Mock Registry 2

What is the correct pixel size for a 17-inch FOV and a matrix size of 1024? A. 0.016 mm B. 0.42 mm C. 2.4 mm D. 60 mm

B. 0.42 mm pixel size= FOV/matrix size

Scottie dog of the lumbar spine

-EAR: superior articular process -FRONT FOOT: inferior articular process -EYE: pedicle -BODY: lamina -NOSE: transverse process

Which of the following indicates bradypnea? A. Less than 12 breaths per minute B. Less than 18 breaths per minute C. More than 20 breaths per minute D. More than 25 breaths per minute

A. Less than 12 breaths per minute

When performing a portable AP chest projection on a patient who is semi-upright, what is the correct angle for the central ray? A. No central ray angle is necessary B. Tube is angled and CR directed perpendicular to the long axis of the sternum C. Tube is angled ad CR directed parallel to the long axis of the sternum D. Tube is angled and CR directed 60 degrees to the long axis of the sternum

B. Tube is angled and CR directed perpendicular to the long axis of the sternum

Why would the Swimmer's position be used during an esophagram study to replace the lateral position? A. To reduce motion B. To reduce OID C. To better demonstrate upper esophagus D. To better demonstrate lower esophagus

C. To better demonstrate upper esophagus The lateral position for post-fluoroscopic images of the esophagram study is used to demonstrate anatomy of the esophagus free of superimposition. The esophagus should be well-visualized between the spine and heart, entirely filled with barium if possible. The optional Swimmer's position would be used to better demonstrate the upper esophagus if the patient has positioning limitations; this positioning would move the arms and shoulders out of the field of view

Which of the following is the first step to be taken in the performance of a radiographic examination? A. Obtain clinical history B. Provide appropriate patient assistance C. Verify patient identity D. Use appropriate infection control

C. Verify patient identity

Which of the following projections demonstrates the pisiform free of superimposition? 1. AP oblique of the wrist 2. Carpal tunnel projection of the wrist 3. Carpal bridge projection of the wrist A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

A. 1 and 2 only The pisiform is located on the medial aspect of the wrist. In order to free the pisiform from superimposition, the wrist can either be semi-supinated to bring the medial aspect of the wrist closest to the IR, or a tangential projection of the carpal tunnel can be performed to project the pisiform away from overlapping carpals

Consider the following scenario and determine which would apply. The radiographer receives an order for a chest x-ray on a patient whose name he remembers from high school. He is curious about his former acquaintance's condition and decides to examine the patient's medical history. On discovering that the patient was diagnosed with hepatitis C, he immediately sends a text message to another friend who knows the patient. A. HIPPA violation and slander B. Assault and battery C. Assault and HIPPA volation D. Libel and HIPPA violation

D. Libel and HIPPA violation

For a properly positioned AP Upright Abdomen, the central ray is directed to A. The mid-sagittal plane at the level of the iliac crests B. The mid-sagittal plane at the umbilicus. C. The mid coronal plane at the level of the iliac crests. D. The mid-sagittal plane and two inches superior to the iliac crests.

D. The mid-sagittal plane and two inches superior to the iliac crests.

Injection of iodinated contrast media may be contraindicated when a patient's creatinine level is A. Above 2.0 mg/dl B. Below 2.0 mg/dl C. Above 0.6 mg/dl D. Below 0.6 mg/dl

A. Above 2.0 mg/dl Blood chemistry should always be checked before administration of iodinated contrast media. High levels of creatinine indicate impaired renal function and may result in a toxic response to iodinated contrast media. The normal range for creatinine is 0.6-1.5 mg/dl

There are several types of DR image receptors used in digital imaging. All of the following use indirect capture EXCEPT: A. Amorphous selenium flat panel detectors B. Gadolinium amorphous silicon flat panel detectors C. Cesium iodide amorphous silicon flat panel detectors D. A charge coupled device

A. Amorphous selenium flat panel detectors Amorphous selenium is a type of flat panel detector that uses direct capture. The x-ray photons are converted directly into electrical signals (A). Both types of amorphous silicon flat panel detectors, gadolinium and cesium iodide, require two steps to convert the x-rays into light and into an electrical signal (B and C). A charge couple device (CCD) also uses indirect capture to produce the electrical signal (D).

Which of the following best describes the relationship between bit depth and contrast resolution? A. As bit depth increases, contrast resolution increases B. As bit depth increases, contrast resolution decreases C. As bit depth decreases, contrast resolution increases D. Bit depth as not affect on contrast resolution

A. As bit depth increases, contrast resolution increases

Sources of natural background radiation include the following (choose the 3 correct answers) A. Building materials B. Nuclear medicine C. Internal sources D. Thoron and radon gases E. Occupational sources

A. Building materials C. Internal sources D. Thoron and radon gases

Which of the following processing functions increases the sharpness of the details in an image? A. Edge enhancement B. Smoothing C. Look-up table D. Equalization

A. Edge enhancement Another name for edge enhancement is high-pass filtering. The purpose of edge enhancement is to make details more defined in the image, which will make them more visible (A). Smoothing can also be referred to as low-pass filtering and can result in a blurry image

Which 3 of the following instructions are a part of patient education following myelography? A. Increase fluid intake B. Avoid bending for a couple of days C. Notify a physician if unable to urinate D. Seizures are a possible complication and are not concerning E. Monoamine oxidase inhibitors must be discontinued for 2 weeks after the procedure

A. Increase fluid intake B. Avoid bending for a couple of days C. Notify a physician if unable to urinate

A condition, often resulting from chest trauma by motor vehicle accident or falling, in which the pleural space is filled with air, is called A. Pneumothorax B. Hemothorax C. Atelectasis D. Cardiac tamponade

A. Pneumothorax Pneumothorax is the condition of having air in the pleural space

Which position will best demonstrate the lumbar zygapophyseal joints closer to the IR? A. Posterior oblique B. anterior oblique C. AP position D. Lateral

A. Posterior oblique

How does the use of beam filtration affect the quantity and quality of the x-ray beam? A. The number of x-rays is decreased and the quality of the x-ray beam is increased. B. The number of x-rays is decreased and the quality of the x-ray beam is decreased. C. The number of x-rays is increased and the quality of the x-ray beam is increased. D. The number of x-rays is increased and the quality of the x-ray beam is decreased.

A. The number of x-rays is decreased and the quality of the x-ray beam is increased.

The term effective dose refers to A. whole-body dose B. localized organ dose C. genetic effects D. somatic and genetic effects

A. whole-body dose

Which of the following conditions can be possibly corrected with a contrast enema procedure? A. Ulcerative colitis B. Intussusception C. Adenocarcinoma D. Diverticulitis

B. Intussusception Intussusception involves a portion of the (large) bowel telescoping into an adjacent section of bowel (B). The pressure of barium contrast flowing through the colon can cause the intussusception to "reduce" itself and return to normal.

What suture separates the two parietal bones from the occipital bone? A. Coronal B. Lambdoidal C. Sagittal D. Squamosal

B. Lambdoidal The lambdoidal suture separates the two parietal bones from the occipital bone

Which of the following is correct regarding the relationship between matrix size and spatial resolution? A. As matrix size decreases, spatial resolution increases. B. As matrix size increases, spatial resolution decreases. C. As matrix size increases, spatial resolution increases. D. Spatial resolution is not affected by the size of the matrix.

C. As matrix size increases, spatial resolution increases.

Which of the following types of compensating filters would primarily be used for shoulder images? A. Wedge filter B. Trough filter C. Boomerang filter D. Bowtie filter

C. Boomerang filter The boomerang filter is primarily used for shoulders and the upper thoracic spine (C). The boomerang filter can also be used for a lateral knee.

The mathematical expression below relates to which law of electrostatics? I1/I2= D2^2/ D1^2 A. Distribution B. Concentration C. Repulsion-attraction D. Inverse square

D. Inverse square The inverse square law expresses the relationship between distance and intensity of radiation and governs the dose received. The law states: "The intensity of radiation is inversely proportional to the square of the distance from the source"

All women of childbearing age should be assessed for pregnancy before an examination. Risks to the fetus are 1. Minimal during first 2 weeks of pregnancy 2. Proportional to time and dose 3. Highest during the 2nd to 10th weeks A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D.1, 2, and 3

C. 2 and 3 only

An increase in technical factors is likely to be required for the following condition(s) 1. Emphysema 2. Atelectasis 3. Ascites A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only

Personnel dose is increased during which examination(s)? 1. CT 2. Fluoroscopy 3. Mobile imaging A. 1 only B. 2 only C. 2 and 3 only D. 1and 3 only

C. 2 and 3 only

Occupational exposure received by the radiographer is mostly from A. Compton scatter B. the photoelectric effect C. coherent scatter D. pair production

A. Compton scatter

Which of the following is responsible for correcting the brightness and contrast of an image, regardless of the technique used? A. Rescaling B. Smoothing C. Edge Enhancement D. Quantization

A. Rescaling Rescaling is a pre-processing function that automatically adjusts the brightness and contrast of an image

Quality control tests monitor the radiation output of x-ray equipment. Which quality control test confirms that when exposure time is adjusted to produce the same mAs at different mA stations, the same radiation intensity will be produced? A. Reproducibility B. Positive Beam Limitation (PBL) C. Linearity D. Exposure timer

C. Linearity Linearity states that when exposure time is adjusted to produce the same mAs at different mA stations, the same radiation intensity will be produced

Due to the utilization of low kVp techniques, which of the following examinations result in reduced personnel exposure? 1. Mammogram 2. Chest x-ray 3. PA abdomen A. 1 only B. 2 only C. 2 and 3 only D. 1 and 3 only

D. 1 and 3 only Lower kVp techniques result in lower scattered radiation. Scattered radiation from the patient increases risk for personnel occupational exposure. Both mammography and abdomen imaging require low kVp techniques due to low/decreased tissue contrast

Tilting of the head during positioning for the lateral skull would result in 1. Superior and inferior separation of orbital roofs 2. Anterior and posterior separation of EAM 3. Superior and inferior separation of sphenoid wings 4. Anterior and posterior separation of mandibular rami A. 1 only B. 4 only C. 3 and 4 only D. 1 and 3 only

D. 1 and 3 only Tilting of the head during lateral positioning causes insufficient demonstration of bony anatomy and requires repeat imaging. Tilt is evident by superior or inferior movement, while rotation is caused by anterior or posterior movement. If tilt is present in lateral skull positioning, the radiograph would show inferior and superior separation of symmetric horizontal structures, such as the orbital roofs and greater sphenoid wings

Which of the following pathologic conditions are considered additive conditions with respect to selection of exposure factors? 1. Osteoma 2. Bronchiectasis 3. Pneumonia A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3

For the AP axial projection of the skull, when utilizing the IOML as a landmark instead of the OML for positioning, what difference exists in the CR angulation? A. 5 degrees cephalic B. 5 degrees caudal C. 7 degrees cephalic D. 7 degrees caudal

D. 7 degrees caudal The OML is the most commonly used landmark for positioning of the AP axial skull projection. When patients are unable to flex their cervical spine for this projection, placing the IOML perpendicular to the IR can be a sufficient substitute. In this scenario, the CR must be angled an additional 7 degrees caudal to account for the 7-degree difference between the OML and IOML (D).

