HESI Radiography Practice Exam With Answers (500 Solved Questions)

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HESI RADIOGRAPHY PRACTICE TEST 1 & 2 With RationaleWhich digital communication network is used to store patient billing information?a. RIS.b. HR.c. PACS.d. HIS. - d. HIS.The HIS, which stands for health information system, is used to store all patientdata that is relative to billing and demographic information. The RIS is theradiology information system and includes information about the patient'sradiology exams and data relevant to them. PACS, which stands for picturearchival and communication system, is used to store images. HR stands forhuman resources and is a department located in the hospital that handles allemployee information.Which grid ratio results in the lowest dose to a patient, because less milliampere-seconds (mAs) is required?a. 12:1.b. 16:1.c. 8:1.

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d. 5:1 - d. 5:1A 5:1 grid ratio provides less exposure to the patient than higher grid ratios due tohigher lead content. Grid selection always involves a trade-off between obtainingan optimal image and exposure to the patient. Higher ratio grids improve imagecontrast at the expense of increased patient dose.What does "ventricular fibrillation" mean?a. Erratically quivering ventricles.b. Slow heart rate.c. Rapid heart rate.d. Premature ventricular contractions. - a. Erratically quivering ventricles.Ventricular fibrillation means that the ventricles are quivering which results in theheart's inability to pump blood. If the heart is beating too slowly, the patient issuffering from bradycardia. On the other hand, if the heart is beating too quickly,the patient has tachycardia. Premature ventricular contractions (PVCs) are extrabeats that do not contribute to the blood flow, but this is not generally a life-threatening rhythm.How should the radiographer position the patient to best demonstrate a leftaxillary 6th rib fracture?a. Supine and 45 degree left posterior oblique (LPO).b. Upright posteroanterior (PA).

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c. Upright and 45 degree left posterior oblique (LPO).d. Prone. - c. Upright and 45 degree left posterior oblique (LPO).To best visualize a left axillary 6th rib fracture, the radiographer should place thepatient in an upright and 45 degree LPO position. Prone or Supine and 45 degreeLPO would be used to visualize ribs below the diaphragm (generally the 9th-12thribs). An upright PA is used to visualize the anterior upper ribs.What is the term for a reduction in x-ray photon intensity as it passes through thepatient?a. Absorption.b. Divergence.c. Scattering.d. Attenuation - d. AttenuationThe reduction in intensity of the xray beam as it passes through matter isattenuation. Absorption occurs when the photon interacts with matter anddisappears. Scattering is when there is a partial transfer of energy to matter.Divergence refers to the x-ray beam spreading out as it travels away from the x-ray tube.A posteroanterior (PA) chest radiograph demonstrates the left clavicle closer tothe center of the spine than the right clavicle. Which action should theradiographer take?

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a. Turn left side closer to image receptor (IR).b. Accept the image.c. Roll shoulders forward.d. Turn right side closer to image receptor (IR). - d. Turn right side closer toimage receptor (IR).The patient is in a slight left anterior oblique (LAO) position, so the right sideshould be rotated closer to the IR. This image should not be accepted, becauserotation is present. Rolling the shoulders forward will move the scapulae out ofthe lung field, but will not change rotation. Turning the left side closer to the IR willincrease the patient's obliquity.What is the angle formed by the intervertebral foramina and the midsagittal planein the thoracic spine?a.70 degrees.b. 15 degrees.c. 90 degrees.d. 45 degree - c. 90 degrees.The intervertebral foramina of the thoracic spine form a 90 degree angle with themidsagittal plane, thus much larger than 15 degrees. The intervertebral foramina

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of the cervical spine form a 45 degree angle with the midsagittal plane. Thethoracic zygapophyseal joints form a 70 degree angle with the midsagittal plane.The radiographer is using automatic brightness control during fluoroscopy. Whatchange in patient exposure should the radiographer expect as the patient sizeincreases?a. Reduction in exposure.b. No change in exposure.c. Indeterminant change in exposure.d. Increase in exposure - d. Increase in exposureAutomatic brightness control (ABC) increases patient exposure as patient sizeincreases, compensating for additional attenuation of a thicker body to maintainimage brightness. ABC does not reduce patient exposure under these conditions.Since the ABC does change patient exposure, it fails to maintain patient exposureat the same level. The patient exposure change is definite--an increase--notindeterminate.Which nonverbal cue best demonstrates attentiveness and concern for a patientwho is giving a medical history?a. A pleasant smile.b. Turning the head to the side to place one ear closer.c. Consistent eye contact.

