Radiographic Principles and Techniques, Exams of Radiology

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ARRT Mock Registry exam with answers

If a radiographic image is produced of a patients body part and the radiographer did not collimate as closely as would be preferred, prior to the exposure, the radiographer should do which of the following during post processing of the image? A) Use digital masking (shuttering) on the image prior to sending it to the radiologist B) Leave all exposed areas of anatomy visible on the image sent to the radiologist C) Repeat the projection with optimal collimation, then submit it to the radiologist D) Using the smoothing function to eliminate scatter fog in the image prior to submitting it to the radiologist - correct answers✔✔B) Leave all exposed areas of anatomy visible on the image sent to the radiologist Which of the following is a legal doctrine that may apply in a medical malpractice case in which negligence would be obvious to any reasonable person? A) Respondent superior B) Tort C) Res Ipsa loquitor D) Attribution - correct answers✔✔C) Res Ipsa loquitor Images recorded as part of a radiographic exam are legally apart of the patients medical record and are the property of what individual or entity? A) the patients B) The institution in which they are performed C) the interpreting radiologist D) The ordering physician - correct answers✔✔B) The institution in which they are performed

Which of the following statements is true about the five stages of grieving, as described by Dr. Elizabeth Kubler-Ross? A) The five stages generally occur in order B) When a person is in the denial stage, medical professionals should try to overcome the denial by stating the truth C) During the anger stage, it is possible that the person will take out anger on family or healing professionals D) Each person dealing with grief will experience all five stages at some point during the grieving process - correct answers✔✔C) During the anger stage, it is possible that the person will take out anger on family or healing professionals Which of the following is an example of therapeutic non verbal communication between a radiographer and a patient? A) Radiographer stands with arms crossed while gathering patient history B) Radiographer tells the patient that he or she will fee; no pain during the procedure but will not return the patients eye contact C) The radiographic room is neat and organized D) The radiographer hugs the patient at the end of the exam because she seems anxious - correct answers✔✔C) The radiographic room is neat and organized You and one assistant receive an average size female patient on a gurney with possible spinal injury. You must transfer her to the exam table to complete her imaging exams. Which would be the best choice of transfer methods in this situation? A} Sliding or "smoothie" board B) Log roll method C) Sheet transfer D) Allow the patient to move herself if she is able - correct answers✔✔A) Sliding or "smoothie" board

Which of the following terms is used to describe a condition that can result from blunt trauma to the chest, in which the heart is bruised and can hemorrhage into the pericardium and prevent expansion of the heart? A) Hematoma B) Myocardial infarction C) Hemothorax D) Cardiac tamponade - correct answers✔✔D) Cardiac tamponade The following symptoms are characteristic of what type of seizure? Symptoms: rigid muscles and arching of back, jerky and irregular body movements, possible vomiting, froth or blood streaked saliva from the mouth, urinary or fecal incontinence A) Generalized B) Complex Partial C) Simple partial D) syncope - correct answers✔✔A) Generalized If a disease causing microorganism is transmitted from one patient to another by means of an improperly cleaned instrument, the means of transmission is? A) indirect contact B) direct contact C) vehicle D) Vector E) Droplet contact - correct answers✔✔A) indirect contact How far can pathogenic organisms that are transmitted by droplet travel? A) 2 feet B) 3 feet

C) 5 feet D) 10 feet - correct answers✔✔B) 3 feet The intrathecal route of drug administration falls into which category of administration? A) Enteral B) Topical C) Parenteral D) Intravenous - correct answers✔✔C) Parenteral Which of the following needle sizes has the largest bore? A) 18 gauge B) 20 gauge C) 22 gauge D) 26 gauge - correct answers✔✔A) 18 gauge Which of the following contrast media is characterized by having the property of molecular dissociation into two charged particles when becoming part of a solution? A) ionic contrast B) positive contrast C) barium D) iodinated contrast - correct answers✔✔A) ionic contrast Which of the following is necessary when claiming a case of malpractice? A) Negligence occurred but did not result in injury or loss to the patient B) Defendant provided mediocre care to the patient

C) Plaintiffs actions contributed to injury of loss D) Improper practices by the defendant caused the injury - correct answers✔✔D) Improper practices by the defendant caused the injury 5 examples of non verbal communication - correct answers✔✔eye contact orderly work area smile gentle touch neat personal appearance The PSP in computed radiography can retain residual energy from previous radiation exposures. Therefore it is important for the radiographer to: A) Scan the PSP imaging plate a second time to capture additional anatomic information for the radiologist to interpret B) Reduce the exposure factors used during subsequent radiographic procedures to take advantage of residual energy, thereby optimizing ALARA C) Remove the residual energy during post processing of the original image to avoid ghost image artifacts D) Erase any potential residual energy within the PSP by exposing the IP to intense light in the CR scanner - correct answers✔✔D) Erase any potential residual energy within the PSP by exposing the IP to intense light in the CR scanner Identify the 4 objective/physical signs below A. Diaphoresis B. Febrile C. Pain level described by patient D. Blood pressure E. Rapid pulse F. Patient description of anxiety - correct answers✔✔A. Diaphoresis B. Febrile D. Blood pressure

