Deck 3: Image Analysis of the Chest and Abdomen

Question 1

For an AP chest projection obtained with a mobile x-ray unit,
1)the IR is positioned parallel with the midcoronal plane.
2)the image is obtained without the use of a grid.
3)the manubrium is superimposed over the fourth thoracic vertebra.
4)10 or 11 posterior ribs are demonstrated above the diaphragm.

A) 1 and 2 only
B) 1, 2, and 3 only
C) 3 and 4 only
D) 1, 2, 3, and 4

Answer 1

1, 2, and 3 only

Question 2

Which of the following pertains to a lateral chest projection with accurate positioning that was obtained with the right side positioned adjacent to the IR?
1)The heart shadow demonstrates increased magnification over a left lateral projection.
2)The left lung demonstrates the sharpest recorded details.
3)The left hemidiaphragm is demonstrated inferior to the right hemidiaphragm.
4)One and one-half inches (4 cm) of space separates the posterior and anterior ribs.

A) 1 only
B) 1 and 3 only
C) 1, 2, and 3 only
D) 2 and 4 only

Answer 2

1 and 3 only

Question 3

A left lateral chest projection demonstrates the gastric air bubble directly beneath the superior hemidiaphragm. Which is the superior lung?

A) Left
B) Right

Answer 3

Left

Question 4

On inhalation, the lungs expand
1)vertically.
2)transversely.
3)anteroposteriorly.

A) 1 only
B) 2 and 3 only
C) 1 and 2 only
D) 1, 2, and 3

Question 5

Heart penetration on an AP chest projection
1)is obtained by increasing the kVp.
2)results in a lower contrast image.
3)is required when apparatuses located at the mediastinal region are of interest.
4)results in a decrease in scatter radiation reaching the IR.

A) 1 and 3 only
B) 1, 2, and 3 only
C) 3 only
D) 1, 2, 3, and 4

Question 6

The last rib is attached to the ____ vertebra.

A) eleventh
B) tenth
C) twelfth
D) ninth

Question 7

For a PA chest projection with accurate positioning, the
1)SID is set at 72 inches (183 cm).
2)shoulders are positioned at equal distances from the IR.
3)upper midcoronal plane is tilted slightly toward the IR.
4)elbows and shoulders are rotated posteriorly.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 8

A PA chest projection with poor positioning demonstrates the scapulae in the lung field and elevated lateral clavicular ends. How should the patient be repositioned for an optimal projection to be obtained?
1)Tilt the upper midcoronal plane away from the IR.
2)Depress the shoulders.
3)Coax the patient into a deeper inspiration.
4)Anteriorly rotate the shoulders and elbows.

A) 1 and 4 only
B) 2 only
C) 2, 3, and 4 only
D) 2 and 4 only

Question 9

A left lateral chest projection with poor positioning demonstrates the humeri soft tissue superimposed over the anterior lung apices. How was the patient positioned for such an image to be obtained?

A) The chest was rotated.
B) The inferior midsagittal plane was tilted toward the IR.
C) The humeri were positioned at a 90-degree angle with the body.
D) The central ray was angled caudally.

Question 10

A mobile AP chest projection obtained with the central ray angled caudally demonstrates
1)vertically contoured ribs.
2)the manubrium projected superior to the fourth thoracic vertebra.
3)less than 1 inch (2.5 cm) of the apices above the clavicles.
4)vertical clavicles.

A) 1 and 3 only
B) 2 and 3 only
C) 2 and 4 only
D) 1 and 4 only

Question 11

The IR is positioned ____ for a PA chest projection of a hypersthenic patient.

A) crosswise
B) lengthwise

Question 12

A PA chest projection obtained with the patient rotated into an RAO position demonstrates
1)1 inch (2.5 cm) of the apical lung field above the clavicles.
2)the vertebral column superimposed over the left sternoclavicular (SC) joint.
3)elevated lateral clavicular ends.
4)the left posterior ribs with greater length than the right posterior ribs.

