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Practice Exam
Question 1. Which of the following is the most appropriate first step when obtaining a patient’s history for a radiographic exam? A) Explain the technical factors you will use B) Review the clinical indication and any contraindications C) Begin positioning the patient immediately D) Ask the patient to sign the consent form Answer: B Explanation: The technologist must first ascertain the clinical indication and identify any contraindications (e.g., pregnancy, implants) to determine the appropriate exam and safety precautions. Question 2. A patient is scheduled for a contrast‑enhanced CT scan and reports a known iodine allergy. Which action should the technologist take? A) Proceed, as the allergy is not relevant to radiography B) Administer a reduced dose of iodinated contrast without pre‑medication C) Notify the radiologist and obtain a pre‑medication order or alternative contrast D) Cancel the exam without further discussion Answer: C Explanation: Iodinated contrast can trigger severe reactions in allergic patients; the technologist must inform the radiologist so that pre‑medication or a non‑iodinated alternative can be considered. Question 3. In accordance with the “five rights” of medication administration, which right is being addressed when the technologist checks the patient’s wristband against the order? A) Right drug B) Right dose C) Right patient
Practice Exam
D) Right route Answer: C Explanation: Verifying the patient’s identity ensures the medication or contrast is given to the correct individual. Question 4. Which standard precaution is mandatory for all patient interactions, regardless of known infection status? A) Use of N95 respirators B) Hand hygiene before and after contact C) Full isolation gowns for every patient D) UV light disinfection of the room after each exam Answer: B Explanation: Hand hygiene is a universal precaution to reduce transmission of blood‑borne and other pathogens. Question 5. When a patient with a suspected airborne disease enters the radiology suite, which additional precaution must be implemented? A) Contact precautions only B) Droplet precautions only C) Airborne precautions, including negative‑pressure room and N95 mask D) No additional precautions beyond standard ones Answer: C Explanation: Airborne pathogens require negative‑pressure environments and respirators to prevent aerosol spread. Question 6. The technologist is preparing to insert a peripheral IV for contrast injection. Which practice helps maintain aseptic technique?
Practice Exam
Question 9. The three cardinal rules of radiation protection include time, distance, and which third factor? A) Frequency B) Shielding C) Energy D) Collimation Answer: B Explanation: Shielding reduces exposure by absorbing or scattering radiation; together with minimizing time and maximizing distance, it protects personnel. Question 10. For a pregnant patient undergoing a lumbar spine radiograph, which protective measure is most appropriate? A) Increase the kVp to reduce mAs B) Place a lead apron over the abdomen and pelvis C) Use a grid with a high ratio D) Perform the exam without any shielding to avoid image distortion Answer: B Explanation: A lead apron (usually 0.5 mm Pb equivalent) over the abdomen reduces fetal dose while preserving image quality. Question 11. What is the maximum permissible occupational dose for the whole body (excluding the lens of the eye) for a radiologic technologist per year according to NRC/ICRP guidelines? A) 5 mSv (500 mrem) B) 10 mSv (1000 mrem) C) 20 mSv (2000 mrem)
Practice Exam
D) 50 mSv (5000 mrem) Answer: B Explanation: The annual occupational dose limit for whole‑body exposure is 10 mSv (1000 mrem) for radiation workers. Question 12. Which type of dosimeter provides real‑time dose monitoring for staff in the fluoroscopy suite? A) Thermoluminescent dosimeter (TLD) B) Optically stimulated luminescence (OSL) badge C) Electronic personal dosimeter (EPD) D. Film badge Answer: C Explanation: Electronic personal dosimeters give instantaneous readouts, useful for high‑dose- rate environments like fluoroscopy. Question 13. In order to reduce patient dose during a routine chest PA, which combination of technical factors is most effective? A) Increase mAs, increase kVp, use a grid B) Decrease kVp, increase mAs, narrow collimation C) Increase kVp, decrease mAs, use appropriate collimation D. Use high mAs and wide collimation to improve image brightness Answer: C Explanation: Higher kVp reduces patient dose by increasing photon energy; decreasing mAs reduces total photons; proper collimation limits the irradiated area. Question 14. Which component of the X‑ray tube is primarily responsible for producing characteristic radiation?