Which element of the transmission cycle of infection is a person with a chronic disease such as diabetes mellitus? A. A reservoir B. A portal of exit C. A means of transmission D. A susceptible host

D. A susceptible host A susceptible host is the final element in the cycle of infection transmission (D). Those who practice poor nutrition, are fatigued, or with chronic diseases are known as susceptible hosts.

Which of the following is/are considered form(s) of acute radiation syndrome? 1. Hematopoietic Syndrome 2. Gastrointestinal Syndrome 3. Syndrome X A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1 and 3 only

B. 1 and 2 only Acute Radiation Syndrome (ARS) is a collection of symptoms associated with high-level radiation exposure; there are 3 types. Hematopoietic Syndrome, which is sometimes referred to as bone marrow syndrome, usually occurs in people who receive whole-body doses of ionizing radiation in the range of 1 to 10 Gy (A). Gastrointestinal Syndrome usually occurs with a dose of more than 10 Gy but it can occur at doses as low as 6 Gy. Survival at this point is rare due to the destructive and non-repairable changes in the GI tract and bone marrow causing infection, dehydration, and electrolyte imbalance. A dose this great can cause death up to 2 weeks post exposure (B). Central nervous system (CNS) or cardiovascular (CV) syndrome occurs at doses greater than 50 Gy and death occurs in 2-3 days. Syndrome X is a group of risk factors that can refer to several different categories such as diabetes, cardiac, or metabolic syndromes (C and D)

Which of the following will result if magnification is used in a 20/9/6 inch image intensifier? 1. Spatial resolution improves 2. Patient dose increases 3. Focal point shifts closer to the output phosphor A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only If magnification is used with an image intensifier, spatial resolution will improve and smaller structures will be more visible. The downside when using magnification is that patient dose increases. When magnification is used in an image intensifier, the focal point shifts closer to the input phosphor. Spatial resolution is not the only correct option in the question (A). Spatial resolution will improve and patient dose will increase when using magnification (B). Patient dose will increase but the focal point shifts toward the input phosphor (C). Option D is incorrect as the focal point would shift closer to the input phosphor during magnification (D).

When performing an AP projection of the tibia and fibula, if the entire part cannot fit on one IR 1. Take two projections in order to include all anatomy 2. One smaller projection includes the joint farthest from the injury site 3. One smaller projection includes the joint closest to the injury site A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 only

B. 1 and 2 only It is ideal to try and obtain the entire tibia and fibula on one image, and this is typically achieved by turning the IR diagonally. However, if the patient is still unable to fit on one image, it is best to take two projections to include all necessary anatomy. The larger image should be taken to include the joint closest to the injury. The smaller image includes the joint farthest from the injury

Exposure cords for fixed equipment must be 1. Attached to the console 2. Short 3. Positioned to allow for the technologist to step outside of the console booth into the examination room during exposure A. 2 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 only

B. 1 and 2 only On fixed x-ray equipment, the exposure control cord should be attached to the console. The cord should be short in order to prevent the technologist from stepping outside of the control booth and into the examination room during exposure. Mobile equipment, on the other hand, requires the use of a long cord so that the technologist can step far enough away from the exposure for personal protection.

The AP projection of the elbow demonstrates which of the following bony structures? 1. Coronoid process 2. Radial head 3. Styloid process of the radius 4. Coracoid process A. 1 only B. 1 and 2 only C. 2 and 3 only D. 2 and 4 only

B. 1 and 2 only The bony anatomy of the elbow joint includes the distal humerus, proximal ulna, and proximal radius. The distal humerus includes both the lateral and medial epicondyles and condyles. The proximal radius includes the radial head, radial tubercle, and proximal radial shaft, while the proximal ulna includes the olecranon process, coronoid process, and proximal ulnar shaft. The coracoid process is located on the scapula and will therefore not be included in the AP projection of the elbow.

It is essential to be certain that the x-ray tube is in the proper detent locks before making an exposure because 1. Improper alignment of the tube and IR could cause incorrect exposure when utilizing AEC 2. Having the tube out of detent could cause anatomy cutoff 3. If the tube is not locked in the transverse position grid cutoff could occur, resulting in overexposure of the part A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only The detent locks function to assist the technologist in proper alignment of the tube to the Bucky and IR. If the tube is not locked in the correct detent positions, the primary beam could be offset to the AEC ionization chambers and result in either over- or underexposure of the part. Additionally, the incorrect alignment of the tube could cause anatomy cutoff since the light field would not be centered to the IR. While being offset in the transverse position could cause grid cutoff, the exposure would be insufficient rather than an overexposure, since the grid would end up absorbing more of the useful beam.

Which of the following is considered a safe gonadal radiation dose? A. 4 mrem B. No dose C. 5 rem D. 0.5 rem

B. No dose There is no 100% safe gonadal radiation dose; even the smallest radiation dose could cause some hereditary damage

The degree of x-ray beam attenuation is affected by 1. Muscle development 2. Z number of tissue 3. Tissue pathology A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2 and 3

D. 1, 2 and 3

In the context of a trauma situation, order the following in highest to lowest priority for evaluation when a patient reaches a trauma center. unordered list -Open fracture -Cardiac arrest -Vertebral fracture -Respiratory arrest

1. Respiratory arrest 2. Cardiac arrest 3. Vertebral fracture 4. Open fracture

Which of the following best describes the relationship between frequency and wavelength? A. As frequency increases, wavelength decreases B. As frequency increases, wavelength increases C. As frequency decreases, wavelength decreases D. Frequency and wavelength do not affect one another

A. As frequency increases, wavelength decreases INVERSE relationship

Which of the following positions will demonstrate the ribs closest to the IR? 1. RPO 2. LPO 3. RAO 4. LAO A. 1 and 2 only B. 1 and 4 only C. 2 and 3 only D. 3 and 4 only

A. 1 and 2 only When imaging the ribs, posterior and anterior oblique positions can be used. Posterior obliques (LPO, RPO) best visualize the ribs closest to the IR, while anterior obliques (LAO, RAO) provide better visualization of the ribs furthest from the IR. Therefore, the RPO and LPO positions would be utilized for the ribs closest to the IR (A).

Which of the following statements is/are false regarding occupational exposure during fluoroscopy? 1. Radiation exposure to the radiologist is higher when the tube is positioned below the patient 2. Beam-on time is directly proportional to occupational exposure 3. Remote fluoroscopy is preferable to reduce occupational exposure A. 1 only B. 2 only C. 1 and 2 only D. 1 and 3 only

A. 1 only In fluoroscopy, the radiographer and radiologist are at higher risk when the tube is positioned above the patient due to increased scattered radiation (A). Beam-on time, or the time that x-rays are being delivered, is directly proportional to dose: the longer the exposure, the higher the dose (B and C). Remote fluoroscopy reduces occupational exposure because the radiographer is behind a protective barrier and is not located in the examination room with the patient (D).

Which of the following is (are) located on the proximal aspect of the humerus? 1. Intertubercular groove 2. Capitulum 3. Coronoid fossa A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only The intertubercular (bicipital) groove is located on the proximal humerus, distal to the head, between the greater and lesser tubercles. The distal humerus articulates with the radius and ulna to form the elbow joint. The lateral aspect of the distal humerus presents a raised, smooth, rounded surface, the capitulum, which articulates with the superior surface of the radial head. The trochlea is on the medial aspect of the distal humerus and articulates with the semilunar notch of the ulna. Just proximal to the capitulum and the trochlea are the lateral and medial epicondyles; the medial is more prominent and palpable. The coronoid fossa is found on the anterior distal humerus and functions to accommodate the coronoid process with the elbow in flexion.

In scoliosis imaging, breast tissue dose for PA imaging is approximately ____ of the dose for AP imaging A. 1% B. 5% C. 10% D. 50%

A. 1% Scoliosis imaging is most often performed on pediatric patients. Therefore, the use of dose-reduction techniques is a crucial factor in these examinations. By positioning the patient for a PA projection, the dose to breast tissue is reduced to approximately 1% compared to the AP projection, with little impact on image quality

What is the correct angulation for an AP axial sacroiliac image on a male patient? A. 30 degree cephalad B. 35 degree cephalad C. 30 degree caudal D. 35 degree caudal

A. 30 degree cephalad Typically, the central ray is angled 30 degrees cephalad for the AP axial sacroiliac image on a male patient (A). The central ray is increased to 35 degrees cephalad for a female patient (B). If the patient is in a PA position, the central ray is angled 35 degrees caudad (C and D).

Which 3 of the following represent therapeutic nonverbal communication on the part of the radiographer? A. A facial expression or gesture that adds emphasis to the spoken word B. Nodding and maintaining eye contact while the patient is speaking C. A facial expression that contradicts the spoken word D. Using "I" statements E. Using humor to lighten every difficult situation F. Wearing professional attire

A. A facial expression or gesture that adds emphasis to the spoken word B. Nodding and maintaining eye contact while the patient is speaking F. Wearing professional attire

Which of the following types of DR image receptors uses a photoconductor? A. Amorphous selenium flat panel detectors B. Gadolinium amorphous silicon flat panel detectors C. Cesium iodide amorphous silicon flat panel detectors D. A charge coupled device

A. Amorphous selenium flat panel detectors Amorphous selenium is a type of direct capture flat panel detector. Photoconductors are used in the detectors so that x-ray photons are converted directly into electrical signals (A). The gadolinium amorphous silicon flat panel detectors (B) and cesium iodide amorphous silicon flat panel detectors (C) use scintillators to convert the x-rays into light and into an electrical signal. A charge couple device (CCD) also uses scintillators to convert the x-rays to light into an electrical signal (D).

Select 3 body mechanics practices used to reduce possibility of injury. A. Bend from the knees rather than from the waist B. Pull heavy objects, rather than push C. Change foot position, rather than twisting the body D. Moving heavy objects is safer when objects are held closer to center of gravity E. Standing with feet closer together improves stability

A. Bend from the knees rather than from the waist C. Change foot position, rather than twisting the body D. Moving heavy objects is safer when objects are held closer to center of gravity

Clostridium difficile, a spore-forming bacterium that can cause sepsis in susceptible patients, is spread by what mode of transmission? A. Contact B. Droplet C. Airborne D. Vector

A. Contact Clostridium difficile or C. difficile grows in the intestinal tract and is spread through contact with an infected person's fecal matter

Which of the following is increased when image latitude is decreased during post-processing? A. Contrast B. Window width C. Overall grays D. Long-scale contrast

A. Contrast Decreasing image latitude will produce an image with higher contrast (A). Image latitude and window width are directly related

Which imaging informatics system is a universal standard regarding how images are communicated between PACS and imaging modalities? A. DICOM B. HIS C. RIS D. HL7

A. DICOM Digital Imaging and Communications in Medicine (DICOM) is a universal standard regarding how information is communicated between PACS and imaging modalities

Quality control testing of digital display monitors should be conducted A. Daily B. Weekly C. Monthly D. Annually

A. Daily Although a comprehensive quality control program is strongly recommended, daily evaluation of digital display monitors is very important (A). This is best accomplished using the TG 18-QC test pattern. Many system performance changes can be readily spotted by the observant technologist, called to the attention of the physicist for further testing. A medical physicist must review the QC program periodically. Weekly, monthly, or annual quality control evaluations of digital display monitors is not timely enough to ensure consistencies in the diagnostic image display.

