Exam 2 (Chs. 5, 6 & 12, 13, 15)

Question 1

The key to producing quality radiographic images is

A. gaining patient trust and cooperation

B. presenting a confident, caring image

C. communicating effectively

D. All of the above

Answer 1

D. All of the above

Question 2

List four aspects of patient relations that help to gain confidence

Answer 2

1. Appearance
2. Attitude
3. interpersonal skills
4. communication

Question 3

Dental radiographers with a positive attitude are more likely to produce high-quality radiographs?

T/F

Answer 3

True

Question 4

When a patient trusts the radiographer, the patient is more likely to cooperate with the radiographic procedure.

T/F

Answer 4

True

Question 5

The ability to share the patient’s emotions and feelings is called?

Answer 5

empathy

Question 6

Each of the following will enhance verbal communication EXCEPT one. Which one is the EXCEPTION?

A. Face the patient

B. Make eye contact

C. Use clear commands

D. Use slang words

Answer 6

D. Use slang words

Question 7

Which of the following words should be avoided when discussing the radiographic procedure?

A. Picture

B. Zap

C. X-ray

D. Radiograph

Answer 7

B. Zap

Question 8

The use of highly technical words may confuse the patient and result in miscommunication.

T/F

Answer 8

True

Question 9

The method of show-tell-do is a beneficial way of communication with?

A. Someone who speaks a different language

B. Children

C. Hearing-impaired patients

D. All of the above

Answer 9

D. All of the above

Question 10

What is the value of patient education regarding dental radiographs?

A. Radiographer is more likely to spend less time exposing radiographs

B. Radiographer is more likely to develop a positive attitude

C. Patient is more likely to accept the treatment plan

D. Patient is more likely to request radiographs at each appointment

Answer 10

C. Patient is more likely to accept the treatment plan

Question 11

Patient education in radiography is necessary to?

A. increase the demand for oral health services.

B. Increase acceptance of oral health care recomendations.

C. Assure the patient that the radiographer is licensed.

D. Meet legally required mandates for it.

Answer 11

B. Increase acceptance of oral health care recomendations.

Question 12

Which of these is NOT an intra-oral radiograph?

A. Bitewing

B. Occlusal

C. Panoramic

D. Periapical

Answer 12

C. Panoramic

Question 13

Which radiograph is used most often to detect proximal surface dental decay?

A. Bitewing

B. Occlusal

C. Panoramic

D. Periapical

Answer 13

A. Bitewing

Question 14

Which intraoral technique satisfies more shadow-casting principles?

A. Bisecting

B. Paralleling

Answer 14

B. Paralleling

Question 15

Each of the following is a shadow casting principle EXCEPT one. Which one is the EXCEPTION?

A. object and image receptor should be perpendicular to each other

B. object and image receptor should be as close as possible to each other

C. object should be as far as practical from the target

D. radiation should strike thee object and image receptor perpendicularly

Answer 15

A. object and image receptor should be perpendicular to each other

Question 16

Which of these factors does NOT need to be considered when deciding which image receptor size to use when exposing a full mouth series?

A. Age of the patient

B. Shape of the dental arches

C. Previous accumulated exposure

D. Patient’s ability to tolerate the image receptor

Answer 16

C. Previous accumulated exposure

Question 17

What is the minimum image receptor requirement for an adult full mouth series of Periapical radiographs?

A. 12

B. 14

C. 16

D. 18

Answer 17

B. 14

M PM C IN C PM M

M PM C IN C PM M

Question 18

How many size #2 image receptors are required by most health care practices for the exposure of posterior radiographs of a full mouth series?

A. 5

B. 6

C. 7

D. 8

Answer 18

D. 8

M PM PM M

M PM PM M

Question 19

Lining the image receptor up behind the right and left central and lateral incisors to include the mesial half of the right and left canines describes the image receptor placement for which of the following periapical radiographs?

A. Central incisors

B. Canines

C. Premolars

D. Molars

Answer 19

A. Central incisors

Question 20

Anterior Periapical image receptors are placed________ in the oral cavity. Posterior periapical image receptors are placed__________ in the oral cavity?

Answer 20

A = vertically

P = horizontally

Question 21

Where should the embossed identification dot be positioned when taking periapical radiographs?

A. Toward the midline of the oral cavity

B. Toward the incisal or occlusal edge of the tooth

C. Toward the palate or floor of the mouth

D. Toward the distal or back of the arch

Answer 21

B. Toward the incisal or occlusal edge of the tooth

Question 22

The x-ray tube head must be swiveled from side to side to adjust the vertical angulation of the central ray.

To avoid overlap error the central ray must be directed perpendicular to the curvature of the arch through the contact points of the teeth.

a. Both statements are true.
b. Both statements are false
c. The first statement is true. The second statement is false.
d. The first statement is false. The second statement is true

Answer 22

d.The first statement is false. The second statement is true

Question 23

At which of the following settings would the PID be pointing to the floor?

a. -30
b. 0
c. +20

Answer 23

c. +20

Question 24

An incorrect point of entry will result in

a. overlapping.
b. foreshortening.
c. cutting off the root apices.
d. conecutting

Answer 24

d.conecutting

Question 25

Which of the following is the correct seating position for the patient during radiographic examinations when an image receptor without an external aiming device is used?

a. Occlusal plane-parallel and midsaggital plane perpendicular to the floor
b. Occlusal plane perpendicular and midsaggital plane-parallel to the floor
c. Occlusal and midsaggital planes parallel to the floor
d. Occlusal and midsaggital planes perpendicular to the floor

Answer 25

a.Occlusal plane-parallel

and

midsaggital plane perpendicular to the floor

Question 26

An image receptor positioner/holder must be used with

a. the paralleling technique.
b. the bisecting technique.
c. the bitewing technique.
d. all of the above technique

Answer 26

d.all of the above technique

Question 27

Which of the following is the best sequencing for exposing a full mouth series of periapical radiographs?

a. Mandibular anteriors, maxillary anteriors, mandibular posteriors, maxillary posteriors
b. Maxillary anteriors, mandibular anteriors, maxillary posteriors, mandibular posteriors
c. Mandibular posteriors, maxillary posteriors, mandibular anteriors, maxillary anteriors
d. Maxillary posteriors, mandibular posteriors, maxillary anteriors, mandibular anteriors

Answer 27

b.Maxillary anteriors, mandibular anteriors,

maxillary posteriors, mandibular posteriors

Question 28

What shadow casting principle is NOT likely to be met when utilizing the paralleling technique?

a. Radiation should strike the object (tooth) and image receptor perpendicularly.
b. Object (tooth) should be as far as practical from the target (source of radiation).
c. Object (tooth) and image receptor should be parallel to each other.
d. Object (tooth) and image receptor should be as close as possible to each other

Answer 28

d.Object (tooth) and image receptor

should be as close as possible to each other

Question 29

To compensate for the increased object–image receptor distance needed to achieve parallelism, the target–image receptor distance should be

a. increased.
b. decreased.

Answer 29

a.increased.

Question 30

Which of the following is NOT an advantage of the paralleling technique?

a. Produces images with minimal dimensional distortion
b. Minimizes superimposition of adjacent structures
c. Satisfies more shadow-casting principles
d. Easy technique for child

Answer 30

d.Easy technique for child

Question 31

The most important reason for using a holder when utilizing the paralleling technique is to stabilize the image receptor in a position

a. at a right angle to the teeth.
b. perpendicular to the teeth.
c. parallel to the teeth.
d. parallel to the bisector

Answer 31

c.parallel to the teeth.

Question 32

Film holders designed for use with the paralleling technique should have a

a. short bite block and L-shaped backing.
b. long bite block and L-shaped backing.
c. short bite block and no backing.
d. long bite block and no back

Answer 32

b.long biteblock and L-shaped backing.

Question 33

Which of the following is an example of a holder that can be used with both the paralleling and the bisecting techniques?

a. SUPA®
b. Uni-GripAR®
c. XCP™
d. Flip R

Answer 33

a.SUPA®

Question 34

Each of the following is a part of the assembled XCP®holder EXCEPT one. Which one is the EXCEPTION?

a. Metal arm
b. Indicator ring
c. Long biteblock
d. 105-degree angled backing

Answer 34

d.105-degree angled backing

Question 35

Lining the image receptor up behind the distal half of the canine to include the first and second premolars and mesial half of the first molar describes the placement for which of the following periapical radiographs?

a. Central incisors
b. Canine
c. Premolar
d. Molar

Answer 35

c.Premolar

Question 36

To determine the horizontal angulation for the maxillary molar periapical radiograph, the central rays of the X-ray beam should be directed at the image receptor perpendicularly through the embrasures of the

a. first and second molars.
b. second premolar and first molar.
c. first and second premolars.
d. canine and first premolar

Answer 36

a.first and second molars.

Question 37

To determine the horizontal angulation for the mandibular premolar periapical radiograph, the central rays of the x-ray beam should be directed at the image receptor perpendicularly through the embrasures of the

a. first and second molars.
b. second premolar and first molar.
c. first and second premolars.
d. canine and first premolar.

Answer 37

c.first and second premolars.

