ARRT Mammography (M) Certification Exam 2026: Comprehensive
Post-Primary Practice Test — Breast Anatomy, Positioning, Imaging
Procedures, Image Evaluation, Radiation Safety & Quality Control —
190 Multiple-Choice Questions with Answers & Detailed Rationales
SECTION 1: PATIENT CARE (Questions 1–35)
Question 1
A patient arrives for her first screening mammogram and states she is "terrified" because her
mother died of breast cancer. Which action best addresses both her emotional state and the
technologist's professional responsibility?
A. Reassure her that mammography has improved and she has nothing to worry about
B. Acknowledge her fear, explain each step before performing it, and answer her questions
honestly
C. Tell her that worrying will not change the outcome and proceed efficiently
D. Refer her to a mental health professional before imaging can begin
Correct Answer: B
Explanation: Acknowledging fear while providing clear, honest communication builds trust
and cooperation; dismissal or false reassurance undermines the therapeutic relationship and
patient autonomy.
Question 2
During a diagnostic mammogram for a palpable lump, the patient asks, "If you find cancer,
will you tell me today?" What is the most appropriate response?
A. "Yes, I will tell you immediately if I see anything concerning."
,B. "No, I am not legally allowed to discuss results with you."
C. "The radiologist will review the images and communicate results through your referring
physician according to facility policy."
D. "You will need to wait for your doctor to call you sometime next week."
Correct Answer: C
Explanation: Technologists do not interpret or disclose results; explaining the established
communication pathway respects scope of practice and reduces patient anxiety.
Question 3
A patient discloses during history-taking that she had a breast reduction six months ago.
How should this information influence the technologist's approach?
A. It has no relevance to positioning or technique
B. The technologist should document it and adjust positioning to account for altered tissue
distribution and possible scarring
C. The examination should be deferred until at least one year post-surgery
D. Only the surgical scars need to be marked on the image
Correct Answer: B
Explanation: Surgical history affects tissue mobility, compression tolerance, and positioning;
documentation ensures the radiologist interprets findings with appropriate clinical context.
Question 4
A 42-year-old patient reports a family history of ovarian cancer and asks whether she should
be concerned about breast cancer risk. Which risk factor is most directly relevant to her
question?
,A. Her age alone exceeds the threshold for average risk
B. BRCA1/BRCA2 mutations are associated with both breast and ovarian cancer
C. Ovarian cancer has no genetic relationship to breast cancer
D. Her risk is identical to that of a woman with no family history
Correct Answer: B
Explanation: BRCA mutations confer elevated lifetime risk for both breast and ovarian
malignancies; this knowledge guides screening frequency and possible genetic counseling
referral.
Question 5
A patient with a known allergy to adhesive tape is scheduled for a needle localization
procedure. What precaution should the technologist take?
A. Proceed as usual; tape allergies are irrelevant to mammography
B. Use paper tape or an alternative fixation method and document the allergy
C. Cancel the procedure until an allergist clears the patient
D. Apply tape only to the unaffected breast
Correct Answer: B
Explanation: Documenting and accommodating allergies prevents adverse reactions;
alternative fixation methods maintain sterility and patient safety during interventional
procedures.
Question 6
A patient tells the technologist she is currently breastfeeding her 4-month-old infant. What
modification to standard screening protocol is most appropriate?
, A. Defer the mammogram until breastfeeding has ceased
B. Perform the examination with special attention to thorough drainage of milk before
imaging
C. Increase compression beyond normal tolerance to compensate for density
D. Image only the symptomatic breast
Correct Answer: B
Explanation: Lactating breasts are denser and more sensitive; encouraging the patient to
feed or pump before imaging reduces discomfort and improves tissue visualization without
deferring necessary screening.
Question 7
During a screening mammogram, a patient mentions she has a pacemaker. What is the
technologist's primary concern?
A. The pacemaker will be damaged by mammographic compression
B. The pacemaker may create an artifact on the image, and positioning may need
adjustment to visualize breast tissue adequately
C. Pacemakers are an absolute contraindication to mammography
D. The patient must provide a cardiology clearance before imaging
Correct Answer: B
Explanation: Implanted devices can project over breast tissue and create artifacts; modified
positioning helps ensure diagnostic-quality images while avoiding device interference.
Question 8
A patient with a physical disability that limits arm mobility presents for mammography. What
is the best approach to obtaining optimal images?
