The ARRT Radiography Boards is a 200-question exam delivered over 3.5 hours, spread across 8 scoring categories. The single best way to prepare is to drill questions in the same format. Below: 20 free practice questions, two or three from each category, with rationale on every answer choice.
Time yourself. Aim for 90 seconds per question.
Patient Interactions and Management (3 questions)
1. A patient is scheduled for a fluoroscopic upper GI series. Before the exam begins, what is the radiographer’s first priority?
- A) Confirm the order with the radiologist
- B) Verify patient identity using two identifiers
- C) Have the patient drink the barium suspension
- D) Position the patient on the fluoroscopy table
Show answer
Correct: B. The Joint Commission requires two-factor identification (typically name and date of birth) before any procedure. Wrong-patient errors are the most common preventable adverse event in imaging. Order verification (A) and barium administration (C) come after identification. Positioning (D) follows consent confirmation.
2. A patient receiving iodinated contrast develops widespread urticaria, mild bronchospasm, and persistent vomiting within 5 minutes of injection. This reaction is best categorized as:
- A) Mild, observation only
- B) Moderate, radiologist notification, IV access, possible diphenhydramine or epinephrine
- C) Severe, immediate epinephrine and code activation
- D) Vasovagal, Trendelenburg position and vital signs
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Correct: B. Extensive urticaria with bronchospasm and persistent vomiting is the textbook moderate reaction. Mild reactions (A) involve transient warmth, metallic taste, or limited urticaria. Severe reactions (C) involve laryngeal edema, anaphylactic shock, or seizure. Vasovagal syncope (D) involves brief loss of consciousness with hypotension and bradycardia.
3. Under ARRT Rule 22, when must you report an error made in patient care?
- A) Only if the patient was injured
- B) Only if a supervisor specifically asks
- C) Immediately, regardless of whether the patient was injured
- D) Only if a colleague witnessed it
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Correct: C. Rule 22 is unconditional. All errors are reported the moment they occur. Waiting for injury (A) or supervisor inquiry (B) is itself a sanctionable violation. Witnesses (D) are irrelevant.
Image Acquisition and Evaluation (3 questions)
4. An adult chest x-ray is performed at 80 kVp and 4 mAs at 72 inches SID. To maintain density at 40 inches SID, what new mAs is required?
- A) 1 mAs
- B) 2 mAs
- C) 1.2 mAs
- D) 13 mAs
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Correct: C. Apply the density maintenance formula: mAs₂ = mAs₁ × (SID₂² / SID₁²) = 4 × (40² / 72²) = 4 × (1600/5184) ≈ 1.2 mAs. Closer SID means more beam intensity, so less mAs is needed. (D) reverses the relationship.
5. A radiograph is too dark by approximately 50%. To correct it on the repeat, the radiographer should:
- A) Decrease mAs by 30%
- B) Decrease mAs by 50%
- C) Decrease kVp by 15%
- D) Decrease kVp by 5%
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Correct: B. Halving the density requires halving the mAs (mAs is directly proportional to density). 30% (A) is the minimum mAs change to produce a visible difference, not the correction for a 2× overexposure. The 15% kVp rule (C) does halve density but also fundamentally changes the contrast scale and is not the right tool for a pure density problem.
6. When using an 8:1 grid instead of a 5:1 grid at the same kVp, the Bucky factor change requires the radiographer to:
- A) Halve the mAs
- B) Maintain the same mAs
- C) Double the mAs
- D) Quadruple the mAs
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Correct: C. The Bucky factor is 2 for 5:1 and 4 for 8:1, so doubling the mAs compensates for the difference. Halving (A) or maintaining (B) results in underexposure. Quadrupling (D) is the change required when going from no grid (Bucky factor 1) to 8:1.
Equipment Operation and QA (2 questions)
7. Annual QC reveals that a generator set to 100 kVp produces 93 kVp actual. Is this within tolerance?
- A) Yes, kVp tolerance is ±10%
- B) No, kVp tolerance is ±5%
- C) Yes, kVp tolerance is ±15% for diagnostic equipment
- D) No, kVp tolerance is ±2%
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Correct: B. kVp accuracy tolerance is ±5%. A 100 kVp setting must produce 95–105 kVp. 93 kVp is below the lower limit and the generator must be serviced. Don’t confuse the QC ±5% with the 15% density rule (C), they’re different concepts.