What structure can be located midway between the anterosuperior iliac spine (ASIS) and pubic symphysis? A. Dome of the acetabulum B. Femoral neck C. Greater trochanter D. Iliac crest

A. Dome of the acetabulum The dome of the acetabulum lies midway between the ASIS and the symphysis pubis. On an adult of average size, a line perpendicular to this point will parallel the plane of the femoral neck. In an AP projection of the hip, the CR should be directed to a point approximately 2 inches down that perpendicular line so as to enter the distal portion of the femoral head.

The purpose of magnification fluoroscopy is to: A. Enhance the image in order to facilitate diagnostic interpretation B. Decrease patient dosage C. Decrease fluoroscopy time D. Increase efficiency of X-ray production

A. Enhance the image in order to facilitate diagnostic interpretation Magnification of the image is an important feature of the image intensifier. The purpose of magnification fluoroscopy is to enhance the image in order to assist the radiologist in diagnostic interpretation (A). Magnification mode in fluoroscopy actually increases patient dosage (B), as more radiation is necessary to produce the brightness levels needed to view the images. The magnification mode should therefore be used only when necessary to enhance diagnostic interpretation of small specific anatomical areas in question. Fluoroscopy time should be limited in order to ensure the practice of ALARA. However, the time needed to evaluate the anatomical areas in question is not limited to a certain time (C). Magnification fluoroscopy neither increases or decreases fluoroscopic evaluation time. X-ray production efficiency is a function of the generator and X-ray tube providing the necessary X-ray energy to produce the fluoroscopic image. Magnification fluoroscopy, therefore, does not alter the efficiency of X-ray production (D)

What may occur if a high-pass filtering function is used on an image with high contrast? A. Excess noise B. Decreased noise C. Long-scale contrast D. Increase in overall grays

A. Excess noise The use of high-pass filtering, or edge enhancement, may increase the amount of image noise

The safe approach to avoid an exposure field recognition error when using CR is to: A. Expose one image on the smallest IP available with collimation margins aligned parallel to the edges of the IP B. Expose multiple images on one IP, but make sure all collimation margins overlap C. Expose one image on the IP, but do not collimate D. Expose multiple images on one IP, but make sure all collimation margins are parallel to each other and do not overlap

A. Expose one image on the smallest IP available with collimation margins aligned parallel to the edges of the IP The safe approach to avoid an exposure field recognition error when using CR is to acquire one image on the smallest IP available. Collimation margins should also be parallel to the edges of the cassette

Which of the following are parenteral routes of drug administration? (select the 4 correct responses) A. Intradermal B. Subcutaneous C. Oral D. Intra-arterial E. Rectal F. Intrathecal

A. Intradermal B. Subcutaneous D. Intra-arterial F. Intrathecal

Which 4 of the following topics are covered in the AHA Patient's Bill of Rights? A. Involvement in your care B. Protection of your privacy C. Death with dignity D. Discussing your treatment plan E. Understanding your healthcare goals and values F. Civil and criminal penalties for HIPAA violation

A. Involvement in your care B. Protection of your privacy D. Discussing your treatment plan E. Understanding your healthcare goals and values

A patient arrives at the emergency room by ambulance with a possible left humeral fracture. Due to the patient's condition, a transthoracic lateral projection will be performed to assess the proximal humerus. Which of the following is the correct position of the patient's left arm? A. Left arm in a neutral position B. Left arm in an internal rotation C. Left arm in an external rotation D. Left arm is elevated above the patient's head

A. Left arm in a neutral position When performing a transthoracic lateral projection of the humerus, the arm should remain in a neutral position (A). Keeping the arm in a neutral position places the humeral epicondyles perpendicular to the image receptor

The usual patient preparation for a UGI examination is A. NPO 8 hour before the examination B. light breakfast only the morning of the examination C. clear fluids only the morning of the examination D. two ounces of castor oil and enemas until clear

A. NPO 8 hour before the examination

Stochastic effects of ionizing radiation are associated with the following (select the 5 correct answers) A. No threshold B. All early effects C. Nonlinear D. Genetic effects E. Cancer F. Most late effects G. No safe dose

A. No threshold D. Genetic effects E. Cancer F. Most late effects G. No safe dose

Which of the following conditions presents as reduced bone mass? A. Osteopenia B. Osteomyelitis C. Osteoarthritis D. Osteomalacia

A. Osteopenia Osteopenia is any decrease in bone mass below normal (A). The rate of bone synthesis is too low to compensate for the normal process of bone resorption. Osteopenia is often a precursor for osteoporosis, a more severe condition of low bone density and deterioration of bone structure

Radiographers must have an awareness of cultural groups in order to achieve professional and effective communication. Select the three cultural groups identified below: A. Perceived gender B. Generational C. Skin and hair color D. Religious

A. Perceived gender B. Generational D. Religious

The energy of the incident photon is completely absorbed during which of the following x-ray interactions with matter? A. Photoelectric absorption B. Bremsstrahlung C. Compton interaction D. Coherent scattering

A. Photoelectric absorption During photoelectric absorption the incident photon gives up all of its energy to the atom; in other words, the photon is truly absorbed and disappears during the interaction.

All of the following can be used in image intensification systems EXCEPT: A. Photostimulable phosphor plate B. Flat panel detectors C. Charge coupled device D. Complementary metal oxide semiconductor

A. Photostimulable phosphor plate Flat panel detectors (B), charge coupled devices (C), and complementary metal oxide semiconductors (D) can all be used in fluoroscopy systems instead of the traditional image intensifier. A photostimulable phosphor plate, normally used in computed radiography, is not used in place of the traditional image intensifier (A).

Which of the following describes the distance from the side of one pixel to the opposite side of that same pixel? A. Pixel size B. Pixel density C. Pixel pitch D. Fill factor

A. Pixel size

Which of the following devices is used to determine blood oxygenation levels? A. Pulse oximeter B. Sphygmomanometer C. Stethoscope D. Cardiac telemeter

A. Pulse oximeter

Which of the following is responsible for producing the diagnostic portion of the image on the image receptor? A. Remnant radiation B. Scatter radiation C. Primary radiation D. Penumbra

A. Remnant radiation Remnant radiation is radiation that results after the x-ray beam exits the object. The remnant radiation produces an image in the image receptor

Which of the following will result if OID is increased? A. Size distortion B. Shape distortion C. Increased spatial resolution D. Increased receptor exposure

A. Size distortion

Along with complete information on the potential risks and benefits of the procedure, valid informed consent is not complete without the following (select the 2 correct responses) A. Suggested alternatives B. Warning that consent is not revocable C. Blanket disclaimer for any deviations from customary protocol D. An offer to answer question about the procedure E. Documentation of prescription for narcotics if the patient signs the consent under the influence of narcotic medication

A. Suggested alternatives D. An offer to answer question about the procedure

The legal doctrine of res ipsa loquitor can be literally interpreted as A. The thing speaks for itself B. Let the master respond C. Reckless disregard for life and limb D. Borrowed servant

A. The thing speaks for itself Res ipsa loquitor is literally translated from Latin as "the thing speaks for itself" (A). This legal doctrine can be applied when a negligent act by a healthcare provider and the subsequent loss or harm is so easily apparent that anyone would find it obvious.

Which of the following methods of radiation dosimetry is most commonly used for patients and personnel? A. Thermoluminescence dosimetry (TLD) B. Geiger-Muller counter C. Photographic emulsion D. Scintillation detector

A. Thermoluminescence dosimetry (TLD) TLD dosimetry has the sensitivity and accuracy required to serve as both personnel monitor and patient dose measurement

If a structure having less tissue density than the part of interest is positioned over the AEC detector, which of the following will result? A. Underexposure B. Overexposure C. distorted image D. correct exposure

A. Underexposure AEC is used to automatically regulate the amount of ionizing radiation delivered through the anatomic part to the IR, thereby serving to produce consistent and comparable radiographic results with minimum patient exposure. Exact positioning and centering are critical when using AEC. The anatomic part of interest must be aligned accurately with the AEC sensors; otherwise, the result can be over- or underexposure. The correct AEC sensors must be selected. If the AEC detectors are incompletely covered by anatomy, premature termination of exposure will likely result, resulting in quantum noise. If a structure having less tissue density than the part of interest is incorrectly positioned above the detector, or if the detector is incompletely covered, the detector will terminate the exposure more quickly and the area of interest will be underexposed

Which of the following examinations of the urinary system demonstrates function? A. Voiding cystourethrography B. Retrograde urethrography C. Retrograde urography D. Retrograde cystography

A. Voiding cystourethrography Following a cystourethrography, a patient may be asked to void while images are taken (A). This is a functional study of the bladder and urethra, evaluating the patient's ability to urinate. Retrograde studies do not assess the physiologic processes that normally occur in the body. Retrograde urethrography is used to assess the urethra (B). Retrograde cystography is a nonfunctional examination used to assess the urinary bladder (D). During a retrograde urography study, contrast is injected into the pelvicalyceal system to assess the urinary system (C).

What is the correct central ray direction for a PA projection of the paranasal sinuses, Caldwell method? A. horizontal beam B. 15 degrees caudad C. 15 degrees cephalad D. 25 degrees caudad

A. horizontal beam X-ray examinations of the paranasal sinuses look to identify air/fluid levels; the central ray should be horizontal with no angulation

The AEC will provide an exposure that produces a diagnostic image when the tissue of interest A. is placed directly over the photocell. B. is placed directly under the photocell. C. is partially over the photocell. D. is partially under the photocell.

A. is placed directly over the photocell. When using automatic exposure control/AEC, proper positioning is very important. For example, the center ionization chamber/photocell would be selected for a lateral lumbar spine and the vertebral bodies should be centered to the photocell. The AEC will provide an exposure that produces a diagnostic image for whatever anatomical tissue is placed directly over the photocell. If the part was positioned too anteriorly, and the spinous processes were positioned directly over the photocell, the image would likely be underexposed because the AEC was "seeing" the much less dense spinous processes rather than the much more dense vertebral bodies.

Which three of the following diseases are spread by vector transmission? A. malaria B. bubonic plague C. gonorrhea D. Lyme disease E. syphillis F. athletes foot

A. malaria B. bubonic plague D. Lyme disease

Before bringing each patient into the radiographic room throughout the day, the radiographer should 1. clean the x-ray table and change the pillowcase. 2. assemble the accessories needed for the examination. 3. warm the x-ray tube anode. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only The patient naturally will feel more comfortable and confident if brought into a clean, orderly, x-ray room that has been prepared appropriately for the examination to be performed. A disorderly, untidy room and a disorganized radiographer hardly inspire confidence; more likely, they will increase anxiety and apprehensiveness. The x-ray tube's anode only needs to be warmed when it is cold, at the beginning of the day, not before every patient.