E. Rapid pulse Which of the following is a phosphor most likely to be used in an indirect radiography system? A) BaSO B) Csl C) NaCl D) a-Se - correct answers✔✔B) Csl If a physician were to complain about poor spatial resolution seen in radiographic images produced in a medical imaging department, the best technical solution would be which of the following? A) Have radiographers increase collimation B) Have radiographers use the smoothing function during post-processing C) Have radiographers increase the field of view D) Utilize a larger matrix size to produce the images - correct answers✔✔D) Utilize a larger matrix size to produce the images In computed radiography (CR), energy stored in the PSP is stimulated in the scanner by? A) low energy xrays B) microwaves C) red light D) ultraviolet light - correct answers✔✔C) red light post-processing a digital radiographic image using electronic masking would result in which of the following?

A) Enhanced visualization of the edges of the anatomical structures B) Magnification of the radiographic image C) radiation dosage to the patient D) Improved spatial resolution - correct answers✔✔A) Enhanced visualization of the edges of the anatomical structures Using post-processing, a radiographer can enhance the subject contrast when using CR by: A) Increasing the kilovoltage B) Using increased filtration of the primary beam C) Increasing OID D) Using a narrower window width setting to display image - correct answers✔✔D) Using a narrower window width setting to display image A megabyte is equal to: A) 1,000,000 bytes B) 1,000 bytes C) 1,000,000,000 bytes D) 1,000,000,000,000 bytes - correct answers✔✔A) 1,000,000 bytes In digital radiography, a charged- coupled device: A) replaces the film used in a conventional fluoroscopic unit B) is used instead of a camera in a conventional fluoroscopic unit C) Eliminates electronic noise in the image D) minimizes the analog image produced at the input phosphor - correct answers✔✔B) is used instead of a camera in a conventional fluoroscopic unit All of the following pertain to the manner in which specific anatomic details are displayed in digital imaging except:

A) by specific pixels in the digital image B) as a specific portion of the image matrix C) as a digital image component displaying specific gray tones D) as a permanent set of brightness levels that cannot be changed - correct answers✔✔D) as a permanent set of brightness levels that cannot be changed The brightness of a pixel depends on all of the following, except: A) Bit depth B) Pixel pitch C) The exposure intensity D) Brightness setting of the monitor - correct answers✔✔B) Pixel pitch A larger number of pixels in the digital matrix image produces A) Increased spatial resolution B) Decreased spatial resolution C) Increased contrast D) Increased image brightness - correct answers✔✔A) Increased spatial resolution The area of anatomical information displayed in a matrix is determined by the A) field of view B) pixel size C) Dynamic range D) Then umber of bits in each pixel - correct answers✔✔A) field of view The dynamic range in a digital image is determined by

A) field of view B) the amount of magnification in the image C) pixel bit depth D) The matrix size - correct answers✔✔C) pixel bit depth A larger dynamic range in a image represents A) Fewer gray tones displayed B) More gray tones displayed C) higher spatial resolution D) A greater signal to noise ratio - correct answers✔✔B) More gray tones displayed Which of the following would be considered a potential disadvantage of CR vs. conventional/analog? A) Dose creep B) increased spatial resolution C) decreased IP fogging due to background radiation D) increased latitude - correct answers✔✔A) Dose creep In CR, the latent image is considered a A) digital image B) analog image C) manifest image D) post processing image - correct answers✔✔B) analog image The purpose of the amorphous silicon photodiode in an indirect capture digital radiography system is to:

A) Allows the current produced to flow in only one direction B) Redirect light produced to a photo multiplier tube C) Convert xray energy to light energy D) Determine the histogram appropriate for the anatomical part being examined - correct answers✔✔A) Allows the current produced to flow in only one direction Spatial resolution is determined by A) the number of gray tones that can be demonstrated in the pixel image B) the minimal distance between two anatomical structures that can be recognized as separate structures in the pixel image C) The size of the field of view D) The pixel bit depth - correct answers✔✔B) the minimal distance between two anatomical structures that can be recognized as separate structures in the pixel image The ability of a digital detector to convert an xray exposure into a useful image is called A) contrast resolution B) spatial resolution C) Pixel sampling D) Detective quantum efficiency - correct answers✔✔D) Detective quantum efficiency Which of the following indicated the amount of exposed used in digital radiography? A) The degree of spatial resolution B) The degree of contrast resolution C) The exposure indicator D) The signal to noise ratio - correct answers✔✔C) The exposure indicator

