Merrill's Atlas of Radiographic Positioning and
Procedures, 15th Edition (Bruc) — Test Bank
1|Page
,Merrill's Atlas of Radiographic Positioning and Procedures, 14th Edition (Bruc) — Test Bank
Total Questions: 450 | Chapters: 30
CHAPTER 1: Preliminary Steps in Radiography
Questions 1–15
Q1. A radiographer is preparing to perform a routine chest examination on an ambulatory
patient. Which of the following should be completed FIRST before positioning the patient?
A. Adjust the collimator to the desired field size
B. Verify the patient's identity and ordered examination
C. Select the appropriate exposure factors
D. Center the central ray to the anatomical structure
Correct Answer: B. Verify the patient's identity and ordered examination
Rationale: Patient identification and verification of the ordered examination are the essential
first steps in any radiographic procedure. This ensures the correct patient receives the correct
examination and prevents medical errors. Collimation, exposure factors, and centering occur after
patient identification is confirmed.
Q2. Which of the following best describes the purpose of gonadal shielding during radiographic
procedures?
A. To increase the contrast of the radiographic image
B. To reduce the production of scatter radiation within the patient
C. To protect radiosensitive reproductive organs from unnecessary radiation exposure
D. To improve the spatial resolution of the resulting image
Correct Answer: C. To protect radiosensitive reproductive organs from unnecessary radiation
exposure
Rationale: Gonadal shielding is placed over the reproductive organs to reduce radiation dose to
these highly radiosensitive tissues. It does not affect image contrast, scatter production within the
patient, or spatial resolution.
Q3. A radiographer is preparing to radiograph a patient's wrist. The patient is seated at the end
of the table. Which of the following should the radiographer do to ensure proper alignment?
A. Position the wrist at the center of the collimated field
B. Ask the patient to hold the wrist above the table surface
C. Rotate the wrist 45 degrees toward the cassette
D. Elevate the wrist on a sponge to align with the central ray
Correct Answer: A. Position the wrist at the center of the collimated field
2|Page
, Rationale: The anatomical part of interest should always be centered to the collimated field and
central ray to ensure proper alignment and minimize distortion. Elevating the wrist, rotating it
unnecessarily, or holding it above the table would compromise positioning accuracy.
Q4. Which of the following is the primary reason for using collimation in radiography?
A. To increase the milliamperage (mA) required for the exposure
B. To reduce patient dose and improve image contrast
C. To allow the radiographer to use a larger focal spot
D. To eliminate the need for gonadal shielding
Correct Answer: B. To reduce patient dose and improve image contrast
Rationale: Collimation restricts the x-ray beam to the area of interest, reducing the volume of
tissue irradiated (patient dose) and decreasing scatter radiation that degrades image contrast. It
does not increase mA requirements or eliminate shielding needs.
Q5. A patient arrives for a radiographic examination wearing a necklace that will interfere with
the anatomy of interest. What is the radiographer's BEST course of action?
A. Ignore the jewelry and proceed with the examination
B. Increase the exposure factors to penetrate through the jewelry
C. Ask the patient to remove the jewelry before positioning
D. Position the central ray to avoid superimposing the jewelry
Correct Answer: C. Ask the patient to remove the jewelry before positioning
Rationale: Metallic objects such as jewelry can produce artifacts on radiographs that may
obscure or be mistaken for pathology. The standard of care is to remove such objects before the
examination. Increasing exposure factors is inappropriate and increases patient dose.
Q6. Which of the following describes the purpose of the source-to-image receptor distance (SID)
in radiographic positioning?
A. To control the degree of magnification and spatial distortion
B. To determine the milliamperage required for the exposure
C. To regulate the automatic exposure control sensitivity
D. To establish the appropriate collimation field size
Correct Answer: A. To control the degree of magnification and spatial distortion
Rationale: SID directly affects magnification and spatial distortion. A longer SID reduces
magnification and improves spatial accuracy, while a shorter SID increases magnification. The
standard SID for most radiographic examinations is 40 inches (100 cm).
