Radiographer Prometric exam questions

The Radiographer exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked Radiographer practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Radiographic Positioning & Imaging Procedures

   For a proximal femur DEXA scan, the leg is placed in approximately 15-25° of internal rotation using a positioning device. What is the purpose of this maneuver?

   1. ATo superimpose the greater and lesser trochanters
   2. BTo foreshorten the femoral neck and shorten scan time
   3. CTo position the femoral neck parallel to the table and present it at its true length for measurement
   4. DTo displace the femoral head out of the acetabulum
   Show answer and explanation

   Correct answer: C. To position the femoral neck parallel to the table and present it at its true length for measurement

   Internal rotation of about 15-25° brings the anteverted femoral neck parallel to the tabletop so it is projected at its true, elongated length, allowing the femoral-neck region of interest to be placed accurately and reproducibly. Correct rotation is confirmed when the lesser trochanter is small or barely visible; external rotation or neutral positioning foreshortens the neck and produces erroneous BMD values.

   Reference: International Society for Clinical Densitometry (ISCD) Official Positions (2019)

2. Question 2 · Patient Care & Management

   A patient scheduled for a contrast-enhanced CT has a documented history of a previous severe (anaphylactoid) reaction to iodinated contrast. Which is the most appropriate management consideration?

   1. AGive the same contrast at a higher dose to overcome the reaction
   2. BSwitch to intrathecal administration of the same agent
   3. CProceed without any precautions because reactions never recur
   4. DConsider an alternative test or, if contrast is essential, use premedication and full resuscitation readiness after risk assessment
   Show answer and explanation

   Correct answer: D. Consider an alternative test or, if contrast is essential, use premedication and full resuscitation readiness after risk assessment

   A prior severe contrast reaction is a strong risk factor for recurrence, so the safest approach is to consider whether an alternative examination will answer the question, or, if iodinated contrast is truly necessary, to risk-assess, use premedication protocols and ensure full emergency preparedness. Repeating the same agent at a higher dose or with no precautions is dangerous, and intrathecal administration is unrelated and hazardous. Careful screening and mitigation are essential.

   Reference: ACR Manual on Contrast Media (2023); ESUR Guidelines on Contrast Agents

3. Question 3 · Image Production, Processing & Quality (Operation of Equipment)

   A department performs 4000 exposures in a month and rejects 240 of them. The reject rate is 6%. If a benchmark target for general radiography is typically in the range of about 4-8%, the most appropriate interpretation is:

   1. AThe rate is far too low and indicates images are not being scrutinized
   2. BThe rate is dangerously high and the department should stop imaging
   3. CThe rate is acceptable but the categorized causes should still be reviewed for improvement opportunities
   4. DReject rate has no relationship to patient dose
   Show answer and explanation

   Correct answer: C. The rate is acceptable but the categorized causes should still be reviewed for improvement opportunities

   A 6% reject rate falls within commonly cited acceptable benchmarks (roughly 4-8%), so it does not indicate a crisis, but ongoing review of the categorized causes is still warranted to drive continuous improvement and further dose reduction. An unusually low rate can indicate under-scrutiny, but 6% is not low; and reject rates directly relate to dose because each repeat adds exposure.

   Reference: Papp, Quality Management in the Imaging Sciences, 6th ed. (2019)

4. Question 4 · Specialized Imaging Modalities (CT, MRI, US, Mammography, Nuclear Medicine, Fluoroscopy/Angiography)

   When performing serial DEXA scans to monitor therapy, the least significant change (LSC) is used to determine whether an observed change in BMD is real. The LSC is derived primarily from:

   1. AThe scanner's spatial resolution
   2. BIn vivo precision (reproducibility) assessment of the facility/technologist
   3. CThe patient's T-score
   4. DThe manufacturer's reference database
   Show answer and explanation

   Correct answer: B. In vivo precision (reproducibility) assessment of the facility/technologist

   The least significant change is calculated from precision error established by repeated in vivo measurements at a given facility, ensuring that a change between scans exceeds normal measurement variability before being called significant. It is not derived from resolution, the T-score, or the reference database. ISCD requires each site to determine its own precision and LSC.

