ARRT Bone Densitometry (BD) Certification Exam 2026:
Comprehensive Professional Practice Test — Bone Mineral Density,
DXA Procedures, Osteoporosis Assessment, Image Analysis,
Radiation Safety & Quality Control — 190 Multiple-Choice Questions
with Answers & Detailed Rationales
Section 1: Patient Care, Bone Health, and Radiation Principles (Questions 1-40)
Question 1
A 68-year-old postmenopausal woman presents for a routine DXA scan. She reports a recent
height loss of 2 inches over the past three years. Which clinical finding does this height loss
most likely suggest?
A. Scoliosis development
B. Vertebral compression fracture
C. Osteoarthritis of the spine
D. Normal age-related changes
Correct Answer: B
Explanation: Height loss exceeding 1.5 inches strongly suggests vertebral compression
fractures, a hallmark consequence of osteoporosis warranting careful VFA evaluation.
Question 2
A patient asks why she needs a bone density test when she feels no pain. Which response
best explains the clinical purpose of DXA?
A. DXA identifies early bone loss before symptoms occur
,B. DXA detects bone tumors that cause pain
C. DXA evaluates joint inflammation
D. DXA measures muscle strength
Correct Answer: A
Explanation: Osteoporosis is asymptomatic until fracture occurs; DXA detects low bone mass
early to guide preventive treatment.
Question 3
A technologist is preparing to scan a 72-year-old man with a history of chronic corticosteroid
use. Which risk category does this medication history represent?
A. Genetic risk factor
B. Nutritional risk factor
C. Secondary osteoporosis risk factor
D. Lifestyle risk factor
Correct Answer: C
Explanation: Glucocorticoid-induced bone loss is a secondary cause of osteoporosis,
requiring special attention in scan interpretation.
Question 4
During patient intake, a 55-year-old woman mentions she had a barium study two days ago.
What is the appropriate action?
,A. Proceed with the scan immediately
B. Reschedule the DXA scan for at least 7-14 days later
C. Scan only the forearm site
D. Reduce scan time by half
Correct Answer: B
Explanation: Residual contrast material can cause artifacts; waiting 7-14 days ensures
accurate BMD measurement.
Question 5
A technologist is reviewing the WHO diagnostic criteria with a patient. Which T-score range
defines osteopenia?
A. -1.0 or higher
B. Between -1.0 and -2.5
C. -2.5 or lower
D. -3.0 or lower
Correct Answer: B
Explanation: The WHO defines osteopenia as a T-score between -1.0 and -2.5, indicating low
bone mass but not osteoporosis.
Question 6
A 45-year-old premenopausal woman undergoes DXA. Which score should be used for her
diagnosis?
, A. T-score
B. Z-score
C. FRAX score
D. Raw BMD value
Correct Answer: B
Explanation: Z-scores are preferred for premenopausal women, men under 50, and children;
T-scores apply to postmenopausal women and men over 50.
Question 7
What is the primary function of osteoblasts in bone physiology?
A. Bone resorption
B. Bone formation
C. Calcium regulation
D. Collagen degradation
Correct Answer: B
Explanation: Osteoblasts are bone-forming cells that synthesize new bone matrix;
osteoclasts handle resorption.
Question 8
A technologist notices a patient's DXA report shows a T-score of -2.7 at the femoral neck.
According to WHO criteria, how should this be classified?
Comprehensive Professional Practice Test — Bone Mineral Density,
DXA Procedures, Osteoporosis Assessment, Image Analysis,
Radiation Safety & Quality Control — 190 Multiple-Choice Questions
with Answers & Detailed Rationales
Section 1: Patient Care, Bone Health, and Radiation Principles (Questions 1-40)
Question 1
A 68-year-old postmenopausal woman presents for a routine DXA scan. She reports a recent
height loss of 2 inches over the past three years. Which clinical finding does this height loss
most likely suggest?
A. Scoliosis development
B. Vertebral compression fracture
C. Osteoarthritis of the spine
D. Normal age-related changes
Correct Answer: B
Explanation: Height loss exceeding 1.5 inches strongly suggests vertebral compression
fractures, a hallmark consequence of osteoporosis warranting careful VFA evaluation.
Question 2
A patient asks why she needs a bone density test when she feels no pain. Which response
best explains the clinical purpose of DXA?
A. DXA identifies early bone loss before symptoms occur
,B. DXA detects bone tumors that cause pain
C. DXA evaluates joint inflammation
D. DXA measures muscle strength
Correct Answer: A
Explanation: Osteoporosis is asymptomatic until fracture occurs; DXA detects low bone mass
early to guide preventive treatment.
Question 3
A technologist is preparing to scan a 72-year-old man with a history of chronic corticosteroid
use. Which risk category does this medication history represent?
A. Genetic risk factor
B. Nutritional risk factor
C. Secondary osteoporosis risk factor
D. Lifestyle risk factor
Correct Answer: C
Explanation: Glucocorticoid-induced bone loss is a secondary cause of osteoporosis,
requiring special attention in scan interpretation.
Question 4
During patient intake, a 55-year-old woman mentions she had a barium study two days ago.
What is the appropriate action?
,A. Proceed with the scan immediately
B. Reschedule the DXA scan for at least 7-14 days later
C. Scan only the forearm site
D. Reduce scan time by half
Correct Answer: B
Explanation: Residual contrast material can cause artifacts; waiting 7-14 days ensures
accurate BMD measurement.
Question 5
A technologist is reviewing the WHO diagnostic criteria with a patient. Which T-score range
defines osteopenia?
A. -1.0 or higher
B. Between -1.0 and -2.5
C. -2.5 or lower
D. -3.0 or lower
Correct Answer: B
Explanation: The WHO defines osteopenia as a T-score between -1.0 and -2.5, indicating low
bone mass but not osteoporosis.
Question 6
A 45-year-old premenopausal woman undergoes DXA. Which score should be used for her
diagnosis?
, A. T-score
B. Z-score
C. FRAX score
D. Raw BMD value
Correct Answer: B
Explanation: Z-scores are preferred for premenopausal women, men under 50, and children;
T-scores apply to postmenopausal women and men over 50.
Question 7
What is the primary function of osteoblasts in bone physiology?
A. Bone resorption
B. Bone formation
C. Calcium regulation
D. Collagen degradation
Correct Answer: B
Explanation: Osteoblasts are bone-forming cells that synthesize new bone matrix;
osteoclasts handle resorption.
Question 8
A technologist notices a patient's DXA report shows a T-score of -2.7 at the femoral neck.
According to WHO criteria, how should this be classified?