A) 2 only
B) 1, 2, and 4 only
C) 3 only
D) 1 and 4 only

Question 13

A PA chest projection obtained on expiration demonstrates
1)a narrower and longer heart shadow.
2)an underexposed image if exposure is not increased when a manual technique is used.
3)a broader and shorter heart shadow.
4)fewer than 10 posterior ribs above the diaphragm.

A) 1 and 2 only
B) 1, 2, and 4 only
C) 3 and 4 only
D) 2, 3, and 4 only

Question 14

A PA chest projection with accurate positioning demonstrates
1)10 or 11 posterior ribs above the diaphragm.
2)equal posterior rib length on both sides of the chest.
3)the manubrium superimposed by the fourth thoracic vertebra.
4)the scapulae outside the lung field.

A) 1, 2, and 4 only
B) 2 and 4 only
C) 1 and 3 only
D) 1, 2, 3, and 4

Question 15

A PA chest projection with poor positioning demonstrates vertical clavicles and the manubrium at the same level as the fifth thoracic vertebra. How was the patient positioned for such an image to be obtained?

A) The shoulders and elbows were not internally rotated.
B) The shoulders were elevated.
C) The patient's upper midcoronal plane was tilted toward the IR.
D) The central ray was angled caudally.

Question 16

A left lateral chest projection obtained with the patient's left side rotated anteriorly demonstrates the
1)anterior and posterior ribs with more than 0.5 inch (1 cm) of superimposition.
2)heart shadow entirely posterior to the sternum.
3)right hemidiaphragm inferior to the left hemidiaphragm.
4)humeral soft tissue superimposed over the anterior lung apices.

A) 1 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 2, and 4 only

Question 17

For a left lateral chest projection with accurate positioning, the
1)SID is set at 40 inches (102 cm).
2)humeri are positioned vertically.
3)shoulders, posterior ribs, and posterior pelvic wings are aligned perpendicular to the image receptor (IR).
4)midsagittal plane is aligned perpendicular to the IR.

A) 1 and 3 only
B) 2 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Question 18

A left lateral chest projection with accurate positioning demonstrates
1)no humeral soft tissue in the lung field.
2)no more than a total of 0.5 inch (1 cm) of space between the posterior or anterior ribs.
3)the right hemidiaphragm inferior to the left hemidiaphragm.
4)the hemidiaphragms inferior to the eleventh thoracic vertebra.

A) 1, 2, and 4 only
B) 1 and 2 only
C) 3 and 4 only
D) 2 and 3 only

Question 19

A rotated left lateral chest projection demonstrates the heart shadow posterior to the sternum. Which is the anteriorly positioned lung?

A) Left
B) Right

Question 20

Air-fluid levels on an AP chest projection
1)demonstrate an increase in density where the fluid is present.
2)are formed when air and fluid separate.
3)are precisely demonstrated when the patient is in a partially upright position.
4)are precisely demonstrated when the central ray is horizontal.

A) 1 and 3 only
B) 1, 2, and 4 only
C) 2 and 4 only
D) 2, 3, and 4 only

Question 21

An AP axial chest projection (lordotic position) with accurate positioning demonstrates
1)the medial ends of the clavicles projected superior to the lung apices.
2)the lateral borders of the scapulae within the lung field.
3)equal distances from the vertebral column to the SC joints.
4)almost horizontal posterior and anterior portions of the first through fourth ribs.

A) 1 and 3 only
B) 2 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

Question 22

Which positioning problem(s) listed result(s) in an AP-PA chest projection (lateral decubitus position) with the manubrium and the fifth thoracic vertebra located at the same level?
1)A patient rotated into an RPO position
2)An AP projection obtained with the upper midcoronal plane tilted away from the IR
3)A PA projection obtained with the upper midcoronal plane tilted toward the IR
4)An AP projection obtained with the central ray angled cephalically

A) 1 only
B) 2 only
C) 2 and 3 only
D) 2, 3, and 4 only

Question 23

For a PA oblique chest projection,
1)the patient is rotated until the midsagittal plane is aligned 45 degrees with the IR.
2)there is twice as much lung field demonstrated on one side of the vertebral column as on the opposite side.
3)10 or 11 posterior ribs are demonstrated above the hemidiaphragm.
4)the apices, costophrenic angles, and lateral chest walls are included on the image.