Nyquist frequency is directly related to A) contrast resolution B) spatial resolution C) signal to noise ratio D) Field of view - correct answers✔✔B) spatial resolution The higher the sampling frequency and the smaller the pixel pitch the A) Better the contrast resolution B) better the contrast resolution C) less DEQ present D) Less the patient exposure - correct answers✔✔B) better the contrast resolutionDe Defective pixels that do not function at all are called A) Lag pixels B) Displaced pixels C) Dead pixels D) ghost pixels - correct answers✔✔C) Dead pixels All of the following are types of digital imaging artifacts except A) Aliasing B) image compression C) collimation D) pixel pitch - correct answers✔✔D) pixel pitch

which of the following environmental factors can reduce optimal image contrast while viewing an anatomical image on a monitor A) Ambient light B) pixel pitch C) scatter radiation D) Room temperature - correct answers✔✔A) Ambient light In a digital image a metalic object would appear as A) A medium gray value B) dark gray value C) white value D) black value - correct answers✔✔C) white value Which of the following would be considered a disadvantage of an indirect capture digital system compared to a direct capture digital system? A) Lower MTF B) Higher MTF C) smaller number of detectors D) Limited field size - correct answers✔✔A) Lower MTF Patient demographic information is critical in digital radiography sytems because of all of the following except? A) It is tied into an MRM or accesion number that can be retrieved for viewing or stored in PACS B) Ensures the correct diagnosis is matched with the correct patient C) Enables proper billing to the correct patient

D) it enables the system to use a histogram that is most appropriate to the patient - correct answers✔✔D) it enables the system to use a histogram that is most appropriate to the patient All of the following have an inverse relationship, except A) pixel size/ spatial resolution B) Collimation/ patient exposure C) Matrix size/ pixel size D) FOV/ patient exposure - correct answers✔✔D) FOV/ patient exposure Which of the following is a formula to determine pixel size? A) Pixel size = FOV/ matrix size B) Pixel size = 1/2 sampling frequency C) Pixel size = matrix size/ bit depth D) Pixel size = pixel pitch/2 - correct answers✔✔A) Pixel size = FOV/ matrix size Image quantum noise is caused by A) Deficient mAs B) Scattered photons C) Excessive edge enhancement D) Small metallic objects in the anatomical part being radiographed - correct answers✔✔A) Deficient mAs All of the follo0wing contribute to the manifest digital image except A) Matrix size B) Pixel bit depth

C) Pixel pitch D) Analog signal - correct answers✔✔D) Analog signal The layer of a PSP that is responsible for trapping electrons in F centers during an exposure is called A) Phosphor layer B) protective layer C) Reflective layer D) Backing layer - correct answers✔✔A) Phosphor layer Which of the following represents contrast resolution in the image acquisition process? A) Pixel B) pixel size C) Pixel pitch D) Bit depth - correct answers✔✔D) Bit depth What form of filtering amplifies high frequencies to increase contrast of large structures? A) Smoothing B) Edge enhancement C) Window level D) Window width - correct answers✔✔B) Edge enhancement The application of pressure to LCD screens can be the cause of

1. dead pixels
2. Stuck pixels

3. Mitotic pixels A) 1 only B) 2 only
4. 1 and 2 only
5. 1, 2 and 3 - correct answers✔✔3) 1 and 2 only Characteristics of tungsten that make it a useful component of xray tubes include
6. high melting point
7. Thermal conductivity
8. High atomic number A) 1 only B) 1 and 2 only C) 2 and 3 only D) 1, 2 and 3 - correct answers✔✔D) 1, 2 and 3 Select the three correct statements regarding the xray tube anode A) An induction motor rotates the anode B) the anode is the negative electrode C) Two parts of an induction motor are its stator and rotor D) The anode rotates at about 3600 RPM E) the anode is heated by 3-5A into 10-12V F) Molybdenum is added to the focal track to help prevent pitting - correct answers✔✔A) An induction motor rotates the anode C) Two parts of an induction motor are its stator and rotor D) The anode rotates at about 3600 RPM