Question 38

Directing the central rays perpendicular to the plane of the image receptor and perpendicular to the long axes of the teeth describes which step of the paralleling technique?

a. Placement
b. Vertical angulation
c. Horizontal angulation
d. Point of entry

Answer 38

b.Vertical angulation

Question 39

Cutting off the root apex portion of the image on a periapical radiograph results from

a. excessive horizontal angulation.
b. inadequate horizontal angulation.
c. excessive vertical angulation.
d. inadequate vertical angulation

Answer 39

d.inadequate vertical angulation

Question 40

The bisecting technique satisfies more shadow-casting rules than the paralleling technique. A better image results when the shadow casting rules are followed.

a. The first statement is true. The second statement is false.
b. The first statement is false. The second statement is true.
c. Both statements are true.
d. Both statements are false.

Answer 40

b.The first statement is false. The second statement is true.

Question 41

Lining the image receptor up behind the distal half of the second premolar to include the first, second, and third molars describes the placement for which of the following periapical radiographs?

a. Central incisors
b. Canine
c. Premolar
d. Molar

Answer 41

d. Molar

Question 42

To determine the horizontal angulation for the mandibular premolar periapical radiograph, the central rays of the x-ray beam should be directed at the image receptor perpendicularly through the embrasures of the …

a. canine & first premolar
b. first & second premolars
c. second premolar & first molar
d. first & second molars

Answer 42

b. first & second premolars

Question 43

Elongation results from …

a. excessive horizontal angulation
b. inadequate horizontal angulation
c. excessive vertical angulation
d. inadequate vertical angulation

Answer 43

d. inadequate vertical angulation

Question 44

Which of the following statements regarding the biological effect mechanisms of the direct theory is FALSE?

a. Most dental x-ray photons pass through the cell, causing no damage.
b. X-ray photons may collide with important cell chemicals and break them apart.
c. Ionization can cause critical damage to large molecules.
d. Irradiated cells cannot be repaired.

Answer 44

d. Irradiated cells cannot be repaired.

Question 45

Which of the following statements regarding the biological effect mechanisms of the indirect effect is FALSE?

a. Ionization dissociates water into hydrogen and hydroxyl radicals.
b. Ions have a strong tendency to seek out new combinations.
c. New chemicals, such as hydrogen peroxide, can form from hydrogen and hydroxyl radicals.
d. Radiation must be massive to destroy entire body tissues that result in death.

Answer 45

b. Ions have a strong tendency to seek out new combinations.

Question 46

Which of the following is most sensitive to damage from radiation?

a. Bone cells
b. Epithelial cells
c. White blood cells
d. Muscle cells

Answer 46

c. White blood cells

According to the Law of Bergonié and Tribondeau, actively dividing cells such as white blood cells are more sensitive to radiation than are slowly dividing cells

Question 47

Which of the following statements about radiation repair is FALSE?

a. Somatic cells cannot repair radiation damage.
b. Scientists believe that some radiation effects are cumulative.
c. Ions have a strong tendency to recombine immediately to form water again.
d. The quantity, duration, and body area irradiated determine the amount of damage inflicted by the radiation.

Answer 47

a. Somatic cells cannot repair radiation damage.
* Relatively minor radiation damage can be repaired in healthy individuals at the rate of 75 percent within 24 hours in somatic cells, whereas radiation damage to reproductive cells cannot be repaired*.

Question 48

Which of the following statements regarding the theory established by a threshold dose-response curve is true?

a. There is a dose below which no biological response would be expected.
b. It predicts the effects of very low levels of radiation exposure.
c. It indicates that any amount of radiation has the potential to cause a biological response.
d. It has been adopted by the radiation protection community as the conservative approach to radiation exposure.

Answer 48

a. There is a dose below which no biological response would be expected.
* A threshold dose-response curve indicates that there is a “threshold” amount of radiation below which no biological response would be expected.*

Question 49

Each of the following is a potential effect of a low dose of radiation EXCEPT one. Which one is the EXCEPTION?

a. No cell response.
b. Cell repairs itself and functions at pre-exposure levels.
c. Cell repairs itself abnormally.
d. Cell becomes radioactive.

Answer 49

d. Cell becomes radioactive.

Several responses are possible, but the cell does not become radioactive.

Question 50

Which of the following statements regarding radiation injury is FALSE?

a. The smaller the area of tissue exposure, the greater the damage to the individual.
b. The greater the dose, the more severe the probable biological event.
c. The rate at which the radiation is absorbed may determine which biological effects occur.
d. A given dose may produce fewer biologic effects if the cells have a chance to recover.

Answer 50

a. The smaller the area of tissue exposure, the greater damage to the individual.

The smaller the area exposed, the less likely there will be radiation-induced damage.

Question 51

Which of the following statements regarding radiation injury is FALSE?

a. The amount of injury to an individual depends on the volume of tissue radiated.
b. The lethal dose (LD 50/30) for humans is 1.5 grays.
c. Younger, more rapidly dividing cells are more likely to incur damage.
d. Individuals vary in radiation sensitivity within the same species.

Answer 51

b. The lethal dose (LD 50/30) for humans is 1.5 grays.

The LD 50/30 for humans is 4.5 grays

Question 52

The lethal dose (LD 50/30) of radiation for humans is estimated to be:

a. 4,500 grays.
b. 450 grays.
c. 45 grays.
d. 4.5 grays.

Answer 52

d. 4.5 grays.

The LD 50/30 for humans is 4.5 grays.

Question 53

Which of these is NOT a symptom of acute radiation syndrome.

a. Constipation
b. Nausea
c. Hemorrhage
d. Hair loss

Answer 53

a. Constipation

Diarrhea, and not constipation, is a symptom of acute radiation syndrome.

Question 54

Which of the following is NOT a component of the Law of Bergonié and Tribondeau?

a. Actively dividing cells are less sensitive.
b. Immature cells are more sensitive.
c. More specialized cells are more radioresistant.
d. Cells are most susceptible to injury during cell division.

Answer 54

a. Actively dividing cells are less sensitive.

Cells with a potential for rapid division are more sensitive to radiation than those that do not divide.

Question 55

Which of the following groups of cells are correctly ranked in order of radiosensitivity beginning with the most sensitive?

a. Muscle, brain, red blood, white blood
b. Reproductive, bone, nerve, muscle
c. Brain, bone, connective tissue, white blood
d. Red blood, bone, muscle, epithelial

Answer 55

b. Reproductive, bone, nerve, muscle

The more specialized a cell is, the more radioresistant it is. The exceptions to this law are white blood cells (lymphocytes) and reproductive cells (oocytes), which do not divide and are very specialized, and yet are radiosensitive.

Question 56

Continued exposure to radiation over prolonged periods may result in each of the following EXCEPT one. Which one is the EXCEPTION?

a. It may alter the ability of genetic cells to reproduce normally.
b. It may affect the ability of genetic cells to repair damage.
c. It may produce offspring with increased resistance to radiation exposure.
d. It may result in cumulative chromosome damage.

Answer 56

c. It may produce offspring with increased resistance to radiation exposure.

The experts do not fully understand all the effects of radiation exposure or their future consequences, but there is no evidence that radiation exposure produces an immunity to radiation effects in future generations.

Question 57

What is the approximate surface (skin) dose of radiation from a full mouth series of 18 F-speed films, exposed at 90 kVp with a 16-inch (41-cm)-length PID?

a. 30 mSv
b. 50 mSv
c. 75 mSv
d. 100 mSv

Answer 57

a. 30 mSv

A full mouth series of 18 F-speed films, exposed at 90 kVp with a 16-inch [41-cm]-length PID is approximately 30 mSv skin exposure.

Question 58

Which of these periods immediately follows radiation exposure?

a. The period of injury
b. The latent period
c. The reparable damage period
d. The recovery period

Answer 58

b. The latent period

Following the initial radiation exposure, and before the first detectable effect occurs, a time lag called the “latent period” occurs.

Question 59

When the severity of change is dependent on the radiation dose, the effect is called a/an:

a. stochastic effect.
b. deterministic effect.
c. acute radiation effect.
d. lethal dose effect.

Answer 59

b. deterministic effect.

When the severity of the change is dependent on the dose, the effect is called a “deterministic effect.”

Question 60

At what dose of whole-body radiation would an observable short-term effect of acute radiation syndrome result?

a. 0.01 Gy
b. 0.25 Gy
c. 0.50 Gy
d. 1.0 Gy

Answer 60

d. 1.0 Gy

If the dose of radiation is large enough (generally over 1.0 Gy or 100 rads, whole body), the resultant signs and symptoms that comprise these short-term effects are collectively known as acute radiation syndrome (ARS).

Question 61

Tissues have the capacity to repair radiation damage to a certain degree. However, some damage cannot be repaired and remains weakened, especially with repeated exposures. This is called:

a. a long-term effect.
b. radioresistant tissue.
c. a cumulative effect.
d. a stochastic effect.

Answer 61

c. a cumulative effect.

A cumulative effect refers to the theory that radiation-exposed tissues accrue damage and may function at a diminished capacity with each repeated exposure.

Question 62

What theory of radiation damage to cells results from free radicals combining to form toxins such as hydrogen peroxide?

a. Primary
b. Secondary
c. Indirect
d. Direct

Answer 62

c. Indirect

Indirect theory is based on the assumption that radiation can cause chemical damage to the cell by ionizing the water within it. Ionization dissociates water into hydrogen and hydroxyl radicals that can form new chemicals such as hydrogen peroxide that act as toxins (poisons) to the body, causing cellular dysfunction.

