Deck 10: Clinical Application of the Chest Radiograph

Question 1

Electrons coming off the cathode in an x-ray machine are focused to hit a small area of the anode called the:

A) tube.
B) target.
C) transformer.
D) focusing plate.

Answer 1

target.

Question 2

Which of the following views is most helpful in identifying a pneumothorax?

A) Expiratory view
B) AP view
C) Left lateral view
D) Lateral decubitus view

Answer 2

Expiratory view

Question 3

AP portable films are obtained to evaluate which of the following?
1) Lung status
2) Lung tumor growth
3) Line and tubing positions
4) Results of invasive therapeutic procedures

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

Answer 3

1, 3, and 4

Question 4

A lateral decubitus view is able to detect as little as _____ mL of the pleural fluid.

A) 25 to 50
B) 50 to 100
C) 100 to 200
D) 200 to 300

Question 5

Which of the following terms defines high-density tissues on the x-ray film?

A) Radiolucent
B) Radiopaque
C) Radiographic
D) Tomographic

Question 6

Which of the following tissues will look radiolucent on a chest radiograph?

A) Blood
B) Bone
C) Lungs
D) Liver

Question 7

Which of the following views provides less cardiac magnification and a sharper view of the left lower lobe?

A) PA view
B) AP view
C) Left lateral view
D) Lateral decubitus view

Question 8

The ability of x-rays to penetrate matter is inversely proportional to which of the following physical properties of matter?

A) Viscosity
B) Density
C) Weight
D) Diffusion

Question 9

What breathing instruction is a patient given immediately before an anteroposterior (AP) or posteroanterior (PA) chest radiograph?

A) Breathe normally.
B) Exhale completely.
C) Take a deep breath.
D) Do not worry about breathing; it will not affect this x-ray.

Question 10

The presence of the characteristic "signet sign" in a computed tomography (CT) scan is consistent with which of the following diseases?

A) Asthma
B) Lung tumor
C) Emphysema
D) Bronchiectasis

Question 11

To minimize the magnification associated with portable films, how far should the patient and the film be from the source of the x-rays in a conventional chest x-ray?

A) 6 feet
B) 8 feet
C) 10 feet
D) 12 feet

Question 12

A portable film is ordered immediately after a patient is intubated in the emergency department. Which of the following distances confirms proper placement of the endotracheal tube?

A) 1 to 2 cm below the cricoid cartilage
B) 3 cm below the thyroid cartilage
C) 3 to 5 cm above the carina
D) 5 to 7 cm above the carina

Question 13

A male patient who is standing upright with his back to the x-ray tube, his anterior thorax pressed against a metal cassette containing the film, and his arms positioned out of the way is positioned for what x-ray view?

A) PA view
B) AP view
C) Apical lordotic view
D) Lateral decubitus view

Question 14

As a patient who is being positioned for a chest x-ray is moved closer to the source of the x-rays, what happens to the shadows of anatomic structures seen on the chest film?

A) They get larger.
B) They get smaller.
C) They get clearer.
D) They stay the same.

Question 15

Which of the following statements are considered an indication for obtaining a radiograph?
1) Determine the appropriate therapy.
2) Evaluate the effectiveness of treatment.
3) Detect alterations of the lung caused by pathologic processes.
4) Diagnose specific diseases.

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

Question 16

Which of the following tissues represent the four distinct densities recognized in the x-ray (from higher to lower density)?

A) Bone, water, air, fat
B) Fat, bone, water, air
C) Bone, water, fat, air
D) Air, fat, water, bone

Question 17

A portable film is ordered immediately after a central venous pressure (CVP) catheter is placed via the subclavian vein. Which of the following is the correct placement site for the catheter?

A) 1 to 2 cm above the right atrium
B) Between the left and right ventricles
C) At the confluence of the superior vena cava and the right atrium
D) Anywhere in the superior vena cava

Question 18

Which of the following views is used to see whether free fluid (pleural effusion or blood) is present in the chest in the left pleural region?

A) AP view
B) Left lateral view
C) Right lateral view
D) Lateral decubitus view

Question 19

Which of the following forms of radiologic assessment is most useful for studying the distribution of ventilation and perfusion and the effects that diseases may have on these two important functions?

A) MRI
B) CT scanning
C) Lung scanning
D) Pulmonary angiography

Question 20

In which of the following areas has magnetic resonance imaging (MRI) demonstrated superiority over CT scanning?

A) Evaluation of the hila
B) Evaluation of diffuse, interstitial lung disease
C) Evaluation of chest wall invasion by lung cancer
D) Evaluation of endotracheal tube placement

Question 21

The presence of "hot spots" in a positron emission tomography (PET) scan is indicative of:

A) metabolically active tumor or infection.
B) pneumothorax.
C) pulmonary embolism.
D) atelectasis.

Question 22

The casting of a white shadow on a film is consistent with which of the following situations?

A) Less exposed film
B) More exposed film
C) More radiolucent film
D) More penetrated film

Question 23

Which of the following would suggest that a patient has congestive heart failure (CHF)?

A) Low and flat diaphragm
B) Increased cardiothoracic ratio
C) Tracheal deviation
D) Increased retrosternal air space on a lateral film

Question 24

Radiographic signs of consolidation include which of the following?
1) Lobar distribution
2) Minimal loss of volume
3) Homogenous density late in the process
4) A low shift of the diaphragm

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

Question 25

On a PA film, what number of posterior ribs visible above the diaphragm indicates a good inspiratory effort?

A) 10
B) 8
C) 6
D) 5

Question 26

Which of the following radiologic terms confirm the presence of intrapulmonary disease?

A) Sulcus sign
B) Compression atelectasis
C) Air bronchogram
D) Platelike atelectasis

Question 27

Which of the following are typical findings of a small pleural effusion?
1) Blunting of the costophrenic angle
2) A small meniscus sign
3) A partially obscured diaphragm
4) Complete whiteout of the affected side

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

Question 28

Which of the following studies is gradually replacing scanning for the diagnosis of pulmonary embolus?

A) MRI
B) CT scanning
C) Lung scanning
D) CT angiography

Question 29

During what type of procedure is the risk of exposure to scatter radiation the greatest?

A) Performing or assisting during fluoroscopy
B) Performing or assisting with a chest radiography
C) Performing or assisting with a bronchoscopy
D) Performing or assisting with a CT angiography

Question 30

Which of the following clinical or chest x-ray findings is consistent with hyperinflation caused by obstructive lung disease?

A) Large retrosternal space
B) Prolonged inspiratory phase
C) Decreased resonance to percussion
D) Decreased functional residual capacity (FRC)

Question 31

What is the significance of the silhouette sign?

A) It allows differentiation between alveolar and interstitial infiltrates.
B) It can aid in detection of pleural effusion.
C) It helps determine whether an infiltrate is in contact with a heart border.
D) It allows differentiation between alveolar and interstitial opacities.

Question 32

Which of the following radiologic findings are consistent with lobar atelectasis?
1) Collapse of lung tissue
2) Shift in hilar structures toward the area of atelectasis
3) Hemidiaphragm elevation
4) Shift in hilar structures away from the area of atelectasis

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