Which of the following images require(s) superimposition of the distal radius and ulna? 1. Lateral hand 2. Lateral forearm 3. Lateral thumb A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only When the hand, wrist, and forearm are in the true lateral position, the distal radius and ulna will be superimposed over each other. For the lateral hand and lateral forearm projections, the wrist will be in the true lateral position. However, for the lateral image of the thumb, the hand will only be slightly medially rotated to bring the thumb into the true lateral position.

Which of the following methods can be utilized to determine if a patient is pregnant? 1. Posting of signs that advise patients to notify the technologist if pregnancy is possible 2. Utilization of questionnaires that question menstrual cycle dates and chances of pregnancy 3. Visual inspection of the patient to determine if they are pregnant 4. Questioning women of reproductive potential before each exam A. 1 and 2 only B. 1, 2, and 4 only C. 2, 3, and 4 only D. 1, 2, 3, and 4

B. 1, 2, and 4 only

What disadvantages come with the use of TLD personnel monitoring? 1. Loss of information when exposed to heat and moisture 2. Cost compared to film badges when read monthly 3. Decreased sensitivity to film badges A. 1 only B. 2 only C. 2 and 3 only D. 1 and 2 only

B. 2 only Some of the advantages of TLD personnel monitoring is the ability of the dosimeters to attenuate radiation similar to tissue, therefore increasing the accuracy of readings compared to film badges (C). TLD also offers increased protection from the elements and is less sensitive to heat and humidity, which would cause fogging on film badges (A and D). The major disadvantage of TLD is their cost; when read monthly, the cost is roughly double compared to film badges. However, their level of accuracy permits quarterly readings thereby decreasing the cost (B).

Which of the following examinations is/are likely to increase personnel dose? 1. Remote fluoroscopy 2. Mobile imaging 3. General radiography A. 1 only B. 2 only C. 1 and 2 only D. 1, 2, and 3

B. 2 only While fluoroscopy does increase personnel dose due to the proximity to the patient and x-ray beam, remote fluoroscopy does not require the technologist to be in the room with the patient during the exam and results in low personnel dose risk similar to that of general radiography. Mobile imaging, however, poses a higher risk to personnel due to the limited availability or use of protective barriers. Ways to reduce personnel exposure during mobile imaging include long exposure cords to increase distance from the beam, personnel protection such as lead aprons and goggles, and practice of ALARA techniques.

When performing a GI series, which of the following structures is (are) not demonstrated with the use of oral barium? 1. Duodenal bulb 2. Pyloric antrum 3. Splenic flexure 4. C-loop of duodenum A. 2 only B. 3 only C. 1 and 4 only D. 2 and 3 only

B. 3 only Exams utilizing oral barium include the esophagram, modified barium swallow, and upper GI series. In these exams, anatomy of the upper gastrointestinal tract is of interest. The duodenal bulb, pyloric antrum, and c-loop of the duodenum are all of interest in the upper GI series (A, C, and D). Therefore, the splenic flexure of the colon would not be well visualized (B). In order to demonstrate pathology of the splenic flexure, a barium enema must be performed, which does not use oral contrast agents.

Which of the following is the guideline for central ray angulation for an AP projection of the knee of a patient with thin thighs and buttocks? A. 0-degree central ray angle B. 3 to 5 degrees caudal angle C. 3 to 5 degrees cephalic angle D. 5 to 7 degrees cephalic angle

B. 3 to 5 degrees caudal angle A 3- to 5-degree caudal angle is used for patients with thin thighs and buttocks (B). No central ray angle is used on an average sized patient (A). A 3- to 5-degree cephalic angle is used on patient's with thick thighs and buttocks (C). The purpose of the angle is to place the central ray parallel to the tibial plateau. A 5- to 7-degree cephalic angle is used on the lateral projection of the knee to superimpose the femoral epicondyles (D).

What is the attenuation percentage for 0.25 mm Pb equivalent aprons at 75 kVp? A. 51% B. 66% C. 88% D. 94%

B. 66% At 75 kVp, they offer 66% and at 100 kVp they offer 51%

When imaging the lateral thoracic spine, and using suspended respiration technique, exposure upon full inspiration can be used to A. Demonstrate anatomy below the diaphragm B. Achieve a more uniform tissue density of the vertebrae above diaphragm C. Blur superimposed rib and lung markings D. Reduce production of scatter radiation

B. Achieve a more uniform tissue density of the vertebrae above diaphragm

Which of the following is an acceptable form of electronic data manipulation? A. Shuttering or masking out areas of the acquired image B. Adding annotation when the lead marker is collimated out of the image field C. Overwriting an image acquired under the correct processing algorithm with an image reprocessed under an alternative processing algorithm that improves the grayscale D. Applying smoothing to an image that demonstrates quantum mottle if it produces an image that appears acceptable

B. Adding annotation when the lead marker is collimated out of the image field Although every attempt should be made to have a lead marker completely visible in the final image, adding an electronic marker to clarify if initials or part of the marker is obscured, or other annotation (such as time on timed images) according to institutional policy is acceptable

Which of the following cells is the least radiosensitive? A. Myelocytes B. Myocytes C. Megakaryocytes D. Erythroblasts

B. Myocytes Bergonié and Tribondeau theorized in 1906 that all precursor cells are particularly radiosensitive (e.g., stem cells found in bone marrow). There are several types of stem cells in bone marrow, and the different types differ in degree of radiosensitivity. Of these, red blood cell precursors, or erythroblasts, are the most radiosensitive. White blood cell precursors, or myelocytes, follow. Platelet precursor cells, or megakaryocytes, are even less radiosensitive. Myocytes are mature muscle cells and are fairly radioresistant.

Which of the following is correct regarding the relationship between pixel size, pixel pitch, and spatial resolution? A. As pixel size decreases, pixel pitch increases, and spatial resolution increases B. As pixel size decreases, pixel pitch decreases, and spatial resolution increases C. As pixel size increases, pixel pitch increases, and spatial resolution increases D. As pixel size increases, pixel pitch decreases, and spatial resolution decreases

B. As pixel size decreases, pixel pitch decreases, and spatial resolution increases The pixel size is measured from side to side of a single pixel. The pixel pitch is measured from the middle of one pixel to the middle of an adjacent pixel. Spatial resolution is the sharpness of the image details. As pixels become smaller or decrease in size, the distance from the middle of two adjacent pixels decreases. When the pixels are smaller, more image detail is possible

Which 2 of the following communication techniques should be employed by a radiographer? A. Using medical terms instead of lay terms to demonstrate that the radiographer is a knowledgeable medical professional. B. Asking the patient to verbally summarize the consent form, to ensure that the patient understands what he or she is signing. C. Using familiar terms, such as "sweetie," to put a patient at ease and establish a comfortable relationship. D. Speaking more clearly and slowly to improve understanding when the situation is urgent or stressful.

B. Asking the patient to verbally summarize the consent form, to ensure that the patient understands what he or she is signing. D. Speaking more clearly and slowly to improve understanding when the situation is urgent or stressful.

The process by which a contaminated object, such as a portable x-ray machine, is cleaned, first by mechanical means and then by wiping or soaking in chemical solutions is called what? A. Antisepsis B. Disinfection C. Sterilization D. Asepsis

B. Disinfection Disinfection is the process by which a non-human object is cleaned if it cannot be sterilized

Which pulse point would a radiographer use to take a pulse when there is questionable compromised peripheral circulation following catherization of the femoral artery or casting of a lower extremity? A. Apical B. Dorsalis pedis C. Carotid D. Brachial

B. Dorsalis pedis The dorsalis pedis or pedal pulse, taken over the instep of the foot, is a significant indicator of blood flow to the lower extremity (B). In trauma, following femoral artery catherization, or after casting of the lower extremity, it is important to determine whether the circulation has been compromised. A palpable pedal pulse indicates that peripheral circulation is uncompromised.

What form of filtering amplifies high frequencies to increase contrast of large structures? A. Smoothing B. Edge enhancement C. Window level D. Window width

B. Edge enhancement Edge enhancement is the process of including fewer pixels in the averaging of neighboring pixels. When pixels are suppressed and fewer are included in the average a shorter scale of contrast is produced

All of the following describe the placement of organs in an asthenic body habitus except A. Low diaphragm B. Gallbladder centered on the right, upper abdominal region C. Heart is near midline and vertical D. Stomach is low and medial

B. Gallbladder centered on the right, upper abdominal region Asthenic patients have a frail build, wide pelvis, and a short abdomen. They also have a long, shallow thorax. As for the placement of organs, the heart is nearly vertical and at midline, the lungs are long, the diaphragm is low, the stomach sits low and medial, and the gallbladder is low and nearer the midline (A, C, and D).

When irradiated in an oxygenated (aerobic) state, biologic tissue _______________ to radiation compared to when it is exposed to radiation under anoxic or hypoxic conditions. A. Is less sensitive B. Is more sensitive C. Has the same sensitivity D. Becomes more immune

B. Is more sensitive When irradiated in an oxygenated, or aerobic, state, biologic tissue is more sensitive to radiation than when it is exposed to radiation under anoxic (without oxygen) or hypoxic (low oxygen) conditions. This is known as the oxygen effect. The oxygen enhancement ratio describes this effect numerically

Compared to centering for the lateral cervical spine, centering for the lateral upper airway is A. Lower and more posterior B. Lower and more anterior C. Higher and more posterior D. Higher and more anterior

B. Lower and more anterior The centering for the lateral cervical spine should be to C5 at the MCP, which would place the cervical spine in the center of the IR. For the lateral upper airway the area of interest is the larynx and trachea and the CR is directed to C 6/7, midway between the laryngeal prominence and jugular notch. Therefore, the CR to enters lower and more anterior than for a lateral cervical spine

When performing the parietoacanthial projection of the facial bones, which of the following is the correct patient position and exit point for the central ray (CR)? A. OML perpendicular to the IR with the CR exiting at the acanthion B. MML perpendicular to the IR with the CR exiting at the acanthion C. LML perpendicular to the IR with the CR exiting at the acanthion D. OML perpendicular to the IR with the CR exiting at the nasion

B. MML perpendicular to the IR with the CR exiting at the acanthion The parietoacanthial projection is also known as the Waters Method. The MML (mentomeatal) line is positioned perpendicular to the IR and the CR should exit the acanthion when assessing the facial bones or orbits

For oblique positioning of the cervical spine, why are anterior oblique positions preferred over posterior oblique positions? A. Better visualization of intervertebral foramina on the side furthest from the IR B. Reduced thyroid dose C. Better visualization of pedicles furthest from IR D. Less rotation needed

B. Reduced thyroid dose Additionally, the PA beam direction results in reduced dose to the thyroid, an advantage over the posterior oblique positions

Which of the following is visualized in a left posterior oblique position of the cervical spine? A. Left intervertebral foramina B. Right intervertebral foramina C. Left zygapophyseal joint D. Right zygapophyseal joint

B. Right intervertebral foramina The left posterior oblique (LPO) position of the cervical spine demonstrates the right intervertebral foramina (B). The RPO position demonstrates the left intervertebral foramina (A). Posterior oblique positions demonstrate the foramina away from the IR. The cervical intervertebral foramina are demonstrated closer to the IR in the anterior oblique (RAO and LAO) positions. The zygapophyseal articulations are demonstrated in the lateral projection/position (C and D).