All the following statement regarding xray production are true except A) Xray production efficiency is independent of tube current B) High speed electron interaction with inner shell target atoms results in Brems radiation C) Xray production efficiency increases with increasing kV D) Heat production increases with increasing kV - correct answers✔✔B) High speed electron interaction with inner shell target atoms results in Brems radiation Select the three phrases below that are associated with deterministic effects A) Have no threshold dose B) Are predictable C) Proportional to dose perceived D) Characterized by linear dose responses E) increasing in number past two decades - correct answers✔✔B) Are predictable C) Proportional to dose perceived E) increasing in number past two decades All of the following statements below regarding stochastic effects of radiation are true except A) likelihood of stochastic effects occurrence depends upon the radiation dose B) The severity of any stochastic effects is dependent upon the radiation dose C) Stochastic effects include heritable genetic effects and some somatic effects D) Stochastic effects are late effects of ionizing radiation exposure - correct answers✔✔B) The severity of any stochastic effects is dependent upon the radiation dose The number of ionizations occurring along the path of the xray phtons refers to

A) LET

B) RBE

C) LNT

D) ALARA - correct answers✔✔A) LET If a radiation damaged cell ceases its efforts tp repair itself, this is called A) Synthesis B) Based damage C) Cell cycle arrest D) Apoptosis - correct answers✔✔C) Cell cycle arrest All of the following are characteristics of xrays except A) Xrays are electrically neutral B) xrays have a psychological effect on living tissue C) xrays are focused in straight lines D) Xrays have a penetrating effect on all matter - correct answers✔✔C) xrays are focused in straight lines Select the three phrases that are associated with Compton interactions A) low energy incident photon B) predominates in the xray energy range C) Characteristic radiation is produced D) portion of incoming photon energy is transferred E) is directly related to atomic number F) responsible for increased patient dose

G) results in ionization and scattered photon - correct answers✔✔B) predominates in the xray energy range D) portion of incoming photon energy is transferred G) results in ionization and scattered photon Select the three essential requirements for x-ray production from those listed below A. thermionic emission B. solid state rectifiers C. electron acceleration D. induction motor E. high-speed rotation F. electron deceleration G. source of direct-current - correct answers✔✔A. thermionic emission C. electron acceleration F. electron deceleration The following are associated with a photoelectric interaction

1. Outer shell interaction
2. Total absorption of incident photon
3. Low energy incident photon A) 1 only B) 1 and 2 only C) 2 and 3 only D) 1,2 and 3 - correct answers✔✔C) 2 and 3 only Xtay photons leaving the anode are referred to as the

A) remnant beam B) primary beam C) leakage radiation D) scattered radiation - correct answers✔✔B) primary beam which interaction is most likely to be associated with increased patient dose? A) bremsstrahlung B) compton C) coherent D) photoelectric - correct answers✔✔D) photoelectric select the correct sequence of events that follow high level radiation exposure resulting in acute radiation syndrome A) manifest illness, prodromal period, latent period B) manifest illness, latent period, prodeomal period C) proposal period, latent period, manifest illness D) latent period, prodromal period, manofest illness - correct answers✔✔C) proposal period, latent period, manifest illness Select the three correct statements from those listed below A) potential biologic effects increase as LET increases B) double strand DNA breaks occur with low LET radiation C) The presence of oxygen increases tissue radiosensitivity D)the direct effect is associated with formation of free radicals E) point mutations are not repairable F) RBE increases as LET increases - correct answers✔✔A) potential biological effects increase as LET increases

C) the presence of oxygen increases tissue radiosensitivity F) RBE increases as LET increases The basic methods of radiation protection are: A) collimation, timr, no repeats B) shielding, time, distance C) collimation, distance, gonadal shielding D) Time, distance, collimation - correct answers✔✔B) shielding, time, distance Which of the following statements regarding the time on fluoroscopy machines is true?

1. It is federal law that requires machines in the United States to an audible 5 minute timer
2. once 5 minutes has elapsed the radiographer must stop the procedure
3. The timer can be set as many times as necessary to complete the procedure A) 1 only B) 1, 2 and 3 C) 2 only D) 1 and 3 only - correct answers✔✔D) 1 and 3 only What is the most dangerous source of radiation for the technologists who remains in the room during a fluoroscopic procedure? A) Xray tube B) Bucky C) patient D) primary radiation - correct answers✔✔C) patient

