Deck 6: Radiographic Assessment

Question 1

How will well-expanded,air-filled lungs appear on a chest radiograph?

A)Light colored
B)Gray
C)Black
D)White

Answer 1

C
The normal structures that are visualized on a chest radiograph are distinguishable because of differences in the absorption of the X-ray beam by the organs and tissues within the thoracic cavity.Bone and metallic orthopedic hardware appear bright white because of greater X-ray absorption and less exposure of the image receptor.In contrast,air has little beam absorption,and therefore well-expanded lungs appear relatively black.Soft tissue organs and fluid usually appear as shades of gray in between the white bones and black lungs.

Question 2

A therapist is viewing frontal and lateral neck X-rays of a 12-month-old child and notices what is described as the "steeple" or "church steeple" sign: subglottic narrowing below the vocal cords,and an overdistended hypopharynx.Which of the following conditions does this child likely have?

A)Laryngotracheobronchitis
B)Tracheomalacia
C)Adenoidal enlargement
D)Epiglottitis

Answer 2

A
Croup (laryngotracheobronchitis)is the most common cause of upper airway obstruction in children,with a peak incidence in infants and children 6 months to 5 years of age.Most cases are virally induced (parainfluenza)and cause inspiratory stridor with a barking cough.Frontal and lateral neck radiographs may show the characteristic subglottic narrowing below the vocal cords with loss of the normal "shouldering" of the airway and resultant "church steeple" appearance.The hypopharynx usually appears overdistended.

Question 3

A therapist is viewing frontal chest X-ray of a 12-year-old child and notices mediastinal shift towards the right hemithorax along with elevated hemidiaphragm and vascular crowding.Which of the following conditions does this child likely have?

A)Atelectasis
B)Pneumonia
C)Pleural effusion
D)ARDS

Answer 3

A
Segments,lobes,and entire lungs may be collapsed,or atelectatic.This loss of volume may shift fissures toward the area of atelectasis,cause mediastinal shift toward the affected side,and elevate the ipsilateral diaphragm.Crowding of the pulmonary vascular and interstitial markings in the affected region will occur.The other lung or adjacent lobes may become more lucent secondary to hyperexpansion.

Question 4

Which of the following radiographic views provides the best perspective for ascertaining the position of an endotracheal tube in the patient's esophagus?

A)Anteroposterior view
B)Left lateral decubitus
C)Lateral view
D)Oblique view

Question 5

Which of the following are criteria to order a chest radiograph in a pediatric patient who does not have chest symptoms?
I)Fever
II)Oxygen saturation < 95%
III)White blood cell count > 20,000/mm³
IV)Creatinine > 2 mg/dL

A)II and III only
B)I and IV only
C)I,II,and III only
D)III only

Question 6

The lateral decubitus view is a frontal radiographic projection whereby the side down can be evaluated for presence of ____________________.

A)Atelectasis;a pneumothorax
B)A pleural effusion;a pneumothorax
C)Consolidation;atelectasis
D)A pleural effusion;consolidation

Question 7

While viewing an anteroposterior view of a chest radiograph of a 24-month-old intubated child,a therapist notices that the endotracheal tube has now migrated right above the inferior clavicular border.What could explain this new location of the endotracheal tube?

A)Flexion of the head
B)Extension of the head
C)Rotation of the head to the right
D)Rotation of the head to the left

Question 8

A therapist is viewing a frontal chest radiograph of a neonate who has just been endotracheally intubated.The tip of the endotracheal tube is located between the inferior clavicular border and the carina.What should the therapist do at this time?

A)Perform routine respiratory assessment in the morning and care for an intubated patient at this time.
B)Withdraw the endotracheal tube a few millimeters.
C)Advance the endotracheal tube a few millimeters.
D)Remove the endotracheal tube and reinsert it because it is in the esophagus.

Question 9

Which of the following structures on a chest radiograph projects to the left,causes a prominent bulge of the superior mediastinum,and creates a mild indentation on the trachea?

A)Left hemidiaphragm
B)Apex of the heart
C)Aortic arch
D)Hilum

Question 10

What type of X-ray view is obtained when the radiographic plate is placed behind the patient's back with the x,and the side up may better define ____________________.

A)Anteroposterior view
B)Posteroanterior view
C)Lateral view
D)Frontal view

Question 11

Which of the following radiographic views would be the best suited for evaluating fractured ribs in a pediatric patient?

A)Lateral decubitus at full inspiration
B)Posteroanterior view at full expiration
C)Anteroposterior view
D)Oblique view

Question 12

A therapist is examining an AP chest radiograph of a neonate and notices a structure projecting away from the mediastinum toward the right upper lung.This structure looks like a sail with a sharp inferior margin and lateral margins with wavy contours.Which of the following structures is the therapist observing?

A)Thymus
B)Right heart border
C)Aortic notch
D)Lymph node in the hilar region on the right

Question 13

A therapist is viewing a chest X-ray of a pediatric patient who recently emerged from general anesthesia after upper abdominal surgery.The right hemidiaphragm is elevated,and atelectasis is seen as a long,thick horizontal line within the right lower lobe.Which of the following terms describes this type of atelectasis?

A)Discoid
B)Lobar atelectasis
C)Silhouette sign
D)Plate

Question 14

While viewing the chest X-ray of an 18-month-old boy,a therapist notices that the trachea is truncated and that the right lung is collapsed.Which of the following situations or conditions may have caused this situation?

A)An elevated right hemidiaphragm
B)A mucous plug in the right mainstem bronchus
C)A mass compressing the trachea
D)A right-sided pneumothorax

Question 15

A pediatric patient with pneumonia has an infiltrate in the lower half of the right lung.The right heart border is obliterated.In which lobe(s)of the right lung is the infiltrate located?

A)Right upper lobe
B)Right middle lobe
C)Right lower lobe
D)Right middle and lower lobes

Question 16

While viewing a lateral view of a neck radiograph of an 18-month-old child,a therapist notices that the epiglottis is enlarged,the aryepiglottic folds are thickened,and the hypopharynx is overdistended.Which of the following conditions does this child likely have?

A)Bronchopulmonary dysplasia
B)Esophageal fistula
C)Croup
D)Epiglottitis

Question 17

A mother has just given birth to a 42-week infant who is small for his gestational age.A chest radiograph of this neonate reveals coarse,patchy opacities secondary to atelectasis from bronchial obstruction alternating with areas of hyperinflation.Which of the following clinical disorders does this infant likely have?

A)Acute respiratory distress syndrome
B)Pulmonary interstitial emphysema
C)Meconium aspiration syndrome
D)Transient tachypnea of the newborn

Question 18

A respiratory therapist is evaluating a chest radiograph of a patient taken 2 days after being admitted for significant respiratory distress right middle lobe pneumonia.Although the therapist notices a dramatic clinical improvement of the patient,the chest X-ray appears to be more radiopaque than the one on admission.What could explain this situation?

A)The therapist is mistakenly looking at a different patient's film.
B)Incorrect exposure of the image receptor may have happened.
C)Although the patient looks better,the pneumonia is probably worse.
D)This is a normal phenomenon.

Question 19

The respiratory therapist is evaluating a child with suspected foreign body aspiration.The radiographer gently adds pressure to the abdomen during expiration to take the chest radiograph.If an obstruction is confirmed,what changes should the RT expect to see?

A)The size of the affected lung will decrease.
B)The size of both lungs will decrease.
C)The size of the affected lung will remain the same or the lung will be hyper-expanded.
D)The size of the unaffected lung will increase.