The main source of radiation exposure for personnel during fluoroscopic exams is A. Leakage from the tube B. Scatter from the patient C. The primary beam D. Secondary radiation from tube housing

B. Scatter from the patient

Which of the following combination of factors will cause the anode heel effect to be more pronounced? A. Smaller anode angle, longer SID, and larger field size B. Smaller anode angle, shorter SID, and larger field size C. Larger anode angle, longer SID, and smaller field size D. Larger anode angle, shorter SID, and larger field size

B. Smaller anode angle, shorter SID, and larger field size

Which of the following describes the section of the histogram that will be included in the displayed image? A. Region of interest B. Values of interest C. Dynamic range D. Window level

B. Values of interest Values of interest (VOI) is the section of the histogram that will be included in the displayed image. The VOI usually excludes anything to the left of SMIN and the right of SMAX of the histogram. This section is where a majority of the image information is located

What is the first technical factor to consider adjusting if quantum mottle is visible with a direct relationship exposure indicator x-ray system? A. decrease mAs B. increase mAs C. decrease kVp D. increase kVp

B. increase mAs Quantum mottle or noise commonly occurs when an insufficient amount of x-ray exposure has reached the image receptor. If quantum mottle is present in an image, first consider increasing the mAs

Sufficient dose of ionizing radiation to the fetus during the early part of the first trimester of pregnancy can potentially cause A. spontaneous abortion B. skeletal anomalies C. neurologic anomalies D. gastrointestinal anomalies

B. skeletal anomalies Skeletal anomalies usually appear if irradiation occurs in the early part of this time period

Select the three correct statements below regarding fixed vs. variable kV technique charts A. mAs is variable when using a variable kV chart B. the fixed kV chart is most commonly used C. each body part has a specific kV when using a variable kV chart D. kV is increased by 2 for each cm increase in thickness when using a variable kV chart E. accurate caliper measurement is required when using a variable kV chart F. mAs compensates for patient size and condition variation in a variable kV chart

B. the fixed kV chart is most commonly used D. kV is increased by 2 for each cm increase in thickness when using a variable kV chart E. accurate caliper measurement is required when using a variable kV chart

Film badges utilize filters composed of which materials? 1. Aluminum 2. Cesium oxide 3. Copper 4. Cobalt A. 1 and 2 B. 2 and 4 C. 1 and 3 D. 2 and 3

C. 1 and 3 Film badges require the use of filters varying in thickness to determine the energy of the photons reaching the film emulsion. Estimations of dose received to personnel can then be made based on the film exposure levels. The filters are most often made from aluminum and copper

Which of the following is/are considered long-term somatic effect(s) of radiation exposure? 1. Carcinogenesis 2. Nausea, vomiting, and diarrhea 3. Cataractogenesis A. 1 only B. 1, 2, and 3 C. 1 and 3 only D. 2 only

C. 1 and 3 only Long-term somatic effects can develop over a long period after exposure. These effects result not only from high doses of radiation, but also from low doses administered over a longer time. Embryologic effects, carcinogenesis, and cataractogenesis are all considered long-term somatic effects

Which of the following are associated with high frequencies and short wavelengths? 1. X-rays 2. Microwaves 3. Gamma rays A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 only

C. 1 and 3 only Low frequencies and long wavelengths are at the bottom end of the spectrum with radio waves and microwaves, visible light is in the center of the spectrum, and at the top of the spectrum are gamma and x-rays, with associated high frequencies and short wavelengths (C)

Which of the following help(s) to reduce patient dose? 1. Tube filtration 2. Proper beam alignment 3. Operator shield 4. Automatic Exposure Control (AEC) A. 1 and 2 only B. 2 and 3 only C. 1, 2, and 4 only D. 1, 3, and 4 only

C. 1, 2, and 4 only An important part of radiation safety is protecting the patient from unnecessary exposure. Filtration within the x-ray tube helps to eliminate weak rays that would only contribute to skin dose and not to a diagnostic image. Automatic Exposure Control (AEC) senses how much radiation is needed for an adequate exposure; this can help prevent repeat exposures and over-exposures when precise positioning is utilized. Proper beam alignment helps to reduce patient dose by minimizing repeat exposures and, if paired with AEC, prevents misalignment with the ionizing chambers that control the amount of radiation needed to result in proper exposure.

If a radiologic examination must be performed during pregnancy, what safeguards can be used for both patient and fetal protection? 1. Accurate collimation 2. Double-shielding 3. Use of low kVp techniques 4. Limited protocols A. 1 and 3 only B. 2 and 4 only C. 1, 2, and 4 only D. 2, 3, and 4 only

C. 1, 2, and 4 only If a radiologic exam must be performed during pregnancy, regardless of the pregnancy trimester, the radiographer must use every safeguard available to protect both the patient and the fetus. Accurate collimation will reduce the direct area of irradiation in addition to scatter production. Double shielding can increase the reduction of x-ray particles reaching unnecessary anatomy. Limited protocols as discussed with the physician or radiologist can be used to reduce the number of images taken during the exam. Lower kVp examinations, however, would require an increase in mAs and would result in a higher patient dose; if possible, higher kVp techniques should be used for dose reduction.

X-rays that possess energy levels below 10 keV can interact with matter through classic coherent scattering. Classic coherent scattering is also known as which of the following? 1. Thompson 2. Compton 3. Unmodified 4. Coherent A. 1 only B. 1 and 3 only C. 1, 3, and 4 D. 2 only

C. 1, 3, and 4 X-rays that possess energy levels below 10 keV can interact with matter through classic coherent scattering. Also known as Thompson, unmodified, and coherent scattering, classic coherent scattering occurs when an incoming x-ray photon strikes an atom and is absorbed, causing the atom to become excited

In what ways can a radiographer reduce patient dose? 1. Improve technical factor selection through observation of patient habitus, positioning, and department protocols 2. Increase positioning accuracy with use of radiopaque sponges under the area of interest to reduce motion 3. Properly dress-down the patient for the exam, including removal of any jewelry or clothing items that could cause an artifact 4. Use clear breathing instructions to improve patient compliance and decrease motion A. 1, 2, and 4 only B. 1, 2, and 3 only C. 1, 3, and 4 only D. 1, 2, 3, and 4

C. 1, 3, and 4 only Proper technique selection, positioning accuracy, patient preparation, and concise breathing instructions all reduce patient exposure through the reduction of repeat images. However, the use of sponges must be limited to those that are radiolucent, not radiopaque, if they will be utilized under the area of interest. Otherwise, they would cause an artifact that could increase the number of repeat exposures and cause a subsequent increase in patient dose.

Which of the following medical equipment is used to determine blood pressure? 1. Pulse oximeter 2. Stethoscope 3. Sphygmomanometer A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only

Which of the following will result as subject tissue thickness increases? 1. Beam attenuation decreases 2. Absorption increases 3. Transmission decreases A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only As the tissue thickness increases, the amount of beam attenuation actually increases, which also results in increased absorption (A, B, and D). Since more of the x-ray beam is attenuated or absorbed by the patient, the amount of x-rays transmitted to the IR will decrease

What advantages do film badges present for personnel monitoring? 1. They can be worn for up to 3 months 2. Inexpensive for production and utilization 3. Simple processing methods A. 1 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only Film badges have been used for decades as a means to monitor personnel radiation exposure. Some advantages include their inexpensive production and utilization, simple processing methods, and accuracy. However, due to fogging of the film, the badges can only be worn for one month at a time to decrease chances of false-high readings. TLD and OSL dosimeters can be worn for longer periods of time.

Which of the following best demonstrates the cuboid, sinus tarsi, and tuberosity of the fifth metatarsal? A. Lateral foot B. Lateral oblique foot C. Medial oblique foot D. Weight-bearing foot

C. Medial oblique foot To demonstrate many of the tarsals and intertarsal spaces, including the cuboid, third (lateral) cuneiform, sinus tarsi, and tuberosity of the fifth metatarsal, a medial oblique projection is required (plantar surface and IR form a 30° angle). The lateral oblique projection of the foot demonstrates the navicular and first (medial) and second (intermediate) cuneiforms. Weight-bearing lateral feet are used to demonstrate the longitudinal arches.

Which of the following are true regarding bone marrow dose? 1. Bone marrow dose can be directly measured 2. Bone marrow dose can be associated with radiation-induced leukemia 3. Bone marrow dose is estimated utilizing the ESE 4. The mean marrow dose is typically lower in children A. 2 and 4 only B. 1 and 4 only C. 2, 3, and 4 only D. 1, 2, and 4 only

C. 2, 3, and 4 only Bone marrow dose is one of the three categories of patient radiation dose, along with entrance skin exposure (ESE) and gonadal dose. The bone marrow dose is important to document due to the role of bone marrow as the primary organ in radiation-induced leukemia formation. The amount of bone marrow dose is typically lower in children due to lower technical factors utilized in pediatric imaging. Measurement of bone marrow dose cannot be done directly, therefore the ESE is used for approximation.

What is the correct central ray placement for the AP projection of the thoracic spine? A. At the jugular notch B. 1 to 2 inches below the jugular notch C. 3 to 4 inches below the jugular notch D. 5 to 6 inches below the jugular notch

C. 3 to 4 inches below the jugular notch The central ray should be directed to the seventh thoracic vertebra. T7 is located approximately 3 to 4 inches below the jugular notch, or 1 to 2 inches below the sternal angle

When positioning for a lateral coccyx image, what is the correct placement of the central ray? A. 2 inches posterior to the ASIS B. 3 to 4 inches posterior to the ASIS C. 3 to 4 inches posterior and 2 inches inferior to the ASIS D. 3 to 4 inches posterior and inferior to the ASIS

C. 3 to 4 inches posterior and 2 inches inferior to the ASIS When imaging only the lateral coccyx, the proper central ray placement is 3 to 4 inches posterior to the ASIS and 2 inches inferior to the ASIS

For the PA axial projection of the knee, Camp Coventry method, which CR angulation is utilized? A. 25-30 degrees caudal B. 15-20 degrees cephalic C. 40-50 degrees caudal D. 25-30 degrees cephalic

C. 40-50 degrees caudal The Camp Coventry method of the PA axial knees is a prone tunnel view to demonstrate the intercondylar fossa of the femurs. This projection is performed to better diagnose pathology involving joint space narrowing and cartilage degeneration. With the patient's knees flexed 40-50 degrees, the CR will be angled perpendicular to the lower leg, which should be 40-50 degrees caudal

According to NCRP Report No.116, the annual occupational equivalent dose limit to localized areas of the hands is A. 50 mSv B. 15 mSv C. 500 mSv D. 150 mSv

C. 500 mSv

Which of the following projections does not demonstrate the olecranon process free of superimposition? A. Acute flexion elbow projection for the distal humerus B. Lateral elbow C. Acute flexion of the elbow for the proximal forearm D. Radial head laterals of the elbow

C. Acute flexion of the elbow for the proximal forearm The olecranon process is located on the posterior proximal ulna. This process is best visualized in the lateral projections of the elbow, including the radial head series and trauma laterals (A, B, and D). The olecranon process can also be well visualized on the acute flexion series of the elbow in the distal humerus projection only; when performing the acute flexion series for the proximal forearm, the olecranon will be superimposed by the distal humerus (C).

