Radiographic Positioning and Exposure Techniques, Exams of Radiology

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ARRT FINAL EXAM 200 QUESTIONS WITH CORRECT

ANSWERS

1. A MRI procedure is contraindicated for a patient who has: a. a pacemaker that was placed 15 years ago b. dental fillings c. subdural bleeding d. scoliosis: A 2. A PA chest image reveals that only eight ribs are seen above the diaphragm. Which of the following suggestions would improve the inspirtations of lungs? a. use higher kV to penetrate the diaphragm b. perform the chest position supine c. take the exposure on the second inspiration rather than on first d. use a shorter exposure time: C 3. A PA chest radiograph reveals that the left sternoclavicular joint is super- imposed upon the spine and the right joint is open and farther from the spine. What specific positioning error has been committed? a. left tilt b. rotation into the LAO position c. right tilt d. rotation into the RAO position: B 4. A response to radiation is directly proportional to the dose received. a. linear b. nonlinear c. curvilinear d. nonthreshold: 5. A critique of this image demonstrates which repeatable error? a. extension of the skull b. mouth not open enough c. flexion of the skull d. rotation of the head to the right: A 6. Which of the following describes the correct relationship between the qual- ity of the x-ray beam and the technique selected on the control panel? a. low beam penetrability due to low kVp b. low beam penetrability due to high kVp c. low beam penetrability due to high mAs

d. low beam penetrability due to low mAs: A

7. A particular radiograph was produced using 8 mAs and 84 kVp with an 8:1 ratio grid. The image is to be repeated using a 16:1 ratio grid. What should be the new mAs to adjust for the grid ratio change? Grid ratio and conversion factor 5:1 ratio - conversion factor of 2 6:1 ratio - conversion factor of 3 8:1 ratio - conversion factor of 4 12:1 ratio - conversion factor of 5 16:1 ratio - conversion factor of 6 a. 5 mAs b. 8 mAs c. 12 mAs d. 20 mAs: C 8. A patient comes to radiology with a possible mass beneath the right clavicle. The PA and left lateral chest projections are inconclusive. Which additional projection can be taken to demonstrate this possible mass? a. AP and lateral of upper airway b. right lateral c. AP erect d. Apical Lordotic: D 9. A patient comes to the imaging department for a follow-up study of the cervical spine. The patient has had a spinal fusion between C5-C performed six months earlier. His physician wants to access the cervical spine for ante- riorposterior mobility. Which of the following projections would provide this assessment? a. AP axial-vertebral arch projection b. Judd or Fuchs position c. Swimmers position d. Hyperflexion and hyperextension projections: D 10. A patient comes to the imaging department for a study of the lumbar spine. He has a clinical history of spondylolisthesis of L5-S1. Which of the following projections will best demonstrate the severity of this condition? a. 30 degree obliques b. AP axial L5-S c. lateral L5-S d. 50 degress obliques: C

11. A patient enters the ER with a possible basilar skull fracture. Which of the following skull projections would best demonstrate any blood present in the sphenoid sinus? a. Haas method b. AP with a 15 degree cephalic angle c. Horizontal beam lateral projection d. SMV: C 12. A patient has a history of recurrent urinary tract infections. The physician is concerned that the young child may have urinary reflux. Which of the following procedures would best demonstrate this condition? a. IVU b. voiding cystourethrogram (VCUG) c. IVU with compression d. cystogram: B 13. A patient has fallen on an out stretched hand and has a posterior wrist/fore- arm fracture approximately one inch proximal to the carpal bones. Which type of fracture is this? a. Boxer b. Smiths c. Colles d. Potts: C 14. A patient is in the ICU after abdominal surgery. The surgeon is concerned about a possible perforated bowel. Thye patient's can't stand or sit. Which of the following positions will best demonstrate any possible intra-abdominal free air? a. ventral decubitus b. dorsal decubitus c. left lateral decubitus d. right lateral decubitus: C 15. Which of the following is NOT a test performed as part of a quality- control (QC) program to check the radiographic equipment? A. reproducibility B. number of repeat images due to technologist collimation errors C. light field to radiation field alignment D. central ray alignment: B 16. A radiograph of an AP mortise projection of the ankle reveals that the lateral malleolus is slightly superimposed over the talus and the lateral joint space is not open. What is most likely cause for this radiographic

outcome? a. Excessive plantar flexion of the foot and ankle b. Excessive dorsiflexion of the foot and ankle c. Insufficient medial rotation of the foot and ankle d. Excessive medial rotation of the foot and ankle: C

17. Contr ast resolution of a CR/DR image is determined by the of the system. a. matrix size b. bit depth c. sampling frequency d. dynamic range: B 18. A radiographic image of the LPO projection of the lumber spine reveals that the downside pedicle is projected too far posteriorly on to the vertebral body. What specific positioning error is present on this radiographic image? a. excessive rotation of the spine b. tilt of the spine c. incorrect CR placement d. insufficient rotation of the spine: A 19. A secondary barrier is designed to absorb radiation.

