Study reference, not clinical guidance. Doses and protocols below are presented as ARRT exam-content facts. They are not a substitute for clinical training, current institutional protocols, or supervision by licensed clinicians. Confirm with your institution’s policies before any patient-care use.
Patient Care is the most-tested content domain on the ARRT Radiography Boards. At ~23% of the exam, it accounts for nearly 1 in 4 questions you’ll answer. It is also the category most students underestimate, the “soft” content that gets crowded out by physics and procedures during cram sessions.
Don’t be that student.
What the ARRT actually tests under “Patient Care”
The 2025 ARRT Content Specifications break Patient Care into the categories most candidates think of as separate chapters:
- Patient identification and verification
- Communication (adult, pediatric, geriatric, non-English)
- Body mechanics and patient transfers
- Vital signs (normal ranges, abnormal recognition)
- Infection control (Standard + Transmission-Based Precautions)
- Patient monitoring during procedures
- Contrast media reactions and management
- Oxygen delivery and emergency response
- Legal foundation (consent, torts, negligence)
- Professional ethics (ARRT Code + Rules)
A registry question can come from any of these. The exam will not warn you when it shifts from “calculate the inverse square law” to “identify the missing element of valid consent.”
Two-factor patient identification
The single most-tested fact in Patient Care: confirm patient identity using two identifiers (typically name and date of birth) before any procedure. The Joint Commission requires this. Wrong-patient errors are the most common preventable adverse event in imaging.
The ARRT will test it in scenario form: “The radiographer brings a patient to the fluoroscopy room. Before the exam begins, what is the radiographer’s first priority?” The answer is always identification, never positioning, never order verification, never barium administration.
Vital signs you must memorize
| Vital | Adult normal | Concern threshold |
|---|---|---|
| Heart rate | 60–100 bpm | <60 (bradycardia), >100 (tachycardia) |
| Respiratory rate | 12–20 breaths/min | <12 or >24 |
| Blood pressure | 120/80 mmHg | <90/60 (hypotension), ≥130/80 (hypertension, 2017 ACC/AHA) |
| Temperature | 98.6°F (37°C) | >100.4°F (fever) |
| Oxygen saturation | 95–100% | <90% (clinical concern), <85% (emergency) |
Pediatric and geriatric ranges differ. Pediatric heart rates run higher (up to 160 in infants). Geriatric blood pressure runs slightly higher and respiratory effort can be diminished. The ARRT will test the difference.
Body mechanics and transfers
Three rules that prevent injury to patient AND radiographer:
- Lift with your legs, not your back. Bend at the knees, keep the load close to your center of gravity.
- Wide base of support. Feet shoulder-width apart, one slightly forward.
- Avoid twisting. Pivot the entire body, not just the spine.
Transfer types by patient ability:
- Stand-pivot transfer: ambulatory patients who can bear weight. Stand on the patient’s weak side.
- Two-person assist: partial weight-bearing patients.
- Mechanical lift (Hoyer): non-ambulatory or unstable patients.
- Slide board / draw sheet: supine-to-supine transfers, comatose patients.
The boards routinely tests pairings, match the patient situation to the transfer type.
Infection control: Standard + Transmission-Based
Standard Precautions apply to every patient, every time. Treat all blood, body fluids, secretions, and non-intact skin as potentially infectious. Hand hygiene is the single most effective intervention.
Transmission-Based Precautions stack on top of Standard:
| Type | When to use | PPE required |
|---|---|---|
| Contact | MRSA, VRE, C. diff, scabies | Gown + gloves + dedicated equipment |
| Droplet | Influenza, pertussis, mumps, RSV | Surgical mask + eye protection within 3–6 feet |
| Airborne | Tuberculosis, measles, varicella | N95 respirator + negative-pressure room |
The ARRT loves pairing questions: “A patient is admitted with active pulmonary tuberculosis and requires a portable chest x-ray. What protective equipment must the radiographer wear?” Answer: N95 respirator (TB is airborne). A surgical mask alone is wrong, it doesn’t filter the small particles.
Iodinated contrast reactions
Reactions occur on a continuum. Recognize the level, respond appropriately.
| Severity | Signs | Response |
|---|---|---|
| Mild | Warmth, metallic taste, mild urticaria, brief flushing, transient nausea | Observation only, no medication |
| Moderate | Extensive urticaria, bronchospasm, persistent vomiting, vasovagal syncope | Notify radiologist, IV access, often diphenhydramine or epinephrine |
| Severe | Laryngeal edema, anaphylactic shock, seizure, cardiac arrest | Immediate epinephrine + code-team activation + ACLS protocol |
Risk factors that increase the probability of a reaction: prior reaction to iodinated contrast (highest), asthma, allergies (especially shellfish, though the seafood-iodine connection is myth, the underlying atopy matters), renal impairment.