An emergency room physician has ordered ankle and lower leg images on a patient with an obvious lower leg deformity. What is the best way to obtain the mortise image? A. Internally rotate the patient's lower leg 15 to 20 degrees B. Internally rotate the patient's lower leg 45 degrees C. Central ray is angled 15 to 20 degrees lateromedial D. Central ray is angled 45 degrees lateromedial

C. Central ray is angled 15 to 20 degrees lateromedial If there is an obvious injury/deformity, the body part should not be rotated. If the patient is unable to internally rotate their leg, a 15- to 20-degree CR lateromedial angle is used to replace part rotation

Which of the following is used to express the effectiveness of a detector to absorb x-ray photons? A. FPD B. PPI C. DQE D. DXA

C. DQE Detective quantum efficiency measures the efficiency of a system to convert an x-ray input signal into a useful output image

Quality Control (QC) testing is used to evaluate digital display monitors in all of the following ways, except A. Display luminance response B. Display resolution C. Display matrix size D. Display noise

C. Display matrix size Monitor display luminance response is evaluated on a regular basis using quality control test patterns such as the TG 18-CT and TG 18-LN test patterns (A). Spatial resolution is the quantitative measure of the ability of the digital display monitor to produce separable images of different points of an object with high fidelity. Test patterns such as the TG 18-CX and TG 18-QC test patterns can be used to evaluate this display resolution (B). Image noise is an important factor in determining the visibility of an object. Any high-frequency variations that interfere with detection of the true signal are classified as noise. Digital display monitor noise can be quantified using the TG 18-AFC test pattern, which is based on the method used to determine noticeable luminance differences in the image (D). The display matrix size is calculated by multiplying the number of pixels in a vertical column by the number of pixels in a horizontal row. The matrix size of the monitor display is fixed. No quality control evaluation is necessary to determine variations in this unchanging characteristic (C).

Which of the following may occur if the X-ray exposure field is not properly collimated, positioned, and sized? A. Modulation transfer function failure B. Moiré artifact C. Exposure field recognition errors may occur D. Ghost artifact

C. Exposure field recognition errors may occur

A source of free electrons required for x-ray production are made available from the A. Glass envelope B. Focal track C. Filament D. Focusing cup

C. Filament

There are many terms related to grids used in radiography. Which term describes the relationship of the lead lines being parallel or angled to each other? A. Grid ratio B. Grid pattern C. Grid focus D. Grid conversion factor

C. Grid focus Grid focus options include parallel or non-focused grids and focused grids. The lead lines in a parallel or non-focused grid run parallel to each other. The lead lines in the focused grids are angled to match the divergent x-ray beam

The division process of genetic cells is termed A. Metaphase B. Mitosis C. Meiosis D. Synthesis

C. Meiosis

What is the purpose of flexing the fingers in a PA projection of the wrist? A. It ensures no rotation of the distal radius and ulna B. It ensure no rotation of the carpal bones C. It brings the carpals in closer contact with the image receptor D. It brings the metacarpals in closer contact with the image receptor

C. It brings the carpals in closer contact with the image receptor The purpose of cupping or flexing the fingers (metacarpophalangeal joints) is to bring the carpal bones closer to the image receptor to eliminate as much OID as possible

The distal end of the non-weight bearing bone of the lower leg is called which of the following? A. Apex of the fibula B. Medial malleolus C. Lateral malleolus D. Fovea capitus

C. Lateral malleolus The two bones of the lower leg are the tibia and fibula. Distal is a medical term meaning furthest from the point of attachment—in this case, furthest from the hip. The distal end of the tibia is the medial malleolus, the distal end of the fibula is the lateral malleolus (B and C). To select the correct choice, the student would have to know that the fibula is the non-weight bearing bone of the lower leg and is located laterally while the tibia is medial, as well as the difference between proximal and distal, as described above.

Which of the following modalities has, in many cases, replaced the need for post arthrogram images? A. Sonography B. CT C. MRI D. Nuclear medicine

C. MRI Arthrograms are used to assess soft tissue structures in joints such as the hip, shoulder, knee, and wrist. Magnetic resonance imaging or MRI has replaced the need for arthrogram procedures to be performed under fluoroscopy or has at least decreased the need for radiographic images following an arthrogram

Which of the following are enteral routes of drug administration? (select the 2 correct responses) A. Transdermal B. Sublingual C. Oral D. Rectal E. Subcutaneous F. Intramuscular

C. Oral D. Rectal Enteral routes of drug administration are any routes that involve administration of medication directly to the gastrointestinal system (C and D). Sublingual (under the tongue) is a topical route (B). Intradermal, subcutaneous, and intramuscular are parenteral routes (A, E, and F).

Which of the following cells do not undergo cell division, are mature bone cells, and maintain the metabolism of bone tissue? A. Osteoblasts B. Chondroblasts C. Osteocytes D. Osteoclasts

C. Osteocytes Osteocytes do not undergo cell division, are mature bone cells, and maintain bone tissue metabolism by exchanging nutrients and wastes with the blood

Which of the following skeletal pathologies requires a decrease in technical factors? A. Acromegaly B. Osteoarthritis C. Osteoporosis D. Osteopetrosis

C. Osteoporosis Acromegaly (A), osteoarthritis (B), and osteopetrosis (D) are all additive pathologies that require an increase in the technique. Osteoporosis is a destructive pathology and requires a decrease in technique (C).

Failing to properly identify the patient before an exam could put the radiographer in violation of A. HIPAA B. OSHA C. Patient's Bill of Rights and Patient Care Partnership D. Good Samaritan laws

C. Patient's Bill of Rights and Patient Care Partnership The Patient's Bill of Rights and Patient Care Partnership guarantee the patient the right to safe care practices and the use of policies and procedures to avoid mistakes

Which of the following describes the distance from the middle of one pixel to the middle of the adjacent pixel? A. Pixel size B. Pixel density C. Pixel pitch D. fill factor

C. Pixel pitch Pixel pitch is determined by the measuring from the middle of one pixel to the middle of the pixel next to it

In a contrast study of the esophagus, which patient position is recommended to best visualize the esophagus projected between the thoracic vertebrae and cardiac anatomy? A. AP or PA B. LAO C. RAO D. RPO

C. RAO In a 35 to 40-degree RAO position, the esophagus is clearly visible between the thoracic vertebrae and heart (C)

Technologists must be able to schedule medical imaging exams, view orders, track patients, and store imaging reports. Which imaging informatics system is responsible for these tasks? A. DICOM B. PACS C. RIS D. HL7

C. RIS Radiology Information System (RIS) is the system used to schedule medical imaging exams, view orders, track patients, and store imaging reports

Which of the following factors is the only thing affected by changing the focal spot size? A. Receptor exposure B. Contrast C. Spatial resolution D. Distortion

C. Spatial resolution Receptor exposure (A), contrast (B), and distortion (D) are not affected when the focal spot size changes. Spatial resolution is affected when focal spot size changes (C). As the focal spot size decreases, spatial resolution increases.

Which part of an induction motor is located outside the x-ray tube glass envelope? A. Filament B. Focusing cup C. Stator D. Rotor

C. Stator

When positioning for a lateral larynx and airway projection, where should the CR enter if the area of interest is the distal larynx and trachea? A. C 3-4 B. C 6-7 C. T 1-2 D. T 3-4

C. T 1-2 Clinical indications for the lateral upper airway projection include epiglottitis and lodging of foreign objects in the larynx or esophagus. For the general upper airway, centering is at the level of C6-7. When the area of interest is the upper trachea and larynx, the centering should be at the laryngeal prominence (C 5). For pathology of the distal larynx and trachea, centering should be at the level of the jugular notch (T 1-2).

The xiphoid tip of the sternum is located at approximately what corresponding vertebral level? A. T5-T6 B. T7-T8 C. T9-T10 D. T11-T12

C. T9-T10

Which of the following statements is false regarding TLD? A. When badges are monitored quarterly, the pricing is equivalent to film badges B. They are durable and hold up to heat and humidity exposure without loss of information C. They are more accurate than OSL, measuring exposures as low as 10 µGya D. They utilize lithium fluoride crystals

C. They are more accurate than OSL, measuring exposures as low as 10 µGya TLD badges have many advantages over film badges, such as increased durability, sensitivity to exposure, and duration of use (B). Even though they are more expensive than film badges, when monitored every 3 months rather than every month, the cost is roughly the same (A). They utilize lithium fluoride, which has a similar attenuation factor as soft tissue, which provides fairly accurate readings (D). However, TLD badges only measure exposures as low as 50 µGya, while OSL badges can detect exposures as low as 10 µGya (C)

Which of the following is an advantage of crossed grids? A. There is low risk of grid cutoff B. They are easily utilized in exams requiring tube angulations C. They have a higher contrast improvement factor than parallel grids D. They require lower patient dose

C. They have a higher contrast improvement factor than parallel grids Crossed grids have few advantages: they have a higher contrast improvement factor than parallel grids due to their increased grid strip count and they are easy to produce (C). However, the clinical applications of crossed grids are limited due to their precise positioning requirements; the tube must be exactly centered to the grid both longitudinally and transversely to avoid grid cutoff (A). These requirements eliminate the use of angled-tube imaging (B). Additionally, due to their increased absorption, they require higher patient dose because of increased technique factors (D)

All of the following are typical ways to express patient dose EXCEPT: A. Bone marrow dose B. Gonadal dose C. Thyroid equivalent D. Entrance skin exposure

C. Thyroid equivalent There are three typical terms to describe patient dose: bone marrow dose, gonadal dose, and entrance skin exposure (A, B, and D). The entrance skin exposure (ESE) is an easy-to-calculate and readily available measurement. Gonadal dose can be directly measured and helps estimate risk of genetic responses to radiation. Bone marrow dose, while it can only be estimated from ESE, is an important tool because of the high association between bone marrow and radiation-induced leukemia. Thyroid equivalent is not a typical way to express patient dose (C).

What carpal bone is located in the distal row, second bone in from the radial side? A. Trapezium B. Triquetrum C. Trapezoid D. Lunate

C. Trapezoid The proximal row of carpal bones from the radial to the ulnar side of the wrist are scaphoid, lunate, triquetrum, and pisiform (B and D). The distal row of carpal bones from the radial to the ulnar side of the wrist are trapezium, trapezoid, capitate, and hamate (A and C).