Question 63

A threshold dose-response relationship indicates that any dose, regardless of amount, can be expected to produce a biologic response.

A linear dose-response relationship indicates that the biologic response is directly proportional to the dose.

a. The first statement is true. The second statement is false.
b. The first statement is false. The second statement is true.
c. Both statements are true.
d. Both statements are false.

Answer 63

b. The first statement is false. The second statement is true.

A nonthreshold dose-response relationship indicates that any dose, regardless of amount, can be expected to produce a biologic response. A linear dose-response relationship indicates that the biologic response is directly proportional to the dose.

Question 64

Scientists do not know whether low levels of radiation exposure carry health risks.

True

False

Answer 64

True

Much of our knowledge base regarding the negative effects of exposure to radiation comes from extrapolated data using high doses and dose rates. Scientists do not know whether a threshold level exists, below which radiation would be safe. To err on the side of caution, the radiation protection community assumes that any dose of radiation may pose a risk.

Question 65

A less specialized cell is more radioresistant.

True

False

Answer 65

False

According to the Law of Bergonié and Tribondeau, the more specialized a cell is, the more radioresistant the cell.

Question 66

A nonthreshold dose-response curve indicates that there is a certain level of radiation below which no biological response should be anticipated.

True

False

Answer 66

False

A threshold dose-response curve indicates that there is a threshold amount of radiation below which no biological effects would be expected.

Question 67

The ALARA concept means “As Low As Reasonably Achievable.”

True

False

Answer 67

True

Radiation biologists are not certain whether a threshold radiation dose exists. Therefore, radiation protection guidelines assume that every dose of radiation produces damage and should be kept to the minimum necessary to meet diagnostic requirements.

Question 68

The effects of radiation depends on the type of energy and duration of the exposure.

True

False

Answer 68

True

Both of these will affect the potential of a biological effect.

Question 69

All humans have the same sensitivity to radiation.

True

False

Answer 69

False

Individuals vary in sensitivity within the same species. Some individual’s genetic makeup predisposes them to be more sensitive to genetic damage from radiation than other individuals.

Question 70

All cells in the human body have the same sensitivity to radiation.

True

False

Answer 70

False

There is a wide variation in sensitivity to radiation among different types of cells and tissues. Cells that rapidly divide are much more sensitive to radiation than specialized cells, which rarely, if ever, divide.

Question 71

X-rays have been shown to have carcinogenic effects.

True

False

Answer 71

True

Anything capable of causing cancer is called a “carcinogen.” X-rays can cause cancer by a variety of mechanisms.

Question 72

The structures of the oral and facial regions are relatively radioresistant.

True

False

Answer 72

True

The maxillofacial structures, composed largely of specialized tissues such as bone, nerve, and muscle, are relatively radioresistant.

Question 73

The Law of Bergonié and Tribondeau states that cells are most sensitive to radiation injury during mitosis (cell division).

True

False

Answer 73

True

The first half of the Law of Bergonié and Tribondeau states that actively dividing cells, such as red blood cells, are more sensitive than slowly dividing cells.

Question 74

The biological effects of very low levels of radiation cannot be predicted.

True

False

Answer 74

True

Radiobiologists have been unable to determine what, if any, effects result from exposure to very low levels of radiation.

Question 75

Radioresistant refers to those tissues that are protected by the lead apron and thyroid collar during a dental x-ray exposure.

True

False

Answer 75

False

Radioresistant refers to a substance or tissue that is not easily injured by ionizing radiation.

Question 76

The latent period refers to the time between exposure to radiation and the ionization of molecules.

True

False

Answer 76

False

The latent period refers to the time between exposure to radiation and the first clinically observable symptoms.

Question 77

When radiation affects any cells of the body except the reproductive cells, the effect is called indirect.

True

False

Answer 77

False

When radiation affects all body cells except the reproductive cells, it is called a “somatic effect.”

Question 78

A stochastic effect is when a biological response is based on the probability of occurrence rather than the severity of the change.

True

False

Answer 78

True

When a biological response is based on the probability of occurrence rather than the severity of the change, it is called a “stochastic effect.”

Question 79

Cancer is a stochastic effect of exposure to radiation.

True

False

Answer 79

True

The occurrence of cancer is a stochastic effect of radiation exposure; it is an “all-or-nothing” occurrence.

Question 80

Erythema is a stochastic effect of exposure to radiation.

True

False

Answer 80

False

Erythema, or reddening of the skin, is expected to be more or less severe with an increase or decrease in radiation dose, respectively. When the severity of the change is dependent on the dose, the effect is called a “**deterministic effect.”

Question 81

Because they do not divide and are very specialized, reproductive cells are radioresistant.

True

False

Answer 81

False

Reproductive cells (oocytes) are very radiosensitive even though they do not divide and are very specialized. They are one of the exceptions to the Law of Bergonié and Tribondeau.

Question 82

White blood cells (lymphocytes) and reproductive cells (oocytes) are two exceptions to the Law of Bergonié and Tribondeau, which states cells that do not divide and are very specialized are radioresistant.

True

False

Answer 82

True

The Law of Bergonié and Tribondeau states that actively dividing, specialized cells are usually radioresistant. The exceptions to this law are white blood cells (lymphocytes) and reproductive cells (oocytes), which do not divide, are very specialized and yet are radiosensitive.

Question 83

The average effective dose equivalent from naturally occurring background radiation to the population of the United States is approximately 8 µSv (microsieverts) per day.

True

False

Answer 83

True

Background radiation, defined as ionizing radiation that is always present in our environment, exposes the population of the United States to approximately 8 µSv (microsieverts) per day.

Question 84

Each of the following statements regarding radiation protection measures for the patient is correct EXCEPT one. Which one is the EXCEPTION?

a. The oral health care team should embrace the ALARA concept.
b. Radiographs must be taken on all new patients.
c. Evidence-based selection criteria should be used when determining which patients need radiographs.
d. The radiographer should possess a working knowledge of appropriate exposure factors.

Answer 84

b. Radiographs must be taken on all new patients.

In maintaining ALARA, copies of radiographs, if available, taken at another practice should be requested to avoid unnecessary additional radiation exposure to the patient.

Question 85

Each of the following statements regarding the technical ability of radiographers is correct EXCEPT one. Which one is the EXCEPTION?

a. They have the ability to communicate clear and concise instructions to the patient.
b. They possess a thorough understanding of how to produce quality images
c. They understand how to perform dental x-ray machine inspections
d. They participate in continuing education

Answer 85

c. They understand how to perform dental x-ray machine inspections

While the dental assistant and dental hygienist may perform quality control tests periodically on dental x-ray machines, inspections, especially when required by law, are to be performed by a qualified radiological technician.

Question 86

The federal performance standard for diagnostic x-ray equipment requires that all x-ray equipment meet each of the following radiation safety requirements EXCEPT one. Which one is the EXCEPTION?

a. Collimators may be round or rectangular.
b. Both inherent and added filtration is usually required.
c. Aluminum filters are required to remove long wavelength x-rays from the beam.
d. A pointed, closed-end PID is acceptable.

Answer 86

d. A pointed, closed-end PID is acceptable.

Only round or rectangular open-ended PIDs are currently acceptable.

Question 87

Which of the following statements regarding x-ray equipment is FALSE?

a. A short (8 in/20.5 cm) PID delivers less radiation to the patient.
b. Total filtration is the sum of inherent and added filtration.
c. A filter placed in the path of the x-ray beam reduces patient radiation exposure.
d. An external collimator can be attached to the PID to achieve rectangular collimation.

Answer 87

a. A short (8 in/20.5 cm) PID delivers less radiation to the patient.

A long (12 or 16 in/30 or 41 cm) PID produces a less divergent x-ray beam, resulting in an exit beam diameter that exposes the patient less than a short (8 in/20.5 cm) PID.

Question 88

Which of the following statements about the position indicating device (PID) is correct?

a. The shorter the PID, the less divergent the beam.
b. The longer the PID, the greater the radiation dose to the patient.
c. Pointed, closed-end plastic cone PIDs should no longer be used.
d. A recessed PID creates a shorter target-surface distance.

Answer 88

c. Pointed, closed-end plastic cone PIDs should no longer be used.

The tip of the pointed cone was supposed to indicate the central ray and aid in positioning. However, x-rays are deflected through contact with the material of the pointed cone, producing scatter radiation, so their use should be discontinued

Question 89

Which of the following statements regarding lead aprons is FALSE?

a. They are fabricated of 0.25-mm lead or lead-equivalent materials.
b. They should be folded and stored when not in use.
c. They provide a protective barrier against scatter radiation.
d. Their use is in keeping with the ALARA concept.

Answer 89

b. They should be folded and stored when not in use.

Lead aprons should be stored flat or hung unbent. Folding the lead apron may cause the material to crack, rendering the apron defective.

Question 90

Which film speed requires the least amount of radiation exposure to produce a diagnostic-quality image?

a. D
b. E
c. F
d. G

Answer 90

c. F

E-speed film provides a 50 percent reduction in radiation exposure over D-speed. F-speed film provides a 20 percent reduction in radiation exposure over E-speed.

Question 91

Which of the following statements is FALSE?

a. Processing errors increase patient radiation exposure by resulting in retake radiographs.
b. Following the time-temperature method of processing radiographs produces images of ideal quality.
c. Careful attention to chemical replenishment avoids retakes.
d. It is acceptable to increase the dose while underdeveloping the film if time is short.