A) 1 and 4 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

Question 24

A PA chest projection (lateral decubitus position) demonstrates
1)the C6-C7 vertebral bodies without distortion.
2)the manubrium superimposed over the fourth vertebral body.
3)a closed C6-C7 intervertebral disk space.
4)clearly shown C6-C7 spinous processes and laminae.

A) 1 and 2 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 3 and 4 only

Question 25

A supine AP abdomen projection with accurate positioning demonstrates the
1)outline of the psoas major muscles and kidneys.
2)symphysis pubis.
3)spinous processes aligned with the midline of the vertebral bodies.
4)long axis of the vertebral column aligned with the long axis of the collimated field.

A) 1 and 2 only
B) 3 and 4 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 26

An AP chest projection obtained with the patient rotated into an RPO position demonstrates
1)the left SC joint superimposed over the vertebral column.
2)the left posterior ribs with greater length than the right posterior ribs.
3)a manubrium superimposed over the fourth thoracic vertebra.
4)elevated lateral clavicular ends.

A) 1 and 3 only
B) 1, 2, and 3 only
C) 3 only
D) 2 and 4 only

Question 27

A right PA oblique chest projection (RAO position) with poor positioning demonstrates almost equal lung fields on both sides of the vertebral column and nine posterior ribs above the diaphragm. How could the positioning setup be adjusted for an optimal image to be obtained?
1)Take the exposure after the second full inspiration.
2)Increase the degree of patient obliquity.
3)Decrease the degree of patient obliquity.
4)Move the IR and central ray inferiorly.

A) 1 and 2 only
B) 1 and 3 only
C) 2 and 4 only
D) 1 and 4 only

Question 28

For an AP-PA chest projection (right lateral position), the
1)shoulders and the posterior ribs are positioned perpendicular to the cart.
2)humeri are positioned at a 90-degree angle with the IR.
3)midcoronal plane is aligned perpendicular to the IR.
4)patient is elevated on a radiolucent sponge or cardiac board.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 29

A left PA 60-degree oblique chest projection (LAO position)
1)demonstrates the heart shadow to the right of the vertebral column.
2)is obtained to evaluate the size and configuration of the heart shadow.
3)best demonstrates the left lung.
4)demonstrates three times as much lung field on one side of the vertebral column as on the opposite side.

A) 1 and 2 only
B) 1 and 3 only
C) 1, 2, and 4 only
D) 2 and 4 only

Question 30

How much should the technique be adjusted from the routine for an AP abdomen projection in a patient who has a large amount of bowel gas?
1)Increase the mAs 30% to 50%.
2)Decrease the mAs 30% to 50%.
3)Increase the kVp 5% to 8%.
4)Decrease the kVp 5% to 8%.

A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only

Question 31

For an upright AP abdomen projection, the
1)ASISs are positioned at equal distances from the IR.
2)patient remains in an upright position at least 5 to 20 minutes before the image is obtained.
3)symphysis pubis should be included.
4)patient is instructed to take a deep inspiration before the image is obtained.

A) 1 and 2 only
B) 1, 2, and 3 only
C) 2 and 3 only
D) 3 and 4 only

Question 32

Voluntary motion can
1)result from patient breathing.
2)be controlled by using a short exposure time.
3)result from peristaltic activity.
4)be identified as sharp bony cortices and blurry gastric and intestinal gases.

A) 1 and 2 only
B) 1, 2, and 4 only
C) 2 and 3 only
D) 3 and 4 only

Question 33

A right PA oblique chest projection (RAO position) corresponds with which AP oblique projection?

