Upgrade to remove ads
Only $2.99/month

hesi review

Mometrix
Get Quizlet's official HESI A2 - 1 term, 1 practice question, 1 full practice test
Preview

Terms in this set (113)

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

A Over prescription of antibiotics and poor infection control practices.Co rrect
B Use of antibiotics with immunosuppressed patients.
C Improper cleaning of medical equipment.
D Poor hygiene and overuse of pain killers.
A. Over prescription of antibiotics and poor infection control practices.
The overuse of antibiotics and lax infection control practices has lead to infections that do not respond to normal antibiotics, such as MRSA. If used properly, antibiotics may be used to treat immunosuppressed patients. Improper cleaning of medical equipment may cause clostridium difficile colitis, another hospital acquired infection, and poor hygiene could
1. X-ray machines are designed to operate at a specific and continuous supply voltage. Which part of the imaging system is responsible for keeping incoming voltage adjusted to the proper value?

A.Milliampere (mA) meter.
B.Line compensator
C.Autotransformer.
D.Kilovolts peak (kVp) meter.
B.Line compensator
2.Which calculation is used to determine grid ratio?

A. The height of the lead strips divided by the width of the lead strips
B. Height of the lead strips divided by the width of the interspace material
C. The width of the interspace material divided by the height of the lead strips.
D. The width of the lead strips divided by the height of the lead strips.
B. Height of the lead strips divided by the width of the interspace material.
3. What is the function of a rectifier?

A. Convert alternating current to pulsating direct current. Correct
B. Convert direct current to alternating current.
C. Increase 60 Hertz alternating current to high frequency current.
D. Change direct current to high frequency current.
A. Convert alternating current
4.The radiographer is using automatic brightness control during a fluoroscopy. What change in patient exposure should the radiographer expect as the patient size increases?

A No change in exposure.
B Increase in exposure.
C Indeterminant change in exposure.
D Reduction in exposure.
B Increase in exposure.
Automatic brightness control (ABC) increases patient exposure as patient size increases, compensating for additional attenuation of a thicker body to maintain image brightness. ABC does not reduce patient exposure under these conditions. Since the ABC does change patient exposure, it fails to maintain patient exposure at the same level. The patient exposure change is definite--an increase--not indeterminate.
5.The Z number of oxygen is 8. The elemental oxygen atom has two electron shells. How many electrons occupy an electrically neutral oxygen atom's outer shell?

A 4
B 6
C 8
D 2
B 6
An electrically neutral oxygen atom's outer shell contains 6 electrons. Two electrons are in the K shell and 6 in the L shell. The other answers are incorrect.
6. Which steps increase contrast in fluoroscopy? (Select the two that apply.)


A Increase kilovolts peak (kVp).
B Increase milliamperes (mA).
C Reduce kilovolts peak (kVp).
D Use a smaller collimator field.
E Use a larger collimator field.
C Reduce kilovolts peak (kVp).
D Use a smaller collimator field.
Using a smaller collimator field increases contrast, by reducing scatter and secondary radiation production, and thus reducing fog. Reducing kVp increases contrast, at the risk of lowered penetration. Changing mA does not impact contrast, assuming adequate exposure is used. The use of a larger collimator field will reduce contrast by increasing secondary and scattered radiation production. Increasing kVp increases penetration and reduces contrast.
7. What causes the build-up of heat at the anode?

A Tungsten deposits on the glass envelope.
B High x-ray tube voltage. Incorrect
C Thermionic emission.
D Electrons colliding with the target.
D Electrons colliding with the target.
The tremendous amount of heat generated at the anode is the result of the electron beam colliding with the target. The vast majority ( >99% according to some authorities) of electron-target interactions take place at such low energy, that the emitted waveform is infrared radiation or heat. Thermionic emission refers to the "boiling off" of electrons at the filament. The x-ray tube voltage creates the flow of electrons from the cathode to the anode. Tungsten deposits within the x-ray tube are caused by evaporation of the filament and can lead to tube failure.
8. Which condition must be met before diagnostically useful characteristic x-rays can be produced?

A An inner shell electron must be completely removed.
B Tissues with high atomic numbers must be present.
C Characteristic x-rays can be produced only above 85 kiloelectron volts (keV).
D A specific milliampere-seconds (mAs) should be selected.
A An inner shell electron must be completely removed.
Diagnostically useful characteristic x-rays are produced when an outer shell electron drops to an inner shell void left, after an inner shell electron has been completely removed. The mAs setting does not affect characteristic x-ray production. Characteristic x-rays may be produced under 85 keV. Increase in the atomic number does enhance the efficiency of characteristic x-ray production, but need not be present.
9. How often should lead aprons be evaluated to determine if cracks or holes are present?

A Every 3 months.
B Annually.
C Every 6 months.
D Monthly.
B Annually.
Lead aprons and gloves should be radiographed or viewed through a fluoroscope on acceptance. Then they should be checked annually (B) thereafter to determine if any cracks or holes are present. Not only is this recommended by health physicists, but it is also a point which is checked by The Joint Commission during their site visits. All other options are incorrect intervals.
10. A Bremsstrahlung interaction is best described by which statement?

A A photon strikes an inner shell electron.
B An electron is slowed and changes direction.
C An electron strikes an inner shell electron.
D A photon is slowed and changes direction.
B An electron is slowed and changes direction
Bremsstrahlung (Brems) interactions occur when an electron is attracted to the positive nuclear charge of a tungsten atom and is slowed as it passes. The statements that refer to photon interactions do not correctly describe Brems interactions. Characteristic radiation is produced when a projectile electron interacts with an inner shell electron of the target atom.
11. A portable knee exam performed in the operating room results in a beam intensity of 2.5 R at 32 inches. What is the intensity of the beam if the same exposure factors are used for a post-operative knee at a distance of 40 inches?

A 1.60 R.
B 3.90 R.
C 3.12 R.
D 2.00 R.
A 1.60 R
The inverse square formula (I1/I2=D22/D21) is used to determine the new intensity: 2.5 / x = 1600 (40 squared) / 1024 (32 squared); x = (2.5) (1024) / 1600 = 1.6 R. All other answers result from incorrect usage of the inverse square formula.
12. Which part of the x-ray circuit is controlled by adjusting the milliamperage (mA) setting on the operating console for the purpose of producing the heat necessary for thermionic emission?

A Timer circuit.
B Primary circuit.
C Secondary circuit.
D Filament circuit.
D Filament circuit.
The filament circuit controls the amount of heat applied to the filament that is required to boil off the desired number of electrons by the process of thermionic emission; the amount of current that is applied to the filament is under the control of the radiographer when the mA station is selected. The primary circuit regulates the incoming power supply and determines the voltage that is applied to the x-ray tube. The secondary circuit contains the mA meter, as well as the entire x-ray tube, except for the filament circuit. The timer circuit is part of the primary circuit and controls the amount of time the filament is heated.
13. The majority of x-rays in the useful beam are created as a result of which process?

A Orbital electrons drop down to fill vacant inner shells.
B Orbital electrons become excited and release their energy.
C Fast-moving electrons approach the nucleus of the target atom and slow down.
D Fast-moving electrons interact with the K shell electrons of the target atom. Incorrect
C Fast-moving electrons approach the nucleus of the target atom and slow down.
Most x-rays in the useful beam are bremsstrahlung x-rays, which are formed when projectile electrons approach the nucleus of the target atom and slow down. The other options describe coherent scattering and characteristic interactions.
14. What is the maximum speed of filament electrons as they travel toward the anode?

A The speed of light. Incorrect
B One-fourth the speed of light.
C One-eighth the speed of light.
D Half the speed of light.
D Half the speed of light.
Filament electrons may reach speeds of about half the speed of light. The other answers are too fast or too slow.
15. Which term refers to the radiation that exits the x-ray tube through the collimator?

A Scatter.
B Leakage.
C Primary.
D Remnant.
C Primary.
The unattenuated radiation that exits the tube through the collimator is called primary radiation. Leakage radiation refers to radiation exiting the tube housing in directions other than toward the patient. Remnant radiation is composed of x-ray photons that strike the image receptor after exiting the patient. Scatter radiation consists of photons from the primary beam that travel randomly in different directions after interacting with matter.
16. Which device temporarily stores an electric charge?