Answer 91

d. It is acceptable to increase the dose while underdeveloping the film if time is short.

While increasing the dose and underdeveloping the film may produce an acceptable image and save time, it is unethical to unnecessarily increase radiation dose to a patient.

Question 92

Which of the following statements regarding protection measures for the operator during exposure is FALSE?

a. The ideal angle to stand from the path of the exiting x-ray beam is 180 degrees.
b. A drifting tube head should not be held in place by the radiographer or the patient.
c. The radiographer should stand at least 6 feet from the head of the patient.
d. A structural barrier provides adequate protection during exposure.

Answer 92

a. The ideal angle to stand from the path of the exiting x-ray beam is 180 degrees.
* The ideal angle to stand from the path of the exiting x-ray beam is 45 degrees.*

Question 93

Which of the following statements regarding radiation monitoring is FALSE?

a. Area monitoring measures output of the x-ray machine.
b. A radiation monitoring service provides a reliable record of occupational radiation exposure.
c. Personnel monitoring devices protect the wearers from scatter radiation.
d. TLDs and OSLs are examples of personnel monitoring devices.

Answer 93

c. Personnel monitoring devices protect the wearers from scatter radiation.

The radiation monitoring device cannot protect the wearer from radiation. The device indicates that an exposure has occurred.

Question 94

Dental radiation exposure to the patient can be reduced by each of the following EXCEPT one. Which one is the EXCEPTION?

a. Using the fastest speed film currently available
b. Prescribing exams based on evidence-based selection criteria
c. Holding the image receptor in the patient’s mouth
d. Restricting the size and shape of the x-ray beam

Answer 94

c. Holding the image receptor in the patient’s mouth

The radiographer must never hold the image receptor in the patient’s mouth. A guardian or caregiver may assist if necessary but must be protected with lead/lead-equivalent barriers. Using an assistant will have no effect on reducing the radiation dose to the patient.

Question 95

The ALARA concept implies that:

a. any radiation dose that can be reduced without major difficulty, great expense, or inconvenience, should be reduced or eliminated.
b. if a radiation dose cannot be reduced without major difficulty, great expense, or inconvenience, then no radiographs should be exposed.
c. radiation dosages slightly above the acceptable level of risk are acceptable only in emergency treatment situations.
d. fewer radiographs should be taken only if a radiation dose cannot be reduced due to major difficulty, inconvenience, and great expense.

Answer 95

a. any radiation dose that can be reduced without major difficulty, great expense, or inconvenience, should be reduced or eliminated.

The ALARA concept implies that any radiation dose that can be reduced without major difficulty, great expense, or inconvenience should be reduced or eliminated.

Question 96

The best way to reduce patient radiation exposure is to:

a. expose routine radiographs.
b. determine the risk/benefit ratio prior to exposure.
c. develop office policy for the maximum number of exposures permissible per patient.
d. use evidence-based selection criteria for prescribing radiographs.

Answer 96

d. use evidence-based selection criteria for prescribing radiographs.
* The most important way to ensure that the patient receives a reasonably low dose of radiation is to use evidence-based* selection criteria when determining which patients need radiographs.

Question 97

Guidelines for prescribing radiographs are based on:

a. medical and dental histories.
b. clinical examination.
c. signs and symptoms.
d. All of the above.

Answer 97

d. All of the above.

Evidence-based selection criteria guidelines are applied only after reviewing the patient’s health history and completing a clinical examination.

Question 98

The function of the collimator in the dental x-ray machine is to:

a. eliminate secondary sources of radiation.
b. reduce the size of the x-ray beam.
c. eliminate primary sources of radiation.
d. allow for faster exposure times.

Answer 98

b. reduce the size of the x-ray beam.
* The collimator constricts the diameter of the x-ray beam to reduce the radiation dose to the patient by reducing the volume of tissue exposed.*

Question 99

The purpose of aluminum filtration is to:

a. absorb the penetrating short wavelengths that fog films unnecessarily.
b. reduce the radiation to the patient by reducing the volume of tissue exposed.
c. eliminate the sources of scatter or secondary radiation to the patient.
d. absorb the less penetrating long wavelengths to reduce radiation exposure.

Answer 99

d. absorb the less penetrating long wavelengths to reduce radiation exposure.
* A filter is an absorbing material (usually aluminum) placed in the path of the x-ray beam to remove a high percentage of the soft x-rays (the longer wavelengths) and reduce patient radiation dose.*

Question 100

A less divergent x-ray beam will:

a. increase the radiation dose to the patient.
b. result in lower-quality radiographic images.
c. create a smaller diameter of exposure.
d. require added filtration.

Answer 100

c. create a smaller diameter of exposure.

The less divergent x-ray beam creates a smaller diameter of exposure.

Question 101

Which of the following will reduce radiation to the patient the most?

a. Fast film speeds.
b. Thyroid collars.
c. Image receptor holders.
d. Rectangular PIDs.

Answer 101

d. Rectangular PIDs.

Rectangular PIDs reduce patient radiation dose by 70 percent.

Question 102

Each of the following protects the radiographer from radiation EXCEPT one. Which one is the EXCEPTION?

a. Wearing a personnel-monitoring device
b. Increased distance from the source of radiation
c. Standing behind protective shielding during exposure
d. Spending less time near radiation-producing equipment

Answer 102

a. Wearing a personnel-monitoring device

Personnel-monitoring devices play a valuable role in recording radiation exposures, but they do not stop radiation from exposing the wearer.

Question 103

A personnel monitoring device can NOT:

a. record the amount of radiation received.
b. measure the amount of radiation received.
c. protect the operator from receiving radiation.
d. indicate the type of radiation received.

Answer 103

c. protect the operator from receiving radiation.

Personnel-monitoring devices play a valuable role in recording the amount and type of radiation received, but they do not stop radiation from exposing the wearer.

Question 104

The best way to reduce patient risk from radiation exposure is to keep exposures ALARA.

True

False

Answer 104

True

While gaining diagnostic benefits from dental radiographs with zero exposure would be ideal, that is not possible. However, the oral health care team should strive for low-dose, high-yield radiography by obtaining the maximum information with the lowest possible dose.

Question 105

Guidance for deciding when, what type, and how many radiographs to expose on a patient have been developed and should be followed.

True

False

Answer 105

True

Expert-recommended evidence-based guidelines are available for the dentist to consult.

Question 106

A rectangular PID requires a larger dose of radiation to produce a diagnostic-quality radiograph than a circular PID.

True

False

Answer 106

False

Round collimators must restrict the x-ray beam to 2.75 inches (7 cm) at the patient end of the PID, while rectangular collimators expose an area slightly greater than a size #2 film. Considerable excess radiation that contributes nothing to the image occurs with round collimation.

Question 107

Pure aluminum will not hinder the passage of high-energy x-rays.

True

False

Answer 107

True

Use of aluminum filters removes from the beam a high percentage of low-energy x-rays that increase radiation exposure but do not contribute useful information to the image.

Question 108

Fast film requires less radiation for exposure and is essential for reducing radiation to the patient.

True

False

Answer 108

True

There are currently three commercially available dental x-ray film speeds: D, E, and F. Compared to D-speed film, E-speed film is twice as fast and requires only half the exposure. F-speed film further reduces radiation exposure by 20 percent compared to E-speed film.

Question 109

Increasing the dose of radiation is a recommended method to compensate for weak processing solutions.

True

False

Answer 109

False

In the past, unethical practitioners might not replenish or change processing chemical solutions according to schedule in order to save time and money. To compensate for the weakening solutions, an increase in radiation dose would be used. It is unethical practice to knowingly use a higher dose of radiation than necessary to achieve a diagnostic image.

Question 110

Thermoluminescent dosimeters (TLDs) contain crystals that absorb energy when exposed to radiation.

True

False

Answer 110

True

TLDs contain lithium fluoride crystals which, when heated after exposure to radiation, give off energy in the form of visible light. The amount of light emitted is proportional to the amount of radiation absorbed by the crystals, making TLDs very accurate radiation monitoring devices.

Question 111

The maximum permissible dose (MPD) for oral health care professionals is 50 mSv/year.

True

False

Answer 111

True

The MPD for the general public is 5 mSv/year. The dose is higher for radiation workers but is still far below a level capable of causing detectable damage.

Question 112

Medical, dental, and therapeutic radiation is included in the MPD.

True

False

Answer 112

False

Necessary medical or dental diagnostic or therapeutic radiation is not counted in the MPD. If a patient needs radiographic services, then that patient needs radiographic services.

Question 113

Regulations governing the use of radiation-producing equipment include federal, state, and some local laws.

True

False

Answer 113

True

There are regulations promulgated by federal and state, and in some cases, county and city, governments which all need to be followed. The oral health care practice needs to be aware of and comply with all regulations that govern the use of ionizing radiation.

Question 114

The United States Nuclear Regulatory Commission has developed dose limits for radiographers and patients.

True

False

Answer 114

True

The United States Nuclear Regulatory Commission has developed radiation protection guidelines referred to as the maximum permissible dose (MPD) for the protection of radiation workers and the general public.

Question 115

The National Committee on Radiation Protection principle to keep exposure down, based on the idea that all radiation, no matter how small the dose, may cause adverse biological effects, is called “ALARA.”

