ARRT board review questions

following portions of the large bowel into order (A-D) from proximal to distal.

(A) Cecum (B) Ascending colon (C) Splenic flexure (D) Sigmoid colon

the following structures into order (A-D) from superior to inferior.

(A) Fundus (B) Gastroesophageal junction (C) Incisure angularis (D) Pylorus

the following body habitus types into order (A-D) from largest to smallest.

(A) Hypersthenic (B) Sthenic (C) Hyposthenic (D) Asthenic

the following structures into anatomic order (A-D), that is, the order in which an oral administration of barium sulfate would pass through them.

(A) Pylorus (B) Duodenum (C) Ileum (D) Sigmoid

WHich may be effects of fetal irradiation? - childhood and early adult cancers -prenatal death -spontaneous abortion - cancers late n adult life -growth retardation

- childhood and early adult cancers -prenatal death -spontaneous abortion -growth retardation

Which statement represents the best guideline for minimizing patient exposure? - a minimum of a 12-in source-to-skin distance must be maintained for fixed fluoroscopy -lowest possible kilivoltage peak used to reduce the amount of radiation striking the patient -total filtration at least 2.5mm Al Eq for units operating at 50-70 kVp -high speed image receptors and immobilization used when performing pediatric exams

-high speed image receptors and immobilization used when performing pediatric exams

Which statement correctly describes the LD 50/30? - lethal dose for 30% of the population -lethal dose for 30% of the cells in 30 days -lethal dose for 50% of the cells in 30 days -lethal dose for 50% of the population in 30 days

-lethal dose for 50% of the population in 30 days

What is the minimum thickness of the requirement for protective lead curtains?

.25 mm Pb

The central-ray angle for a lateral coccyx and sacrum is:

0 degrees

Which of the following equipment is necessary for ERCP?

1. A fluoroscopic unit with imaging device and tilt table capabilities 2. A fiberoptic endoscope 3. Polyethylene catheters

For which of the following conditions is operative cholangiography a useful tool?

1. Biliary tract calculi 2. Patency of the biliary ducts 3. Function of the sphincter of Oddi

Which of the following projections of the abdomen may be used to demonstrate air or fluid levels?

1. Dorsal decubitus 2. Lateral decubitus

What instructions might a patient be given following an upper GI examination?

1. Drink plenty of fluids. 2. Take a mild laxative. 3. Increase dietary fiber.

A patient is usually required to drink barium sulfate suspension to demonstrate which of the following structures?

1. Esophagus 2. Pylorus

Place the following steps in order of importance

1. High mA, short exposure time combinations 2. Expose at full inspiration 3. Immobilization devices 4. A family member to hold the patient

Which projection(s) of the abdomen would be used to demonstrate pneumoperitoneum?

1. Left lateral decubitus 2. Upright

Which statements are accurate about control monitoring badges?

1. Measures background exposure during transportation, handling, and storage 2. Should be kept in a distant room from the radiation area

Possible effects of fetal irradiation. (four)

1. Prenatal death. 2. Childhood and early adult cancers. 3. Spontaneous abortion. 4. Growth retardation

What steps increase contrast in fluoroscopy?

1. Reduce kVp 2. Use a smaller collimator field

Accurate statements about control monitoring badges. (two)

1. Should be kept in a distant room from the radiation area. 2. Measures background exposure during transportation, handling, and storage.

Which of the following structures is (are) located in the left upper quadrant (LUQ)?

1. Stomach 2. Spleen

Ingestion of barium sulfate is contraindicated in which of the following situations?

1. Suspected perforation of a hollow viscus 2. Suspected large-bowel obstruction 3. Presurgical patients

During an upper gastrointestinal (GI) examination, the AP recumbent projection of a stomach of average shape will usually demonstrate

1. barium-filled fundus. 2. double-contrast body and antral portions.

Occasionally, a patient may have to be placed in the prone position for a sacrum radiography, and a PA projection performed. What is the central-ray angle for this projection?

15 degrees caudad

CR entrance for AP axial c-spine?

15-20 cephalic, C4.

Where does the central ray enter the patient for an AP axial projection of the coccyx?

2 inches superior to the pubic symphysis

Where does the central ray enter the patient for an AP axial projection of the sacrum?

2 inches superior to the pubic symphysis

Which technique produces a 2 milliroentgens (mR) exposure to an image receptor plate if 70 kilovolts peak (kVp) at 25 milliampere-seconds (mAs) produces 1.6 mR? 70 kVp at 27.5 mAs. Incorrect 70 kVp at 31.25 mAs. Correct 70 kVp at 50 mAs. 70 kVp at 35 mAs.

2 mR is 25% greater than 1.6 mR; so, a 25% increase in mAs achieves this result. 25 mAs x 1.25 = 31.25 mAs. All other responses are incorrect due to math errors or misunderstanding the relationship of mAs to exposure.

*Routine* RAO (35 - 45°) LATERAL AP (PA) *Special* LAO Soft-tissue lateral

3 Routine projections for Esophagram 2 Special projections

How is the central ray directed with an AP knee for thin thighs and butt?

3-5 caudad.

raise exposure factors

42 which change should be made when performing an abdomen radiograph on a patient with ascites? a. choose a lower milliampere (mA) station b. raise exposure factors c. use an abdominal compression device. d. increase source to image receptor distance

How many vertebrae are there in the sacrum?

5

11. A portable knee exam performed in the operating room results in a beam intensity of 2.5 R at 32 inches. What is the intensity of the beam if the same exposure factors are used for a post-operative knee at a distance of 40 inches? A 1.60 R. B 3.90 R. C 3.12 R. D 2.00 R.

A 1.60 R The inverse square formula (I1/I2=D22/D21) is used to determine the new intensity: 2.5 / x = 1600 (40 squared) / 1024 (32 squared); x = (2.5) (1024) / 1600 = 1.6 R. All other answers result from incorrect usage of the inverse square formula.

The lead radiographer is planning a strategy to efficiently manage the morning workload. The department is short-staffed due to meetings and four patients are now ready for their examinations. Assuming none of the exams are emergent which patient should be seen first?

A 2 year old child for a barium swallow.

16. Which device temporarily stores an electric charge? A Capacitor. B Autotransformer. C Diode. D Rectifier.

A Capacitor. A capacitor temporarily stores an electric charge. A diode only allows electrons to flow in one direction. A rectifier converts alternating current (AC) to direct current (DC). An autotransformer is a transformer operating on the process of self-induction.

192. Can the positioning of this oblique view of the c-spine be improved? A Yes, the foramina would open more if the CR was angled 15 degrees cephalic B Yes, the head should be turned into a true lateral position. C No, it is optimum. D No, the problem here is exposure, not positioning.

A Yes, the foramina would open more if the CR was angled 15 degrees cephalic The positioning of this oblique view of the c-spine could be improved by angling the CR 15 degrees cephalic. This appearance is characteristic of oblique c-spines done without CR angle. Note the essentially lateral appearance of the posterior arch of C1. It is not optimum. The head should be nearer to true lateral and the chin tipped up, but this is not as critical a problem as the CR angle. The exposure here is optimum.

Comminuted

A carpenter smashes his index finger with a hammer. Which type of fracture might be shown on the subsequent radiographs of the finger?

196.Place the cursor over the area which depicts history of a cholecystectomy and click to select. Created with Raphaël 2.1.0

A cholecystectomy is the removal of the gallbladder. The gallbladder is usually located in the right upper quadrant; surgical clips mark the area from which it was removed.

white line; short

A crack in the phosphor layer of the CR cassette will appear as a _________ _________, but would generally be a _________ line

High Signal-to-Noise Ratio

A high signal-to-noise ratio, which is the goal in digital radiography, reduces quantum mottle and increases contrast resolution.

The central ray will be well anterior to the L-5/S-1 junction

A lateral L-5/S-1 lumbosacral junction is performed with the central ray (CR) directed 2 inches anterior to the anterior superior iliac spine (ASIS) and 1-1/2 inches inferior to the iliac crest. Which statement describes this method?

Which step will reduce digital image noise, assuming no other changes? Longer exposure time. Correct Decreased kilovolts peak (kVp). Incorrect Small pixel size. Image magnification.

A longer exposure time results in a greater amount of photons reaching the image receptor, which reduces image noise. Decreased kVp reduces the quantity of x-rays that reach the image receptor, which increases image noise. A matrix with a large number of small pixels results in greater image noise due to the availability of fewer photons per pixel. Magnification of the digital image does not affect image noise, but it may make what noise is there more visible.

Anaphylactic Shock

A patient becomes unresponsive after an injection of iodinated contrast media. Their blood pressure is 80/50, what has occurred?

Radiologist

A patient is scheduled for IV radiology that requires General anesthesia, who is the most appropriate person to obtain informed consent?

Ask the patient if that have a history of asthma

A patient who is anxious starts wheezing, what do you do?

Vein

A patient's abdominal image reveals the presence of multiple phleboliths. Where are these small calcifications found?

Turn right side closer to image receptor (IR).

A posteroanterior (PA) chest radiograph demonstrates the left clavicle closer to the center of the spine than the right clavicle. Which action should the radiographer take?

b. right anterior oblique

A projection of the stomach with the right side of the prone body on the table and the patient's left side obliqued up at a 45 degree angle would demonstrate which position? a. left anterior oblique b. right anterior oblique c. left posterior oblique d. right posterior oblique

Barium regurgitates into esophagus

A water test is positive if ?

The radiographer is using automatic brightness control during a fluoroscopy. What change in patient exposure should the radiographer expect as the patient size increases? A. Increase in exposure B. Indeterminant change in exposure. C. No change in exposure D. Reduction in exposure.

A. Increase in exposure

All of the following may be determined by oral cholecystography

A. liver function. B. ability of the gallbladder to concentrate bile. C. emptying power of the gallbladder.

Which of the following will best demonstrate the size and shape of the liver and kidneys?

AP abdomen

What is the best projection and position to demonstrate the right cervical IVF?

AP axial LPO

Which of the following is the essential projection used to demonstrate the zygapophyseal joints of the lumbar spine?

AP oblique, RPO and LPO positions

During a double-contrast BE, which of the following positions would afford the best double-contrast visualization of both colic flexures?

AP or PA erect

Which position best demonstrates posterior rib injury above the diaphragm?

AP upright.

The region of interest.

According to Merrill's Atlas, which location represents the correct central ray (CR) placement for an axiolateral oblique mandible projection for the ramus?

What x-ray beam characteristic is reduced by adding aluminum filtration?

Added aluminum filtration results in a reduction in the quantity of x-rays in the primary beam.

A patient with a history of stroke and hemi-paralysis is transported to the x-ray department by wheelchair. Which action should the radiographer perform in order to safely transfer the patient?

Adjust the table to height of wheelchair.

a. 2" higher than normal

An UGI series on a hypersthenic patient would require what kind of adjustment of the central ray? a. 2" higher than normal b. 2" lower than normal c. more medial than normal d. no adjustment would be needed

No correction needed

An anteroposterior (AP) oblique mortise joint projection demonstrates the distal fibula without talar superimposition and an open talofibular joint. What should the radiographer do next?

Place the forearm parallel to the image receptor

An anteroposterior (AP) trauma elbow image reveals a normal-looking distal humerus, but the proximal forearm appears foreshortened. How should the radiographer position the patient for an additional AP projection?

Tibia-fibula.

An emergency room physician suspects a 14-year-old male patient may have Osgood-Schlatter's disease. Which radiographic exam might the ER physician order to evaluate this?

A patient reports symptoms including itching rash formation and difficulty breathing immediately following the administration of IV contrast. Assuming the patient has had no prior exposure to radiopaque contrast media, what is the most likely cause of these symptoms?

Anaphylactoid reaction.

Which of the following techniques would provide a PA projection of the gastroduodenal surfaces of the barium-filled, high and transverse stomach?

Angle the central ray 35° to 45° cephalad

How often should lead aprons be evaluated to determine if cracks or holes are present?

Annually

What is the best projection and position to demonstrate the right cervical intervertebral foramina?

Anteroposterior (AP) axial oblique projection, left posterior oblique (LPO) position

What habitus requires the patient to be in the Trendelenburg position during a SBS.

Asthenic.

Which patient body habitus may require the patient to be in the Trendelenburg position during a small bowel series?

Asthenic.

The x-ray beam and the light beam must correspond to 2% of the SID, so, at 50 inches, this is 1 inch. This is found by multiplying 50 inches and .02 (2%).

At a 50 inch source-to-image-receptor-distance (SID), how closely must the x-ray beam and the light field be aligned?

b. L2

At what level should the CR enter for a RAO of the stomach of an average patient? a. T12 b. L2 c. L4 d. iliac crest

ABC

Automatic Brightness Control is a fluoroscopic control to maintain image density as the image intensifier is moved over the patient.

Automatic Collimation

Automatic collimation sets the field size at the image receptor size.

Which rule is followed when examining unconscious patients?

Avoid saying things you would not say to a conscious patient

Which rule is followed when examining unconscious patients?

Avoid saying things you would not say to a conscious patient.

60.What is the term for the adjustment of image brightness, regardless of exposure received? A Detective quantum efficiency (DQE). B Rescaling. C Dose area product (DAP). D Automatic brightness control (ABC).

B Rescaling. Rescaling is the adjustment of digital data to a preset brightness depending on the body part selected. DAP is an indicator of exposure for cassetteless digital systems. DQE indicates speed class or how sensitive a receptor is to radiation exposure. ABC is a fluoroscopic control to maintain image density as the image intensifier is moved over the patient.

The tarsal sinus is visualized when the foot is seen in what projection? A. Dorsoplantar B. 30 degree medial oblique C. Lateral D. 30 degree lateral oblique

B. 30 degree medial oblique A properly positioned 30 degree medial oblique will show the tarsal sinus, located between the talus and calcaneus.

Which grid ratio results in the lowest dose to a patient, because less milliampere-seconds (mAs) is required? A. 16:01 B. 5:01 C. 8:01 D. 12:01

B. 5:01 A 5:1 grid ratio provides less exposure to the patient than higher grid ratios due to higher lead content.

The Z number of oxygen is 8. The elemental oxygen atom has two electron shells. How many electrons occupy an electrically neutral oxygen atom's outer shell? A. 4 B. 6 C. 8 D. 2

B. 6 An electrically neutral oxygen atom's outer shell contains 6 electrons. Two electrons are in the K shell and 6 in the L shell.

What is the term for a reduction in x-ray photon intensity as it passes through the patient? A. Divergence B. Attenuation C. Absorption D. Scattering

B. Attenuation The reduction in intensity of the xray beam as it passes through matter is attenuation.

Which nonverbal cue best demonstrates attentiveness and concern for a patient who is giving a medical history? A. A pleasant smile. B. Consistent eye contact. C. Taking notes. D. Turning the head to the side to place one ear closer.

B. Consistent eye contact. Maintaining eye contact is an effective way to show the patient attentiveness and concern.

A radiographer is performing a forearm exam on a patient with advanced Parkinson's Disease. Which echnical factor adjustments should be used? A. Increase the mAs from normal to compensate for increased tissue attenuation. B. Decrease the exposure time to reduce risk of patient motion. C. Increase the kilovolts peak (kVp) from normal to compensate for increased bone density. D. Decrease the milliampere-seconds (mAs) from normal to compensate for decreased bone density.

B. Decrease the exposure time to reduce risk of patient motion. Patients with Parkinson's have uncontrollable tremors, that may cause motion on a radiograph; so, shorter exposure time should be used to forestall motion in the image.

Picture archiving and communication system (PACS) networks are capable of performing which functions? (Select the two that apply.) A. Tracking billing information. B. Downloading images from different imaging modalities. C. Tracking radiology scheduling information. D. Processing laboratory reports. E. Transmitting diagnostic images to remote work stations.

B. Downloading images from different imaging modalities. E. Transmitting diagnostic images to remote work stations.

What is the maximum speed of filament electrons as they travel toward the anode? A. One-eighth the speed of light. B. Half the speed of light. C. The speed of light. D. One-fourth the speed of light.

B. Half the speed of light Filament electrons may reach speeds of about half the speed of light.

Which wrist position radiographically demonstrates the carpal canal? A. Hyperflexion. B. Hyperextension. C. Ulnar deviation. D. Radial deviation.

B. Hyperextension. The wrist must be hyperextended to radiographically demonstrate the carpal canal.

Who judges radiographic images for quality? (Select the four that apply.) A. Lawyers B. Quality control technologists C. Radiologists D. Radiographers E. Ordering physicians

B. Quality control technologists C. Radiologists D. Radiographers E. Ordering physicians

An increase in which factor will improve spatial resolution? A. OID B. SID C. Grid ratio D. Focal spot size

B. SID An increase in SID decreases the amount of unsharpness and increases spatial resolution.

Which steps increase contrast in fluoroscopy? (Select the two that apply.) A. Increase kVp B. Use a smaller collimator field C. Use a larger collimator field D. Increase mA E. Reduce kVp

B. Use a smaller collimator field E. Reduce kVp Using a smaller collimator field increases contrast, by reducing scatter and secondary radiation production, and thus reducing fog. Reducing kVp increases contrast, at the risk of lowered penetration.

1. X-ray machines are designed to operate at a specific and continuous supply voltage. Which part of the imaging system is responsible for keeping incoming voltage adjusted to the proper value? A.Milliampere (mA) meter. B.Line compensator C.Autotransformer. D.Kilovolts peak (kVp) meter.

B.Line compensator

Which legal concept is violated by a radiographer who performs an examination without an examination order?

Battery

A radiographer receives a request for a portable CXR and then performs the x-ray on the incorrect patient. Which legal term describes the action?

Battery.

Which legal concept is violated by a radiographer who performs an exam without an order?

Battery.

Beam Restriction

Beam restriction is the act of reducing the radiation field size mechanically or electrically.

biliary system

Bile leaves the liver through the right and left hepatic ducts, which join to form the common hepatic duct. Bile enters the gallbladder through the cystic duct. The gallbladder stores and concentrates bile, and when it contracts, bile flows out through the cystic duct and down the common bile duct. The common bile duct and pancreatic duct unite to form the short hepatopancreatic ampulla (of Vater), which empties into the duodenum

What is the most likely cause of free intraperitoneal air on an AP erect abdomen radiograph?

Bowel perforation

Which is the most likely cause of free intraperitoneal air on an anteroposterior (AP) erect abdomen radiograph?

Bowel perforation

Which is the most likely cause of free air on AP erect abdomen?

Bowel perforation.

Window Level

Brightness

Factor that will decrease the patient's dose during fluoroscopy.

Bring the image intensifier as close as possible to the patient.

Designed to reduce exposure to personnel.

Bucky Slot Cover and Protective Curtain

Through estimation by entrance skin dose read by thermoluminescent dosimeter

By which method is exposure to the patients bone marrow calculated?

Which device temporarily stores an electric charge? A. Rectifier B. Diode C. Capacitor D. Autotransformer

C. Capacitor A capacitor temporarily stores an electric charge.

Which type of contrast agent is preferred for low risk and low cost for a patient diagnosed with a possible perforated bowel? A. Barium sulfate suspension, flavored B. Gaseous media in the form of crystals C. Ionic, water soluble, diluted with juice D. Nonionic, water soluble, diluted with juice

C. Ionic, water soluble, diluted with juice The least risk with the least cost would dictate ionic, water soluble media. Barium should definitely be avoided, because of the risk of introducing contrast into the peritoneum. Barium sulfate suspension might cause adhesions if it spills into the peritoneum via a perforation. Gaseous media will not yield all of the information that positive media will in this case.

Which item can be used as an indicator of the quality of the diagnostic x-ray beam? A. Object-to-image-receptor-distance (OID). B. Source-to-image-receptor-distance (SID). C. Kilovolts peak (kVp). D. Exposure time.

C. Kilovolts peak (kVp). X-ray beam quality is controlled by kVp.

In a properly positioned oblique lumbar spine radiograph, what makes up the "body" of the "Scotty dog?" A. Pedicle B. Pars interarticularis C. Lamina D. Superior articular process

C. Lamina The lamina is the body while the pars interarticularis represents the neck. The pedicle is the eye of the Scotty dog. The ear is the superior articular process.

Which position should a patient be placed in immediately following a seizure? A. Sitting B. Dorsal recumbent C. Lateral recumbent D. Ventral recumbent

C. Lateral recumbent Lateral recumbent is the preferred position for patients to be placed after having a seizure to avoid aspiration of secretions.

According to Merrill's Atlas, which location represents the correct central ray (CR) placement for an axiolateral oblique mandible projection for the ramus? A. The acanthion B. The occlusal plane C. The region of interest D. The point of contact between the lips

C. The region of interest According to "Merrill's Atlas," the CR should be centered to the region of interest on the mandible.

35 - 40° RAO CR directed to T5 - 6 Exposure on expiration after 3rd swallow of barium

CR and obliquity for the RAO projection on esophagram?Make exposure when?

L1 & midway between midline & left lateral margin of abdomen -- Hyper - 1 in higher -- Asthenic - 2 in lower and near midline

CR for AP projection UGI

CR for sthenic - L1(L2MONICA) & 1 in. left of spine CR for Hypersthenic - 2 in higher / near midline CR for Asthenic - 2 in lower & 1 in left of spine

CR for sthenic, hypersthenic, and Asthenic pt for PA projection Upper GI

CR for sthenic - L1 & 1-1.5 in anterior to mid coronal plane CR for Hypersthenic - 2 in higher CR for Asthenic - 2 in lower

CR for sthenic, hypersthenic, and Asthenic pt for lateral projection Upper GI

For which long term effect is a 28yr old radiographer with a cumulative effective dose of 20 rem at an increased risk?

Cancer

For which long term effect is a 28 year old radiographer with a cumulative effective dose of 20 rem at an increased risk?

Cancer CumEfD limit = 10 x the worker's age in mSv

For which long term effect is a 28-year-old radiographer with a cumulative effective dose (CumEfD) or 20 rem (200 mSv) at an increased risk?

Cancer. The CumEfD limit for occupationally exposed persons is equal to the worker's age in rem (example: CumEfD limit = 28rem or 280mSv) or 10 times the worker's age in mSv.

How can a radiographer reduce a patient's exposure during a lumbar spine series?

Carefully explain the procedure

How can a radiographer reduce a patient's exposure during a lumbar spine series?

Carefully explain the procedures.

Which of the following structures is (are) located in the right lower quadrant (RLQ)?

Cecum

In a typical x-ray examination room, what is considered a secondary protective barrier?

Ceiling

In a typical x-ray examination room, what is considered a secondary protective barrier?

Ceiling.

In a typical x-ray examination room, what is considered secondary protective barrier?

Ceiling. Secondary barriers are not normally exposed to the primary bean but are located wherever scatter or leakage may strike. The ceiling is always considered a secondary barrier.

To ensure a reduction in irritation to the intestines, which temperature of water should be mixed with the barium on lower gastrointestinal studies?

Cold

Collimation

Collimation is the act of reducing the radiation field size mechanically or electrically.

Smashed index finger might show what fracture?

Comminuted.

A carpenter smashes his index finger with a hammer. Which type of fracture might be shown on the subsequent radiographs of the finger?

Comminuted. The blunt force of the hammer would likely cause several fracture fragments, or a comminuted fracture. Torus fractures are usually seen in long bones of children. Twisting forces cause spiral fractures. Depressed fractures (C) are caused by blunt force, but are normally seen in the skull or tibial plateau.

During prep for a surgical procedure an unopened sterile pack becomes damp from drip of saline. Which is appropriate?

Consider contaminated.

Which nonverbal cue best demonstrates attentiveness and concern for a patient who is giving medical history?

Consistent eye contact.

Window Width

Contrast - Shades of gray

Which action is best taught to the patient using the communication technique of demonstration?

Correct positioning for a particular projection.

Cosmic Rays

Cosmic rays are extremely energetic particulate radiation emitted by the sun (C) and stars, which account for an average of 5% of the total dose.

Which is the most likely cause of film fog prior to development?

Cracked safelight filter

What is the most likely cause of film fog prior to development?

Cracked safelight filter - will allow unfiltered light to reach unprocessed x-ray films, which causes fogging of the film.

190. a metallic artifact seen in the open mouth odontoid image? A The receptionist. B The patient. C The ordering physician. D The radiographer

D The radiographer. A metallic artifact from an object that can be clearly seen as the patient is positioned is clearly the responsibility of the radiographer. For those who would argue that the radiographer is not responsible for caps on teeth, notice that the head is tipped too far forward. The occipital bone is not even visualized on this image. This cap need not have obscured the tip of the odontoid process. No one else is responsible in this case.

How can a radiographer reduce a patient's exposure during a lumbar spine series? A. Decrease kilovolts peak (kVp). B. Collimate to include psoas muscles. C. Increase milliampere-seconds (mAs). D. Carefully explain the procedure.

D. Carefully explain the procedure. Carefully explaining the need to hold still and to employ breath holding correctly can save repeat procedures which definitely reduces overall exposure.

Which condition warrants an arthrogram of the knee? A. Glenoid labrum tear B. Abnormalities of the articular disk C. Trauma to capitate D. Meniscus tear

D. Meniscus tear A meniscus tear warrants an arthrogram of the knee.

An anteroposterior (AP) oblique mortise joint projection demonstrates the distal fibula without talar superimposition and an open talofibular joint. What should the radiographer do next? A. Increase external rotation. B. Increase cephalic angulation. C. Increase internal rotation. D. No correction needed.

D. No correction needed. Demonstration of the distal fibular without talar superimposition and an open talofibular joint (lateral mortise) are both criteria for a correctly positioned mortise oblique ankle.

A patient who complains of blurred vision and dizziness upon standing for an upright chest x-ray may be experiencing which condition? A. Orthostatic hypertension B. Hyperglycemia C. Hypoglycemia D. Orthostatic hypotension

D. Orthostatic hypotension A patient exhibiting blurred vision and dizziness upon standing is most likely experiencing orthostatic hypotension which is a sudden drop in blood pressure.

When using film-screen systems, which method will result in greater radiographic contrast?

Decreased field size

DQE

Detective Quantum Efficiency indicates speed class or how sensitive a receptor is to radiation exposure.

Which feature of digital fluoroscopic systems is most likely to result in increased patient dose? (charge-coupled device, last image hold, pulse-progressive fluoroscopy, or digital spot images)

Digital Spot Images - are very easy to acquire with digital fluoroscopic systems; but excessive use of this feature results in a reduction in the dose savings that is expected when switching from conventional fluoroscopy. Last image hold, charge-coupled device image capture, and pulse-progressive fluoroscopy are features of digital fluoroscopic systems that reduce patient dose relative to conventional fluoroscopy.

When dealing with radiation exposure, what is the most effective protection for a radiographer?

Distance. - Due to the divergence of the beam, doubling the distance decreases the dose by a factor of 4.

Which of the following positions is obtained with the patient lying supine recumbent on the radiographic table and the central ray (CR) directed horizontally to the iliac crest?

Dorsal decubitus position

DAP

Dose Area Product

DAP

Dose Area Product is an indicator of exposure for cassetteless digital systems.

PACS networks are capable of performing?

Downloading images from different imaging modalities. Transmitting diagnostic images to remote work stations.

Subarachnoid

During a lumbar myelogram, the needle is placed into which meningeal space?

d. all of the above

During an UGI series, which of the following would help demonstrate esophageal reflux? a. compression paddle b. water test c. toe-touch method d. all of the above

RAO

During an UGI, which projection best illustrates the pylorus of stomach, c-loop of duodenum, and duodenal bulb in profile

Where is edge enhancement post processing be most helpful in digital radiography?

During low contrast situations. Edge enhancement post processing has been shown in research to be helpful in low contrast situations.

Where is edge enhancement post processing most helpful in digital radiography? Low contrast situations. Correct High contrast situations. Abdominal soft tissue studies. Incorrect Spinal examinations.

Edge enhancement post processing has been shown in research to be helpful in low contrast situations. Available research in higher contrast situations, abdominal soft tissue studies, and spinal exams, has emphasized the gain in quantum mottle seen with edge enhancement post processing.

Which condition represents the most likely indication for an anteroposterior (AP) chest projection with the patient in the left lateral decubitus position?

Effusion in left lung

What causes the build-up of heat at the anode?

Electrons colliding with the target

Best practice suggests erasing all CR plates once a day. What is the purpose of this?

Erasing IPs on a daily basis, to reduce amount of accumulated scatter on the IP; usually at the start of the day cuts down on the amount of background and scatter radiation that has accumulated in the active layer of the plate.

What is the current recommendation from the NCRP regarding the scheduling of elective examinations on women who are in the child-bearing age range?

Examinations should be scheduled a few days after the onset of menses

What is the current recommendation from the NCRP regarding the scheduling of elective examinations on women who are in the child-bearing age range?

Examinations should be scheduled a few days after the onset of menses - since this is the most unlikely period for them to be pregnant.

Excessive developer temperature may result in..

Excessive developer temperature may result in a processing artifact known as a chemical fog, which occurs DURING (not prior to) the developing process.

Exit Radiation

Exit radiation is the portion of the primary beam that passes through the patient to form the image on the image receptor.

Which statement is true regarding exposure indicator and the evaluation of digital images?

Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range

What is true in describing the appearance of a correctly positioned AP hip?

Femora neck without foreshortening.

In an x-ray tube, what is the the source of electrons used to make x-rays?

Filament. (Electrons from tungsten atoms in the filament are used in the x-ray tube to make x-rays. The x-ray tube anode and target is what the electrons strike to create x-rays.)

What normal physiology occurs in the renal cortex?

Filtration of the blood.

According to traditional textbooks in radiography, which results in decreased patient dose?

Fixed kVp, variable mAs exposure charts.

What protective feature is designed to reduce exposure to the patient during fluoroscopic procedures?

Foot switch. Radiologists are trained to repeatedly depress and release the fluoroscopic foot switch in order to reduce beam-on time and patient exposure.

Rotated toward the right side

For a tangential inferosuperior projection of the zygomatic arch, how is the patient's head positioned to demonstrate a depressed fracture of the right zygomatic arch?

2 meters

For protection, how long must the exposure cord be on a mobile x-ray unit?

Stones in the renal pelvis

For which condition is the use of ureteric compression contraindicated?

Cancer limit is equal to the workers age

For which long term effect is a 28 year old radiographer with a cumulative effective dose of 20 rem at an increased risk?

On an accurately positioned posteroanterior (PA) chest radiograph, the manubrium of the sternum is seen at the level of which thoracic vertabrae when the patient is sthenic?

Fourth. The manubrium of the sternum is projected at the level of the fourth thoracic vertebra on a properly positioned PA chest radiograph. When the upper midcoronal plane of the patient is tilted backwards (away from the film), the manubrium is positioned between the first and third thoracic vertebra. If the upper midcoronal plane of the patient is tilted toward the image receptor, the manubrium will be seen at the level of the fifth thoracic vertebra or lower.

Why is the left lateral decubitus position recommended as part of the acute abdomen series?

Free air away from gastric bubble.

the level of anatomy that will be seen with the greatest detail

Fulcrum height determines...

Esophageal reflux

Gastric contents return and irritate the lining of the esophagus

GSD

Genetically Significant Dose

no grid - 1 5:1 - 2 x mAs 6:1 - 3 8:1 - 4 10:1 - 5 12:1 - 5 16:1 - 6 GCF1/mAs1 = GCF2/mAs2

Grid conversion factor

Increased Grid Ratio

Grids with higher ratios are able to remove more photons from the x-ray beam; the grid reduces the number of photons reaching the image receptor, it also causes a decrease in film density.

What is the maximum speed of filament electrons as they travel toward the anode?

Half the speed of light

.25 Gy

Hemotologic depression is noted on blood tests of a patient who has had several radiation therapy treatments. What is the most probable minimum dose that this patient received?

Which wrist position radiographically demonstrates the carpal canal?

Hyperextension

Which wrist position demonstrates the carpal canal?

Hyperextension.

How should a drug be administered to get the quickest response?

IV.

Diabetes

Identify the medical condition in a patients history which should be cleared before injection of an ionic, water soluble contrast agent? Drug interaction of metformin

Lamina

In a properly positioned oblique lumbar spine radiograph, what makes up the "body" of the "Scotty dog?"

Radiographers have developed a habit of dropping leaded aprons on a table in the exposure room, following fluoroscopy. What is the best approach to use in correcting this poor treatment of important shielding equipment?

In service training session with radiographers identifying the reasons that aprons crack. The best approach to solve practice issues is to get Radiographers to accept ownership of the problem.

c. the presence of gas or fluid levels

In the case of a suspected bowel obstruction, a lateral decubitus film would be most likely used to demonstrate: a. an inflamed appendix b. stratification of gallstones c. the presence of gas or fluid levels d. the motility of the colon

d. high and horizontal

In the hypersthenic patient, how does the stomach lie? a. low and vertical b. low and horizontal c. high and vertical d. high and horizontal

In order to increase the number of shades of gray displayed on a digital image what should be done?

Increase the window width.

Which change is needed to compensate for a soft tissue mass in the abdomen?

Increased mAs

What is the position of the gallbladder in an asthenic patient?

Inferior and medial

Mumps

Inflammation and enlargement of the parotid glands

Trichobezoar

Ingested hair trapped in stomach

Phytobezoar

Ingested vegetable fiber or seeds trapped in stomach

Which of the following is a major cause of bowel obstruction in children?

Intussusception

Which of the following positions will most effectively move the gallbladder away from the vertebrae in the asthenic patient?

LAO

What is the body of the scotty dog?

Lamina.

In a properly positioned oblique lumbar spine radiograph, what makes up the "body" of the "Scotty dog?"

Lamina. The lamina is the body while the pars interarticularis represents the neck. The pedicle is the eye of the Scotty dog. The ear is the superior articular process.

Which radiation dose is required to produce mitotic death?

Less than the dose needed to produce apoptosis in slowly dividing cells or nondividing cells.

LD 50/30

Lethal Dose for 50% of the population in 30 days.

How is signal maximized to a digital image receptor?

Longer exposure time

Which step will reduce digital image noise, assuming no other changes?

Longer exposure time

How is signal maximized to a digital image receptor?

Longer exposure time.

Which step will reduce digital image noise, assuming no other changes?

Longer exposure time. (A longer exposure time results in a greater amount of photons reaching the image receptor, which reduces image noise.)

Where is edge enhancement post processing most helpful in digital radiography?

Low contrast situations

Low Relative Humidity is likely to contribute to...

Low relative humidity is likely to contribute to static artifacts.

brightness

Luminescence testing is a quality control test for the _________________ of display monitors

Contact isolation

MRSA would be considered what type of precaution?

Magnification Mode

Magnification mode requires an increase in mAs to compensate for the necessary reduction in minification gain, resulting in greater patient exposure.

The radiographer is assisting a patient to move from a wheelchair to the x-ray table. Which represents the safest practice by the radiographer when moving this patient?

Maintain the center of gravity over the base of support.

Which statements are accurate about control monitoring badges?

Measures background exposure during transportation, handling, and storage. Should be kept in a distant room from the radiation area.

Which projection of the foot will best demonstrate the medial and lateral borders of a normal middle cuneiform without superimposition?

Medial oblique.

Which term best describes the process of cleaning the surfaces in a radiology department with 10% bleach solution in water?

Medical asepsis.

Which source of ionizing radiation represents the largest contribution of radiation dose to the average person in the US?

Medical x-rays

Which source of ionizing radiation represents the largest contribution of radiation dose to the average person in the U.S.? (Cosmic rays, Medical x-rays, the sun, or Radon)

Medical x-rays. Medical x-rays account for slightly in excess of 50% of the average American's radiation dose.

Which condition warrants an arthrogram of the knee?

Meniscus tear

What warratns knee arthrogram?

Meniscus tear.

Fundus

Most posterior part of the stomach?

NCRP

National Council of Radiation Protection

AP oblique mortise demonstrates distal fibula without taller superimposition and an open talofibular joint

No correction needed.

An anteroposterior (AP) oblique mortise joint projection demonstrates the distal fibula without talar superimposition and an open talofibular joint. What should the radiographer do next?

No correction needed.

What is the advantage of Homblad over Camp Coventry?

No distortion.

How much compensation is needed for a change to a small focal spot?

None.

Nonthreshold

Nonthreshold dose implies that any dose could produce skin cancer.

