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234
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
52. D
The head and neck are rotated anteriorly 15 de-
grees to 20 degrees. Internally rotating the entire
leg will place the neck parallel for a true AP image
of the hip.
53. D
The average angle of the neck to shaft is 125 de-
grees, with a possible 15-degree variance based on
the width of the patient’s pelvis.
54. A
70-degree oblique or 20 degrees off lateral would
best demonstrate the zygapophyseal joints of the
thoracic spine.
55. A
HNP is when the inner material of the vertebral
disk extrudes from the annulus fibrosis.
56. B
Spondylolisthesis involves forward slipping of one
vertebra onto another, commonly due to a defect
in the pars interarticularis.
57. B
Posterior oblique positions demonstrate the down
side zygapophyseal joints.
58. A
Flexion/extension laterals will demonstrate the
mobility of the spine.
59. B
The measurement of tabletop to ASIS allows the ra-
diographer to angle the tube correctly and brings
the tube parallel with the joint space.
60. C
A 45-degree medial oblique of the knee will move
the fibula away from the tibia.
61. D
A medial oblique of the knee will demonstrate the
proximal tibiofibular joint space open.
62. B
A 20-degree to 30-degree knee flexion opens the
femoropatellar joint space.
63. A
A cross-table lateral knee with a horizontal central
ray will demonstrate an effusion.
64. A
The patella and tibial tubercle are seen in profile in
a properly positioned lateral knee.
41. C
Control-booth barriers protect the radiographer
during an examination, and personnel must remain
completely behind the booth for maximal protec-
tion. The barrier intercepts only leakage and scat-
ter radiation.
42. D
Primary barriers consist of
1
⁄
16
⬙ lead or lead equiva-
lent and extend 7 feet from the floor with the x-ray
tube and 5 to 7 feet from the primary wall.
43. A
While the radiographer should maintain appropri-
ate distance and remain available for assistance
during radiographic procedures, he or she should
be dressed adequately. Protective aprons of 0.5 mm
lead equivalent must be worn with protective lead
gloves of 0.25 mm lead equivalent. In addition, thy-
roid shields of 0.5 mm lead equivalent should also
be worn.
44. B
The NCRP mandates that the SSD should be no less
than 15⬙ for stationary fluoroscopes and no less
than 12⬙ for mobile fluoroscopes.
45. D
A 35-degree angle is appropriate for females due to
the lumbosacral curve.
46. B
A 30-degree angle is used for imaging the SI joints
for male patients.
47. A
A cephalic angle is appropriate when the patient
is supine on the imaging table to open the SI joints
and L5–S1 junction.
48. A
Centering 2⬙ below the iliac crest will place the cen-
tral ray at the midpoint of the SI joints.
49. B
When the head is flexed too much, the lower mar-
gin of the front teeth is superimposed over the
odontoid.
50. C
The Judd view is performed PA and decreases thy-
roid dose when the dens is of interest.
51. C
Positioning the patient PA reduces the thyroid
dose.
235
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
78. C
Long-scale contrast requires higher kVp.
79. A
Having the patient stand 12⬙ in front of the IR and
lean against it pushes the clavicles superior to
the apices, demonstrating the apical region of the
lungs.
80. D
A 10-degree to 15-degree oblique image will remove
superimposed tissue.
81. D
A 60-degree LAO is required for a heart study.
82. B
The RPO position will best demonstrate the right
posterior ribs.
83. B
Lower ribs require exhalation because it will push
the diaphragm up to improve visualization of the
ribs.
84. C
An LPO image of the ribs will demonstrate the left
posterior ribs.
85. D
An LAO image of the ribs will demonstrate the
right anterior ribs.
86. A
For lower ribs, exhalation will move the diaphragm
up and improve visualization.
87. C
Inhalation will push the sternum away from the
thoracic cavity, allowing better visualization of the
sternum.
88. A
A 15-degree to 20-degree RAO will move the
sternum away from the spine and into the heart
shadow to better demonstrate the sternum.
89. B
Pectus excavatum is a condition in which the chest
is concave rather than convex and is best demon-
strated on a lateral image of the sternum.