True

False

Answer 115

True

The ALARA concept implies that any radiation dose that can be reduced without major difficulty, great expense, or inconvenience should be reduced or eliminated.

Question 116

Federal regulations require that the intraoral x-ray beam be collimated to a diameter of 3.75 inches at the patient’s skin.

True

False

Answer 116

False

Federal regulations require that the intraoral x-ray beam be collimated to a diameter of 2.75 inches at the patient’s skin.

Question 117

If the tube head support arm drifts from its appropriate position when taking a radiograph, the radiographer should ask the patient to hold the PID stable during the exposure.

True

False

Answer 117

False

A drifting tube head should never be held during the exposure either by the radiographer or the patient. Radiation leakage from the tube head can be significant. If the tube head drifts, it should be serviced to stabilize it.

Question 118

If the area of interest is imaged correctly on an adjacent radiograph, it is possible that an undiagnostic radiograph may not need to be retaken.

True

False

Answer 118

• True*
• Not every undiagnostic radiograph must be retaken. If multiple radiographs are taken at the same time, the radiographer should check to see if the area of interest is imaged on an adjacent radiograph. Sometimes a retake radiograph may be avoided if the area of interest is imaged diagnostically on an adjacent radiograph.*

Question 119

Based on evidence-based selection criteria for keeping radiation exposure ALARA, an adult recall patient with no risk factors for caries would most likely be assessed for bitewing radiographs annually.

True

False

Answer 119

False

Based on evidence-based selection criteria, an adult recall patient with no risk factors for caries would most likely be assessed for bitewing radiographs every 24 to 36 months.

Question 120

Based on evidence-based selection criteria for keeping radiation exposure ALARA, a child recall patient with several risk factors for caries would most likely be assessed for bitewing radiographs every 6 to 12 months.

True

False

Answer 120

True

Based on evidence-based selection criteria, a child recall patient with several risk factors for caries would most likely be assessed for bitewing radiographs every 6 to 12 months.

Question 121

Based on evidence-based selection criteria for keeping radiation exposure ALARA, a high level of caries experience or demineralization increases a patient’s risk for future caries.

True

False

Answer 121

True

A high level of caries experience or demineralization is one of the factors increasing risk for caries listed by the evidence-based selection criteria.

Question 122

High-energy x-rays are the most harmful to the patient because they easily penetrate to the deep tissues of the body.

True

False

Answer 122

False

Low-energy x-rays are harmful to the patient because they are absorbed by the skin, increasing the patient’s dose.

Question 123

Each of the following plays a role in gaining patient confidence and cooperation EXCEPT one. Which one is the EXCEPTION?

a. Appearance
b. Anxiety
c. Attitude
d. Communication

Answer 123

b. Anxiety

Appearance, attitude, interpersonal skills, and communication are needed to gain patient trust and confidence. A confident radiographer will foster confidence in the patient, who, in turn, will be better able and willing to follow directions during the procedure.

Question 124

Which of these statements regarding patient relations is FALSE?

a. Respectfulness and courtesy are examples of interpersonal skills.
b. The radiographer’s attitude toward his or her own technical ability is conveyed to the patient.
c. If a patient has concerns regarding x-ray exposure, the radiographer should tell the patient not to worry, everything will be okay.
d. If the radiographer feels the procedure is unnecessary or uncomfortable, these feelings will be conveyed to the patient.

Answer 124

c. If a patient has concerns regarding x-ray exposure, the radiographer should tell the patient not to worry, everything will be okay.

Statements such as “Don’t worry” and “Everything will be okay” convey an attitude of apathy or imply that the patient’s feelings do not matter.

Question 125

Which of the following statements regarding interpersonal skills is best?

a. The radiographer should praise the patient for their assistance with the procedure.
b. Acknowledge mistakes with an easygoing “Oops,” indicating that it is not serious.
c. It is natural to show frustration with a patient who is having difficulty managing the procedure.
d. If a patient is feeling discomfort, tell him or her to hang on and be patient.

Answer 125

a. The radiographer should praise the patient for their assistance with the procedure.

Positive reinforcement and feedback that the procedure is going well will help foster more cooperation.

Question 126

Each of the following statements regarding communication is correct EXCEPT one. Which one is the EXCEPTION?

a. Patient questions must be answered honestly to develop trust.
b. Communication is the process by which information is exchanged between two or more people.
c. Establish how you will communicate with the patient prior to putting on the mask required for radiographic procedures.
d. In an uncomfortable discussion, avoid eye contact with the patient.

Answer 126

d. In an uncomfortable discussion, avoid eye contact with the patient.

Effective use of words in verbal communication begins with facing the patient directly and maintaining eye contact.

Question 127

Each of the following statements regarding effective nonverbal communication is correct EXCEPT one. Which one is the EXCEPTION?

a. Nonverbal communication is not very believable.
b. A nod of the head indicates “yes” or agreement.
c. A smile by the radiographer can help to relax the patient and reduce apprehension.
d. Facial expressions strongly convey the attitude of the radiographer.

Answer 127

a. Nonverbal communication is not very believable.

We usually use a combination of verbal and nonverbal communication. Nonverbal communication is very believable and often conveys the strongest message.

Question 128

Which of these statements is FALSE?

a. A panoramic radiograph records all maxillary and mandibular teeth and surrounding bone.
b. Adults generally need x-rays more often than children.
c. X-ray exams should be individualized for each patient.
d. Radiographs may aid in the evaluation of periodontal diseases.

Answer 128

b. Adults generally need x-rays more often than children.

Children generally need dental x-rays more often than adults because they are still developing and the teeth are more likely to be affected by decay than those of adults.

Question 129

Which of the following statements is correct?

a. The measurement term “gray” indicates comparisons between different types of radiation.
b. Exposures are recorded with the term “sievert.”
c. The amount of radiation absorbed by the tissue is referred to as the dose.
d. mSv stands for one-hundredth of a sievert.

Answer 129

c. The amount of radiation absorbed by the tissue is referred to as the dose.

When human tissue is exposed to radiation, some of the energy is absorbed and some passes through without effect. The amount of energy absorbed by the tissue is the dose.

Question 130

Which of these statements is FALSE?

a. The radiographer must remain in the room during the exposure to be sure the patient does not move.
b. A lead/lead-equivalent apron and thyroid collar can be used to protect the patient from stray radiation.
c. Scientists know that exposure to large doses of radiation is more likely to cause biological harm.
d. The risk of harmful effects from dental x-ray exams is extremely small.

Answer 130

a. The radiographer must remain in the room during the exposure to be sure the patient does not move.

If the radiographer did not leave the room or stand behind a barrier, he/she would be exposed to needless radiation many times a day. Even though the amount of exposure each time is small, the cumulative dose over time is not necessary.

Question 131

Which of the following statements regarding dental radiography during pregnancy is correct?

a. It causes premature delivery.
b. It overexposes the area of the developing fetus.
c. It has been linked to full-term, low birth-weight infants.
d. It creates birth defects.

Answer 131

c. It has been linked to full-term, low birth-weight infants.

Dental radiography during pregnancy is associated with low birth weight, especially in full-term pregnancies. Whether dental radiation affects the reproductive organs directly or whether exposure of the thyroid gland affects pregnancy outcomes indirectly is not yet known.

Question 132

Each of the following is a precaution that minimizes the amount of radiation a patient receives EXCEPT one. Which one is the EXCEPTION?

a. Take only necessary radiographs.
b. Use the slowest film speed currently available.
c. Use collimating equipment that restricts the beam size and shape.
d. Cover all patients with a lead/lead-equivalent apron and thyroid shield.

Answer 132

b. Use the slowest film speed currently available.

The fastest type of x-ray film currently available should be used to minimize exposure.

Question 133

Which of the following statements would be acceptable communication with a patient?

a. “We need to retake your radiographs because the films got stuck in the processor again.”
b. “This tube head always drifts.”
c. “This x-ray machine is making a strange noise. Let’s see if it will affect your radiographs.”
d. “Your radiographs are too dark but we corrected the problem. Let’s take them again.”

Answer 133

d. “Your radiographs are too dark but we corrected the problem. Let’s take them again.”

Being honest about problems gains patient’s confidence. However, care must be taken to not imply that defective equipment has been used on the patient.

Question 134

If you are uncertain of the correct pronunciation of the patient’s name:

a. ask the patient to pronounce his or her name for you.
b. pronounce the name phonetically and let the patient correct you.
c. ask the receptionist for the correct pronunciation.
d. address the patient using his or her first name.

Answer 134

a. ask the patient to pronounce his or her name for you.

Always greet the patient by name. Address the patient using their proper title (Miss, Mrs., Ms., Mr., Dr., etc.) and last name. If you are uncertain of the correct pronunciation of the patient’s name, ask the patient to pronounce it for you.

Question 135

Which attitude is more likely to gain the patient’s trust with respect to the radiographer’s ability?

a. “I know this is an uncomfortable procedure, so I’ll be as quick as possible.”
b. “This is an easy procedure, but I need you to help by slowly closing.”
c. “I always gag on the back ones, so I understand your apprehension.”
d. “A small mouth makes it difficult, but this will only be for a few seconds.”

Answer 135

b. “This is an easy procedure, but I need you to help by slowly closing.”