When using film-screen, which most accurately describes the effect on the resultant image when kVp is increased?

Number of gray tones will be increased. An increase in kv will result in shorter wavelength x-ray beams that more uniformly penetrate body parts, resulting in lower contrast and more gray tones in the radiograph.

When performing an AP axial (Towne method) image of the skull, which reference line should be perpendicular to the IR if using a 30 degree caudal angle?

OML

Towne

OML perpendicular

Which type of personnel dose monitoring devices is the best choice to monitor the whole body dosage of radiographer?

OSL

Advantage of using a optically stimulated luminescent (OSL) dosimeter as opposed to a film badge

OSLs are not fogged by heat like film badges.

Off-focus Radiation

Off-focus radiation describes x-rays produced within the tube, but outside of the focal spot.

Fourth

On an accurately positioned posteroanterior (PA) chest radiograph, the manubrium of the sternum is seen at the level of which thoracic vertabrae when the patient is sthenic?

How does the central ray (CR) for an anteroposterior (AP) scapula differ from an AP shoulder x-ray?

One inch lower.

How does the central ray (CR) for an anteroposterior (AP) scapula differ from an AP shoulder x-ray?

One inch lower. The CR for an AP scapula is one inch lower than the CR for an AP shoulder, or two inches inferior to the coracoid process. The CR is not the same for these two projections. One inch higher is at the level of the coracoid process, too high. At the same level, but medial, will be one inch too high.

Alimentary canal

Oral cavity, pharynx, esophagus, stomach, duodenum and small intestine, large intestine, anus make up the

What is the wide spread of MRSA attributed to?

Over prescription of antibiotics and poor infection control practices

What is the wide spread of MRSA attributed to?

Overly used antibiotics and poor infection control.

Which thumb projection requires two through five to be extended with palmar surface on flat against IR?

PA oblique.

LPO

PT position?

RAO (Prone)

PT position?

RAO (Prone) **notice the scotty dogs**

PT position?

Supine

PT position?

A flat and upright abdomen is requested on an acutely ill patient, to demonstrate the presence of air-fluid levels. Because of the patient's condition, the x-ray table can be tilted upright only 70° (rather than the desired 90°). How should the central ray be directed?

Parallel to the floor

c. NPO after midnight

Patient preparation for an UGI series would require which of the following? a. high fat diet the evening before b. low fat diet the evening before c. NPO after midnight d. light breakfast the day of the procedure

Factors that affect radiographic image density? (four)

Patient thickness. (increases, density is reduced) kVp. (increases, density increases) mAs. (increases, density increases) SID. (increases, density decreases)

Which central ray (CR) orientation is recommended for an anteroposterior (AP) knee projection if the measurement from the tabletop to the patient's anterior superior iliac spine (ASIS) is 22 cm?

Perpendicular to the image receptor (IR).

PACS

Picture Archiving and Communication Systems

Which is the disease process that causes increased radiodensity in the lung fields on an image due to inflammation and accumulation of fluid?

Pneumonia

Which is the disease process that causes increased radiodensity in the lung fields on an image due to inflammation and accumulation of fluid?

Pneumonia The disease process that causes increased density in the lungs from inflammation and accumulation of fluid is pneumonia. Primary tuberculosis is noted by enlarged mediastinal lymph nodes and small focal lesions in the lungs. Pneumothorax is an accumulation of air in the pleural cavity and would not cause increased density on a radiograph. Pleurisy is an inflammation of the pleura that surrounds the lungs.

Pneumonia

Pneumonia is a inflammatory condition of the lung; common lung infection that inflames the air sacs and may fill with fluid or pus.

Which is the disease process that causes increased radio density in the lung field?

Pneumonia.

Poor film-screen contact causes...

Poor film-screen contact causes blurring and a dark area on the image following exposure.

Which projection of the thumb requires digits two through five to be extended, with the palmar surface of the hand flat against the image receptor (IR) as if for a posteroanterior (PA) hand projection?

Posteroanterior (PA) Oblique Digits two through five are extended, and the palmar surface of the hand is flat against the IR for a PA oblique thumb projection. The palmer surface of the hand is not flat against the IR for the other thumb projections.

Which term refers to the radiation that exits the x-ray tube through the collimator?

Primary

Primary Protective Barrier(s)

Primary protective barriers are located wherever the useful beam may strike the wall or the floor.

Which joint is the central ray (CR) entrance point for a posteroanterior (PA) finger projection?

Proximal interphalangeal (PIP

Who judges radiographs for quality?

QC technologists. Ordering physicians. Radiologists. Radiographers.

Which x-ray beam characteristic is reduced by adding aluminum filtration?

Quantity of x-rays

Insufficient exposure to a photostimulable phosphor (PSP) plate results in what type of image degradation?

Quantum noise occurs due to an insufficient exposure to the image receptor resulting in an uneven density over the image.

Which projection best demonstrates the aortic impression on the esophagus in an esophagram?

RAO

Which best demonstrates aortic impression on esophagram?

RAO.

In service training session with radiographers explaining the reasons aprons crack

Radiographer have developed a habit of dropping lead aprons on the floor? What is the best approach in correcting this problem?

Radon

Radon is a radioactive gas present in the earth produced by the natural decay of uranium. Radon inhaled from the ground accounts for less than half of the total radiation exposure to the average U.S. person.

What is the impact of using 2.5mm of aluminum equivalent filtration on the primary x-ray beam?

Reduction of the patient's skin dose.

Which location represents the correct R placement for an xiolateral oblique mandible for ramus?

Region of interest.

A patient cease to breathe while in medical imaging. There is a clearly marked DNR order on the patient's chart. What should the radiographer do first?

Report to the QC supervisor, but do not do CPR.

What is the term for the adjustment of image brightness, regardless of exposure received?

Rescaling is the adjustment of digital data to a present brightness depending on the body part selected.

What is the term for the adjustment of image brightness, regardless of exposure received? Automatic brightness control (ABC). Incorrect Dose area product (DAP). Rescaling. Correct Detective quantum efficiency (DQE).

Rescaling is the adjustment of digital data to a preset brightness depending on the body part selected. DAP is an indicator of exposure for cassetteless digital systems. DQE indicates speed class or how sensitive a receptor is to radiation exposure. ABC is a fluoroscopic control to maintain image density as the image intensifier is moved over the patient.

What study is a nonfunctional exam of the urinary system?

Retrograde.

In the radiograph where is the gas located?

Right hemidiaphragm.

A PA chest demonstrated the left clavicle closer to the center of the spin than the right. What action do you take?

Right side closer to the IR.

A radiographer prepares to transfer a patient from a wheelchair to the x-ray table. The patient recently suffered a stroke exhibits left side weakness and is able t bear some weight. How should the patient go to the table?

Right side next to the table.

A radiographer critiques an image of an anteroposterior (AP) pelvis. The left obturator foramen is narrower than the right. What should the radiographer do?

Rotate patient to the right

A radiographer critiques an image of an anteroposterior (AP) pelvis. The left obturator foramen is narrower than the right. What should the radiographer do?

Rotate the patient to the right.

For a tangential inferosuperior projection of the zygomatic arch, how is the patient's head positioned to demonstrate a depressed fracture of the right zygomatic arch?

Rotated toward the right side.

30-60° LPO CR - l1 & midway between midline of body and left lateral margin of abdomen -- Hyper - 2 in higher -- Asthenic - 2 in lower and near midline

Rotation and CR for LPO projection of UGI

40-70° RAO CR: l1(L2 monica) & midway between spine and lateral border of abdomen (upside((left side of PT))

Rotation and CR for the RAO projection UGI

RAO PA Right lateral LPO AP

Routine projections for Upper GI

An increase in which factor will improve recorded detail?

SID

accessory organs

Salivary glands (parotid, submandibular, sublingual) pancreas, liver, gallbladder are all ?

Which carpal bone is most commonly fractured?

Scaphoid.

Which carpal bone is most commonly fractured?

Scaphoid. Scaphoid fractures account for approximately 60% of carpal fractures. The lunate and triquetrum are carpals, but not frequently fractured. The cuboid is a tarsal (B).

Which is the most likely cause of a histogram error?

Selection of an incorrect exam from the look-up table.

Describe correct positioning with PA chest

Shoulders equal distance chin extended shoulders depressed.

Which digital post-processing results in black background surrounding the original collimated edges?

Shuttering is a post exposure processing technique that results in a black background surrounding the original collimated edges.

What is the best approach for speaking to a patient with a hearing impairment?

Speak in a low register

Which is the best approach to speaking to a patient with impairment?

Speak in a low register.

Which is the most appropriate guideline to follow when radiographing patients in their late adult years?

Speak slowly in a low tone of voice.

How should a radiographer increase the stability of the base of support?

Stand with feet a great distance apart.

How should a radiographer increase the stability of the base of support?

Stand with feet a greater distance apart. (The base of support is drawn between two points of contact with the floor. The stability of the base of support increases when the feet are a greater distance apart.)

For which condition is the use of ureteric compression contraindicated?

Stones in the renal pelvis. Ureteric compression may be used to ensure adequate filling of the upper renal collecting system, but is contraindicated for patients with a possible obstruction, such as a pelvic stone (C), due to an increased risk of rupture. Ureteral compression may be indicated in patients with pyelonephritis, renal hypertension, or recurrent urinary tract infection.

For condition is use of ureteric compression inappropatie?

Stones.

During a lumbar myelogram, the needle is placed into which meningeal space?

Subarachnoid

During a lumbar myelogram, the needle is placed into which meningeal space?

Subarachnoid.

Subtraction

Subtraction is a technique to selectively remove superimposing structure by electronically deducting the relative brightness of a scout image from that of the diagnostic image.

What procedure is an example of surgical asepsis?

Surgical hand scrub.

False Ascites, or fluid in the abdomen, causes increased beam attentuation, so it requires increase in technique

T or F A pt with ascites condition requires less attenuation of the beam

False EI is determined by the amount of light given off by the plate in response to x-gradation and gives an approximate idea of the dose the patient received. EI gives an approximation of patient dose and is a measure of luminescence of the plate, but does not take into account scattered radiation; so, it cannot be greater than patient dose. EI do not give accurate patient doses, because they do not account for scatter.

T or F EI gives an accurate patient's dose.

Which bone contains a mastoid process?

Temporal.

Upper GI Pt Prep - Pregnancy

The 10 day rule pertains to what?

.25mm

The bucky slot cover should offer at least what lead thickness?

Bucky Slot Shielding Device and Spot Film Device Protective Curtain

The bucky slot shielding device and the spot film device protective curtain are designed to protect imaging personnel, not the patient.

Which statement accurately describes the appearance of a correctly positioned anteroposterior (AP) hip image?

The femoral neck is demonstrated without foreshortening. A correctly positioned anteroposterior hip radiograph is achieved by internally rotating the affected leg 15 - 20 degrees which then demonstrates the femoral neck without foreshortening by placing the neck of the femur parallel to the image receptor. The neck of the femur, not the femoral head, should be at the center of the collimated field. The proximal one-third of the femur should be visualized, not the proximal two-thirds. The lesser trochanter is superimposed by the medial border of the femur, though the tip is sometimes visualized.

When film-screen technology is used, which kilovolts-peak (kVp) setting produces the best scale of contrast for imaging ribs? 90 kVp. 80 kVp. 100 kVp. Incorrect 70 kVp. Correct

The lowest kVp of 70 provides the shortest scale of contrast. The other choices 100, 90, and 80 provide a longer scale of contrast.

Trapezium and first metacarpal

The only saddle joint in the body is found between which two bones?

b. cardiac orifice

The opening located between the esophagus and the stomach is called the: a. pyloric antrum b. cardiac orifice c. duodenum d. pyloric orifice

Which information in the patient history should prompt the radiographer to decide against using automatic exposure controls when taking a chest x-ray? Chronic bronchitis. Emphysema. Correct Pneumothorax. Oat cell carcinoma. Incorrect

The pathophysiologic changes to lung tissue in emphysema result in easy penetration, so automatic exposure controls (AEC) should not be enabled for radiographic exams in these patients because the film will be too dense as a result of the control failing to shut the exposure off quickly enough. Patients with pneumothorax, chronic bronchitis, or oat cell carcinoma do not have hyperinflation of the lungs, therefore AEC can be enabled for their exams.

A patient receives 100 mL of IV contrast as part of an abdominal CT scan, as well as 500 mL of dilute oral contrast prior to coming to the radiology for a separate order, an IVU. Why should this be rescheduled?

The presence of previous oral contrast in the abdomen.

A patient received 100 ml of IV contrast media as a part of an abdominal CT scan, as well as 500 ml of dilute oral contrast, prior to coming to radiology for a separate order, an IVU. The patient's creatinine is 0.4 mg/dl and BUN is 36 mg/dl. Why should this IVU be rescheduled?

The presence of the previous oral contrast in the abdomen precludes an IVU

A patient received 100 ml of IV contrast media as a part of an abdominal computed tomography (CT) scan, as well as 500 ml of dilute, oral contrast, prior to coming to Radiology for a separate order, an intravenous urogram (IVU). The patient's creatinine is 0.4 mg/dl and BUN is 36 mg/dl. Why should this IVU be rescheduled?

The presence of the previous oral contrast in the abdomen precludes an IVU.

The Holmblad method shows no distortion longitudinally or laterally

The radiographer uses the Holmblad method to perform a tunnel view of the knee. What is the primary advantage of utilizing this method instead of the Camp Coventry method?

30 degree medial oblique.

The tarsal sinus is visualized when the foot is seen in what projection?

screen/film contact.

The wire mesh test is used to determine ________________ __________________

What do limiting spatial resolution (LSR) and modulation transfer function (MTF) have in common?

They both measure spatial resolution in digital imaging.

List contrast media in order of decreasing opacity

Thick thin ionic carbon dioxide.

Where is the central ray (CR) directed for an oblique posteroanterior (PA) hand?

Third metacarpophalangeal joint

Hyposthenic/asthenic

This Body habitus has a - J - Shaped and low stomach - Duodenal bulb/GB - L3 - 4 - Large intestine low near pelvis

Sthenic

This Body habitus has a - J - Shaped stomach - Duodenal bulb/GB - L1-2 - Large intestine w/ high L colic flexure

Hypersthenic

This Body habitus has a - high and transverse stomach - Duodenal bulb/GB - t11/12 - Large intestine widely distrbuted

AP

This UGI projection best illustrates the fundus of the stomach and duodenum

PA projection

This UGI projection best illustrates the fundus, stomach & duodenum with barium in the body @ pylorus of the stomach

Right lateral

This UGI projection best illustrates the stomach & duodenum w/ a view of retrogastric space with barium primarily in mid & distal stomach and duodenum

Mueller maneuver - to diagnose esophageal reflux

This breathing technique is when the patient exhales then tries to inhale against closed glottis. What is it and why is it performed during an esophgram?

Valsalva maneuver

This breathing technique is when the pt takes in a deep breath and holds breath in while bearing down as if trying to move the bowels

Esophagram

This exam best illustrates barium - filled esophagus from the pharynx through the cardiac antrum to the fundus of the stomach

Toe - Touch Maneuver

This technique is useful for diagnosing reflux and hiatal hernias

What is the dose response relationship for radiation-induced skin cancer, such as has been documented in early radiologists?

Threshold

What is the dose-response relationship of radiation-induced skin cancer?

Threshold - cancer has developed due to radiation exposure, then a certain minimum dose must have been received.

What is the dose response relationship for radiation-induced skin cancer, such as has been documented in early radiologist?

Threshold. Radiation-induced skin cancer has a threshold response, which means that below a certain dose, it is unlikely for skin cancer to occur to irradiation.

By which method is exposure to a patient's bone marrow calculated?

Through estimation by entrance skin dose read by a TLD

By which method is exposure to a patient's bone marrow calculated?

Through estimation by entrance skin dose read by a thermoluminescent dosimeter (TLD).

Best practice suggests erasing all CR plates once a day. What is the purpose of this?

To reduce amount of accumulated scatter on the IP

Only saddle joint in the body

Trapezium and first metacarpal.

The only saddle joint in the body is found between which two bones?

Trapezium and first metacarpal.

1) Perforated viscus 2)Pre Surgical procedure

Two indications for using Water soluble iodinated contrast media during UGI

Bezoar

Undigested material that becomes trapped in the stomach - Hair, fibers, wood, teeth

How should the radiographer position the patient to show left axillary 6th rib?

Upright 45 degree LPO.

How should the radiographer position the patient to best demonstrate a left axillary 6th rib fracture?

Upright and 45 degree left posterior oblique (LPO).

Increase kVp and filtration

Using fixed flouro technology, what method will lesson patient dose?

Where are small phleoboliths found?

Vein.

Erratically quivering ventricles

Ventricular fibrillation.

T11-12

Vertebral level duodenal bulb/GB: *Hypersthenic*

More accurate

What advantage does TLD have over a film badge?

Head trauma

What condition could lead to neurogenic shock

Hep B

What disease is contracted by exposure to infected blood?

100 mrem/ 1 mSv

What is the annual effective dose limit for a rad student under 18?

5 Rem

What is the annual occupational dose limit for radiographers? Regardless of age

Iodinated, nonionic

What is the best contrast for a patient with asthma? Increased risk for reactions

Anteroposterior (AP) axial oblique projection, left posterior oblique (LPO) position.

What is the best projection and position to demonstrate the right cervical intervertebral foramina?

Interpreter

What is the best way to communicate with a patient who does not speak English?

Exams should be scheduled a few days after the onset of menses

What is the current recommendation from the National Council on Radiation Protection regarding the scheduling of elective exams on women of child bearing age?

200 R per cm squared the volume of tissue radiated multiplied by the dose received

What is the dose area product if the collimated field is 10 x 10cm with a dose of 2 roentgens per minute?

Threshold Meaning that below a certain dose it is unlikely for

What is the dose response relationship for radiation-induced skin cancer, such as has been documented in early radiologists?

Threshold

What is the dose response relationship of radiation induced skin cancer?

Reduction of patients skin dose

What is the impact of using a 2.5mm filtration on a primary x-ray beam?

Rad (gray) English unit

What unit is preferred to express the radiation dose this patient received?

Inflated under the stomach with pt in prone position

When using a compression paddle to diagnose reflux, where is the paddle inflated and what is the patients position?

Six feet behind the IR

Where is the best place to stand with the c-arm?

Proximal interphalangeal (PIP).

Which joint is the central ray (CR) entrance point for a posteroanterior (PA) finger projection?

Molybdenum

Which material is used on most anode disks and is light, strong, and heat-resistant?

Childhood and early adult cancers Growth retardation Prenatal death Spontaneous abortion

Which may be effects of fetal irradiation?

d. taking a deep breath and straining down

Which of the following describes the valsalva maneuver? a. exhaling and holding breath out b. taking a deep breath and holding it c. bending over and straining down d. taking a deep breath and straining down

a. duodenal cap

Which of the following is located within the RUQ of the body? a. duodenal cap b. descending colon c. appendix d. splenic flexure

Should be kept in a distant room from the radiation area Measures background radiation during transportation, handling, and storage

Which statements are accurate about control monitoring badges?

Decreasing; increasing

________________ the window level decreases the brightness of the displayed images, while _____________ the window level increases the brightness.

deglutition

act of swallowing

Which feature of fluoscopic equipment is designed to reduce entrance skin exposure to the patient?

beam filtration

decrease

because the grid reduces the # of photons reaching the image receptor, it also causes a ______ in film density

Which factor will decrease the patient's dose during fluoro?

bring the image intensifier as close as possible to the patient

How can a radiographer reduce a patient's exposure during a lumbar spine series?

carefully explain the procedure

In a typical x-ray examination room, what is considered a secondary protective barrier? - ceiling - wall below the chest board -floor - wall behind the chest board

ceiling

In the prone oblique positions (RAO and LAO), the flexure disclosed is the one

closer to the IR. Therefore, the LAO position will "open up" the splenic flexure, and the RAO will demonstrate the hepatic flexure. The AP oblique positions (RPO and LPO) demonstrate the side farther from the IR.

Double-contrast studies of the stomach or large intestine involve

coating the organ with a thin layer of barium sulfate, then introducing air. This permits seeing through the organ to structures behind it and, most especially, allows visualization of the mucosal lining of the organ. A barium-filled stomach or large bowel demonstrates the position, size, and shape of the organ and any lesion that projects out from its walls, such as diverticula. Polypoid lesions, which project inward from the wall of an organ, may go unnoticed unless a double-contrast examination is performed.

If 7 milliampere-seconds (mAs) provides optimal density without a grid, which mAs should be used with a 12:1 grid? A. 21 B. 42 C. 28 D. 35

d

more scatter radiation which = film density

decrease in beam restriction =

x-ray beam intensity

decreasing SID + greater

A successful oral cholecystogram

depends on the ability of the liver to remove contrast from the portal bloodstream and to excrete it with bile. A healthy gallbladder should concentrate and store bile as well as contrast medium. With a functioning gallbladder and liver, an opacified gallbladder should result. The pancreas plays an integral part in the digestive process, but it is not in the biliary system.

Which feature of digital fluoroscopic systems is most likely to result in increased patient dose?

digital spot images

What type of relationship does cell growth rate have on the sensitivity of tissues to ionizing radiation?

direct

Peptic ulcers

erosions of the stomach or duodenum

The phase of respiration for an AP projection of the lumbar spine is

expiration

Which protective feature is designed to reduce exposure to the patient during fluoro procedures?

foot switch

photons

grids with higher ratios are able to remove______ from x-ray beam.

pixel depth

how many shades of gray will be displayed

radiographers have developed a habit of dropping leaded aprons on a table in the exposure room, following fluoroscopy. What is the best approach to use in correcting this poor treatment of important shielding equipment?

in service training with radiographers identifying the reasons that aprons crack

Which term describes thee process y which most x-ray induced cellular damage occurs?

indirect effect

With the patient in the erect position, barium moves

inferiorly and air rises to provide double-contrast visualization of the hepatic and splenic flexures. The LAO and RPO positions are used to demonstrate especially the splenic/left colic flexure; the hepatic flexure generally appears self-superimposed in this position. A left lateral decubitus position will demonstrate a double-contrast visualization of right-sided bowel structures—that is, the right side of the ascending colon, the right side of the sigmoid and rectum, and so on. The lateral position offers a singularly valuable view of the rectum.

Gastritis

inflamation of the lining/mucosa of the stomach

mastication

initiates mechanical digestion

peristalsis

involuntary muscular contractions

Regional enteritis (Crohn's disease)

is a chronic granulomatous inflammatory disorder that can affect any part of the GI tract but generally involves the area of the terminal ileum

The cecum

is the most distal end of the large bowel and is normally located in the RLQ

Which zygapophyseal joints are demonstrated on the AP oblique projection of the lumbar spine?

joints closest to the IR

100 - 125 kVp center cell

kVp and photocell for all films of esophagus?

80 - 100 (book 90 - 100)

kVp for double contrast barium/air study of UGI

100 - 125

kVp for single contrast barium study of UGI

Which plane is centered to the midline of the grid when positioning for an AP oblique sacroiliac joint?

longitudinal plane 1 inch medial to the elevated ASIS

An abnormally increased concavity of the lumbar spine is termed

lordosis

The stomach of an asthenic patient is most likely to be located

low, vertical, and toward the midline

Which source of ionizing radiation represents the largest contribution of radiation dose to the average person in the U.S.?

medical x-rays

Which is an advantage of using a optically stimulated luminescent dosimeter as opposed to a film badge?

not fogged by heat

The usual patient preparation for an upper GI series is

npo after midnight

Appendicitis

occurs when an obstructed appendix becomes inflamed. Distention of the appendix occurs and, if the appendix is left untended, gangrene and perforation can result.

The gallbladder is located

on the posterior surface of the liver in the right upper quadrant (RUQ). The hepatic flexure, so named because of its close proximity to the liver, is also in the RUQ. The vermiform appendix projects from the first portion of the large bowel, the cecum, located in the right lower quadrant (RLQ).

hospital information system

on which system does hospital staff input new orders for radiologic examinations? a. digital imaging and communications system. b. picture archiving and communication system c. hospital information system d. radiology information system

The position, shape, and motility of various organs can differ greatly from

one body habitus to another. The hypersthenic individual is large and heavy; the lungs and heart are high, the stomach is high and transverse, the gallbladder is high and lateral, and the colon is high and peripheral. In contrast, the other habitus extreme is the asthenic individual. This patient is slender and light, and has a long and narrow thorax, a low and long stomach, a low and medial gallbladder, and a low medial and redundant colon. The radiographer must consider these characteristic differences when radiographing individuals of various body types.

The short, thick processes that project posteriorly on each side of a vertebral body are called the:

pedicles

directly related to contrast resolution

pixel depth is directly related to

What is the impact of using 2.5 mm of Al Eq filtration on the primary x-ray beam?

reduction of the patient's skin dose

The vertebral column articulates with the hip bone at the:

sacroiliac joint

An abnormal lateral curvature of the spine is termed:

scoliosis

Which statement are accurate about control monitoring badges?

should be kept in a distant room from the radiation area ad measures background exposure during transportation, handling, and storage

The AP projection provides a general survey of the abdomen

showing the size and shape of the liver, spleen, and kidneys. When performed erect, it should demonstrate both hemidiaphragms. The lateral projection is sometimes requested and is useful for evaluating the prevertebral space occupied by the aorta. Ventral and dorsal decubitus positions provide a lateral view of the abdomen that is useful for demonstration of air-fluid levels.

capacitor

temporarily stores an electric charge

To demonstrate esophageal varices, the patient must be examined in

the recumbent position

the highest potential dose to the radiographer during c-arm fluoroscopy originates from which source?

the side where x-rays enter the patient

electrons colliding with the target

what causes the build up of heat at the anode? A. Tungsten deposits on the glass envelope. b electrons colliding with the target c. thermionic emission d. high x-ray tube voltage.

a. erratically quivering ventricles

what does ventricular fibrillation mean? a. erratically quivering ventricles b. rapid heart rate c. premature ventricular contractions d. slow heart rate

line compensator (adjusts the voltage supplied by the power company, which fluctuates due to variations in power distribution and consumption.)

x-ray machine are designed to operate at a specific and continuous supply voltage. which part of the imaging system is responsible for keeping incoming voltage adjusted to proper value? a. autotransformer b. milliampere (mA) meter c. line compensator d. kilovolts peak (kVp) meter

The articulations between the articular processes of the vertebral arches are called the:

zygapophyseal joints

Which of the following are functions of the vertebral column? 1.) supports the trunk 2.) protects the spinal cord 3.) supports the skull superiorly

1,2 and 3

What causes the build-up of heat at the anode? A. Tungsten deposits on the glass envelope. B. High x-ray tube voltage. C. Thermionic emission. D. Electrons colliding with the target.

D. Electrons colliding with the target. The tremendous amount of heat generated at the anode is the result of the electron beam colliding with the target. The vast majority (>99% according to some authorities) of electron-target interactions take place at such low energy, that the emitted waveform is infrared radiation or heat.

Which information in the patient history should prompt the radiographer to decide against using automatic exposure controls when taking a chest x-ray? A. Oat cell carcinoma B. Pneumothorax C. Chronic bronchitis D. Emphysema

D. Emphysema The pathophysiologic changes to lung tissue in emphysema result in easy penetration, so automatic exposure controls (AEC) should not be enabled for radiographic exams in these patients because the film will be too dense as a result of the control failing to shut the exposure off quickly enough.

What does "ventricular fibrillation" mean? A. Premature ventricular contractions. B. Slow heart rate. C. Rapid heart rate. D. Erratically quivering ventricles

D. Erratically quivering ventricles Ventricular fibrillation means that the ventricles are quivering which results in the heart's inability to pump blood.

Which part of the x-ray circuit is controlled by adjusting the milliamperage (mA) setting on the operating console for the purpose of producing the heat necessary for thermionic emission? A. Timer circuit B. Primary circuit C. Filament circuit D. Secondary circuit

D. Filament circuit The filament circuit controls the amount of heat applied to the filament that is required to boil off the desired number of electrons by the process of thermionic emission; the amount of current that is applied to the filament is under the control of the radiographer when the mA station is selected.

Why is the left lateral decubitus position recommended as part of an acute abdominal series? A. Aspiration may be avoided in case of vomiting. B. The patient is unable to stand. C. Air-fluid levels are better visualized. D. Free air is demonstrated away from the gastric bubble.

D. Free air is demonstrated away from the gastric bubble The purpose of the left lateral decubitus position is to demonstrate free air in the area of the right upper abdomen away from the gastric bubble

Which type of joint classification describes the joint between the foot and the tibia/fibula? A. Saddle B. Gliding C. Condyloid D. Hinge

D. Hinge The ankle is a hinge joint. Condyloid joints are typified by the knee, where facing condyles articulate with one another. The only saddle joint is the first carpometacarpal joint. Gliding joints exhibit sliding movement between two relatively flat facing articular surfaces, such as those in zygapophyseal joints.

Which action can improve recorded detail? A. Use the largest focal spot. B. Select a larger kilovolts peak (kVp). C. Increase the object-image receptor-distance (OID). D. Increase the source-image receptor-distance (SID).

D. Increase the source-image receptor-distance (SID). Increasing the SID will cause an increase in recorded detail on the image.

Which factor will increase x-ray beam quantity at the image receptor without increasing heat units produced by the tube?

Decreased filtration will allow more low energy photons to reach the IR without affecting heat production.

A radiographer does a PA hand in a cupped position. It appears magnified how can this be minimized?

Decreasing OID.

When using film-screen systems, what method will result in greater radiographic contrast?

Decreasing field size results in a decrease in the number of x-ray photons available to undergo Compton interactions, this reduces scatter production, which increases radiographic contrast.

Decreasing kVp results in...

Decreasing kVp results in a decrease in shades of gray. High contrast.

A radiographer obtains a posteroanterior (PA) image of a hand casted in a slightly cupped position. The image appears magnified. How can this effect best be minimized?

Decreasing object to image receptor distance (OID)

File size is determined by determining the total number of pixels multiplied by the scale bit depth divided by 8. Eight bits are in a byte. 512 x 512 x 12/8 = 393,216 bytes.

Determine the file size for an image with a 512 x 512 matrix and 12 gray scale bit depth.

How does an increase in noise affect the quality of a digital image?

Digital image contrast is decreased by the presence of noise. Image noise has an inverse relationship with contrast.

Esophageal Varicies

Dilation of the veins in the distal esophagus (often associated with cirrhosis)

What type of relationship does cell growth have on the sensitivity of tissues to ionizing radiation?

Direct. According to the law of Bergonie and Tribondeau, cell growth has a direct relationship to the sensitivity of tissues to ionizing radiation; as the growth rate for tissues increases, the radiosensitivity also increases.

Which condition is most likely indication for an AP chest with left lateral decub position?

Effusion of left lung

What causes the build-up of heat at the anode?

Electrons colliding with the target.

Which information in the patient history should prompt the radiographer to decide against using AEC when taking a chest x-ray?

Emphysema

Which pathologic condition requires a reduction in exposure factors to produce an acceptable image? Late stage Paget's disease. Congestive heart failure (CHF). Atelectasis. Incorrect Emphysema. Correct

Emphysema is considered a destructive disease which requires a reduction in exposure factors. Atelectasis, late stages of Paget's disease, and CHF are all considered additive pathologic diseases and require an increase in exposure factors.

destructive; decrease

Emphysema, gout, and multiple myeloma are _______________ conditions because they __________________ attenuation of the beam

What is the wide spread of Methicillin-resistant Staphylococcus aureas (MRSA) mainly attributed to?

Over prescription of antibiotics and poor infection control practices

A radiographer prepares to position a patient with a suspected hip injury. The patient is positioned on a backboard with the right leg and foot lying on its lateral aspect. Which should the radiographer do to successfully complete the examination?

Perform the exam without repositioning the leg

A radiographer prepares to position a patient with a suspected hip injury. The patient is on the backboard with right leg and foot on lateral sect. What do you do?

Perform without repositioning.

Which central ray (CR) orientation is recommended for an anteroposterior (AP) knee projection if the measurement from the tabletop to the patient's anterior superior iliac spine (ASIS) is 22 cm?

Perpendicular to the image receptor (IR). (The CR is directed perpendicular to the IR for an AP knee projection if the table top to ASIS measurement is between 19 and 24 cm.)

What is the result if pixel bit depth is decreased? Image noise is decreased. Incorrect Brightness is increased. Contrast resolution is decreased. Correct Spatial resolution is increased.

Pixel depth determines how many shades of gray will be displayed so is directly related to contrast resolution. A decrease in pixel depth would mean a decrease in contrast resolution. Brightness of a digital image is dependent upon the look up table. Image noise is related to signal received and scatter radiation. Pixel size and matrix size determine spatial resolution.

Pixel Saturation

Pixel saturation occurs when too much exposure is used. It is similar to D-Max in film-based systems.

Pneumothorax

Pneumothorax is an abnormal collection of air or gas in the pleural space. A collapsed lung occurs when air escapes from the lung, the air then fills the space outside of the lung, between the lung and the chest wall.

Which aspect of electrical power is responsible for accelerating electrons in an x-ray tube?

Potential Difference. (Selected kVp, also known as potential difference, accelerates electrons crossing an x-ray tube.)

Without changing any other factors, which effect is caused by decreasing the field size from 14X17 inches to 8X10 inches? Increase in the amount of scatter radiation within the part. Decrease x-ray penetration of the part. Decrease in the amount of scatter radiation within the part. Correct Increase x-ray penetration of the part. Incorrect

Reducing the size of the field limits the amount of scatter produced. Increasing field size increases the amount of scatter. X-ray penetration is controlled by kilovoltage peak (kVp).

Which study is considered a nonfunctional examination of the urinary system?

Retrograde urogram Retrograde urography involves the introduction of contrast media directly retrograde, or against the flow, into the pelvicalyceal system. This is considered a nonfunctional exam because the patient's normal physiologic processes are not involved in the procedure. An intravenous urogram is considered a functional study because the molecules in the contrast medium are removed from the blood stream and excreted by the kidneys. A hypertensive urogram is a variation of the intravenous urogram that is used to determine if there is a renal component in patients with hypertension. A voiding cystourethrogram evaluates the patient's ability to urinate, therefore it is also considered a functional study.

Scatter

Scatter is a change in direction of x-rays as the beam passes through an object in its path.

The radiographer uses the Holmblad method to perform a tunnel view of the knee. What is the primary advantage of utilizing this method instead of the Camp Coventry method?

The Holmblad method shows no distortion longitudinally or laterally.

cystic and hepatic ducts. It is located inferior to the gallbladder.

The common bile duct is formed by the junction of the

The side where x-rays enter the patient

The highest potential dose to the radiographer during C-arm flouro originates from what source?

protection from leakage radiation

The housing of an x-ray tube provides ...

Right Iliac

The ileocecal valve is normally located in which of the following body regions?

When determining the thickness of a primary protective barrier in an x-ray department, distance is a factor. The measurement should be made from where to the x-ray tube?

The inside wall of the adjacent room, when the rube is as near to it as it will be in actual use.

When determining the thickness of a primary protective barrier in an x-ray department, distance is a factor. The measurement should be made from where to the x-ray tube?

The inside wall of the adjacent room, where the tube is as near to it as it will be in actual use

Which pathologic condition will result in the greatest attenuation of the beam? A. Emphysema. B. Multiple Myeloma. C. Gout. D. Ascites.

d

Which term refers to unwanted fluctuations in the brightness of an image? A. Static. B. Flux. C. Interference. D. Noise.

d

Why is it important for the radiographer to observe the milliampere seconds (mAs) readout at the end of each exposure when using automatic exposure control (AEC)? A. It provides an indication that the proper amount of exposure was used. B. This value may be used to estimate patient dose. C. It provides a visual cue to release the exposure switch. D. This value may be used as a basis for calculating manual techniques.

d

How can the contrast scale be modified on a digital image? (Select the two that apply.) A. Decrease the kilovolts peak (kVp). B. Increase the kilovolts peak (kVp). C. Alter the window level. D. Collimate more closely. E. Alter the window width.

d e

The AP Trendelenburg position is often used during an upper GI examination to demonstrate

hiatal hernia

By which method is exposure to a patient's bone marrow calculated?

through estimation by entrance skin dose read by a TLD

How is the central ray directed for an anteroposterior (AP) axial projection of the cervical vertebrae?

