

TOP: Obstructive urinary tract abnormalities 8. All of the following findings are observed in hydronephrosis except:

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank a. anteroposterior (AP) renal pelvic diameter is greater than 5 to 10 millimeters

(mm). b. rim of renal parenchyma is preserved. c. calyceal distention is seen with central pelvis communication. d. renal enlargement is found.

ANS: D

Renal enlargement is not a finding in hydronephrosis.

PTS: 1 REF: pp. 1456-1457 OBJ: Distinguish between the different types of urinary obstruction.

TOP: Obstructive urinary tract abnormalities 9. A dilated bladder with a “keyhole” appearance is most likely which one of the following

conditions? a. Ureterovesical junction obstruction b. Posterior urethral valve obstruction c. Reflux of the ureter into the bladder d. UPJ obstruction ANS: B

Posterior urethral valve obstruction demonstrates a “keyhole” appearance on ultrasound.

PTS: 1 REF: p. 1470 OBJ: Distinguish between the different types of urinary obstruction.

TOP: Obstructive urinary tract abnormalities 10. Sonographic findings in prune belly syndrome include all of the following except: NURSINGTB.COM a. oligohydramnios. b. pulmonary hypoplasia. c. fetal ascites. d. renal agenesis.

ANS: D

Sonographic findings in prune belly syndrome include oligohydramnios, pulmonary hypoplasia, fetal ascites, and mild-to-severe bilateral hydronephrosis.

PTS: 1 REF: pp. 1471-1472 OBJ: Detail the complications of renal agenesis.

TOP: Obstructive urinary tract abnormalities 11. The bladder wall thickness in a fetus is normally _____ mm. a. 2 b. 3 c. 4 d. 5 ANS: A

The normal bladder wall can be measured and should be thin (2 mm or less).

PTS: 1 REF: p. 1453 OBJ: Describe the sonographic appearance of the fetal kidneys and bladder.

TOP: Sonographic evaluation of the urogenital system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

12. The renal system fails to develop in which one of the following conditions? a. Posterior urethral valve b. Potter syndrome c. Prune belly syndrome d. Renal agenesis ANS: D

Renal agenesis means a virtual absence of one or both kidneys.

PTS: 1 REF: p. 1458 TOP: Abnormalities of the urinary tract

OBJ: Detail the complications of renal agenesis.

13. The permanent kidneys arise from the ____________________. a. pronephros b. metanephros c. mesonephroi d. mesoderm ANS: B

The permanent kidneys arise from the metanephros and begin to develop early in the fifth gestational week.

PTS: 1 REF: p. 1450 OBJ: Discuss the development of the urogenital and genital systems.

TOP: Embryology and development of the urogenital system 14. The ureteric bud gives rise to all of the following except the: NURSINGTB.COM a. ureter. b. renal pelvis. c. Bowman capsule. d. calyces.

ANS: C

The ureteric bud gives rise to the ureter, renal pelvis, calyces, and collection tubules.

PTS: 1 REF: p. 1450 OBJ: Discuss the development of the urogenital and genital systems.

TOP: Embryology and development of the urogenital system 15. The kidneys initially lie in which one of the following positions? a. Far apart in the pelvis b. Very close together in the pelvis c. Close together in the upper abdomen d. Far apart in the upper abdomen ANS: B

The kidneys initially lie very close together in the pelvis.

PTS: 1 REF: p. 1451 OBJ: Describe the sonographic appearance of the fetal kidneys and bladder.

TOP: Embryology and development of the urogenital system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 16. Which one of the following conditions develops if the lumen of the allantois persists while the

urachus forms? a. Urachal fistula b. Urachal cyst c. Exstrophy of the bladder d. Urachal sinus ANS: A

If the lumen of the allantois persists while the urachus forms, a urachal fistula develops. Then only a small part of the lumen (urachal cyst) or a larger portion of the lumen (urachal sinus) persists.

PTS: 1 REF: p. 1461 OBJ: Discuss the development of the urogenital and genital systems.