   Reference: ISCD Official Positions (2019)

5. Question 5 · Contrast Media, Pharmacology & Drug Administration

   Which statement best characterises anaphylactoid (allergic-like) contrast reactions compared with physiologic (chemotoxic) reactions?

   1. AAnaphylactoid reactions are strictly dose-dependent and predictable from the injected volume
   2. BAnaphylactoid reactions are generally not dose-dependent and can occur after a small test dose
   3. CPhysiologic reactions always progress to anaphylaxis
   4. DBoth types are prevented completely by premedication
   Show answer and explanation

   Correct answer: B. Anaphylactoid reactions are generally not dose-dependent and can occur after a small test dose

   Anaphylactoid reactions resemble allergy but are not IgE-driven and are generally not dose-dependent, so a small volume can still trigger a severe response. Physiologic (chemotoxic) reactions such as warmth or nausea tend to relate to dose, osmolality, and volume and do not necessarily progress to anaphylaxis. Premedication reduces but does not eliminate reaction risk.

   Reference: ACR Manual on Contrast Media (2023)

6. Question 6 · Radiographic Positioning & Imaging Procedures

   A horizontal-beam (cross-table) lateral projection of the knee is performed on a trauma patient. Demonstration of a fat-fluid level (lipohemarthrosis / FBI sign) in the suprapatellar region most reliably indicates which of the following?

   1. AA normal finding produced by knee flexion
   2. BChronic osteoarthritis of the knee
   3. CA purely inflammatory joint effusion
   4. DAn intra-articular fracture releasing marrow fat into the joint
   Show answer and explanation

   Correct answer: D. An intra-articular fracture releasing marrow fat into the joint

   A horizontal beam is required to demonstrate the fat-blood interface (FBI sign): marrow fat released by an intra-articular fracture floats on the denser blood, forming a visible fat-fluid level in the suprapatellar bursa. The buoyancy separation only appears on a horizontal-beam image and specifically signals cortical disruption, not a simple inflammatory effusion, a normal flexed knee, or degenerative change.

   Reference: Bontrager's Textbook of Radiographic Positioning and Related Anatomy, Lampignano & Kendrick, 10th ed. (2021)

7. Question 7 · Patient Care & Management

   A radiographer must explain an intravenous urogram to a patient who speaks little of the local language. Which approach best supports valid informed consent?

   1. AAsk a passing porter to translate quickly to save time
   2. BAsk the patient's young child to translate the risks
   3. CHave the patient sign the form and explain nothing to avoid confusion
   4. DUse a professional or hospital-approved interpreter service to convey the information
   Show answer and explanation

   Correct answer: D. Use a professional or hospital-approved interpreter service to convey the information

   Valid consent requires the patient to genuinely understand the information, so a professional or approved interpreter should be used to overcome the language barrier. Ad-hoc translators such as porters or children may be inaccurate, breach confidentiality and cannot ensure medical terms are conveyed correctly. Obtaining a signature without explanation does not create informed consent.

   Reference: GMC Consent Guidance (2020); Society and College of Radiographers (SCoR) Consent to Imaging (2018)

8. Question 8 · Image Production, Processing & Quality (Operation of Equipment)

   The line-focus principle allows a tube to have a small effective focal spot for sharpness while dissipating heat over a larger area. However, the effective focal spot size varies along the beam. Along the cathode-to-anode axis, the effective focal spot is:

   1. ALarger at the anode end of the field
   2. BUniform across the entire field
   3. CLarger at the cathode end of the field
   4. DSmallest at the central ray only
   Show answer and explanation

   Correct answer: C. Larger at the cathode end of the field

   Because of the projected geometry of the angled anode target, the effective focal spot appears larger toward the cathode side of the field and smaller toward the anode side. This means recorded detail is slightly better on the anode side. This is distinct from the anode heel effect, which concerns beam intensity rather than focal spot size.