15-20 degrees cephalic to enter at C-4.

The patient positioned for a T-tube cholangiography is in a

15° to 20° RPO

Which of the following devices are necessary to optimally perform a lateral projection of the sacrum or coccyx? 1.) sandbags 2.) radiolucent sponges 3.) sheet of leaded rubber

2 and 3

Which of the following devices are necessary to perform a lateral projection of the lumbar spine? 1.) small sandbags 2.) radiolucent support sponge 3.) sheet of leaded rubber

2 and 3

Which projection of the lumbar spine displays the vertebrae in the form of a "Scottie dog"? 1.) lateral 2.) AP oblique 3.) PA oblique

2 and 3

Women cannot be shielded for an AP projection of the: 1.) hip 2.) sacrum 3.) coccyx

2 and 3

80kvp

26. which represents the optimum kilovolts peak (kip) for exposing film-scream radiographs of the adult anteroposterior (ap) lumbar spine? a. 60kvp b. 80kvp c. 90kvp d. 70kvp

100 mAs

27. assuming that automatic exposure control is to be used, what backup milliampere-seconds (mAs) are sufficient for a large adult (AP) lumbar spine at 80 kilovolts peak? a. 60 mAs b. 40 mAs c. 100 mAs d. 80 mAs

Which technique mimics the use of a grid?

Increased OID. (The air-gap technique, or increased OID, may be used to reduce scatter radiation and thus, increase image contrast.)

Which change in technical factors is most likely to result in decreased film density?

Increased grid ratio

What change is needed to compensate for a soft tissue mass in the abdomen?

Increased mAs - to compensate for the additional tissue presence of a soft tissue mass.

Under the patient

A radiographer is using a c-arm to assist during an operative procedure. What is the best X-ray tube position to minimize occupational exposure?

Decreasing object to image receptor distance

A radiographer obtains a posteroanterior (PA) image of a hand casted in a slightly cupped position. The image appears magnified. How can this effect best be minimized?

Which projection best demonstrates the tripod fracture of the orbit?

Modified parietoacanthial (Modified Waters)

What projection demonstrates the tripod fracture of the orbit?

Modified waters.

Moire Pattern

Moire pattern is associated with grid frequencies and sampling frequencies that are too nearly the same.

a. duodenal cap (bulb)

Most gastric ulcers appear within the: a. duodenal cap (bulb) b. lesser curvature of the stomach c. greater curvature of the stomach d. fundus

1 foot from the table for 45 minutes Using inverse square law

A radiographer stands 4 feet from the flouro table for a half hour and receives 100 mR of exposure. Which of these adjustments would cause the highest increase in exposure?

d. a & b only

A reason you might use a water- soluble contrast in an UGI would be: a. possible pre-operative patient b. small bowel obstruction c. children d. a & b only

The central-ray angle for a lateral coccyx is:

0 degrees

The central-ray angle for an AP oblique sacroiliac joint is

0 degrees

Which is the genetically significant dose for the population of the United States?

0.20 mSv

What is the genetically significant dose (GSD) for the population of the United States?

0.20 millisievert (mSv)

The bucky slot cover should offer at least what lead thickness?

0.25mm

What is the minimum thickness of requirement for protective lead curtains?

0.25mm lead equivalence.

The annual effective dose equivalent limit for infrequent exposures recommended by the National Council on Radiation Protection (NCRP) for a member of the general public is equal to how many rem(s)?

0.5

the annual effective dose equivalent limit for infrequent exposures recommended by the national council on radiation protection for a member of the general public is equal to how many rems?

0.5

the bucky slot cover should offer at least what lead thickness?

0.5 mm

The annual effective dose equivalent limit for infrequent exposures recommended by the NCRP for a member of the general public is equal to how many rem(s)?

0.5 rem

Which of the following should be performed to reduce the lordotic curvature of the lumbar spine for the AP projection? 1.) flex the hips 2.) flex the knees 3.) flex the elbows

1 and 2

Which projections will demonstrate the right sacroiliac joint? 1.) AP oblique, LPO position 2.) AP oblique, RPO position 3.) PA oblique, RAO position

1 and 3

a radiographer is standing 4 ft from the fluorscopic table for a half hour and receives a dose of 100 mR. WHich of these adjustments would cause the highest increase in dose? -1 foot from the table for 45min -3 feet from the table for 15 mins -4ft from the table for 1 hr -6 feet from the table for 30 min

1 foot from the table for 45 min

Advantages of using a thermoluminescent dosimeter (TLD) compared to a film badge. (four)

1. Does not fog. 2. Highly accurate. 3. Can be used up to a year. 4. Not affected by heat or moisture.

Endoscopic retrograde cholangiopancreatography (ERCP) usually involves

1. cannulation of the hepatopancreatic ampulla. 2. introduction of contrast medium into the common bile duct.

To make the patient as comfortable as possible during a single-contrast barium enema (BE), the radiographer should

1. instruct the patient to relax the abdominal muscles to prevent intra-abdominal pressure. 2. instruct the patient to concentrate on breathing deeply to reduce colonic spasm.

During GI radiography, the position of the stomach may vary depending on

1. respiratory phase. 2. body habitus. 3. patient position.

Operative cholangiography may be performed to

1. visualize biliary stones or a neoplasm. 2. determine function of the hepatopancreatic ampulla. 3. examine the patency of the biliary tract.

The central-ray angle for an AP axial projection of the coccyx is

10 degrees caudad

Occasionally, a patient may have to be placed in the prone position for a PA projection of the coccyx. What is the central-ray angle for this projection?

10 degrees cephalad

A radiographer chooses a portable non-grid chest x-ray technique of 80 kVp at 4 mAs. Before making the exposure, the radiographer decides to use an 8:1 grid. Which change in technical factors is most appropriate based on this new information?

106 kVp at 4 mAs (8:1 grid as a GF of 4, which can be compensated by using two 15% increases in kVp)

What is the longest field size dimension allowable for 10 inches by 12 inches collimation at a 40 inch source to image distance (SID)?

12.8 inches. (Field size may be off +/- 2% of the SID, which in this case is 0.8 inches)

The central-ray angle for an AP axial projection of the sacrum is:

15 degrees cephalad

Which angle of insertion is recommended when performing venipuncture?

15 degrees.

Where is the longitudinal plane of the lumbar spine positioned for the AP oblique projection?

2 inches medial to the elevated ASIS

What is the central-ray centering point for an AP oblique lumbar spine?

2 inches medial to the elevated ASIS and 1 1/2 inches above the iliac crests

Which of the following describes the central ray centering point for the L5-S1 lateral projection?

2 inches posterior to the ASIS and 1 1/2 inches below the iliac crests

for the protection of the radiographer, how long must the exposure cord be on a mobile radiographic unit?

2 meters

What is the dose area product if the collimated field is 10x10 cm with a dose of 2 R/min?

200 R per cm squared

What is the dose area product (DAP) if the collimated field is 10 x 10 cm with a dose of 2 R/min?

200 R per cm squared volume of tissue radiated x dose received

How many true, or movable, vertebrae are there in the vertebral column?

24

Which input image intensifier screen provides the best radiation protection to the patient during fluroscopy?

25 cm

Which input image intensifier screen provides the best radiation protection to the patient during fluoroscopy?

25 cm. (Smaller input screens are used during magnification fluoroscopy to reduce the field of view and magnify the image. However, this comes at the cost of higher exposure to the patient.)

How many degrees is the body rotated for the AP oblique projection of the sacroiliac joint?

25 to 30 degrees

a

28 a radiographer makes an exposure using an 8:1, 100 line per inch grid. when processing the IP through the reader, the radiographer notices that a moire pattern is seen on the displayed image. what is the probable cause of this artifact? a. the grid had a frequency similar to the readers sampling frequency. b. the IP was not fully erased the last time is was used c. the IP was upside down in the bucky tray. d. underexposure to the IP.

a, b, c, e

29 who judges radiographic images for quality? a. quality control techs b. radiographers c. ordering physicians d. lawyers. e. radiologists.

Where is the central ray positioned for a lateral coccyx?

3 1/2 inches posterior to ASIS and 2 inches inferior

How is the central ray directed when performing an anteroposterior (AP) knee projection for a patient with thin thighs and buttocks?

3 to 5 degrees caudad. An AP knee projection for a patient with thin thighs and buttocks (less than 19 cm from table top to ASIS) is 3 to 5 degrees caudad. All other choices do not project an open femorotibial joint space.

How is the central ray directed when performing an anteroposterior (AP) knee projection for a patient with thin thighs and buttocks?

3-5 degrees caudal

c

30 digital radiography has the ability to produce 16,000 shades of gray. which appropriate bit-dephy (dynamic range) does this represent? a. 2 raised to the 12th power b. 2 raised to the 16th power c 2 raised to the 14th power d. 2 raised to the 10th power

The tarsal sinus is visualized when the foot is seen in what projection?

30 degree medial oblique

Tarsal sinus visualized when in what position?

30 degree medial oblique.

The zygapophyseal joints of the lumbar spine form an angle of how many degrees from the posterior midsagittal plane?

30 to 50 degrees

If a PA chest projection results in a dose of .1 mSv and a CT scan results in a dose of 3rem, how many PA chest projections would be equal the dose from one CT scan?

300

If a PA chest projection results in a dose of 0.1 mSv and a CT scan results in a dose of 3 rem, how many PA chest projections would equal the dose from one CT scan?

300. The conversion from rem to Sievert is 100 rem = 1 Sv. 3rem/100rem per Sv = 0.03Sv x 1000mSv = 30mSv. If the dose of a PA chest is 0.1mSv, it would require 30mSv per CT / 0.1mSv per PA chest = 300 projections to equal one CT.

number of gray tones will be increased

31. when using film screen which most accurately describes the effect on the resultant image when kilovolts peak is increased? a. recorded detail will be decreased b. recorded detail will be increased c. number of gray tones will increased d. number of gray tones will be decreased

increased grid ratio

32 which change in technical factors is most likely to result in decreases film density? a. increased grid ratio b. decreased source to image receptor distance c. increased screen speed d. decreases beam restriction.

How many vertebrae make up the vertebral column?

33

b

33 a radiographer of the distal femur demonstrates adequate radiographic density but requires a shorter scale of contrast. With original exposure factors of 80kvp, a 200 milliampere (mA) station, and an exposure time of 0.08 seconds, which set of factors is most likely to produce desired results? a. 92 kvp; 100 mA; 0.08 seconds b. 68 kvp; 200 mA; 0.16 seconds c. 68 kvp; 200 mA; 0.11 seconds d. 92 kvp; 200 mA; 0.08 seconds

b

34 a radiographer makes an exposure using a fuji CR system. The S number reads out at 480 and the image appears grainy. what is the problem with the image and how should it be corrected? a. the radiographer underexposed the image and should decrease the technique. b. the radiographer underexposed the image and should increase the technique. c. the radiographer overexposed the image and should decrease technique. d. the radiographer overexposed the image and should increase technique.

IF a radiographer receives an exposure of 550 mR at a distance of 1.5ft from the tube of a portable x-ray unit, what will the exposure be at a distance of 6ft from the tube?

34.4 mR

If a radiographer received an exposure of 550 milliroentgens (mR) at a distance of 1.5 feet from the tube of a portable x-ray unit, what will the exposure be at a distance of 6 feet from the tube?

34.4 mR. The inverse square law formula is used to solve this problem: I1 / I2 = (D2 / D1)squared.

the ir was not properly erased from the last examination.

35 a radiographer performs a chest examination using a CR system. PA and lateral images are taken, and the imaging receptors are processed in the CR reader. The PA image appears to have two PA chest images present. the lateral image is processed and appears fine. What is a possible cause of the double image? a. the image reader has malfunctioned. b. the IR has been sitting too long and and has been exposed by background radiation. c. the radiographer accidentally exposed the back side of the IR during the PA position. d. the ir was not properly erased from the last examination.

If 7 mAs provides optimal density without a grid, which mAs should be used with a 12:1 grid?

35.

selecting only the detector on the left side

36 prior to performing a PA chest projection with AEC the radiographer discovers that the patient has had a right total pneumonectomy. which technical consideration should be considered? a. selecting the center detector b. selecting only the detector on the right side c. selecting only the detector on the left side d. selecting both outer detectors

c

37 which technique would produce a 2 milliroentgens (mR) exposure to an image receptor plate if 70 kvps at 25 mAs produces 1.6? a. 70 kvp at 50 mAs b. 70 kvp at 27.5 mAS c. 70 kvp at 31.25 mAs d. 70 kvp at 35 mAs

image noise is increased (increasing the size of the collimated field increases the quantity of scatter produced but does not affect the size of the pixels.)

38 opening the collimators wider than necessary using digital radiography has which effect on image quality? a. there is no effect on image quality b. the spatial resolution of the image is decreased c. the spatial resolution of the image is increased d. image noise is increased

quantum noise (quantum noise occurs due to an insufficient exposure to the image receptor resulting in an uneven density over the image).

39 insufficient exposure to a photostimulable phosphor plate results in which type of image degradation? a. high signal to noise ratio b. pixel saturation c. quantum noise d. moire pattern

When viewed from the side, the vertebral column presents how many curves?

4

longer exposure time

40 how is signal maximized to a digital receptor? a. lower millamperage (mA) Setting. b. shorter exposure time c. longer exposure time d. hight source to image receptor distance

increased milliampere seconds

41 which change is needed to compensate for a soft tissue mass in the abdomen? a. reduced kilovolts b. reduced mAs c. increased source to image receptor distance d. increased milliampere seconds

cracked safelight filter (a cracked safelight filter will allow unfiltered light to reach unprocessed x-ray films, which causes fogging of the film)

43 which is the most likely cause of film fog prior to development? a. poor film screen contact b. low relative humidity c. cracked safelight filter d. excessive developer temperature

SID

44 An increase in which factor will improve recorded detail? a. sid b. milliamperage setting c. focal spot size d. film screen speed

To demonstrate the zygapophyseal joints of the lumbar spine, the patient angle is:

45 degrees

quantity of x-rays (added aluminum filtration results in a reduction in the quantity of x-rays in the primary beam.)

45. which x-ray beam characteristic is reduced by adding aluminum filtration? a. x-ray beam quality b. half value layer c. quantity of x-rays d. energy of the x-ray beam

contrast is decreased (by the presence of noise)

46 how does an increase in noise affect the quality of a digital image? a. contrast is increased b. contrast is decreased c. density is increased d. density is decreased

longer exposure time

47 which step will reduce digital image noise assuming no other changes? a. image magnification b. decreased kvp c. longer exposure time d. small pixel size

In order to reduce distortion of the intervertebral joint spaces of the lumbar spine for an AP projection, an SID of ____ inches is suggested

48

decreased field size

48 when using film screen systems, which method will result in greater radiographic contrast a. decreased beam filtration b. decreased field size c. increased screen speed d. increased kvp

On a well positioned PA chest, the manubrium of the sternum is at what level of the t-spine in a sthenic patient?

4th.

Which central ray (CR) angle is best for heavy, wide-hipped patients for lateral lumbar spine projections?

5 degrees caudad

Which central ray (CR) angle is best for heavy, wide-hipped patients for lateral lumbar spine projections?

5 degrees caudad.

What is the recommended central ray (CR) angle if the lumbar spine cannot be adjusted so it is horizontal for the lateral projection?

5 degrees for men, and 8 degrees caudad for women

If the lumbar spine cannot be adjusted so it is horizontal for the lateral projection, the central ray should be angled:

5 degrees men, 8 degrees women - caudad

What is the CR angle if the lumbar spine can't be adjusted for a horizontal lateral?

5-8 caudad.

b

50 when using film screen, an exam utilizing 90 kilovolts peak and 10 mAs provides adequate density but has inadequate contrast (contrast scale is too long) which technical exposure factors increase contrast while maintaining adequate density? a. 77 kvp and 40 mAs b. 77 kvp and 20 mas c. 45 kvp and 20 mas d. 90 kvp and 20 mas

A breathing technique is planned for a RAO sternum. The intended exposure is 50 mAs at 75 kVp at 40in (100cm) SID. Which mA station is preferred, assuming the radiographer ensures exposure occurs during the act of inspiration?

50. An exposure time of 1 second if optimal for breathing technique, provided the radiographer ensures exposure occurs during the act of inspiration. To obtain 50 mAs at an exposure time of 1 second means use of the 50 mA station.

Optimal radiographic density is achieved with 400 mA, 0.25 seconds, and 75 kVp using a 400 speed film-screen system. Which adjustment in mA is needed to maintain density if the exposure time is increased to 0.4 seconds, and a 200 speed system is used?

500 mA (mAs1/mAs2 = RS2/RS1)

d

51 a radiographer chooses a portable non-grid chest x-ray technique of 80 kip at 4 milliampere-seconds (was) before making the exposure, the radiographer decides to use 8:1 grid. which change in technical factors is most appropriate based on this new information a. 92 kvp at 4 mas b. 80 kvp at 2 mas c. 68 kvp at 4 mas d. 106 kvp at 4 mas

selection of an incorrect exam from the look up table

52. which is the most likely cause of a histogram error? a. malfunction of the plate reader electronics b. underexposure of the image receptor c. incomplete erasure of the image plate d. selection of an incorrect exam from the look up table

to reduce amount of accumulated scatter on the imaging plate?

53 best practice suggests erasing all computed radiography plates once a day. what is the purpose of this? a. to ensure removal of phantom images from high exposes b. to keep exposure indices within appropriate ranges c. to keep imaging plate free from dust and other potential artifact producing phenomena d. to reduce amount of accumulated scatter on the imaging plate

contrast resolution is decreased

55 what is the result if pixel bit depth is decreased? a. image noise is decreased b. contrast resolution is decreased c. spatial resolution is increased d. brightness is increased

d.

56 which statement is true regarding exposure indicator and the evaluation of digital images? a. radiographers do not need to review the exposure indicator during image evaluation. b. if the exposure indicator falls within the manufacturers acceptable range, image contrast and brightness do not need to be reviewed. c. exposure indicator is reviewed only when image contrast or brightness suboptimal d. exposure indicator must be reviewed with every image and must fall within the manufactures acceptable range.

a

57. how does the density log exposure curve appear for a digital imaging receptor? a. a straight line at a 45 degree angle b. a shallow slope. c. an s curve d. a steep slope

they both measure spatial resolution in digital imaging

58 what do limiting spatial resolution and modulation transfer function have in common? a. they measure how efficiently an image is moved to the picture archiving and communication system b. the both measure spatial resolution in digital imaging c. they are both indicator of exposure for digital receptors d the both affect brightness of the digital image

rescaling

59 what is the term for the adjustment of image brightness, regardless of exposure received? a. automatic brightness control b. rescaling c detective quantum efficiency d. dose are product

Which grid ratio results in the lowest dose to a patient, because less mAs is required?

5:1

In order to protect the radiographer, how long must the exposure cord be on a portable x-ray machine?

6 ft

image contrast

60 a radiographier uses 70 kilovolts peak at 30 mas on a film screen radiograph. if a repeat radiograph is acquired at 80kvp and 15mas, which factor will be affected? a distortion subject contrast c. optical density d. image contrast

surgical hand scrub

61 which procedure is an example of surgical asepsis? a hand washing b. surgical hand scrub c. clean grown application d. clean glove application

battery

62 a radiographer recieves a request for a portable chest x-ray and then performs the x-ray not he incorrect patient which legal term best describes the actions of the radiographer a. assault b. battery c. invasion of privacy d negligence.

b

63 the lead radiographer is planning a strategy to efficiently manage the morning workload. the department is short staffed due to meetings and four patients are now ready for their exemptions. assuming that none of the exams is emergent, which patient should be seen first? a. a 18 year old female for an intravenous urogram b. a two year old child for a barium swallow. c. an 83 year old female for a chest x-ray. d. an 54 year old male with type 2 diabetes for an upper GI

D

64 which type of contrast agent would be preferred for low risk and low cost for a patient diagnosed with a perforated bowel? a. gaseous media in the form of crystals b. nonionic, water soluble, diluted with juice c. barium sulfate suspension, flavored d ionic, water soluble, diluted with juice.

anaphylactoid reaction

65 a patient reports symptoms including itching, rash formation, and difficulty breathing immediately following the administration of intravenous contrast media. Assuming the patient has had no prior exposure to radiopaque contrast media, what is the most likely cause of these symptoms? a. acute bronchospasm b. anaphylactoid reaction c. allergic reaction d. acute renal failure

report the even to the quality control supervisor but do not star car

66 a patient ceases to breathe while in medical imaging. there is a clearly marked DNR order on the patients chart. what should the radiographer do first? a. immediately begin CPR, and call for help b. call a code c. report the even to the quality control supervisor but do not star car d. scream for help

d. immediately begin the CPR process.

67 a radiographer is on an elevator with a patient who is being transported. the patient ceases to breathe, but the patients chart is not present. what should the radiographer do first? a. call a code b. scream for help c. report the event to the QC tech, but do not start CPR d. immediately begin the CPR process.

D

68 a patient received 100 ml of IV contrast media as a part of an abdominal computed tomography scan, as well as 500 ml of dilute, oral contrast, prior to coming to radiology for a separate order, an intravenous urogram (IVU) the patients creatinine is 0.4 mg/dl and BUN is 36 mg/dl. why should this ivy be rescheduled? a. the presences of the previous intravenous contrast precludes an IVU B. the lab values indicate that the contrast would not be excreted in sufficient quantity to be useful for an IVU c. the lab values indicate increased risk for contrast injection. d. the presence of the previous oral contrast in the abdomen precludes an IVU.

b

69 The radiographer is assisting a patient to move from a wheelchair to the x-ray table. Which represents the safest practice but he radiographer when moving this patient? a. extent the arms as far as possible to increase the base of support b. maintain the center of gravity over the base of support c. ben as the waist so that the center of gravity is midway between the patient and the base of support d. reduce the base of support slightly so the center of gravity is easier to maintain.

medical asepsis

70 which term best describes the process of cleaning the surfaces in a radiology department with 10% bleach solution in water? a. surgical asepsis b. medical asepsis c. sterile technique d. sterilization

b

71 which action is best taught to the patient using the communication technique of demonstration? a. direction on where to sit relate to the radiography table b. the correct positioning for a particular projection c. instructions for donning and removing a patient gown. d. the correct direction to face when sitting a the radiography table.

a, b c, e

72 which steps are involved in legally obtaining informed consent to perform a radiographic procedure (select the four that apply) a. the patient has been informed about procedures i place to mitigate risks b. the patient is legally competent. c. the patient has been informed about the risks involved in the procedure d. the patient signed an informed consent form of their own volition in view of multiple witnesses e. the patient has been informed about alternatives to this particular procedure.

intravenously

73 how should a drug be administered to get the quickest response? a. orally b. intravenously c. subcutaneously d. rectally

consistent eye contact

74 which of the non verbal cue best demonstrates attentiveness and concern for a patient who is giving medical history a. turning head to the side close to the ear b. a pleasant smile c. consistent eye contact d. taking notes

b. initiate a backwards thrust in the center of the sternum

75 a radiographer enters a room to do a portable foot series on a patient in her final trimester of pregnancy. the patient begins choking. how should the radiographer respond to this medical emergency? a. apply in inward and and upward thrust in the midline of the abdomen b. initiate a backwards thrust in the center of the sternum c. place the patient in trendlenberg d. start cpr

d. stand with feet at greater distance apart

76 how should a radiographer increase the stability of the base of support a. keep back straight and knees bent b. hold heavy objects close to body c. stand on one foot d. stand with feet at greater distance apart

a, b, c, e

77. identify the medical conditions in a patients history which should be cleared by the radiologists before injection of an ionic water soluble, injectable contrast agent. (select 4 that apply) a. compromised renal function b. sickle cell anemia c. pheochromocytoma d. age over 40 e. diabetes.

b.position the right side of the wheelchair next to the table

78 a radiographer prepares to transfer a patient from a wheel chair to the x-ray table. the patient recently suffered a stroke and exhibits left sided weakness, and is able to bare some weight. how should the radiographer move the patient to the table. a. use a hydraulic lift b.position the right side of the wheelchair next to the table c. have one radiographer lift the torso while the other one holds the feet d. position the left side of the wheel chair next to the table

d. 90 - and above

8. The most beneficial kVp range for studies including barium as the contrast agent should be in the _____ - _____ range. a. 60 - 70 b. 70 - 80 c. 80 - 90 d. 90 - and above

a. adjust the x-ray table to the same height as the wheelchair

81 a patient with a history of of stroke and hemi paralysis is transported to the x-ray department by wheelchair. which action should should the radiographer perform in order to safely transfer the patient to the x-ray table a. adjust the x-ray table to the same height as the wheelchair b. stand behind the patient during the transfer c. place the patients weak side next to the table d. instruct the patient to lead with weak side.

b. speak in a low register voice

82 which is the best approach for speaking to a patient with a hearing impairment? a. ask patient to adjust hearing aid volume b. speak in a low register voice c talk very slowly d. do not make eye contact

a. avoid saying things you would say to a conscious patient

83 which rule is followed when examining unconscious patients? a. avoid saying things you would say to a conscious patient b. proceed as if the patient were conscious patient c. speak openly in front of the patient since they cannot hear or understand you d. remain as quiet as possible to avoid waking the patient during the exam

c. over prescription of antibiotics and poor infection control practices

84 what is the widespread of MRSA attributed to? a. improper cleaning of medial equipment b. poor hygiene and overuse of pain killers c. over prescription of antibiotics and poor infection control practices d. use of antibiotics with immunosuppressed patients

d. speak slowly and in a low tone voice

85 which is the most appropriate guideline to follow when radiographing patients in their late adult years. a. assume the patient has reduced mental capacity b. repeat instructions often so the patient won't forget c. perform exam as quickly as possible d. speak slowly and in a low tone voice

a. battery

86 which legal concept is violated by a radiographer who performs an examination without an examination order? a. battery b. malpractice c. res ipsa loquitur d. respondent superior

Where is the safest place for the radiographer to stand during fluoroscopy?

90 degrees and 1 meter from the patient

Where is the safest place for the radiographer to stand during fluoroscopy?

90 degrees and one meter (three feet) from the patient.

What is the magnitude of the angle formed by the IV foramina and the MSP in a t-spine?

90 degrees.

What is the magnitude of the angle formed by the intervertebral foramina and the midsagittal plane in the thoracic spine?

90 degrees. The intervertebral foramina of the thoracic spine form a 90 degree angle with the midsagittal plane, thus much larger than 15 degrees. The intervertebral foramina of the cervical spine form a 45 degree angle with the midsagittal plane. The zygapophyseal joint forms a 70 degree angle with the midsagittal plane in the thoracic spine.

How much can exposure to the lens of the eyes be reduced by utilizing the PA projection of the cranium over the AP projection?

95%

How much can exposure to the lens of the eyes be reduced by utilizing the posteroanterior (PA) projection of the cranium over the anteroposterior (AP) projection?

95%

How much exposure to the lens of the eyes be reduced by utilizing the PA projection of the cranium over the AP projection?

95%. By placing the eyes as far away from the primary beam as possible and using the contents of the cranium as a filter, the exposure to the lens of the eyes in a PA projection is reduced by 95% percent in comparison to use of the AP projection.

174. Which grid ratio results in the lowest dose to a patient, because less milliampere-seconds (mAs) is required? A 5:1. B 12:1 C 16:1 D 8:1.

A 5:1. A 5:1 grid ratio provides less exposure to the patient than higher grid ratios due to higher lead content. Grid selection always involves a trade-off between obtaining an optimal image and exposure to the patient. Higher ratio grids improve image contrast at the expense of increased patient dose.

38.Which technique would produce a 2 milliroentgens (mR) exposure to an image receptor plate if 70 kilovolts peak (kVp) at 25 milliampere-seconds (mAs) produces 1.6 mR? A 70 kVp at 31.25 mAs. B 70 kVp at 27.5 mAs. C 70 kVp at 50 mAs. D 70 kVp at 35 mAs.

A 70 kVp at 31.25 mAs 2 mR is 25% greater than 1.6 mR; so, a 25% increase in mAs would achieve this result. 25 mAs x 1.25 = 31.25 mAs. All other responses are incorrect due to math errors or misunderstanding the relationship of mAs to exposure.

8. Which condition must be met before diagnostically useful characteristic x-rays can be produced? A An inner shell electron must be completely removed. B Tissues with high atomic numbers must be present. C Characteristic x-rays can be produced only above 85 kiloelectron volts (keV). D A specific milliampere-seconds (mAs) should be selected.

A An inner shell electron must be completely removed. Diagnostically useful characteristic x-rays are produced when an outer shell electron drops to an inner shell void left, after an inner shell electron has been completely removed. The mAs setting does not affect characteristic x-ray production. Characteristic x-rays may be produced under 85 keV. Increase in the atomic number does enhance the efficiency of characteristic x-ray production, but need not be present.

82.A patient in the radiology department suddenly develops a nosebleed. The radiographer instructs the patient to lean forward and pinch the affected nostril against the midline nasal cartilage, but the bleeding does not stop. What should the radiographer do next? A Apply a moist compress. B Instruct the patient to tilt the head back. C Transport the patient to the emergency room. D Place the patient in a recumbent position.

A Apply a moist compress. If gentle pressure is unsuccessful, the patient should apply a moist compress. A patient should never be instructed to tilt the head back or be placed in the recumbent position as the patient may aspirate the blood. It is not necessary to transport the patient to the emergency room at this point.

181. Which factor will decrease the patient's dose during fluoroscopy? A Bring the image intensifier as close as possible to the patient. B Use continuous fluoroscopy. C Increase the milliampere-seconds (mAs). D Use the magnification mode.

A Bring the image intensifier as close as possible to the patient. The patient dose is decreased by bringing the image intensifier as close to the patient as possible. Continuous fluoroscopy, the magnification mode, and increased mAs will all increase the patient's dose.

81.What does "ventricular fibrillation" mean? A Erratically quivering ventricles. B Premature ventricular contractions. C Rapid heart rate. D Slow heart rate.

A Erratically quivering ventricles. Ventricular fibrillation means that the ventricles are quivering which results in the heart's inability to pump blood. If the heart is beating too slowly, the patient is suffering from bradycardia. On the other hand, if the heart is beating too quickly, the patient has tachycardia. Premature ventricular contractions (PVCs) are extra beats that do not contribute to the blood flow, but this is not generally a life-threatening rhythm.

68.A radiographer is on an elevator with a patient who is being transported. The patient ceases to breathe, but the patient's chart is not present. What should the radiographer do first? A Immediately begin the CPR process. B Call a code. C Report the event to the QC tech, but do not start CPR. D Scream for help.

A Immediately begin the CPR process. Under these conditions, the radiographer is legally obligated to immediately begin CPR by checking for a pulse. If the patient is found to be pulseless, then compressions are begun. There is no need to involve the QC supervisor, who is in radiology, and not present. CPR should be continued as the patient is transported. Screaming for help likely will not be heard, and if it is, it is likely to frighten whoever hears it. The transporter can call a code, using the elevator's phone, after CPR has started.

78.A radiographer enters a room to take a portable foot series on a patient in her final trimester of pregnancy. The patient is just finishing her lunch and begins choking. How should the radiographer respond to this medical emergency? A Initiate a backward thrust in the center of the sternum. B Start cardiopulmonary resuscitation (CPR). C Apply an inward and upward thrust in the midline of the abdomen. D Place the patient in the Trendelenburg position.

A Initiate a backward thrust in the center of the sternum. Abdominal thrusts can be dangerous in the late stages of pregnancy, so the radiographer should use backward thrusts in the center of the sternum. CPR should not be performed on patients who are conscious. The Trendelenburg position is useful for patients recovering from syncope or experiencing shock. Abdominal thrusts can be dangerous in the late stages of pregnancy and should not be attempted.

76.How should a drug be administered to get the quickest response? A Intravenously. B Orally. C Subcutaneously. D Rectally.

A Intravenously. Intravenous medication administrations result in the quickest response. Drugs can be administered subcutaneously but it is not the quickest route. Rectal and oral administration are slow methods of medication administration.

194. When performing an Anteroposterior (AP) Axial (Towne method) image of the skull, which reference line should be perpendicular to the image receptor (IR) if using a 30 degree caudal angle? A Line B. Correct B Line C. C Line A. D Line D.

A Line B. When performing an AP Axial skull (Town method), the central ray should be oriented 30 degrees caudal to the orbitomeatal line (OML), or line B. Line A, or the supraorbital meatal line (SOML), is not typically used for AP Axial skull images. Line C, or the infraorbital meatal line (IOML), is placed perpendicular to the IR when a 37 degree caudal angle is used. The acanthiomeatal line (AML) is not typically used for AP Axial skull images.

74.Identify the medical conditions in a patient's history which should be cleared by the radiologist before injection of an ionic, water soluble, injectable contrast agent. (Select the four that apply.) A Pheochromocytoma. B Diabetes. C Age over 40. D Sickle cell anemia. E Compromised renal function.

A Pheochromocytoma. B Diabetes. D Sickle cell anemia. E Compromised renal function. The patient with diabetes should be checked for taking metformin as a treatment. They should not take it for 24 - 48 hours after the contrast injection, per Radiologist order. The American College of Radiology (ACR) lists sickle cell anemia, pheochromocytoma, and compromised renal function as justification for the use of nonionic media. Age 40 is not a caution or contraindication, although the ACR lists age 60 as a caution, and a justification for choosing nonionic contrast agents.

191. An anteroposterior (AP) trauma elbow image reveals a normal-looking distal humerus, but the proximal forearm appears foreshortened. How should the radiographer position the patient for an additional AP projection? A Place the forearm parallel to the image receptor (IR). B Place humerus parallel to image receptor (IR). C Extend elbow. D Elevate forearm.

A Place the forearm parallel to the image receptor (IR). In this case, an additional AP projection is needed with the forearm parallel to the IR in order to demonstrate the proximal forearm without distortion. Forced extension should not be performed in the setting of trauma. Elevation of the forearm would again result in foreshortening of the proximal forearm. The initial image was acquired with the humerus parallel to the IR.

26. ID: 3017347850 Who judges radiographic images for quality? (Select the four that apply.) A Quality control technologists. B Lawyers. C Ordering physicians. D Radiographers. E Radiologists.

A Quality control technologists. C Ordering physicians. D Radiographers. E Radiologists. Radiographs are judged for quality by essentially all quality control technologists, ordering physicians, radiographers, and radiologists who see them. Lawyers depend upon hired expert radiologists to judge radiographs for them

46. Which x-ray beam characteristic is reduced by adding aluminum filtration? A Quantity of x-rays. B Energy of the x-ray beam. C Half-value layer. D X-ray beam quality.

A Quantity of x-rays. Added aluminum filtration results in a reduction in the quantity of x-rays in the primary beam. The half-value layer (HVL) is a numerical value used to identify the quality of the beam; added filtration results in an increase in HVL, not a reduction. The quality of the x-ray beam refers to its penetrability, which increases as a result of added filtration, not a reduction. Because most of the x-rays removed by the filter are of low energy, there is an increase in the average energy of the primary x-ray beam, not a reduction.

37.Prior to performing a posteroanterior (PA) chest projection with automatic exposure control (AEC), the radiographer discovers that the patient has had a right total pneumonectomy. Which technical consideration should be considered? A Selecting only the detector on the left side. B Selecting only the detector on the right side. C Selecting the center detector. D Selecting both outer detectors.

A Selecting only the detector on the left side. Selecting the left detector in this scenario will result in proper exposure of the image and is the correct answer. If only the right detector is selected, the exposure will be too dark for an optimal image. If the radiographer selects both outer detectors, the exposure will be too dark, because the cell is detecting the increased density of the right hemithorax which has gradually filled with interstitial fluid following the surgery. Selecting the center detector places the thoracic spine in the detector, which is more dense than the lung and will cause an overexposed image.

187. Consider this supine abdomen image. What should the radiographer do next? A Submit the image as-is and include a 10 x 12 inch of the bladder region to include the pubis. B Submit the image as is for interpretation without any additional images. C Reject the image and repeat the abdomen using a 14 x 17 inch receptor centering more superior to include the diaphragm. D Reject the image and repeat the abdomen using a 14 x 17 inch image receptor centering more inferior to include the pubis.