90. D
Pectus excavatum is a chest that is positioned in a
sunken or funnel position.
91. A
Hypersthenic patients require less obliquity.
65. C
The femoropatellar joint space should be open on
a lateral knee.
66. B
The adductor tubercle will be demonstrated if the
knee is underrotated.
67. D
Sinding-Larsen-Johansson is a ligament disorder
that pulls on the apex of the patella.
68. B
Osgood-Schlatter disease is a patellar ligament dis-
order that attaches to the tibial tuberosity and is
best demonstrated on a lateral knee image.
69. B
Intercondylar fossa views will better demonstrate
the tibial eminences and possible degenerative
joint disease.
70. C
The femoral epicondyles are perpendicular to the
IR in a lateral knee image.
71. A
Dropping the patient’s shoulders helps to move
the clavicles inferiorly from the apices.
72. A
Double inhalation helps to moves the diaphragm
more inferior versus single inhalation and allows
for greater lung expansion.
73. D
A 14⬙ ⫻ 17⬙ lengthwise is the best choice for a hy-
posthenic patient in order to include the entire
lung field.
74. B
The central ray is directed to T6–T7, which is also
at the level of the inferior scapula.
75. A
Centering 4⬙ below the jugular notch brings the
central ray to the level of T6–T7.
76. C
A 40⬙ SID would cause the heart to appear magni-
fied, so a 72⬙ SID is used to reduce the magnifica-
tion of the heart.
77. C
Long-scale contrast allows for lung tissue to be vi-
sualized by demonstrating white, gray, and black
structures.
236
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
103. C
A fracture ½⬙ distal to the base of the 5th metatar-
sal (Jones fracture) is common.
104. C
More angle is required for a patient with high
arches.
105. A
Less angle is required for a patient with flat feet.
106. B
The 3rd through 5th metatarsals are free of super-
imposition, whereas the 1st and 2nd metatarsals
are superimposed.
107. B
A medial oblique view will superimpose medial anat-
omy; however, it will demonstrate lateral anatomy.
108. D
Dorsoplantar axial projections of the calcaneus
will demonstrate medial or lateral displacement of
the calcaneus.
109. A
When performing a weight-bearing lateral image
of the foot, the patient should put his or her full
weight onto the affected foot.
110. B
When a patient is positioned prone (Lewis method)
to demonstrate the sesamoids, the central ray is
directed tangential to the sesamoids.
111. C
A patient would be supine and instructed to dorsi-
flex the foot, placing the calcaneus in contact with
the IR.
112. B
A 7-degree to 10-degree posterior angle is required
to open tarsal interspaces.
113. C
Lateral weight-bearing radiographs demonstrate
the true integrity of a patient’s arch.
114. A
The base of the 5th metatarsal is a common site of
fracture.
115. D
A 15-degree to 20-degree internal rotation of the
ankle brings the intermalleolar line parallel to the
IR and opens the mortise.
92. B
Asthenic patients require more obliquity than hy-
persthenic patients.
93. C
Autotomography will help blur out vascular mark-
ings, allowing better visualization of the sternum.
94. C
The joint closest to the IR will be demonstrated
when the patient is an anterior oblique position.
95. A
An anterior oblique position brings the S-C joint
closest to the IR and decreases magnification/
distortion.
96. D
The symphysis pubis is the appropriate landmark
to ensure the bladder will appear on an abdominal
radiograph (KUB) as the distal part of the bladder
terminates at the symphysis pubis.
97. A
The diaphragm must be demonstrated on an erect
abdominal radiograph to determine if free air is
under diaphragm.
98. C
When the patient is placed prone, the small intes-
tines are closest to the IR because the kidneys are
located in the anterior region of the abdominal
cavity.
99. B
The erect abdomen image should be performed
first because the patient is ambulatory and has
been upright for the minimum requirement of
5 minutes. The AP supine image should be per-
formed second.
100. B
To best demonstrate free air in the abdomen of
a nonambulatory patient, a decubitus projection
should be performed because the patient would
not be able to stand for an erect abdomen.