A Capacitor.
B Autotransformer.
C Diode.
D Rectifier.
A Capacitor.
A capacitor temporarily stores an electric charge. A diode only allows electrons to flow in one direction. A rectifier converts alternating current (AC) to direct current (DC). An autotransformer is a transformer operating on the process of self-induction.
17. What is the longest field size dimension allowable for 10 inches by 12 inches collimation at a 40 inch source to image distance (SID)?

A 11.4 inches.
B 13.2 inches.
C 10.6 inches.
D 12.8 inches.
D 12.8 inches.
Field size may be off +/- 2% of the SID, which in this case is 0.8 inches. 12.8 inches is in the acceptable range. 10.6 inches and 11.4 inches have collimation-field size discrepancies that are within the acceptable range. 13.2 inches exceeds the acceptable range.
18. What is the process if a lead apron is suspected of being defective?

A Wait until the scheduled semiannual apron inspection to act.
B Do a visual inspection. If nothing seen, return the apron for use.
C Remove the apron from use, visually inspect for defects, and fluoroscope for cracks.
D Place the apron at the back of the apron rack so it is used only on rare occasions
C Remove the apron from use, visually inspect for defects, and fluoroscope for cracks
A defective apron should be removed from circulation, visually inspected, and fluoroscoped for cracks in the lead. Apron inspection should occur twice yearly or at least annually. A visual inspection only would not reveal cracks in the lead. Defective aprons should be removed from use until they are repaired.
19. Which item can be used as indicators of the quality of the diagnostic x-ray beam?

A Exposure time.
B Object-to-image-receptor-distance (OID).
C Kilovolts peak (kVp).
D Source-to-image-receptor-distance (SID).
C Kilovolts peak (kVp)
X-ray beam quality is controlled by kVp. Exposure time, OID, and SID affect beam quantity, not quality.
20. Why should computed radiography (CR) image receptors (IR) be erased if they haven't been used?

A Eliminate phantom artifacts.
B Prevent a Moire effect.
C Ensure dropout artifacts do not occur.
D Remove fog from background radiation.
D Remove fog from background radiation.
If IRs haven't been used, they should be erased due to fogging from background radiation. A Moire effect, dropout artifact, and phantom artifact are all unaffected by how long or how often IRs have been used.
21. Which information in the patient history should prompt the radiographer to decide against using automatic exposure controls when taking a chest x-ray?

A Pneumothorax.
B Emphysema.
C Oat cell carcinoma.
D Chronic bronchitis.
B Emphysema.
The pathophysiologic changes to lung tissue in emphysema result in easy penetration, so automatic exposure controls (AEC) should not be enabled for radiographic exams in these patients because the film will be too dense as a result of the control failing to shut the exposure off quickly enough. Patients with pneumothorax, chronic bronchitis, or oat cell carcinoma do not have hyperinflation of the lungs, therefore AEC can be enabled for their exams.
22. Where is edge enhancement post processing be most helpful in digital radiography?

A Spinal examinations.
B Abdominal soft tissue studies.
C Low contrast situations.
D High contrast situations.
C. Low contrast situations.
Edge enhancement post processing has been shown in research to be helpful in low contrast situations. Available research in higher contrast situations, abdominal soft tissue studies, and spinal exams, has emphasized the gain in quantum mottle seen with edge enhancement post processing. So far Radiologists are distancing themselves from all but low contrast circumstances.
23. On which system does hospital staff input new orders for radiologic examinations?

A Picture archiving and communication system.
B Hospital information system.
C Digital imaging and communications system.
D Radiology information system.
B Hospital information system.
New orders are entered on the hospital information system.The radiology information system tracks workflow and collects work-related data in the Radiology department only. There really isn't a digital imaging and communications (DICOM) system. Instead there is a DICOM standard, which permits picture archiving and communications systems (PACS) to communicate with each other and connected computers. Picture archiving and communication systems (PACS) store medical images, essentially replacing the file room.
24. Which digital post-processing results in a black background surrounding the original collimated edges?

A Beam restriction.
B Subtraction.
C Collimation.
D Shuttering.
D Shuttering
Shuttering is a post exposure processing technique that results in a black background surrounding the original collimated edges. Beam restriction is the act of reducing the radiation field size mechanically or electrically. Subtraction is a technique to selectively remove superimposing structure by electronically deducting the relative brightness of a scout image from that of the diagnostic image. Collimation is the act of reducing the radiation field size mechanically or electrically.
25. Which conditions will require an increase in technical factors when performing a KUB?
1. Ascites.
2. Diabetes.
3. Bowel Gas.
4. Pneumonia.
5. Soft tissue masses.

A 1, 2, and 5.
B 3 and 5.
C 1 and 5.
D 2 and 4.
C 1 and 5.
Ascites and soft tissue masses will require an increase in technical factors because sections of the abdomen that normally contain gas or fat are filled in with denser tissue/water. Diabetes will not affect the density of the abdomen. Bowel gas will require a decrease in technical factors because the extra gas in the abdomen requires less penetration of the beam. Pneumonia will affect densities in the thorax, not the abdomen.
26.
ID: 3017347850
Who judges radiographic images for quality? (Select the four that apply.)


A Quality control technologists.
B Lawyers.
C Ordering physicians.
D Radiographers.
E Radiologists.
A Quality control technologists.
C Ordering physicians.
D Radiographers.
E Radiologists.
Radiographs are judged for quality by essentially all quality control technologists, ordering physicians, radiographers, and radiologists who see them. Lawyers depend upon hired expert radiologists to judge radiographs for them
27. Which represents the optimum kilovolts peak (kVp) for exposing film-screen radiographs of the adult anteroposterior (AP) lumbar spine?

A 70 kVp.
B 80 kVp.
C 60 kVp.
D 90 kVp.
B 80 kVp.
Film-screen radiographs of the adult AP lumbar spine should, optimally, be exposed at 80 kVp. 60 kVp is not sufficient for adequate penetration of bony structures of the lower spine. 70 kVp may provide penetration, but would cause excessively short scale contrast in the image. 90 kVp would cause excessively long scale contrast in the image.
28. Assuming that automatic exposure control is to be used, what backup milliampere-seconds (mAs) are sufficient for a large (100 kg) adult anteroposterior (AP) lumbar spine done at 80 kilovolts peak (kVp)?

A 40 mAs.
B 80 mAs.
C 100 mAs.
D 60 mAs.
C 100 mAs.
The rule of thumb suggests a back up mAs 50% larger than the highest expected mAs. Experience teaches that it is never a bad idea to use extra back up mAs, as it is difficult to predict the influence of musculature and pathology on a lumbar spine image. Thus 100 mAs is the best choice. 40 mAs might reasonably be expected to be the minimum mAs used for the actual exposure, not backup. 60 mAs might reasonably be expected to be needed for muscular or heavily arthritic patients. Thus 50% more than the highest expectation is 90 mAs. So 80 mAs, by that reasoning, is too low.
29. Picture archiving and communication system (PACS) networks are capable of performing which functions? (Select the two that apply.)


A Tracking billing information.
B Transmitting diagnostic images to remote work stations.
C Downloading images from different imaging modalities.
D Tracking radiology scheduling information.
E Processing laboratory reports.
B Transmitting diagnostic images to remote work stations.
C Downloading images from different imaging modalities.
PACS is a computerized system that allows different digital imaging programs to download from CR, DR, MR, Nuclear Medicine, PET, Ultrasound, CT, and film digitizers; and transmits images from work stations for viewing. A Hospital Information System (HIS) tracks billing information. Laboratory reports may be processed by an HIS, or one of its medical sub-systems. A Radiology Information System (RIS) contains radiology scheduling information.
30. Digital radiography has the ability to produce 16,000 shades of gray. Which appropriate bit-depth (dynamic range) does this represent?