A Submit the image as-is and include a 10 x 12 inch of the bladder region to include the pubis. A supine abdomen image must include the bladder region down to the pubis. Since this image lacks the pubis, a 10 x 12 inch of the bladder region will complete this study while minimizing patient radiation exposure. Then, both images should be submitted. The image should not be submitted without an additional image. Completing another 14 x 17 inch of the abdomen to include the pubis or diaphragm will expose the patient to unnecessary radiation.

62.Which procedure is an example of surgical asepsis? A Surgical hand scrub. B Clean glove application. C Hand washing. D Clean gown application.

A Surgical hand scrub. Asepsis is the absence of disease-producing (pathogenic) organisms. Surgical asepsis, or sterile technique, includes procedures used to eliminate all microorganisms from an area. Surgical hand scrub, sterile glove application, and sterile gown application are examples of surgical asepsis. Medical asepsis, or clean technique, includes procedures used to reduce the number of and prevent the spread of microorganisms. Hand washing, barrier techniques (clean glove and clean gown application), and routine environmental cleaning are examples of medical asepsis.

72.Which action is best taught to the patient using the communication technique of demonstration? A The correct positioning for a particular projection. B Instructions for donning and removing a patient gown. C The correct direction to face when sitting at the radiography table. D Direction on where to sit relative to the radiography table.

A The correct positioning for a particular projection. Demonstration is particularly effective for showing a patient the specifics of a position. Verbal explanations work best for "how to put on a gown." Verbal directions are the best approach where to sit or to communicate facing direction to the patient.

75.Which steps are involved in legally obtaining informed consent to perform a radiographic procedure? (Select the four that apply.) A The patient has been informed about alternatives to this particular procedure. B The patient signed an informed consent form of their own volition in view of multiple witnesses. C The patient has been informed about procedures in place to mitigate risks. D The patient is legally competent. E The patient has been informed about the risks involved in the procedure.

A The patient has been informed about alternatives to this particular procedure. C The patient has been informed about procedures in place to mitigate risks. D The patient is legally competent. E The patient has been informed about the risks involved in the procedure. In order to give consent, a patient must be legally competent. In order to give informed consent, the patient must be informed of the risks involved in the procedure, the steps taken to mitigate those risks in this case, and alternative procedures, as well as their risks. In the event a patient is under age or legally incompetent, a parent or guardian can participate in all of the steps of the process and sign the form to give consent. Informed consent is complete, when all information has been presented, and the patient or parent or guardian has, of their own volition, signed a consent form in the view of a witness. Note multiple witnesses are not required.

188. Place the types of contrast media in order of decreasing opacity. A Ionic, water soluble. B Thin barium sulfate. C Carbon dioxide. D Thick barium sulfate.

A Thick barium sulfate. B Thin barium sulfate. C Ionic, water soluble. D Carbon dioxide. Barium sulfate is the most radiopaque substance in this list. The thick barium is the most radiopaque followed by thin barium. Ionic, water soluble contrast media is next. Finally, carbon dioxide is the least radiopaque because it is a gas.

54.Best practice suggests erasing all computed radiography (CR) plates once a day. What is the purpose of this? A To reduce amount of accumulated scatter on the imaging plate (IP). B To keep exposure indices within appropriate ranges. C To keep the imaging plate (IP) free from dust and other potential artifact producing phenomena. D To ensure removal of phantom images from high exposures.

A To reduce amount of accumulated scatter on the imaging plate Erasing IPs on a daily basis, usually at the start of the day cuts down on the amount of background and scatter radiation that has accumulated in the active layer of the plate. IPs accumulate little background radiation and would have minimal effect on exposure indices. Phantom images are rarely an issue and would not necessitate every IP be erased. Erasing cassettes daily has no impact on dust or debris producing artifacts.

Rotate the patient to the right

A radiographer critiques an image of an anteroposterior (AP) pelvis. The left obturator foramen is narrower than the right. What should the radiographer do?

This requires knowing the grid conversion factors (GCF). The GCF for a 12:1 grid is 5, and the GCF for an 8:1 grid is 4. The formual is GCF1:GF2::mAs1:mAs2; so mAs2 = (mAs1 x GCF2)/GCF1. So mAs2 = ((50 mAs)(4))/5 = 40 mAs.

A radiographer is performing a portable abdomen is using an image receptor with an 8:1 grid. The radiographer knows a technique for the abdomen using a 12:1 grid is 80 kilovolts peak (kVp) using 50 milliampere-seconds (mAs). Which would the new technique be in order to maintain image quality?

ZZ. Anteroposterior (AP) projection in neutral rotation and posteroanterior (PA) oblique scapular Y

A request for a shoulder exam comes from the emergency room. The patient has a large deformity anterior to the shoulder and the physician suspects an anterior dislocation. Which are the most appropriate views to take on this patient?

300turns/220volts = x/66,000volts 220x = 19,800,000 x = 19,800,000/220 = 90,000 turns

A step-up transformer with 300 turns in the primary coil is supplied with 220 volts to this primary. How many secondary turns are needed to produce a 66,000 volt output?

How does the density log exposure curve appear for a digital IR?

A straight line at a 45 degree angle

How does the Density log Exposure (D log E) curve appear for a digital IR?

A straight line at a 45degree angle.

The lead radiographer is planning a strategy to efficiently manage the morning workload. The department is short-staffed due to meetings, and four patients are now ready for their examinations. Assuming that none of the exams is emergent, which patient should be seen first?

A two-year-old child for a barium swallow.

Which is the genetically significant dose (GSD) for the population of the United States? A. 0.20 mSv B. 1 mSv C. 0.40 mSv D. 0.80 mSv

A. 0.20 mSv The GSD for the United States is approximately 0.20 millisievert (mSv).

The bucky slot cover should offer at least what lead thickness? A. 0.25 mm B. 0.35 mm C. 1 mm D. 0.5 mm

A. 0.25 mm

A portable knee exam performed in the operating room results in a beam intensity of 2.5 R at 32 inches. What is the intensity of the beam if the same exposure factors are used for a post-operative knee at a distance of 40 inches? A. 1.60 R B. 3.12 R C. 3.90 R D. 2.00 R

A. 1.60 R The inverse square formula (I1/I2=D22/D21) is used to determine the new intensity: 2.5 / x = 1600 (40 squared) / 1024 (32 squared); x = (2.5) (1024) / 1600 = 1.6 R.

How is the central ray directed for an anteroposterior (AP) axial projection of the cervical vertebrae? A. 15-20 degrees cephalic to enter at C-4. B. 15-20 degrees caudad to enter at C-2. C. 15-20 degrees caudad to enter at C-4. D. 15-20 degrees cephalad to enter at C-2.

A. 15-20 degrees cephalic to enter at C-4. For an AP axial projection of the cervical vertebrae, the central ray is directed to enter C-4 and angled 15-20 degrees cephalic, not caudad. The central ray is not directed to enter C-2.

If a radiographer receives an exposure of 550 milliroentgens (mR) at a distance of 1.5 feet from the tube of a portable x-ray unit, what will the exposure be at a distance of 6 feet from the tube? A. 34.4 mR B. 20.6 mR C. 88.0 mR D. 137.5 mR

A. 34.4 mR The inverse square law formula is used to solve this problem: I1 / I2 = (D2 / D1) squared.

What is the magnitude of the angle formed by the intervertebral foramina and the midsagittal plane in the thoracic spine? A. 90 degrees B. 45 degrees C. 15 degrees D. 70 degrees

A. 90 degrees The intervertebral foramina of the thoracic spine form a 90 degree angle with the midsagittal plane, thus much larger than 15 degrees. The intervertebral foramina of the cervical spine form a 45 degree angle with the midsagittal plane. The zygapophyseal joint forms a 70 degree angle with the midsagittal plane in the thoracic spine.

Where is the safest place for the radiographer to stand during fluoroscopy? A. 90 degrees and one meter from the patient. B. 90 degrees from the patient C. At the foot of the table. D. At the head of the table.

A. 90 degrees and one meter from the patient Ninety degrees and one meter from the patient results in the least scatter dosage of these responses. If it is practical, it is even better to stand one meter behind the radiologist.

In which clinical situation has valid consent been obtained? A. A 16-year-old mother provides consent to perform an x-ray her 6-month-old child. B. Consent to perform an x-ray on a 3-year-old grandchild is provided by the child's grandmother. C. A 17-year-old male provides consent for a myelogram to be performed. D. Consent to perform an angiogram on a mentally disabled adult is provided by a healthcare worker from the facility where the patient resides.

A. A 16-year-old mother provides consent to perform an x-ray her 6-month-old child. A 16-year-old mother is considered an emancipated minor and has the legal right to grant consent for procedures to be performed on her child.

Which position best demonstrates a posterior rib injury above the diaphragm? A. AP, upright B. PA, upright C. AP, supine D. PA, prone

A. AP, upright A posterior rib injury above the diaphragm is best demonstrated by an AP projection in an upright position.

A request for a shoulder exam comes from the emergency room. The patient has a large deformity anterior to the shoulder and the physician suspects an anterior dislocation. Which are the most appropriate views to take on this patient? A. Anteroposterior (AP) projection in neutral rotation and posteroanterior (PA) oblique scapular Y. B. Posteroanterior (PA) internal and external rotation views. C. Anteroposterior (AP) projections in internal, external, and neutral rotation. D. Posteroanterior (PA) neutral and external rotation views.

A. Anteroposterior (AP) projection in neutral rotation and posteroanterior (PA) An AP projection in neutral position and a scapular Y view provide the necessary information without risk of further injury to the patient.

What should the radiographer do if a radiologist's instructions are unclear? A. Ask for clarification B. Question the lead technologist C. Read the protocol book D. Perform the exam in the usual way

A. Ask for clarification The radiographer should ask for clarification. This will allow for any miscommunication to be corrected and improve the patient outcome.

A radiographer receives a request for a portable chest x-ray and then performs the x-ray on the incorrect patient. Which legal term best describes the actions of the radiographer? A. Battery B. Negligence C. Assault D. Invasion of privacy

A. Battery Battery is defined as touching to which the victim has not consented. Performing a procedure on the wrong patient may constitute grounds for a charge of battery.

Which is the most likely cause of free intraperitoneal air on an anteroposterior (AP) erect abdomen radiograph? A. Bowel perforation B. Pancreatitis C. Intestinal obstruction D. Cirrhosis

A. Bowel perforation Free intraperitoneal air is usually the result of a perforated hollow viscus, such as a portion of small bowel.

During preparation for a surgical procedure, an unopened sterile package becomes damp from an accidental spill of saline. Which response is most appropriate? A. Consider the package contaminated and replace it with a sterile item. B. Quickly remove the instrument from the package and add it to the sterile field. C. Dry the package with a sterile towel and continue preparations. D. Continue to use the damp package if sterility is not essential.

A. Consider the package contaminated and replace it with a sterile item. Since moisture facilitates the transfer of bacteria, damp packages must be discarded, even if the package is sealed. Drying the package or quickly removing the instrument from the package is not recommended, since wet items are no longer considered sterile. Sterility is essential for any surgical procedure.

3. What is the function of a rectifier? A. Convert alternating current to pulsating direct current. Correct B. Convert direct current to alternating current. C. Increase 60 Hertz alternating current to high frequency current. D. Change direct current to high frequency current.

A. Convert alternating current

A radiographer obtains a posteroanterior (PA) image of a hand casted in a slightly cupped position. The image appears magnified. How can this effect best be minimized? A. Decreasing object to image receptor distance (OID). B. Reducing part angulation to zero. C. Decreasing central ray angulation to zero. D. Reducing source to image receptor distance (SID).

A. Decreasing object to image receptor distance (OID). The best way to minimize magnification is to decrease OID by turning the hand over and performing an anteroposterior (AP) projection.

Which pathologic condition requires a reduction in exposure factors to produce an acceptable image? A. Emphysema B. Late stage Paget's disease C. Congestive heart failure D. Atelectasis

A. Emphysema Emphysema is considered a destructive disease which requires a reduction in exposure factors.

Which statement is true regarding exposure indicator and the evaluation of digital images? A. Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range. B. Radiographers do not need to review the exposure indicator during image evaluation. C. If the exposure indicator falls within the manufacturer's acceptable range, image contrast and brightness do not need to be reviewed. D. Exposure indicator is reviewed only when image contrast or brightness is suboptimal.

A. Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range. Exposure indicator is a numeric value assigned by the digital system manufacturer that indicates exposure to the image receptor. Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range to assure proper image quality when viewed by the radiologist.

39. Opening the collimators wider than necessary using digital radiography has which effect on image quality? A Image noise is increased B There is no effect on image quality. C The spatial resolution of the image is decreased. Incorrect D The spatial resolution of the image is increased.

A. Image noise is increased. . Increasing the size of the collimated field increases the quantity of scatter produced but does not affect the size of the pixels. Pixel size in digital radiography is determined by the CR scanning frequency or the DR DEL size.

65.Which type of contrast agent would be preferred for low risk and low cost for a patient diagnosed with a possible perforated bowel? A Ionic, water soluble, diluted with juice. B Nonionic, water soluble, diluted with juice. C Barium sulfate suspension, flavored. D Gaseous media in the form of crystals.

A. Ionic, water soluble, diluted with juice. The least risk with the least cost would dictate ionic, water soluble media. Barium should definitely be avoided, because of the risk of introducing contrast into the peritoneum. Barium sulfate suspension might cause adhesions if it spills into the peritoneum via a perforation. Gaseous media will not yield all of the information that positive media will in this case. For instance, gaseous media will not necessarily outline a perforation. Nonionic, water soluble media is too expensive for this application.

X-ray machines are designed to operate at a specific and continuous supply voltage. Which part of the imaging system is responsible for keeping incoming voltage adjusted to the proper value? A. Line compensator. B. Kilovolts peak (kVp) meter. C. Autotransformer. D. Milliampere (mA) meter.

A. Line compensator The line compensator adjusts the voltage supplied by the power company, which fluctuates due to variations in power distribution and consumption.

The radiographer is assisting a patient to move from a wheelchair to the x-ray table. Which represents the safest practice by the radiographer when moving this patient? A. Maintain the center of gravity over the base of support. B. Extend the arms as far as possible to increase the base of support. C. Bend at the waist so the center of gravity is midway between the patient and the base of support. D. Reduce the base of support slightly so the center of gravity is easier to maintain.

A. Maintain the center of gravity over the base of support. The radiographer should maintain the center of gravity over the base of support. If movement is required, then the feet should be moved to maintain this relationship. All other responses violate proper body mechanics.

Which projection best demonstrates the tripod fracture of the orbit? A. Modified parietoacanthial (Modified Waters). B. Parietoacanthial (Waters). C. Posteroanterior (PA) axial (Caldwell). D. Anteroposterior (AP) axial (Towne).

A. Modified parietoacanthial (Modified Waters). A tripod fracture would be best demonstrated in a modified parietoacanthial (Modified Waters) projection. The floor of the orbit (where one of the three fractures is located) would suffer from bony superimposition in a PA axial (Caldwell). The AP axial (Towne) poorly demonstrates the floor of the orbit and the frontal process of the zygoma (where two of the three fractures would be found). A parietoacanthial (Waters) also superimposes the floor of the orbit.

Which type of personnel dose monitoring devices is the best choice to monitor the whole body dosage of radiographers? A. Optically stimulated luminescent dosimeter (OSL). B. Geiger counter. C.Pocket gas ionization chamber. D. Baldwin-Farmer meter

A. Optically stimulated luminescent dosimeter (OSL). Viable means of monitoring occupational whole body dosage include the OSL.

86. What is the wide spread of Methicillin-resistant Staphylococcus aureas (MRSA) attributed to? A Over prescription of antibiotics and poor infection control practices.Co rrect B Use of antibiotics with immunosuppressed patients. C Improper cleaning of medical equipment. D Poor hygiene and overuse of pain killers.

A. Over prescription of antibiotics and poor infection control practices. The overuse of antibiotics and lax infection control practices has lead to infections that do not respond to normal antibiotics, such as MRSA. If used properly, antibiotics may be used to treat immunosuppressed patients. Improper cleaning of medical equipment may cause clostridium difficile colitis, another hospital acquired infection, and poor hygiene could

Which joint is the central ray (CR) entrance point for a posteroanterior (PA) finger projection? A. PIP B. CMC C. MCP D. IP

A. PIP

When the frequency of the voltage waveform supplied to the x-ray tube is increased, what aspect is reduced? (Select the three that apply.) A. Patient exposure. B. Average wavelength of the x-ray beam. C. Power consumption. D. Heat loading on the anode disk. E. X-ray output of the tube.

A. Patient exposure. B. Average wavelength of the x-ray beam D. Heat loading on the anode disk. As waveform frequency increases, the average wavelength of the x-ray beam decreases. Heat loading on the anode disc is reduced because less mAs is required for a given kVp. Patient exposure is reduced due increased efficiency, which results in decreased exposure times.

Which central ray (CR) orientation is recommended for an anteroposterior (AP) knee projection if the measurement from the tabletop to the patient's anterior superior iliac spine (ASIS) is 22 cm? A. Perpendicular to the IR B. 3-5 degrees cephalad C. 3-5 degrees caudad D. Perpendicular to the long axis of the patella

A. Perpendicular to the IR The tabletop to ASIS measurement determines the degree and direction of the CR angle. The CR is directed perpendicular to the IR for an AP knee projection if the table top to ASIS measurement is between 19 and 24 cm.

Identify the medical conditions in a patient's history which should be cleared by the radiologist before injection of an ionic, water soluble, injectable contrast agent. (Select the four that apply.) A. Pheochromocytoma B. Age over 40 C. Compromised renal function D. Diabetes E. Sickle cell anemia

A. Pheochromocytoma C. Compromised renal function D. Diabetes E. Sickle cell anemia

Which actions should the radiographer take to help prevent acquired infections in hospitals or clinics? (Select the four that apply.) A. Placing used needles in sharps containers. B. Placing biologically soiled linen in biohazard linen bags. C. Wearing exam gloves and changing them between each patient. D. Placing used syringes in isolated trash receptacles. E. Washing hands frequently and using hand lotion afterward.

A. Placing used needles in sharps containers. B. Placing biologically soiled linen in biohazard linen bags. C. Wearing exam gloves and changing them between each patient. E. Washing hands frequently and using hand lotion afterward.

Which condition represents the most likely indication for an anteroposterior (AP) chest projection with the patient in the left lateral decubitus position? A. Pneumothorax in left lung. B. Effusion in left lung. C. Pulmonary embolism in right lung. D. Sarcoidosis in right lung.

A. Pneumothorax in left lung. The lateral decubitus chest position demonstrates fluid in the pleural cavity when the affected side is down, or small amounts of air when the affected side is up. The left lateral decubitus position demonstrates pleural effusions in the left lung, which appear as air-fluid levels in the pleural space.

Which may be effects of fetal irradiation? (Select the four apply.) A. Prenatal death B. Spontaneous abortion C. Growth retardation D. Childhood and early adult cancers E. Cancers late in adult life

A. Prenatal death B. Spontaneous abortion C. Growth retardation D. Childhood and early adult cancers

A radiographer critiques an image of an anteroposterior (AP) pelvis. The left obturator foramen is narrower than the right. What should the radiographer do? A. Rotate the patient to the right. B. Accept the image. C. Rotate the patient to the left. D. Internally rotate both feet

A. Rotate the patient to the right. The patient is in a left posterior oblique (LPO) position, so the patient should be rotated to the right to be in a true AP position.

Which digital post-processing results in a black background surrounding the original collimated edges? A. Shuttering B. beam restriction C. Subtraction D. Collimation

A. Shuttering Shuttering is a post exposure processing technique that results in a black background surrounding the original collimated edges.

The radiographer uses the Holmblad method to perform a tunnel view of the knee. What is the primary advantage of utilizing this method instead of the Camp Coventry method? A. The Holmblad method shows no distortion longitudinally or laterally. B. The Holmblad method is easier for the radiographer to properly position C. The Holmblad method is quick to position D. The Holmblad method is easier for the patient than the Camp Coventry method.

A. The Holmblad method shows no distortion longitudinally or laterally. Done properly, the Holmblad shows no distortion of the intercondylar fossa, either longitudinally or laterally. The Holmblad method is not quick. Instead, it is a difficult and demanding position for radiographer and patient to perform.

Which action is best taught to the patient using the communication technique of demonstration? A. The correct positioning for a particular projection. B. Instructions for donning and removing a patient gown. C. The correct direction to face when sitting at the radiography table. D. Direction on where to sit relative to the radiography table.

A. The correct positioning for a particular projection. Demonstration is particularly effective for showing a patient the specifics of a position.

Which steps are involved in legally obtaining informed consent to perform a radiographic procedure? (Select the four that apply.) A. The patient has been informed about alternatives to this particular procedure. B. The patient has been informed about procedures in place to mitigate risks. C. The patient has been informed about the risks involved in the procedure. D. The patient is legally competent. E. The patient signed an informed consent form of their own volition in view of multiple witnesses

A. The patient has been informed about alternatives to this particular procedure. B. The patient has been informed about procedures in place to mitigate risks. C. The patient has been informed about the risks involved in the procedure. D. The patient is legally competent.

What is required under the Health Insurance Portability and Accountability Act (HIPAA)? (Select the three that apply.) A. The patient must receive written information on how the health information will be used. B. The patients are able to request amendments to their records. C. All health record information, except biometric information, must be removed when using for research purposes. D. Patients have the right to request restrictions on disclosures of their information. E. Only patient schedules may be posted in public areas, but no other information.

A. The patient must receive written information on how the health information will be used. B. The patients are able to request amendments to their records. D. Patients have the right to request restrictions on disclosures of their information.

A patient received 100 ml of IV contrast media as a part of an abdominal computed tomography (CT) scan, as well as 500 ml of dilute, oral contrast, prior to coming to Radiology for a separate order, an intravenous urogram (IVU). The patient's creatinine is 0.4 mg/dl and BUN is 36 mg/dl. Why should this IVU be rescheduled? A. The presence of the previous oral contrast in the abdomen precludes an IVU. B. The lab values indicate increased risk for contrast injection. C. The lab values indicate that the contrast would not be excreted in sufficient quantity to be useful for an IVU. D. The presence of the previous intravenous contrast precludes an IVU

A. The presence of the previous oral contrast in the abdomen precludes an IVU. The single, most compelling reason to reschedule this IVU is the presence of previous oral contrast in the abdomen.

Which describes the correct positioning for a posteroanterior (PA) chest projection? (Select the three that apply.) A. The shoulders are depressed. B. The clavicles are elevated. C. The arms and shoulders are rotated posteriorly. D. The shoulders are at equal distances from the image receptor (IR). E. The chin is extended.

A. The shoulders are depressed. D. The shoulders are at equal distances from the image receptor (IR). E. The chin is extended.

What do limiting spatial resolution (LSR) and modulation transfer function (MTF) have in common? A. They both measure spatial resolution in digital imaging. B. They measure how efficiently an image is moved to the picture archiving and communication system (PACS). C. They both affect brightness of the digital image. D. They are both indicators of exposure for digital receptors.

A. They both measure spatial resolution in digital imaging. LSR and MTF are measures of how accurately anatomy is reproduced in a digital image or measures of spatial resolution.

Free air in the abdominal cavity is best demonstrated in which of the following positions?

AP projection, left lateral decubitus position

A request for a shoulder exam comes from the ER. The patient has a large deformity anterior to the shoulder and the physician suspects an anterior dislocation. Which views are appropriate?

AP, scapular Y.

A patient in the radiology department suddenly develops a nosebleed. The radiographer instructs the patient to lean forward and pinch the affected nostril against the midline nasal cartilage, but the bleeding does not stop. What should you do next?

Apply a moist compress.

Which x-ray beam characteristic is reduced by adding aluminum filtration? X-ray beam quality. Quantity of x-rays. Correct Half-value layer. Incorrect Energy of the x-ray beam.

Added aluminum filtration results in a reduction in the quantity of x-rays in the primary beam. The half-value layer (HVL) is a numerical value used to identify the quality of the beam; added filtration results in an increase in HVL, not a reduction. The quality of the x-ray beam refers to its penetrability, which increases as a result of added filtration, not a reduction. Because most of the x-rays removed by the filter are of low energy, there is an increase in the average energy of the primary x-ray beam, not a reduction.

Compton effect

An interaction in which high energy photon strikes a loosely bound outer electron resulting in only a partial loss of incident energy to the orbital electron

Anode Heel Effect

Anode heel effect is a phenomenon where x-ray intensity is greater under the cathode, but actually somewhat less under the anode, not greater under the anode. Part of the x-ray beam is not absorbed by the focusing cup. The target track does not absorb part of the beam. The heel of the anode (outside the target track, part of the molybdenum anode disk) actually absorbs some of the x-ray emission from the target track, which is in that direction. The absorption by the anode heel produces the phenomenon, the anode heel effect.

A request for a shoulder exam comes from the emergency room. The patient has a large deformity anterior to the shoulder and the physician suspects an anterior dislocation. Which are the most appropriate views to take on this patient?

Anteroposterior (AP) projection in neutral rotation and posteroanterior (PA) oblique scapular Y

Which position best demonstrates a posterior rib injury above the diaphragm?

Anteroposterior (AP), upright

A patient in the radiology department suddenly develops a nosebleed. The radiographer instructs the patient to lean forward and pinch the affected nostril against the midline nasal cartilage, but the bleeding does not stop. What should the radiographer do next?

Apply a moist compress. (If gentle pressure is unsuccessful, the patient should apply a moist compress. A patient should never be instructed to tilt the head back or be placed in the recumbent position as the patient may aspirate the blood.)

As SID increases...

As SID increases, recorded detail increases (decrease of unsharpness)

Less than 1 rad

As a result of imaging pregnant patients, which is the fetal exposure for most radiographic exams?

As film-screen speed increases...

As film-screen speed increases, recorded detail decreases.

As focal spot increases...

As focal spot increases, recorded detail decreases.

As mA increases...

As mA setting increases, it may cause an increase in actual focal spot size known as blooming, which results in a decrease in recorded detail.

Which conditions will require an increase in technical factors when performing a KUB? 1. Ascites. 2. Diabetes. 3. Bowel Gas. 4. Pneumonia. 5. Soft tissue masses. 2 and 4. 1 and 5. Correct 3 and 5. 1, 2, and 5. Incorrect

Ascites and soft tissue masses will require an increase in technical factors because sections of the abdomen that normally contain gas or fat are filled in with denser tissue/water. Diabetes will not affect the density of the abdomen. Bowel gas will require a decrease in technical factors because the extra gas in the abdomen requires less penetration of the beam. Pneumonia will affect densities in the thorax, not the abdomen.

Which conditions will require an increase in technical factors when performing a KUB? (Ascites, Diabetes, Bowel Gas, Pneumonia, and/or Soft Tissue Masses)

Ascites and soft tissue masses will require an increase in technical factors because sections of the abdomen that normally contain gas or fat are filled with denser tissue/water. Bowel gas will require a decrease. Pneumonia will affect densities in the thorax, not the abdomen.

Ascites

Ascites is the accumulation of fluid in the peritoneal cavity.

182. A radiographic rating chart is provided for a portable unit. Which combination of milliamperes (mA), seconds, and kilovolts peak (kVp) is permissible for a single exposure according to the chart? A 160 mA, 1/30 second, 80 kVp. B 100 mA, 1/20 second, 110 kVp. C 200 mA, 1/60 second, 70 kVp. D 140 mA, 1/10 second, 90 kVp.

B 100 mA, 1/20 second, 110 kVp. The only permissible exposure according to the provided chart is 100 mA, 1/20 second and 110 kVp. The point of intersection between 100 mA and 1/20 second is found to be below and to the left of the 110 kVp curve, and therefore is permissible. All other responses correspond to points found above and to the right of their respective kVp curves and are thus forbidden.

30. Digital radiography has the ability to produce 16,000 shades of gray. Which appropriate bit-depth (dynamic range) does this represent? A 2 raised to the 10th power. B 2 raised to the 14th power. C 2 raised to the 12th power. D 2 raised to the 16th power.

B 2 raised to the 14th power. Bit-depth is the image receptor's ability to display shades of gray. Each pixel has the ability to be turned on (white) or off (black), therefore each bit depth equals 2 raised to the depth power. A bit depth of 8 is equal to 2 to the eighth power or 256. A system capable of displaying 16,000 shades of gray is equal to 2 to the fourteenth power or a bit-depth of 14. That is, 2 raised to the fourteenth power = 16,384. 2 raised to the tenth power = 1024. 2 raised to the twelfth power = 4096. 2 raised to the sixteenth power = 65,536.

5.The Z number of oxygen is 8. The elemental oxygen atom has two electron shells. How many electrons occupy an electrically neutral oxygen atom's outer shell? A 4 B 6 C 8 D 2

B 6 An electrically neutral oxygen atom's outer shell contains 6 electrons. Two electrons are in the K shell and 6 in the L shell. The other answers are incorrect.

51. When using film-screen, an exam utilizing 90 kilovolts peak (kVp) and 10 milliampere-seconds (mAs) provides adequate density but has inadequate contrast (contrast scale is too long). Which technical exposure factors increase contrast while maintaining adequate density? A 77 kVp and 40 mAs. B 77 kVp and 20 mAs. C 90 kVp and 20 mAs. D 45 kVp and 20 mAs.

B 77 kVp and 20 mAs. Using the 15% rule allows a radiographer to adjust contrast while maintaining density. In this case, the contrast scale is too long, or one might say the image is too gray, yet the density is acceptable. Decreasing the kVp by 15% and doubling the mAs will increase contrast and maintain density. The result of this adjustment is 77 kVp and 20 mAs. The other options result from math errors or incorrect use of the 15% rule formula.

27. Which represents the optimum kilovolts peak (kVp) for exposing film-screen radiographs of the adult anteroposterior (AP) lumbar spine? A 70 kVp. B 80 kVp. C 60 kVp. D 90 kVp.

B 80 kVp. Film-screen radiographs of the adult AP lumbar spine should, optimally, be exposed at 80 kVp. 60 kVp is not sufficient for adequate penetration of bony structures of the lower spine. 70 kVp may provide penetration, but would cause excessively short scale contrast in the image. 90 kVp would cause excessively long scale contrast in the image.

83.A patient with a history of stroke and hemi-paralysis is transported to the x-ray department by wheelchair. Which action should the radiographer perform in order to safely transfer the patient to the x-ray table? A Instruct the patient to lead with his weak leg. B Adjust the x-ray table to the same height as the wheelchair. C Stand behind the patient during the transfer. D Place the patient's weak side next to the table.

B Adjust the x-ray table to the same height as the wheelchair. Patients who have suffered stroke typically have weakness of one side of the body and require special consideration when performing transfers. If the table is adjustable, it should be lowered to the height of the chair. The patient's weak side should be placed away from the x-ray table. The patient should not be instructed to lead with the weak leg. Whenever a patient requires assistance to transfer to or from a wheelchair, the radiographer should be positioned face-to-face with the patient, not behind the patient.

10. A Bremsstrahlung interaction is best described by which statement? A A photon strikes an inner shell electron. B An electron is slowed and changes direction. C An electron strikes an inner shell electron. D A photon is slowed and changes direction.

B An electron is slowed and changes direction Bremsstrahlung (Brems) interactions occur when an electron is attracted to the positive nuclear charge of a tungsten atom and is slowed as it passes. The statements that refer to photon interactions do not correctly describe Brems interactions. Characteristic radiation is produced when a projectile electron interacts with an inner shell electron of the target atom.

66.A patient reports symptoms including itching, rash formation, and difficulty breathing immediately following the administration of intravenous (IV) contrast media. Assuming the patient has had no prior exposure to radiopaque contrast media, what is the most likely cause of these symptoms? A Acute bronchospasm. B Anaphylactoid reaction. C Allergic reaction. D Acute renal failure.

B Anaphylactoid reaction. The symptoms described in this scenario are the result of an anaphylactoid reaction, a type of reaction that clinically mimics anaphylaxis but requires no previous exposure to contrast media. Acute bronchospasm is unrelated to itching or rash formation. The effects of acute renal failure will not typically manifest immediately, although patients may develop symptoms such as shortness of breath and generalized swelling. The symptoms described cannot be allergic, because of the lack of prior exposure to contrast media. Allergy occurs due to the formation of antibodies in a prior exposure to the allergen.

9. How often should lead aprons be evaluated to determine if cracks or holes are present? A Every 3 months. B Annually. C Every 6 months. D Monthly.

B Annually. Lead aprons and gloves should be radiographed or viewed through a fluoroscope on acceptance. Then they should be checked annually (B) thereafter to determine if any cracks or holes are present. Not only is this recommended by health physicists, but it is also a point which is checked by The Joint Commission during their site visits. All other options are incorrect intervals.

77.Which nonverbal cue best demonstrates attentiveness and concern for a patient who is giving a medical history? A Taking notes. B Consistent eye contact. C A pleasant smile. D Turning the head to the side to place one ear closer.

B Consistent eye contact. Maintaining eye contact is an effective way to show the patient attentiveness and concern. A pleasant smile communicates warmth, but may not be appropriate while listening to a medical history. Taking notes requires listening, but appropriate eye contact conveys understanding. Turning the head to the side to place one ear closer might imply that it is difficult to hear the patient.

44.Which is the most likely cause of film fog prior to development? A Poor film-screen contact. B Cracked safelight filter. C Excessive developer temperature. D Low relative humidity.

B Cracked safelight filter A cracked safelight filter will allow unfiltered light to reach unprocessed x-ray films, which causes fogging of the film. Low relative humidity is likely to contribute to static artifacts, not fog. Poor film-screen contact causes blurring and a dark area on the image following exposure, rather than fog. Excessive developer temperature may result in a processing artifact known as chemical fog, which occurs during (not prior to) the developing process.

21. Which information in the patient history should prompt the radiographer to decide against using automatic exposure controls when taking a chest x-ray? A Pneumothorax. B Emphysema. C Oat cell carcinoma. D Chronic bronchitis.

B Emphysema. The pathophysiologic changes to lung tissue in emphysema result in easy penetration, so automatic exposure controls (AEC) should not be enabled for radiographic exams in these patients because the film will be too dense as a result of the control failing to shut the exposure off quickly enough. Patients with pneumothorax, chronic bronchitis, or oat cell carcinoma do not have hyperinflation of the lungs, therefore AEC can be enabled for their exams.

23. On which system does hospital staff input new orders for radiologic examinations? A Picture archiving and communication system. B Hospital information system. C Digital imaging and communications system. D Radiology information system.

B Hospital information system. New orders are entered on the hospital information system.The radiology information system tracks workflow and collects work-related data in the Radiology department only. There really isn't a digital imaging and communications (DICOM) system. Instead there is a DICOM standard, which permits picture archiving and communications systems (PACS) to communicate with each other and connected computers. Picture archiving and communication systems (PACS) store medical images, essentially replacing the file room.

61.A radiographer uses 70 kilovolts peak (kVp) at 30 milliampere seconds (mAs) on a film-screen radiograph. If a repeat radiograph is acquired at 80 kVp and 15 mAs, which factor will be affected? A Optical density. B Image contrast. C Distortion. D Subject contrast.

B Image contrast. Manipulation of kVp in either direction will affect image contrast due to differential absorption. Distortion is affected by geometric factors, not technical factors. By using the 15% rule, the kVp will be increased 15%, and the mAs decreased by half. Therefore, optical density will remain constant. Subject contrast is inherent in the patient, and therefore is not affected by the change of technical factors.

4.The radiographer is using automatic brightness control during a fluoroscopy. What change in patient exposure should the radiographer expect as the patient size increases? A No change in exposure. B Increase in exposure. C Indeterminant change in exposure. D Reduction in exposure.

B Increase in exposure. Automatic brightness control (ABC) increases patient exposure as patient size increases, compensating for additional attenuation of a thicker body to maintain image brightness. ABC does not reduce patient exposure under these conditions. Since the ABC does change patient exposure, it fails to maintain patient exposure at the same level. The patient exposure change is definite--an increase--not indeterminate.