If the radiographer feels that the procedure is uncomfortable or unnecessary, these feelings will be conveyed to the patient. The radiographer should not impose his or her own feelings onto the patient.

Question 136

Which communication to a patient is contraindicated during radiographic procedures?

a. “Open wider, please.”
b. “I need you to slowly close.”
c. “This won’t hurt a bit.”
d. “Breathe through your nose.”

Answer 136

c. “This won’t hurt a bit.”

Telling the apprehensive patient, “This won’t hurt a bit” may convey an attitude of apathy, or imply that the patient’s apprehensions do not matter.

Question 137

Effective verbal communication begins with:

a. facing the patient directly, maintaining eye contact, and giving specific directions.
b. speaking lower than the patient’s educational level to ensure that directions are understood.
c. giving instructions quickly to minimize the length of time the patient must bite down.
d. repeating requests several times to greater facilitate comprehension.

Answer 137

a. facing the patient directly, maintaining eye contact, and giving specific directions.
* Effective use of words in* verbal communication begins with facing the patient directly and maintaining eye contact.

Question 138

Which word is least likely to be understood by the average patient?

a. Dental film
b. X-ray film
c. Radiograph
d. Periapical

Answer 138

d. Periapical

The radiographer’s choice of words and sentence structure are important. Words used should be at a level the patient can understand. Too many highly technical words may confuse the patient and result in misunderstandings.

Question 139

Which of the following are considered forms of nonverbal communication?

a. Facial expressions
b. Body movements
c. Listening
d. All of the above

Answer 139

d. All of the above
* Nonverbal communication includes gestures, facial expressions, body movement, and listening.*

Question 140

Which of the following best responds to this patient question: “How often should children have dental x-rays?”

a. Every 6 months
b. Once a year
c. Whenever the child needs them
d. After the first permanent molars erupt

Answer 140

c. Whenever the child needs them

How often radiographs (dental x-rays) should be taken depends on the patient’s individual health needs. It is important to recognize that just as each patient is different from the next, so should the scheduling of x-ray exams be individualized for each patient.

Question 141

Which of the following best responds to this patient question: “Why do you use a lead apron when exposing my radiographs?”

a. “In case you are pregnant.”
b. “To protect you from possible scatter radiation.”
c. “To assist with holding you still in the chair.”
d. “Because it’s required by law.”

Answer 141

b. “To protect you from possible scatter radiation.”
* Lead and other materials that simulate lead used in protective aprons and thyroid collars absorb potential scatter radiation and protect other parts of the body from unnecessary radiation.*

Question 142

A position assumed by the body in connection with a feeling or mood is called:

a. attitude.
b. empathy.
c. communication.
d. chairside manner.

Answer 142

a. attitude.

Attitude is defined as the position assumed by the body in connection with a feeling or mood.

Question 143

Attitude is defined as the position assumed by the body in connection with a feeling or mood.

True

False

Answer 143

True

Attitude plays a significant role in gaining the patient’s trust in the radiographer’s ability. A fresh, positive attitude with each new patient will most likely encourage a cooperative patient.

Question 144

Attitudes toward an employer and co-workers play a role in determining the degree of successful patient management.

True

False

Answer 144

True

Patients can sense the health care professional’s attitude, by the way he/she walks, talks, and behaves. Patients will easily sense disgruntled members of the oral health care team. Maintaining a pleasant, positive attitude will help generate the same from patients.

Question 145

Apathy is the ability to share in another’s emotions or feelings.

True

False

Answer 145

False

Empathy is the ability to share another’s emotions or feelings. Apathy implies that a patient’s emotions and apprehensions do not matter.

Question 146

If placement of an intraoral image receptor is uncomfortable for the patient, the radiographic procedure should be postponed.

True

False

Answer 146

False

If placement of the image receptor during the radiographic procedure is uncomfortable, show empathy. Empathy is the ability to share in another’s feelings. If discomfort must be tolerated to produce the necessary radiographs, empathetic, yet direct and tactful communication can bring the desired result.

Question 147

When placing the image receptor intraorally, the radiographer should ask the patient, “Does that feel okay?”

True

False

Answer 147

False

The patient will assume that discomfort means incorrect placement and will feel obligated to tell the radiographer of any and all feelings associated with placements.

Question 148

Prior to leaving the operatory to make an exposure, the radiographer should ask the patient, “Can you hold still, please?”

True

False

Answer 148

False

This query will likely cause the patient to move to answer the radiographer, defeating the purpose of the request. The command, “Hold still, please” is less likely to prompt the patient to move.

Question 149

Sentence structure is important for the short, precise directions used in dental radiography.

True

False

Answer 149

True.

The radiographer may want the patient to close slowly, but by saying, “Close slowly, please” the patient may be closed before the radiographer says the word “slowly.” Rearranging the words to, “Slowly close, please” is more likely to produce the desired results.

Question 150

Nonverbal communication includes gestures, facial expressions, body movement, and listening.

True

False

Answer 150

True

We usually use a combination of verbal and nonverbal communication.

Question 151

Educating patients about the importance of dental radiographs in comprehensive oral health care depends on the radiographer’s ability to communicate.

True

False

Answer 151

True

The ability to communicate is based on the radiographer’s knowledge, education, and training in the area of dental radiology. Many patients do not comprehend the enormous value of a radiographic exam of their teeth and supporting structures.

Question 152

A patient can refuse dental radiographs and still be treated.

True

False

Answer 152

False

Treatment without necessary radiographs is considered negligent care. A patient cannot sign a paper refusing radiographs releasing the dentist from liability. This would be consenting to negligent care, which is illegal.

Question 153

An educated patient is more inclined to understand and accept dental treatment plans and embrace suggestions for oral health promotion and disease prevention.

True

False

Answer 153

True

It is surprising how many patients do not comprehend the enormous value of a radiographic examination of their teeth and the supporting oral structures. An educated patient is more inclined to understand and accept dental treatment plans and embrace suggestions for oral health promotion and disease prevention.

Question 154

Patients who have had radiation therapy for cancer of tissues located in the head or neck region should avoid dental radiographs.

True

False

Answer 154

False

The dose of radiation required for dental x-rays is extremely small compared to that used for radiation therapy. The effects of very high doses involved in therapeutic radiation may increase susceptibility to diseases, such as tooth decay. This can occur as a result of a decrease in secretions of the salivary glands. It is especially important that patients who have had radiation therapy for cancer of tissues in the head or neck regions have dental x-ray exams as needed, to detect problems at an early stage.

Question 155

When verbal and nonverbal communication is not in synch, it is the verbal communication that is more believable.

True

False

Answer 155

False

When the two methods are not in synch, the nonverbal communication usually conveys the strongest message. Patients feel that actions speak louder than words.

Question 156

Show-tell-do is a method of communication reserved for the child patient.

True

False

Answer 156

False

The use of show-tell-do as a method of combined verbal and nonverbal communication is useful in dental radiography for all patients, especially when barriers to communication exist such as in the case of a language or cultural difference, a sensory impairment, a cognitive impairment, and for children.

Question 157

The best answer to the patient question, “Why do I need x-rays?” is because the dentist requested them.

True

False

Answer 157

False

A better answer to the patient question, “Why do I need x-rays?” is because many diseases cannot be detected by clinical exam alone.

Question 158

Respectfulness and courtesy are examples of interpersonal skills.

True

False

Answer 158

True

Interpersonal skills are used to communicate with others successfully. Respectfulness; courtesy; empathy; and patient, honest, and tactful communication are examples of interpersonal skills.

Question 159

If the radiographer feels the procedure is unnecessary or uncomfortable, these feelings will be conveyed to the patient.

True

False

Answer 159

True

Attitude will play a significant role in gaining the patient’s trust in the radiographer’s ability. The attitude of the radiographer toward the procedure will be conveyed to the patient. If the radiographer feels that the procedure is uncomfortable or unnecessary, these feelings will be conveyed to the patient. The radiographer should not impose his or her own feelings onto the patient.

Question 160

Dismissing the patient’s fears and reassuring him or her that everything will be okay prior to the procedure improves chairside manner.

True

False

Answer 160

False

Dismissing the patient’s fears may convey an attitude of apathy, or imply that the patient’s apprehensions do not matter. If placement of an intraoral imaging receptor during the radiographic procedure is uncomfortable, show empathy.

Question 161

The radiographer’s attitude toward his or her own technical ability will also be conveyed to the patient.

True

False

Answer 161

True

Because a demonstration of technical skill will build patient confidence, the radiographer should feel that his or her training and education provided adequate preparation for this role. Having confidence in oneself fosters confidence in others.

Question 162

The radiographer should respond to a patient’s fear of radiation by stating that excess radiation exposure from dental radiographs is not a concern of the practice.

True

False

Answer 162

False

The radiographer can verbally agree with the patient that excess radiation exposure is a concern and that the practice has adopted a strict radiation safety program

Question 163

Which of the following is NOT an intraoral radiograph?

a. Occlusal
b. Bitewing
c. Panoramic
d. Periapical

Answer 163

c. Panoramic

Intraoral radiography consists of methods of exposing an image receptor placed inside the oral cavity. Bitewing, periapical, and occlusal examinations all involve the exposure of image receptors placed in the mouth, while the panoramic examination uses a receptor placed outside the mouth.

