Free Radiographer mock test

Radiographer sample questions with answers

10 more original exam-style Radiographer questions, worked in full. They are not real or recalled exam questions, and none of them is in the mock above or on the bank page, so sit the mock first if you have not.

1. Question 1 · Radiation Protection & Safety

   Following the ICRP reduction of the occupational equivalent dose limit for the lens of the eye to 20 mSv/year, which protective device has become particularly important for interventional operators?

   1. ALead-lined shoe covers
   2. BLeaded protective eyewear (glasses)
   3. CA second, thicker thyroid collar
   4. DFull-length leaded gauntlet gloves
   Show answer and explanation

   Correct answer: B. Leaded protective eyewear (glasses)

   Because the lens of the eye is radiosensitive and its occupational equivalent dose limit was lowered to 20 mSv/year (averaged over 5 years), leaded protective eyewear is emphasised for interventional and fluoroscopy operators to reduce lens dose and the risk of radiation-induced cataract. Shoe covers, an extra thyroid collar, and gauntlet gloves do not protect the lens.

   Reference: ICRP Statement on Tissue Reactions (2011); ICRP Publication 103 (2007)

2. Question 2 · Radiation Physics & X-ray Production

   Most cellular radiation damage from diagnostic x-rays occurs by the indirect action mechanism, which involves:

   1. ADirect ionization of the DNA molecule by the incident photon
   2. BHeat deposition denaturing cellular proteins
   3. CRadiolysis of water producing free radicals that then damage DNA
   4. DPhotoelectric absorption in mitochondria only
   Show answer and explanation

   Correct answer: C. Radiolysis of water producing free radicals that then damage DNA

   Because cells are largely water, low-LET radiation such as diagnostic x-rays mostly acts indirectly: it ionizes water (radiolysis) to form reactive free radicals (e.g., hydroxyl radicals) that diffuse and damage DNA. Direct action, in which the photon or electron ionizes DNA itself, is more prominent with high-LET radiation. Thermal denaturation and mitochondria-only absorption do not describe the indirect mechanism.

   Reference: Bushong, Radiologic Science for Technologists, 11th ed. (2017), Ch. 34 Fundamental Principles of Radiobiology

3. Question 3 · Anatomy, Physiology & Pathology (Clinical Principles)

   A patient presents to the emergency department with a sudden 'thunderclap' headache and suspected acute subarachnoid hemorrhage. Which is the most appropriate first-line imaging modality?

   1. ASkull radiographs
   2. BMRI with gadolinium
   3. CNon-contrast CT of the head
   4. DCarotid Doppler ultrasound
   Show answer and explanation

   Correct answer: C. Non-contrast CT of the head

   Non-contrast CT of the head is the first-line investigation for suspected acute subarachnoid hemorrhage because it rapidly and reliably detects acute blood as high attenuation in the basal cisterns and sulci. MRI is less available and less sensitive for hyperacute blood in this setting, skull radiographs cannot show intracranial hemorrhage, and carotid Doppler does not evaluate the brain parenchyma or cisterns.

   Reference: ACR Appropriateness Criteria: Headache (2022)

4. Question 4 · Professional Practice, Ethics & Quality Assurance

   A positive patient-safety culture that emphasizes learning from errors rather than punishing individuals for honest mistakes is best described as a:

   1. ABlame culture
   2. BJust culture
   3. CCulture of secrecy
   4. DZero-tolerance culture
   Show answer and explanation

   Correct answer: B. Just culture

   A 'just culture' balances accountability with system-level learning, encouraging staff to report errors and near misses without fear of unfair punishment while still addressing reckless behavior. A blame culture, secrecy, or blanket zero-tolerance all discourage reporting and undermine safety improvement.

   Reference: James Reason, Managing the Risks of Organizational Accidents (1997); WHO Patient Safety culture guidance

5. Question 5 · Infection Control & General/Occupational Safety

   Which statement best reflects proper hazardous-chemical labeling under the Globally Harmonized System (GHS) used on department chemicals?

   1. AOnly the chemical name is required on the label
   2. BPictograms are optional if staff are experienced
   3. CLabels must include a signal word, hazard pictograms, and hazard/precautionary statements
   4. DSecondary containers never require any labeling
   Show answer and explanation

   Correct answer: C. Labels must include a signal word, hazard pictograms, and hazard/precautionary statements

   Under GHS, a compliant label carries the product identifier, a signal word (Danger/Warning), standardized hazard pictograms, and hazard and precautionary statements plus supplier information. Reducing it to a name only, treating pictograms as optional, or leaving secondary/working containers unlabeled violates the hazard-communication requirements.