1. leakage 2. scattered 3. primary a. 1 only b. 2 only c. 3 only d. Both 1 and 2.: D 20. A technologist can reduce his or her exposure during fluoroscopy by stepping: 1. back from the patient. 2. behind the radiologist. 3. close to the patient's head. a. 1 & 3 only b. 1 only c. 2 & 3 only d. 1 & 2 only: D 21. A(n) effect increases with incidence but not severity as the dose increases. a. stochastic b. localized

c. early d. deterministic (tissue reaction): A

22. Air or gas that escapes into the pleural cavity results in a condition known as: a. air bronchogram b. pneumothorax c. hemidiaphragm d. hemothorax: B 23. Which of the following is not appropriate for a technologist to do? a. compare the imaging order to the patient's history b. identify the patient using name and birth date c. crop off anatomy on the processed image d. use a sandbag as an immobilization device while positioning a patient: C 24. Which of the following veins is commonly used for venipuncture? a. cephalic vein b. internal jugular vein c. dorsal vein d. popliteal vein: A 25. Which of the following is an example of a positive contrast medium? a. air b. soda water c. barium sulfate d. gas-producing crystals: C 26. Which of the following is NOT a type of nonverbal communication? a. smiling at the patient b. asking the patient for a medical history c. having a clean x-ray room d. having a puzzled facial expression: B 27. Which of the following components are included in the CR reader? a. thin-film transistor b. DEL c. capacitor d. beam-shaping optics: D 28. Three of the four following statements best describe the proper use of standard precautions. Which statement is FALSE? a. Wash your hands or use hand sanitizer before and after patient contact

b. Use standard precautions when caring for all patients c. Use precautions only for patients from the emergency department d. Never recap used needles: C

29. A ll the hereditary information about an individual is contained in the cells. a. skin b. brain

c. blood d. germ: D

30. Which of the following best demonstrates the coracoacromial arch? a. West Point method b. Y view method c. Fisk method d. Neer method: D 31. An increase in exposure factors is usually required in which of the follow- ing circumstances?

1. edema 2. ascities 3. acromegaly a. 1 only b. 1 and 2 only c. 1 and 3 only d. 1,2 and 3: D 32. An x-ray image of an ankle was made at 40-SID, 200 mA, 50 ms, 70 kV, 0.6mm focal spot and 2 inches of OID. Which of the following modifications would result in the greatest increase in magnification? a. 1.2 mm focal spot b. 36-inch SID c. 44-inch SID d. 4-inch OID: D 33. Angulation across the long axis of a linear grid causes: a. grid shadowing. b. cross-hatched impressions. c. grid cut-off. d. grid convergence.: C 34. As LET the RBE. a. increases, increases b. increases, remains the same c. decreases, remains the same d. increases, decreases: A 35. As kVp , the probability of photoelectric absorption. a. increases, remains the same b. increases, decreases c. decreases, decreases d. decreases, remains the same: B 36. Which of the following terms describe the ratio of the sensitive area to

the entire area of a DEL?

a. size b. pitch c. fill factor d. bit depth: C

37. At what time(s) does a patient have the right to revoke consent? A. only before the procedure begins B. only after the procedure has started C. after the procedure is completed D. anytime - either before or during the procedure: D 38. At which level of the lumbar spine does the radiologist place the spinal needle to collect spinal fluid? a. L4-L b. L2-L c. L3-L d. L1-L2: C 39. Because of the anode heel effect, x-ray beam intensity: a. is greater under the cathode side of the tube. b. is greater under the anode side of the tube. c. is equal across the beam long axis. d. changes with patient position.: A 40. Compared with a low-ratio grid, a high-ratio grid will

1. allow more centering latitude
2. absorb more scattered radiation
3. absorb more primary radiation a. 1 only b. 1 and 2 only c. 2 and 3 only d. 1, 2, and 3: C 41. During a fluoroscopic examination, a resettable cumulative timing device times the x-ray beam-on time and sounds an audible alarm or temporarily interrupts the exposure after the fluoroscope has been activated for what length of time? a. 1 minute b. 3 minutes c. 5 minutes d. 10 minutes: C 42. During a single-contrast barium enema, the radiologist detects a possible defect within the right colic flexure. Which of the following