A) RPO
B) LPO

Question 34

An AP axial chest projection (lordotic position) with poor positioning demonstrates the clavicles within the lung apices. How should the positioning setup be adjusted for an optimal image to be obtained?
1)Increase the degree of cephalic central ray angulation.
2)Anteriorly rotate the elbows and shoulders.
3)Arch the patient's back more, increasing the midcoronal plane to IR angle.
4)Position the patient's feet closer to the IR.

A) 1 and 3 only
B) 2 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 35

For an AP axial chest projection (lordotic position),
1)the shoulders are positioned at equal distances from the IR.
2)the patient's back is arched until the midcoronal plane and IR form a 45-degree angle.
3)a 15-degree cephalad central ray angulation is used if the patient is standing erect.
4)the elbows and shoulders are rotated anteriorly.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 36

An AP chest projection (lateral decubitus position) obtained with the patient in an RPO position demonstrates
1)the right SC joint without vertebral column superimposition.
2)9 or 10 posterior ribs above the diaphragm.
3)the manubrium superimposed over the fifth thoracic vertebra.
4)the left posterior ribs with greater length than the right posterior ribs.

A) 1 and 2 only
B) 1, 2, and 4 only
C) 2 and 3 only
D) 1 and 4 only

Question 37

Which side of the patient is positioned against the imaging table or cart for an AP-PA chest projection (lateral decubitus position) to rule out a left side pleural effusion?

A) Right
B) Left

Question 38

An AP-PA chest projection (lateral decubitus position) with accurate positioning demonstrates
1)a marker indicating the side of the patient adjacent to the cart.
2)equal posterior rib length on both sides of the chest.
3)the manubrium at the fifth thoracic vertebra.
4)nine or ten posterior ribs above the diaphragm.

A) 1, 2, and 4 only
B) 2 and 4 only
C) 2 only
D) 3 and 4 only

Question 39

A supine AP abdomen projection obtained with the patient in an LPO position demonstrates
1)the sacrum and coccyx aligned with the symphysis pubis.
2)a distance from the pedicles to the spinous processes that is narrower on the right side than on the left side.
3)the sacrum rotated toward the patient's right side.
4)the symphysis pubis rotated toward the patient's right side.

A) 1, 2, and 3 only
B) 2 and 3 only
C) 2 and 4 only
D) 1 and 4 only

Question 40

Which side of the patient is positioned against the imaging table or cart for an AP-PA chest projection (lateral decubitus position) to rule out a right side pneumothorax?

A) Right
B) Left

Question 41

Sufficient penetration has been obtained on a PA chest projection when the _____ and posterior ribs are demonstrated through the heart and mediastinal structures.

A) fluid levels
B) vascular lung markings
C) thoracic vertebrae
D) aorta

Question 42

A PA chest projection that demonstrates the manubrium at the same level as the first thoracic vertebra

A) was obtained with the midcoronal plane tilted away from the IR.
B) was taken with a caudal angle accidentally left of the central ray.
C) was obtained with the patient rotated toward the right side.
D) will also demonstrate vertical clavicles.

Question 43

A PA chest projection obtained in full lung expansion

A) demonstrates 10 to 11 posterior ribs above the diaphragm.
B) demonstrates the greatest expansion transversely.
C) would have been obtained with the patient in a seated position.
D) demonstrates a broader and shorter heart shadow than if obtained in expiration.

Question 44

To position the scapulae outside the lung field for a PA chest projection, the patient's

A) midcoronal plane is aligned parallel with the IR.
B) shoulders are depressed.
C) elbows and shoulders are rotated anteriorly.
D) arms are adducted.

Question 45

For an AP neonatal or infant chest projection, the
1)central ray is centered to the midsagittal plane at the level of the mammary line.
2)longitudinal collimation should be open enough to include the upper airway.
3)head faces straight up, without rotation.
4)central ray is angled 5 degrees caudally.

A) 1 and 2 only
B) 2 and 4 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 46

How should the technique be adjusted from the routine for an AP abdomen projection (lateral decubitus position) in a patient with ascites or a bowel obstruction?
1)Increase the mAs 30% to 50%.
2)Decrease the mAs 30% to 50%.
3)Increase the kVp 5% to 8%.
4)Decrease the kVp 5% to 8%.