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d. Taking notes - c. Consistent eye contact.Maintaining eye contact is an effective way to show the patient attentiveness andconcern. A pleasant smile communicates warmth, but may not be appropriatewhile listening to a medical history. Taking notes requires listening, butappropriate eye contact conveys understanding. Turning the head to the side toplace one ear closer might imply that it is difficult to hear the patient.How is signal maximized to a digital image receptor?a. Lower milliamperage (mA) setting.b. Shorter exposure time.c. Higher source to image receptor distance (SID) value.d. Longer exposure time. - d. Longer exposure time.The greatest signal strength is obtained with longer exposure time. The otherresponses reduce signal at the digital image receptor.Which is the best approach for speaking to a patient with a hearing impairment?a. Ask patient to adjust hearing aid volume.b. Speak in a low register.c. Talk very slowly.

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d. Do not make eye contact. - b. Speak in a low register.Patients with hearing loss most often have difficulty hearing voices in a highregister, so speaking in a low register is recommended. Speaking at a moderatepace is preferable, rather than very slowly. It is best to face the patient withhearing loss, so good eye contact is appropriate. Patients should not be advised toadjust their hearing aids in order to facilitate communication.Which protective feature is designed to reduce exposure to the patient duringfluoroscopic procedures?a. Bucky slot cover.b. Magnification mode.c. Protective curtain.d. Foot switch. - d. Foot switch.Radiologists are trained to repeatedly depress and release the fluoroscopic footswitch in order to reduce beam-on time and patient exposure. The bucky slotcover and protective curtain are designed to reduce exposure to personnel,rather than to the patient. While the magnification mode is helpful in certainsituations, it does increase exposure to the patient.How can digital radiography contribute to patient dose reduction today, in spite ofgenerally being slower in system speed than 400 speed film screen systems?a. Lower kilovolts peak (kVp) should be used with digital.

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b. Lower milliampere-seconds (mAs) should be used with digital.c. Higher milliampere-seconds (mAs) should be used with digital.d. Higher kilovolts peak (kVp) should be used with digital - d. Higher kilovolts peak(kVp) should be used with digitalHigher kVp should be used with digital radiography, because lost contrast can bereplaced during image processing. The net effect is a patient dose reductioncompared to film-screen systems for the same body part. Lower kVp should notbe used. Lower mAs cannot be assured due to the speed of the imaging system,but it may result from the choice of higher kVp. Higher mAs may be required dueto the speed of the imaging system, but it certainly does not contribute to patientdose reduction.Which position should a patient be placed in immediately following a seizure?a. Dorsal recumbent.b. Sitting.c. Lateral recumbent.d. Ventral recumbent. - c. Lateral recumbent.Lateral recumbent is the preferred position for patients to be placed after havinga seizure to avoid aspiration of secretions. Dorsal recumbent inhibits breathing

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and does not prevent aspiration. Ventral recumbent hides the patient's face frombeing observed for further complications. Sitting is contraindicated due to thepatient weakness following the seizure.Who judges radiographic images for quality? (Select the four that apply.)a. Ordering physicians.b. Lawyers.c. Radiologists.d. Radiographers.e. Quality control technologists - a. Ordering physicians.c. Radiologists.d. Radiographers.e. Quality control technologistsRadiographs are judged for quality by essentially all quality control technologists,ordering physicians, radiographers, and radiologists who see them. Lawyersdepend upon hired expert radiologists to judge radiographs for them.How does the Density log Exposure (D log E) curve appear for a digital imagingreceptor (IR)?a. A straight line at a 45 degree angle.b. An S curve.

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c. A shallow slope.d. A steep slope. - a. A straight line at a 45 degree angle.D log E curves for digital imaging demonstrate the wide dynamic range of theimage 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 curveswith the left half of the bell demonstrated. A steep slope and shallow slope pertainto film/screen imaging.Following administration of contrast media, the radiologist asks the radiographerto obtain a conus projection. Which patient position and centering point should beused for the image?a. Lateral centered to L3-L4.b. Anteroposterior (AP) centered to L3-L-4.c. Lateral centered to T12-L-1.d. Anteroposterior (AP) centered to T-12-L - d. Anteroposterior (AP) centered to T-12-LThe conus projection is used to image the conus medullaris or terminal end of thespinal cord. It terminates at L1-L2. An AP position centered to T12-L1 is obtained tobest image this structure. An AP centered to L3-L4 is below the conus medullaris.A lateral position centered to T12-L1 does not demonstrate the conus medullaris aswell as in the AP position. Using a lateral centered to L3-L4 is below the level ofthe conus medullaris.