   Reference: OSHA Hazard Communication Standard aligned with GHS (29 CFR 1910.1200)

6. Question 6 · Radiation Protection & Safety

   Three factors used in the NCRP method to calculate the required thickness of a primary barrier are the workload (W), the use factor (U), and the:

   1. AOccupancy factor (T) of the area beyond the barrier
   2. BHalf-value layer of the patient
   3. CGrid ratio of the Bucky
   4. DFocal-spot size of the tube
   Show answer and explanation

   Correct answer: A. Occupancy factor (T) of the area beyond the barrier

   Structural shielding calculations combine workload (W, the tube output in mA-min/week), use factor (U, the fraction of time the beam points at the barrier), and occupancy factor (T, the fraction of time the adjacent area is occupied) together with the distance and permissible dose. Patient half-value layer, grid ratio and focal-spot size are not parameters in the barrier-thickness equation.

   Reference: NCRP Report No. 147 (2004)

7. Question 7 · Radiation Physics & X-ray Production

   The probability of a photoelectric interaction is highly dependent on the atomic number of the absorber, varying approximately as:

   1. AThe atomic number (Z)
   2. BThe atomic number squared (Z squared)
   3. CThe inverse of the atomic number (1/Z)
   4. DThe atomic number cubed (Z cubed)
   Show answer and explanation

   Correct answer: D. The atomic number cubed (Z cubed)

   Photoelectric absorption probability is proportional to roughly Z cubed (and inversely proportional to photon energy cubed), which is why high-Z materials such as bone and iodinated/barium contrast media absorb strongly and produce high subject contrast. A linear or inverse relationship would not explain the marked contrast difference between bone and soft tissue.

   Reference: Bushong, Radiologic Science for Technologists, 11th ed. (2017), Ch. 9 X-ray Interaction with Matter

8. Question 8 · Anatomy, Physiology & Pathology (Clinical Principles)

   A patient with a large left-lung collapse (atelectasis) is imaged. Which of the following radiographic signs would be expected?

   1. AShift of the trachea and mediastinum away from the affected side
   2. BFlattening of the hemidiaphragm on the affected side
   3. CShift of the trachea and mediastinum toward the affected side
   4. DWidening of the intercostal spaces on the affected side
   Show answer and explanation

   Correct answer: C. Shift of the trachea and mediastinum toward the affected side

   Atelectasis (volume loss) reduces the volume of the affected lung, drawing the trachea, mediastinum, and hemidiaphragm toward the collapsed side and narrowing the intercostal spaces. Shift away from the affected side and rib-space widening are features of volume-increasing processes such as a large pleural effusion or tension pneumothorax.

   Reference: Fundamentals of Diagnostic Radiology (Brant & Helms), 5th ed. (2018)

9. Question 9 · Professional Practice, Ethics & Quality Assurance

   During a mobile chest examination in ICU, a radiographer realizes the request form has the wrong patient's name although the room and bedside match a different individual. The best professional decision is to:

   1. AStop, verify the patient's identity using two identifiers, and resolve the discrepancy before any exposure
   2. BExpose the image and correct the name later to avoid delay
   3. CAsk the nurse to sign the form and continue
   4. DCancel the examination permanently without follow-up
   Show answer and explanation

   Correct answer: A. Stop, verify the patient's identity using two identifiers, and resolve the discrepancy before any exposure

   Correct patient identification using two identifiers before exposure is essential, and an identity discrepancy must be resolved to prevent a wrong-patient event and unnecessary dose. Exposing first, obtaining an unrelated signature, or abandoning a clinically needed examination without follow-up all fail the accountability and patient-safety standard.

   Reference: The Joint Commission National Patient Safety Goal on patient identification; WHO Surgical/Correct-Patient safety principles

10. Question 10 · Infection Control & General/Occupational Safety

    Under the Spaulding classification, an instrument that contacts intact mucous membranes but not sterile tissue (e.g., a cavity ultrasound probe covered by a sheath) is categorized as which item, requiring what minimum level of reprocessing?

    1. ACritical item requiring sterilization
    2. BNoncritical item requiring low-level disinfection
    3. CEnvironmental surface requiring detergent cleaning only
    4. DSemicritical item requiring high-level disinfection
    Show answer and explanation

    Correct answer: D. Semicritical item requiring high-level disinfection

    Under Spaulding's classification, devices contacting mucous membranes or non-intact skin are semicritical and require at least high-level disinfection. Critical items enter sterile tissue and must be sterilized, while noncritical items touch only intact skin and need low-level disinfection, so those levels would be inadequate or excessive for a mucosal-contact probe.

    Reference: CDC Guideline for Disinfection and Sterilization in Healthcare Facilities (Rutala & Weber, 2008)