TOP: Abnormalities of the urinary tract 17. The normal AP diameter of the renal pelvis at 20 weeks’ gestation should not exceed _____

mm. a. 4 b. 5 c. 7 d. 10 ANS: A

The upper limits of normal AP measurement of the renal pelvis should not exceed 4 mm up to 33 weeks’ gestation.

PTS: 1 REF: p.N 1453 URSINGofTB.C OMkidneys and bladder.

OBJ: Describe the sonographic appearance the fetal TOP: Sonographic evaluation of the urogenital system 18. An anechoic cystic structure within the fetal bladder is most likely a ______________. a. diverticulum b. ureterocele c. urachal cyst d. ureterovesical obstruction ANS: B

A ureterocele is a cystic dilation within the fetal bladder.

PTS: 1 REF: p. 1472 OBJ: Discuss the development of the urogenital and genital systems.

TOP: Other urinary anomalies 19. The most likely cause of bilateral hydronephrosis in the fetus is which one of the following? a. Pelviureteric obstruction b. Meckel-Gruber syndrome c. Multicystic renal dysplasia d. Bladder outlet obstruction ANS: D

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank With bilateral hydronephrosis, the possibility of bladder outlet obstruction should be considered.

PTS: 1 REF: p. 1456 OBJ: Distinguish between the different types of urinary obstruction.

TOP: Renal cystic disease 20. Normal amniotic fluid volume cannot exclude renal agenesis before _____ weeks’ gestation. a. 12 to 14 b. 20 to 24 c. 14 to 16 d. 18 to 20 ANS: C

The fetal kidneys do not become the major contributor to the amniotic fluid volume until 14 to 16 weeks’ gestation. Therefore observation of the amniotic fluid volume before 14 to 16 weeks’ gestation cannot exclude renal agenesis.

PTS: 1 REF: p. 1456 OBJ: Detail the complications of renal agenesis.

TOP: Sonographic evaluation of the urogenital system 21. Sonographic findings in posterior urethral valve obstruction include all of the following

except: a. hydroureter. b. oligohydramnios. c. thinning of the bladder wall. d. hydronephrosis.

ANS: C

NURSINGTB.COM

Posterior urethral valve obstruction causes bladder dilation with a thickening of the bladder walls.

PTS: 1 REF: p. 1470 OBJ: Distinguish between the different types of urinary obstruction.

TOP: Sonographic findings suggesting abnormalities of the urogenital system 22. Which one of the following statements about a fetal ovarian cyst is incorrect? a. A fetal ovarian cyst often appears multiseptated. b. A fetal ovarian cyst often appears bilaterally. c. A fetal ovarian cyst results from maternal hormone stimulation. d. A fetal ovarian cyst has no diagnostic significance.

ANS: D

Although most fetal ovarian cysts regress, this finding has diagnostic significance because the mass may twist on itself, which may lead to torsion, rupture, or intestinal obstruction.

PTS: 1 REF: p. 1476 OBJ: Identify congenital malformations of the genital system.

TOP: Other pelvic masses

23. When the fetal kidneys appear enlarged and echogenic, the sonographer should suspect which

one of the following conditions? a. Multicystic renal dysplasia

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Infantile polycystic disease c. Renal duplication d. Congenital hydronephrosis ANS: B

When the fetal kidneys appear enlarged and echogenic, the sonographer should suspect autosomal-recessive polycystic kidney disease (ARPKD) or infantile polycystic disease.

PTS: 1 REF: p. 1457 OBJ: Describe the sonographic findings associated with abnormalities of the kidney.

TOP: Renal cystic disease 24. Renal malformations may be divided into which of the following two categories? a. Cystic and solid b. Cystic and obstructive c. Congenital and obstructive d. Congenital and cystic ANS: C

Renal malformations may be divided into two categories: (1) those involving congenital malformations, and (2) those resulting from an obstructive process.