8. The anode heel effect causes:
- A) Greater beam intensity on the cathode side of the field
- B) Greater beam intensity on the anode side of the field
- C) Heat to be retained at the anode bearings
- D) Light intensity to fall off at the periphery of the image
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Correct: A. The heel of the anode self-absorbs more of the diverging beam on the anode side, leaving more beam intensity on the cathode side. The clinical implication: place thicker body parts on the cathode side. (B) reverses the effect. (C) confuses the heel effect with bearing wear. (D) is light field falloff, unrelated.
Radiation Physics and Radiobiology (2 questions)
9. Which photon interaction is the primary source of contrast between bone and soft tissue?
- A) Compton scatter
- B) Pair production
- C) Photoelectric effect
- D) Coherent (classical) scatter
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Correct: C. The photoelectric effect is highly dependent on atomic number (Z³) and photon energy (1/E³). Bone (high Z) absorbs photoelectrically much more than soft tissue, producing the contrast we see. Compton (A) is the source of operator dose, not contrast. Pair production (B) requires energies above 1.022 MeV. Coherent scatter (D) is minor at diagnostic energies.
10. A stochastic effect of ionizing radiation is best characterized as:
- A) Threshold-based, with severity increasing with dose
- B) Probabilistic, with no threshold
- C) Predictable and reversible
- D) Limited to deterministic skin reactions
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Correct: B. Stochastic effects (cancer, genetic mutations) are probabilistic, the probability of the effect increases with dose, but the severity does not, and there is no safe threshold. (A) describes deterministic effects (skin erythema, cataracts). (C) confuses stochastic with deterministic; stochastic effects are probabilistic, not necessarily reversible. (D) confuses the two categories.
Radiation Protection (2 questions)
11. During a portable chest x-ray, the radiographer must stand at minimum:
- A) 3 feet (1 meter) from the patient
- B) 6 feet (2 meters) from the patient
- C) 10 feet (3 meters) from the patient
- D) Behind a lead apron at any distance
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Correct: B. The 6-foot rule is the established standard for portable imaging. At 6 feet, scatter intensity is approximately 1/16 of intensity at 18 inches (inverse square law). Closer distances (A) produce unacceptable operator dose. 10 feet (C) is safer but not always practical. The lead apron alone (D) is necessary but not sufficient.
12. The NCRP-recommended occupational annual whole-body dose limit is:
- A) 0.1 rem (1 mSv)
- B) 0.5 rem (5 mSv)
- C) 5 rem (50 mSv)
- D) 50 rem (500 mSv)
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Correct: C. Occupational annual whole-body limit is 5 rem (50 mSv). 0.1 rem (A) is the public limit. 0.5 rem (B) is the pregnant radiographer total over the gestation. 50 rem (D) is the skin dose limit, not whole-body.
Extremity Procedures (2 questions)
13. A patient has wrist pain after falling on an outstretched hand. Routine PA, lateral, and oblique projections are negative but clinical suspicion for scaphoid fracture remains. The supplementary projection of choice is:
- A) Carpal tunnel projection
- B) Stecher method
- C) AP oblique with medial rotation
- D) Lateral with radial deviation
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Correct: B. The Stecher method (PA wrist with ulnar deviation, central ray angled 20° proximally toward the elbow) elongates the scaphoid and reveals fractures missed on routine PA. (A) demonstrates the carpal tunnel itself. (C) is for the elbow, not the wrist. (D) requires ulnar deviation, not radial.
14. The AP mortise projection of the ankle requires the foot to be rotated:
- A) 15–20° internally
- B) 30–40° internally
- C) 45° externally
- D) 90° (true lateral)
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Correct: A. 15–20° internal rotation opens the talocrural (mortise) joint space free of overlap. 30–40° (B) is the AP oblique foot rotation. (C) and (D) are not standard ankle projections.