A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only

Question 47

An AP chest projection that demonstrates the manubrium superimposing the third thoracic vertebra

A) can be improved by tilting the patient's upper midcoronal plane posteriorly.
B) was taken with the central ray angled toward the right side of the patient.
C) will also demonstrate horizontally running posterior ribs.
D) was taken with the central ray angled too cephalically.

Question 48

For an AP abdominal projection (lateral decubitus position),
1)the right hemidiaphragm and iliac wing must be included to demonstrate intraperitoneal air.
2)position the shoulders and the ASISs at equal distances from the IR.
3)obtain the exposure on expiration.
4)position the patient's right side adjacent to the imaging table or cart.

A) 1 and 2 only
B) 1 and 3 only
C) 2 and 4 only
D) 1, 2, and 3 only

Question 49

An AP neonatal chest projection with accurate positioning demonstrates
1)the right and left side inferior posterior ribs at equal lengths.
2)upwardly projecting anterior ribs.
3)at least nine posterior ribs above the diaphragm.
4)the chin superior to the airway.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only

Question 50

An AP axial chest projection (lordotic position) demonstrates the clavicles superimposing the lung apices and the anterior ribs inferior to their corresponding posterior ribs. How should the positioning setup be changed to obtain an optimal projection?

A) Move the IR more inferiorly.
B) Position the central ray more superiorly on the patient.
C) Decrease the degree of central ray angulation.
D) Increase the degree of midcoronal plane tilt with the IR.

Question 51

For a lateral neonatal or infant chest projection, the
1)neonate or infant remains supine for a cross-table projection.
2)neonate or infant is elevated on a radiolucent sponge for an overhead projection.
3)central ray is centered to the mammary line.
4)humeri are positioned at a 90-degree angle with the chest.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 1, 2, and 4 only

Question 52

For an AP chest projection obtained in a neonate or infant who is being ventilated with a high-frequency ventilator, the exposure should be obtained

A) when the manometer moves to its highest position.
B) at the direction of the respiratory therapist.
C) when the manometer moves to its lowest position.
D) at any time.

Question 53

The right SC joint is visible away from the vertebral column, and the left SC joint is superimposing the vertebral column on a mobile AP chest projection. How should the positioning setup be adjusted to obtain an optimal image?

A) Adjust the central ray angulation toward the left side of the patient.
B) Rotate the patient toward the right side.
C) Adjust the central ray angulation caudally.
D) Adjust the central ray angle toward the right side of the patient.

Question 54

An AP neonatal or infant chest projection that demonstrates an excessive lordotic appearance
1)may have been obtained with the central ray centered too superiorly.
2)will also demonstrate downwardly projecting anterior ribs.
3)will also demonstrate horizontally appearing posterior ribs.
4)may have been obtained with a perpendicular central ray.

A) 1 only
B) 1 and 3 only
C) 2, 3, and 4 only
D) 1, 2, and 3 only

Question 55

A lateral chest projection demonstrates the posterior ribs separated by 2.5 inches (6.35 cm). The superior heart shadow does not extend into the anteriorly situated lung. How should the patient be repositioned to obtain an optimal image?

A) Rotate the left side of the chest 1.25 inches (3 cm) anteriorly.
B) Rotate the right side of the chest 1 inch (2.5 cm) anteriorly.
C) Rotate the right side of the chest 1 inch (2.5 cm) posteriorly.
D) This is an acceptable separation, so no movement is needed.

Question 56

A PA chest projection that demonstrates the vertebral column superimposing the left SC joint

A) was obtained with the midcoronal plane tilted toward the IR.
B) was obtained with the patient rotated toward the left side.
C) will also demonstrate vertical clavicles.
D) was obtained with the patient in an RAO position.

Question 57

An AP chest projection obtained with the central ray angled too caudally demonstrates _____ than 1 inch (2.5 cm) of the apices above the clavicles and _____ shaped posterior ribs.

