Ch. 3 - Chest & Abdomen Questions

Question 1

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

Answer 1

a. 1 and 2 only

Question 2

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

Answer 2

d. 1, 2, 3, and 4

Question 3

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

Answer 3

d. 2, 3, and 4

Question 4

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

Answer 4

d. 1 and 4 only

Question 5

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 mispositioned 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.

Answer 5

c. The patient’s upper midcoronal plane was tilted toward the IR

Question 6

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

Answer 6

d. 2 and 4 only

Question 7

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

Answer 7

c. 2 and 3 only

Question 8

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 and/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

Answer 8

a. 1, 2, and 4 only

Question 9

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

Answer 9

a. 1 only

Question 10

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.

Answer 10

c. The humeri were positioned at a 90-degree angle with the body

Question 11

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

a. Left
b. Right

Answer 11

b. Right

Question 12

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

a. Left
b. Right

Answer 12

b. Right

Question 13

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 13

b. 1, 2, and 3 only

Question 14

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

Answer 14

d. 1 and 4 only

Question 15

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

Answer 15

a. 1 and 3 only

Question 16

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

Answer 16

a. 1 and 2 only

Question 17

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

Answer 17

d. 1, 2, 3, and 4

Question 18

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

Answer 18

d. 2 and 4 only

Question 19

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

Answer 19

b. 2 and 3 only

Question 20

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

Answer 20

d. 1, 2, 3, and 4

Question 21

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

Answer 21

a. 1 and 4 only

Question 22

For a lateral neonatal or infant chest projection, the

1. neonate or infant remains supine.
2. neonate or infant is elevated on a radiolucent sponge.
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

Answer 22

a. 1 and 2 only

Question 23

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

Answer 23

c. Thoracic vertebrae

Question 24

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.

Answer 24

d. Air in the right pleural cavity

Question 25

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.

Answer 25

c. Rotate the right side of the chest 1 inch (2.5 cm) posteriorly

Question 26

An AP chest projection obtained with the central ray angled too caudally demonstrates:

a. less than 1 inch (2.5 cm) of the apices above the clavicles and horizontally shaped posterior ribs.
b. less than 1 inch (2.5 cm) of the apices above the clavicles and vertically shaped posterior ribs.
c. more than 1 inch (2.5 cm) of the apices above the clavicles and vertically shaped posterior ribs.
d. more than 1 inch (2.5 cm) of the apices above the clavicles and horizontally shaped posterior ribs.

Answer 26

c. More than 1 inch (2.5 cm) of the apices above the clavicle and vertically shaped posterior ribs

Question 27

The right SC joint is visible away from the vertebral column, whereas 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.

Answer 27

a. Adjust the central ray angulation toward the left side of the patient

Question 28

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 angled too cephalically.

Answer 28

b. Was taken with the central ray angled too cephalically

Question 29

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

Answer 29

d. Psoas major muscle, kidneys, inferior ribs, and lumbar transverse processes

Question 30

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 a 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.

Answer 30

a. Was taken with the patient in an LPO position