71.Which term best describes the process of cleaning the surfaces in a radiology department with 10% bleach solution in water? A Surgical asepsis. B Medical asepsis. C Sterilization. D Sterile technique.

B Medical asepsis. Proper cleanliness, like hand washing and cleaning surfaces, is termed medical asepsis. Sterile technique is a system of practices to prevent the entry of infectious agents into a surgical field. Surgical asepsis and sterilization are practices involved in sterile technique.

80.A radiographer prepares to transfer a patient from a wheelchair to the x-ray table. The patient recently suffered a stroke, exhibits left-sided weakness, and is able to bear some weight. How should the radiographer move the patient to the table? A Have one radiographer lift the torso while another lifts the feet. B Position the right side of the wheelchair next to the table. C Use a hydraulic lift. D Position the left side of the wheelchair next to the table.

B Position the right side of the wheelchair next to the table. Because the patient's strongest side is the right side, the radiographer should position the right side of the wheelchair next to the table. Hydraulic lifts are used for patients who cannot bear weight and are too heavy to lift. Positioning the left side of the wheelchair to the table places the patient's strong side away from the table. Two radiographers to move the patient is called a two-person lift and is used when the patient cannot bear weight but can be lifted manually.

43.Which change should be made when performing an abdomen radiograph on a patient with ascites? A Increase source to image receptor distance (SID). B Raise exposure factors. C Choose a lower millampere (mA) station. D Use an abdominal compression device.

B Raise exposure factors Ascites is the accumulation of fluid in the abdomen. Higher exposure factors are needed to penetrate the extra fluid content of the abdomen in such cases. The use of an abdominal compression device is not prudent in an ascites case. A lower mA station and increased SID decrease image density.

67. A patient ceases to breathe while in Medical Imaging. There is a clearly marked DNR order on the patient's chart. What should the radiographer do first? A Immediately begin CPR, and call for help. B Report the event to the quality control supervisor, but do not start CPR. C Scream for help. D Call a code.

B Report the event to the quality control supervisor, but do not start CPR The radiographer should report the event to the quality control supervisor. The DNR marking means, "Do Not Resuscitate" so CPR should not be started. The quality control supervisor will likely call the patient's physician, and contact the coroner. A scream for help will likely alarm all who hear it. This is unnecessary. There is no emergency, but the event should be reported and documented (likely with an incident report). A code should not be called.

45.An increase in which factor will improve recorded detail? A Milliamperage setting. B Source to image receptor distance (SID). C Focal spot size. Incorrect D Film-screen speed.

B Source to image receptor distance (SID) An increase in SID decreases the amount of unsharpness and increases recorded detail. As focal spot size increases, recorded detail decreases. Increasing the relative speed of the film-screen system decreases the recorded detail. An increase in the milliamperage setting may cause an increase in actual focal spot size known as blooming, which results in a decrease in recorded detail.

193. Study the posteroanterior (PA) chest projection. What best summarizes an evaluation of this image? A This is a diagnostic chest radiograph. B The first ribs are clipped; so, it should be repeated. C The inspiration is not sufficient; so, it should be repeated. D The apices of the lungs are clipped; so, it should be repeated.

B The first ribs are clipped; so, it should be repeated. The PA chest projection should be repeated, because the first ribs and even the right second rib are clipped. It is not a diagnostic chest, because the first ribs are not fully demonstrated. The inspiration is sufficient, as 10 ribs can be counted above the diaphragm. The lungs are not clipped.

59. What do limiting spatial resolution (LSR) and modulation transfer function (MTF) have in common? A They are both indicators of exposure for digital receptors. B They both measure spatial resolution in digital imaging. C They both affect brightness of the digital image. D They measure how efficiently an image is moved to the picture archiving and communication system (PACS).

B They both measure spatial resolution in digital imaging. LSR and MTF are measures of how accurately anatomy is reproduced in a digital image or measures of spatial resolution. The histogram and window leveling affect brightness of a digital image. Exposure indicators for digital receptors are exposure indicator numbers, S numbers, or Log median exposure numbers depending on equipment manufacturer. There is no one measurement for efficiency of images moving into the PACS system.

29. Picture archiving and communication system (PACS) networks are capable of performing which functions? (Select the two that apply.) A Tracking billing information. B Transmitting diagnostic images to remote work stations. C Downloading images from different imaging modalities. D Tracking radiology scheduling information. E Processing laboratory reports.

B Transmitting diagnostic images to remote work stations. C Downloading images from different imaging modalities. PACS is a computerized system that allows different digital imaging programs to download from CR, DR, MR, Nuclear Medicine, PET, Ultrasound, CT, and film digitizers; and transmits images from work stations for viewing. A Hospital Information System (HIS) tracks billing information. Laboratory reports may be processed by an HIS, or one of its medical sub-systems. A Radiology Information System (RIS) contains radiology scheduling information.

73.Which actions should the radiographer take to help prevent acquired infections in hospitals or clinics? (Select the four that apply.) A Placing used syringes in isolated trash receptacles. B Wearing exam gloves and changing them between each patient. C Washing hands frequently and using hand lotion afterward. D Placing biologically soiled linen in biohazard linen bags. E Placing used needles in sharps containers.

B Wearing exam gloves and changing them between each patient. C Washing hands frequently and using hand lotion afterward. D Placing biologically soiled linen in biohazard linen bags. E Placing used needles in sharps containers. Wearing exam gloves and changing them between each patient protects the radiographer from the patient and vice versa from an infection. Washing hands frequently reduces the likelihood of the radiographer acquiring or carrying infection. Placing biologically soiled linen in the proper biohazard linen bags insures proper laundry handling. Placing needles in sharps containers and used syringes in biohazard disposal containers is the proper step to prevent transmission of infection from one patient to the next, or to the radiographer. Used syringes should never be placed in isolated trash receptacles.

Which angle of insertion is recommended when performing venipuncture? A. 5 degrees B. 15 degrees C. 45 degrees D. 90 degrees

B. 15 degrees When the radiographer is inserting a needle into a vein, the needle should be at approximately 15 degrees. Angles of insertion less than 15 degrees may result in the needle entering above the vein. A 90-degree angle is recommended for intramuscular injections. A 45-degree angle of insertion may result in the needle going through the vein.

Where is the central ray (CR) directed for an oblique posteroanterior (PA) hand? A. 1st metacarpophalangeal joint B. 3rd metacarpophalangeal joint C. 2nd metacarpophalangeal joint D. 4th metacarpophalangeal joint

B. 3rd metacarpophalangeal joint

How does the Density log Exposure (D log E) curve appear for a digital imaging receptor (IR)? A. A shallow slope B. A straight line at a 45 degree angle C. An S curve D. A steep slope

B. A straight line at a 45 degree angle D log E curves for digital imaging demonstrate the wide dynamic range of the image receptor as a straight line at a 45 degree angle.

A Bremsstrahlung interaction is best described by which statement? A. A photon is slowed and changes direction. B. An electron is slowed and changes direction. C. A photon strikes an inner shell electron. D. An electron strikes an inner shell electron.

B. An electron is slowed and changes direction. Bremsstrahlung (Brems) interactions occur when an electron is attracted to the positive nuclear charge of a tungsten atom and is slowed as it passes.

Which patient body habitus may require the patient to be in the Trendelenburg position during a small bowel series? A. Hyposthenic B. Asthenic C. Sthenic D. Hypersthenic

B. Asthenic Asthenic patients may be placed in Trendelenburg position to separate overlapping loops of small bowel.

Which legal concept is violated by a radiographer who performs an examination without an examination order? A. Malpractice B. Battery C. Res ipsa loquitor D. Respondeat superior

B. Battery A radiographer who performs an examination without an examination order could be accused of battery.

Which factor will decrease the patient's dose during fluoroscopy? A. Use the magnification mode. B. Bring the image intensifier as close as possible to the patient. C. Increase the milliampere-seconds (mAs). D. Use continuous fluoroscopy.

B. Bring the image intensifier as close as possible to the patient. The patient dose is decreased by bringing the image intensifier as close to the patient as possible. Continuous fluoroscopy, the magnification mode, and increased mAs will all increase the patient's dose.

Which feature of fluoroscopic equipment is designed to reduce entrance skin exposure to the patient? A. Beam filtration. B. Bucky slot shielding device. C. Magnification mode. D. Spot film device protective curtain.

B. Bucky slot shielding device. The function of beam filtration in fluoroscopy is to reduce entrance skin exposure to the patient. Magnification mode requires an increase in mAs to compensate for the necessary reduction in minification gain, resulting in greater patient exposure. The bucky slot shielding device and the spot film device protective curtain are designed to protect imaging personnel, not the patient.

For which long term effect is a 28-year-old radiographer with a cumulative effective dose (CumEfD) of 20 rem (200 mSv) at an increased risk? A. Cataracts B. Cancer C. Sterility D. Fibrosis

B. Cancer The cumulative effective dose (CumEfD) limit for occupationally exposed persons is equal to the worker's age in rem (in this example: CumEfD limit = 28 rem or 280 millisieverts (mSv)) or 10 x the worker's age in mSv. Although the radiographer is within the established limits for whole body dose, any exposure increases the risk of cancer.

In a typical x-ray examination room, what is considered a secondary protective barrier? A. Wall below the chest board B. Ceiling C. Wall behind chest board D. Floor

B. Ceiling Secondary barriers are not normally exposed to the primary beam but are located wherever scatter or leakage radiation may strike. The ceiling is nearly always considered a secondary barrier.

Which factors affect radiographic image density? (Select the four that apply.) A. Digital imaging system speed. B. Film-screen system speed. C. Kilovolts peak (kVp). D. Milliampere-seconds (mAs). E. Source to image receptor distance (SID).

B. Film-screen system speed. C. Kilovolts peak (kVp). D. Milliampere-seconds (mAs). E. Source to image receptor distance (SID). As kVp increases, density increases. As film-screen imaging system speed increases, density increases. As mAs increases, density increases. As SID increases, density or brightness decreases.

Which items can be used as indicators of the quality of the diagnostic x-ray beam? (Select the two that apply.) A. Object to image receptor distance (OID). B. Half Value Layer (HVL). C. Source to image receptor distance (SID). D. Kilovolts peak (kVp). E. S (exposure time).

B. Half Value Layer (HVL). D. Kilovolts peak (kVp). kVp is our x-ray beam quality controller, which is also indicated by HVL measurements. Exposure time affects beam quantity, not quality. OID and SID affect quantity, but not quality.

Where is the central ray (CR) directed for an anteroposterior (AP) projection of the lower leg? A. 2 inches distal to the medical condyle of the tibia B. Mid-lower leg C. At the level of the medial malleolus D. 0.5 inch inferior to the patellar apex

B. Mid-lower leg

2.Which calculation is used to determine grid ratio? A. The height of the lead strips divided by the width of the lead strips B. Height of the lead strips divided by the width of the interspace material C. The width of the interspace material divided by the height of the lead strips. D. The width of the lead strips divided by the height of the lead strips.

B. Height of the lead strips divided by the width of the interspace material.

Why should a radiographer routinely use a small focal spot when imaging extremities? A. Decrease in contrast. B. Increase in recorded detail. C. Decrease in patient dose. D. Increase the life of the x-ray tube.

B. Increase in recorded detail. A smaller focal spot decreases unsharpness and increases recorded detail. This is important when imaging extremities.

Which technique mimics the use of a grid? A. Decreased source-image receptor-distance (SID). B. Increased object-to-image-receptor-distance (OID). C. Increased kilovolts peak (kVp). D. Decreased milliampere-seconds (mAs).

B. Increased object-to-image-receptor-distance (OID). The air-gap technique, or increased OID, may be used to reduce scatter radiation and thus, increase image contrast.

Which is the primary advantage of using the Camp Coventry method instead of the Holmblad method when obtaining a tunnel view of the knee? A. Greater ease for the radiographer. B. Increased patient comfort. C. Less image distortion. D. Decreased time.

B. Increased patient comfort. The Camp Coventry method is considerably easier for the patient than the Holmblad method (try kneeling on a sore knee). The Camp Coventry method does not necessarily take less time to perform than the Holmblad method. Some longitudinal distortion is acceptable with the Camp Coventry method due to the central ray angle. In fact, lack of distortion is the only advantage for using the Holmblad method. The Camp Coventry method is not easier for the radiographer to perform than the Holmblad method.

Which change causes a decrease in resistance and an increase in current flow? A. Increasing the temperature of the conductor. B. Increasing the diameter of the conductor. C. Changing to a more complex compound for conduction. D. Lengthening the conductor.

B. Increasing the diameter of the conductor. Conductors of a larger diameter allow more current to flow with less resistance to flow.

How should a drug be administered to get the quickest response? A. Subcutaneously B. Intravenously C. Orally D. Rectally

B. Intravenously Intravenous medication administrations result in the quickest response.

Which term describes stray radiation that is emitted through the x-ray tube housing? A. Off-focus B. Leakage C. Scatter D. Exit

B. Leakage Leakage radiation is radiation emitted through the housing of the x-ray tube that results in additional exposure to the patient and radiographer.

Which radiation dose is required to produce mitotic death? A. Nonexistent, as mitotic death cannot be produced in slowly dividing cells or nondividing cells. B. Less than the dose needed to produce apoptosis in slowly dividing cells or nondividing cells. C. More than the dose needed to produce apoptosis in slowly dividing cells or nondividing cells. D. The same as the dose needed to produce apoptosis in slowly dividing cells or nondividing cells.

B. Less than the dose needed to produce apoptosis in slowly dividing cells or nondividing cells. The radiation dose that is required to produce mitotic death is less than the dose needed to produce apoptosis, or programmed cell death, in slowly dividing or nondividing cells.

Which statement correctly describes the LD 50/30? A. Lethal dose for 50% of the cells in 30 days. B. Lethal dose for 50% of the population in 30 days. C. Lethal dose for 30% of the population. D. Lethal dose for 30% of the cells in 50 days.

B. Lethal dose for 50% of the population in 30 days.

How is signal maximized to a digital image receptor? A. Shorter exposure time B. Longer exposure time C. Higher source to image receptor distance (SID) value D. Lower milliamperage (mA) setting.

B. Longer exposure time The greatest signal strength is obtained with longer exposure time. The other responses reduce signal at the digital image receptor.

Which term best describes the process of cleaning the surfaces in a radiology department with 10% bleach solution in water? A. Sterile technique B. Medical asepsis C. Sterilization D. Surgical asepsis

B. Medical asepsis Proper cleanliness, like hand washing and cleaning surfaces, is termed medical asepsis.

Which projection best demonstrates the aortic impression on the esophagus in an esophagram? A. Left lateral B. RAO C. LAO D. PA

B. RAO The best view of the aortic impression on the esophagus is obtained in the RAO projection. This impression is hidden from view in the LAO, PA, and left lateral.

Which change should be made when performing an abdomen radiograph on a patient with ascites? A. Increase SID B. Raise exposure factors C. Choose a lower mA station D. Use an abdominal compression device

B. Raise exposure factors Ascites is the accumulation of fluid in the abdomen. Higher exposure factors are needed to penetrate the extra fluid content of the abdomen in such cases.

For a tangential inferosuperior projection of the zygomatic arch, how is the patient's head positioned to demonstrate a depressed fracture of the right zygomatic arch? A. Elevated toward the x-ray tube. B. Rotated toward the right side. C. Lowered toward the radiography table. D. Turned toward the left side.

B. Rotated toward the right side. Depressed zygomatic arch fractures are best demonstrated on the oblique tangential projection. Proper positioning requires 15 degrees head rotation toward the side to be examined, with chin tilt 15 degrees toward the side of interest.

Which is the most likely cause of a histogram error? A. Underexposure of the image receptor. B. Selection of an incorrect exam from the look-up table. C. Malfunction of the plate reader electronics. D. Incomplete erasure of the image plate.

B. Selection of an incorrect exam from the look-up table. A histogram error, which results in improper image brightness and contrast, occurs when the radiographer selects an incorrect exam (anatomical structure, position and projection) from the look-up table before the image plate is scanned.

How should a radiographer increase the stability of the base of support? A. Hold heavy objects close to body. B. Stand with feet a greater distance apart. C. Stand on one foot. D. Keep back straight and knees bent.

B. Stand with feet a greater distance apart. The base of support is drawn between two points of contact with the floor. The stability of the base of support increases when the feet are a greater distance apart.

For which condition is the use of ureteric compression contraindicated? A. Pyelonephritis B. Stones in the renal pelvis C. Renal hypertension D. Recurrent UTI

B. Stones in the renal pelvis Ureteric compression may be used to ensure adequate filling of the upper renal collecting system, but is contraindicated for patients with a possible obstruction, such as a pelvic stone (C), due to an increased risk of rupture.

A lateral L-5/S-1 lumbosacral junction is performed with the central ray (CR) directed 2 inches anterior to the anterior superior iliac spine (ASIS) and 1-1/2 inches inferior to the iliac crest. Which statement describes this method? A. The central ray will be well posterior to the L-5/S-1 junction. B. The central ray will be well anterior to the L-5/S-1 junction. C. The central ray will be correctly centered to the L-5/S-1 junction. D.The central ray will be well superior to the L-5/S-1 junction.

B. The central ray will be well anterior to the L-5/S-1 junction. To demonstrate the L-5/S-1 lumbosacral junction, the central ray (CR) is directed 2 inches posterior to the anterior superior iliac spine (ASIS) and 1-1/2 inches inferior to the iliac crest.

Which factor determines the amount of energy of a bremsstrahlung x-ray? A. The difference in the binding energies of the orbital shells involved. B. The distance between the filament electron and the nucleus of the target atom. C. The number of electrons traveling from cathode to anode. D. The atomic number of the target material.

B. The distance between the filament electron and the nucleus of the target atom. The closer the filament electron comes to the nucleus of the target atom, the greater the energy of the bremsstrahlung x-ray produced.

A radiographer makes an exposure using an 8:1, 100 line per inch grid. When processing the image plate (IP) through the reader, the radiographer notices that a Moire pattern is seen on the displayed image. What is the probable cause of this artifact? A. The IP was not fully erased the last time it was used. B. The grid had a frequency similar to the reader's sampling frequency. C. Underexposure to the IP. D. The IP was upside down in the bucky tray.

B. The grid had a frequency similar to the reader's sampling frequency. Moire artifacts on digital images occur when the frequency of the grid closely matches the sampling frequency of the CR reader.

An emergency room physician suspects a 14-year-old male patient may have Osgood-Schlatter's disease. Which radiographic exam might the ER physician order to evaluate this? A. Ankle B. Tibia-fibula C. Foot D. Femur

B. Tibia-fibula Osgood-Schlatter's disease (or syndrome) is the incomplete separation (aseptic necrosis) of the tibial tuberosity from the tibia; any projection that demonstrates the proximal tibia (such as a tibia-fibula) is appropriate.

Which is the most appropriate reason for the application of gonadal shielding? A. To reduce the amount of internal scatter reaching the reproductive organs. B. To safe guard the reproductive potential of patients. C. To shield the patient when the beam is not sufficiently collimated D. To protect reproductive organs within the field.

B. To safe guard the reproductive potential of patients. Gonadal shielding is required to safe guard the reproductive potential of patients from possible genetic effects of radiation exposure.

How should the radiographer position the patient to best demonstrate a left axillary 6th rib fracture? A. Prone. B. Upright and 45 degree left posterior oblique (LPO). C. Upright posteroanterior (PA). D. Supine and 45 degree left posterior oblique (LPO).

B. Upright and 45 degree left posterior oblique (LPO). To best visualize a left axillary 6th rib fracture, the radiographer should place the patient in an upright and 45 degree LPO position.

A radiographer receives a request for a portable chest x-ray and then performs the x-ray on the incorrect patient. Which legal term best describes the actions of the radiographer?

Battery. (Battery is defined as touching to which the victim has not consented. Performing a procedure on the wrong patient may constitute grounds for a charge of battery.)

Feature of fluoroscopic equipment is designed to reduce entrance skin exposure to the patient.

Beam filtration - in fluoroscopy is to reduce entrance skin exposure to the patient.

The patient position for operative cholangiography

Because the radiographs are obtained while the patient has an indwelling T-tube, they must be obtained with the patient in the supine rather than the prone position. A slight oblique (15° to 20°) will allow visualization of the biliary tract free of superimposition from the vertebrae. The LPO would place the biliary vessels over the spine. A 45° oblique is too steep for visualization of the gallbladder and biliary tree.

25. Which conditions will require an increase in technical factors when performing a KUB? 1. Ascites. 2. Diabetes. 3. Bowel Gas. 4. Pneumonia. 5. Soft tissue masses. A 1, 2, and 5. B 3 and 5. C 1 and 5. D 2 and 4.

C 1 and 5. Ascites and soft tissue masses will require an increase in technical factors because sections of the abdomen that normally contain gas or fat are filled in with denser tissue/water. Diabetes will not affect the density of the abdomen. Bowel gas will require a decrease in technical factors because the extra gas in the abdomen requires less penetration of the beam. Pneumonia will affect densities in the thorax, not the abdomen.

28. Assuming that automatic exposure control is to be used, what backup milliampere-seconds (mAs) are sufficient for a large (100 kg) adult anteroposterior (AP) lumbar spine done at 80 kilovolts peak (kVp)? A 40 mAs. B 80 mAs. C 100 mAs. D 60 mAs.

C 100 mAs. The rule of thumb suggests a back up mAs 50% larger than the highest expected mAs. Experience teaches that it is never a bad idea to use extra back up mAs, as it is difficult to predict the influence of musculature and pathology on a lumbar spine image. Thus 100 mAs is the best choice. 40 mAs might reasonably be expected to be the minimum mAs used for the actual exposure, not backup. 60 mAs might reasonably be expected to be needed for muscular or heavily arthritic patients. Thus 50% more than the highest expectation is 90 mAs. So 80 mAs, by that reasoning, is too low.

52. A radiographer chooses a portable non-grid chest x-ray technique of 80 kilovolts peak (kVp) at 4 milliampere-seconds (mAs). Before making the exposure, the radiographer decides to use an 8:1 grid. Which change in technical factors is most appropriate based on this new information? A 92 kVp at 4 mAs. B 68 kVp at 4 mAs. C 106 kVp at 4 mAs. D 80 kVp at 2 mAs.

C 106 kVp at 4 mAs. An 8:1 grid has a grid factor of four which can be compensated for by using two 15% increases in kVp. This results in new technical factors of 106 kVp at 4 mAs. All other factors are incorrect.

34.A radiograph of the distal femur demonstrates adequate radiographic density but requires a shorter scale of contrast. With original exposure factors of 80 kilovolts peak (kVp), a 200 milliampere (mA) station, and an exposure time of 0.08 seconds, which set of factors is most likely to produce the desired result? A 92 kVp; 100 mA; 0.08 seconds. B 92 kVp; 200 mA; 0.08 seconds. C 68 kVp; 200 mA; 0.16 seconds. D 68 kVp; 200 mA; 0.11 seconds.

C 68 kVp; 200 mA; 0.16 seconds. When a shorter scale (high contrast) image is desired without a change in radiographic density, the 15% rule may be applied. A kVp of 68 represents a reduction of 15% from the original kVp ... (80)(.15) = 12 kVp; 80-12 = 68 kVp. A 200 mA station with a 0.16 second exposure timeyields a 50% increase from the original milliampere-seconds (mAs) of 16 ... (200)(0.16) = 32 mAs. A 200 mA station with an exposure time of 0.11 seconds (22 mAs) does not produce enough intensity to compensate for the reduction in kVp. Increasing the kVp by 15% while reducing the mAs by 50% results in a longer scale of contrast. A 15% increase in kVp without a change in mAs results in a doubling of radiographic density.

85.Which rule is followed when examining unconscious patients? A Proceed as if the patient were conscious, asking questions and giving instructions. Incorrect B Remain as quiet as possible to avoid waking the patient during the exam. C Avoid saying things you would not say to a conscious patient. D Speak openly in front of the patient, since they cannot hear or understand you.

C Avoid saying things you would not say to a conscious patient Unconscious patients may retain the ability to hear and remember what is said, so it is appropriate to avoid making statements that you would not make if they were conscious. Remaining quiet in order to avoid waking the patient is not necessary, especially if the patient's state is due to the administration of narcotics; such patients are not likely to regain consciousness solely due to auditory stimuli. It is not appropriate to speak as if the unconscious patient cannot hear you, since evidence suggests that the opposite is true. Asking questions and giving instructions to an unconscious patient is not appropriate due to lack of responsiveness.

63.A radiographer receives a request for a portable chest x-ray and then performs the x-ray on the incorrect patient. Which legal term best describes the actions of the radiographer? A Assault. B Negligence. C Battery. D Invasion of privacy.

C Battery. Battery is defined as touching to which the victim has not consented. Performing a procedure on the wrong patient may constitute grounds for a charge of battery. Invasion of privacy is defined as unjustifiable intrusion on another's right of privacy. Assault may be alleged if the radiographer threatens to perform the x-ray, however, battery occurs when the x-ray is actually performed. Negligence represents a breach in established standards of care resulting in harm to the patient. Negligence would exist in this case, if the patient were demonstrably harmed.

47.How does an increase in noise affect the quality of a digital image? A Contrast is increased. B Density is increased. C Contrast is decreased. D Density is decreased.

C Contrast is decreased. Digital image contrast is decreased by the presence of noise. Due to the ability of digital imaging systems to compensate for lack of density by adjusting the window level, image noise is not relevant to either increases or decreases in density. Because image noise has an inverse relationship with contrast, the increased noise does not increase contrast. And in spite of the ability of digital processing to increase image contrast, when this is done to a noisy image, it only makes the noise more visible. And in consequence detail visibility (the function of contrast) is definitely inferior to an image not affected by noise.

49.When using film-screen systems, which method will result in greater radiographic contrast? A Increased kilovolts peak (kVp). B Decreased beam filtration. C Decreased field size. D Increased screen speed.

C Decreased field size Decreasing field size results in a decrease in the number of x-ray photons available to undergo Compton interactions; this reduces scatter production. This increases radiographic contrast. Increased screen speed has no effect on contrast. Decreased beam filtration results in a greater number of lower energy x-rays in the primary beam, which increases scatter and reduces contrast. Increased kVp results in a greater amount of scatter reaching the image receptor (IR), which reduces contrast.

41.How is signal maximized to a digital image receptor? A Shorter exposure time. B Higher source to image receptor distance (SID) value. C Longer exposure time. D Lower milliamperage (mA) setting.

C Longer exposure time. The greatest signal strength would be obtained with longer exposure time. The other responses reduce signal at the digital image receptor.

57.Which statement is true regarding exposure indicator and the evaluation of digital images? A Exposure indicator is reviewed only when image contrast or brightness is suboptimal. B If the exposure indicator falls within the manufacturer's acceptable range, image contrast and brightness do not need to be reviewed. C Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range. D Radiographers do not need to review the exposure indicator during image evaluation.

C Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range. Exposure indicator is a numeric value assigned by the digital system manufacturer that indicates exposure to the image receptor. Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range to assure proper image quality when viewed by the radiologist. Exposure indicators should be reviewed, along with image contrast and brightness. Exposure indicator falling within the manufacturer's acceptable range does not negate the need to evaluate image contrast and brightness.

13. The majority of x-rays in the useful beam are created as a result of which process? A Orbital electrons drop down to fill vacant inner shells. B Orbital electrons become excited and release their energy. C Fast-moving electrons approach the nucleus of the target atom and slow down. D Fast-moving electrons interact with the K shell electrons of the target atom. Incorrect

C Fast-moving electrons approach the nucleus of the target atom and slow down. Most x-rays in the useful beam are bremsstrahlung x-rays, which are formed when projectile electrons approach the nucleus of the target atom and slow down. The other options describe coherent scattering and characteristic interactions.

55. Consider this lateral lumbar spine image. Which strategy will have the greatest improvement on image quality? A Decrease the source to image receptor distance (SID). B Select a faster speed image receptor. C Immobilize the patient. D Increase milliampere-seconds (mAs).

C Immobilize the patient. This lumbar image shows loss of resolution due to blurring. Since the single greatest cause of loss of image sharpness is patient motion, immobilizing the patient will likely have the greatest improvement on image quality. Adjusting mAs will not affect image sharpness. Selecting a faster image receptor speed and decreasing SID will degrade image sharpness further.

33.Which change in technical factors is most likely to result in decreased film density? A Decreased beam restriction. B Decreased source to image receptor distance (SID). C Increased grid ratio. D Increased screen speed.

C Increased grid ratio Grids with higher ratios are able to remove more photons from the x-ray beam. Because the grid reduces the number of photons reaching the image receptor, it also causes a decrease in film density. Decreasing the SID results in greater x-ray beam intensity and therefore greater film density. A decrease in beam restriction results in more scatter radiation reaching the film, which produces an increase in nondiagnostic film density known as fog. Faster speed screens emit more light when struck by x-rays, which results in greater film density on the finished radiograph.

19. Which item can be used as indicators of the quality of the diagnostic x-ray beam? A Exposure time. B Object-to-image-receptor-distance (OID). C Kilovolts peak (kVp). D Source-to-image-receptor-distance (SID).

C Kilovolts peak (kVp) X-ray beam quality is controlled by kVp. Exposure time, OID, and SID affect beam quantity, not quality.

48.Which step will reduce digital image noise, assuming no other changes? A Decreased kilovolts peak (kVp). B Small pixel size. C Longer exposure time. D Image magnification.

C Longer exposure time. A longer exposure time results in a greater amount of photons reaching the image receptor, which reduces image noise. Decreased kVp reduces the quantity of x-rays that reach the image receptor, which increases image noise. A matrix with a large number of small pixels results in greater image noise due to the availability of fewer photons per pixel. Magnification of the digital image does not affect image noise, but it may make what noise is there more visible.

15. Which term refers to the radiation that exits the x-ray tube through the collimator? A Scatter. B Leakage. C Primary. D Remnant.

C Primary. The unattenuated radiation that exits the tube through the collimator is called primary radiation. Leakage radiation refers to radiation exiting the tube housing in directions other than toward the patient. Remnant radiation is composed of x-ray photons that strike the image receptor after exiting the patient. Scatter radiation consists of photons from the primary beam that travel randomly in different directions after interacting with matter.

40.Insufficient exposure to a photostimulable phosphor (PSP) plate results in which type of image degradation? A High signal-to-noise ratio. B Moire pattern. C Quantum noise. D Pixel saturation.

C Quantum noise. Quantum noise occurs due to an insufficient exposure to the image receptor resulting in an uneven density over the image. Moire pattern is associated with grid frequencies and sampling frequencies that are too nearly the same. Pixel saturation occurs when too much exposure is used. It is similar to D-Max in film-based systems. A high signal-to-noise ratio, which is the goal in digital radiography, reduces quantum mottle and increases contrast resolution.

6. Which steps increase contrast in fluoroscopy? (Select the two that apply.) A Increase kilovolts peak (kVp). B Increase milliamperes (mA). C Reduce kilovolts peak (kVp). D Use a smaller collimator field. E Use a larger collimator field.

C Reduce kilovolts peak (kVp). D Use a smaller collimator field. Using a smaller collimator field increases contrast, by reducing scatter and secondary radiation production, and thus reducing fog. Reducing kVp increases contrast, at the risk of lowered penetration. Changing mA does not impact contrast, assuming adequate exposure is used. The use of a larger collimator field will reduce contrast by increasing secondary and scattered radiation production. Increasing kVp increases penetration and reduces contrast.

18. What is the process if a lead apron is suspected of being defective? A Wait until the scheduled semiannual apron inspection to act. B Do a visual inspection. If nothing seen, return the apron for use. C Remove the apron from use, visually inspect for defects, and fluoroscope for cracks. D Place the apron at the back of the apron rack so it is used only on rare occasions

C Remove the apron from use, visually inspect for defects, and fluoroscope for cracks A defective apron should be removed from circulation, visually inspected, and fluoroscoped for cracks in the lead. Apron inspection should occur twice yearly or at least annually. A visual inspection only would not reveal cracks in the lead. Defective aprons should be removed from use until they are repaired.

84.Which is the best approach for speaking to a patient with a hearing impairment? A Talk very slowly. B Ask patient to adjust hearing aid volume. C Speak in a low register. D Do not make eye contact.

C Speak in a low register. Patients with hearing loss most often have difficulty hearing voices in a high register, so speaking in a low register is recommended. Speaking at a moderate pace is preferable, rather than very slowly. It is best to face the patient with hearing loss, so good eye contact is appropriate. Patients should not be advised to adjust their hearing aids in order to facilitate communication.

79.How should a radiographer increase the stability of the base of support? A Hold heavy objects close to body. B Keep back straight and knees bent. C Stand with feet a greater distance apart. D Stand on one foot.

C Stand with feet a greater distance apart. The base of support is drawn between two points of contact with the floor. The stability of the base of support increases when the feet are a greater distance apart. Standing on one foot will provide a narrow, unstable base of support. Holding heavy objects close to the body and keeping the back straight and bending at the knees are practices of good body mechanics, but are not related to the base of support.

31.A radiographer makes an exposure using an 8:1, 100 line per inch grid. When processing the image plate (IP) through the reader, the radiographer notices that a Moire pattern is seen on the displayed image. What is the probable cause of this artifact? A The IP was upside down in the bucky tray. B Underexposure to the IP. Incorrect C The grid had a frequency similar to the reader's sampling frequency. D The IP was not fully erased the last time it was used.

C The grid had a frequency similar to the reader's sampling frequency. Moire artifacts on digital images occur when the frequency of the grid closely matches the sampling frequency of the CR reader. Underexposure of the plate will result in a salt and pepper appearance termed quantum mottle. Imaging the backside of the plate will result in geometric patterns on the image due to supporting structures located in the back of the cassette. When the IP is not fully erased, the previously taken image may be visible along with the new image. This is termed ghosting.

35.A radiographer makes an exposure using a Fuji computed radiography (CR) system. The S number reads out at 480 and the image appears grainy. What is the problem with the image and how should it be corrected? A The radiographer overexposed the image and should decrease the technique. B The radiographer overexposed the image and should increase the technique. C The radiographer underexposed the image and should increase the technique. D The radiographer underexposed the image and should decrease the technique.

C The radiographer underexposed the image and should increase the technique. The graininess and S number indicate that the image was underexposed, so the technique should be increased. The S number is related to relative exposure to the image plate and the relationship is inverse. In the case of underexposure, the technique should be increased, not decreased. Because the S number is higher than 250, under exposure, not overexposure, is demonstrated.

183. Study the provided filament thermal emissions chart. Note the distinct shoulder on each kilovolt peak (kVp) curve. What do these shoulders indicate? A That excellent milliamperage (mA) reciprocity exists at 30 kVp. Incorrect B The emissions limited region. C The space charge limited region D That the milliamperage (mA) is highly predictable at 40 kVp.

C The space charge limited region. The shoulders of filament thermal emissions charts indicate the space charge limited region. At this point, further increase in mA is limited by the space charge around the filament at the indicated voltage. One does not want to operate an x-ray tube in this region, because mA is unpredictable and nonlinear. One prefers to operate the tube in the emissions limited region at voltages higher than 40 kVp. Because of the space charge limitation, mA does not exhibit good reciprocity, nor is it predictable for the same reason, at voltages below 40 kVp.

186. Consider this anteroposterior (AP) mobile chest image. What will improve the photographic quality of this image? A Decreasing the kilovolts-peak (kVp). B Increasing milliampere-seconds (mAs). Incorrect C Using a grid D Increasing the source-to-image-receptor-distance (SID).