A) less; horizontally
B) less; vertically
C) more; vertically
D) more; horizontally

Question 58

A PA chest projection on a patient with a right side pneumothorax will demonstrate

A) a density line created when the fluid and air separate.
B) the right pleural cavity without the lung.
C) intraperitoneal air.
D) air in the right pleural cavity.

Question 59

An AP chest projection (lateral decubitus position) obtained with the right side positioned against the imaging table will best demonstrate which of the following conditions?

A) Right pneumothorax
B) Right pleural effusion
C) Left pleural effusion
D) Intraperitoneal air

Question 60

A 45-degree PA oblique chest projection (LAO position) demonstrates the heart shadow without vertebral column superimposition. How should the positioning setup be adjusted to obtain an optimal image?

A) Center the central ray more toward the patient's left side.
B) Tilt the patient's upper midcoronal plane away from the IR.
C) Decrease the degree of patient rotation.
D) Increase the degree of patient rotation.

Question 61

To best demonstrate intraperitoneal air,

A) the abdomen projection should be taken after a full inspiration.
B) an AP abdomen projection (lateral decubitus position) should be obtained with the patient lying on the right side.
C) allow the patient to be positioned upright for 5 to 20 minutes before obtaining the exposure for an upright AP abdomen projection.
D) the left iliac wing needs to be included in an AP abdomen projection (lateral decubitus position) on a patient with narrow hips.

Question 62

For AP projections of the chest performed with a portable x-ray unit, placing the IR lengthwise is not appropriate for which body habitus?

A) Hypersthenic
B) Hyposthenic
C) Sthenic
D) Asthenic

Question 63

Optimal contrast, density, and penetration have been achieved on AP abdominal projections when which anatomic structures are demonstrated?

A) Intestinal gas, diaphragmatic dome, and symphysis pubis
B) Psoas major muscle, kidneys, intestinal gas, and lumbar transverse processes
C) Kidneys, intestinal gas, and intrinsic fat
D) Psoas major muscle, kidneys, inferior ribs, and lumbar transverse processes

Question 64

Excessive lung markings indicate all of the following except

A) fibrosis.
B) pleural effusion.
C) alveolar edema.
D) compression of the lung tissue.

Question 65

To reposition a decubitus abdomen projection that demonstrates longer right posterior ribs and a wider right iliac wing,

A) rotate the right side of the patient away from the IR.
B) elevate the thorax with a radiopaque sponge.
C) rotate the right side of the patient toward the IR.
D) rotate the right shoulder only toward the IR.

Question 66

A neonate lateral chest projection taken without full inspiration

A) demonstrates the hemidiaphragms situated high in the thorax with an exaggerated cephalic curvature.
B) demonstrates nine posterior ribs above the diaphragm.
C) may result when using a high-frequency ventilator.
D) may result when the image is exposed with the ventilator's manometer at its highest level.

Question 67

An AP abdomen projection demonstrates greater distances from the left lumbar vertebral pedicle to the spinous process than the right pedicles to the spinous process. The projection

A) was taken with the patient in an LPO position.
B) was taken with the right side of the patient placed closer to the IR than the left.
C) will also demonstrate the sacrum rotated toward the left side.
D) was obtained with the central ray angled toward the right side.

Question 68

A neonate AP chest projection demonstrates the left posterior ribs with greater length than the right posterior ribs. How should the positioning setup be changed to obtain an optimal projection?

A) Angle the central ray cephalically.
B) Angle the central ray toward the patient's right side.
C) Rotate the left side of the patient closer to the IR.
D) Move the central ray toward the patient's left side.

Question 69

An AP neonate abdomen projection that was obtained with the patient in a slight RPO position will demonstrate

A) the patient's upper vertebral column tilted toward the left side.
B) the sacrum aligned with the symphysis pubis.
C) longer appearing left side posterior ribs.
D) a wider right iliac wing.

Question 70

The recommended kV range for a child PA chest technique at 72 inches is

A) 65 to 70.
B) 75 to 80.
C) 80 to 85.
D) 70 to 80.