LMRT STATE EXAM 2025-2026 ACTUAL EXAM - 194
Questions
This exam assesses the candidate's mastery of patient care and safety protocols essential for the limited medical
radiologic technologist (LMRT). It covers radiation protection, infection control, patient communication,
emergency preparedness, contrast media management, and safe patient handling. Questions require application
of ALARA principles, identification verification, shielding protocols, and response to adverse events, reflecting
current ARRT and JRCERT standards. It contains 194 multiple-choice questions, each with four distractors and a
fully worked rationale that explains why the keyed answer is correct. Content is organized into 8 focused sections:
Patient Care and Safety, Radiation Protection, Image Production and Evaluation, Radiographic Procedures and
Positioning, Anatomy and Physiology, Equipment Operation and Quality Assurance, Medical Ethics and Legal
Issues, Infection Control. Targeted learning outcomes include: Apply ALARA and radiation safety principles to
minimize patient dose.; Implement proper patient identification and verification procedures.; Demonstrate
infection control and aseptic technique in the clinical setting.; Recognize and manage contrast media reactions
and emergencies.. Every item has been reviewed for clinical accuracy, current guidelines, and clarity so that
students can study with confidence and self-correct as they work through the bank. Use it as a high-yield review
immediately before the exam, or as a structured practice tool during the unit - the rationales double as concise
teaching notes. The recommended writing time is 3 hours, with a passing score of 75%. Aligned with Meets or
Section 1: Patient Care and Safety (Questions 1-22)
1 Which radiation protection principle is best demonstrated by selecting the
lowest possible exposure factors while maintaining diagnostic image
quality?
A) Time
B) Distance
C) Shielding
D) ALARA
Answer: D
Rationale: ALARA (As Low As Reasonably Achievable) is the principle that
mandates minimizing patient dose without compromising diagnostic efficacy.
Time, distance, and shielding are methods to achieve ALARA, but the concept
itself is the overarching radiation safety philosophy.
2 A patient presents for an upper GI series and reports a history of severe
allergic reaction to iodinated contrast. The exam requires a non-ionic
contrast agent. Which of the following is the most appropriate premedication
regimen for an elective procedure?
A) Diphenhydramine 50 mg IV and methylprednisolone 40 mg IV given 1
hour prior
,B) Prednisone 50 mg orally at 13, 7, and 1 hour before, plus
diphenhydramine 50 mg orally 1 hour before
C) Epinephrine 0.3 mg IM and albuterol nebulizer 30 minutes prior
D) No premedication is required as non-ionic contrast is considered safe
Answer: B
Rationale: The standard premedication protocol for patients with a history of
contrast allergy includes a 13-hour course of corticosteroids (e.g., prednisone)
and an antihistamine (diphenhydramine) 1 hour before contrast. Option A is
insufficient (only 1 hour pre) and IV route is not standard. Option C is for
anaphylaxis treatment, not prophylaxis. Option D is incorrect because
non-ionic contrast still carries a risk of allergic reaction.
3 Which patient identification procedure is correct to prevent wrong-patient
errors?
A) Use of the patient's room number and bed assignment
B) Verification using two patient identifiers, such as full name and date of
birth, comparing to the requisition and patient ID band
C) Asking the patient to confirm their name once while checking the chart
D) Relying on the family member to identify the patient
Answer: B
Rationale: Joint Commission standards require at least two patient identifiers
(e.g., name and date of birth) that are matched to the patient's ID band and
requisition. Room number is not a reliable identifier; family members may be
mistaken; and single verbal confirmation is insufficient.
4 During a CT scan with iodinated contrast, the patient reports mild urticaria
and nasal congestion. What is the priority immediate action?
A) Administer epinephrine 0.3 mg IM immediately
B) Stop the injection, assess airway, and administer diphenhydramine 50 mg
IV
C) Continue the scan but reduce injection rate
D) Administer oxygen via non-rebreather mask
Answer: B
Rationale: Mild allergic reaction (urticaria, nasal congestion) does not require
epinephrine. The contrast should be stopped immediately, airway assessed, and
an antihistamine (diphenhydramine) given. Continuing contrast or only
,providing oxygen is insufficient; epinephrine is reserved for anaphylaxis
(severe respiratory or cardiovascular compromise).
5 Which of the following is the most appropriate method to prevent falls in a
patient with lower extremity weakness who requires a chest X-ray in the
upright position?
A) Have the patient stand independently with the X-ray technologist in the
room
B) Use a wheelchair and have the patient lean forward for the image
C) Use a gait belt and have two staff members assist the patient to a standing
position, with the patient holding onto the upright Bucky
D) Perform the exam as a portable supine study in the patient's bed
Answer: C
Rationale: For a patient with weakness, a gait belt and two-person assist
provide stability and reduce fall risk. Standing independently is unsafe; a
wheelchair may not allow optimal positioning for a chest X-ray; supine
portable is acceptable only if standing is contraindicated but may compromise
image quality if the patient can safely stand with assistance.