When dealing with a pediatric patient as young as 3 or 4 years of age, what should be your first choice in regards to immobilizing the patient? A) Sheet restraints B) pig o stat C) plexiglas paddle D) Try to gain the trust of the child by communicating on their age level - correct answers✔✔D) Try to gain the trust of the child by communicating on their age level Which of the following devices allow for the limitation of the beam to the area of clinical interest? A) collimator B) Grid C) lead shields D) Compensating filter - correct answers✔✔A) collimator What is the purpose of using filtration in regards to minimizing the patient exposure? A) It increases the patient dose so you can lower your technique B) It allows you to see where you should be aligning the tube C) It is used to selectively absorb low energy photons D) It allows for adequate gonadal shielding - correct answers✔✔C) It is used to selectively absorb low energy photons What is the NRCP recommended total filtration for xray equipment operating above 70 kVp? A) 2.5 mm aluminum equivalent B) 1.5 mm aluminum equivalent C) 0.5 mm aluminum equivalent

D) 2.0 mm aluminum equivalent - correct answers✔✔A) 2.5 mm aluminum equivalent The NCRP recommends that the annual occupational exposure to the lens of the eye not exceed A) 5mSv B) 15 mSv C) 50mSv D) 150mSv - correct answers✔✔D) 150mSv The NCRP recommends that the annual occupational exposure to the hands, feet and skin not exceed A) 500 mSv B) 150 mSv C) 100 mSv D) 50 mSv - correct answers✔✔A) 500 mSv The exposure rate caused by scatter emerging from the patient during fluoroscopic procedures is greatest at A) the exit surface of the patient B) the entrance surface of the patient C) the patient surface away from the xray tube D) Right angles to the patient - correct answers✔✔B) the entrance surface of the patient Select the three correct statements regarding the bucky slot cover A) The bucky slot cover is a hinged metal arm attached to the bucky tray

B) The bucky slot cover is in place when the bucky tray is positioned at the foot of the xray table C) Bucky slot cover must have at least 0.5 mm Pb equivalent D) The bucky slot cover reduces occupational gonadal dose E) The bucky slot cover increases patient dose - correct answers✔✔A) The bucky slot cover is a hinged metal arm attached to the bucky tray B) The bucky slot cover is in place when the bucky tray is positioned at the foot of the xray table D) The bucky slot cover reduces occupational gonadal dose The risk of occupational exposure is more significant in which 3 of the following? A. Lumbar spine imaging B. General fluoroscopy C. Scoliosis series D. Mobile imaging E. Interventional procedures - correct answers✔✔B. General fluoroscopy D. Mobile imaging E. Interventional procedures The type of personnel monitor having an ionization chamber using Bluetooth technology is the A) pocket dosimeter B) optically stimulated luminescence dosimeter C) direct ion storage dosimeter D) thermoluminescent dosimeter - correct answers✔✔C) direct ion storage dosimeter Select the 3 statements regarding xray beam protective filtration A) Equipment operated above 70kV must have at least 3.5mm AL equivalent

B) filtration removes low energy xrays from primary beam, thereby reducing patient skin dose C) filtration removes low energy xrays from primary beam, thereby decreasing the average energy of the beam D) filtration is usually expressed in milimeters of Pb equivalent E) filtration removes low energy xrays from primary beam, thereby increasing the average energy of the beam F) Filters are built into the xray tube construction or added to the xray tube - correct answers✔✔B) filtration removes low energy xrays from primary beam, thereby reducing patient skin dose E) filtration removes low energy xrays from primary beam, thereby increasing the average energy of the beam F) Filters are built into the xray tube construction or added to the xray tube An optically stimulated luminescence dosimetry system is most likely to use which of the following active ingredients? A. Silver bromide B. Air C. Lithium fluoride D. Aluminum oxide - correct answers✔✔D. Aluminum oxide Radiography students younger than 18 years must not exceed what dose limit? A. 50 mSv B. 5 mSv C. 1 mSv D. 0.5 mSv - correct answers✔✔C. 1 mSv Advantages of fewer fluoroscopic pulse/second sequences include

1. Less image noise

2. Lower patient dose
3. Less x-ray tube wear and tear
4. Greater temporal resolution A. 1 and 2 only B. 2 and 3 only C. 1, 2, and 3 only D. 1, 3, and 4 only - correct answers✔✔B. 2 and 3 only Which of the following advance directives names a proxy to make decisions if the patient becomes unable to make or communicate medical decisions? A) Do Not Intubate (DNI) B) living will C) Do Not Resuscitate (DNR) D) Durable Power of Attorney for healthcare (DPOA) - correct answers✔✔D) Durable Power of Attorney for healthcare (DPOA) During post-processing of a digital radiographic image, the radiographer may increase the window width to change image contrast. This action does not change which of the following? A. Pixel bit depth B. Image contrast C. Image visibility D. A more black and white image to one with more gray tones - correct answers✔✔A. Pixel bit depth In digital radiography, a pixel that is 16 bits deep means that it can display A) 65,536 gray tones