Question 164

Which of the following is NOT a shadow-casting principle?

a. Use the largest possible source of radiation (focal spot).
b. The tooth should be as far as possible from the source of radiation.
c. The tooth and image receptor should be as close together as possible.
d. The tooth and image receptor should be parallel to each other.

Answer 164

a. Use the largest possible source of radiation (focal spot).

The smallest focal spot of radiation should be selected.

Question 165

Each of the following statements regarding the fundamentals of periapical radiographs is correct EXCEPT one. Which one is the EXCEPTION?

a. Periapical radiographs may be taken using the paralleling or bisecting technique.
b. Placement of the image receptor-holding device must be evaluated to avoid angulation errors.
c. The patient’s finger can be used to hold a large image receptor in position in the oral cavity.
d. The size of image receptor chosen depends on the shape and size of the dental arches.

Answer 165

c. The patient’s finger can be used to hold a large image receptor in position in the oral cavity.

An image receptor holder with an external aiming device will assist the radiographer with directing the x-ray beam at the correct angle. Using the patient’s finger to hold the image receptor in place during exposure is not acceptable.

Question 166

Each of the following is standard placement for a full mouth series of periapical radiographs using a size #2 image receptor on an adult patient EXCEPT one. Which one is the EXCEPTION?

a. Four incisor periapical radiograph
b. Four canine periapical radiographs
c. Four premolar periapical radiographs
d. Four molar periapical radiographs

Answer 166

a. Four incisor periapical radiograph

Only one maxillary and one mandibular image receptor placed in the incisor areas would be required.

Question 167

Which of the following statements is FALSE?

a. A minimum of 10 periapical radiographs is required for a full mouth survey on an adult patient.
b. The long dimension of the image receptor is positioned horizontally in the posterior regions.
c. A size #1 image receptor is the best fit for the canine region.
d. Six size #2 image receptors may be used to record the maxillary and mandibular anterior region.

Answer 167

a. A minimum of 10 periapical radiographs is required for a full mouth survey on an adult patient.

The number and size of image receptors used for a full mouth series of bitewing and periapical radiographs varies among oral health care practices. A minimum of 4 bitewing and 14 periapical radiographs

Question 168

Which of the following statements regarding orientation of a film packet is FALSE?

a. The white, unprinted side of the film packet must face the source of radiation.
b. The identification dot should be positioned toward the apices of the teeth when placing periapical radiographs.
c. The identification dot is used during interpretation of the radiograph to distinguish between the patient’s left and right sides.
d. The film may be positioned with the long dimension vertically or horizontally when placing posterior bitewing radiographs.

Answer 168

b. The identification dot should be positioned toward the apices of the teeth when placing periapical radiographs.

The identification dot is used to differentiate the right from the left side of the patient. However, it has the potential to obscure information imaged on the film and therefore should be positioned away from the area of interest.

Question 169

Which of these statements is FALSE?

a. Incorrect vertical angulation results in overlapped contact points.
b. Negative angulation is generally used for exposure of the mandibular arch.
c. Positive angulation is generally used for exposure of the maxillary arch.
d. An image receptor will aid the radiographer in determining the correct angulations.

Answer 169

a. Incorrect vertical angulation results in overlapped contact points.
* Incorrect horizontal angulation results in overlapped contact points.*

Question 170

Which of these statements is FALSE?

a. Negative angulation directs the central ray upward toward the ceiling.
b. Accurate vertical angulation is more important to the paralleling than the bisecting technique.
c. 0˚ vertical angulation directs the PID parallel to the floor.
d. Vertical angulation refers to directing the PID up and down.

Answer 170

b. Accurate vertical angulation is more important to the paralleling than the bisecting technique.

Although the vertical angulation settings vary between these two techniques, both the paralleling and the bisecting techniques require correct vertical angulation to produce diagnostic-quality radiographs.

Question 171

Each of the following statements regarding the point of entry is correct EXCEPT one. Which one is the EXCEPTION?

a. Incorrect point of entry results in cone cut error.
b. Care must be taken to center the image receptor within the beam of radiation.
c. The open end of the PID should be placed two inches from the patient’s skin.
d. An image receptor holder with an external aiming device aids in locating the point of entry.

Answer 171

c. The open end of the PID should be placed two inches from the patient’s skin.

The open end of the PID should be placed as close to the patient’s skin as possible, without touching, to avoid an underexposed radiograph. As the beam of radiation spreads out, less radiation is available to strike the film and produce a diagnostic-quality radiograph.

Question 172

Which of the following statements is FALSE?

a. Determining horizontal angulation is the same for both the bisecting and the paralleling techniques.
b. Vertical angulation is accomplished by directing the central ray parallel to the image receptor.
c. Angulation is changed by rotating the tube head horizontally and vertically.
d. To change horizontal angulation, the tube head is swiveled from side to side.

Answer 172

b. Vertical angulation is accomplished by directing the central ray parallel to the image receptor.

Vertical angulation is accomplished by directing the central ray perpendicular to the image receptor in the paralleling technique and perpendicular to the imaginary bisector when using the bisecting technique.

Question 173

Which of the following statements is correct?

a. Vertical angulation is usually described in millimeters.
b. Vertical angulation of the tube head and PID begins at 90 degrees.
c. To change vertical angulation, the tube head is swiveled from side to side.
d. When the open end of the PID is tilted toward the floor, the vertical angle is positive.

Answer 173

d. When the open end of the PID is tilted toward the floor, the vertical angle is positive.

Vertical angulation is described in degrees, with the vertical angulation of the tube head and PID beginning at zero, where they are parallel to the floor. The vertical angulations, scaled in 5 or 10 degrees, are inscribed on the sides of the yoke, where the tube head is connected. When pointing down toward the floor, the vertical angulation is called “positive,” and when pointing up toward the ceiling, the vertical angulation is called “negative.”

Question 174

Which of these statements is FALSE?

a. Bitewing radiographs record the apices of teeth and surrounding bone.
b. Bitewing radiographs record the coronal portions of teeth and alveolar crests of both arches.
c. Periapical radiographs may be taken using the bisecting or paralleling technique.
d. Occlusal radiographs record the maxillary or mandibular arch (or a portion thereof) on a single image receptor.

Answer 174

a. Bitewing radiographs record the apices of teeth and surrounding bone.

The fundamental purpose of the bitewing exam is to show the coronal portions of the teeth and alveolar crests of a segment of both the mandible and maxilla on one film. The periapical radiograph is designed to image the apices of teeth and surrounding bone.

Question 175

Which of these statements is FALSE?

a. The two basic techniques employed in intraoral radiography are bisecting and paralleling.
b. The paralleling technique arose through application of the rule of isometry.
c. Both the paralleling and the bisecting techniques can be modified to meet special conditions.
d. The paralleling technique is newer than the bisecting technique.

Answer 175

b. The paralleling technique arose through application of the rule of isometry.

The concept of the bisecting technique (also called “bisecting-angle” or “short-cone technique”) originated through application of a geometric principle known as the rule of isometry.

Question 176

The paralleling technique is also called the:

a. right-angle technique.
b. extension-cone technique.
c. long-cone technique.
d. All of the above.

Answer 176

d. All of the above.
* The* paralleling technique is also called “right-angle,” “extension-cone,” or “long-cone” technique.

Question 177

Which one of the following is NOT a principle of shadow casting?

a. Long axes of the teeth and image receptor should be parallel to each other.
b. Long axes of the teeth and image receptor should be as close to each other as possible.
c. Source of radiation should be as small as possible.
d. Teeth should be as close as possible to the radiation source.

Answer 177

d. Teeth should be as close as possible to the radiation source.

The object (tooth) should be as far as practical from the target (source of radiation).

Question 178

If vertical angulation of the tube head is set at zero, the PID will be:

a. parallel to the floor.
b. perpendicular to the floor.
c. in positive angulation.
d. in negative angulation.

Answer 178

a. parallel to the floor.

The vertical angulation of the tube head and the PID begins at zero. In the zero position, the PID is parallel to the plane of the floor.

Question 179

Conditions that would indicate the need for a periapical radiograph include each of the following EXCEPT one. Which one is the EXEPTION?

a. Abscess
b. Cleft palate
c. Large caries
d. Root fracture

Answer 179

b. Cleft palate
* Conditions prompting the exposure of a periapical radiograph include apical pathology (abscesses), fractures, large carious lesions, extensive periodontal involvement, examination of developmental anomalies such as missing teeth and abnormal eruption patterns, and any unexplained pain or bleeding. Occlusal radiographs would be a better choice for imaging a large area such as a cleft palate.*

Question 180

Periapical radiographs can be taken with each of the following image receptor sizes EXCEPT one. Which one is the EXCEPTION?

a. 0
b. 1
c. 2
d. 3

Answer 180

d. 3

A size #3 image receptor with dimensions of 1 1/16 inches by 2 1/8 inches is used for horizontal bitewing radiographs.

Question 181

A minimum of how many periapical radiographs should make up a full mouth survey for most adult patients?

a. 10
b. 12
c. 14
d. 16

Answer 181

c. 14

The number and size of image receptors used for a full mouth series of bitewing and periapical radiographs varies among oral health care practices. A minimum of 4 bitewing and 14 periapical radiographs

Question 182

The identification dot on an intraoral radiograph film is used to:

a. provide a comparative reference to pathology.
b. identify buccal and lingual surfaces of the teeth.
c. distinguish occlusal or incisal edges from apices.
d. distinguish between the patient’s right and left sides.