A 2 raised to the 10th power.
B 2 raised to the 14th power.
C 2 raised to the 12th power.
D 2 raised to the 16th power.
B 2 raised to the 14th power.
Bit-depth is the image receptor's ability to display shades of gray. Each pixel has the ability to be turned on (white) or off (black), therefore each bit depth equals 2 raised to the depth power. A bit depth of 8 is equal to 2 to the eighth power or 256. A system capable of displaying 16,000 shades of gray is equal to 2 to the fourteenth power or a bit-depth of 14. That is, 2 raised to the fourteenth power = 16,384. 2 raised to the tenth power = 1024. 2 raised to the twelfth power = 4096. 2 raised to the sixteenth power = 65,536.
31.A radiographer makes an exposure using an 8:1, 100 line per inch grid. When processing the image plate (IP) through the reader, the radiographer notices that a Moire pattern is seen on the displayed image. What is the probable cause of this artifact?

A The IP was upside down in the bucky tray.
B Underexposure to the IP. Incorrect
C The grid had a frequency similar to the reader's sampling frequency.
D The IP was not fully erased the last time it was used.
C The grid had a frequency similar to the reader's sampling frequency.
Moire artifacts on digital images occur when the frequency of the grid closely matches the sampling frequency of the CR reader. Underexposure of the plate will result in a salt and pepper appearance termed quantum mottle. Imaging the backside of the plate will result in geometric patterns on the image due to supporting structures located in the back of the cassette. When the IP is not fully erased, the previously taken image may be visible along with the new image. This is termed ghosting.
32. When using film-screen, which most accurately describes the effect on the resultant image when kilovolts peak (kVp) is increased?

A Recorded detail will be increased.
B Recorded detail will be decreased.
C Number of gray tones will be decreased.
D Number of gray tones will be increased.
D Number of gray tones will be increased.
An increase in kilovoltage will result in shorter wavelength x-rays beams that more uniformly penetrate body parts, resulting in lower contrast and more gray tones in the radiograph. A decrease in the number of gray tones is expected with a decrease in kVp. Voltage is not a primary controlling factor for recorded detail.
33.Which change in technical factors is most likely to result in decreased film density?

A Decreased beam restriction.
B Decreased source to image receptor distance (SID).
C Increased grid ratio.
D Increased screen speed.
C Increased grid ratio
Grids with higher ratios are able to remove more photons from the x-ray beam. Because the grid reduces the number of photons reaching the image receptor, it also causes a decrease in film density. Decreasing the SID results in greater x-ray beam intensity and therefore greater film density. A decrease in beam restriction results in more scatter radiation reaching the film, which produces an increase in nondiagnostic film density known as fog. Faster speed screens emit more light when struck by x-rays, which results in greater film density on the finished radiograph.
34.A radiograph of the distal femur demonstrates adequate radiographic density but requires a shorter scale of contrast. With original exposure factors of 80 kilovolts peak (kVp), a 200 milliampere (mA) station, and an exposure time of 0.08 seconds, which set of factors is most likely to produce the desired result?

A 92 kVp; 100 mA; 0.08 seconds.
B 92 kVp; 200 mA; 0.08 seconds.
C 68 kVp; 200 mA; 0.16 seconds.
D 68 kVp; 200 mA; 0.11 seconds.
C 68 kVp; 200 mA; 0.16 seconds.
When a shorter scale (high contrast) image is desired without a change in radiographic density, the 15% rule may be applied. A kVp of 68 represents a reduction of 15% from the original kVp ... (80)(.15) = 12 kVp; 80-12 = 68 kVp. A 200 mA station with a 0.16 second exposure timeyields a 50% increase from the original milliampere-seconds (mAs) of 16 ... (200)(0.16) = 32 mAs. A 200 mA station with an exposure time of 0.11 seconds (22 mAs) does not produce enough intensity to compensate for the reduction in kVp. Increasing the kVp by 15% while reducing the mAs by 50% results in a longer scale of contrast. A 15% increase in kVp without a change in mAs results in a doubling of radiographic density.
35.A radiographer makes an exposure using a Fuji computed radiography (CR) system. The S number reads out at 480 and the image appears grainy. What is the problem with the image and how should it be corrected?

A The radiographer overexposed the image and should decrease the technique.
B The radiographer overexposed the image and should increase the technique.
C The radiographer underexposed the image and should increase the technique.
D The radiographer underexposed the image and should decrease the technique.
C The radiographer underexposed the image and should increase the technique.
The graininess and S number indicate that the image was underexposed, so the technique should be increased. The S number is related to relative exposure to the image plate and the relationship is inverse. In the case of underexposure, the technique should be increased, not decreased. Because the S number is higher than 250, under exposure, not overexposure, is demonstrated.
36.A radiographer performs a chest examination using a computed radiography (CR) system. Posteroanterior (PA) and lateral images are taken, and the imaging receptors (IR) are processed in the CR reader. The PA image appears to have two PA chest images present. The lateral image is processed and appears fine. What is a possible cause of the double image?

A The radiographer accidentally exposed the back side of the IR during the PA position.
B The image reader has malfunctioned.
C The IR has been sitting too long and has been exposed by background radiation.
D The IR was not properly erased from the last examination.
D The IR was not properly erased from the last examination
IRs can retain images from previous exams if the reader is unable to properly erase the receptor. Image reader malfunctions may happen, but they will not produce double images. Exposing the back of the IR demonstrates geometric patterns on the image. An IR that has been sitting too long results in overall density increase to the image from fog.
37.Prior to performing a posteroanterior (PA) chest projection with automatic exposure control (AEC), the radiographer discovers that the patient has had a right total pneumonectomy. Which technical consideration should be considered?

A Selecting only the detector on the left side.
B Selecting only the detector on the right side.
C Selecting the center detector.
D Selecting both outer detectors.
A Selecting only the detector on the left side.
Selecting the left detector in this scenario will result in proper exposure of the image and is the correct answer. If only the right detector is selected, the exposure will be too dark for an optimal image. If the radiographer selects both outer detectors, the exposure will be too dark, because the cell is detecting the increased density of the right hemithorax which has gradually filled with interstitial fluid following the surgery. Selecting the center detector places the thoracic spine in the detector, which is more dense than the lung and will cause an overexposed image.
38.Which technique would produce a 2 milliroentgens (mR) exposure to an image receptor plate if 70 kilovolts peak (kVp) at 25 milliampere-seconds (mAs) produces 1.6 mR?

A 70 kVp at 31.25 mAs.
B 70 kVp at 27.5 mAs.
C 70 kVp at 50 mAs.
D 70 kVp at 35 mAs.
A 70 kVp at 31.25 mAs
2 mR is 25% greater than 1.6 mR; so, a 25% increase in mAs would achieve this result. 25 mAs x 1.25 = 31.25 mAs. All other responses are incorrect due to math errors or misunderstanding the relationship of mAs to exposure.
39. Opening the collimators wider than necessary using digital radiography has which effect on image quality?

A Image noise is increased
B There is no effect on image quality.
C The spatial resolution of the image is decreased. Incorrect
D The spatial resolution of the image is increased.
A. Image noise is increased. .
Increasing the size of the collimated field increases the quantity of scatter produced but does not affect the size of the pixels. Pixel size in digital radiography is determined by the CR scanning frequency or the DR DEL size.
40.Insufficient exposure to a photostimulable phosphor (PSP) plate results in which type of image degradation?

A High signal-to-noise ratio.
B Moire pattern.
C Quantum noise.
D Pixel saturation.
C Quantum noise.
Quantum noise occurs due to an insufficient exposure to the image receptor resulting in an uneven density over the image. Moire pattern is associated with grid frequencies and sampling frequencies that are too nearly the same. Pixel saturation occurs when too much exposure is used. It is similar to D-Max in film-based systems. A high signal-to-noise ratio, which is the goal in digital radiography, reduces quantum mottle and increases contrast resolution.
41.How is signal maximized to a digital image receptor?

A Shorter exposure time.
B Higher source to image receptor distance (SID) value.
C Longer exposure time.
D Lower milliamperage (mA) setting.
C Longer exposure time.
The greatest signal strength would be obtained with longer exposure time. The other responses reduce signal at the digital image receptor.
42.Which change is needed to compensate for a soft tissue mass in the abdomen?