PTS: 1 REF: p. 1458 OBJ: Distinguish between the different types of urinary obstruction.

TOP: Abnormalities of the urinary tract 25. The testes are not visible within the scrotal sac until approximately _____ weeks’ gestation. a. 25 NURSINGTB.COM b. 28 c. 32 d. 36 ANS: B

The testes are not visible within the scrotal sac until approximately 28 weeks’ gestation.

PTS: 1 REF: p. 1456 OBJ: Describe the sonographic appearance of the fetal kidneys and bladder.

TOP: Sonographic evaluation of the urogenital system

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank

Chapter 65: Fetal Skeleton Hagen-Ansert: Textbook of Diagnostic Sonography, 8th Edition MULTIPLE CHOICE 1. Which one of the following anomalies demonstrates similar ultrasound characteristics to

trisomy 18? a. Arthrogryposis multiplex congenita b. Jeune syndrome c. Multiple pterygium syndrome d. Pena-Shokeir syndrome ANS: D

Pena-Shokeir syndrome and trisomy 18 have similar features.

PTS: 1 REF: p. 1489 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Congenital hypophosphatasia 2. Which one of the following anomalies is associated with micromelia and a “hitchhiker

thumb”? a. Diastrophic dysplasia b. Ellis-van Creveld syndrome c. Roberts syndrome d. Tar syndrome ANS: A

NURSINGTB.COM

Diastrophic dysplasia is associated with micromelia and the “hitchhiker thumb.”

PTS: 1 REF: p. 1485 OBJ: List limb abnormalities and the anomalies associated with specific defects.

TOP: Congenital hypophosphatasia 3. Which one of the following terms describes a shortening of the proximal portion of the

extremity? a. Hemimelia b. Mesomelia c. Micromelia d. Rhizomelia ANS: D

Rhizomelia is a shortening of the proximal portion of the extremity.

PTS: 1 REF: p. 1481 OBJ: List limb abnormalities and the anomalies associated with specific defects.

TOP: Abnormalities of the skeleton 4. All of the following are characteristics of thanatophoric dysplasia except: a. cloverleaf skull. b. microcephaly. c. extreme micromelia.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. short ribs.

ANS: B

Thanatophoric dysplasia demonstrates macrocephaly.

PTS: 1 REF: p. 1482 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Abnormalities of the skeleton 5. Which one of the following anomalies is associated with the Amish community? a. Congenital hypophosphatasia b. Ellis-van Creveld syndrome c. Holt-Oram syndrome d. Roberts syndrome ANS: B

Ellis-van Creveld syndrome is associated with an increased frequency among the Amish community.

PTS: 1 REF: p. 1488 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Key Pearls 6. Which one of the following diagnoses is most likely when multiple fractures and a

compressible calvarium are identified? a. Achondrogenesis b. Achondroplasia c. Osteogenesis imperfecta N R I G B.COM d. Thanatophoric dysplasia U S N T ANS: C

Osteogenesis imperfecta demonstrates multiple fractures of the long bones, ribs, and spine with hypomineralization of bone causing compression of the calvarium.

PTS: 1 REF: p. 1484 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplasias 7. Which one of the following anomalies is associated with a cloverleaf skull? a. Achondroplasia b. Congenital hypophosphatasia c. Osteogenesis imperfecta d. Thanatophoric dysplasia ANS: D

Thanatophoric dysplasia may demonstrate a cloverleaf skull.

PTS: 1 REF: p. 1482 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplasias 8. Which one of the following nonlethal skeletal dysplasias is most common? a. Achondroplasia

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank b. Achondrogenesis c. Diastrophic dysplasia d. Short-rib polydactyly syndrome ANS: A

Achondroplasia is the most common nonlethal skeletal dysplasia.

PTS: 1 REF: p. 1483 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplasias 9. Which one of the following anomalies is caused by an alkaline phosphatase

deficiency? a. Achondrogenesis b. Congenital hypophosphatasia c. Diastrophic dysplasia d. Thanatophoric dysplasia ANS: B

Congenital hypophosphatasia is a condition that demonstrates diffuse hypomineralization of the bones caused by an alkaline phosphatase deficiency.