Answer 182

d. distinguish between the patient’s right and left sides.
* The* identification dot, embossed into the film by the manufacturer, will be used during interpretation of the radiograph to distinguish between the patient’s right and left sides.

Question 183

Radiographs are shadow images on an image receptor.

True

False

Answer 183

True

X-rays producing an image on an image receptor is similar to light casting a shadow of an object. When a hand is placed between a light bulb and a countertop, a shadow of the hand appears on the countertop. In the same way, x-rays cast a shadow of the teeth on the image receptor.

Question 184

The open end of the PID should almost touch the face with its midpoint centered over the point of entry before exposure.

True

False

Answer 184

True

The open end of the PID should be placed as close to the patient’s skin as possible without touching. Failure to bring the end of the PID in close to the patient will result in an underexposed radiograph because as the beam of radiation spreads out, less radiation is available to strike the image receptor and produce a diagnostic-quality image.

Question 185

All vertical angle deviations from zero in which the tip of the PID is tilted toward the floor are called “negative angulations.”

True

False

Answer 185

False

All deviations in which the PID is tilted toward the floor are called “positive angulations.”

Question 186

The purpose of the periapical examination is to record the crowns and alveolar bone crests of the teeth in both arches on one radiograph.

True

False

Answer 186

False

The purpose of the periapical examination is to view the entire tooth and surrounding bone.

Question 187

The word “periapical” is derived from the Greek word peri (meaning around) and the Latin word apex (meaning highest point).

True

False

Answer 187

True

This name is given to the periapical radiograph because it images the entire tooth from the crown to the root end and the surrounding bone.

Question 188

Periapical radiographs can image only one tooth on each radiograph.

True

False

Answer 188

False

Periapical radiographs are used to examine a single tooth or condition but more than one tooth will be imaged on a single radiograph.

Question 189

An image receptor holding device should be used to position intraoral radiographs.

True

False

Answer 189

True

An image receptor holder with an external aiming device will assist the radiographer with directing the x-ray beam at correct angles.

Question 190

While the use of a size #2 image receptor for anterior periapical radiographs is acceptable, the narrower size #1 image receptor may fit this area better.

True

False

Answer 190

True

When using a size #2 image receptor in the anterior region, there is a tendency to bend film or phosphor plate corners to make it fit more comfortably. A solid-state digital sensor may impinge on sensitive tissues. Bending the image receptor distorts the image or damages the receptor. A smaller image receptor is often the better alternative.

Question 191

Periapical image receptors for exposure of posterior areas are placed with the long dimension vertically.

True

False

Answer 191

False

Periapical image receptors for exposure of posterior areas are placed with the long dimension horizontally. This is known as horizontal placement.

Question 192

Periapical image receptors for exposure of anterior areas are placed with the long dimension vertically.

True

False

Answer 192

True

Image receptors placed in the anterior regions should be oriented with the longer dimension vertical. This is known as vertical placement.

Question 193

The identification dot should be placed toward the apices of the teeth when exposing periapical radiographs.

True

False

Answer 193

False

The identification dot may obscure information in that portion of the image and should be positioned away from the area of interest. In the case of periapical radiographs, the identification dot should be positioned toward the incisal/occlusal edges, where it is least likely to interfere with diagnostic information.

Question 194

Placing the dot in the slot of the film holder positions the identification dot toward the apices of teeth.

True

False

Answer 194

False

Placing the dot in the slot for periapical projections positions the identification dot toward the occlusal or incisal edges, away from the apices of teeth.

Question 195

The correct horizontal and vertical angulations are critical to producing quality periapical radiographs.

True

False

Answer 195

True

Incorrect horizontal angulation produces overlapped contact points. Incorrect vertical angulation using the paralleling technique results in cutting off a portion of the area of interest from the radiograph. Incorrect vertical angulation using the bisecting technique results in elongation or foreshortening of the image.

Question 196

The periapical examination is sometimes referred to as an interproximal radiograph.

True

False

Answer 196

False

The bitewing examination is sometimes referred to as an interproximal radiograph.

Question 197

The technique used to image bitewing radiographs is unique to the bitewing exam.

True

False

Answer 197

True.

The technique used to image bitewing radiographs is unique to the bitewing exam.

Question 198

The bitewing technique could be considered a modification of the bisecting technique used for exposing periapical radiographs.

True

False

Answer 198

False

The technique used to image bitewing radiographs is unique to the bitewing exam. However, because of the almost parallel relationship of the image receptor to the teeth, the bitewing technique could be considered a modification of the paralleling technique used for exposing periapical radiographs.

Question 199

Neither the paralleling nor the bisecting technique completely meets all five requirements for accurate shadow casting in all regions of the oral cavity on all patient types.

True

False

Answer 199

True

Neither the paralleling nor the bisecting technique completely meets all five requirements for accurate shadow casting in all regions of the oral cavity on all patient types.

Question 200

The size #3 film or phosphor plate is used exclusively for occlusal radiographs of adult patients, and the size #4 film or phosphor plate is used exclusively for horizontal bitewing radiographs of adult patients.

True

False

Answer 200

False

The size #4 film or phosphor plate is used exclusively for occlusal radiographs of adult patients, and the size #3 film or phosphor plate is used exclusively for horizontal bitewing radiographs of adult patients.

Question 201

The bitewing survey may consist of two to eight radiographs.

True

False

Answer 201

True

The bitewing survey may consist of two to eight radiographs. A complete set of seven or eight vertical bitewing radiographs may be exposed for the examination of a periodontally involved patient. This vertical bitewing set will include both posterior and anterior radiographs. When the patient does not require anterior bitewings, two or four posterior bitewing radiographs positioned either vertically or horizontally are usually taken.

Question 202

Which of the following statements regarding image receptor holders is FALSE?

a. Short bite blocks should be used for the bisecting technique.
b. External aiming devices help locate correct angles and points of entry.
c. External aiming devices eliminate the need to position the patient’s head precisely.
d. Bite blocks with an L-shaped back plate should be used with the bisecting technique.

Answer 202

d. Bite blocks with an L-shaped back plate should be used with the bisecting technique.

Bite blocks with a 105-degree back plate should be used with the bisecting technique. The parallelling technique requires a bite block with an L-shaped (90˚) back plate.

Question 203

Which of the following statements regarding patient preparation for dental radiography is NOT correct?

a. The patient should be protected with a lead/lead-equivalent apron and thyroid collar.
b. The patient’s occipital protuberance should be against the headrest during exposure.
c. The patient’s eyeglasses may be left in place to protect the eyes.
d. Objects in the mouth such as dentures, partials, and retainers should be removed prior to exposure.

Answer 203

c. The patient’s eyeglasses may be left in place to protect the eyes.

The radiographer should ask the patient to remove the eyeglasses. If the metal or thick plastic frame of the eyeglasses lies in the path of the beam of radiation, they will be imaged onto the radiograph.

Question 204

Which of the following will correct an elongated image?

a. Increasing the vertical angulation
b. Decreasing the vertical angulation
c. Directing the central ray perpendicular to the plane of the image receptor
d. Directing the central ray perpendicular to the long axis of the tooth

Answer 204

a. Increasing the vertical angulation

Elongation results from inadequate vertical angulation.

Question 205

Which of the following will correct a foreshortened image?

a. Increasing the vertical angulation
b. Decreasing the vertical angulation
c. Directing the central ray perpendicular to the plane of the image receptor
d. Directing the central ray perpendicular to the long axis of the tooth

Answer 205

b. Decreasing the vertical angulation

Foreshortening results from excessive vertical angulation.

Question 206

Which of the following will correct an overlapping error?

a. Increasing the vertical angulation
b. Decreasing the vertical angulation
c. Directing the central ray perpendicular to the plane of the image receptor
d. Directing the central ray perpendicular to the long axis of the tooth

Answer 206

c. Directing the central ray perpendicular to the plane of the image receptor

Overlapping error results when the central rays of the x-ray beam are directed obliquely toward the image receptor in the horizontal plane.

Question 207

The recommended vertical angulation for exposing a mandibular premolar periapical radiograph

using the bisecting technique is:

a. -10 degrees
b. -15 degrees
c. -20 degrees
d. -5 degrees

Answer 207

a. -10 degrees

To obtain a radiograph with an accurate representation of the mandibular premolar, the central ray of the x-ray beam should be directed toward the imaginary bisector between the long axis of the canine and the plane of the image receptor in the vertical dimension at -10 degrees.

Question 208

Changes in vertical angulation are indicated when the patient’s palatal vault is high or low.

Answer 208

True

When the palatal vault is high, the angulation can be decreased no more than 15 degrees because of the more vertical position of the image receptor. When the vault is low, the vertical angulation can be increased up to 15 degrees.

Question 209

The horizontal angulation is determined in the same manner for both the bisecting and the paralleling techniques.

True

False

Answer 209

True

The steps for determining correct horizontal angulation are the same for both the bisecting and paralleling techniques.

Question 210

The seating position of the patient is not important in using predetermined anatomical landmarks to direct the central ray of the x-ray beam toward the point of entry.

True

False

Answer 210

False

The patient must be seated correctly with the midsaggital plane perpendicular to the floor and the occlusal plane parallel to the floor to use predetermined anatomical landmarks through which to direct the central ray of the x-ray beam.