   Reference: Bushong, Radiologic Science for Technologists, 12th ed. (2021)

9. Question 9 · Specialized Imaging Modalities (CT, MRI, US, Mammography, Nuclear Medicine, Fluoroscopy/Angiography)

   For a pediatric chest CT, which single parameter change would most effectively reduce dose while sometimes even improving vascular/iodine contrast?

   1. ALowering kVp from 120 to 80-100
   2. BWidening the reconstruction kernel
   3. CIncreasing the rotation time
   4. DIncreasing kVp from 100 to 140
   Show answer and explanation

   Correct answer: A. Lowering kVp from 120 to 80-100

   Lowering kVp toward the k-edge of iodine (33 keV) increases iodine attenuation and contrast while substantially reducing dose, which is particularly beneficial in small pediatric patients. Increasing kVp raises dose, kernel choice does not change dose, and longer rotation time increases both dose and motion risk.

   Reference: Image Gently Alliance; Goo, Korean Journal of Radiology (2012)

10. Question 10 · Contrast Media, Pharmacology & Drug Administration

    In a common elective oral corticosteroid premedication regimen, prednisone is given at approximately which time points before contrast injection?

    1. AOnly 5 minutes before
    2. B13, 7, and 1 hours before, with an antihistamine 1 hour before
    3. C24 and 48 hours after the scan
    4. DContinuously for one week prior
    Show answer and explanation

    Correct answer: B. 13, 7, and 1 hours before, with an antihistamine 1 hour before

    A widely cited elective regimen gives prednisone about 13, 7, and 1 hours before contrast, with an antihistamine (e.g., diphenhydramine) about 1 hour before. A single dose minutes before does not allow the corticosteroid to take effect, and dosing after the scan or for a week beforehand is not the standard prophylaxis.

    Reference: ACR Manual on Contrast Media (2023)

11. Question 11 · Radiographic Positioning & Imaging Procedures

    Sialography of the parotid gland is requested. Which of the following is a contraindication to performing the examination at this time?

    1. AA palpable calculus within the salivary duct
    2. BAcute salivary gland infection (acute sialadenitis)
    3. CChronic dry mouth (xerostomia)
    4. DA history of a prior salivary duct stricture
    Show answer and explanation

    Correct answer: B. Acute salivary gland infection (acute sialadenitis)

    Sialography is contraindicated during acute salivary gland infection because cannulation and contrast injection can force organisms retrograde, worsen the inflammation, and cause severe pain. A ductal calculus, chronic xerostomia, and prior stricture are in fact common indications for the study, used to localize obstruction or map ductal anatomy once any acute infection has resolved.

    Reference: Merrill's Atlas of Radiographic Positioning and Procedures, 14th ed. (2023)

12. Question 12 · Radiation Protection & Safety

    A referring physician requests a lumbar spine radiograph 'just to reassure' a patient who has no clinical signs and a normal recent examination. Under the ICRP system, the radiographer's primary protection concern with this request relates to which principle?

    1. AOptimisation, because the technique factors could be lowered
    2. BJustification, because the examination must produce sufficient benefit to outweigh the radiation detriment
    3. CDose limitation, because patient dose limits would be exceeded
    4. DApplication of diagnostic reference levels to the individual patient
    Show answer and explanation

    Correct answer: B. Justification, because the examination must produce sufficient benefit to outweigh the radiation detriment

    An examination without a valid clinical indication fails the principle of justification, which requires that the benefit to the patient outweigh the radiation detriment before any exposure. Optimisation and DRLs address how a justified exam is done, not whether it should occur, and dose limits do not apply to patient medical exposures at all.

    Reference: ICRP Publication 103 (2007); ICRP Publication 105 (2007)

Radiographer reference books and guidelines

Every question in this bank names the textbook or guideline its answer rests on. These are the sources our Radiographer questions cite most often - the reading list to revise from alongside the bank.

Where your regulator publishes a reading list, use the editions it names. Exam questions are not taken from any one book.