Practice Exam
Explanation: Inherent filtration (e.g., the tube’s glass envelope and oil) preferentially absorbs low‑energy photons, reducing patient skin dose and improving beam quality. Question 17. Which of the following best describes the effect of increasing the kilovoltage peak (kVp) on radiographic contrast? A) Increases contrast by enhancing photoelectric effect B) Decreases contrast because higher energy photons are less differentially absorbed C) Has no effect on contrast, only on patient dose D. Increases contrast only when used with a high‑ratio grid Answer: B Explanation: Higher kVp produces more penetrating photons, reducing the differential attenuation between tissues and thus lowering contrast. Question 18. During a chest radiograph, a grid is used. What is the primary purpose of the grid? A) To increase the exposure time automatically B) To absorb scattered radiation before it reaches the detector, improving contrast C) To focus the X‑ray beam onto the patient’s thorax D. To reduce the need for collimation Answer: B Explanation: Grids consist of lead strips that preferentially absorb scatter, thereby enhancing image contrast. Question 19. Which of the following factors most directly influences geometric unsharpness (blur) in a radiograph? A) Filtration level B) Focal spot size
Practice Exam
C) Grid ratio D. Detector sensitivity Answer: B Explanation: A larger focal spot creates a larger penumbra, increasing geometric unsharpness; a small focal spot improves detail. Question 20. When performing a lumbar spine AP view, the technologist positions the patient with the central ray (CR) at which anatomical landmark? A) L1 spinous process B) L3 spinous process C) L5–S1 interspace D. Sacral promontory Answer: C Explanation: The lumbar AP is centered at the L5–S1 interspace to include the entire lumbar spine and sacrum. Question 21. In a digital radiography (DR) system, which detector type converts X‑ray photons directly into electrical charges? A) Indirect‑conversion flat‑panel detector (CsI scintillator) B) Direct‑conversion flat‑panel detector (amorphous selenium) C) Computed radiography (CR) phosphor plate D. Photostimulable phosphor plate Answer: B Explanation: Direct‑conversion DR uses amorphous selenium, which generates charge carriers directly upon X‑ray absorption, eliminating the intermediate light step.
Practice Exam
Explanation: Grid cutoff occurs when the grid is not properly aligned with the detector, causing the peripheral portion of the image to be under‑exposed (dark) while the central area remains adequately exposed. Question 25. During a barium swallow study, a patient experiences severe nausea and vomiting. What is the technologist’s immediate priority? A) Continue the study to obtain diagnostic images B) Administer anti‑emetic medication without physician order C) Stop the procedure, assess the patient, and initiate emergency protocols if needed D. Increase the contrast concentration to improve visualization Answer: C Explanation: Patient safety supersedes imaging; the technologist must stop the exam, assess the patient’s condition, and follow emergency procedures. Question 26. Which of the following is a contraindication for a routine pelvic radiograph? A) Pregnancy B) Diabetes mellitus C) Hypertension D. Prior abdominal surgery Answer: A Explanation: Radiation exposure to a fetus can cause teratogenic effects; pregnancy is a contraindication unless the exam is essential and alternatives are unavailable. Question 27. In a portable chest X‑ray performed on an ICU patient, the technologist uses a 0.5‑mm lead apron placed over the patient’s abdomen. What is the primary purpose of this apron? A) To improve image contrast by absorbing scatter
Practice Exam
B) To protect the patient’s gonads and lower abdomen from unnecessary radiation C) To reduce exposure time required for the image D. To increase the kVp automatically Answer: B Explanation: The lead apron shields radiosensitive organs (e.g., gonads) from scattered radiation, reducing dose while not affecting the diagnostic area. Question 28. Which of the following best describes the purpose of a “dose‑area product” (DAP) meter? A) Measures the total radiation dose absorbed by the patient’s skin B) Calculates the product of dose and the irradiated area, reflecting overall patient exposure C) Determines the amount of scatter reaching the detector D. Monitors the voltage output of the X‑ray generator Answer: B Explanation: DAP (Gy·cm²) quantifies the total energy delivered to the patient, accounting for both dose and field size, and is useful for dose monitoring. Question 29. When performing an AP supine abdomen (KUB) radiograph, the technologist should include which anatomical landmark to ensure the entire exam is captured? A) Diaphragm dome B) Iliac crests C) Symphysis pubis and the fifth lumbar vertebra (L5) D. Lower ribs Answer: C Explanation: Including the symphysis pubis and L5 ensures visualization of the entire urinary and gastrointestinal tracts evaluated in a KUB.
Practice Exam
D. Subdural hematoma Answer: A Explanation: Iodinated contrast can impair renal function, especially in patients with pre‑existing kidney disease; monitoring for contrast‑induced nephropathy is essential. Question 33. Which of the following best describes the principle of “justification” in radiologic practice? A) Using the highest possible dose to ensure diagnostic certainty B) Ensuring that every imaging exam has a net benefit that outweighs radiation risk C) Performing all possible imaging studies on a patient for completeness D. Limiting imaging to only pediatric patients Answer: B Explanation: Justification requires that the clinical benefit of an imaging study exceeds the potential radiation risk. Question 34. A technologist discovers that the patient’s identification wristband does not match the order. What is the correct action? A) Proceed with the exam, noting the discrepancy later B) Cancel the exam and inform the patient of the error C) Verify the correct patient identity before proceeding, possibly involving a supervisor D. Use the order as is, assuming it is a clerical mistake Answer: C Explanation: Patient identification is critical for safety; the technologist must resolve the mismatch before exposing any patient to radiation. Question 35. Which of the following legal concepts holds an employer liable for the negligent acts of its employees performed within the scope of employment?