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Which term describes stray radiation that is emitted through the x-ray tubehousing?a. Exit .b. Off-focus.c. Scatter.d. Leakage. - d. Leakage.Leakage radiation is radiation emitted through the housing of the x-ray tube thatresults in additional exposure to the patient and radiographer. Exit radiation is theportion of the primary beam that passes through the patient to form the image onthe image receptor. Scatter is a change in direction of x-rays as the beam passesthrough an object in its path. Off-focus radiation describes x-rays produced withinthe tube, but outside of the focal spot.What is the longest field size dimension allowable for 10 inches by 12 inchescollimation at a 40 inch source to image distance (SID)?a. 12.8 inches.b. 13.2 inches.c. 10.6 inches.d. 11.4 inches. - a. 12.8 inches.

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Field size may be off +/- 2% of the SID, which in this case is 0.8 inches. 12.8inches is in the acceptable range. 10.6 inches and 11.4 inches have collimation-fieldsize discrepancies that are within the acceptable range. 13.2 inches exceeds theacceptable range.A radiographer prepares to transfer a patient from a wheelchair to the x-raytable. The patient recently suffered a stroke, exhibits left-sided weakness, and isable to bear some weight. How should the radiographer move the patient to thetable?a. Position the left side of the wheelchair next to the table.b. Have one radiographer lift the torso while another lifts the feet.c. Use a hydraulic lift.d. Position the right side of the wheelchair next to the table - d. Position the rightside of the wheelchair next to the tableBecause the patient's strongest side is the right side, the radiographer shouldposition the right side of the wheelchair next to the table. Hydraulic lifts are usedfor patients who cannot bear weight and are too heavy to lift. Positioning the leftside of the wheelchair to the table places the patient's strong side away from thetable. Two radiographers to move the patient is called a two-person lift and isused when the patient cannot bear weight but can be lifted manually.How does the central ray (CR) for an anteroposterior (AP) scapula differ from anAP shoulder x-ray?a. CR is the same.

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b. One inch lower.c. One inch higher.d. Same level, medial. - b. One inch lower.The CR for an AP scapula is one inch lower than the CR for an AP shoulder, or twoinches inferior to the coracoid process. The CR is not the same for these twoprojections. One inch higher is at the level of the coracoid process, too high. Atthe same level, but medial, will be one inch too high.Where is the central ray (CR) directed for an anteroposterior (AP) projection ofthe lower leg?a. At the level of the medial malleolus.b. Two inches distal to the medial condyle of the tibia.c. Mid-lower leg.d. 0.5 inch inferior to patellar apex. - c. Mid-lower leg.An AP projection of the lower leg requires the CR to enter mid-lower leg. Half aninch inferior to the patellar apex, the level of the medial malleolus, and two inchesdistal to the medial condyle of the tibia are all either too high or too low.What should the radiographer do if a radiologist's instructions are unclear?a. Question the lead technologist.

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b. Perform the exam in the usual way.c. Read the protocol book.d. Ask for clarification - d. Ask for clarificationThe radiographer should ask for clarification. This will allow for anymiscommunication to be corrected and improve the patient outcome. The otheroptions are incorrect.c. The radiographer.A metallic artifact from an object that can be clearly seen as the patient ispositioned is clearly the responsibility of the radiographer. For those who wouldargue that the radiographer is not responsible for caps on teeth, notice that thehead is tipped too far forward. The occipital bone is not even visualized on thisimage. This cap need not have obscured the tip of the odontoid process. No oneelse is responsible in this case. - Who is responsible for the metallic artifact seenin the open mouth odontoid image?a. The ordering physician.b. The receptionist.c. The radiographer.d. The patientWhich step will reduce digital image noise, assuming no other changes?a. Longer exposure time.

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b. Image magnification.c. Decreased kilovolts peak (kVp).d. Small pixel size. - a. Longer exposure time.A longer exposure time results in a greater amount of photons reaching the imagereceptor, which reduces image noise. Decreased kVp reduces the quantity of x-rays that reach the image receptor, which increases image noise. A matrix with alarge number of small pixels results in greater image noise due to the availabilityof fewer photons per pixel. Magnification of the digital image does not affect imagenoise, but it may make what noise is there more visible.Which system can store images?a. Picture archival and communication system (PACS).b. Hospital information system (HIS).c. Digital imaging and communication in medicine (DICOM).d. Radiology information system (RIS). - a. Picture archival and communicationsystem (PACS).The PACS can store images. The HIS contains much information, including billinginformation and patient treatment plans, but does not contain images. Likewise,the RIS does not contain images, though it has radiology-specific information,such as a radiology schedule history. The DICOM standard allows images to beexchanged between different devices.

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