C Using a grid. This AP mobile chest image shows a significant loss of contrast due mainly to excessive scatter radiation from the obese patient. Using a grid is the best method of reducing the impact of scatter on image quality. Increasing SID will have no impact on radiographic contrast. Decreasing kVp is not appropriate since a high kVp is necessary for chest imaging. Increasing mAs will not reduce the effects of scatter radiation on image quality

What is the minimum thickness of lead required for protective lead curtains? A. 1 mm Pb/eq B. 0.35 mm Pb/eq C. 0.25 mm Pb/eq D. 0.75 mm Pb/eq

C. 0.25 mm Pb/eq

The annual effective dose equivalent limit for infrequent exposures recommended by the National Council on Radiation Protection (NCRP) for a member of the general public is equal to how many rem(s)? A. 5 B. 15 C. 0.5 D. 1

C. 0.5 The annual effective dose equivalent limit recommended by the NCRP for the general public is equal to 0.5 rem.

How does the central ray (CR) for an anteroposterior (AP) scapula differ from an AP shoulder x-ray? A. 1 inch higher B. CR is the same C. 1 inch lower D. Same level, medial

C. 1 inch lower

Which conditions will require an increase in technical factors when performing a KUB? 1. Ascites. 2. Diabetes. 3. Bowel Gas. 4. Pneumonia. 5. Soft tissue masses. A. 2, 4 B. 3, 5 C. 1, 5 D. 1, 2, 5

C. 1, 5 Ascites and soft tissue masses will require an increase in technical factors because sections of the abdomen that normally contain gas or fat are filled in with denser tissue/water.

What is the longest field size dimension allowable for 10 inches by 12 inches collimation at a 40 inch source to image distance (SID)? A. 10.6 inches B. 13.2 inches C. 12.8 inches D. 11.4 inches

C. 12.8 inches Field size may be off +/- 2% of the SID, which in this case is 0.8 inches. 12.8 inches is in the acceptable range.

Which input image intensifier screen provides the best radiation protection to the patient during fluoroscopy? A. 18 cm B. 15 cm C. 25 cm D. 20 cm

C. 25 cm Smaller input screens are used during magnification fluoroscopy to reduce the field of view and magnify the image. However, this comes at the cost of higher exposure to the patient.

How is the central ray directed when performing an anteroposterior (AP) knee projection for a patient with thin thighs and buttocks? A. 5 to 7 degrees cephalad. B. 3 to 5 degrees cephalad. C. 3 to 5 degrees caudad. D. 5 to 7 degrees caudad.

C. 3 to 5 degrees caudad. An AP knee projection for a patient with thin thighs and buttocks (less than 19 cm from table top to ASIS) is 3 to 5 degrees caudad.

On an accurately positioned posteroanterior (PA) chest radiograph, the manubrium of the sternum is seen at the level of which thoracic vertabrae when the patient is sthenic? A. 3rd B. 2nd C. 4th D. 5th

C. 4th The manubrium of the sternum is projected at the level of the fourth thoracic vertebra on a properly positioned PA chest radiograph.

How much can exposure to the lens of the eyes be reduced by utilizing the posteroanterior (PA) projection of the cranium over the anteroposterior (AP) projection? A. 30% B. 55% C. 95% D. 75%

C. 95% By placing the eyes as far away from the primary beam as possible and using the contents of the cranium as a filter, the exposure to the lens of the eyes in a PA projection is reduced by 95% in comparison to use of the AP projection.

Which elbow projection will show the radial head freest of superimposition? A. Lateral B. AP C. AP, external oblique D. AP, internal oblique

C. AP, external oblique

A patient reports symptoms including itching, rash formation, and difficulty breathing immediately following the administration of intravenous (IV) contrast media. Assuming the patient has had no prior exposure to radiopaque contrast media, what is the most likely cause of these symptoms? A. Acute bronchospasm B. Allergic reaction C. Anaphylactoid reaction D. Acute renal failure

C. Anaphylactoid reaction The symptoms described in this scenario are the result of an anaphylactoid reaction, a type of reaction that clinically mimics anaphylaxis but requires no previous exposure to contrast media.

How often should lead aprons be evaluated to determine if cracks or holes are present? A. Monthly B. Every 6 months C. Annually D. Every 3 months

C. Annually Lead aprons and gloves should be radiographed or viewed through a fluoroscope on acceptance. Then they should be checked annually (B) thereafter to determine if any cracks or holes are present. Not only is this recommended by health physicists, but it is also a point which is checked by The Joint Commission during their site visits.

What is the best projection and position to demonstrate the right cervical intervertebral foramina? A. Cross table lateral projection, dorsal recumbent position B. Cross table lateral projection, ventral recumbent position. C. Anteroposterior (AP) axial oblique projection, left posterior oblique (LPO) position D. Anteroposterior (AP) axial oblique projection, right posterior oblique (RPO) position.

C. Anteroposterior (AP) axial oblique projection, left posterior oblique (LPO) position

A patient in the radiology department suddenly develops a nosebleed. The radiographer instructs the patient to lean forward and pinch the affected nostril against the midline nasal cartilage, but the bleeding does not stop. What should the radiographer do next? A. Instruct the patient to tilt the head back. B. Transport the patient to the emergency room. C. Apply a moist compress. D. Place the patient in a recumbent position.

C. Apply a moist compress. If gentle pressure is unsuccessful, the patient should apply a moist compress. A patient should never be instructed to tilt the head back or be placed in the recumbent position as the patient may aspirate the blood.

What is the most likely consequence for a cell when an x-ray photon interacts with and inactivates the cell's master molecule? A. Lose of all intracellular fluid. B. Disruption of cell chemistry only. C. Cell death. D. Cell membrane rupture.

C. Cell death. The cell's master molecule is DNA. The consequence of inactivating DNA is likely cell death.

To ensure a reduction in irritation to the intestines, which temperature of water should be mixed with the barium on lower gastrointestinal studies? A. Warm B. Tepid C. Cold D. Hot

C. Cold General recommendations are that barium sulfate be mixed with cold tap water to reduce irritation to the colon and to aid the patient in holding the enema during the examination. Mixing the barium sulfate with room temperature water has also been recommended for maximal patient comfort. Hot water should not be used as it may burn the colon.

A carpenter smashes his index finger with a hammer. Which type of fracture might be shown on the subsequent radiographs of the finger? A. Depressed B. Torus C. Comminuted D. Spiral

C. Comminuted The blunt force of the hammer would likely cause several fracture fragments, or a comminuted fracture. Torus fractures are usually seen in long bones of children. Twisting forces cause spiral fractures. Depressed fractures (C) are caused by blunt force, but are normally seen in the skull or tibial plateau.

What type of relationship does cell growth rate have on the sensitivity of tissues to ionizing radiation? A. Disproportional B. Inverse C. Direct D. Not related

C. Direct According to the law of Bergonie and Tribondeau, cell growth rate has a direct relationship to the sensitivity of tissues to ionizing radiation; as the growth rate for tissues increases, the radiosensitivity also increases.

When dealing with radiation exposure, what is the most effective protection for a radiographer? A. Lead gloves B. Thyroid collar C. Distance D. Lead apron

C. Distance The most effective protection is distance. The further away from the source, the less radiation one will receive. Due to the divergence of the beam, doubling the distance decreases the dose by a factor of 4.

A radiographer has made a good exposure of a lateral lumbar spine, and now must make a lateral spot L5S1 image using a 6€� x 6€� field. What parameter change is needed if manual exposure control is being used? A. No change B. 15% increase in kVp C. Double the mAs D. 15% reduction in kVp

C. Double the mAs Using manual exposure control, double the mAs will be needed to offset the loss of density due to loss of scatter density with the smaller field.

Which is the disease process that causes increased radiodensity in the lung fields on an image due to inflammation and accumulation of fluid? A. Primary tuberculosis B. Pleurisy C. Pneumonia D. Pneumothorax

C. Pneumonia The disease process that causes increased density in the lungs from inflammation and accumulation of fluid is pneumonia.

The majority of x-rays in the useful beam are created as a result of which process? A. Orbital electrons drop down to fill vacant inner shells. B. Orbital electrons become excited and release their energy C. Fast-moving electrons approach the nucleus of the target atom and slow down. D. Fast-moving electrons interact with the K shell electrons of the target atom.

C. Fast-moving electrons approach the nucleus of the target atom and slow down. Most x-rays in the useful beam are bremsstrahlung x-rays, which are formed when projectile electrons approach the nucleus of the target atom and slow down.

In an x-ray tube, what is the the source of electrons used to make x-rays? A. Anode B. Target C. Filament D. Focusing cup

C. Filament Electrons from tungsten atoms in the filament are used in the x-ray tube to make x-rays.

Which protective feature is designed to reduce exposure to the patient during fluoroscopic procedures? A. Magnification mode. B. Bucky slot cover. C. Foot switch. D. Protective curtain.

C. Foot switch Radiologists are trained to repeatedly depress and release the fluoroscopic foot switch in order to reduce beam-on time and patient exposure.

Which calculation is used to determine grid ratio? A. The height of the lead strips divided by the width of the lead strips. B. The width of the interspace material divided by the height of the lead strips. C. Height of the lead strips divided by the width of the interspace material. D. The width of the lead strips divided by the height of the lead strips.

C. Height of the lead strips divided by the width of the interspace material.

How can digital radiography contribute to patient dose reduction today, in spite of generally being slower in system speed than 400 speed film screen systems? A. Lower milliampere-seconds (mAs) should be used with digital. B. Lower kilovolts peak (kVp) should be used with digital C. Higher kilovolts peak (kVp) should be used with digital D. Higher milliampere-seconds (mAs) should be used with digital.

C. Higher kilovolts peak (kVp) should be used with digital Higher kVp should be used with digital radiography, because lost contrast can be replaced during image processing. The net effect is a patient dose reduction compared to film-screen systems for the same body part.

On which system does hospital staff input new orders for radiologic examinations? A. Radiology information system. B. Digital imaging and communications system. C. Hospital information system. D. Picture archiving and communication system.

C. Hospital information system New orders are entered on the hospital information system.The radiology information system tracks workflow and collects work-related data in the Radiology department only.

What characteristics do high linear energy transfer (LET) radiations have when compared with low-LET radiation? A. Decreased mass, increased penetration B. Electrically charged, less ionizing. C. Increased mass, decreased penetration. D. No electrical charge, more ionizing.

C. Increased mass, decreased penetration. High-LET radiations have increased mass and decreased penetration. Because of their electrical charge and substantial mass, they cause more ionizations in a dense amount of tissue, quickly losing energy. This causes them to be less penetrating than low-LET radiations such as x-rays and gamma rays.

42.Which change is needed to compensate for a soft tissue mass in the abdomen? A Increased source to image receptor distance (SID). B Reduced kilovolts peak (kVp). C Increased milliampere-seconds (mAs). D Reduced milliampere-seconds (mAs).

C. Increased milliampere-seconds (mAs). Increased mAs is needed to compensate for the additional tissue presence of a soft tissue mass. Reduced mA, kVp, or increased SID cause an underexposed image of an abdomen with a soft tissue mass.

22. Where is edge enhancement post processing be most helpful in digital radiography? A Spinal examinations. B Abdominal soft tissue studies. C Low contrast situations. D High contrast situations.

C. Low contrast situations. Edge enhancement post processing has been shown in research to be helpful in low contrast situations. Available research in higher contrast situations, abdominal soft tissue studies, and spinal exams, has emphasized the gain in quantum mottle seen with edge enhancement post processing. So far Radiologists are distancing themselves from all but low contrast circumstances.

Which statements are accurate about control monitoring badges? (Select the two that apply.) A. Returned to the supplier in a special envelope separate from individual badges. B. Should be kept in a distant room from the radiation area. C. Measures background exposure during transportation, handling, and storage. D. Should be worn underneath the lead apron during fluoroscopy exams. E. Measures radiation exposure in the work area.

C. Measures background exposure during transportation, handling, and storage. E. Measures radiation exposure in the work area.

Which is an advantage of using a optically stimulated luminescent (OSL) dosimeter as opposed to a film badge? A. Readings as low as 5 millirem (mrem). B. Inexpensive. C. Not fogged by heat D. Immediate readings available.

C. Not fogged by heat OSLs are not fogged by heat like film badges. OSLs can measure exposures as low as 1 mrem, not 5 mrem, but film badges are accurate at 10 mrem or higher.

What is the wide spread of Methicillin-resistant Staphylococcus aureas (MRSA) mainly attributed to? A. Improper cleaning of medical equipment. B. Poor hygiene and overuse of pain killers. C. Over prescription of antibiotics and poor infection control practices. D. Use of antibiotics with immunosuppressed patients.

C. Over prescription of antibiotics and poor infection control practices. The overuse of antibiotics and lax infection control practices has lead to infections that do not respond to normal antibiotics, such as MRSA. If used properly, antibiotics may be used to treat immunosuppressed patients. Improper cleaning of medical equipment may cause clostridium difficile colitis, another hospital acquired infection, and poor hygiene could lead to community-acquired MRSA.

A radiographer prepares to position a patient with a suspected hip injury. The patient is positioned on a backboard with the right leg and foot lying on its lateral aspect. Which should the radiographer do to successfully complete the examination? A. Medially rotate both feet and lower legs 15 to 20 degrees. B. Request that pain medication be given prior to rotating the leg. C. Perform the exam without repositioning the leg. D. Ask the physician if the leg can be rotated.

C. Perform the exam without repositioning the leg. Because pelvic fractures may result in serious complications including vascular injury, shock, and even possibly death, a trauma hip exam should be performed without attempting to reposition the leg.

A radiographer prepares to transfer a patient from a wheelchair to the x-ray table. The patient recently suffered a stroke, exhibits left-sided weakness, and is able to bear some weight. How should the radiographer move the patient to the table? A. Use a hydraulic lift. B. Position the left side of the wheelchair next to the table. C. Position the right side of the wheelchair next to the table. D. Have one radiographer lift the torso while another lifts the feet.

C. Position the right side of the wheelchair next to the table. Because the patient's strongest side is the right side, the radiographer should position the right side of the wheelchair next to the table.

Which projection of the thumb requires digits two through five to be extended, with the palmar surface of the hand flat against the image receptor (IR) as if for a posteroanterior (PA) hand projection? A. Posteroanterior (PA). B. Lateral. C. Posteroanterior (PA) Oblique. D. Anteroposterior (AP).

C. Posteroanterior (PA) Oblique

What is the impact of using 2.5 millimeters of aluminum equivalent filtration on the primary x-ray beam? A. Increase in the number of x-rays reaching the patient. B. Noticeable reduction in density. C. Reduction of the patient's skin dose. D. Noticeable increase in contrast.

C. Reduction of the patient's skin dose. When a diagnostic x-ray beam is filtered by 2.5 millimeters of aluminum or its equivalent, there will be a reduction in the patient's skin dosage.

Why should computed radiography (CR) image receptors (IR) be erased if they haven't been used? A. Ensure dropout artifacts do not occur. B. Eliminate phantom artifacts. C. Remove fog from background radiation. D. Prevent a Moire effect.

C. Remove fog from background radiation. If IRs haven't been used, they should be erased due to fogging from background radiation.

What is the term for the adjustment of image brightness, regardless of exposure received? A. Detective quantum efficiency (DQE). B. Automatic brightness control (ABC). C. Rescaling. D. Dose area product (DAP).

C. Rescaling. Rescaling is the adjustment of digital data to a preset brightness depending on the body part selected.

Which carpal bone is most commonly fractured? A. Triquetrum B. Cuboid C. Scaphoid D. Lunate

C. Scaphoid Scaphoid fractures account for approximately 60% of carpal fractures.

Which is the best approach for speaking to a patient with a hearing impairment? A. Ask patient to adjust hearing aid volume. B. Do not make eye contact. C. Speak in a low register. D. Talk very slowly.

C. Speak in a low register. Patients with hearing loss most often have difficulty hearing voices in a high register, so speaking in a low register is recommended. Speaking at a moderate pace is preferable, rather than very slowly.

Which accurately describes the radiation dose absorbed by bone marrow? A. The dose can be accurately measured by using an optically stimulated luminescent (OSL) dosimeter. B. The dose can be accurately measured by a direct method. C. The dose will be less than the entrance skin exposure. D. The dose will be greater than the entrance skin exposure.

C. The dose will be less than the entrance skin exposure. The radiation dose absorbed by an organ such as bone marrow will be less than the entrance skin exposure. The dose will be less than the entrance skin exposure, not greater.

Which statement accurately describes the appearance of a correctly positioned anteroposterior (AP) hip image? A. The proximal two-thirds of the femur is visualized. B. The lesser trochanter is demonstrated in profile. C. The femoral neck is demonstrated without foreshortening. D. The femoral head is at the center of the collimated field.

C. The femoral neck is demonstrated without foreshortening. A correctly positioned anteroposterior hip radiograph is achieved by internally rotating the affected leg 15 - 20 degrees which then demonstrates the femoral neck without foreshortening by placing the neck of the femur parallel to the image receptor.

Which process describes the electron-target interaction in which most diagnostic x-rays are produced? A. At certain energy levels, a filament electron strikes an orbital electron and removes it from orbit. B. Outer shell electrons have a higher energy level, but are not ionized. C. The filament electron misses all of the orbital electrons and interacts with the target atom nucleus. D. An outer shell electron fills an inner shell vacancy.

C. The filament electron misses all of the orbital electrons and interacts with the target atom nucleus Most x-rays in the diagnostic range are the result of Bremsstrahlung interactions, in which a projectile electron completely avoids the orbital electrons and interacts with the target atom nucleus.

The highest potential dose to the radiographer during c-arm fluoroscopy originates from which source? A. The side where x-rays exit the patient. B. Leakage radiation from the image intensifier. C. The side where x-rays enter the patient. D. Leakage radiation from the x-ray tube.

C. The side where x-rays enter the patient. The highest scatter dose during c-arm fluoroscopy is at the entrance surface of the patient, closest to the x-ray tube.

The only saddle joint in the body is found between which two bones? A. Navicular and first metatarsal. B. Trapezium and first metatarsal. C. Trapezium and first metacarpal D. Scaphoid and trapezium.

C. Trapezium and first metacarpal

The wide latitude (dynamic range in electronic terms) of the CR system and its ability to demonstrate such a wide spectrum of grays offsets the loss of geometric detail with CR

CR) imaging creates images with poorer resolution than that of film screen. What compensates for this loss of resolution?

When using film-screen, which step would maximize image contrast?

Choice of a high ratio grid would maximize contrast.

Following the ingestion of a fatty meal, what hormone is secreted by the duodenal mucosa to stimulate contraction of the gallbladder?

Cholecystokinin

When using film-screen, which choice would maximize exposure latitude?

Choose high kVp

What is the result if pixel bit depth is decreased?

Contrast resolution is decreased

What is the result if pixel bit depth is decreased?

Contrast resolution is decreased. Pixel depth determines how many shades of gray will be displayed so is directly related to contrast resolution.

17. What is the longest field size dimension allowable for 10 inches by 12 inches collimation at a 40 inch source to image distance (SID)? A 11.4 inches. B 13.2 inches. C 10.6 inches. D 12.8 inches.

D 12.8 inches. Field size may be off +/- 2% of the SID, which in this case is 0.8 inches. 12.8 inches is in the acceptable range. 10.6 inches and 11.4 inches have collimation-field size discrepancies that are within the acceptable range. 13.2 inches exceeds the acceptable range.

50.Optimal radiographic density is achieved with 400 milliamperes (mA), 0.25 second, and 75 kilovolts peak (kVp) using a 400 speed film-screen system. Which adjustment in mA is needed to maintain density if the exposure time is increased to 0.4 seconds, and a 200 speed system is used? A 100 mA. B 200 mA. C 400 mA. D 500 mA.

D 500 mA. 400 mA multiplied by 0.25 seconds equals 100 milliampere-seconds (mAs). If 100 mAs is used with a 400 speed film-screen system, calculations must be made to adjust the mAs to the proper value for a 200 speed film-screen system. Use the film-screen speed conversion formula, mAs1 / mAs2 = RS2 / RS1. By using this formula, it is determined that 200 mAs is necessary with a 200 speed film-screen system. 200 mAs divided by the new time of 0.4 second equals 500 mA. All other responses result from math errors or incorrect use of formulas.

180. In order to protect the radiographer, how long must the exposure cord be on a portable xray machine? A 8 feet. B 2 feet. C 4 feet. D 6 feet.

D 6 feet. The exposure cord must be at least six feet long. The other answers are incorrect.

58.How does the Density log Exposure (D log E) curve appear for a digital imaging receptor (IR)? A A shallow slope. B An S curve. Incorrect C A steep slope. D A straight line at a 45 degree angle.

D A straight line at a 45 degree angle. D log E curves for digital imaging demonstrate the wide dynamic range of the image receptor as a straight line at a 45 degree angle. As an image is windowed, the data is moved up and down the 45 degree line. D log E curves are bell curves with the left half of the bell demonstrated. A steep slope and shallow slope pertain to film/screen imaging.

64. The lead radiographer is planning a strategy to efficiently manage the morning workload. The department is short-staffed due to meetings, and four patients are now ready for their examinations. Assuming that none of the exams is emergent, which patient should be seen first? A An 54-year-old male with type 2 diabetes for an upper GI. B A 18-year-old female for an intravenous urogram. C An 83-year-old female for a chest x-ray. D A two-year-old child for a barium swallow.

D A two-year-old child for a barium swallow An x-ray department should begin the day with patients who are fasting prior to their examination. In this example, more than one of the patients is fasting, so the radiographer must decide who goes first based on other factors. Since none of the cases are emergent, consideration should be given to pediatric and geriatric patients because they have the most difficulty being NPO for long periods of time. The geriatric patient, however, is not required to fast. Patients with diabetes who have postponed their insulin should also be given special consideration. Since type 2 diabetes is non-insulin dependent, the two-year-old child represents the best option. In addition, the 18-year-old female is likely able to handle being NPO.

56. What is the result if pixel bit depth is decreased? A Image noise is decreased. B Brightness is increased. C Spatial resolution is increased. D Contrast resolution is decreased.

D Contrast resolution is decreased. Pixel depth determines how many shades of gray will be displayed so is directly related to contrast resolution. A decrease in pixel depth would mean a decrease in contrast resolution. Brightness of a digital image is dependent upon the look up table. Image noise is related to signal received and scatter radiation. Pixel size and matrix size determine spatial resolution.

7. What causes the build-up of heat at the anode? A Tungsten deposits on the glass envelope. B High x-ray tube voltage. Incorrect C Thermionic emission. D Electrons colliding with the target.

D Electrons colliding with the target. The tremendous amount of heat generated at the anode is the result of the electron beam colliding with the target. The vast majority ( >99% according to some authorities) of electron-target interactions take place at such low energy, that the emitted waveform is infrared radiation or heat. Thermionic emission refers to the "boiling off" of electrons at the filament. The x-ray tube voltage creates the flow of electrons from the cathode to the anode. Tungsten deposits within the x-ray tube are caused by evaporation of the filament and can lead to tube failure.

12. Which part of the x-ray circuit is controlled by adjusting the milliamperage (mA) setting on the operating console for the purpose of producing the heat necessary for thermionic emission? A Timer circuit. B Primary circuit. C Secondary circuit. D Filament circuit.

D Filament circuit. The filament circuit controls the amount of heat applied to the filament that is required to boil off the desired number of electrons by the process of thermionic emission; the amount of current that is applied to the filament is under the control of the radiographer when the mA station is selected. The primary circuit regulates the incoming power supply and determines the voltage that is applied to the x-ray tube. The secondary circuit contains the mA meter, as well as the entire x-ray tube, except for the filament circuit. The timer circuit is part of the primary circuit and controls the amount of time the filament is heated.

175. Which protective feature is designed to reduce exposure to the patient during fluoroscopic procedures? A Magnification mode. B Protective curtain. C Bucky slot cover. D Foot switch.

D Foot switch. Radiologists are trained to repeatedly depress and release the fluoroscopic foot switch in order to reduce beam-on time and patient exposure. The bucky slot cover and protective curtain are designed to reduce exposure to personnel, rather than to the patient. While the magnification mode is helpful in certain situations, it does increase exposure to the patient.

14. What is the maximum speed of filament electrons as they travel toward the anode? A The speed of light. Incorrect B One-fourth the speed of light. C One-eighth the speed of light. D Half the speed of light.

D Half the speed of light. Filament electrons may reach speeds of about half the speed of light. The other answers are too fast or too slow.

70. The radiographer is assisting a patient to move from a wheelchair to the x-ray table. Which represents the safest practice by the radiographer when moving this patient? A Reduce the base of support slightly so the center of gravity is easier to maintain. B Extend the arms as far as possible to increase the base of support. C Bend at the waist so the center of gravity is midway between the patient and the base of support. D Maintain the center of gravity over the base of support.

D Maintain the center of gravity over the base of support. The radiographer should maintain the center of gravity over the base of support. If movement is required, then the feet should be moved to maintain this relationship. All other responses violate proper body mechanics.

176. Which is an advantage of using a optically stimulated luminescent (OSL) dosimeter as opposed to a film badge? A Inexpensive. B Readings as low as 5 millirem (mrem). C Immediate readings available. D Not fogged by heat.

D Not fogged by heat. OSLs are not fogged by heat like film badges. OSLs can measure exposures as low as 1 mrem, not 5 mrem, but film badges are accurate at 10 mrem or higher. Film badges are less expensive than OSLs, and neither can give immediate readings.

32. When using film-screen, which most accurately describes the effect on the resultant image when kilovolts peak (kVp) is increased? A Recorded detail will be increased. B Recorded detail will be decreased. C Number of gray tones will be decreased. D Number of gray tones will be increased.

D Number of gray tones will be increased. An increase in kilovoltage will result in shorter wavelength x-rays beams that more uniformly penetrate body parts, resulting in lower contrast and more gray tones in the radiograph. A decrease in the number of gray tones is expected with a decrease in kVp. Voltage is not a primary controlling factor for recorded detail.

177. Which type of personnel dose monitoring devices is the best choice to monitor the whole body dosage of radiographers? A Geiger counter. B Baldwin-Farmer meter. C Pocket gas ionization chamber. D Optically stimulated luminescent dosimeter (OSL).

D Optically stimulated luminescent dosimeter (OSL). Viable means of monitoring occupational whole body dosage include the OSL. Geiger counters are excellent at detecting radiation, but fail completely at measuring it. The Baldwin-Farmer meter is a highly accurate laboratory device for measuring exposure in air. It is impractical for personal monitoring. The pocket gas ionization chamber should only be used to monitor those who are occasionally exposed.

178. What is the impact of using 2.5 millimeters of aluminum equivalent filtration on the primary x-ray beam? A Increase in the number of x-rays reaching the patient. B Noticeable reduction in density. C Noticeable increase in contrast. D Reduction of the patient's skin dose.

D Reduction of the patient's skin dose. When a diagnostic x-ray beam is filtered by 2.5 millimeters of aluminum or its equivalent, there will be a reduction in the patient's skin dosage. There will be a decrease, not increase, in the number of xrays reaching the patient. Density and contrast will not be noticeably affected, particularly now with digital imaging.

20. Why should computed radiography (CR) image receptors (IR) be erased if they haven't been used? A Eliminate phantom artifacts. B Prevent a Moire effect. C Ensure dropout artifacts do not occur. D Remove fog from background radiation.

D Remove fog from background radiation. If IRs haven't been used, they should be erased due to fogging from background radiation. A Moire effect, dropout artifact, and phantom artifact are all unaffected by how long or how often IRs have been used.

53. Which is the most likely cause of a histogram error? A Incomplete erasure of the image plate. B Underexposure of the image receptor. C Malfunction of the plate reader electronics. Incorrect D Selection of an incorrect exam from the look-up table.

D Selection of an incorrect exam from the look-up table. A histogram error, which results in improper image brightness and contrast, occurs when the radiographer selects an incorrect exam (anatomical structure, position and projection) from the look-up table before the image plate is scanned. Malfunction of the plate reader electronics can cause the appearance of line patterns. Incomplete erasure of the image plate results in a phantom, or ghost, image artifact. Underexposure of the image receptor results in quantum mottle.

24. Which digital post-processing results in a black background surrounding the original collimated edges? A Beam restriction. B Subtraction. C Collimation. D Shuttering.

D Shuttering Shuttering is a post exposure processing technique that results in a black background surrounding the original collimated edges. Beam restriction is the act of reducing the radiation field size mechanically or electrically. Subtraction is a technique to selectively remove superimposing structure by electronically deducting the relative brightness of a scout image from that of the diagnostic image. Collimation is the act of reducing the radiation field size mechanically or electrically.

36.A radiographer performs a chest examination using a computed radiography (CR) system. Posteroanterior (PA) and lateral images are taken, and the imaging receptors (IR) are processed in the CR reader. The PA image appears to have two PA chest images present. The lateral image is processed and appears fine. What is a possible cause of the double image? A The radiographer accidentally exposed the back side of the IR during the PA position. B The image reader has malfunctioned. C The IR has been sitting too long and has been exposed by background radiation. D The IR was not properly erased from the last examination.

D The IR was not properly erased from the last examination IRs can retain images from previous exams if the reader is unable to properly erase the receptor. Image reader malfunctions may happen, but they will not produce double images. Exposing the back of the IR demonstrates geometric patterns on the image. An IR that has been sitting too long results in overall density increase to the image from fog.

69. A patient received 100 ml of IV contrast media as a part of an abdominal computed tomography (CT) scan, as well as 500 ml of dilute, oral contrast, prior to coming to Radiology for a separate order, an intravenous urogram (IVU). The patient's creatinine is 0.4 mg/dl and BUN is 36 mg/dl. Why should this IVU be rescheduled? A The lab values indicate that the contrast would not be excreted in sufficient quantity to be useful for an IVU. B The lab values indicate increased risk for contrast injection. C The presence of the previous intravenous contrast precludes an IVU. D The presence of the previous oral contrast in the abdomen precludes an IVU.

D The presence of the previous oral contrast in the abdomen precludes an IVU The single, most compelling reason to reschedule this IVU is the presence of previous oral contrast in the abdomen. The lab values do suggest increased risk and a low level of contrast excretion, but both of those are frequently ignored by ordering physicians and radiologists. The use of nonionic contrast agents can mitigate much of the risk. The presence of intravenous contrast in the urinary collecting system would preclude an IVU for perhaps 30 minutes, but that delays, rather than cancels, the study. Awarded 0.0 points out of 1.0 possible points.

189.In this chest radiograph, where is the clinically significant gas located? A Under the left hemidiaphragm. Incorrect B Within the stomach. C Within the thorax. D Under the right hemidiaphragm

D Under the right hemidiaphragm. In this image there is free gas under the right hemidiaphragm, identifiable by the fact that the right hemidiaphragm is higher than the left, because of the liver. Free gas is seen under the left hemidiaphragm. No free gas is located within the thorax. Gas in the stomach is quite a normal finding and not clinically significant.

For the protection of the radiographer, how long must the exposure cord be on a mobile radiographic unit? A. 1 foot B. 2 feet C. 1 meter D. 2 meters

D. 2 meters The exposure cord on a mobile radiographic unit must be at least 2 meters.

Which central ray (CR) angle is best for heavy, wide-hipped patients for lateral lumbar spine projections? A. 5 degrees cephalad B. Perpendicular C. 10 degrees caudad D. 5 degrees caudad

D. 5 degrees caudad With heavy, wide hipped patients, it is best to begin with a 5 degree caudal angle. Perpendicular CRs simply don't work well with these patients. Extreme cases of wide hips may require even more angle of 10 degrees caudad, but these will be the true exception, rather than the rule. A cephalic angle would close the joint spaces.

What is the recommended central ray (CR) angle if the lumbar spine cannot be adjusted so it is horizontal for the lateral projection? A. 8 degrees for men, and 5 degrees cephalad for women. B. 5 degrees for men, and 8 degrees cephalad for women. C. 8 degrees for men, and 5 degrees caudad for women. D. 5 degrees for men, and 8 degrees caudad for women.

D. 5 degrees for men, and 8 degrees caudad for women. If the lumbar spine cannot be adjusted so it is horizontal for the lateral projection, the CR should be angled 5 degrees for men and 8 degrees caudad for women.

When film-screen technology is used, which kilovolts-peak (kVp) setting produces the best scale of contrast for imaging ribs? A. 100 kVp B. 90 kVp C. 80 kVp D. 70 kVp

D. 70 kVp The lowest kVp of 70 provides the shortest scale of contrast.

Which technique produces a 2 milliroentgens (mR) exposure to an image receptor plate if 70 kilovolts peak (kVp) at 25 milliampere-seconds (mAs) produces 1.6 mR? A. 70 kVp at 35 mAs. B. 70 kVp at 27.5 mAs. C. 70 kVp at 50 mAs. D. 70 kVp at 31.25 mAs.

D. 70 kVp at 31.25 mAs. 2 mR is 25% greater than 1.6 mR; so, a 25% increase in mAs achieves this result. 25 mAs x 1.25 = 31.25 mAs.

The lead radiographer is planning a strategy to efficiently manage the morning workload. The department is short-staffed due to meetings, and four patients are now ready for their examinations. Assuming that none of the exams is emergent, which patient should be seen first? A. An 54-year-old male with type 2 diabetes for an upper GI B. A 18-year-old female for an intravenous urogram C. An 83-year-old female for a chest x-ray D. A two-year-old child for a barium swallow

D. A two-year-old child for a barium swallow An x-ray department should begin the day with patients who are fasting prior to their examination. In this example, more than one of the patients is fasting, so the radiographer must decide who goes first based on other factors. Since none of the cases are emergent, consideration should be given to pediatric and geriatric patients because they have the most difficulty being NPO for long periods of time.

Which condition must be met before diagnostically useful characteristic x-rays can be produced? A. Characteristic x-rays can be produced only above 85 kiloelectron volts (keV). B. A specific milliampere-seconds (mAs) should be selected. C. Tissues with high atomic numbers must be present. D. An inner shell electron must be completely removed.

D. An inner shell electron must be completely removed. Diagnostically useful characteristic x-rays are produced when an outer shell electron drops to an inner shell void, after an inner shell electron has been completely removed.

Which rule is followed when examining unconscious patients? A. Proceed as if the patient were conscious, asking questions and giving instructions. B. Remain as quiet as possible to avoid waking the patient during the exam. C. Speak openly in front of the patient, since they cannot hear or understand you. D. Avoid saying things you would not say to a conscious patient.

D. Avoid saying things you would not say to a conscious patient. Unconscious patients may retain the ability to hear and remember what is said, so it is appropriate to avoid making statements that you would not make if they were conscious.

How does an increase in noise affect the quality of a digital image? A. Contrast is increased. B. Density is increased. C. Density is decreased. D. Contrast is decreased.

D. Contrast is decreased. Digital image contrast is decreased by the presence of noise.

What is the result if pixel bit depth is decreased? A. Brightness is increased. B. Spatial resolution is increased. C. Image noise is decreased. D. Contrast resolution is decreased.

D. Contrast resolution is decreased. Pixel depth determines how many shades of gray will be displayed so is directly related to contrast resolution. Pixel size and matrix size determine spatial resolution.

What is the function of a rectifier? A. Convert direct current to alternating current. B. Change direct current to high frequency current. C. Increase 60 Hertz alternating current to high frequency current. D. Convert alternating current to pulsating direct current.

D. Convert alternating current to pulsating direct current. Rectifiers function to convert alternating current to direct current. Rectifiers do not function to change direct current to alternating current.

Without changing any other factors, which effect is caused by decreasing the field size from 14X17 inches to 8X10 inches? A. Decrease x-ray penetration of the part. B. Increase x-ray penetration of the part. C. Increase in the amount of scatter radiation within the part. D. Decrease in the amount of scatter radiation within the part.

D. Decrease in the amount of scatter radiation within the part. Reducing the size of the field limits the amount of scatter produced. Increasing field size increases the amount of scatter.

Which change is needed to compensate for a soft tissue mass in the abdomen? A. Reduced kVp B. Reduced mAs C. Increased SID D. Increased mAs

D. Increased mAs Increased mAs is needed to compensate for the additional tissue presence of a soft tissue mass.

When using film-screen technology, how are the required milliampere-seconds (mAs), contrast, and patient dose affected as the grid ratio changes from 6:1 to 12:1? A. Decreased mAs, decreased contrast, and decreased patient dose. B. Decreased mAs, increased contrast, and decreased patient dose. C. Increased mAs, decreased contrast, and increased patient dose. D. Increased mAs, decreased contrast, and increased patient dose.

D. Increased mAs, decreased contrast, and increased patient dose. As grid ratio increases, an increase in mAs is needed to maintain density. Increased contrast and increased patient dose will also be noted.

Which term describes the process by which most x-ray-induced cellular damage occurs? A. Direct effect B. Oxygen enhancement C. Target theory D. Indirect effect

D. Indirect effect Since humans are about 80% water and indirect effect involves ionization of water, it is widely believed that the indirect effect is responsible for most biologic effects of radiation exposure.

