HESI Radiography Practice Exam With Answers (500 Solved Questions)

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HESI RADIOGRAPHY PRACTICE TEST 1 & 2 With Rationale
Which 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 patient
data that is relative to billing and demographic information. The RIS is the
radiology information system and includes information about the patient's
radiology exams and data relevant to them. PACS, which stands for picture
archival and communication system, is used to store images. HR stands for
human resources and is a department located in the hospital that handles all
employee 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.

d. 5:1 - d. 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.
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 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.
How should the radiographer position the patient to best demonstrate a left
axillary 6th rib fracture?
a. Supine and 45 degree left posterior oblique (LPO).
b. Upright posteroanterior (PA).

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 the
patient in an upright and 45 degree LPO position. Prone or Supine and 45 degree
LPO would be used to visualize ribs below the diaphragm (generally the 9th-12th
ribs). 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 the
patient?
a. Absorption.
b. Divergence.
c. Scattering.
d. Attenuation - d. Attenuation
The reduction in intensity of the xray beam as it passes through matter is
attenuation. Absorption occurs when the photon interacts with matter and
disappears. 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 to
the center of the spine than the right clavicle. Which action should the
radiographer take?

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 to
image receptor (IR).
The patient is in a slight left anterior oblique (LAO) position, so the right side
should be rotated closer to the IR. This image should not be accepted, because
rotation is present. Rolling the shoulders forward will move the scapulae out of
the lung field, but will not change rotation. Turning the left side closer to the IR will
increase the patient's obliquity.
What is the angle formed by the intervertebral foramina and the midsagittal plane
in 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 the
midsagittal plane, thus much larger than 15 degrees. The intervertebral foramina

of the cervical spine form a 45 degree angle with the midsagittal plane. The
thoracic zygapophyseal joints form a 70 degree angle with the midsagittal plane.
The radiographer is using automatic brightness control during fluoroscopy. What
change in patient exposure should the radiographer expect as the patient size
increases?
a. Reduction in exposure.
b. No change in exposure.
c. Indeterminant change in exposure.
d. Increase in exposure - d. 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.
Which nonverbal cue best demonstrates attentiveness and concern for a patient
who 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 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.
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 other
responses 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 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.
Which protective feature is designed to reduce exposure to the patient during
fluoroscopic 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 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.
How can digital radiography contribute to patient dose reduction today, in spite of
generally 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 digital
Higher kVp should be used with digital radiography, because lost contrast can be
replaced during image processing. The net effect is a patient dose reduction
compared to film-screen systems for the same body part. Lower kVp should not
be 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 due
to the speed of the imaging system, but it certainly does not contribute to patient
dose 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 having
a 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 from
being observed for further complications. Sitting is contraindicated due to the
patient 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 technologists
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.
How does the Density log Exposure (D log E) curve appear for a digital imaging
receptor (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 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.
Following administration of contrast media, the radiologist asks the radiographer
to obtain a conus projection. Which patient position and centering point should be
used 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-L
The conus projection is used to image the conus medullaris or terminal end of the
spinal cord. It terminates at L1-L2. An AP position centered to T12-L1 is obtained to
best 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 as
well as in the AP position. Using a lateral centered to L3-L4 is below the level of
the conus medullaris.

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Which term describes stray radiation that is emitted through the x-ray tube
housing?
a. Exit .
b. Off-focus.
c. Scatter.
d. Leakage. - d. Leakage.
Leakage radiation is radiation emitted through the housing of the x-ray tube that
results in additional exposure to the patient and radiographer. Exit radiation is the
portion of the primary beam that passes through the patient to form the image on
the image receptor. Scatter is a change in direction of x-rays as the beam passes
through an object in its path. Off-focus radiation describes x-rays produced within
the tube, but outside of the focal spot.
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. 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. 12.8
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.
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. 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 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.
How does the central ray (CR) for an anteroposterior (AP) scapula differ from an
AP 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 two
inches inferior to the coracoid process. The CR is not the same for these two
projections. One inch higher is at the level of the coracoid process, too high. At
the same level, but medial, will be one inch too high.
Where is the central ray (CR) directed for an anteroposterior (AP) projection of
the 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 an
inch inferior to the patellar apex, the level of the medial malleolus, and two inches
distal 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 clarification
The radiographer should ask for clarification. This will allow for any
miscommunication to be corrected and improve the patient outcome. The other
options are incorrect.
c. 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. - Who is responsible for the metallic artifact seen
in the open mouth odontoid image?
a. The ordering physician.
b. The receptionist.
c. The radiographer.
d. The patient
Which 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 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.
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 communication
system (PACS).
The PACS can store images. The HIS contains much information, including billing
information 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 be
exchanged between different devices.

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HESI Radiography Practice Exam With Answers (500 Solved Questions)

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