PTS: 1 REF: p. 1485 OBJ: Describe in detail the embryologic development of the fetal skeleton.

TOP: Congenital hypophosphatasia 10. A congenital condition characterized by a disorder of collagen production is which one of the

following?

NURSINGTB.COM a. Achondroplasia b. Osteogenesis imperfecta c. Achondrogenesis d. Thanatophoric dysplasia ANS: B

Osteogenesis imperfecta is a rare disorder of collagen production leading to brittle bones.

PTS: 1 REF: p. 1483 OBJ: Describe in detail the embryologic development of the fetal skeleton.

TOP: Sonographic evaluation of skeletal dysplasias 11. Sonographic findings of severe micromelia, decreased or absent ossification of the spine,

macrocephaly, and micrognathia describe which one of the following conditions? a. Osteogenesis imperfecta b. Achondroplasia c. Achondrogenesis d. Diastrophic dysplasia ANS: C

Achondrogenesis demonstrates severe micromelia, decreased or absent ossification of the spine, macrocephaly, micrognathia, short thorax and ribs, short trunk, polyhydramnios, and possibly hydrops.

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank PTS: 1 REF: p. 1483 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplasias 12. A group of lethal skeletal dysplasias characterized by bowing of the long bones is which one

of the following abnormalities? a. Diastrophic dysplasia b. Congenital hypophosphatasia c. Camptomelic dysplasia d. Postural anomalies ANS: C

Camptomelic dysplasia is a group of lethal skeletal dysplasias characterized by a bowing of the long bones.

PTS: 1 REF: p. 1485 OBJ: List limb abnormalities and the anomalies associated with specific defects.

TOP: Sonographic evaluation of skeletal dysplasias 13. Sonographic features of a small thorax, rhizomelia, renal dysplasia, and polydactyly are

associated with which one of the following conditions? a. Jeune syndrome b. Short-rib polydactyly c. Ellis-von Creveld syndrome d. Roberts syndrome ANS: A

Sonographic features of a small rhizomelia, NUthorax, RSING B.COMrenal dysplasia, and polydactyly are T associated with Jeune syndrome.

PTS: 1 REF: p. 1487 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplasias 14. A diagnosis of talipes may be made with which one of the following characteristics? a. Persistent inversion of the foot b. Persistent abnormal inversion of the foot parallel to the lower leg c. Persistent abnormal inversion of the foot perpendicular to the lower leg d. Persistent abnormal inversion of the lower leg ANS: C

A diagnosis of talipes may be made with a persistent abnormal inversion of the foot perpendicular to the lower leg.

PTS: 1 REF: p. 1490 OBJ: List limb abnormalities and the anomalies associated with specific defects.

TOP: Other limb abnormalities 15. Fusion of the lower extremities is associated with which one of the following? a. Sirenomelia b. Hypophosphatasia c. Osteogenesis imperfecta

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank d. Thanatophoric dysplasia ANS: A

Sirenomelia is an anomaly in which the fusion of the lower extremities occurs.

PTS: 1 REF: p. 1488 OBJ: List limb abnormalities and the anomalies associated with specific defects.

TOP: Congenital hypophosphatasia 16. The sonographic features of achondroplasia may not be evident until after _____ weeks’

gestation. a. 18 b. 20 c. 22 d. 24 ANS: C

The sonographic features of achondroplasia may not be evident until after 22 weeks’ gestation.

PTS: 1 REF: p. 1483 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplasias 17. The most common lethal skeletal dysplasia is which one of the following conditions? a. Osteogenesis imperfecta b. Thanatophoric dysplasia c. Achondroplasia NURSINGTB.COM d. Craniosynostosis ANS: B

Thanatophoric dysplasia is the most common lethal skeletal dysplasia.