A radiographer enters a room to take a portable foot series on a patient in her final trimester of pregnancy. The patient is just finishing her lunch and begins choking. How should the radiographer respond to this medical emergency? A. Place the patient in the Trendelenburg position. B. Start cardiopulmonary resuscitation (CPR). C. Apply an inward and upward thrust in the midline of the abdomen. D. Initiate a backward thrust in the center of the sternum.

D. Initiate a backward thrust in the center of the sternum. Abdominal thrusts can be dangerous in the late stages of pregnancy, so the radiographer should use backward thrusts in the center of the sternum.

Which projection of the sternum is most likely to demonstrate a fracture? A. Straight posteroanterior (PA). B. Left anterior oblique (LAO). C. Right anterior oblique (RAO). D. Lateral

D. Lateral The lateral is the sternum projection most likely to demonstrate a fracture, because most sternal fractures involve anterior or posterior displacement of one or more fragments.

As a result of imaging pregnant patients, which is the fetal exposure for most radiographic exams? A. Greater than 100 rads B. 25 rads C. 50 rads D. Less than 1 rad

D. Less than 1 rad Because most medical procedures result in fetal exposures of less than 1 rad, the risk of abnormality is small. During diagnostic radiography, fetal exposures do not generally approach 100 rads, 50 rads, or 25 rads.

Which step will reduce digital image noise, assuming no other changes? A. Decrease kVp B. Image magnification C. Small pixel size D. Longer exposure time

D. Longer exposure time A longer exposure time results in a greater amount of photons reaching the image receptor, which reduces image noise.

Where is edge enhancement post processing most helpful in digital radiography? A. Spinal examinations. B. High contrast situations. C. Abdominal soft tissue studies. D. Low contrast situations.

D. Low contrast situations. Edge enhancement post processing has been shown in research to be helpful in low contrast situations.

Which aspect of electrical power is responsible for accelerating electrons in an x-ray tube? A. Current flow B. Resistive heat C. Total wattage D. Potential difference

D. Potential difference Selected kVp, also known as potential difference, accelerates electrons crossing an x-ray tube.

Which term refers to the radiation that exits the x-ray tube through the collimator? A. Scatter B. Remnant C. Leakage D. Primary

D. Primary The unattenuated radiation that exits the tube through the collimator is called primary radiation.

Which x-ray beam characteristic is reduced by adding aluminum filtration? A. Half-value layer B. X-ray beam quality C. Energy of the x-ray beam D. Quantity of x-rays

D. Quantity of x-rays Added aluminum filtration results in a reduction in the quantity of x-rays in the primary beam.

Which study is considered a nonfunctional examination of the urinary system? A. Voiding cystourethrogram. B. Intravenous urogram. C. Hypertensive urogram D. Retrograde urogram

D. Retrograde urogram Retrograde urography involves the introduction of contrast media directly retrograde, or against the flow, into the pelvicalyceal system. This is considered a nonfunctional exam because the patient's normal physiologic processes are not involved in the procedure.

Prior to performing a posteroanterior (PA) chest projection with automatic exposure control (AEC), the radiographer discovers that the patient has had a right total pneumonectomy. Which technical consideration should be considered? A. Selecting only the detector on the right side. B. Selecting the center detector. C. Selecting both outer detectors D. Selecting only the detector on the left side.

D. Selecting only the detector on the left side. Selecting the left detector in this scenario will result in proper exposure of the image and is the correct answer.

Which is the most appropriate guideline to follow when radiographing patients in their late adult years? A. Perform the exam as quickly as possible. B. Assume the patient has reduced mental capacity. C. Repeat instructions often so the patient won't forget. D. Speak slowly and in a low tone of voice.

D. Speak slowly and in a low tone of voice. When speaking to patients in their late adult years, it is often helpful to speak more slowly and in a lower tone.

During a lumbar myelogram, the needle is placed into which meningeal space? A. Epidural B. Subthecal C. Subdural D. Subarachnoid

D. Subarachnoid The subarachnoid space is where cerebrospinal fluid (CSF) can be removed for analysis and where contrast media is injected for diagnostic imaging examinations.

Which procedure is an example of surgical asepsis? A. Clean glove application. B. Hand washing C. Clean gown application D. Surgical hand scrub.

D. Surgical hand scrub. Asepsis is the absence of disease-producing (pathogenic) organisms. Surgical asepsis, or sterile technique, includes procedures used to eliminate all microorganisms from an area. Surgical hand scrub, sterile glove application, and sterile gown application are examples of surgical asepsis.

Which bone contains a mastoid process? A. Occipital B. Sphenoid C. Parietal D. Temporal

D. Temporal The mastoid process is on the temporal bone, located posterior to the external auditory meatus.

What is the dose-response relationship of radiation-induced skin cancer? A. Nonlinear B. Nonthreshold C. Hormesis D. Threshold

D. Threshold Radiation-induced skin cancer has a threshold response, which means that if, cancer has developed due to radiation exposure, then a certain minimum dose must have been received.

A posteroanterior (PA) chest radiograph demonstrates the left clavicle closer to the center of the spine than the right clavicle. Which action should the radiographer take? A. Roll shoulders forward. B. Turn left side closer to image receptor (IR). C. Accept the image. D. Turn right side closer to image receptor (IR).

D. Turn right side closer to image receptor (IR). The patient is in a slight left anterior oblique (LAO) position, so the right side should be rotated closer to the IR. This image should not be accepted, because rotation is present.

How can magnification of the heart be reduced when performing a chest x-ray? A. Use a 40-inch source-image-receptor-distance (SID). B. Use a high kVp and low mAs technique. C. Use the shortest possible exposure time. D. Use a 72-inch source-image-receptor-distance (SID).

D. Use a 72-inch source-image-receptor-distance (SID). As the SID increases, magnification decreases. Therefore, the radiographer should use a 72-inch SID.

A patient's abdominal image reveals the presence of multiple phleboliths. Where are these small calcifications found? A. Gallbladder B. Kidney C. Ureter D. Vein

D. Vein A phlebolith is a small calcification commonly located in the veins of the lower part of the pelvis. Small calcifications in the ureter and/or the kidneys are referred to as renal, or urinary, calculi. Small stones that form in the gallbladder are known as gallstones, or choleliths.

Which change in technical factors is most likely to result in decreased exposure to the image receptor (IR)? A. Increased focal spot size. B. Decreased source to image receptor distance (SID). C. Decreased beam restriction. D. Increased grid ratio.

D. increased grid ratio Grids with higher ratios are able to remove more photons from the x-ray beam. Because the grid reduces the number of photons reaching the image receptor, it also causes a decrease in exposure to the IR.

What information in the patient history should prompt the radiographer to decide against using AEC when taking a chest x-ray?

Emphysema. The pathophysiologic changes to lung tissue in emphysema result in easy penetration, so AEC should not be enabled for radiographic exams because the film will be too dense as a result of the control failing to shut the exposure off quickly enough.

Which pathologic condition requires a reduction in exposure factors to produce an acceptable image?

Emphysema. (Emphysema is considered a destructive disease which requires a reduction in exposure factors.)

Which elbow projection will show the radial head freest of superimposition?

External

Which elbow projection will show the radial head freest of superimposition?

External oblique.

Which part of the x-ray circuit is controlled by adjusting the mA setting on the operating console for the purpose of producing the heat necessary for thermionic emission?

Filament circuit

Why is the left lateral decubitus position recommended as part of an acute abdominal series?

Free air is demonstrated away from the gastric bubble

Why is the left lateral decubitus position recommended as part of an acute abdominal series?

Free air is demonstrated away from the gastric bubble The purpose of the left lateral decubitus position is to demonstrate free air in the area of the right upper abdomen away from the gastric bubble. Aspiration may be avoided by positioning the patient on either side. Air-fluid levels are adequately visualized with a horizontal beam, regardless of which decubitus position is used. The lateral decubitus position is included as part of an acute abdomen series when the patient is unable to stand, however, the left lateral decubitus position is recommended to demonstrate free air.

Which best controls motion issues, generally?

High mA, short exposure time combinations.

High ratio grids improve..

High ratio grids improve image contrast at the expense of increased patient dose.

Which statement represents the best guideline for minimizing patient exposure?

High speed image receptors and immobilization used when performing pediatric exams

Best guideline for minimizing patient exposure.

High speed image receptors and immobilization used when performing pediatric exams in order to reduce radiation dose, as well as the need for repeat exposures. The use of higher kVp techniques, not lower, should be used to allow for lower mAs in order to reduce the amount of radiation to the patient. Total filtration must be at least 2.5mm aluminum equivalent for units operating above 70 kVp; 1.5mm total filtration is required for units operating at 50-70kVp.

How can digital radiography contribute to patient dose reduction today, in spite of being generally slower in system speed than 400 speed film screen systems?

Higher kVp should be used with digital

How can digital radiography contribute to patient dose reduction today, in spite of generally being slower in system speed than 400 speed film screen systems?

Higher kilovolts peak (kVp) should be used with digital - because lost contrast can be replaced during image processing. The net effect is a patient dose reduction compared to film-screen systems for the same body part.

Which type of joint is the foot and tibia fibula?

Hinge.

Which type of joint classification describes the joint between the foot and the tibia/fibula?

Hinge. The ankle is a hinge joint. Condyloid joints are typified by the knee, where facing condyles articulate with one another. The only saddle joint is the first carpometacarpal joint. Gliding joints exhibit sliding movement between two relatively flat facing articular surfaces, such as those in zygapophyseal joints.

Hormesis

Hormesis is a term that suggests a little bit of radiation is good.

On which system does hospital staff input new orders for radiologic examinations?

Hospital information system

On which system does hospital staff input new orders for radiologic examinations?

Hospital information system.

Carefully explaining the procedure

How can a radiographer reduce a patient's exposure during a lumbar spine series?

Higher kVp should be used with digital

How can general radiography contribute to patient dose even though the system speed is generally slower than 400 film screen speed?

1) Close collimation positively impacts the contrast scale on digital imaging by decreasing the amount of scatter radiation produced. 2) Altering the window width can change the contrast scale in digital imaging to demonstrate a wide dynamic range of grays. Altering the kVp does not impact the displayed image contrast because the histogram selected determines the optimum contrast for the selected body part. Altering the window level changes the displayed brightness.

How can the contrast scale be modified on a digital image?

1) A longer exposure time increases photon flux to the image receptor. 2) Compression of the body part makes it thinner, increasing photon flux to the image receptor. 3) A shorter SID increases photon flux to the receptor by inverse square law.

How does a radiographer maximize signal to digital image receptors?

with a shorter SID, beam intensity is greater; therefore less image noise.

How does a short SID affect image noise?

One inch lower

How does the central ray (CR) for an anteroposterior (AP) scapula differ from an AP shoulder x-ray?

1 inch (T5 - T6)

How far inferior to sternal angle should central ray be for projections of the esophagus?

it helps control the flow of electrons from the cathode to the anode

How is a focusing cup an important component in x-ray production?

15-20 degrees cephalic to enter at C-4

How is the central ray directed for an anteroposterior (AP) axial projection of the cervical vertebrae?

3 to 5 degrees caudad

How is the central ray directed when performing an anteroposterior (AP) knee projection for a patient with thin thighs and buttocks?

Must increase technical factors, therefore, pt dose also increases.

How is the pt dose affected if using a higher grid ratio?

95%

How much exposure to the lens of the eyes can be reduced by doing a PA skull over an AP skull?

.25mm

How much lead equivalence is required for fluoroscopic curtains?

2.5mm

How much total filtration is required for a fixed X-ray unit operating over 70 kVp?

Upright and 45 degree left posterior oblique

How should the radiographer position the patient to best demonstrate a left axillary 6th rib fracture?

1/7mAs = 5/x x = 35 mAs 2:1 grid has a grid conversion factor of 5, it requires the use of 5 times the mAs used without a grid, or 35 mAs

If 7 milliampere-seconds (mAs) provides optimal density without a grid, which mAs should be used with a 12:1 grid?

Why should computed radiography (CR) image receptors (IR) be erased if they haven't been used? Prevent a Moire effect. Remove fog from background radiation. Correct Ensure dropout artifacts do not occur. Eliminate phantom artifacts. Incorrect

If IRs haven't been used, they should be erased due to fogging from background radiation. A Moire effect, dropout artifact, and phantom artifact are all unaffected by how long or how often IRs have been used.

300 100 rem = 1 Sv .03 sV x 1000 mSv = 30 mSv

If a PA chest results in a dose of .1 mSv and a CT scan results in a dose of 3 rem, how many chest x-rays would equal the dose from the CT?

Fomite

If a patient contracts an infectious microorganism from soiled linen, which term refers to this method of disease transmission?

Using the inverse square law I1/I2=(D2^2/D1^2) 34.4 mR

If a radiographer receives an exposure of 550 mR at a distance of 1.5 feet from the tube of a portable xray unit, what will be the exposure at 6 feet?

Increase kilovolts peak (kVp) by 15%. A kVp increase of 15% will double image density but will not double the patient's dose.

If a radiographer wanted to double image density without doubling the patient's dose, which action should be taken?

The automatic exposure control (AEC) is set at an inappropriate speed class.

If all the bucky digital images from one radiographic room seem to appear excessively noisy, what might the radiographer suspect?

A radiographer uses 70 kVp at 30 mAs on a film-screen radiograph. If a repeat radiograph is acquired at 80 kVp at 15 mAs, which factor will be affected?

Image contrast

A radiographer is on an elevator with a patient who is being transported. The patient ceases to breather but the chart is not present. What should the radiographer do first?

Immediately begin CPR.

Ceiling

In a typical x-ray exam room, what is considered a secondary protective barrier?

Exposure angle - is the arc formed by the movement of the x-ray tube; this is the primary factor affecting thickness that is under the control of the radiographer. As the exposure angle increases, image slice thickness decreases.

In conventional tomography, the radiographer is able to control the thickness of the tomographic slice by altering which of the following?

Increasing the window width increases the number of shades of gray on display.Decreasing the window width decreases the number of shades of gray.

In order to increase the number of shades of gray displayed on a digital image what should be done?

What characteristics do high linear energy transfer (LET) radiations have when compared with low-LET radiation?

Increased mass, decreased penetration. (Because of their electrical charge and substantial mass, they cause more ionizations in a dense amount of tissue, quickly losing energy. This causes them to be less penetrating than low-LET radiations such as x-rays and gamma rays.)

What is the primary advantage of Camp coventry?

Increased patient comfort.

Which is the primary advantage of using the Camp Coventry method instead of the Holmblad method when obtaining a tunnel view of the knee?

Increased patient comfort. The Camp Coventry method is considerably easier for the patient than the Holmblad method (try kneeling on a sore knee). The Camp Coventry method does not necessarily take less time to perform than the Holmblad method. Some longitudinal distortion is acceptable with the Camp Coventry method due to the central ray angle. In fact, lack of distortion is the only advantage for using the Holmblad method. The Camp Coventry method is not easier for the radiographer to perform than the Holmblad method.

Which advantage does a 500 mA station have over a 200 mA station?

Increased photon flux to the image receptor is obtained with 500 mA.

Term described the process by which most x-ray-induced cellular damage occurs.

Indirect effect. Since humans are about 80% water and indirect effect involves ionization of water, it is widely believed that the indirect effect is responsible for most biologic effects of radiation exposure.

A radiographer enters a room to take a portable foot series on a patient in her final trimester of pregnancy. The patient is just finishing her lunch and begins choking. How should the radiographer respond to this medical emergency?

Initiate a backward thrust in the center of the sternum.

Which type of contrast agent would be preferred for low risk and low cost for a patient diagnosed with a possible perforated bowel?

Ionic, water soluble, diluted with juice

Which type of contrast agent is preferred for low risk and low cost for a patient diagnosed with a possible perforated bowel?

Ionic, water soluble, diluted with juice.

Which type of contrast agent would be preferred for low risk and low cost for a patient diagnosed with a possible perforated bowel?

Ionic, water soluble, diluted with juice.

What do limiting spatial resolution (LSR) and modulation transfer function (MTF) have in common? They both measure spatial resolution in digital imaging. Correct They both affect brightness of the digital image. They measure how efficiently an image is moved to the picture archiving and communication system (PACS). They are both indicators of exposure for digital receptors. Incorrect

LSR and MTF are measures of how accurately anatomy is reproduced in a digital image or measures of spatial resolution. The histogram and window leveling affect brightness of a digital image. Exposure indicators for digital receptors are exposure indicator numbers, S numbers, or Log median exposure numbers depending on equipment manufacturer. There is no one measurement for efficiency of images moving into the PACS system.

Which will increase the appearance of noise in a digital image, assuming only the named factor in each response is changed?

Large Matrix contains a large amount of small pixels, resulting in fewer photons per pixel and a greater likelihood for image noise.

Which projection of the sternum is most likely to demonstrate a fracture?

Lateral

Which position should a patient be placed in immediately following a seizure?

Lateral Recumbent (Lateral recumbent is the preferred position for patients to be placed after having a seizure to avoid aspiration of secretions.)

Which of the following is recommended to demonstrate small amounts of air within the peritoneal cavity?

Lateral decubitus, affected side up

Which projection of the sternum is most likely to demonstrate a fracture?

Lateral.

Term describing stray radiation that is emitted through the x-ray tube housing?

Leakage. Leakage radiation is radiation emitted through the housing of the x-ray tube that results in additional exposure to the patient and radiographer.

As a result of imaging pregnant patients, which is the fetal exposure for most radiographic exams?

Less than 1 rad. Because most medical procedures result in fetal exposure of less than 1 rad, the risk of abnormality is small.

Linear Quadratic

Linear Quadratic is the shape of a specific dose response curve.

Where is the central ray (CR) directed for an anteroposterior (AP) projection of the lower leg?

Mid-lower leg

Which describes the correct positioning for a posteroanterior (PA) chest projection? (Select the three that apply.)

The chin is extended. The shoulders are at equal distances from the image receptor (IR). The shoulders are depressed.

Which of the following barium-filled anatomic structures is best demonstrated in the LAO position?

Splenic flexure

nine regions. The upper lateral regions are the left and right hypochondriac, with the epigastric separating them. The middle lateral regions are the left and right lumbar, with the umbilical region between them. The lower lateral regions are the left and right iliac, with the hypogastric region between them. The ileocecal valve, cecum, and appendix (if present) are located in the lower right abdomen—therefore, the right iliac region.

The abdomen is usually divided into:

.05

The annual effective dose equivalent limit for infrequent exposures for a member of the of the general public is equal to how many REMs?

The annual effective dose equivalent limit for infrequent exposures recommended by the National Council on Radiation Protection (NCRP) for a member of the general public is equal to how many rem(s)?

The annual effective dose equivalent limit recommended by the NCRP for the general public is equal to 0.5 rem.

A lateral L-5/S-1 lumbosacral junction is performed with the central ray (CR) directed 2 inches anterior to the anterior superior iliac spine (ASIS) and 1-1/2 inches inferior to the iliac crest. Which statement describes this method?

The central ray will be well anterior to the L-5/S-1 junction To demonstrate the L-5/S-1 lumbosacral junction, the central ray (CR) is directed 2 inches posterior to the anterior superior iliac spine (ASIS) and 1-1/2 inches inferior to the iliac crest. When directing the central ray 2 inches anterior to the ASIS and 1-1/2 inches inferior to the iliac crest, the CR will be centered well anterior to the L-5/S-1 lumbosacral junction and thus not properly centered. The CR will not be posterior or superior to the L-5/S-1 junction.

195.Identify the common bile duct in the AP oblique postoperative cholangiogram. (Click to select the chosen region.) Created with Raphaël 2.1.0

The common bile duct is formed by the junction of the cystic and hepatic ducts. It is located inferior to the gallbladder.Incorrec

184. Place these bit depths in order from the one that will produce the least number of grays to the one that will produce the greatest number of grays. A 14 B 12 C 10 D 8

The correct order is: A 8 B 10 C 12 D 14 The number of grays that is produced is calculated by taking two to the power of the bit depth. So, 2 to the power of 8 equals 256 shades of gray. A bit depth of 10 results in 1,024 grays. A bit depth of 12 equals 4,096. A bit depth of 14 equals 16,384.

Place the following steps in order of importance, 1 - 4, for controlling motion in a chest examination on a 9-month-old child. A Immobilization devices (like the Pigg-o-stat). B A family member to hold the patient. C High mA, short exposure time combinations. D Expose at full inspiration.

The correct order is: A High mA, short exposure time combinations. B Expose at full inspiration. C Immobilization devices (like the Pigg-o-stat). D A family member to hold the patient. The most important step to control motion is always high mA, coupled with short exposure time. Next most important is exposing on full inspiration. These first two steps work with many motion control situations, not just chest radiography on children. Third most important choice would be the use of immobilization devices like the Pigg-o-stat. Fourth most important is the use of a family member to hold the patient.

How is signal maximized to a digital image receptor? Longer exposure time. correct Higher source to image receptor distance (SID) value. Shorter exposure time. Lower milliamperage (mA) setting. Incorrect

The greatest signal strength is obtained with longer exposure time. The other responses reduce signal at the digital image receptor.

A radiographer makes an exposure using an 8:1, 100 line per inch grid. When processing the IP through the reader, the radiographer notices that a Moire pattern is seen on the displayed image. What is the probably cause of this artifact?

The grid had a frequency similar to the reader's sampling frequency

According to Merrill's Atlas, which location represents the correct central ray (CR) placement for an axiolateral oblique mandible projection for the ramus?

The region of interest.

Study the provided filament thermal emissions chart. Note the distinct shoulder on each kilovolt peak (kVp) curve. What do these shoulders indicate? The space charge limited region. Correct That excellent milliamperage (mA) reciprocity exists at 30 kVp. That the milliamperage (mA) is highly predictable at 40 kVp. The emissions limited region. Incorrect

The shoulders of filament thermal emissions charts indicate the space charge limited region. At this point, further increase in mA is limited by the space charge around the filament at the indicated voltage. One does not want to operate an x-ray tube in this region, because mA is unpredictable and nonlinear. One prefers to operate the tube in the emissions limited region at voltages higher than 40 kVp. Because of the space charge limitation, mA does not exhibit good reciprocity, nor is it predictable for the same reason, at voltages below 40 kVp.

The highest potential dose to the radiographer during c-arm fluoroscopy originates from which source?

The side where the x-rays enter the patient.

c. LUQ

The stomach is located primarily within the: a. RLQ b. RUQ c. LUQ d. LLQ

Consider this lateral lumbar spine image. Which strategy will have the greatest improvement on image quality? Select a faster speed image receptor. Increase milliampere-seconds (mAs). Incorrect Immobilize the patient. Correct Decrease the source to image receptor distance (SID).

This lumbar image shows loss of resolution due to blurring. Since the single greatest cause of loss of image sharpness is patient motion, immobilizing the patient will likely have the greatest improvement on image quality. Adjusting mAs will not affect image sharpness. Selecting a faster image receptor speed and decreasing SID will degrade image sharpness further.

Mid saggital

This plane is perpendicular to IR for AP (PA) projection of esophagus

Mid coronal plane CR to T5 - T6 Top of cassette 2 inches above shoulders

This plane is perpendicular to the IR for the lateral projection of the esophagus. CR? top of cassette?

RAO 35 - 40°

This position used during an esophagram best illustrates the esophagus between the heart and thoracic spine

What X-ray might evaluate Osgood'Schlatter?

Tibia fibula.

An emergency room physician suspects a 14-year-old male patient may have Osgood-Schlatter's disease. Which radiographic exam might the ER physician order to evaluate this?

Tibia-fibula.

Most appropriate reason for the application of gonadal shielding?

To safe guard the reproductive potential of patients - from possible genetic effects of radiation exposure. Gonadal shielding does NOT protect the patient from all internal scatter.

Which is the most appropriate reason for the application of gonadal shielding?

To safe guard the reproductive potential of patients.

For the tangential inferosuperior projection of the zygomatic arch how is the patients head position for depressed fracture of the right arch?

Toward the right.

A posteroanterior (PA) chest radiograph demonstrates the left clavicle closer to the center of the spine than the right clavicle. Which action should the radiographer take?

Turn right side closer to image receptor (IR)

A posteroanterior (PA) chest radiograph demonstrates the left clavicle closer to the center of the spine than the right clavicle. Which action should the radiographer take?

Turn the right side closer to the IR

Which steps increase contrast in fluoroscopy? (Select the two that apply.) Use a larger collimator field. Use a smaller collimator field. Correct Increase milliamperes (mA). Reduce kilovolts peak (kVp). Correct Increase kilovolts peak (kVp). Incorrect

Using a smaller collimator field increases contrast, by reducing scatter and secondary radiation production, and thus reducing fog. Reducing kVp increases contrast, at the risk of lowered penetration. Changing mA does not impact contrast, assuming adequate exposure is used. The use of a larger collimator field will reduce contrast by increasing secondary and scattered radiation production. Increasing kVp increases penetration and reduces contrast.

A patient's abdominal image reveals the presence of multiple phleboliths. Where are these small calcifications found?

Vein. A phlebolith is a small calcification commonly located in the veins of the lower part of the pelvis. Small calcifications in the ureter and/or the kidneys are referred to as renal, or urinary, calculi. Small stones that form in the gallbladder are known as gallstones, or choleliths.

l3-4

Vertebral level duodenal bulb/GB: *Hyposthenic/asthenic*

l1-2

Vertebral level duodenal bulb/GB: *Sthenic*

1) Electronic noise can produce noticeable white or dark lines of varying thicknesses running in the same direction across an image. 2) Utilizing a grid with a frequency the same as the laser raster pattern 3) Using a grid with the lead strips running parallel to the direction of the laser raster pattern, will create a Moire artifact.

What could cause a computed radiography image with very noticeable lines uniformly in the same direction over the entire image?

A named patient is called for a barium enema

What example represent a violation of patients rights?

Greater tissue density Increased thickness of body part Higher atomic number

What factors will result in greater x-ray attenuation? Absorption

Society of Motion Picture and Television Engineers (SMPTE) test pattern

What is a method of electronic display resolution quality control testing?

Classifies various energy levels of radiation received

What is an advantage of OSL?

0.1 Rem

What is the NCRP recommended maximum annual equivalent dose to the general public for frequent exposure? Infrequent exposure = .5 Rem

Posterior and distal to body

What is the Pylorus located in relation to the body?

APR gives an average technique for body part and may be a combination of manual technique and AEC

What is the function of anatomically programmed radiography (APR)?

controls the flow of electrons from the photocathode to the output phosphor

What is the function of electrostatic focusing lenses that are components of fluoroscopic image intensifier tubes?

90 degrees

What is the magnitude of the angle formed by the intervertebral foramina and the midsagittal plane in the thoracic spine?

100mR per hour

What is the maximum leakage radiation quantity permitted for diagnostic X-ray tube housing when measured at 1 meter from the housing

.25mm

What is the minimum protective thickness of lead curtains?

to shield the eye from extra light and allow fine details to be more easily seen.

What is the purpose of shuttering?

5 degrees for men, and 8 degrees caudad for women

What is the recommended central ray (CR) angle if the lumbar spine cannot be adjusted so it is horizontal for the lateral projection?

Trendelenburg position

What modification can be made to the AP projection UGI to rule out hiatal hernia?

Latent

What phase of acute radiation syndrome has the patient feeling better after vomiting/ nausea for 2 days

First trimester (8 weeks gestation)

What pregnant patients are at most risk for catastrophic embryonic damage from radiation?

Lower contrast, but greater error margin in central ray (CR) placement.

What results from utilizing a lower ratio grid?

Gastrogafin Isovue is more expensive

What type of contrast is best for a patient suspected of having a perforated bowel?

Short

What type of exposure time for upper GI?

Direct

What type of relationship does cell growth rate have on the sensitivity of tissues to ionizing radiation?

Dirt on the light guide or laser head will prevent light from the CR plate from being read, leaving a thin radiolucent line across the entire CR image.

What would a continuous, fine, horizontal white line across the computed radiography image indicate?

Roll or push the object

When attempting to move a 300 pound object, which rule of body mechanics represents the safest option?

distance

When dealing with radiation exposure, what is the most effective protection for the radiographer?

The inside wall of the adjacent room, when the tube is as near to it as it is in actual use.

When determining the thickness of a primary protective barrier in an x-ray department, distance is a factor. The measurement should be made from where to the x-ray tube?

b. a short exposure

When making a radiograph of the gastrointestinal tract, it is important to use: a. a long target-film distance b. a short exposure c. self-rectified equipment d. a low kVp range

Anterior and inferior

Where is the body of the stomach located in relation to the fundus?

Mid-lower leg.

Where is the central ray (CR) directed for an anteroposterior (AP) projection of the lower leg?

Third metacarpophalangeal joint

Where is the central ray (CR) directed for an oblique posteroanterior (PA) hand?

90 degrees and one meter from the patient

Where is the safest place for a radiographer to stand during digital flouro?

The dose will be less than entrance skin dose

Which accurately describes the radiation dose absorbed by bone marrow?

Increased photon flux to the image receptor (IR)

Which advantage does a 500 milliampere (mA) station have over a 200 mA station?

Can be used up to a year Highly accurate Does not fog Not affected by heat or moisture

Which are advantages of using a thermoluminescent dosimeter compared to a film badge?

Temporal

Which bone contains a mastoid process?

b

Which calculation is used to determine grid ratio? a. The width of the lead strips divided by the height of the lead strips. B. height of the lead strips divided by the width of the interspace material. c. the width of the interspace material divided by the lead strips d. the height of the lead strips divided by the width of the lead strips.

Scaphoid

Which carpal bone is most commonly fractured?

5 degrees caudad.

Which central ray (CR) angle is best for heavy, wide-hipped patients for lateral lumbar spine projections?

Perpendicular to the image receptor

Which central ray (CR) orientation is recommended for an anteroposterior (AP) knee projection if the measurement from the tabletop to the patient's anterior superior iliac spine (ASIS) is 22 cm?

Collimator restricts beam to AOI.

Which component of a diagnostic x-ray tube restricts the primary beam to the area of interest?

Amorphous selenium - direct capture DR Direct capture DR exhibits the highest contrast resolution currently since remnant x-rays are directly converted to electrons by the detector. Photostimulable CR and both forms of indirect capture DR exhibit lower contrast resolution than direct capture DR.

Which computed radiography (CR) or digital radiography (DR) system produces images with the highest spatial resolution?

Effusion in left lung

Which condition represents the most likely indication for an anteroposterior (AP) chest projection with the patient in the left lateral decubitus position?

Meniscus tea

Which condition warrants an arthrogram of the knee?

The shoulders are depressed. The chin is extended The shoulders are at equal distances from the image receptor (IR).

Which describes the correct positioning for a posteroanterior (PA) chest projection?

Graph where x-axis is the amount of exposure read, and the y-axis is the number of pixels. The histogram is then compared to stored "norm" of that same anatomical part. The histogram is not a routine part of the human visual image acceptance process. The algorithm is the mathematical analysis of acquired data. The quantization of the data occurs in the analog to digital converter (ADC).

Which description best defines a histogram?

Chicken Pox

Which disease requires the infected patient to be placed on airborne precautions?

Anteroposterior (AP), external oblique

Which elbow projection will show the radial head freest of superimposition?

Bring the image intensifier as close as possible to the patient

Which factor will decrease the patients dose during flouro?

Decreased filtration will allow more low-energy photons to reach the IR without affecting heat production

Which factor will increase x-ray beam quantity at the image receptor (IR) without increasing heat units produced by the tube?

Digital spot images

Which feature in digital flouroscopy is most likely to result in increased patient dose?

beam filtration

Which feature of flouroscopic equipment is designed to reduce entrance skin dose to the patient?

Lowest grid ratio requires the least amount of mAs

Which grid ratio results in the lowest dose to the patient, because less mAs is required?

The largest input screen

Which input image intensifier screen provides the patient the best protection during flouro?

Not fogged by heat

Which is an advantage of using optically stimulated luminescent dosimeter as opposed to a film badge?

Pneumonia

Which is the disease process that causes increased radiodensity in the lung fields on an image due to inflammation and accumulation of fluid?

.20 mSv

Which is the genetically significant dose for the population of the US

To safe guard the reproductive potential of patients

Which is the most appropriate reason for the application of gonad shielding?

Bowel perforation

Which is the most likely cause of free intraperitoneal air on an anteroposterior (AP) erect abdomen radiograph?

Increased patient comfort

Which is the primary advantage of using the Camp Coventry method instead of the Holmblad method when obtaining a tunnel view of the knee?

Asthenic.

Which patient body habitus may require the patient to be in the Trendelenburg position during a small bowel series?

Anteroposterior (AP), upright

Which position best demonstrates a posterior rib injury above the diaphragm?

Right anterior oblique (RAO).

Which projection best demonstrates the aortic impression on the esophagus in an esophagram?

Modified parietoacanthial (Modified Waters).

Which projection best demonstrates the tripod fracture of the orbit?

LPO

Which projection best illustrates stomach with barium filled body and fundus with pylorus and profile of air filled duodenal bulb?

Right anterior oblique (RAO

Which projection of the sternum is most likely to demonstrate a fracture?

Posteroanterior (PA) Oblique.

Which projection of the thumb requires digits two through five to be extended, with the palmar surface of the hand flat against the image receptor (IR) as if for a posteroanterior (PA) hand projection?

foot switch

Which protective feature is designed to reduce exposure to the patient during flouro?

Knowledge of proper radiation safety

Which qualification is needed to hold the position of radiation safety officer

medical x-rays

Which source of ionizing radiation represents the largest contribution of radiation dose on the US population?

The femoral neck is demonstrated without foreshortening.

Which statement accurately describes the appearance of a correctly positioned anteroposterior (AP) hip image?

Lethal dose for 50% of the population in 30 days

Which statement correctly describes the LD 50/30?

Retrograde urogram.

Which study is considered a nonfunctional examination of the urinary system?

Leakage

Which term describes stray radiation that is emitted through the x-ray tube housing?

indirect effect

Which term describes the process by which most xray induced cellular damage occurs?

AUTOMATIC RESCALING is the process by which images are automatically displayed with appropriate brightness levels, even if too much or too little exposure was used.

Which term refers to the process by which digital radiography (DR) systems adjust for exposure errors so that the image is displayed with proper brightness and contrast levels?

Noise; the amount of image noise increases when too few photons strike the image receptor

Which term refers to unwanted fluctuations in the brightness of an image?

A variable kVp exposure system will allow the radiographer to make fine changes in technique for small body parts.

Which type of exposure technique chart would allow the radiographer to make small, fine adjustments for orthopedic work?

Hinge

Which type of joint classification describes the joint between the foot and the tibia/fibula?

optically stimulated luminescent dosimeter

Which type of personnel dose monitoring device is the best at monitoring the whole body of radiographers?

Diagnostic x-rays (Low linear energy transfer)

Which type of radiation causes cells to demonstrate the greatest radiosensitivity when in an highly oxygenated state?

Photoelectric Effect

Which type of x-ray interaction results in the complete absorption of the incident photon by an orbital electron

Rem

Which unit of measurement was developed to account for the variation of biological harm caused by different types of radiation?

Large matrix - contains a large amount of small pixels resulting in fewer photons per pixels therefore likelihood of image noise.

Which will increase the appearance of noise in a digital image, assuming only the named factor in each response is changed? High kVp technique. Large matrix. Increased mAs. Short SID.

Hyperextension

Which wrist position radiographically demonstrates the carpal canal?

The radiographer

Who is responsible for the metallic artifact seen in the open mouth odontoid image?

this value can be used as a point of reference for the calculation of manual techniques

Why is it important for the radiographer to observe the milliampere seconds (mAs) readout at the end of each exposure when using automatic exposure control (AEC)?

Very high exposure to PT

Why is soft tissue later of esophagus not recomended?

Free air is demonstrated away from the gastric bubble

Why is the left lateral decubitus position recommended as part of an acute abdominal series?