projections best

demonstrate this region of the colon? a. AP axial b. LPO c. RPO d. LAO: B

43. Exposure (Gy a ) refers to radiation intensity in. a. air b. skin c. water d. gonads: A 44. Exposure to the technologist is lowest during mobile C-arm fluoroscopy if the x-ray tube is placed: a. facing the technologist. b. under the patient. c. over the patient. d. facing the wall.: B 45. How will the digital xray image appear if it is grossly overexposed? a. The image will be grainy. b. There will be loss of contrast in the image. c. The image will have higher contrast. d. The appear will appear to be noisy.: B 46. How is pixel pitch determined? a. measurement from side to side of the pixel b. measurement from the center of one pixel to the center of the adjacent pixel c. height of the pixel divided by the width d. FOV divided by the matrix size: B 47. How much CR angulation should be used for a scapular Y projection? a. No CR angle should be used b. 10 to 15 degrees caudad c. 10 to 15 degrees cephalad d. 20 to 25 degrees caudad: A 48. Humans are most radiosensitive during: a. fetal stages. b. old age. c. adulthood. d. infancy.: A

49. If 300 mA has been selected for a particular exposure, what exposure time would be required to produce 6 mAs?

a. 5 ms b. 10 ms c. 15 ms d. 20 ms: D

50. If a patient is cyantoic, what condition may they suffering from and what area(s) of the body can the effects be seen? a. insufficient oxygen in body tissues; lips and nailbeds b. excessive oxygen in body tissues; lips and nailbeds c. excessive bile; eyes and skin d. hyperthemia; skin: A 51. If a radiographer is unable to achieve a short OID because of the structure of the body part or patient condition, which of the following adjustments can be made to minimize magnification distortion? a. A smaller focal-spot size should be used b. A longer SID should be used c. A shorter SID should be used d. A lower radio grid should be used: B 52. Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand? a. Prevents foreshortening of phalanges and obscuring of interphalangeal joints. b. Prevents foreshortening of radiocarpal joint. c. Opens up the carpometacarpal joints. d. Demonstrates the sesamoid bones near the first interphalangeal joint.: A 53. If a response to radiation is expected no matter how small the dose, then that dose-response is. a. nonthreshold b. linear c. threshold d. nonlinear: A 54. If a technologist is exposed to 4 mGy/hr for 45 minutes during a fluo- roscopy exam, what will be her total exposure? a. 2 mGy b. 1 mGy c. 4 mGy d. 3 mGy: D 55. If a technologist is receiving 2 mGy/hr standing 1 foot from the patient during fluoroscopy, what will the technologists rate of exposure when

he/she

steps back to a distance of 2 feet from the patient? a. 0.7 mGy/hr b. 1 mGy/hr c. 0.5 mGy/hr d. 8 mGy/hr: C

56. In DR and CR, the signal must be changed to digital form by a(n): A. digital-to-analog converter B. flux capacitor C. analog-to-digital converter D. DVD-ROM: C 57. In digital imaging, as pixel size or DEL size decreases: a. brightness increases b. brightness decreases c. spatial resolution increases d. spatial resolution decreases: C 58. In fluoroscopy, which of the following can be used to capture a radiograph- ic image?

1. image intensifier
2. indirect-capture flat-panel detector
3. direct-capture flat-panel detector
4. CCD or CMOS A. 1 and 2 only B. 1 and 3 only C. 1, 2, and 3 only D. 1, 2, 3, and 4: D 59. Which of the following is the correct formula for total brightness gain? a. minification gain times flux gain b. minification gain divided by flux gain c. flux gain divided by minification gain d. minification gain2 x flux gain2: A 60. Meiosis is the process of cell division for cells. a. muscle b. somatic c. skin d. genetic: D 61. Monitoring and documentation of procedural fluoroscopic time is essen- tial to good practice. The responsibility for monitoring and

documentation generally belongs to:

a. The nurse assisting the physician with the procedure b. The physician performing the procedure c. The radiographer assisting with the procedure d. Radiology department secretarial personnel: C

62. Part 6 (notch on scapula) refers to the: a. coracoid process b. scapular spine c. acromion process d. coronoid process: A 63. Pediatric patients require special consideration and appropriate radiation protection procedures because they are much more vulnerable to which of the following? a. Only the early somatic effects of radiation. b. Only the late somatic effects of radiation c. The late effects of radiation d. Only the genetic effects of radiation.: C 64. Primary radiation is:

1. leakage radiation
2. the scattered beam
3. the useful beam a. 1 and 2 b. 2 only c. 3 only d. 1, 2 and 3: C 65. In digital radiography, spatial resolution is improved with an increased . a. field of view b. pixel pitch c. pixel size d. matrix size: D 66. Technologists working in receive higher occupational exposure than those working in other areas of radiology. a. CT b. mammography c. interventional radiology d. surgery: C 67. The LD50/60 for humans is approximately Gray.