101. A
The mA would be halved for a soft tissue analog
neck radiograph, which would better demonstrate
soft tissue rather than bone.
102. D
The lateromedial lateral position of the ankle is
the best position to demonstrate a displaced ankle
fracture.
237
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
130. C
An aperture diaphragm is considered a beam re-
striction device.
131. D
A beam restriction device reduces patient expo-
sure, improves image quality, and can be a manual
or automatic collimator.
132. A
The rectifier changes the current from AC to DC.
133. A
Incoming power needs to be converted from AC to DC.
134. B
The power in the United States is 60 Hz AC.
135. C
Three phase x-ray systems are generally used in
general radiography, fluoroscopy, and angiography
units.
136. B
In a digital fluoroscopic unit, the flat panel detec-
tors replace the image intensifier.
137. D
DR uses flat panel detectors.
138. D
Dedicated chest units can be either a CR system, a
DR system, or a conventional film-type system.
139. A
A tomography unit creates a pivot point or fulcrum
between the x-ray tube and IR.
140. C
Grids increase image quality.
141. A
True statements regarding quality assurance test-
ing for light field and radiation field testing would
include radiopaque markers on the edge of the
light field, a fluorescent plate, and a plastic or alu-
minum tube for beam alignment.
142. A
When x-ray equipment malfunctions, it can endan-
ger the patient and the operator; the procedure
should be stopped immediately, and the issue
should be reported to maintenance.
143. B
Digital imaging receptors are subject to artifacts.
144. B
A ghost image can occur with DR when the previ-
ous exposure is trapped.
116. C
A 45-degree internal oblique allows the distal tibio-
fibular joint space to open.
117. A
A lateral (external) oblique view of the ankle will
demonstrate the posterior malleolus.
118. B
The 15-degree mortise most accurately demon-
strates the ankle joint.
119. A
Eversion stress places stress on the medial com-
partment of the ankle, demonstrating possible me-
dial ligament tears.
120. D
Zenker diverticulum is a large outpouching of the
proximal esophagus.
121. C
The aorta and left primary bronchus cause two in-
dentations in the esophagus.
122.
D
The timer is used to control the amount of time the
x-ray is on (duration).
123. A
The anode rotates inside the x-ray tube and is posi-
tively charged.
124. C
The filaments are two different-sized wires that
emit electrons during thermionic emission.
125. B
The outer edge of the anode is made of tungsten.
126. B
The rotating anode is an induction motor that con-
tains a stator and a rotor.
127. D
AEC can be adjusted in exposure settings in small
increments that are commonly from ⫺2 up to a ⫹2
density.
128. B
AEC units have three different ionization chambers
that can be selected by the radiographer prior to
patient exposure.
129. D
AEC uses ionization chambers (detectors) to de-
termine the appropriate amount of radiation for an
imaging study.
238
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
154. A
Characteristic radiation produced in other orbital
shells than the k-orbit produces radiation that is of
lower energy and not useful for imaging.
155. B
The effective energy of characteristic x-rays de-
creases with target elements of lower Z. The x-ray
energies associated with characteristic radiation
have precisely fixed energies and form discrete
spectrums.
156. B
Bremsstrahlung radiation is dependent on the elec-
tron speed used and the proximity to the nucleus.
157. C
Electromagnetic radiation in the form of x-rays
possesses wavelength and frequency; the relation-
ship between these properties is inverse.
158. A
Electromagnetic radiation is inversely related to
the square of the distance from the source. Should
the distance from the source of radiation increase
by one-half, the intensity of the radiation is re-
duced by 25%, or one-fourth.
159. D
A change that occurs to kVp or tube voltage will
result in either an increase or decrease in ampli-
tude and energy. There will be no effect to target
material or filtration.
160. A
A change that occurs to mA/s or tube current will
result in only either an increase or decrease in
amplitude.
161. B
Added filtration will decrease the intensity of the
x-ray produced.
162. B
The higher the Z of the target material, the greater
the efficiency of brems radiation produced.