Which of the following is the post-processing function responsible for adjusting the contrast of a digital image? A. Smoothing B. Edge enhancement C. Window width D. Window level

C. Window width Window width controls the amount of contrast in the image

The dose limits established for the OSL dosimeter, TLD, and film badge are valid for A. alpha, beta, and x-radiations B. x- and gamma radiations only C. beta, x-, and gamma radiations D. all ionizing radiations

C. beta, x-, and gamma radiations The occupational dose limit is valid for x-, beta, and gamma radiations.

Each of the following statements regarding respiratory structures is true EXECPT A. the left lung has two lobes B. the lower portion of the lung is the base C. each lung is enclosed in peritoneum D. the main stem bronchus enters the lung hilum

C. each lung is enclosed in peritoneum The trachea (windpipe) bifurcates into left and right main stem bronchi, each of which enters its respective lung hilum. The left bronchus divides into two portions—one for each lobe of the left lung. The right bronchus divides into three portions—one for each lobe of the right lung. The lungs are conical in shape, consisting of upper pointed portions, termed the apices (plural of apex), and broad lower portions (or bases). The lungs are enclosed in a double-walled serous membrane called the pleura.

All the following statements regarding an exact PA projection of the skull are true EXCEPT A. the orbitomeatal line is perpendicular to the IR. B. the petrous pyramids fill the orbits. C. the midsagittal plane (MSP) is parallel to the IR. D. the central ray is perpendicular to the IR and exits at the nasion.

C. the midsagittal plane (MSP) is parallel to the IR.

The base of the fifth metatarsal should be visualized on which of the following projections? 1. AP foot 2. Medial oblique foot 3. AP ankle 4. Mortise oblique ankle A. 1 only B. 1 and 2 only C. 1, 2, and 4 only D. 1, 2, 3 and 4

D. 1, 2, 3 and 4 The base of the fifth metatarsal is a common fracture site. It is well visualized in the AP and medial oblique projections of the foot, and in the mortise oblique of the ankle. The AP projection of the ankle will also demonstrate the base of the fifth metatarsal. Fractures of the base of the fifth metatarsal can cause swelling in both the foot and the ankle, therefore it is important to ensure that it is included in all ankle imaging as well as foot imaging.

Which of the following materials would make an acceptable secondary barrier? 1. Lead acrylic 2. Glass 3. Gypsum board 4. Concrete A. 1 and 2 only B. 1 and 3 only C. 2, 3, and 4 only D. 1, 2, 3, and 4

D. 1, 2, 3, and 4 Secondary barriers are those that protect from scattered and leakage radiation. Since they are not attempting to protect from the primary beam, the secondary barriers can be thinner than primary barriers and are not required to contain lead so long as their thickness is equivalent to 0.8 mm Pb. Some of the materials that secondary barriers can be composed of include glass, lead acrylic, aluminum, concrete, and gypsum board

When patient dose cannot be estimated using patient radiation monitors, what other resources are available for ESE estimations? 1. Nomograms 2. Output intensity of the x-ray equipment in use 3. kVp used during the examination 4. mAs used during the examination A. 1 and 3 only B. 2 and 3 only C. 1, 2 and 4 only D. 1, 2, 3, and 4

D. 1, 2, 3, and 4 The best way to monitor patient dose during a radiographic or fluoroscopic examination is with patient monitoring devices, such as TLD. However, when that is not available, a nomogram can be a reference guide for ESE estimations, preferably a nomogram made by the radiation physicist specific to the room in use. Additional information needed would be the kVp, mAs, and SID used during the exam. The output intensity for the room can also be a way to estimate ESE; the output intensity is measured at certain SIDs or SSDs, therefore measurements can be concerted using the inverse square law so that it applies directly to the exam in question.

Which of the following factors can affect patient ESE? 1. Efficiency of x-ray production 2. Technical factors 3. OID 4. SID A. 1 and 3 only B. 2 and 3 only C. 2, 3, and 4 only D. 1, 2, 3, and 4

D. 1, 2, 3, and 4 The choice of technical factors and efficiency of x-ray production determine the quantity and quality of the x-ray beam. An increase in mAs will increase patient dose, while an increase in kVp will lower patient ESE. SID and OID have opposite effects on ESE: as SID increases, patient ESE is decreased; however, if OID is increased, the ESE will be higher.

The erect abdomen position is utilized to visualize air/fluid levels in the abdomen. Which other body position(s) could be utilized to demonstrate air/fluid levels if the patient is too weak or is unable to stand for longer than 5 to 10 minutes? 1. Left lateral decubitus 2. Right lateral decubitus 3. Lateral 4. Supine A. 1 only B. 2 and 3 only C. 1 and 4 only D. 1, 2, 3, and 4

D. 1, 2, 3, and 4 When assessing air/fluid levels, the patient must be in the desired position for at least 5 minutes; if possible, 10 minutes or more is preferable to allow fluid to settle and air to rise within the abdomen. When in the prone, supine, or lateral positions, the fluid will fall towards the surface against the table. Therefore, all of the options could properly demonstrate air-fluid levels depending on the beam/IP relationship (D)

Which of the following examinations of the abdomen require the image to be taken with suspended breathing on expiration? 1. Dorsal decubitus 2. Lateral 3. AP erect 4. Lateral decubitus A. 1 and 2 only B. 1 and 4 only C. 1, 2, and 4 only D. 1, 2, 3, and 4

D. 1, 2, 3, and 4 With abdomen imaging, all projections should be taken after full expiration. Even though all of the projections listed require visualization of the diaphragm, CR centering should be such that the diaphragm is included in the radiograph after expiration (D). Expiration is ideal to better visualize abdominal structures. Choices (A), (B), and (C) are incorrect as per the previous explanation.

Possible responses to irradiation in utero include 1. spontaneous abortion 2. congenital anomalies 3. childhood malignancies A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3

Which of the following is/are a feature(s) of x-ray equipment, designed especially to eliminate unnecessary radiation to the patient? 1. Filtration 2. Minimum SSD of 30 cm 3. Collimator accuracy A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 According to NCRP regulations, radiographic and fluoroscopic equipment must have a total Al filtration of at least 2.5 mm Al equivalent whenever the equipment is operated at 70 kV or greater, to reduce excessive exposure to low-energy radiation. Collimator and beam alignment must be accurate to within 2% for manual, and 4% for PBL. The SSD must not be less than 30 cm (12 inches) for all procedures other than dental radiography. Distance is the single best protection from radiation. Excessively short SIDs/SSDs cause a significant increase in patient skin dose.

In which of the following procedures is quiet, shallow breathing recommended during the exposure to obliterate prominent pulmonary vascular markings? 1. RAO sternum 2.Lateral thoracic spine 3.AP scapula A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Pulmonary vascular markings often are prominent in the elderly and in smokers. Quiet, shallow breathing may be used during a long exposure (with a compensating low milliamperage) to blur them out. Oblique sternum, AP scapula, and lateral thoracic spine projections are examinations in which this technique is useful.

Which of the following is (are) shown in both the right and left dorsal decubitus positions of the abdomen? 1. Diaphragm 2. Posterior border of iliac wings 3. Air-fluid levels A. 1 only B. 2 only C. 3 only D. 1, 2, and 3

D. 1, 2, and 3 The dorsal decubitus position of the abdomen is used to visualize air-fluid levels, aneurysms, trapped gas, calcifications, and potential hernias. The radiograph should include both iliac crests, the spinal column, and diaphragm (D).

Which of the following shoulder projections is/are contraindicated when a fracture or dislocation is suspected? 1. AP Projection-External Rotation 2. AP Projection-Internal Rotation 3. Inferiosuperior Axial Projection-Lawrence Method A. 1 and 3 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 When imaging the shoulder, it is imperative to avoid rotation of the arm if a fracture or dislocation is suspected. In both the AP internal and external projections, the arm needs to be rotated to better visualize the lesser and greater tubercles respectively. For the inferiosuperior axial projection (Lawrence), the arm is externally rotated. All three projections are contraindicated for fractures and dislocations. More appropriate projections would include transthoracic lateral and scapular Y

Which of the following is (are) valid evaluation criteria for a lateral projection of the forearm? 1. The radius and the ulna should be superimposed distally. 2. The coronoid process and the radial head should be partially superimposed. 3. The humeral epicondyles should be superimposed. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 To accurately position a lateral forearm, the elbow must form a 90-degree angle with the humeral epicondyles superimposed. The radius and ulna are superimposed distally. Proximally, the coronoid process and radial head are partially superimposed. Failure of the elbow to form a 90-degree angle or the hand to be lateral results in a less than satisfactory lateral projection of the forearm.

Which of the following situations could arise from over-flexing the knee in the lateral projection? 1. Obscured soft tissue 2. Fat pad displacement 3. Patellar fracture separation 4. Increased joint space visualization A. 2 and 3 only B. 1 and 2 only C. 2 and 4 only D. 1, 2, and 3 only

D. 1, 2, and 3 only Flexing the knee beyond 20-30 degrees could cause the patella to move into the intercondylar sulcus; in addition, soft tissue visualization decreases and fat pads can be pushed out of place. If there is a risk for patellar fractures, full extension laterals must be performed to avoid displacement or separation. Lastly, over-flexion can decrease the appearance of joint spaces, leading to inaccurate diagnoses

Methods that can be used to reduce patient exposure include increased (select the 3 correct completions) 1. beam restriction 2. kV 3. exposure time 4. mAs 5. SID 6. filtration A. 1, 3, and 6 B. 2, 3, and 5 C. 3, 4, and 5 D. 1, 2, and 6

D. 1, 2, and 6 Technologists must be conscientious about reducing patient exposure to ionizing radiation. Collimation/beam restriction limits the field of radiation and decreases the production of scattered radiation; the more the field can be restricted, the less the patient dose. Higher kV levels increase transmission of ionizing radiation through the body to the image receptor. Aluminum filtration absorbs low energy photons that are more likely to be absorbed by the body. An increase in mAs and/or exposure time increases the intensity/quantity of x-ray photons, thereby increasing patient exposure. An increase in SID requires an increase in exposure according to the inverse square law of radiation, thereby increasing exposure as well.

Differential absorption of the x-ray beam is dependent on 1. Atomic number of the irradiated tissues 2. Collimation 3. Beam quality 4. Part density A. 1 and 4 only B. 2 and 3 only C. 2 and 4 only D. 1, 3 and 4 only

D. 1, 3 and 4 only Differential absorption refers to variation in x-ray photon absorption and is the determining factor for image contrast. Factors that influence differential absorption include the atomic number of the irradiated tissue (1), the quality of the x-ray beam (3), and the density of the part being imaged (4). Higher atomic numbers translate to increased photon absorption, such as the high atomic number of bones compared to adipose tissue. Additionally, higher energy waves pass through more tissue than low energy waves, and lead to less absorption of the beam. Part thickness, or density, is also critical for absorption since thicker body parts absorb more of the beam. While collimation can reduce the size of the x-ray field, it is not a determining factor of differential absorption.