Practice Exam
A) Res ipsa loquitur B) Negligence per se C) Respondeat superior D. Vicarious liability Answer: C Explanation: Respondeat superior makes the employer responsible for the actions of its employees carried out in the course of their duties. Question 36. In fluoroscopy, which parameter most directly influences patient skin dose? A) Frame rate (frames per second) B) Grid ratio C. SID (source‑to‑image distance) D. Collimation width Answer: A Explanation: Higher frame rates increase the number of X‑ray pulses per unit time, directly raising the cumulative skin dose. Question 37. A patient undergoing a barium enema complains of severe abdominal pain and guarding. Which immediate step should the technologist take? A) Continue the study, as pain is common B) Stop the procedure, assess for perforation, and notify the radiologist/physician C. Increase the amount of barium to improve visualization D. Apply a warm compress to the abdomen Answer: B Explanation: Guarding suggests possible perforation; the exam must be halted, and emergent medical evaluation is required.
Practice Exam
Explanation: The CR reader uses a laser to stimulate the phosphor plate; the emitted light is captured and converted into a digital image. Question 41. Which of the following best explains why a higher grid ratio improves image contrast? A) It increases the amount of primary radiation reaching the detector B) It removes more scattered radiation while allowing primary photons to pass C. It reduces patient dose by absorbing more photons D. It shortens the exposure time required for adequate density Answer: B Explanation: A higher grid ratio (e.g., 12:1) has more lead strips, which intercept scatter more effectively, enhancing contrast at the cost of increased dose. Question 42. During a lateral knee projection, the technologist notices that the femur appears foreshortened. Which adjustment will correct this geometric distortion? A) Increase kVp B) Decrease SID C. Increase SID (move the tube farther from the patient) D. Use a higher‑ratio grid Answer: C Explanation: Increasing the source‑to‑image distance reduces magnification and geometric distortion, improving the representation of the femur’s length. Question 43. Which of the following is a typical indication for a postero‑anterior (PA) chest radiograph rather than an AP view? A) Patient is supine in the ICU B) Need to evaluate the mediastinum without magnification of the heart
Practice Exam
C. Suspected spinal trauma D. Evaluation of the abdomen Answer: B Explanation: PA positioning places the heart closer to the detector, reducing magnification and providing a more accurate assessment of cardiac size and mediastinal structures. Question 44. In a digital radiography system, a “burned‑out” pixel appears as a permanently bright spot on all images. What is the most likely cause? A) Over‑exposure during a single exam B) Defective detector element that continuously generates signal C. Incorrect collimation D. Excessive scatter radiation Answer: B Explanation: A burned‑out pixel is a hardware defect where a detector element is stuck at maximum signal, appearing bright regardless of exposure. Question 45. Which of the following best describes a “phantom” image artifact in CR? A) A repeated pattern caused by a malfunctioning readout scanner B) A uniform dark area due to under‑exposure C. A light‑colored circular area caused by a faulty laser in the reader D. A streak caused by patient motion Answer: A Explanation: Phantom artifacts arise from defects in the CR reader’s scanning mechanism, producing repetitive patterns unrelated to patient anatomy.
Practice Exam
Answer: C Explanation: The lead apron attenuates primary photons, creating a localized region of increased absorption (appearing darker) on the image; the radiologist must recognize this artifact. Question 49. Which of the following is the most appropriate method for confirming proper placement of a peripheral IV line before contrast injection? A) Visual inspection of the IV site only B) Flushing the line with saline and observing for blood return and lack of resistance C. Administering a small test dose of contrast without checking D. Relying on the patient’s report of pain Answer: B Explanation: Proper IV placement is confirmed by aspirating blood and flushing with saline to ensure patency and correct positioning before contrast administration. Question 50. In a digital radiography system, the “window level” adjustment primarily affects: A) The spatial resolution of the image B) The brightness (density) and contrast displayed on the monitor C. The amount of scatter radiation reaching the detector D. The exposure time required for acquisition Answer: B Explanation: Window level (center) and width control how pixel values are mapped to grayscale, influencing perceived brightness and contrast. Question 51. Which of the following best describes the purpose of a “collimator” in an X‑ray system?
Practice Exam
A) To increase the focal spot size for better image detail B) To limit the size and shape of the X‑ray beam, reducing patient dose and scatter C. To convert X‑rays into visible light D. To monitor the exposure time automatically Answer: B Explanation: Collimators define the field size, minimizing irradiated area and scatter, thereby reducing dose and improving image quality. Question 52. During a routine chest PA, the technologist notices that the exposure indicator (EI) is significantly above the acceptable range. What is the most appropriate immediate action? A) Increase mAs for the next patient to compensate B) Decrease kVp for the next patient C. Review and adjust technique factors (e.g., reduce mAs, increase kVp) to bring the EI within range for subsequent exposures D. Ignore the EI, as it does not affect image quality Answer: C Explanation: An EI outside the optimal range indicates over‑exposure; adjusting technique to bring EI into the acceptable window prevents unnecessary dose. Question 53. Which of the following is a key component of the “Code of Ethics” for radiologic technologists? A) Maximizing departmental revenue B) Providing care without regard for patient autonomy C. Maintaining confidentiality of patient health information D. Delegating all patient communication to physicians Answer: C