163. D
Generators such as a three-phase or high-frequency
types are more efficient than single-phase types.
As the efficiency of the generator increases, less
voltage ripple will occur, which will increase the
intensity and energy of the x-ray beam produced.
164. C
Leakage radiation is any radiation that is not con-
sidered a primary radiation.
145. C
Incomplete system erasures on CR and DR systems
can contribute to imaging artifacts.
146. D
An SMPTE pattern can be used to check for sharp-
ness, distortion, and luminescence.
147. A
The manual exposure setting should be used when
checking lead aprons to prevent excessive radiation.
148. C
The rotor is made up of soft iron and copper bars.
149. C
There are three critical elements that must occur
in order for radiation to be emitted from the x-ray
tube. These elements include (1) the source of the
free electrons, which are located in the focusing
cup of the tube as a result of thermionic emissions;
(2) the focusing of these electrons to be acceler-
ated from the cathode to the anode through the
use of kV; and (3) the target of the anode, which
acts as the site of interaction of the projectile elec-
trons, resulting in the projectile electrons either
slowing down as they come close to the nuclear
field or interacting with the orbital electrons lo-
cated in the target atom.
150. B
Infrared radiation makes up approximately 99% of
the kinetic energy of the projectile electrons.
151. D
Bremsstrahlung radiation refers to the interaction
of the projectile electron that is influenced by the
nuclear field of the target atom.
152. D
The majority of radiation that results from in-
teractions at the target atom is classified as
Br
emsstrahlung.
153. C
When a projectile electron interacts with an inner-
shell electron and succeeds in totally removing it
from its orbital shells, an ion is produced. This pro-
cess is referred to as ionization
. In addition, the
resulting open space in the shell is replaced by an
outer-shell electron dropping into this slot through
a process referred to as transition. Transition is
accompanied by the release of characteristic ra-
diation and energy resulting from the difference
between the binding energies of the orbital shells
involved in this replacement process.
239
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
178. D
Influenza is transmitted in the air with large drop-
lets that cannot travel greater than 3 feet.
179. B
A tort is a civil wrong against a person or property
that is not punishable by imprisonment.
180. A
A normal BP is a systolic of 120 mm Hg or less and
a diastolic of 80 mm Hg or less.
181. B
Elderly patients commonly do not have a greater
support system than young patients due to major
life changes such as illness or death of a spouse,
no assistance from adult children, or no family in
the local area.
182. C
The pathogen must have a means to exit the in-
fected person before there can be a mode of trans-
mission or portal of entry.
183. A
The five elements of cultural competency include
value diversity, capacity for self-assessment, under-
stand cross-cultural interactions, applying cultural
knowledge to medical care, and adapting patient
services that reflect cultural understanding.
184. C
Anaerobes do not require oxygen to survive.
185. B
A normal adult respiratory rate is 10 to 20 breaths
per minute.
186. D
A Pigg-O-Stat can be used for infants during chest
radiography.
187. B
The radial pulse is most commonly taken with the
hands.
188. A
The enema bag should be hung 18⬙ to 24⬙ above
the table during a barium enema.
189. C
A cathartic is commonly administered to cleanse
the bowel of any remaining fecal material.
190. D
Droplets are spread 3 feet or less, so the patient
can be placed with another patient who is more
than 3 ft away.
165. A
Primary radiation is produced when the target is
bombarded by electrons.
166. A
Consent forms are not transferrable to another
date even for the same procedure.
167. C
Battery is the physical touching of a person with-
out his or her consent.
168. B
DNR stands for do not resuscitate and no efforts
to restart the heart or respiratory function can be
done on the patient.
169. D
Normal floras are pathogens present on or in a per-
son that do not cause infection for the person.
170. B
Pathogenicity is defined as the ability of a microor-
ganism to produce disease.
171. D
Restraints cannot be applied without a medical
order and are considered false imprisonment be-
cause the patient cannot free himself or herself
from the restraint.
172. C
Structured interviews use simple, one-response
questions to gather quick, specific information.
173. A
The HIPAA privacy practices notification describes
how a physician’s office uses a patient’s personal
health information.