Oxygen delivery: a tested fact set
| Device | FiO2 | Flow rate |
|---|---|---|
| Nasal cannula | 24–44% | 1–6 L/min |
| Simple face mask | 35–50% | 6–10 L/min (never below 5, CO2 rebreathing risk) |
| Non-rebreather mask | 60–95% | 10–15 L/min |
| Venturi mask | Precise % | Specific to mask color (e.g. 28% green) |
| Bag-valve-mask (BVM) | Up to 100% | 15 L/min during resuscitation |
Venturi masks are used in COPD where CO2 retention is a concern, they deliver a precise FiO2 that won’t suppress the hypoxic drive. The ARRT tests this distinction.
Emergency response sequence
C-A-B for cardiac arrest (Compressions, Airway, Breathing, current AHA 2020+ guideline). Compressions at 100–120/min, 2 inches deep.
Syncope (vasovagal): lay the patient flat, elevate legs, vital signs, monitor for full recovery.
Shock: Trendelenburg position, oxygen via non-rebreather, IV access, monitor.
Seizure: clear the area, do NOT restrain, time the event, protect head from injury, side-lying recovery position when seizure ends.
Anaphylaxis: IM epinephrine (0.3 mg adult, 0.15 mg pediatric in lateral thigh), oxygen, IV access, code activation if airway compromised.
Legal foundation: consent
The four conditions for valid consent:
- Of legal age. Or legal guardian for minors.
- Of sound mind. Cognitive capacity to understand.
- Given freely. No coercion.
- Adequately informed. Procedure, purpose, risks, alternatives.
Missing any one invalidates the consent. The ARRT will give you a scenario where one is missing, your job is to identify which.
Three forms of consent:
- Verbal: sufficient for routine, low-risk procedures
- Written: required for any exam involving greater-than-usual risk (invasive vascular studies, contrast injection, etc.)
- Implied: assumed in emergencies when the patient is unconscious
A patient can withdraw consent at any time, even mid-procedure. You must stop.
Legal foundation: torts
Intentional torts (willful acts):
- Assault: threatening harm. The threat is the tort. No contact required.
- Battery: carrying out the threat. Performing an exam after refusal is the textbook example.
- False imprisonment: illegal restriction of freedom (unauthorized restraints).
- Defamation: detrimental disclosure. Slander spoken, libel written.
- Invasion of privacy: disclosing confidential info to unauthorized people.
Negligence (unintentional tort) requires four elements:
- Duty: the standard of care that should have been provided
- Breach: deviation from the standard
- Injury: actual harm sustained by the patient
- Cause: direct link between breach and injury
Missing any element defeats the claim. The ARRT will give you a scenario where one element is missing and ask which.
Professional ethics: ARRT Rules 21 and 22
Two rules that turn passive observation into active responsibility:
Rule 21: Duty to report violations by other technologists. Failing to report is itself a violation.
Rule 22: Duty to immediately self-report any error in patient care, regardless of whether the patient was injured.
These appear on virtually every administration of the ARRT Radiography Boards, often in scenario form. Memorize the rule numbers and the principle.
Communication strategies by patient type
Adult cooperative: clear, concise. Explain what you’ll do, what they’ll feel, how long it takes.
Pediatric: simple language, reassuring tone. Show before doing. Engage parents. Use child-friendly imagery (“I’m going to take a picture of your bones”).
Geriatric: slow, clear, respectful. Speak directly (not loudly unless hearing-impaired). Allow extra time for repositioning. Ensure warmth, hospital gowns leave older patients cold.
Non-English-speaking: use an interpreter (medical interpreter preferred over family member when possible). Demonstrate physically. Confirm understanding before exposure.
Cognitively impaired or distressed: short, simple instructions. Demonstrate, don’t only explain. Family member or aide as a calming presence when appropriate.
How the ARRT tests Patient Care
Across the ~46 questions in this category (23% of 200):
- 5–7 patient identification + communication
- 4–6 vital signs + monitoring
- 5–7 infection control
- 4–6 contrast reactions + emergency response
- 4–6 body mechanics + transfers
- 4–6 consent + tort + negligence
- 4–6 ARRT ethics
The pattern: scenario-based reasoning. Memorize the rules; recognize the rule in the question stem.
Study path for Patient Care
- Foundations of Practice, patient rights, law, ethics
- Patient Communication and Care, workflow, identification, vitals, transfers
- Infection Control, Standard + Transmission-Based
- Patient Monitoring and Emergencies, contrast reactions, oxygen, codes
Then drill the Patient Interactions practice category, 124 questions in the bank with rationales on every option.
What I want you to remember
Patient Care is not the soft category. It is the largest scoring category and the one where misjudgment in the clinic causes real harm. The exam tests this material because the ARRT wants registered technologists who know the rules cold.
Memorize the dose-table-style facts (vital ranges, oxygen delivery, contrast severity tiers, tort definitions, consent conditions). Practice the scenario reasoning. The questions become reflex.
Sign up free, the first chapter (Foundations of Practice) is yours plus 50 mixed-category practice questions. The Premium subscription unlocks all 4 Patient Care chapters and the 124-question practice bank.