3|Page
, Q7. A radiographer is preparing to perform a portable chest radiograph on an ICU patient. Which
of the following is the MOST important consideration for radiation protection?
A. Using the highest possible exposure factors
B. Maximizing the distance between the x-ray source and the patient
C. Collimating to the area of interest and using appropriate shielding
D. Performing the examination as quickly as possible
Correct Answer: C. Collimating to the area of interest and using appropriate shielding
Rationale: Proper collimation limits the radiation field, and shielding protects radiosensitive
tissues. These are fundamental radiation protection principles that apply regardless of the
examination setting. Speed and exposure factors do not directly protect the patient from
unnecessary radiation.
Q8. Which of the following best describes the role of the radiographer in patient care during
radiographic procedures?
A. To diagnose the patient's medical condition from the images
B. To ensure patient comfort, safety, and accurate positioning
C. To prescribe the appropriate radiographic examination
D. To interpret the radiographic findings for the patient
Correct Answer: B. To ensure patient comfort, safety, and accurate positioning
Rationale: The radiographer's role includes patient care, positioning, radiation safety, and
producing diagnostic-quality images. Diagnosis, prescribing examinations, and interpreting findings
are the responsibilities of the radiologist or other qualified physicians.
Q9. A patient with a suspected fracture of the forearm arrives in the radiology department. The
patient is in significant pain. Which of the following should the radiographer do FIRST?
A. Perform the examination as quickly as possible without regard to patient comfort
B. Administer pain medication before the examination
C. Assess the patient's condition and modify positioning to minimize discomfort
D. Refuse to perform the examination until the patient is pain-free
Correct Answer: C. Assess the patient's condition and modify positioning to minimize discomfort
Rationale: The radiographer should assess the patient's condition and adapt positioning
techniques to minimize pain while still obtaining diagnostic images. Administering medication is
outside the radiographer's scope of practice, and delaying care unnecessarily is inappropriate.
Q10. Which of the following is an example of a "preliminary step" that should be completed
before exposing a radiograph?
A. Reviewing the patient's previous imaging studies
B. Developing the radiograph in the darkroom
4|Page
Procedures, 15th Edition (Bruc) — Test Bank
1|Page
,Merrill's Atlas of Radiographic Positioning and Procedures, 14th Edition (Bruc) — Test Bank
Total Questions: 450 | Chapters: 30
CHAPTER 1: Preliminary Steps in Radiography
Questions 1–15
Q1. A radiographer is preparing to perform a routine chest examination on an ambulatory
patient. Which of the following should be completed FIRST before positioning the patient?
A. Adjust the collimator to the desired field size
B. Verify the patient's identity and ordered examination
C. Select the appropriate exposure factors
D. Center the central ray to the anatomical structure
Correct Answer: B. Verify the patient's identity and ordered examination
Rationale: Patient identification and verification of the ordered examination are the essential
first steps in any radiographic procedure. This ensures the correct patient receives the correct
examination and prevents medical errors. Collimation, exposure factors, and centering occur after
patient identification is confirmed.
Q2. Which of the following best describes the purpose of gonadal shielding during radiographic
procedures?
A. To increase the contrast of the radiographic image
B. To reduce the production of scatter radiation within the patient
C. To protect radiosensitive reproductive organs from unnecessary radiation exposure
D. To improve the spatial resolution of the resulting image
Correct Answer: C. To protect radiosensitive reproductive organs from unnecessary radiation
exposure
Rationale: Gonadal shielding is placed over the reproductive organs to reduce radiation dose to
these highly radiosensitive tissues. It does not affect image contrast, scatter production within the
patient, or spatial resolution.
Q3. A radiographer is preparing to radiograph a patient's wrist. The patient is seated at the end
of the table. Which of the following should the radiographer do to ensure proper alignment?
A. Position the wrist at the center of the collimated field
B. Ask the patient to hold the wrist above the table surface
C. Rotate the wrist 45 degrees toward the cassette
D. Elevate the wrist on a sponge to align with the central ray
Correct Answer: A. Position the wrist at the center of the collimated field
2|Page
, Rationale: The anatomical part of interest should always be centered to the collimated field and
central ray to ensure proper alignment and minimize distortion. Elevating the wrist, rotating it
unnecessarily, or holding it above the table would compromise positioning accuracy.