Which of the following statements regarding pregnant radiographers are true? 1. Due to back problems associated with pregnancy, aprons using 0.5 mm Pb equivalent are more desirable than 1 mm Pb equivalent despite lower attenuation percentages 2. A second dosimeter can be worn outside of a lead apron at waist level 3. A dose limit of 0.5 mSv per month is established for the length of pregnancy 4. The pregnancy should be declared as soon as possible A. 1 and 4 only B. 2 and 3 only C. 1, 2 and 4 only D. 1, 3, and 4 only

D. 1, 3, and 4 only

Which of the following is the correct angle for an intradermal injection? A. 90 degrees B. 45 degrees C. 30 degrees D. 15 degrees

D. 15 degrees

When performing radiographic exams on a patient after pacemaker placement, the radiographer should avoid abducting or elevating the left arm for how many hours after the pacemaker placement procedure? A. 12 B. 48 C. 8 D. 24

D. 24 To avoid dislodging the pacemaker or catheter after placement, the patient's movement of the left arm is restricted for 24 hours (D). The radiographer should be especially conscious of this restriction when positioning the patient for the post-operative chest radiograph that checks pacemaker and lead positioning.

Which of the following positions is most likely to offer the best visualization of the pulmonary apices? A. Lateral decubitus B. Dorsal decubitus C. Erect lateral D. AP axial lordotic

D. AP axial lordotic The pulmonary apices are often at least partially obscured by the clavicles. To visualize the entire lung apex and any suspicious areas, the clavicles must be "removed." This can be accomplished with the AP axial lordotic position. Through the arching of the patient's back and the cephalad angulation, the clavicles are projected upward and out of the pulmonary apices.

Which of the following additional projections may be performed to assess the early structural changes of scoliosis, herniated disks, and motion after a spinal fusion? A. LPO and RPO lumbar spine B. LAO and RAO lumbar spine C. Lateral lumbar spine D. AP right and left bending lumbar spine

D. AP right and left bending lumbar spine An AP right and left bending lumbar spine can be used to assess the early structural changes of scoliosis, herniated disks, and motion after a spinal fusion

Which of the following is an SI quantity that can be used to specify the amount of radiation transferred to a point at the surface of a patient's or radiographer's body? A. Absorbed dose B. Dose equivalent C. Effect dose D. Air kerma

D. Air kerma Air kerma is an SI quantity that can be used to express radiation concentration transferred to a point, which may be at the surface of a patient's or radiographer's body. Air kerma identifies calculation of radiation intensity in air and replaces the traditional quantity, exposure

In order to avoid background radiation artifacts when using CR, it is important to: A. Erase all image plates that have not been used for 48 hours B. Erase all image plates if there is any question about how long it has been since the plate has been erased C. Erase an image plate if there is any doubt as to when it was last erased, especially in the case of pediatric radiography D. All of these are correct actions

D. All of these are correct actions It is important to be aware of the necessity of erasing image plates that have not been used for 24 hours. If there is any question about how long it has been since the plate has been through the read/erase cycle, one should erase the plate, especially if pediatric images are being performed. One should also be aware if images suddenly begin to exhibit low contrast, because the erasure system may have failed (D).

Which elbow projection demonstrates the radial head free of superimposition? A. AP neutral B. AP internal rotation C. AP partial flexion D. Coyle

D. Coyle There is slight superimposition of the radial head in the AP neutral position (A). The radial head and neck are completely superimposed over the proximal ulna in the AP internal rotation projection (B). The AP partial flexion is used when a patient is unable to fully straighten their elbow for the AP neutral projection (C). The radial head will be slightly superimposed over the ulna just as in the AP neutral projection. With the Coyle method, a 45-degree central ray angle toward the shoulder is used to free the radial head and neck from the superimposition of the coronoid process of the ulna (D).

Which of the following describes the amount of the detector element that is dedicated to absorbing x-ray photons? A. Pixel size B. Pixel density C. Pitch pitch D. Fill factor

D. Fill factor Fill factor is the sensing area (i.e., the amount of the detector element that is dedicated to absorbing x-ray photons)

Which of the following combinations will provide better visibility of detail and the least amount of noise in a digital image? A. Low SNR and low CNR B. Low SNR and high CNR C. High SNR and low CNR D. High SNR and high CNR

D. High SNR and high CNR NR is the abbreviation for signal-to-noise ratio and refers to the amount or strength of the signal received by the IR. If there is more signal received, less noise will occur in the image. Decreasing the SNR results in more noise in the image compared to the signal. The same correlation happens with contrast-to-noise ratio (CNR). As CNR increases, the longer scale of contrast (low contrast) will increase the visibility of detail compared to the amount of noise. Using these descriptions, the best combination to have is a high SNR and high CNR

Without changing any other factors, which of the following best describes the impact on the final image when SID is increased? A. Image receptor exposure increases and spatial resolution decreases B. Image receptor exposure increases and spatial resolution increases C. Image receptor exposure decreases and spatial resolution decreases D. Image receptor exposure decreases and spatial resolution increases

D. Image receptor exposure decreases and spatial resolution increases As SID is increased, the amount of x-rays reaching the image receptor will decrease resulting in less image receptor exposure. When SID increases, the amount of visible detail or spatial resolution will increase

Which of the following is necessary to perform digital image stitching? A. Multiple plates B. Special wire alignment grid C. Single exposure D. Multiple exposures

D. Multiple exposures In digital radiography, stitching software requires multiple exposures captured with a moving detector to form a single body-length image (D). A single exposure over multiple plates attached by special wire alignment grids is used to produce a single body-length image in CR imaging; however, these conditions utilized in CR may not produce the same quality images as DR due to the beam divergence in a single exposure (A, B, and C).

Which of the following rib positions are recommended for a patient who complains of left-sided anterior rib pain? A. AP and LPO B. AP and RPO C. PA and LAO D. PA and RAO

D. PA and RAO The patient's area of injury, whether anterior or posterior, should be placed closest to the image receptor whenever possible. That is, a posterior injury would be performed in an AP position and an anterior injury would be imaged in a PA position (A and B). In the case of an anterior rib injury, the patient is placed with anterior body surface adjacent to the image receptor. For oblique images of the anterior ribs, the side is rotated away from the image receptor. Right-sided anterior rib imaging requires PA and LAO (C). The opposite is true for posterior ribs (i.e., for right-sided posterior ribs, AP and RPO should be used) (B).

Which of the following projections will free a majority of the clavicle from superimposition and decrease the OID? A. AP B. AP axial C. PA D. PA axial

D. PA axial The clavicle is superimposed over the scapular spine on the AP projection (A). The AP axial projection reduces the amount of clavicle superimposed on the scapular spine and the second and third ribs (B) but increases the OID (when compared to the PA projection). The PA projection reduces the OID but with superimposition of other bony structures upon the clavicle (C). The PA axial projection places the clavicle closer to the image receptor, reducing the amount of OID. The 15- to 30-degree caudal angle reduces the superimposition of the clavicle on the scapular spine and ribs (D).

What does the abbreviation PBL represent? A. Positive-Barrier Limit B. Proactive-Beam Limitation C. Positive-Beam Lighting D. Positive-Beam Limitation

D. Positive-Beam Limitation PBL, or positive-beam limitation, is an automatic collimation process that limits the shutter size to that of the image receptor (D). PBL helps reduce patient dose by restricting the beam to the size needed, excluding unessential anatomy from the x-ray image.

What is the method of infection control that is used for immunocompromised patients, such as a patient receiving chemotherapy or immunosuppressant medications? A. Standard precautions B. Isolation precautions C. Contact precautions D. Reverse isolation precautions

D. Reverse isolation precautions

Which of the following is visualized in a right posterior oblique position of the lumbar spine? A. Left intervertebral foramina B. Right intervertebral foramina C. Left zygapophyseal joints D. Right zygapophyseal joints

D. Right zygapophyseal joints

Centering for the AP projection of the upper airway is at the level of A. C3-4 B. C5-6 C. C7-T1 D. T1-2

D. T1-2 The AP projection of the upper airway is used to demonstrate pathology of the larynx and trachea. Since the proximal larynx is superimposed by bony structures of the skull and facial bones, centering for the AP projection requires lower centering. The CR should enter at T1-2 to include more of the distal air-filled larynx and trachea

Disclosure of radiography examination content using significantly similar language would result in sanctions against the offending party for violation of A. The ARRT Code of Ethics B. Laws of copyright infringement C. State licensing laws D. The ARRT Rules of Ethics

D. The ARRT Rules of Ethics The ARRT Rules of Ethics are mandatory and enforced by the ARRT

Which type of seizure is sometimes preceded by an aura? A. Focal seizure B. Petite mal seizure C. Absence seizure D. Tonic-clonic seizure

D. Tonic-clonic seizure A tonic-clonic seizure, also known as grand mal or major motor seizure, is the most severe type of seizure and is sometimes preceded by an aura, a premonitory sign

The anode focal track is made of: A. Cesium B. Nickel C. Molybdenum D. Tungsten

D. Tungsten The focal track is made of a tungsten-rhenium alloy (for extra protection from heat).

Which of the following is the post-processing function responsible for adjusting the brightness of a digital image? A. Smoothing B. Edge enhancement C. Window width D. Window level

D. Window level Adjusting the window level alters the brightness in the image

Select the 4 statements below that are NOT correct regarding x-ray characteristics A. X-rays produce fluorescence in certain phosphors B. X-rays have a photographic effect on film emulsion C. X-rays have an ionizing effect on air D. X-rays are focused using collimators E. X-rays have a physiological effect on living tissue F. The x-ray beam is monoenergetic G. X-rays have a penetrating effect on all matter H. X-rays are negatively charged I. X-rays travel at the speed of sound J. X-rays travel in straight lines K. X-rays are not perceptible by the senses

D. X-rays are focused using collimators F. The x-ray beam is monoenergetic H. X-rays are negatively charged I. X-rays travel at the speed of sound

Which of the following produces a potential difference within the x-ray tube during an exposure? A. mA B. mAs C. Ohms D. kVp

D. kVp

A lateral projection of the larynx and upper trachea is occasionally required to rule out foreign body, polyps, or tumor. The CR should be directed A. just below the EAM B. to the level of the mandibular angles C. to the level of the laryngeal prominence D. midway between laryngeal prominence and jugular notch

D. midway between laryngeal prominence and jugular notch For the lateral projection of the upper airway, larynx and upper trachea is the area of interest and the central ray is directed to C 6/7, midway between the laryngeal prominence and jugular notch. Lateral cervical spine centering should be to C5 at the MCP.

In myelography, the contrast medium generally is injected into the A. cisterna magna B. individual intervertebral disks C. subarachnoid space between the first and second lumbar vertebrae D. subarachnoid space between the third and fourth lumbar vertebrae

D. subarachnoid space between the third and fourth lumbar vertebrae Generally, contrast medium is injected into the subarachnoid space between the third and fourth lumbar vertebrae (Figure 2-62). Because the spinal cord ends at the level of the first or second lumbar vertebra, this is considered to be a relatively safe injection site. The cisterna magna can be used, but the risk of contrast medium entering the ventricles and causing side effects increases. Diskography requires injection of contrast medium into the individual intervertebral disks.

Which of the following types of patient consent can lead to charges of negligence against a radiographer? A. Implied consent B. No consent obtained C. Express consent D. Written consent E. Inadequate consent

E. Inadequate consent If a patient gives consent but has not been given enough information to make an adequate decision, the radiographer performing the procedure could be charged with negligence, especially if the patient is harmed as a result. Inadequate consent is also referred to as ignorant consent