HESI RADIOLOGY EXIT EXAM PREP
VERSION 3 — 2026/2027
Comprehensive Radiologic Sciences Competency Assessment
for Nursing & Allied Health Professionals
Elsevier Evolve / ARRT & ASRT Guidelines Alignment
75 Multiple-Choice Questions with Detailed Rationales
Exam-Style Practice | 100% Verified | Graded A+
Total Questions: 75 MCQ
Testing Time: 105 Minutes
Format: Computer-Based | Proctored via Elsevier Evolve Platform
Passing Score: 850 HESI or 75-80% (56-60/75 Correct)
Domains: Radiation Physics | Imaging Modalities | Anatomy/Pathology | Patient Safety | Contrast Media
| Image Quality | Professional Practice
Aligned with ARRT/ASRT Guidelines, Elsevier HESI Test Blueprints, and ACR Contrast Media Manual
, TABLE OF CONTENTS
Examination Overview
Domain 1: Radiation Physics & Protection (Q1–Q12) — 16%
Domain 2: Imaging Modalities (Q13–Q27) — 20%
Domain 3: Anatomy & Pathology Recognition (Q28–Q40) — 17%
Domain 4: Patient Care & Safety in Radiology (Q41–Q51) — 15%
Domain 5: Contrast Media & Pharmacology (Q52–Q61) — 13%
Domain 6: Image Quality & Technical Factors (Q62–Q69) — 11%
Domain 7: Professional Practice & Scenario Application (Q70–Q75) — 8%
Answer Key
Domain Score Tracker
References
, EXAMINATION OVERVIEW
Domain Questions Key Topics Weight
Radiation Physics & 12 ALARA Principles, 16%
Protection Time/Distance/Shielding, Radiation
Units (Gy/Sv), Dosimetry, Pregnancy
Considerations
Imaging Modalities 15 X-ray/Fluoroscopy, CT Principles, 20%
MRI Safety/Contraindications,
Ultrasound Physics, Nuclear
Medicine Basics
Anatomy & 13 Radiographic Anatomy, Common 17%
Pathology Pathologies
Recognition (Fractures/Pneumonia/Obstruction),
Normal Variants, Image Orientation
Patient Care & Safety 11 Patient Identification, Positioning 15%
in Radiology Assistance, Infection Control,
Pediatric/Geriatric Considerations,
Communication
Contrast Media & 10 Iodinated/Gadolinium Contrast, 13%
Pharmacology Allergy Assessment, Nephrotoxicity
Prevention, Extravasation
Management, Premedication
Protocols
Image Quality & 8 kVp/mAs Relationships, Collimation, 11%
Technical Factors Grid Use, Artifact Recognition,
Digital Imaging Principles
Professional Practice 6 Scope of Practice, Ethical Decision- 8%
& Scenario Making, Interprofessional
Application Communication, Multi-Domain
Integration
, ━━━ RADIATION PHYSICS & PROTECTION ━━━
Q1 – Q12 | 16%
1. Which principle of radiation protection emphasizes using the minimum radiation dose
necessary to achieve diagnostic image quality?
A. Justification
B. Optimization (ALARA)
C. Dose Limitation
D. Collimation
Correct Answer: B
Rationale: Optimization, commonly expressed as ALARA (As Low As Reasonably Achievable), is
the principle that radiation exposure should be kept as low as reasonably achievable while still
obtaining diagnostic-quality images. Justification (A) refers to ensuring the examination is clinically
warranted. Dose limitation (C) applies to occupational and public exposure limits, not diagnostic
imaging. Collimation (D) is a technical method to reduce exposure but is not the overarching
principle. ALARA guides all radiation protection decisions in medical imaging.
2. A pregnant patient requires an urgent CT scan of the abdomen. Which action best aligns
with radiation protection principles?
A. Cancel the study entirely due to pregnancy
B. Proceed with the study using standard protocols without modification
C. Consult with radiology to optimize protocol (reduce mAs, limit scan range, use
shielding if feasible) and document risk-benefit discussion with the patient
D. Substitute MRI for all abdominal imaging regardless of clinical indication
Correct Answer: C
Rationale: When imaging is clinically necessary in pregnancy, the study should proceed with
optimization strategies: reducing mAs, limiting scan range to the area of interest, and using
shielding when it does not interfere with diagnostic quality. The risk-benefit discussion must be
documented. Canceling a necessary study (A) may harm the patient. Using standard protocols (B)
ignores fetal protection considerations. Substituting MRI (D) is not always clinically appropriate or
available; modality selection must be based on diagnostic need, not just radiation concerns.
3. Which imaging modality is contraindicated in a patient with a non-MRI-conditional
pacemaker?
A. Computed Tomography (CT)
B. Magnetic Resonance Imaging (MRI)
C. Ultrasound
D. Plain Radiography
Correct Answer: B
Rationale: MRI uses strong magnetic fields and radiofrequency pulses that can interfere with
pacemaker function, cause lead heating, or reprogram the device. Non-MRI-conditional pacemakers
are an absolute contraindication to MRI unless under specialized protocols with
cardiology/radiology collaboration. CT (A), ultrasound (C), and plain radiography (D) do not use
magnetic fields and are safe for patients with pacemakers. Screening for implanted devices is a
critical safety step before any MRI.