A Increased source to image receptor distance (SID).
B Reduced kilovolts peak (kVp).
C Increased milliampere-seconds (mAs).
D Reduced milliampere-seconds (mAs).
C. Increased milliampere-seconds (mAs).
Increased mAs is needed to compensate for the additional tissue presence of a soft tissue mass. Reduced mA, kVp, or increased SID cause an underexposed image of an abdomen with a soft tissue mass.
43.Which change should be made when performing an abdomen radiograph on a patient with ascites?

A Increase source to image receptor distance (SID).
B Raise exposure factors.
C Choose a lower millampere (mA) station.
D Use an abdominal compression device.
B Raise exposure factors
Ascites is the accumulation of fluid in the abdomen. Higher exposure factors are needed to penetrate the extra fluid content of the abdomen in such cases. The use of an abdominal compression device is not prudent in an ascites case. A lower mA station and increased SID decrease image density.
44.Which is the most likely cause of film fog prior to development?

A Poor film-screen contact.
B Cracked safelight filter.
C Excessive developer temperature.
D Low relative humidity.
B Cracked safelight filter
A cracked safelight filter will allow unfiltered light to reach unprocessed x-ray films, which causes fogging of the film. Low relative humidity is likely to contribute to static artifacts, not fog. Poor film-screen contact causes blurring and a dark area on the image following exposure, rather than fog. Excessive developer temperature may result in a processing artifact known as chemical fog, which occurs during (not prior to) the developing process.
45.An increase in which factor will improve recorded detail?

A Milliamperage setting.
B Source to image receptor distance (SID).
C Focal spot size. Incorrect
D Film-screen speed.
B Source to image receptor distance (SID)
An increase in SID decreases the amount of unsharpness and increases recorded detail. As focal spot size increases, recorded detail decreases. Increasing the relative speed of the film-screen system decreases the recorded detail. An increase in the milliamperage setting may cause an increase in actual focal spot size known as blooming, which results in a decrease in recorded detail.
46. Which x-ray beam characteristic is reduced by adding aluminum filtration?

A Quantity of x-rays.
B Energy of the x-ray beam.
C Half-value layer.
D X-ray beam quality.
A Quantity of x-rays.
Added aluminum filtration results in a reduction in the quantity of x-rays in the primary beam. The half-value layer (HVL) is a numerical value used to identify the quality of the beam; added filtration results in an increase in HVL, not a reduction. The quality of the x-ray beam refers to its penetrability, which increases as a result of added filtration, not a reduction. Because most of the x-rays removed by the filter are of low energy, there is an increase in the average energy of the primary x-ray beam, not a reduction.
47.How does an increase in noise affect the quality of a digital image?

A Contrast is increased.
B Density is increased.
C Contrast is decreased.
D Density is decreased.
C Contrast is decreased.
Digital image contrast is decreased by the presence of noise. Due to the ability of digital imaging systems to compensate for lack of density by adjusting the window level, image noise is not relevant to either increases or decreases in density. Because image noise has an inverse relationship with contrast, the increased noise does not increase contrast. And in spite of the ability of digital processing to increase image contrast, when this is done to a noisy image, it only makes the noise more visible. And in consequence detail visibility (the function of contrast) is definitely inferior to an image not affected by noise.
48.Which step will reduce digital image noise, assuming no other changes?

A Decreased kilovolts peak (kVp).
B Small pixel size.
C Longer exposure time.
D Image magnification.
C Longer exposure time.
A longer exposure time results in a greater amount of photons reaching the image receptor, which reduces image noise. Decreased kVp reduces the quantity of x-rays that reach the image receptor, which increases image noise. A matrix with a large number of small pixels results in greater image noise due to the availability of fewer photons per pixel. Magnification of the digital image does not affect image noise, but it may make what noise is there more visible.
49.When using film-screen systems, which method will result in greater radiographic contrast?

A Increased kilovolts peak (kVp).
B Decreased beam filtration.
C Decreased field size.
D Increased screen speed.
C Decreased field size
Decreasing field size results in a decrease in the number of x-ray photons available to undergo Compton interactions; this reduces scatter production. This increases radiographic contrast. Increased screen speed has no effect on contrast. Decreased beam filtration results in a greater number of lower energy x-rays in the primary beam, which increases scatter and reduces contrast. Increased kVp results in a greater amount of scatter reaching the image receptor (IR), which reduces contrast.
50.Optimal radiographic density is achieved with 400 milliamperes (mA), 0.25 second, and 75 kilovolts peak (kVp) using a 400 speed film-screen system. Which adjustment in mA is needed to maintain density if the exposure time is increased to 0.4 seconds, and a 200 speed system is used?

A 100 mA.
B 200 mA.
C 400 mA.
D 500 mA.
D 500 mA.
400 mA multiplied by 0.25 seconds equals 100 milliampere-seconds (mAs). If 100 mAs is used with a 400 speed film-screen system, calculations must be made to adjust the mAs to the proper value for a 200 speed film-screen system. Use the film-screen speed conversion formula, mAs1 / mAs2 = RS2 / RS1. By using this formula, it is determined that 200 mAs is necessary with a 200 speed film-screen system. 200 mAs divided by the new time of 0.4 second equals 500 mA. All other responses result from math errors or incorrect use of formulas.
51. When using film-screen, an exam utilizing 90 kilovolts peak (kVp) and 10 milliampere-seconds (mAs) provides adequate density but has inadequate contrast (contrast scale is too long). Which technical exposure factors increase contrast while maintaining adequate density?

A 77 kVp and 40 mAs.
B 77 kVp and 20 mAs.
C 90 kVp and 20 mAs.
D 45 kVp and 20 mAs.
B 77 kVp and 20 mAs.
Using the 15% rule allows a radiographer to adjust contrast while maintaining density. In this case, the contrast scale is too long, or one might say the image is too gray, yet the density is acceptable. Decreasing the kVp by 15% and doubling the mAs will increase contrast and maintain density. The result of this adjustment is 77 kVp and 20 mAs. The other options result from math errors or incorrect use of the 15% rule formula.
52. A radiographer chooses a portable non-grid chest x-ray technique of 80 kilovolts peak (kVp) at 4 milliampere-seconds (mAs). Before making the exposure, the radiographer decides to use an 8:1 grid. Which change in technical factors is most appropriate based on this new information?

A 92 kVp at 4 mAs.
B 68 kVp at 4 mAs.
C 106 kVp at 4 mAs.
D 80 kVp at 2 mAs.
C 106 kVp at 4 mAs.
An 8:1 grid has a grid factor of four which can be compensated for by using two 15% increases in kVp. This results in new technical factors of 106 kVp at 4 mAs. All other factors are incorrect.
53. Which is the most likely cause of a histogram error?

A Incomplete erasure of the image plate.
B Underexposure of the image receptor.
C Malfunction of the plate reader electronics. Incorrect
D Selection of an incorrect exam from the look-up table.
D Selection of an incorrect exam from the look-up table.
A histogram error, which results in improper image brightness and contrast, occurs when the radiographer selects an incorrect exam (anatomical structure, position and projection) from the look-up table before the image plate is scanned. Malfunction of the plate reader electronics can cause the appearance of line patterns. Incomplete erasure of the image plate results in a phantom, or ghost, image artifact. Underexposure of the image receptor results in quantum mottle.
54.Best practice suggests erasing all computed radiography (CR) plates once a day. What is the purpose of this?

A To reduce amount of accumulated scatter on the imaging plate (IP).
B To keep exposure indices within appropriate ranges.
C To keep the imaging plate (IP) free from dust and other potential artifact producing phenomena.
D To ensure removal of phantom images from high exposures.
A To reduce amount of accumulated scatter on the imaging plate
Erasing IPs on a daily basis, usually at the start of the day cuts down on the amount of background and scatter radiation that has accumulated in the active layer of the plate. IPs accumulate little background radiation and would have minimal effect on exposure indices. Phantom images are rarely an issue and would not necessitate every IP be erased. Erasing cassettes daily has no impact on dust or debris producing artifacts.
55. Consider this lateral lumbar spine image. Which strategy will have the greatest improvement on image quality?