6 A female patient of reproductive age is scheduled for an abdominal X-ray.
She states she is not pregnant but her last menstrual period was 6 weeks ago.
What is the best course of action?
A) Proceed with the exam using strict low-dose techniques and no special
action
B) Delay the exam until pregnancy is ruled out by a serum beta-hCG test or
the next menstrual period
C) Use a lead apron to shield the abdomen and proceed with the exam
D) Ask the patient if she could be pregnant and if she says 'no', proceed
Answer: B
Rationale: When there is a potential for pregnancy (missed period), the exam
should be deferred unless urgent. Relying on patient statement alone is
insufficient; low-dose techniques and lead apron do not eliminate fetal risk if
pregnancy exists. The standard is to confirm non-pregnancy before elective
irradiation.
, 7 Which of the following is the correct initial response when a patient
experiences a vasovagal reaction during a radiographic exam?
A) Place the patient in the Trendelenburg position and call for emergency
assistance
B) Administer atropine 0.5 mg IV and monitor vital signs
C) Move the patient to supine, elevate the legs, and monitor vital signs
D) Administer ammonia inhalants and continue the exam
Answer: C
Rationale: A vasovagal reaction (faintness, bradycardia, hypotension) often
responds to simple positioning: supine with legs elevated to increase venous
return. Atropine is indicated for symptomatic bradycardia but is not first-line;
ammonia inhalants may cause harm; Trendelenburg (head down) is not
recommended as it increases intracranial pressure.
8 Which of the following statements about the use of gonadal shielding is
correct?
A) Gonadal shielding is required for all patients under 50 years of age
B) Shielding should always be used when the gonads lie within the primary
X-ray field, unless it would obscure diagnostic information
C) Lead aprons are equivalent to gonadal shields for protecting reproductive
organs
D) Gonadal shielding is not necessary for patients who have had a
hysterectomy
Answer: B
Rationale: Gonadal shielding should be used when the gonads are in the
primary beam, provided it does not compromise the diagnostic purpose. It is
not required for all under 50; lead aprons are not specifically designed for
gonadal shielding (they reduce scatter but may not cover the exact site). Even
after hysterectomy, the opposite gonad may still be present; however, shielding
is based on beam location, not surgical history.
9 A patient with a known latex allergy is scheduled for an intravenous
pyelogram (IVP). Which of the following precautions is most important?
A) Use non-latex gloves for the technologist only
B) Use a latex-free contrast media injection system and ensure all equipment
(tourniquet, blood pressure cuff) is latex-free
Questions
This exam assesses the candidate's mastery of patient care and safety protocols essential for the limited medical
radiologic technologist (LMRT). It covers radiation protection, infection control, patient communication,
emergency preparedness, contrast media management, and safe patient handling. Questions require application
of ALARA principles, identification verification, shielding protocols, and response to adverse events, reflecting
current ARRT and JRCERT standards. It contains 194 multiple-choice questions, each with four distractors and a
fully worked rationale that explains why the keyed answer is correct. Content is organized into 8 focused sections:
Patient Care and Safety, Radiation Protection, Image Production and Evaluation, Radiographic Procedures and
Positioning, Anatomy and Physiology, Equipment Operation and Quality Assurance, Medical Ethics and Legal
Issues, Infection Control. Targeted learning outcomes include: Apply ALARA and radiation safety principles to
minimize patient dose.; Implement proper patient identification and verification procedures.; Demonstrate
infection control and aseptic technique in the clinical setting.; Recognize and manage contrast media reactions
and emergencies.. Every item has been reviewed for clinical accuracy, current guidelines, and clarity so that
students can study with confidence and self-correct as they work through the bank. Use it as a high-yield review
immediately before the exam, or as a structured practice tool during the unit - the rationales double as concise
teaching notes. The recommended writing time is 3 hours, with a passing score of 75%. Aligned with Meets or
Section 1: Patient Care and Safety (Questions 1-22)
1 Which radiation protection principle is best demonstrated by selecting the
lowest possible exposure factors while maintaining diagnostic image
quality?
A) Time
B) Distance
C) Shielding
D) ALARA
Answer: D
Rationale: ALARA (As Low As Reasonably Achievable) is the principle that
mandates minimizing patient dose without compromising diagnostic efficacy.
Time, distance, and shielding are methods to achieve ALARA, but the concept
itself is the overarching radiation safety philosophy.
2 A patient presents for an upper GI series and reports a history of severe
allergic reaction to iodinated contrast. The exam requires a non-ionic
contrast agent. Which of the following is the most appropriate premedication
regimen for an elective procedure?