• a.

b. 1 c. 10 d. 2: A

68. The Law of states that the radiosensitivity of living tissue is a function of the metabolism and maturation of that tissue. a. Watson and Crick b. Hurter and Driffield c. Bergonie and Tribondeau d. Roentgen and Plank: C 69. The NCRP makes regarding dose limits. a. recommendations b. requirements c. laws d. measurements: A 70. The accuracy of collimation at a 72-inch SID must be: A. +/- 1.44 inches B. +/- 7.2 inches C. +/- 3.6 inches D. +/- 0.02 inches: A 71. What type of CR angle is required for the PA axial weight-bearing bilateral knee projection (Rosenberg method)? a. 10° caudad b. 5° to 7° cephalad c. 20° to 25° caudad d. None. CR is perpendicular to IR: A 72. The concept that although x-ray photons exist as waves, they exhibit properties of particles is(are) known as: A. wave-particle duality B. Law of Conservation C. Laws of Electrostatics D. Faraday's law: A 73. The cumulative (ED) dose limit for an occupationally exposed worker is: a. 10 mSv x years of age. b. 1 mSv x years of age. c. 100 mSv x years of age. d. 50 mSv x years of age.: A 74. T he disassociation of water molecules following irradiation is termed.

a. point mutation

b. radiolysis c. cross-linking d. ionization: B

75. The dose limit for the general public is the dose limit for occupational exposure. a. 3/4 b. 1/10 c. 1/2 d. 1/5: B 76. The effects of radiation on biologic material depend on several factors. If a quantity of radiation is delivered to a body over a long period of time, the effect: a. has no relation to how it is delivered in time b. will be greater than if it were delivered all at one time c. will be less than if it were delivered all at one time d. depend solely on the radiation quality: C 77. The fluoroscopic exposure control switch is always a(n) type. a. rheostat b. deadman c. automatic d. on-off: B 78. The internal prominence or ridge where the trachea bifurcates into the right and left bronchi is termed the: a. hilum b. carina c. thyroid cartilage d. costophrenic angle: B 79. The leakage radiation limit for x-ray tubes is less than at 1 meter from the tube housing. a. 0.5 mGy a /hr b. 1 mGy a /hr c. 3 mGy a /hr d. 2 mGy a /hr: B 80. The medical suffix plasia refers to: a. embryonic

b. condition c. movement d. development: D

81. T

he recommended thickness for protective aprons set by the NCRP is Pb equivalent. a. 1.0 mm b. 0.5 mm c. 0.3 mm d. 0.25 mm: B

82. The most radiosensitive target molecule in the human cell is the. a. hormone b. protein c. DNA d. glucose: C 83. The patient arrives from the ER with anterior rib pain for ribs 8-12. Which projections should be performed for this patient to better image the area of concern? a. AP and anterior oblique on inspiration b. PA and posterior oblique on expiration c. PA and anterior oblique on expiration d. AP and posterior oblique on inspiration: C 84. The patient is positioned prone, the midsagittal plane is perpendicular to the image receptor, the OML is perpendicular to the image receptor and the central ray is angled 15 degrees caudad. Where should the petrous ridges be located on the radiographic image? a. the petrous ridges will fill the orbits b. the petrous ridges will be mid-orbit c. the petrous ridges will be in the lower one third of the orbits d. the petrous ridges will be just below the maxillary sinuses: C 85. The patient is positioned with PA, with the midsagittal plane perpendicular and the OML forms a 37 degree angle to the image receptor. Which anatomical part will be best demonstrated? a. Frontal sinuses b. Maxillary sinuses c. Ethmoid sinuses d. Floor of the orbits: B 86. The primary means of communication with a hearing-impaired patient is through: a. writing

b. touch

c. a bilingual family member d. continual conversation: A

87. The most common interactions with low LET radiation and the human body are assumed to be: a. indirect effects (action). b. DNA damage. c. direct effects (action). d. cell destruction.: A 88. The probability of occurrence of photoelectric absorption as the energy of the incident photon decreases and the atomic number of the irradiated atoms. a. stays the same, increases b. decreases, increases c. increases, increases d. increases, decreases: C 89. The result of thermionic emission is a(n): A. recoil electron B. electron cloud C. scattered photon D. characteristic photon: B 90. The source- to-skin distance must not be less than on stationary fluoroscopes. a. 30 cm b. 48 cm c. 38 cm d. 42 cm: C 91. The spinal cord tapers off to a point distally at the level of: a. L1-L2 intervertebral space b. L2-L3 intervertebral space c. L5-S1 intervertebral space d. L4-L5 intervertebral space: A 92. The three cardinal principles of radiation protection involve: a. ALARA, time, and distance. b. dose, shielding, and exposure. c. time, distance, and shielding. d. exposure, shielding, and ALARA.: C 93. The tissue in the is more