Post-Primary Practice Test — Breast Anatomy, Positioning, Imaging
Procedures, Image Evaluation, Radiation Safety & Quality Control —
190 Multiple-Choice Questions with Answers & Detailed Rationales
SECTION 1: PATIENT CARE (Questions 1–35)
Question 1
A patient arrives for her first screening mammogram and states she is "terrified" because her
mother died of breast cancer. Which action best addresses both her emotional state and the
technologist's professional responsibility?
A. Reassure her that mammography has improved and she has nothing to worry about
B. Acknowledge her fear, explain each step before performing it, and answer her questions
honestly
C. Tell her that worrying will not change the outcome and proceed efficiently
D. Refer her to a mental health professional before imaging can begin
Correct Answer: B
Explanation: Acknowledging fear while providing clear, honest communication builds trust
and cooperation; dismissal or false reassurance undermines the therapeutic relationship and
patient autonomy.
Question 2
During a diagnostic mammogram for a palpable lump, the patient asks, "If you find cancer,
will you tell me today?" What is the most appropriate response?
A. "Yes, I will tell you immediately if I see anything concerning."
,B. "No, I am not legally allowed to discuss results with you."
C. "The radiologist will review the images and communicate results through your referring
physician according to facility policy."
D. "You will need to wait for your doctor to call you sometime next week."
Correct Answer: C
Explanation: Technologists do not interpret or disclose results; explaining the established
communication pathway respects scope of practice and reduces patient anxiety.
Question 3
A patient discloses during history-taking that she had a breast reduction six months ago.
How should this information influence the technologist's approach?
A. It has no relevance to positioning or technique
B. The technologist should document it and adjust positioning to account for altered tissue
distribution and possible scarring
C. The examination should be deferred until at least one year post-surgery
D. Only the surgical scars need to be marked on the image
Correct Answer: B
Explanation: Surgical history affects tissue mobility, compression tolerance, and positioning;
documentation ensures the radiologist interprets findings with appropriate clinical context.
Question 4
A 42-year-old patient reports a family history of ovarian cancer and asks whether she should
be concerned about breast cancer risk. Which risk factor is most directly relevant to her
question?
,A. Her age alone exceeds the threshold for average risk
B. BRCA1/BRCA2 mutations are associated with both breast and ovarian cancer
C. Ovarian cancer has no genetic relationship to breast cancer
D. Her risk is identical to that of a woman with no family history
Correct Answer: B
Explanation: BRCA mutations confer elevated lifetime risk for both breast and ovarian
malignancies; this knowledge guides screening frequency and possible genetic counseling
referral.
Question 5
A patient with a known allergy to adhesive tape is scheduled for a needle localization
procedure. What precaution should the technologist take?
A. Proceed as usual; tape allergies are irrelevant to mammography
B. Use paper tape or an alternative fixation method and document the allergy
C. Cancel the procedure until an allergist clears the patient
D. Apply tape only to the unaffected breast
Correct Answer: B
Explanation: Documenting and accommodating allergies prevents adverse reactions;
alternative fixation methods maintain sterility and patient safety during interventional
procedures.
Question 6
A patient tells the technologist she is currently breastfeeding her 4-month-old infant. What
modification to standard screening protocol is most appropriate?
, A. Defer the mammogram until breastfeeding has ceased
B. Perform the examination with special attention to thorough drainage of milk before
imaging
C. Increase compression beyond normal tolerance to compensate for density
D. Image only the symptomatic breast
Correct Answer: B
Explanation: Lactating breasts are denser and more sensitive; encouraging the patient to
feed or pump before imaging reduces discomfort and improves tissue visualization without
deferring necessary screening.
Question 7
During a screening mammogram, a patient mentions she has a pacemaker. What is the
technologist's primary concern?
A. The pacemaker will be damaged by mammographic compression
B. The pacemaker may create an artifact on the image, and positioning may need
adjustment to visualize breast tissue adequately
C. Pacemakers are an absolute contraindication to mammography
D. The patient must provide a cardiology clearance before imaging
Correct Answer: B
Explanation: Implanted devices can project over breast tissue and create artifacts; modified
positioning helps ensure diagnostic-quality images while avoiding device interference.
Question 8
A patient with a physical disability that limits arm mobility presents for mammography. What
is the best approach to obtaining optimal images?