A Decrease the source to image receptor distance (SID).
B Select a faster speed image receptor.
C Immobilize the patient.
D Increase milliampere-seconds (mAs).
C Immobilize the patient.
This lumbar image shows loss of resolution due to blurring. Since the single greatest cause of loss of image sharpness is patient motion, immobilizing the patient will likely have the greatest improvement on image quality. Adjusting mAs will not affect image sharpness. Selecting a faster image receptor speed and decreasing SID will degrade image sharpness further.
200. Place the cursor on the sinus tarsi. (Click the chosen location. To change, click on the new location.)
...
56. What is the result if pixel bit depth is decreased?

A Image noise is decreased.
B Brightness is increased.
C Spatial resolution is increased.
D Contrast resolution is decreased.
D Contrast resolution is decreased.
Pixel depth determines how many shades of gray will be displayed so is directly related to contrast resolution. A decrease in pixel depth would mean a decrease in contrast resolution. Brightness of a digital image is dependent upon the look up table. Image noise is related to signal received and scatter radiation. Pixel size and matrix size determine spatial resolution.
57.Which statement is true regarding exposure indicator and the evaluation of digital images?

A Exposure indicator is reviewed only when image contrast or brightness is suboptimal.
B If the exposure indicator falls within the manufacturer's acceptable range, image contrast and brightness do not need to be reviewed.
C Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range.
D Radiographers do not need to review the exposure indicator during image evaluation.
C Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range.
Exposure indicator is a numeric value assigned by the digital system manufacturer that indicates exposure to the image receptor. Exposure indicator must be reviewed with every image and must fall within the manufacturer's acceptable range to assure proper image quality when viewed by the radiologist. Exposure indicators should be reviewed, along with image contrast and brightness. Exposure indicator falling within the manufacturer's acceptable range does not negate the need to evaluate image contrast and brightness.
58.How does the Density log Exposure (D log E) curve appear for a digital imaging receptor (IR)?

A A shallow slope.
B An S curve. Incorrect
C A steep slope.
D A straight line at a 45 degree angle.
D A straight line at a 45 degree angle.
D log E curves for digital imaging demonstrate the wide dynamic range of the image receptor as a straight line at a 45 degree angle. As an image is windowed, the data is moved up and down the 45 degree line. D log E curves are bell curves with the left half of the bell demonstrated. A steep slope and shallow slope pertain to film/screen imaging.
59. What do limiting spatial resolution (LSR) and modulation transfer function (MTF) have in common?

A They are both indicators of exposure for digital receptors.
B They both measure spatial resolution in digital imaging.
C They both affect brightness of the digital image.
D They measure how efficiently an image is moved to the picture archiving and communication system (PACS).
B They both measure spatial resolution in digital imaging.
LSR and MTF are measures of how accurately anatomy is reproduced in a digital image or measures of spatial resolution. The histogram and window leveling affect brightness of a digital image. Exposure indicators for digital receptors are exposure indicator numbers, S numbers, or Log median exposure numbers depending on equipment manufacturer. There is no one measurement for efficiency of images moving into the PACS system.
60.What is the term for the adjustment of image brightness, regardless of exposure received?

A Detective quantum efficiency (DQE).
B Rescaling.
C Dose area product (DAP).
D Automatic brightness control (ABC).
B Rescaling.
Rescaling is the adjustment of digital data to a preset brightness depending on the body part selected. DAP is an indicator of exposure for cassetteless digital systems. DQE indicates speed class or how sensitive a receptor is to radiation exposure. ABC is a fluoroscopic control to maintain image density as the image intensifier is moved over the patient.
61.A radiographer uses 70 kilovolts peak (kVp) at 30 milliampere seconds (mAs) on a film-screen radiograph. If a repeat radiograph is acquired at 80 kVp and 15 mAs, which factor will be affected?

A Optical density.
B Image contrast.
C Distortion.
D Subject contrast.
B Image contrast.
Manipulation of kVp in either direction will affect image contrast due to differential absorption. Distortion is affected by geometric factors, not technical factors. By using the 15% rule, the kVp will be increased 15%, and the mAs decreased by half. Therefore, optical density will remain constant. Subject contrast is inherent in the patient, and therefore is not affected by the change of technical factors.
62.Which procedure is an example of surgical asepsis?

A Surgical hand scrub.
B Clean glove application.
C Hand washing.
D Clean gown application.
A Surgical hand scrub.
Asepsis is the absence of disease-producing (pathogenic) organisms. Surgical asepsis, or sterile technique, includes procedures used to eliminate all microorganisms from an area. Surgical hand scrub, sterile glove application, and sterile gown application are examples of surgical asepsis. Medical asepsis, or clean technique, includes procedures used to reduce the number of and prevent the spread of microorganisms. Hand washing, barrier techniques (clean glove and clean gown application), and routine environmental cleaning are examples of medical asepsis.
63.A radiographer receives a request for a portable chest x-ray and then performs the x-ray on the incorrect patient. Which legal term best describes the actions of the radiographer?

A Assault.
B Negligence.
C Battery.
D Invasion of privacy.
C Battery.
Battery is defined as touching to which the victim has not consented. Performing a procedure on the wrong patient may constitute grounds for a charge of battery. Invasion of privacy is defined as unjustifiable intrusion on another's right of privacy. Assault may be alleged if the radiographer threatens to perform the x-ray, however, battery occurs when the x-ray is actually performed. Negligence represents a breach in established standards of care resulting in harm to the patient. Negligence would exist in this case, if the patient were demonstrably harmed.
64. The lead radiographer is planning a strategy to efficiently manage the morning workload. The department is short-staffed due to meetings, and four patients are now ready for their examinations. Assuming that none of the exams is emergent, which patient should be seen first?

A An 54-year-old male with type 2 diabetes for an upper GI.
B A 18-year-old female for an intravenous urogram.
C An 83-year-old female for a chest x-ray.
D A two-year-old child for a barium swallow.
D A two-year-old child for a barium swallow
An x-ray department should begin the day with patients who are fasting prior to their examination. In this example, more than one of the patients is fasting, so the radiographer must decide who goes first based on other factors. Since none of the cases are emergent, consideration should be given to pediatric and geriatric patients because they have the most difficulty being NPO for long periods of time. The geriatric patient, however, is not required to fast. Patients with diabetes who have postponed their insulin should also be given special consideration. Since type 2 diabetes is non-insulin dependent, the two-year-old child represents the best option. In addition, the 18-year-old female is likely able to handle being NPO.
65.Which type of contrast agent would be preferred for low risk and low cost for a patient diagnosed with a possible perforated bowel?

A Ionic, water soluble, diluted with juice.
B Nonionic, water soluble, diluted with juice.
C Barium sulfate suspension, flavored.
D Gaseous media in the form of crystals.
A. Ionic, water soluble, diluted with juice.
The least risk with the least cost would dictate ionic, water soluble media. Barium should definitely be avoided, because of the risk of introducing contrast into the peritoneum. Barium sulfate suspension might cause adhesions if it spills into the peritoneum via a perforation. Gaseous media will not yield all of the information that positive media will in this case. For instance, gaseous media will not necessarily outline a perforation. Nonionic, water soluble media is too expensive for this application.
66.A patient reports symptoms including itching, rash formation, and difficulty breathing immediately following the administration of intravenous (IV) contrast media. Assuming the patient has had no prior exposure to radiopaque contrast media, what is the most likely cause of these symptoms?

A Acute bronchospasm.
B Anaphylactoid reaction.
C Allergic reaction.
D Acute renal failure.
B Anaphylactoid reaction.
The symptoms described in this scenario are the result of an anaphylactoid reaction, a type of reaction that clinically mimics anaphylaxis but requires no previous exposure to contrast media. Acute bronchospasm is unrelated to itching or rash formation. The effects of acute renal failure will not typically manifest immediately, although patients may develop symptoms such as shortness of breath and generalized swelling. The symptoms described cannot be allergic, because of the lack of prior exposure to contrast media. Allergy occurs due to the formation of antibodies in a prior exposure to the allergen.
67. A patient ceases to breathe while in Medical Imaging. There is a clearly marked DNR order on the patient's chart. What should the radiographer do first?