Thorax and Abdomen Procedures (2 questions)
15. On a properly inspired adult PA chest, how many posterior ribs should be visible above the diaphragm?
- A) 8
- B) 10
- C) 12 (anterior)
- D) Both costophrenic angles
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Correct: B. At least 10 posterior ribs above the diaphragm indicates adequate inspiration. 8 (A) is underinspiration. Anterior ribs (C) are less reliable; posterior ribs are the standard. Costophrenic angle visibility (D) is part of quality assessment but does not specifically indicate inspiration adequacy.
16. During an upper GI series, the duodenal bulb is best demonstrated in profile with the patient in which position?
- A) Supine
- B) RAO 40–70°
- C) Left lateral
- D) Prone
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Correct: B. RAO 40–70° rotates the duodenal bulb away from the spine and into profile. (A) and (D) overlie the bulb on the spine or pyloric region. (C) is a useful position for esophageal imaging, not the bulb.
Head, Spine, and Pelvis (2 questions)
17. A 45° posterior oblique projection of the lumbar spine demonstrates the Scotty Dog. A “collar” on the dog’s neck represents:
- A) Spondylolisthesis
- B) Spondylolysis
- C) Disk herniation
- D) Compression fracture
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Correct: B. The Scotty Dog’s neck is the pars interarticularis. A collar indicates a defect or fracture of the pars, spondylolysis. (A) is forward slippage of one vertebra on another, best assessed laterally. (C) requires MRI. (D) involves vertebral body height loss, best on lateral.
18. The Towne method (AP axial skull) requires the central ray to be angled:
- A) 15° caudad to the OML
- B) 30° caudad to the OML
- C) Perpendicular to the IOML
- D) 25° cephalad to the OML
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Correct: B. The Towne uses 30° caudad to the OML (or 37° to IOML) to project the dorsum sellae within the foramen magnum. (A) is Caldwell. (C) is SMV. (D) is not a standard skull projection.
Two more for bonus practice
19. The four conditions for valid patient consent require that the patient:
- A) Has a witness present, has been informed, is alert, and is sober
- B) Is of legal age, of sound mind, gives consent freely, and is adequately informed
- C) Has signed paperwork, has answered all screening questions, has medical insurance, and is alert
- D) Has been told the cost, has been told the duration, has been told the alternatives, and has agreed
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Correct: B. The four conditions are universal. Missing any one invalidates consent. Witnessing (A) is helpful documentation but not a legal requirement. Insurance and cost disclosure (C, D) are not consent requirements.
20. To convert 0.3 Gy of neutron exposure (radiation weighting factor 10) to equivalent dose in sieverts, the calculation is:
- A) 0.03 Sv
- B) 0.3 Sv
- C) 3.0 Sv
- D) 30 Sv
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Correct: C. Equivalent dose H = D × W_R = 0.3 Gy × 10 = 3.0 Sv. The neutron weighting factor of 10 reflects the higher biological damage per absorbed dose for neutrons compared to x-rays (W_R = 1).
How did you score?
18–20 correct: You’re ready. Take a full timed 200-question mock to confirm.
14–17 correct: Solid base. Identify the categories you missed and re-drill them. You’re 2–3 weeks of focused work from being ready.
10–13 correct: Strong foundation. Work through the full curriculum and aim for 70+ correct on a 100-question mixed drill before retesting at this level.
Below 10: This is not a setback. It’s a baseline. Start with the 27-chapter curriculum and a 60-day study plan. Most students who start here pass on first attempt with structured prep.
Where to get more practice questions
The 20 questions above are a tiny sample of the 751-question bank in the full Radtechprepper app. Inside the app you get adaptive drilling (the algorithm shows you more questions in your weakest categories), 3 timed full-length mock exams, and rationales on every question. Sign up for the free tier, 50 questions, no credit card required.
If you’re ready to commit to passing the ARRT Boards on the first attempt, the Premium subscription unlocks the full bank and the timed mocks for the 60–90 days you need.