Q4. Which of the following is the primary reason for using collimation in radiography?
A. To increase the milliamperage (mA) required for the exposure
B. To reduce patient dose and improve image contrast
C. To allow the radiographer to use a larger focal spot
D. To eliminate the need for gonadal shielding
Correct Answer: B. To reduce patient dose and improve image contrast
Rationale: Collimation restricts the x-ray beam to the area of interest, reducing the volume of
tissue irradiated (patient dose) and decreasing scatter radiation that degrades image contrast. It
does not increase mA requirements or eliminate shielding needs.
Q5. A patient arrives for a radiographic examination wearing a necklace that will interfere with
the anatomy of interest. What is the radiographer's BEST course of action?
A. Ignore the jewelry and proceed with the examination
B. Increase the exposure factors to penetrate through the jewelry
C. Ask the patient to remove the jewelry before positioning
D. Position the central ray to avoid superimposing the jewelry
Correct Answer: C. Ask the patient to remove the jewelry before positioning
Rationale: Metallic objects such as jewelry can produce artifacts on radiographs that may
obscure or be mistaken for pathology. The standard of care is to remove such objects before the
examination. Increasing exposure factors is inappropriate and increases patient dose.
Q6. Which of the following describes the purpose of the source-to-image receptor distance (SID)
in radiographic positioning?
A. To control the degree of magnification and spatial distortion
B. To determine the milliamperage required for the exposure
C. To regulate the automatic exposure control sensitivity
D. To establish the appropriate collimation field size
Correct Answer: A. To control the degree of magnification and spatial distortion
Rationale: SID directly affects magnification and spatial distortion. A longer SID reduces
magnification and improves spatial accuracy, while a shorter SID increases magnification. The
standard SID for most radiographic examinations is 40 inches (100 cm).
3|Page
, Q7. A radiographer is preparing to perform a portable chest radiograph on an ICU patient. Which
of the following is the MOST important consideration for radiation protection?
A. Using the highest possible exposure factors
B. Maximizing the distance between the x-ray source and the patient
C. Collimating to the area of interest and using appropriate shielding
D. Performing the examination as quickly as possible
Correct Answer: C. Collimating to the area of interest and using appropriate shielding
Rationale: Proper collimation limits the radiation field, and shielding protects radiosensitive
tissues. These are fundamental radiation protection principles that apply regardless of the
examination setting. Speed and exposure factors do not directly protect the patient from
unnecessary radiation.
Q8. Which of the following best describes the role of the radiographer in patient care during
radiographic procedures?
A. To diagnose the patient's medical condition from the images
B. To ensure patient comfort, safety, and accurate positioning
C. To prescribe the appropriate radiographic examination
D. To interpret the radiographic findings for the patient
Correct Answer: B. To ensure patient comfort, safety, and accurate positioning
Rationale: The radiographer's role includes patient care, positioning, radiation safety, and
producing diagnostic-quality images. Diagnosis, prescribing examinations, and interpreting findings
are the responsibilities of the radiologist or other qualified physicians.
Q9. A patient with a suspected fracture of the forearm arrives in the radiology department. The
patient is in significant pain. Which of the following should the radiographer do FIRST?
A. Perform the examination as quickly as possible without regard to patient comfort
B. Administer pain medication before the examination
C. Assess the patient's condition and modify positioning to minimize discomfort
D. Refuse to perform the examination until the patient is pain-free
Correct Answer: C. Assess the patient's condition and modify positioning to minimize discomfort
Rationale: The radiographer should assess the patient's condition and adapt positioning
techniques to minimize pain while still obtaining diagnostic images. Administering medication is
outside the radiographer's scope of practice, and delaying care unnecessarily is inappropriate.
Q10. Which of the following is an example of a "preliminary step" that should be completed
before exposing a radiograph?
A. Reviewing the patient's previous imaging studies
B. Developing the radiograph in the darkroom
4|Page