174. C
Respondeat superior states that the employer is
responsible for the actions of the employee.
175. B
Virulence defines how likely a pathogen is to re-
sult in active disease; the pathogen’s degree of
pathogenicity.
176. A
Iatrogenic illness is acquired through the treat-
ment prescribed by the physician and does not
need to occur in the hospital setting.
177. D
Autoclave sterilization uses high, moist heat (steam).
240
APPENDIX C
|
ANSWERS TO COMPREHENSIVE EXAM 2
206. D
Patients with pyrexia experience fever and have an
increased pulse rate.
207. B
Hospice provides palliative care.
208. D
Drugs can be secreted through the urine, sweat,
and feces.
209. C
Contrast is defined as the visible difference
between two densities on an image.
210. A
mA/s affects radiographic density.
211. A
As mA/s decreases, density decreases as a result of
decreased thermionic emission.
212. B
kVp is the main controlling factor of contrast.
213. C
The law of reciprocity states that different com-
binations of mA and time that produce the same
mA/s produce the same density.
214. B
The law of reproducibility states that every time
the same combination of mA and time is set on the
same x-ray unit, the resulting image will demon-
strate the same density.
215. C
mA affects radiation quantity.
216. D
Film-screen speed and density are directly pro-
portional. As film-screen speed increases, density
increases.
217. A
The inverse square law states that the intensity of
radiation is inversely proportional to the square of
the distance from the x-ray source.
218. C
A minimum air gap of 6⬙ will have an effect on density.
219. B
The air-gap technique may be used to minimize the
amount of scatter reaching the IR when a grid is
not available.
191. B
The needle should always be positioned bevel up
and an angle of 45 degree when injecting contrast
media.
192. C
The median cubital vein is located in the arm.
193. B
Metformin (Glucophage) should be stopped 1 day
before a radiographic contrast procedure.
194. A
BUN evaluates kidney function and an abnormal
level may prohibit an intravenous urography ex-
amination.
195. C
The height of the enema bag should be reduced to
decrease flow and pressure.
196. D
Patients with megacolon are at an increased risk
for increased fluid in the blood (hypovolemia).
197.
D
Hygroscopic as it relates to barium sulfate is
defined as a substance that absorbs liquid.
198. B
The hypothalamus regulates body temperature.
199. A
Diarrhea is not a complication of barium sulfate
after a barium enema.
200. C
Glucagon is commonly found in a crash cart.
201. B
An itchy throat may occur with a mild reaction to
contrast media.
202. D
Ecchymosis is the proper medical terminology for
“black and blue.”
203. D
A patient may experience a severe reaction to
latex-based products.
204. C
Hypothermia is the medical term for a body
temperature below 95°F.
205. A
A patient with a spinal cord trauma injury may
exhibit flaccid paralysis.
241
ARRT Content Specifications for
the Examination in Radiography
APPENDIX
D
CONTENT SPECIFICATIONS FOR
THE EXAMINATION IN RADIOGRAPHY
Publication Date: August 2010
Implementation Date: January 2012
The purpose of the ARRT Examination in Radiography is to assess the knowledge and
cognitive skills underlying the intelligent performance of the tasks typically required of the staff
technologist at entry into the profession. To identify the knowledge and skills covered by the
examination, the ARRT periodically conducts practice analysis studies involving a nationwide
sample of staff technologists
1
. The results of the most recent practice analysis are reflected in
this document. The complete task inventory, which serves as the basis for these content
specifications, is available from our website www.arrt.org.
The table below presents the five major content categories, along with the number and
percentage of test questions appearing in each category. The remaining pages provide a
detailed listing of topics addressed within each major content category.
This document is not intended to serve as a curriculum guide. Although certification programs
and educational programs may have related purposes, their functions are clearly different.
Educational programs are generally broader in scope and address subject matter not included
in these content specifications.