A finished radiograph has marked quantum mottle. Positioning, collimation, and identification markers are correct. Which action should the radiographer take? A. Repeat the image with an appropriate increase in technical factors. B. Reprocess the image under a different algorithm to improve visual appearance. C. Alter the image window width and level to improve the visual appeal, then approve. D. Approve the image and send it to Picture Archiving and Communication System (PACS).

a

A radiographer is performing a portable abdomen is using an image receptor with an 8:1 grid. The radiographer knows a technique for the abdomen using a 12:1 grid is 80 kilovolts peak (kVp) using 50 milliampere-seconds (mAs). Which would the new technique be in order to maintain image quality? A. 80 kVp @ 40 mAs. B. 80 kVp @ 25 mAs. C. 80 kVp @ 30 mAs. D. 80 kVp @ 60.5 mAs.

a

How does emphysema impact radiographic imaging of the chest? A. Emphysema is a destructive disease, meaning the chest tissue is more radiolucent. B. Emphysema is an additive disease, meaning the chest tissue is more radiopaque. C. Emphysema has no effect on the chest tissue, requiring no technical compensation. D. Emphysema is a destructive disease, but this will not have an effect on the patient's mass.

a

How much compensation is needed for a change to a small focal spot? A. None. B. Add 30% to milliampere-seconds (mAs). C. Add 15% to kilovolts peak (kVp). D. Double milliampere-seconds (mAs).

a

If computed radiography (CR) imaging plates (IP) haven't been used, how often should they be erased? A. 48 hours. B. 72 hours. C. 96 hours. D. 24 hours.

a

In order to increase the number of shades of gray displayed on a digital image what should be done? A. Increase the window width. B. Increase the window level. C. Decrease the window level. D. Decrease the window width.

a

What would a continuous, fine, horizontal white line across the computed radiography image indicate? A. Dirt on the light guide or laser head. B. Backscatter artifact. C. Static electricity. D. A crack in the phosphor layer of the cassette.

a

Which term refers to the process by which digital radiography (DR) systems adjust for exposure errors so that the image is displayed with proper brightness and contrast levels? A. Automatic rescaling. B. Edge enhancement. C. Image inversion. D. Contrast manipulation.

a

an electron is slowed and changes direction. (electon is attracted to the positive nuclear charge of a tungsten atom and is slowed as it passes.)

a bremsstrahlung interaction is best described by which statement? a. an electron is slowed and changes direction. b. an electron strikes an inner shell electron c. a photon strikes an inner shell electron. d. a photon is slowed and changes direction.

How does a radiographer maximize signal to digital image receptors? (Select the three that apply.) A. Shorter source to image receptor distance (SID). B. Lower milliamperage (mA). C. Longer source to image receptor distance (SID). D. Compression of the body part. E. Longer exposure time.

a d e

1.60

a portable knee exam performed in the operating room results in a beam intensity of 2.5 r at 32 inches. what is the intensity of the beam if the same exposure factors are used for a post operative knee at a distance of 40 inches.

Perhaps the most important prerequisite to a successful BE examination is

a thoroughly clean large bowel. Any retained fecal material can simulate pathology. A single-contrast examination demonstrates the anatomy and contour of the large bowel, as well as anything that may project out from the bowel wall (eg, diverticula). In a double-contrast examination, the bowel wall is coated with barium and then the lumen is filled with air. This enables visualization of any intraluminal lesions such as polyps and tumor masses.

179. What is the minimum thickness of requirement for protective lead curtains? A 0.25 mm lead equivalence. B 1 mm lead equivalence. C 0.75 mm lead equivalence. D 0.35 mm lead equivalence.

a. 0.25 mm lead equivalence. Protective curtains are required to have a thickness of 0.25 mm of lead equivalence. While the curtains may be thicker, they are not required to be.

An erect abdomen or left lateral decubitus should be performed for demonstration of

air-fluid levels in the abdomen. The right lateral decubitus position is used to demonstrate the layering of gallstones. It will not show free air within the peritoneum because of the overlying gastric bubble on the elevated left side of the body

The erect position is most often employed to demonstrate

air-fluid levels in the chest or abdomen or both. However, patients having traumatic injuries must frequently be examined in the recumbent position. The recumbent position will not demonstrate air-fluid levels unless it is a decubitus position. If free air is being questioned, we will look for that quantity of air on the "up" side because air rises. However, because liver tissue is so homogeneous, a small amount of air will be more easily perceived superimposed on it, rather than on left-sided structures. Thus, an AP projection obtained in the left lateral decubitus position will best demonstrate small amount of free air because that air will be superimposed on the liver.

Ulceration

and formation of fistulous tracts often occur. Ulcerative colitis occurs most often in the young adult; its etiology is unknown, although psychogenic or autoimmune factors seem to be involved.

Where is the central ray positioned for a lateral sacrum?

at the level of the ASIS and 3 1/2 inches posterior

A breathing technique is planned for a right anterior oblique (RAO) sternum radiograph. The intended exposure is 50 milliampere-seconds (mAs) at 75 kilovolts peak (kVp) at 100 centimeter source to image receptor distance (SID). Which milliampere (mA) station is preferred, assuming the radiographer ensures exposure occurs during the act of inspiration? A. 100 B. 50 C. 25 D. 10

b

An imaging department, having difficulty obtaining acceptable tangential patella images, has opted to have the post processing mode set to "fixed" for all patella images. Why is this a good choice? A. Fixed mode does not recognize collimation borders. B. Fixed mode works well for exams where it is difficult to center the image on the image receptor (IR). C. Fixed mode ignores exposure index (EI) and is useful for body parts with a prosthesis. D. Fixed mode compares acquired data to a histogram and chooses appropriate brightness and contrast.

b

Computed radiography (CR) imaging creates images with poorer resolution than that of film screen. What compensates for this loss of resolution? A. The ability to reprocess images. B. The wide latitude. C. Use of edge enhancement. D. Use of high-pass filtering.

b

Determine the file size for an image with a 512 x 512 matrix and 12 gray scale bit depth. A. 262,144 bytes. B. 393,216 bytes. C. 3,145,748 bytes. D. 25,165,824 bytes.

b

If a radiographer wanted to double image density without doubling the patient's dose, which action should be taken? A. Double kilovolts peak (kVp). B. Increase kilovolts peak (kVp) by 15%. C. Increase milliampere-seconds (mAs) by 15%. D. Double milliampere-seconds (mAs).

b

If all the bucky digital images from one radiographic room seem to appear excessively noisy, what might the radiographer suspect? A. The x-ray room may need recalibration. B. The automatic exposure control (AEC) is set at an inappropriate speed class. C. There is a problem with the digital receptor. D. It could be an anomaly and should continue to be monitored.

b

In conventional tomography, the radiographer is able to control the thickness of the tomographic slice by altering which of the following? A. Fulcrum height. B. Exposure angle. C. Amplitude. D. Tube trajectory.

b

In which way can the radiographer minimize motion due to peristalsis? A. Give the patient explicit instructions. B. Decrease exposure time. C. Expose the radiograph on inspiration. D. Expose the radiograph on expiration.

b

Pelvis routine calls for an anteroposterior (AP) with a perpendicular central ray (CR), and an axial AP with a 40 degree cephalic angle. Using a caliper measurement, the technique chart yields a perfect set of exposure factors for the perpendicular AP. How will the necessary exposure factors for the axial differ from the perpendicular AP? A. Same measurement, but more bone, higher kilovolts peak (kVp) and milliampere-seconds (mAs). B. Greater measurement, higher kilovolts peak (kVp) and milliampere-seconds (mAs). C. Smaller measurement, lower kilovolts peak (kVp) and milliampere-seconds (mAs). D. Same measurement, same technical factors.

b

Which advantage does a 500 milliampere (mA) station have over a 200 mA station? A. Greater visibility of detail. B. Increased photon flux to the image receptor (IR). C. Longer exposure time. D. Higher load on the x-ray tube.

b

Which component of radiographic noise in digital imaging is controlled by the radiographer? A. Structure mottle. B. Quantum mottle. C. Film graininess. D. Electronic noise.

b

Which factor will increase x-ray beam quantity at the image receptor (IR) without increasing heat units produced by the tube? A. Decreased potential difference. B. Decreased filtration. C. Increased grid ratio. D. Increased source-image distance (SID).

b

Which factor would the radiographer choose to maximize recorded detail in the image? A. Low milliampere-seconds (mAs). B. Small focal spot. C. 100 cm source to image receptor distance (SID). D. High kilovolts peak (kVp).

b

Which statement is correct regarding the relationship of patient dose to exposure index (EI)? A. EI gives a very accurate representation of patient dose. B. EI gives an approximation of the patient's dose. C. EI gives an exact measurement of patient dose. D. EI is always greater than the patient's dose.

b

Which will increase the appearance of noise in a digital image, assuming only the named factor in each response is changed? A. Short SID. B. Large matrix. C. Increased mAs. D. High kVp technique.

b

Place the following milliampere-seconds (mAs) selections in order from which will cause the greatest exposure to the image receptors (IR) to the least exposure, if all other factors remain the same. a. 100 mAs. b. 200 mAs. c. 25 mAs. d. 50 mAs.

b a d c

What is the dose area product (DAP) if the collimated field is 10 X 10 cm with a dose of 2 roentgens/minute (R/min)? A. 100 R per cm squared. b. 20 R per cm squared. C. 200 R per cm squared. D. 10 R per cm squared.

b. 20 R per cm squared. DAP considers not only the dose, but also the volume of tissue irradiated. To arrive at the correct answer, the volume of tissue radiated (100 cm2) is multiplied by the dose received (2 R/min).

A step-up transformer with 300 turns in the primary coil is supplied with 220 volts to this primary. How many secondary turns are needed to produce a 66,000 volt output? A. 66,000 turns. B. 14 turns. C. 90,000 turns. D. 1 turn.

c

At a 50 inch source-to-image-receptor-distance (SID), how closely must the x-ray beam and the light field be aligned? A. 2 inches. B. 0.5 inches. C. 1 inch. D. 5 inches.

c

Digital radiography has the ability to produce 16,000 shades of gray. What appropriate bit depth (dynamic range) does this represent? A. 10 bit depth. B. 12 bit depth. C. 14 bit depth. D. 16 bit depth.

c

What is a method of electronic display resolution quality control testing? A. Detective quantum efficiency (DQE) test. B. Luminescence test. C. Society of Motion Picture and Television Engineers (SMPTE) test pattern. D. Wire mesh test.

c

What is the result if the total lead content of a grid is decreased? A. Greater image contrast. B. Increased scatter absorption. C. Decreased scatter absorption. D. Higher patient dose.

c

What results from utilizing a lower ratio grid? A. Higher contrast and greater latitude in central ray (CR) positioning. B. Higher contrast and less latitude in central ray (CR) positioning. C. Lower contrast, but greater error margin in central ray (CR) placement. D. Lower contrast, but less leeway in positioning the central ray (CR) to the grid.

c

Which function are Radiology information system (RIS) networks are capable of performing? A. Processing laboratory reports. B. Tracking billing information. C. Tracking radiology scheduling information. D. Recording and retrieving diagnostic images.

c

Which is one function of a picture archiving and communication system (PACS) network? A. Holding reports dictated by the radiologist. B. Listing inpatient ordering information. C. Downloading images from different imaging modalities. D. Tracking billing information.

c

Which is the preferred method for indicating the correct anatomic side on a radiographic image? A. Photoflash the marker on a corner of the image after exposure. B. Write the appropriate marker directly on the film after exposure. C. Place a side marker directly on the image receptor (IR) prior to exposure. D. Electronically annotate the correct side prior to exposure.

c

Which material is used on most anode disks and is light, strong, and heat-resistant? A. Chrome vanadium steel alloy. B. Mild steel. C. Molybdenum. D. Lead.

c

Which type of exposure technique chart would allow the radiographer to make small, fine adjustments for orthopedic work? A. Automatic exposure control (AEC). B. Anatomically programmed radiography (APR). C. Variable kilovolts peak (kVp). D. Fixed kilovolts peak (kVp).

c

What could cause a computed radiography image with very noticeable lines uniformly in the same direction over the entire image? (Select the three that apply.) A. Cassette exposed to the wrong side. B. Cassette was exposed to background radiation. C. Grid used with grid frequency equal to the image reader's laser scan lines. D. Grid utilized with grid lines running parallel to the laser scan lines of the image reader device. E. Noise resulting from the plate reader electronics.

c d e

Assuming other exposure factors remain the same, which source-to-image-receptor-distance (SID) causes the greatest reduction in x-ray quantity at the image receptor (IR)? A. 44 inches. B. 60 inches. C. 72 inches. D. 40 inches.

c. 72 inches

WHich are advantages of using a TLD compared to a film badge?

can be used up to a year, does not fog, highly accurate, and not affected by heat or moisture

About 30 minutes after the ingestion of fatty foods,

cholecystokinin is released from the duodenal mucosa and absorbed into the bloodstream. As a result, the gallbladder is stimulated to contract, releasing bile into the intestine

Historically, rhenium was alloyed to the tungsten in the filament of valve tubes to increase electron emission. What is the major reason this isn't used in x-ray tube filaments? A. To maximize the melting point of the filament. B. To increase the working life of the filament. C. To reduce the vaporization of the filament. D. To permit fine control of electron emission by filament heating current.

d

If a transformer has a greater number of turns in the secondary coil than in the primary coil, how will the output voltage be affected? A. Unable to determine from information given. B. Decreased. C. No change. D. Increased.

d

What is the purpose of shuttering? A. To improve image appearance and replace the need for close collimation. B. Solely to replace the need for close collimation. C. To remove extraneous information from the digital image and not overload the system with unneeded data. D. To black out areas of light and make fine details more visible.

d

Which best describes anode heel effect? A. Absorption of part of the x-ray beam by the target track. B. A phenomenon where x-ray intensity is greater under the anode. C. Absorption of part of the x-ray beam by the focusing cup. D. A phenomenon where x-ray intensity is greater under the cathode.

d

Which component of a diagnostic x-ray tube restricts the primary beam to the area of interest? A. Focusing cup. B. Protective housing. C. Electrostatic lenses. D. Collimator.

d

Which computed radiography (CR) or digital radiography (DR) system produces images with the highest spatial resolution? A. Photostimulable phosphor CR. B. Cesium iodide / amorphous silicon - indirect DR. C. Cesium iodide - indirect capture DR D. Amorphous selenium - direct capture DR.

d

Which description best defines a histogram? A. The quantization of photon data striking the image receptor (IR). B. The visual means for the radiographer to critique the radiographic image. C. The mathematical analysis of the data set received by the image receptor (IR). D. Graph where x-axis is the amount of exposure read, and the y-axis is the number of pixels.

d

Air or fluid levels will be clearly delineated only if the central ray is

directed parallel to them. Therefore, the erect or decubitus position should be used. Small amounts of fluid within the peritoneal cavity are best demonstrated in the lateral decubitus position, affected side down. Small amounts of air within the peritoneal cavity are best demonstrated in the lateral decubitus position, affected side up.

When dealing with radiation exposure, what is the most effective protection fro a radiographer?

distancce

c. consider the instrument contaminated and replace it with a sterile item.

during preparation for a surgical procedure an unopened sterile package becomes damp from an accidental spill of saline. which response most appropriate? a. quickly remove the instrument and at it to the sterile field. b. continue to use the damp instrument if sterility is not essential c. consider the instrument contaminated and replace it with a sterile item. d. dry the package with a sterile towel and continue preparations

With the body in the AP recumbent position, barium flows

easily into the fundus of the stomach, displacing the stomach somewhat superiorly. The fundus, then, is filled with barium, while the air that had been in the fundus is displaced into the gastric body, pylorus, and duodenum, illustrating them in double-contrast fashion. Air-contrast delineation of these structures allows us to see through the stomach to the retrogastric areas and structures. Anterior and posterior aspects of the stomach are visualized in the lateral position; medial and lateral aspects of the stomach are visualized in the AP projection.

The upper GI tract must be

empty for best x-ray evaluation. Any food or liquid that mixes with the barium sulfate suspension can simulate pathology. Preparation therefore is to withhold food and fluids for 8 to 9 hours before the examination, typically after midnight, as fasting examinations are usually performed first thing in the morning. Enemas until clear prior to the examination is a part of the typical preparation for barium enema/air contrast.

A fluoroscopic unit with spot device and tilt table should be used for

endoscopic retrograde pancreatography. The Trendelenburg position is sometimes necessary to fill the interhepatic ducts, and a semierect position may be necessary to fill the lower end of the common bile duct. Also necessary are a fiberoptic endoscope for locating the hepatopancreatic ampulla and polyethylene catheters for the introduction of contrast media.

What is the current recommendation from the national council on radiation protection regarding the scheduling of elective examinations on women who are in the child-bearing age range?

examinations should be scheduled a few days after the onset of menses

The respiration phase for the AP oblique projection of the lumbar spine is:

expiration

light, film density

faster speed screen= emits more _______ = greater

Rugae

gastric folds in the internal lining of the lesser curvature of the stomach?

Double-contrast examinations of the stomach or large bowel are performed to better visualize the

gastric or bowel mucosa

To reduce anxiety prior to the examination, the radiographer should

give the patient a full explanation of the enema procedure. This explanation should include keeping the anal sphincter tightly contracted, relaxing the abdominal muscles, and deep breathing. The barium suspension should be either just below body temperature (at 85° to 90°F) to prevent injury and bowel irritation or cold (at 41°F) to produce less colonic irritation and to stimulate contraction of the anal sphincter.

The condition in which an intervertebral disk "slips" and protrudes into the vertebral canal is called:

herniated nucleus pulposus (HNP)

how can digital radiography contribute to patient dose reduction today, in spite of generally being slower n system speed than 400 speed film screen system?

higher kVp should be used with digital

annually

how often should lead aprons be evaluated to determine if cracks or holes are present? monthly every 3 months annually every 6 months

The four body types (from largest to smallest) are

hypersthenic, sthenic, hyposthenic, and asthenic. The abdominal viscera of the asthenic person are generally located quite low, vertical, and toward the midline. The opposite is true of the hypersthenic individual: Organs are located high, transverse, and lateral.

Where is the 14X17 inch (35X43 cm) IR centered for a lateral lumbar spine?

iliac crests

Where is the IR centered for an AP projection of the lumbosacral spine?

iliac crests

Where is the central ray directed for a lateral lumbosacral spine?

iliac crests

Where is the central ray directed for an AP lumbosacral spine?

iliac crests

oblique position of the large bowel,

illustrating an "open" view of the hepatic/right colic flexure and ascending colon, with the splenic/left colic flexure superimposed on the descending colon. Therefore, the radiograph must have been made in either an RAO (if the patient was prone) or an LPO (if the patient was supine) position. The LAO and RPO positions are used to demonstrate the splenic flexure and descending colon free of self-superimposition. AP or PA axial is generally used to visualize the rectosigmoid colon.

The approximately 5-foot-long large intestine (colon) functions

in the formation, transport, and evacuation of feces. The colon begins at the terminus of the small intestine; its first portion is the dilated saclike cecum located inferior to the ileocecal valve (see Figure 6-90). Projecting posteromedially from the cecum is the short (approximately 3.5 inches) vermiform appendix. Its lumen is particularly narrow in adolescents and young adults and may become occluded by a fecalith and result in inflammation (appendicitis). The ascending colon is continuous with the cecum and is located along the right side of the abdominal cavity. It bends medially and anteriorly in the right hypochondrium, forming the right colic (hepatic) flexure. The colon traverses the abdomen as the transverse colon and bends posteriorly and inferiorly in the left hypochondrium, forming the left colic (splenic) flexure. The descending colon continues down the left side of the abdominal cavity, and at about the level of the pelvic brim, the colon moves medially to form the S-shaped sigmoid colon. The rectum is that part of the large intestine, approximately 5 inches in length, between the sigmoid and the anal canal.

If the patient was AP, barium would be located

in the fundus of the stomach because the fundus is more posterior, and barium would flow down to fill the posterior structure. If the patient was in the Trendelenburg position, barium flow to the fundus would be even more facilitated. If the patient was erect, air-fluid levels would be clearly defined. Additionally, the barium-filled stomach tends to spread more horizontally in the PA position (as is seen in the radiograph).

The ileocecal valve

is located at the terminal ileum, where it meets the first portion of the large bowel, the cecum. Most small-bowel examinations are performed following oral administration of barium sulfate suspension. The first small-bowel radiograph is taken 15 minutes after the first swallow of barium, with subsequent radiographs made every 15 to 30 minutes, depending on how quickly the barium is moving through the small bowel. Each image is shown to the radiologist, and a decision is made regarding the time of the next image. When the barium reaches the terminal ileum, fluoroscopy may be performed and compression spot images taken of the ileocecal valve.

A decubitus projection

is obtained using a horizontal x-ray beam. The type of decubitus projection depends on the patient's recumbent position. When the patient is laying anteroposterior (AP) recumbent, he or she is said to be in the dorsal decubitus position. When the patient is lying prone, he or she is in the ventral decubitus position. If the patient is lying in the left or right lateral recumbent position with the x-ray beam directed horizontally, the patient is said to be in the left or right lateral decubitus position, respectively.

The stomach

is the dilated saclike portion of the GI tract. When the stomach is empty, its mucosal lining forms soft folds called rugae. Gastritis is an inflammation of the gastric mucosa that can be caused by excessive secretion of acids or by ingestion of irritants such as aspirin or corticosteroids. Exteriorly, it presents a greater curvature on its lateral surface and a lesser curvature on its medial surface. The proximal opening of the stomach, at the gastroesophageal junction (GEJ), is the cardiac sphincter; the pyloric sphincter is located at its distal end. The portion of the stomach around the distal esophagus is called the cardia; that portion superior to the esophageal juncture is the fundus. The sharp angle between the esophagus and fundus is the cardiac notch. The major portion of the stomach is the body; the distal portion is the pylorus. The incisura angularis is located on the lesser curvature and marks the beginning of the pylorus. The distal portion of the pylorus is marked by the pyloric sphincter.

Barium sulfate suspension

is the usual contrast medium of choice for investigation of the alimentary tract. There are, however, a few exceptions. Whenever there is the possibility of escape of contrast medium into the peritoneal cavity, barium sulfate is contraindicated and a water-soluble iodinated medium is recommended, as it is easily aspirated before surgery. Rupture of a hollow viscus (eg, perforated ulcer) and patients who are scheduled for surgery are two examples. Patients with suspected large-bowel obstruction should also ingest only water-soluble iodinated media.

Which term describes stray radiation that is emitted through the x-ray tube housing?

leakage

As a result of imaging pregnant patients, which is the fetal exposure for most radiographic exams?

less than 1 rad

Lateral projections of the barium-filled stomach

may be performed recumbent or upright for the demonstration of the retrogastric space. With the patient in the (usually right) lateral position, the central ray is directed to a point midway between the midcoronal line and the anterior surface of the abdomen, at the level of L1. When the patient is in the LPO or RAO position, the central ray should be directed midway between the vertebral column and lateral border of the abdomen. For the PA projection, the central ray is directed perpendicular to the IR at the level of L2.

ERCP

may be performed to investigate abnormalities of the biliary system or pancreas. The patient's throat is treated with a local anesthetic in preparation for the passage of the endoscope. The hepatopancreatic ampulla (of Vater) is located, and a cannula is passed through it so that contrast medium may be introduced into the common bile duct. Spot images of the common bile duct and pancreatic duct are frequently taken in the oblique position. Direct injection of barium mixture into the duodenum occurs during an enteroclysis procedure of the small bowel.

Operative cholangiography

may be performed to visualize biliary stones or a neoplasm, determine the function of the hepatopancreatic ampulla, and examine the patency of the biliary tract. Any strictures or obstructions may be localized when contrast medium is introduced into the catheter and images are obtained. It is important that no air bubbles are introduced into the biliary tract because they can imitate radiolucent stones. The radiographer can coordinate the time of exposure with the anesthesiologist to obtain the radiographs during suspended respiration

Which of the following planes is placed perpendicular to the tabletop and centered to the midline of the grid for a lateral lumbar spine?

midcoronal plane

For the average patient, the central ray for a lateral projection of a barium-filled stomach should enter

midway between the midcoronal line and the anterior abdominal surface

bremsstrahlung

most x-rays in the useful beam are a. characteristic b. bremsstrahlung

Whenever a part is being radiographed for demonstration of air-fluid levels, the central ray must be directed

parallel to the floor. In this example, the patient was unable to tolerate the 90° tilt of the x-ray table. If the radiographer were to compensate for this by directing the central ray perpendicular to the IR (angling 20° caudad), it is very possible that any air-fluid level would be blurred and indistinct, and would go unrecognized. Remember that air or fluid always levels out parallel to the floor. Thus, if the air-fluid level needs to be demonstrated, the central ray must also be parallel to the floor.

Air or fluid levels will be clearly demonstrated only if the central ray is directed

parallel to them. Therefore, to demonstrate air or fluid levels, the erect or decubitus position should be used. Small amounts of fluid are best demonstrated in the lateral decubitus position, affected side down. Small amounts of air are best demonstrated in the lateral decubitus position, affected side up. Dorsal and ventral decubitus positions made with a horizontal x-ray beam can also be used to demonstrate air or fluid levels.

right lateral decubitus position

part of a series of radiographs made during an air-contrast (double-contrast) BE examination. A double-contrast examination of the large bowel is performed to see through the bowel to its posterior wall and to visualize any intraluminal (eg, polypoid) lesions or masses. Various body positions are used to redistribute the barium and air. To demonstrate the medial and lateral walls of the bowel, decubitus positions are performed. The radiograph presents a right lateral decubitus position, because the barium has gravitated to the right side (the side of the hepatic flexure). The air rises and delineates the medial side of the ascending colon and the lateral side of the descending colon. The posterior wall of the rectum could be visualized using the ventral decubitus position and a horizontal beam lateral of the rectum.

Which of the following will prevent the AEC detector from prematurely terminating the exposure during a lateral lumbar spine?

placing a sheet of rubber on the table behind the patient

Operative cholangiography

plays a vital role in biliary tract surgery. The contrast medium is injected, and imaging occurs following a cholecystectomy. This procedure is used to investigate the patency of the bile ducts, the function of the hepatopancreatic sphincter (of Oddi), and previously undetected biliary tract calculi.

Hiatal hernia

portion of the stomach herniates through the diaphragmatic opening

A double-contrast examination of the large bowel is performed to

see through the bowel to its posterior wall and to visualize any intraluminal lesions or masses. Oblique projections are used to "open up" the flexures: the RAO for the hepatic flexure and the LAO for the splenic flexure. To view the redundant S-shaped sigmoid in the AP position, the central ray is directed 30° to 40° cephalad. The central ray is reversed when the patient is PA; that is, the central ray is 30° to 40° caudal with the patient PA.

Polyp

small mass growing from the mucosal wall

Fluoroscopic imaging of the ileocecal valve is generally part of a(n)

small-bowel series

The condition of the lumbar spine in which there is anterior displacement of one vertebra over another is termed:

spondylolisthesis

Barium can dry and harden in the large bowel, causing

symptoms ranging from mild constipation to bowel obstruction. It is therefore essential that the radiographer provide clear instructions, especially to outpatients, for follow-up care, along with the rationale for this care. To avoid the possibility of fecal impaction, patients should drink plenty of fluids for the next few days, increase their dietary fiber, and take a mild laxative such as milk of magnesia

Radiographic examinations of the large bowel generally include

the AP or PA axial position to "open" the S-shaped sigmoid colon, the lateral position especially for the rectum, and the LAO and RAO (or LPO and RPO) to "open" the colic flexures. The left and right decubitus positions are usually employed only in double-contrast barium enemas to better demonstrate double contrast of the medial and lateral walls of the ascending and descending colon.

The position of the gallbladder varies with

the body habitus of the patient. Hypersthenic patients are more likely to have their gallbladder located high and lateral. The asthenic patient's gallbladder is most likely to occupy a low and medial position, occasionally superimposed on the vertebrae or iliac fossa. The LAO position is most often used to move the gallbladder away from the spine. The erect position would make the gallbladder move even more inferior and medial.

The term body habitus refers to

the body's physical appearance. Variations in body habitus have a significant effect on the shape and location of organs and can affect their function. It is essential that radiographers are knowledgeable about the characteristics of each body habitus and how to use that knowledge when imaging patients of varying habitus. The hypersthenic habitus is the largest of the four types. This type is large and heavy; the chest area is short, with a high diaphragm. The viscera (i.e., stomach, gallbladder, and colon) are usually high and lateral. The sthenic habitus is defined as an average athletic build. Compared with the hypersthenic, it is characterized by a longer chest and abdomen, with viscera located more medially. The hyposthenic habitus is slighter version of the sthenic—less athletic/strong. The asthenic habitus is the smallest/slightest of the four types. This habitus can be frail-looking, slender, and slight. The chest is long, and the abdominal viscera are located quite low and medial.

Which accurately describes the radiation dose absorbed by bone marrow?

the dose will be less than the entrance skin exposure

When determining the thickness of a primary protecctive barrier in an x-ray department, distance is a factor. The measurement should be made from where to the x-ray tube?

the inside of the wall of the adjacent room, when the tube is as near to it as it will be in actual use

fast moving electrons approach the nucleus of the target atom and slow down

the majority of x-rays in the useful beam are created as a result of which process? a. orbital electrons drop down to fill vacant inner shells b. fast moving electrons interact with the k shell electrons of the target atom c. orbital electrons become excited and release their energy. D. fast moving electrons approach the nucleus of the target atom and slow down.

During GI radiography,

the position of the stomach may vary depending on the respiratory phase, the body habitus, and the patient position. Inspiration causes the lungs to fill with air and the diaphragm to descend, thereby pushing the abdominal contents downward. On expiration, the diaphragm will rise, allowing the abdominal organs to ascend. Body habitus is an important factor in determining the size and shape of the stomach. An asthenic patient may have a long, J-shaped stomach, while the stomach of a hypersthenic patient may be transverse. The body habitus is an important consideration in determining the positioning and placement of the cassette. The patient position can also alter the position of the stomach. If a patient turns from the RAO position into the AP position, the stomach will move into a more horizontal position. Although the cardiac sphincter and the pyloric sphincter are relatively fixed, the fundus is quite mobile and will vary in position.

Placing the patient in a 20° to 30° AP Trendelenburg position during an upper GI examination helps demonstrate

the presence of a hiatal hernia. A 10° to 15° Trendelenburg position with the patient rotated slightly to the right will also help demonstrate regurgitation and hiatal hernia. Filling of the duodenal bulb and demonstration of the duodenal loop are best seen in the RAO position. Congenital hypertrophic pyloric stenosis is caused by excessive thickening of the pyloric sphincter. It is noted in infancy and characterized by projectile vomiting. The pyloric valve will let very little pass through, and as a result the stomach becomes enlarged (hypertrophied).

Increase in exposure

the radiographer is using automatic brightness control during a fluoroscopy. What change in patient exposure should the radiographer expect as the patient size increases? Reduction in exposure no change in exposure increase in exposure indeterminate change in exposure.

The LAO and RPO positions are used to demonstrate

the splenic flexure and descending colon free of self-superimposition. AP or PA axial is generally used to visualize the rectosigmoid colon.

Intussusception

the telescoping of one part of the intestinal tract into another. It is a major cause of bowel obstruction in children, usually in the region of the ileocecal valve, and is much less common in the adult. Radiographically, intussusception appears as the classic "coil spring," with barium trapped between folds of the telescoped bowel. The diagnostic BE procedure can occasionally reduce the intussusception, although care must be taken to avoid perforation of the bowel.

Oral administration of barium sulfate is used to demonstrate

the upper digestive tract: the esophagus; the fundus, body, and pylorus of the stomach; and the small bowel, consisting of duodenum, jejunum, and ileum. Consistent care must be taken to read and record patient information accurately and correctly. The large bowel is usually demonstrated via rectal administration of barium.

6

the z number os oxygen is 8. the elemental oxygen atom has two electron shells. how many electrons occupy an electrically neutral oxygen atoms outer shell? 2 4 6 8

What is the dose response relationship for radiation-induced skin cancer, such as has been documented in early radiologists?

threshold

What is the dose-response relationship of radiation induced skin cancer?

threshold

Which is the most appropriate reason for the application of gonadal shielding? - to shield the patient when the beam is not sufficiently collimated -to reduce the amount of internal scatter reaching the reproductive organs -to safe guard the reproductive potential of patients -to protect the reproductive organs within the field

to safe guard the reproductive potential of patients

Esophageal varices

tortuous dilatations of the esophageal veins. They are much less pronounced in the erect position and must always be examined with the patient recumbent. The recumbent position affords more complete filling of the veins, as blood flows against gravity.

In the PA position, portions of the barium-filled hypersthenic stomach

uperimpose upon themselves. Thus, patients with a hypersthenic body habitus usually present a high transverse stomach, with poorly defined curvatures. If the PA stomach is projected with a 35° to 45° cephalad central ray, the stomach "opens up." That is, the curvatures, the antral portion, and the duodenal bulb all appear as a sthenic habitus stomach would appear. A 35° to 40° RAO position is used to demonstrate many of these structures in the average, or sthenic, body habitus. A lateral position is used to demonstrate the anterior and posterior gastric surfaces and retrogastric space.

With oral administration, barium sulfate suspension would first pass through the

upper gastrointestinal (GI) tract—mouth, pharynx, esophagus, stomach (fundus, body, pylorus), small bowel (duodenum, jejunum, ileum), large bowel (cecum, ascending colon, right colic/hepatic flexure), transverse colon, left colic/splenic flexure, and descending colon, sigmoid colon, rectum).

D

what is the function of a rectifier? A. convert direct current to alternating current B. increase 60 hertz alternating current to high frequency current. C. change direct current to high frequency current D. convert alternating current to pulsating direct current.

half the speed of light

what is the maximum speed of filament electrons as they travel toward the anode? a. one eighth the speed of light b. half the speed of light c. the speed of light d. one fourth the speed of light.

remove the apron from use, visually inspect for defects, and fluoroscope for cracks.

what is the process if a lead apron is suspected of being defective? a. wait until the schedule semiannual apron inspection to act b. do a visual inspection. if nothing seen, return the apron for use c. place the apron at the back the apron rack soit is used only on rare occasions d. remove the apron from use, visually inspect for defects and fluoroscope for cracks.

low contrast situations

where is edge enhancement post processing be most helpful in digital radiography? a. high contrast situations. b. low contrast situations c. abdominal soft tissue studies d. spinal examinations

A

which condition must be met before diagnostically useful characteristic x-rays can be produced? a. an inner shell electron must be completely removed. b. a specific milliampere-seconds (mAs) should be selected c. tissues with high atomic numbers must be present d. characteristic x-rays can be produced only above 85 kilo electron volts (keV).

capacitor

which device temporarily stores an electric charge? a. rectifier b. diode c capacitor d. autotransformer

shuttering (shuttering is a post exposure processing technique that results in a black background surrounding the original collimated edges.)

which digital post processing results in a black background surrounding the original collimated edges? a. collimation b. subratraction c. beam restriction. d. shuttering

emphysema (changes in lung tissue cause for easy penetration)

which information in the patient history should prompt the radiographer to decide against using automatic exposure controls when taking a chest x-ray? a. emphysema b. pneumothorax c. chronic bronchitis d. oat cell carcinoma

kilovolts peak (kVp).

which item can be used as indicators of the quality of the diagnostic x-ray beam? A. exposure time b. kilovolts peak (kip) c. object to image receptor distance (OID) d. source to image receptor distance (SID

filament circuit (the filament circuit controls the amount of heat applied to the filament that is required to boil off the desired number of electrons)

which part of the x-ray circuit is controlled by adjusting the milliamperage (mA) setting on the operating console for the purpose of producing the heat necessary for thermionic emission. a. filament circuit b. secondary circuit c. primary circuit d. timer circuit.

A and D

which steps increase contrast in fluoroscopy? (select the two that apply.) a. use a smaller collimator field b. increase kilovolts peak (kVp). c. use a larger collimator field d. reduce kilovolts peak (kVp). e. increase milliamperes (mA)

primary

which term refers to the radiation that exits the x-ray tube through the collimator? a. remnant b. scatter c. primary d. leakage

remove fog from the background radiation

why should computed radiography (CR) image receptors (IR) be erased if they haven't been used? a. remove fog from background radiation b. eliminate phantom artifacts c. prevent a moire effect d. ensure dropout artifacts do not occur.