A Immediately begin CPR, and call for help.
B Report the event to the quality control supervisor, but do not start CPR.
C Scream for help.
D Call a code.
B Report the event to the quality control supervisor, but do not start CPR
The radiographer should report the event to the quality control supervisor. The DNR marking means, "Do Not Resuscitate" so CPR should not be started. The quality control supervisor will likely call the patient's physician, and contact the coroner. A scream for help will likely alarm all who hear it. This is unnecessary. There is no emergency, but the event should be reported and documented (likely with an incident report). A code should not be called.
68.A radiographer is on an elevator with a patient who is being transported. The patient ceases to breathe, but the patient's chart is not present. What should the radiographer do first?

A Immediately begin the CPR process.
B Call a code.
C Report the event to the QC tech, but do not start CPR.
D Scream for help.
A Immediately begin the CPR process.
Under these conditions, the radiographer is legally obligated to immediately begin CPR by checking for a pulse. If the patient is found to be pulseless, then compressions are begun. There is no need to involve the QC supervisor, who is in radiology, and not present. CPR should be continued as the patient is transported. Screaming for help likely will not be heard, and if it is, it is likely to frighten whoever hears it. The transporter can call a code, using the elevator's phone, after CPR has started.
70. The radiographer is assisting a patient to move from a wheelchair to the x-ray table. Which represents the safest practice by the radiographer when moving this patient?

A Reduce the base of support slightly so the center of gravity is easier to maintain.
B Extend the arms as far as possible to increase the base of support.
C Bend at the waist so the center of gravity is midway between the patient and the base of support.
D Maintain the center of gravity over the base of support.
D Maintain the center of gravity over the base of support.
The radiographer should maintain the center of gravity over the base of support. If movement is required, then the feet should be moved to maintain this relationship. All other responses violate proper body mechanics.
71.Which term best describes the process of cleaning the surfaces in a radiology department with 10% bleach solution in water?

A Surgical asepsis.
B Medical asepsis.
C Sterilization.
D Sterile technique.
B Medical asepsis.
Proper cleanliness, like hand washing and cleaning surfaces, is termed medical asepsis. Sterile technique is a system of practices to prevent the entry of infectious agents into a surgical field. Surgical asepsis and sterilization are practices involved in sterile technique.
72.Which action is best taught to the patient using the communication technique of demonstration?

A The correct positioning for a particular projection.
B Instructions for donning and removing a patient gown.
C The correct direction to face when sitting at the radiography table.
D Direction on where to sit relative to the radiography table.
A The correct positioning for a particular projection.
Demonstration is particularly effective for showing a patient the specifics of a position. Verbal explanations work best for "how to put on a gown." Verbal directions are the best approach where to sit or to communicate facing direction to the patient.
73.Which actions should the radiographer take to help prevent acquired infections in hospitals or clinics? (Select the four that apply.)


A Placing used syringes in isolated trash receptacles.
B Wearing exam gloves and changing them between each patient.
C Washing hands frequently and using hand lotion afterward.
D Placing biologically soiled linen in biohazard linen bags.
E Placing used needles in sharps containers.
B Wearing exam gloves and changing them between each patient.
C Washing hands frequently and using hand lotion afterward.
D Placing biologically soiled linen in biohazard linen bags.
E Placing used needles in sharps containers.
Wearing exam gloves and changing them between each patient protects the radiographer from the patient and vice versa from an infection. Washing hands frequently reduces the likelihood of the radiographer acquiring or carrying infection. Placing biologically soiled linen in the proper biohazard linen bags insures proper laundry handling. Placing needles in sharps containers and used syringes in biohazard disposal containers is the proper step to prevent transmission of infection from one patient to the next, or to the radiographer. Used syringes should never be placed in isolated trash receptacles.
75.Which steps are involved in legally obtaining informed consent to perform a radiographic procedure? (Select the four that apply.)


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

A Intravenously.
B Orally.
C Subcutaneously.
D Rectally.
A Intravenously.
Intravenous medication administrations result in the quickest response. Drugs can be administered subcutaneously but it is not the quickest route. Rectal and oral administration are slow methods of medication administration.
77.Which nonverbal cue best demonstrates attentiveness and concern for a patient who is giving a medical history?

A Taking notes.
B Consistent eye contact.
C A pleasant smile.
D Turning the head to the side to place one ear closer.
B Consistent eye contact.
Maintaining eye contact is an effective way to show the patient attentiveness and concern. A pleasant smile communicates warmth, but may not be appropriate while listening to a medical history. Taking notes requires listening, but appropriate eye contact conveys understanding. Turning the head to the side to place one ear closer might imply that it is difficult to hear the patient.
78.A radiographer enters a room to take a portable foot series on a patient in her final trimester of pregnancy. The patient is just finishing her lunch and begins choking. How should the radiographer respond to this medical emergency?

A Initiate a backward thrust in the center of the sternum.
B Start cardiopulmonary resuscitation (CPR).
C Apply an inward and upward thrust in the midline of the abdomen.
D Place the patient in the Trendelenburg position.
A Initiate a backward thrust in the center of the sternum.
Abdominal thrusts can be dangerous in the late stages of pregnancy, so the radiographer should use backward thrusts in the center of the sternum. CPR should not be performed on patients who are conscious. The Trendelenburg position is useful for patients recovering from syncope or experiencing shock. Abdominal thrusts can be dangerous in the late stages of pregnancy and should not be attempted.
79.How should a radiographer increase the stability of the base of support?

A Hold heavy objects close to body.
B Keep back straight and knees bent.
C Stand with feet a greater distance apart.
D Stand on one foot.
C Stand with feet a greater distance apart.
The base of support is drawn between two points of contact with the floor. The stability of the base of support increases when the feet are a greater distance apart. Standing on one foot will provide a narrow, unstable base of support. Holding heavy objects close to the body and keeping the back straight and bending at the knees are practices of good body mechanics, but are not related to the base of support.
80.A radiographer prepares to transfer a patient from a wheelchair to the x-ray table. The patient recently suffered a stroke, exhibits left-sided weakness, and is able to bear some weight. How should the radiographer move the patient to the table?

A Have one radiographer lift the torso while another lifts the feet.
B Position the right side of the wheelchair next to the table.
C Use a hydraulic lift.
D Position the left side of the wheelchair next to the table.
B Position the right side of the wheelchair next to the table.
Because the patient's strongest side is the right side, the radiographer should position the right side of the wheelchair next to the table. Hydraulic lifts are used for patients who cannot bear weight and are too heavy to lift. Positioning the left side of the wheelchair to the table places the patient's strong side away from the table. Two radiographers to move the patient is called a two-person lift and is used when the patient cannot bear weight but can be lifted manually.
81.What does "ventricular fibrillation" mean?

A Erratically quivering ventricles.
B Premature ventricular contractions.
C Rapid heart rate.
D Slow heart rate.
A Erratically quivering ventricles.
Ventricular fibrillation means that the ventricles are quivering which results in the heart's inability to pump blood. If the heart is beating too slowly, the patient is suffering from bradycardia. On the other hand, if the heart is beating too quickly, the patient has tachycardia. Premature ventricular contractions (PVCs) are extra beats that do not contribute to the blood flow, but this is not generally a life-threatening rhythm.
82.A patient in the radiology department suddenly develops a nosebleed. The radiographer instructs the patient to lean forward and pinch the affected nostril against the midline nasal cartilage, but the bleeding does not stop. What should the radiographer do next?

A Apply a moist compress.
B Instruct the patient to tilt the head back.
C Transport the patient to the emergency room.
D Place the patient in a recumbent position.
A Apply a moist compress.
If gentle pressure is unsuccessful, the patient should apply a moist compress. A patient should never be instructed to tilt the head back or be placed in the recumbent position as the patient may aspirate the blood. It is not necessary to transport the patient to the emergency room at this point.
83.A patient with a history of stroke and hemi-paralysis is transported to the x-ray department by wheelchair. Which action should the radiographer perform in order to safely transfer the patient to the x-ray table?