CONTENT CATEGORY
PERCENT
OF TEST
NUMBER OF
QUESTIONS
2
A. Radiation Protection 22.5% 45
B. Equipment Operation and Quality Control 11.0% 22
C. Image Acquisition and Evaluation 22.5% 45
D. Imaging Procedures 29.0% 58
E. Patient Care and Education 15.0%
30
100% 200
1. A special debt of gratitude is due to the hundreds of professionals participating in this
project as committee members, survey respondents, and reviewers.
2. Each exam includes up to an additional 20 unscored (pilot) questions. On the pages that
follow, the approximate number of test questions allocated to each content category
appears in parentheses.
© 2014 The American Registry of Radiologic Technologists.
Disclaimer: The ARRT does not review, evaluate, or endorse publications. Permission to reproduce ARRT copyrighted materials
within this publication should not be construed as an endorsement of the publication by the ARRT.
242
APPENDIX D
|
ARRT CONTENT SPECIFICATIONS FOR THE EXAMINATION
A. RADIATION PROTECTION (45)
1. Biological Aspects of Radiation (10)
A. Radiosensitivity
1. dose-response relationships
2. relative tissue radiosensitivities
(e.g., LET, RBE)
3. cell survival and recovery (LD
50
)
4. oxygen effect
B. Somatic Effects
1. short-term versus long-term effects
2. acute versus chronic effects
3. carcinogenesis
4. organ and tissue response (e.g., eye,
thyroid, breast, bone marrow, skin,
gonadal)
C. Acute Radiation Syndromes
1. CNS
2. hemopoietic
3. GI
D. Embryonic and Fetal Risks
E. Genetic Impact
1. genetic significant dose
2. goals of gonadal shielding
F. Photon Interactions with Matter
1. Compton effect
2. photoelectric absorption
3. coherent (classical) scatter
4. attenuation by various tissues
a. thickness of body part (density)
b. type of tissue (atomic number)
2. Minimizing Patient Exposure (15)
A. Exposure Factors
1. kVp
2. mAs
B. Shielding
1. rationale for use
2. types
3. placement
C. Beam Restriction
1. purpose of primary beam restriction
2. types (e.g., collimators)
D. Filtration
1. effect on skin and organ exposure
2. effect on average beam energy
3. NCRP recommendations (NCRP #102,
minimum filtration in useful beam)
E. Exposure Reduction
1. patient positioning
2. automatic exposure control (AEC)
3. patient communication
4. digital imaging
5. pediatric dose reduction
6. ALARA
F. Image Receptors (e.g., types, relative speed,
digital versus film)
G. Grids
H. Fluoroscopy
1. pulsed
2. exposure factors
3. grids
4. positioning
5. fluoroscopy time
(Section A continues on the following page)
243
APPENDIX D
|
ARRT CONTENT SPECIFICATIONS FOR THE EXAMINATION
A. RADIATION PROTECTION (cont.)
3. Personnel Protection (11)
A. Sources of Radiation Exposure
1. primary x-ray beam
2. secondary radiation
a. scatter
b. leakage
3. patient as source
B. Basic Methods of Protection
1. time
2. distance
3. shielding
C. Protective Devices
1. types
2. attenuation properties
3. minimum lead equivalent (NCRP #102)
D. Special Considerations
1. portable (mobile) units
2. fluoroscopy
a. protective drapes
b. protective Bucky slot cover
c. cumulative timer
3. guidelines for fluoroscopy and portable
units (NCRP #102, CFR-21)
a. fluoroscopy exposure rates
b. exposure switch guidelines
4. Radiation Exposure and Monitoring (9)
A. Units of Measurement*
1. absorbed dose
2. dose equivalent
3. exposure
B. Dosimeters
1. types
2. proper use
C. NCRP Recommendations for Personnel
Monitoring (NCRP #116)
1. occupational exposure
2. public exposure
3. embryo/fetus exposure
4. ALARA and dose equivalent limits
5. evaluation and maintenance of personnel
dosimetry records
D. Medical Exposure of Patients (NCRP #160)
1. typical effective dose per exam
2. comparison of typical doses by modality
* Conventional units are generally used. However,
questions referenced to specific reports (e.g., NCRP)
will use SI units to be consistent with such reports.