PTS: 1 REF: p. 1482 OBJ: Describe in detail the embryologic development of the fetal skeleton.

TOP: Sonographic evaluation of skeletal dysplasias 18. Which one of the following statements about achondroplasia is incorrect? a. Advanced maternal age is a risk factor. b. Patients with heterozygous achondroplasia have a poor survival rate. c. Achondroplasia is most commonly the result of a spontaneous mutation. d. Achondroplasia results from decreased endochondral bone formation.

ANS: B

Patients with heterozygous achondroplasia have a good survival rate.

PTS: 1 REF: p. 1483 OBJ: Describe in detail the embryologic development of the fetal skeleton.

TOP: Sonographic evaluation of skeletal dysplasias 19. Type ____ classification of osteogenesis imperfecta is considered the most severe. a. I b. II

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank c. III d. IV ANS: B

Type II is considered the most severe form of osteogenesis imperfecta.

PTS: 1 REF: p. 1483 OBJ: Describe in detail the embryologic development of the fetal skeleton.

TOP: Sonographic evaluation of skeletal dysplasias 20. A rare condition characterized by phocomelia and facial anomalies is which one of the

following syndromes? a. Roberts b. Jeune c. Ellis-van Creveld d. Pena-Shokeir ANS: A

Roberts syndrome is a rare condition characterized by phocomelia and facial anomalies.

PTS: 1 REF: p. 1486 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Sonographic evaluation of skeletal dysplfferentiate sonographically among the most common skeletal dysplasias.

21. The majority of talipes is _______________. a. associated with most chromosomal abnormalities b. associated with most skeletal dysplasias NURSINGTB.COM c. idiopathic d. associated with advanced maternal age ANS: C

The majority of talipes is idiopathic and an isolated finding.

PTS: 1 REF: p. 1490 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Other limb abnormalities 22. Abnormal growth and density of cartilage and bone is described as which one of the

following? a. Skeletal anomalies b. Skeletal dysplasia c. Achondroplasia d. Osteogenesis imperfecta ANS: B

Skeletal dysplasia is the term used to describe abnormal growth and density of cartilage and bone.

PTS: 1 REF: p. 1479 OBJ: Describe in detail the embryologic development of the fetal skeleton.

TOP: Abnormalities of the skeleton

NURSINGTB.COM

Textbook of Diagnostic Sonography 8th Edition Hagen-Ansert Test Bank 23. Which one of the following conditions is caused by cartilage abnormalities that result in

abnormal bone formation and hypomineralization? a. Osteogenesis imperfecta b. Thanatophoric dysplasia c. Hypophosphatasia d. Achondrogenesis ANS: D

Achondrogenesis is caused by cartilage abnormalities that result in abnormal bone formation and hypomineralization.

PTS: 1 REF: p. 1483 OBJ: Differentiate sonographically among the most common skeletal dysplasias.

TOP: Congenital hypophosphatasia 24. A lethal skeletal dysplasia characterized by short ribs, short limbs, and polydactyly is which

one of the following? a. Hypophosphatasia b. Arthrogryposis multiplex congenita c. Short-rib polydactyly d. Camptomelic dysplasia ANS: C

Short-rib polydactyly is a lethal skeletal dysplasia characterized by short ribs, short limbs, and polydactyly.

PTS: 1 REF: p. 1487 OBJ: List limb abnormalities and the anomalies associated with specific defects.

NUR SINGTB.COM TOP: Congenital hypophosphatasia 25. Webbing across the joint and multiple contractures are sonographic findings of which one of

the following abnormalities? a. Roberts syndrome b. Jeune syndrome c. Arthrogryposis multiplex congenita d. Lethal multiple pterygium syndrome ANS: D

Lethal multiple pterygium syndrome demonstrates webbing across the joint and multiple contractures.

PTS: 1 REF: p. 1489 OBJ: List limb abnormalities and the anomalies associated with specific defects.

TOP: Congenital hypophosphatasia

NURSINGTB.COM