A Instruct the patient to lead with his weak leg.
B Adjust the x-ray table to the same height as the wheelchair.
C Stand behind the patient during the transfer.
D Place the patient's weak side next to the table.
B Adjust the x-ray table to the same height as the wheelchair.
Patients who have suffered stroke typically have weakness of one side of the body and require special consideration when performing transfers. If the table is adjustable, it should be lowered to the height of the chair. The patient's weak side should be placed away from the x-ray table. The patient should not be instructed to lead with the weak leg. Whenever a patient requires assistance to transfer to or from a wheelchair, the radiographer should be positioned face-to-face with the patient, not behind the patient.
85.Which rule is followed when examining unconscious patients?

A Proceed as if the patient were conscious, asking questions and giving instructions. Incorrect
B Remain as quiet as possible to avoid waking the patient during the exam.
C Avoid saying things you would not say to a conscious patient.
D Speak openly in front of the patient, since they cannot hear or understand you.
C Avoid saying things you would not say to a conscious patient
Unconscious patients may retain the ability to hear and remember what is said, so it is appropriate to avoid making statements that you would not make if they were conscious. Remaining quiet in order to avoid waking the patient is not necessary, especially if the patient's state is due to the administration of narcotics; such patients are not likely to regain consciousness solely due to auditory stimuli. It is not appropriate to speak as if the unconscious patient cannot hear you, since evidence suggests that the opposite is true. Asking questions and giving instructions to an unconscious patient is not appropriate due to lack of responsiveness.
84.Which is the best approach for speaking to a patient with a hearing impairment?

A Talk very slowly.
B Ask patient to adjust hearing aid volume.
C Speak in a low register.
D Do not make eye contact.
C Speak in a low register.
Patients with hearing loss most often have difficulty hearing voices in a high register, so speaking in a low register is recommended. Speaking at a moderate pace is preferable, rather than very slowly. It is best to face the patient with hearing loss, so good eye contact is appropriate. Patients should not be advised to adjust their hearing aids in order to facilitate communication.
197. Identify the left coracoid process.
...
Identify the right cardiophrenic angle
...
195.Identify the common bile duct in the AP oblique postoperative cholangiogram. (Click to select the chosen region.) Created with Raphaël 2.1.0
The common bile duct is formed by the junction of the cystic and hepatic ducts. It is located inferior to the gallbladder.Incorrec
196.Place the cursor over the area which depicts history of a cholecystectomy and click to select. Created with Raphaël 2.1.0
A cholecystectomy is the removal of the gallbladder. The gallbladder is usually located in the right upper quadrant; surgical clips mark the area from which it was removed.
69. A patient received 100 ml of IV contrast media as a part of an abdominal computed tomography (CT) scan, as well as 500 ml of dilute, oral contrast, prior to coming to Radiology for a separate order, an intravenous urogram (IVU). The patient's creatinine is 0.4 mg/dl and BUN is 36 mg/dl. Why should this IVU be rescheduled?

A The lab values indicate that the contrast would not be excreted in sufficient quantity to be useful for an IVU.
B The lab values indicate increased risk for contrast injection.
C The presence of the previous intravenous contrast precludes an IVU.
D The presence of the previous oral contrast in the abdomen precludes an IVU.
D The presence of the previous oral contrast in the abdomen precludes an IVU
The single, most compelling reason to reschedule this IVU is the presence of previous oral contrast in the abdomen. The lab values do suggest increased risk and a low level of contrast excretion, but both of those are frequently ignored by ordering physicians and radiologists. The use of nonionic contrast agents can mitigate much of the risk. The presence of intravenous contrast in the urinary collecting system would preclude an IVU for perhaps 30 minutes, but that delays, rather than cancels, the study. Awarded 0.0 points out of 1.0 possible points.
198. Identify the most commonly fractured carpal bone. (Click the chosen location
...
74.Identify the medical conditions in a patient's history which should be cleared by the radiologist before injection of an ionic, water soluble, injectable contrast agent. (Select the four that apply.)


A Pheochromocytoma.
B Diabetes.
C Age over 40.
D Sickle cell anemia.
E Compromised renal function.
A Pheochromocytoma.
B Diabetes.
D Sickle cell anemia.
E Compromised renal function.
The patient with diabetes should be checked for taking metformin as a treatment. They should not take it for 24 - 48 hours after the contrast injection, per Radiologist order. The American College of Radiology (ACR) lists sickle cell anemia, pheochromocytoma, and compromised renal function as justification for the use of nonionic media. Age 40 is not a caution or contraindication, although the ACR lists age 60 as a caution, and a justification for choosing nonionic contrast agents.
174. Which grid ratio results in the lowest dose to a patient, because less milliampere-seconds (mAs) is required?


A 5:1.
B 12:1
C 16:1
D 8:1.
A 5:1.
A 5:1 grid ratio provides less exposure to the patient than higher grid ratios due to higher lead content. Grid selection always involves a trade-off between obtaining an optimal image and exposure to the patient. Higher ratio grids improve image contrast at the expense of increased patient dose.
175. Which protective feature is designed to reduce exposure to the patient during fluoroscopic procedures?


A Magnification mode.
B Protective curtain.
C Bucky slot cover.
D Foot switch.
D Foot switch.
Radiologists are trained to repeatedly depress and release the fluoroscopic foot switch in order to reduce beam-on time and patient exposure. The bucky slot cover and protective curtain are designed to reduce exposure to personnel, rather than to the patient. While the magnification mode is helpful in certain situations, it does increase exposure to the patient.
176. Which is an advantage of using a optically stimulated luminescent (OSL) dosimeter as opposed to a film badge?


A Inexpensive.
B Readings as low as 5 millirem (mrem).
C Immediate readings available.
D Not fogged by heat.
D Not fogged by heat.
OSLs are not fogged by heat like film badges. OSLs can measure exposures as low as 1 mrem, not 5 mrem, but film badges are accurate at 10 mrem or higher. Film badges are less expensive than OSLs, and neither can give immediate readings.
177. Which type of personnel dose monitoring devices is the best choice to monitor the whole body dosage of radiographers?
A Geiger counter.
B Baldwin-Farmer meter.
C Pocket gas ionization chamber.
D Optically stimulated luminescent dosimeter (OSL).
D Optically stimulated luminescent dosimeter (OSL).
Viable means of monitoring occupational whole body dosage include the OSL. Geiger counters are excellent at detecting radiation, but fail completely at measuring it. The Baldwin-Farmer meter is a highly accurate laboratory device for measuring exposure in air. It is impractical for personal monitoring. The pocket gas ionization chamber should only be used to monitor those who are occasionally exposed.
178. What is the impact of using 2.5 millimeters of aluminum equivalent filtration on the primary x-ray beam?


A Increase in the number of x-rays reaching the patient.
B Noticeable reduction in density.
C Noticeable increase in contrast.
D Reduction of the patient's skin dose.
D Reduction of the patient's skin dose.
When a diagnostic x-ray beam is filtered by 2.5 millimeters of aluminum or its equivalent, there will be a reduction in the patient's skin dosage. There will be a decrease, not increase, in the number of xrays reaching the patient. Density and contrast will not be noticeably affected, particularly now with digital imaging.
179. What is the minimum thickness of requirement for protective lead curtains?


A 0.25 mm lead equivalence.
B 1 mm lead equivalence.
C 0.75 mm lead equivalence.
D 0.35 mm lead equivalence.
a. 0.25 mm lead equivalence.
Protective curtains are required to have a thickness of 0.25 mm of lead equivalence. While the curtains may be thicker, they are not required to be.
180. In order to protect the radiographer, how long must the exposure cord be on a portable xray machine?