4. Select All That Apply: Which statements accurately describe the physical principles of
ultrasound imaging? [SATA]
VERSION 3 — 2026/2027
Comprehensive Radiologic Sciences Competency Assessment
for Nursing & Allied Health Professionals
Elsevier Evolve / ARRT & ASRT Guidelines Alignment
75 Multiple-Choice Questions with Detailed Rationales
Exam-Style Practice | 100% Verified | Graded A+
Total Questions: 75 MCQ
Testing Time: 105 Minutes
Format: Computer-Based | Proctored via Elsevier Evolve Platform
Passing Score: 850 HESI or 75-80% (56-60/75 Correct)
Domains: Radiation Physics | Imaging Modalities | Anatomy/Pathology | Patient Safety | Contrast Media
| Image Quality | Professional Practice
Aligned with ARRT/ASRT Guidelines, Elsevier HESI Test Blueprints, and ACR Contrast Media Manual
, TABLE OF CONTENTS
Examination Overview
Domain 1: Radiation Physics & Protection (Q1–Q12) — 16%
Domain 2: Imaging Modalities (Q13–Q27) — 20%
Domain 3: Anatomy & Pathology Recognition (Q28–Q40) — 17%
Domain 4: Patient Care & Safety in Radiology (Q41–Q51) — 15%
Domain 5: Contrast Media & Pharmacology (Q52–Q61) — 13%
Domain 6: Image Quality & Technical Factors (Q62–Q69) — 11%
Domain 7: Professional Practice & Scenario Application (Q70–Q75) — 8%
Answer Key
Domain Score Tracker
References
, EXAMINATION OVERVIEW
Domain Questions Key Topics Weight
Radiation Physics & 12 ALARA Principles, 16%
Protection Time/Distance/Shielding, Radiation
Units (Gy/Sv), Dosimetry, Pregnancy
Considerations
Imaging Modalities 15 X-ray/Fluoroscopy, CT Principles, 20%
MRI Safety/Contraindications,
Ultrasound Physics, Nuclear
Medicine Basics
Anatomy & 13 Radiographic Anatomy, Common 17%
Pathology Pathologies
Recognition (Fractures/Pneumonia/Obstruction),
Normal Variants, Image Orientation
Patient Care & Safety 11 Patient Identification, Positioning 15%
in Radiology Assistance, Infection Control,
Pediatric/Geriatric Considerations,
Communication
Contrast Media & 10 Iodinated/Gadolinium Contrast, 13%
Pharmacology Allergy Assessment, Nephrotoxicity
Prevention, Extravasation
Management, Premedication
Protocols
Image Quality & 8 kVp/mAs Relationships, Collimation, 11%
Technical Factors Grid Use, Artifact Recognition,
Digital Imaging Principles
Professional Practice 6 Scope of Practice, Ethical Decision- 8%
& Scenario Making, Interprofessional
Application Communication, Multi-Domain
Integration
, ━━━ RADIATION PHYSICS & PROTECTION ━━━
Q1 – Q12 | 16%
1. Which principle of radiation protection emphasizes using the minimum radiation dose
necessary to achieve diagnostic image quality?
A. Justification
B. Optimization (ALARA)
C. Dose Limitation
D. Collimation
Correct Answer: B
Rationale: Optimization, commonly expressed as ALARA (As Low As Reasonably Achievable), is
the principle that radiation exposure should be kept as low as reasonably achievable while still
obtaining diagnostic-quality images. Justification (A) refers to ensuring the examination is clinically
warranted. Dose limitation (C) applies to occupational and public exposure limits, not diagnostic
imaging. Collimation (D) is a technical method to reduce exposure but is not the overarching
principle. ALARA guides all radiation protection decisions in medical imaging.
2. A pregnant patient requires an urgent CT scan of the abdomen. Which action best aligns
with radiation protection principles?
A. Cancel the study entirely due to pregnancy
B. Proceed with the study using standard protocols without modification
C. Consult with radiology to optimize protocol (reduce mAs, limit scan range, use
shielding if feasible) and document risk-benefit discussion with the patient
D. Substitute MRI for all abdominal imaging regardless of clinical indication
Correct Answer: C
Rationale: When imaging is clinically necessary in pregnancy, the study should proceed with
optimization strategies: reducing mAs, limiting scan range to the area of interest, and using
shielding when it does not interfere with diagnostic quality. The risk-benefit discussion must be
documented. Canceling a necessary study (A) may harm the patient. Using standard protocols (B)
ignores fetal protection considerations. Substituting MRI (D) is not always clinically appropriate or
available; modality selection must be based on diagnostic need, not just radiation concerns.
3. Which imaging modality is contraindicated in a patient with a non-MRI-conditional
pacemaker?
A. Computed Tomography (CT)
B. Magnetic Resonance Imaging (MRI)
C. Ultrasound
D. Plain Radiography
Correct Answer: B
Rationale: MRI uses strong magnetic fields and radiofrequency pulses that can interfere with
pacemaker function, cause lead heating, or reprogram the device. Non-MRI-conditional pacemakers
are an absolute contraindication to MRI unless under specialized protocols with
cardiology/radiology collaboration. CT (A), ultrasound (C), and plain radiography (D) do not use
magnetic fields and are safe for patients with pacemakers. Screening for implanted devices is a
critical safety step before any MRI.
4. Select All That Apply: Which statements accurately describe the physical principles of
ultrasound imaging? [SATA]