A) Diphenhydramine 50 mg IV and methylprednisolone 40 mg IV given 1
hour prior
,B) Prednisone 50 mg orally at 13, 7, and 1 hour before, plus
diphenhydramine 50 mg orally 1 hour before
C) Epinephrine 0.3 mg IM and albuterol nebulizer 30 minutes prior
D) No premedication is required as non-ionic contrast is considered safe
Answer: B
Rationale: The standard premedication protocol for patients with a history of
contrast allergy includes a 13-hour course of corticosteroids (e.g., prednisone)
and an antihistamine (diphenhydramine) 1 hour before contrast. Option A is
insufficient (only 1 hour pre) and IV route is not standard. Option C is for
anaphylaxis treatment, not prophylaxis. Option D is incorrect because
non-ionic contrast still carries a risk of allergic reaction.
3 Which patient identification procedure is correct to prevent wrong-patient
errors?
A) Use of the patient's room number and bed assignment
B) Verification using two patient identifiers, such as full name and date of
birth, comparing to the requisition and patient ID band
C) Asking the patient to confirm their name once while checking the chart
D) Relying on the family member to identify the patient
Answer: B
Rationale: Joint Commission standards require at least two patient identifiers
(e.g., name and date of birth) that are matched to the patient's ID band and
requisition. Room number is not a reliable identifier; family members may be
mistaken; and single verbal confirmation is insufficient.
4 During a CT scan with iodinated contrast, the patient reports mild urticaria
and nasal congestion. What is the priority immediate action?
A) Administer epinephrine 0.3 mg IM immediately
B) Stop the injection, assess airway, and administer diphenhydramine 50 mg
IV
C) Continue the scan but reduce injection rate
D) Administer oxygen via non-rebreather mask
Answer: B
Rationale: Mild allergic reaction (urticaria, nasal congestion) does not require
epinephrine. The contrast should be stopped immediately, airway assessed, and
an antihistamine (diphenhydramine) given. Continuing contrast or only
,providing oxygen is insufficient; epinephrine is reserved for anaphylaxis
(severe respiratory or cardiovascular compromise).
5 Which of the following is the most appropriate method to prevent falls in a
patient with lower extremity weakness who requires a chest X-ray in the
upright position?
A) Have the patient stand independently with the X-ray technologist in the
room
B) Use a wheelchair and have the patient lean forward for the image
C) Use a gait belt and have two staff members assist the patient to a standing
position, with the patient holding onto the upright Bucky
D) Perform the exam as a portable supine study in the patient's bed
Answer: C
Rationale: For a patient with weakness, a gait belt and two-person assist
provide stability and reduce fall risk. Standing independently is unsafe; a
wheelchair may not allow optimal positioning for a chest X-ray; supine
portable is acceptable only if standing is contraindicated but may compromise
image quality if the patient can safely stand with assistance.
6 A female patient of reproductive age is scheduled for an abdominal X-ray.
She states she is not pregnant but her last menstrual period was 6 weeks ago.
What is the best course of action?
A) Proceed with the exam using strict low-dose techniques and no special
action
B) Delay the exam until pregnancy is ruled out by a serum beta-hCG test or
the next menstrual period
C) Use a lead apron to shield the abdomen and proceed with the exam
D) Ask the patient if she could be pregnant and if she says 'no', proceed
Answer: B
Rationale: When there is a potential for pregnancy (missed period), the exam
should be deferred unless urgent. Relying on patient statement alone is
insufficient; low-dose techniques and lead apron do not eliminate fetal risk if
pregnancy exists. The standard is to confirm non-pregnancy before elective
irradiation.
, 7 Which of the following is the correct initial response when a patient
experiences a vasovagal reaction during a radiographic exam?
A) Place the patient in the Trendelenburg position and call for emergency
assistance
B) Administer atropine 0.5 mg IV and monitor vital signs
C) Move the patient to supine, elevate the legs, and monitor vital signs
D) Administer ammonia inhalants and continue the exam
Answer: C
Rationale: A vasovagal reaction (faintness, bradycardia, hypotension) often
responds to simple positioning: supine with legs elevated to increase venous
return. Atropine is indicated for symptomatic bradycardia but is not first-line;
ammonia inhalants may cause harm; Trendelenburg (head down) is not
recommended as it increases intracranial pressure.
8 Which of the following statements about the use of gonadal shielding is
correct?
A) Gonadal shielding is required for all patients under 50 years of age
B) Shielding should always be used when the gonads lie within the primary
X-ray field, unless it would obscure diagnostic information
C) Lead aprons are equivalent to gonadal shields for protecting reproductive
organs
D) Gonadal shielding is not necessary for patients who have had a
hysterectomy
Answer: B
Rationale: Gonadal shielding should be used when the gonads are in the
primary beam, provided it does not compromise the diagnostic purpose. It is
not required for all under 50; lead aprons are not specifically designed for
gonadal shielding (they reduce scatter but may not cover the exact site). Even
after hysterectomy, the opposite gonad may still be present; however, shielding
is based on beam location, not surgical history.
9 A patient with a known latex allergy is scheduled for an intravenous
pyelogram (IVP). Which of the following precautions is most important?
A) Use non-latex gloves for the technologist only
B) Use a latex-free contrast media injection system and ensure all equipment
(tourniquet, blood pressure cuff) is latex-free