A 8 feet.
B 2 feet.
C 4 feet.
D 6 feet.
D 6 feet.
The exposure cord must be at least six feet long. The other answers are incorrect.
181. Which factor will decrease the patient's dose during fluoroscopy?
A Bring the image intensifier as close as possible to the patient.
B Use continuous fluoroscopy.
C Increase the milliampere-seconds (mAs).
D Use the magnification mode.
A Bring the image intensifier as close as possible to the patient.
The patient dose is decreased by bringing the image intensifier as close to the patient as possible. Continuous fluoroscopy, the magnification mode, and increased mAs will all increase the patient's dose.
182. A radiographic rating chart is provided for a portable unit. Which combination of milliamperes (mA), seconds, and kilovolts peak (kVp) is permissible for a single exposure according to the chart?
A 160 mA, 1/30 second, 80 kVp.
B 100 mA, 1/20 second, 110 kVp.
C 200 mA, 1/60 second, 70 kVp.
D 140 mA, 1/10 second, 90 kVp.
B 100 mA, 1/20 second, 110 kVp.
The only permissible exposure according to the provided chart is 100 mA, 1/20 second and 110 kVp. The point of intersection between 100 mA and 1/20 second is found to be below and to the left of the 110 kVp curve, and therefore is permissible. All other responses correspond to points found above and to the right of their respective kVp curves and are thus forbidden.
183. Study the provided filament thermal emissions chart. Note the distinct shoulder on each kilovolt peak (kVp) curve. What do these shoulders indicate?
A That excellent milliamperage (mA) reciprocity exists at 30 kVp. Incorrect
B The emissions limited region.
C The space charge limited region
D That the milliamperage (mA) is highly predictable at 40 kVp.
C The space charge limited region.
The shoulders of filament thermal emissions charts indicate the space charge limited region. At this point, further increase in mA is limited by the space charge around the filament at the indicated voltage. One does not want to operate an x-ray tube in this region, because mA is unpredictable and nonlinear. One prefers to operate the tube in the emissions limited region at voltages higher than 40 kVp. Because of the space charge limitation, mA does not exhibit good reciprocity, nor is it predictable for the same reason, at voltages below 40 kVp.
184. Place these bit depths in order from the one that will produce the least number of grays to the one that will produce the greatest number of grays.
A 14
B 12
C 10
D 8
The correct order is:
A 8
B 10
C 12
D 14

The number of grays that is produced is calculated by taking two to the power of the bit depth. So, 2 to the power of 8 equals 256 shades of gray. A bit depth of 10 results in 1,024 grays. A bit depth of 12 equals 4,096. A bit depth of 14 equals 16,384.
Place the following steps in order of importance, 1 - 4, for controlling motion in a chest examination on a 9-month-old child.
A Immobilization devices (like the Pigg-o-stat).
B A family member to hold the patient.
C High mA, short exposure time combinations.
D Expose at full inspiration.
The correct order is:
A High mA, short exposure time combinations.
B Expose at full inspiration.
C Immobilization devices (like the Pigg-o-stat).
D A family member to hold the patient.

The most important step to control motion is always high mA, coupled with short exposure time. Next most important is exposing on full inspiration. These first two steps work with many motion control situations, not just chest radiography on children. Third most important choice would be the use of immobilization devices like the Pigg-o-stat. Fourth most important is the use of a family member to hold the patient.
186. Consider this anteroposterior (AP) mobile chest image. What will improve the photographic quality of this image?
A Decreasing the kilovolts-peak (kVp).
B Increasing milliampere-seconds (mAs). Incorrect
C Using a grid
D Increasing the source-to-image-receptor-distance (SID).
C Using a grid.
This AP mobile chest image shows a significant loss of contrast due mainly to excessive scatter radiation from the obese patient. Using a grid is the best method of reducing the impact of scatter on image quality. Increasing SID will have no impact on radiographic contrast. Decreasing kVp is not appropriate since a high kVp is necessary for chest imaging. Increasing mAs will not reduce the effects of scatter radiation on image quality
187. Consider this supine abdomen image. What should the radiographer do next?
A Submit the image as-is and include a 10 x 12 inch of the bladder region to include the pubis.
B Submit the image as is for interpretation without any additional images.
C Reject the image and repeat the abdomen using a 14 x 17 inch receptor centering more superior to include the diaphragm.
D Reject the image and repeat the abdomen using a 14 x 17 inch image receptor centering more inferior to include the pubis.
A Submit the image as-is and include a 10 x 12 inch of the bladder region to include the pubis.
A supine abdomen image must include the bladder region down to the pubis. Since this image lacks the pubis, a 10 x 12 inch of the bladder region will complete this study while minimizing patient radiation exposure. Then, both images should be submitted. The image should not be submitted without an additional image. Completing another 14 x 17 inch of the abdomen to include the pubis or diaphragm will expose the patient to unnecessary radiation.
188. Place the types of contrast media in order of decreasing opacity.
A Ionic, water soluble.
B Thin barium sulfate.
C Carbon dioxide.
D Thick barium sulfate.
A Thick barium sulfate.
B Thin barium sulfate.
C Ionic, water soluble.
D Carbon dioxide.
Barium sulfate is the most radiopaque substance in this list. The thick barium is the most radiopaque followed by thin barium. Ionic, water soluble contrast media is next. Finally, carbon dioxide is the least radiopaque because it is a gas.
189.In this chest radiograph, where is the clinically significant gas located?
A Under the left hemidiaphragm. Incorrect
B Within the stomach.
C Within the thorax.
D Under the right hemidiaphragm
D Under the right hemidiaphragm.
In this image there is free gas under the right hemidiaphragm, identifiable by the fact that the right hemidiaphragm is higher than the left, because of the liver. Free gas is seen under the left hemidiaphragm. No free gas is located within the thorax. Gas in the stomach is quite a normal finding and not clinically significant.
190. a metallic artifact seen in the open mouth odontoid image?
A The receptionist.
B The patient.
C The ordering physician.
D The radiographer
D The radiographer.
A metallic artifact from an object that can be clearly seen as the patient is positioned is clearly the responsibility of the radiographer. For those who would argue that the radiographer is not responsible for caps on teeth, notice that the head is tipped too far forward. The occipital bone is not even visualized on this image. This cap need not have obscured the tip of the odontoid process. No one else is responsible in this case.
191. An anteroposterior (AP) trauma elbow image reveals a normal-looking distal humerus, but the proximal forearm appears foreshortened. How should the radiographer position the patient for an additional AP projection?
A Place the forearm parallel to the image receptor (IR).
B Place humerus parallel to image receptor (IR).
C Extend elbow.
D Elevate forearm.
A Place the forearm parallel to the image receptor (IR).
In this case, an additional AP projection is needed with the forearm parallel to the IR in order to demonstrate the proximal forearm without distortion. Forced extension should not be performed in the setting of trauma. Elevation of the forearm would again result in foreshortening of the proximal forearm. The initial image was acquired with the humerus parallel to the IR.
192. Can the positioning of this oblique view of the c-spine be improved?
A Yes, the foramina would open more if the CR was angled 15 degrees cephalic
B Yes, the head should be turned into a true lateral position.
C No, it is optimum.
D No, the problem here is exposure, not positioning.
A Yes, the foramina would open more if the CR was angled 15 degrees cephalic

The positioning of this oblique view of the c-spine could be improved by angling the CR 15 degrees cephalic. This appearance is characteristic of oblique c-spines done without CR angle. Note the essentially lateral appearance of the posterior arch of C1. It is not optimum. The head should be nearer to true lateral and the chin tipped up, but this is not as critical a problem as the CR angle. The exposure here is optimum.
193. Study the posteroanterior (PA) chest projection. What best summarizes an evaluation of this image?
A This is a diagnostic chest radiograph.
B The first ribs are clipped; so, it should be repeated.
C The inspiration is not sufficient; so, it should be repeated.
D The apices of the lungs are clipped; so, it should be repeated.
B The first ribs are clipped; so, it should be repeated.
The PA chest projection should be repeated, because the first ribs and even the right second rib are clipped. It is not a diagnostic chest, because the first ribs are not fully demonstrated. The inspiration is sufficient, as 10 ribs can be counted above the diaphragm. The lungs are not clipped.
194. When performing an Anteroposterior (AP) Axial (Towne method) image of the skull, which reference line should be perpendicular to the image receptor (IR) if using a 30 degree caudal angle?

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