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ARRT Mammography study materials
ARRT Mammography study resources

ARRT Mammography practice questions

One question at a time. Build your ARRT Mammography understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

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Question 1Patient Education and Assessment

A patient scheduled for a screening mammogram asks whether she should use her usual antiperspirant on the day of the exam. What is the most appropriate instruction?

  1. Bring the product and apply it after the technologist has positioned the breast.
  2. Use a spray deodorant instead, because sprays do not affect the image.
  3. Apply antiperspirant generously before the exam so the skin stays dry during compression.
  4. Skip deodorant, powder, and antiperspirant on exam day. Correct answer.

Explanation

Antiperspirants, deodorants, powders, and lotions can contain aluminum or zinc particles that appear radiopaque and may mimic microcalcifications. Patients are therefore asked to omit these products on the day of the examination. Washing the skin before imaging also removes residue.

Question 2Patient Education and Assessment

Which statement best explains to a patient why breast compression is used during mammography?

  1. It increases the magnification of small calcifications within the breast.
  2. It moves the breast away from the chest wall to protect the heart.
  3. It thins the breast, reducing tissue overlap and radiation dose. Correct answer.
  4. It numbs the breast so that the examination is completely painless.

Explanation

Compression spreads fibroglandular tissue over a larger area, decreasing the thickness that x-rays must penetrate. Thinner tissue means less scattered radiation, better contrast, fewer overlapping structures, and a lower glandular dose. It also holds the breast still to prevent motion blur.

Question 3Patient Education and Assessment

Which instruction best reflects the concept of breast self-awareness rather than a rigid monthly self-examination routine?

  1. Examine only the upper outer quadrant, where most cancers develop.
  2. Skip self-exams entirely if you have dense breasts on mammography.
  3. Learn how your breasts normally look and feel, and report changes. Correct answer.
  4. Perform a careful self-exam on the first day of every menstrual period.

Explanation

Breast self-awareness emphasizes knowing one's own normal appearance and texture so that a new change is recognized and reported promptly. It is not tied to a fixed calendar schedule or a single quadrant. Any persistent change should be evaluated by a clinician.

Question 4Patient Education and Assessment

A clinical breast examination is best described as which of the following?

  1. A self-performed palpation that a woman completes at home each month.
  2. A blood test that screens for breast tumor markers.
  3. A low-dose x-ray imaging study of both breasts.
  4. Palpation of the breasts by a trained health care provider. Correct answer.

Explanation

A clinical breast examination is a systematic physical palpation of the breasts, axillae, and supraclavicular regions performed by a clinician. It complements, but does not replace, mammography. It is distinct from self-examination and from any laboratory or imaging test.

Question 5Patient Education and Assessment

Which information is most important to obtain so that a patient's new mammogram can be meaningfully compared with earlier studies?

  1. The patient's preferred appointment time and preferred radiologist.
  2. Where and when her previous mammograms were performed. Correct answer.
  3. The patient's height, weight, and shoe size at her last visit.
  4. The name of the patient's insurance carrier and her policy number.

Explanation

Comparison with prior images is one of the most powerful tools in mammographic interpretation, so the facility must be able to request or access earlier studies. Knowing the date and location of prior examinations allows records to be retrieved. Insurance and scheduling details do not affect image comparison.

Question 6Patient Education and Assessment

A patient having her first mammogram asks how many pictures will be taken during a routine bilateral screening examination. What is the standard answer?

  1. Two views of each breast. Correct answer.
  2. One view of each breast.
  3. Four views of each breast.
  4. Three views of each breast.

Explanation

A standard screening mammogram includes two projections per breast: the craniocaudal and the mediolateral oblique views. Together these sample most of the breast tissue and are the accepted minimum for screening. Additional views are added only when needed for a diagnostic evaluation.

Question 7Patient Education and Assessment

A patient with limited English proficiency arrives for her mammogram. What is the best approach to ensure she understands the procedure?

  1. Ask her English-speaking child to translate the instructions for her.
  2. Skip the explanation and begin positioning to save appointment time.
  3. Arrange a qualified medical interpreter for the visit. Correct answer.
  4. Speak more loudly and repeat the same English instructions.

Explanation

Title VI and accreditation standards require meaningful access to care, which is best achieved with a qualified medical interpreter. Untrained interpreters, including family members, may mistranslate or filter sensitive information. Interpreter services should be offered at no cost to the patient.

Question 8Patient Education and Assessment

Which action best reduces a patient's anxiety before her first mammogram?

  1. Explain each step and how compression feels beforehand. Correct answer.
  2. Reassure her that mammography is completely painless.
  3. Withhold details about the procedure until she is positioned.
  4. Discourage questions so that the schedule stays on time.

Explanation

Anxiety is reduced when patients know what to expect, including the sensation and duration of compression and the sequence of images. Accurate preparation lets the patient anticipate and cooperate with positioning. Promising a painless examination sets up a mismatch with the actual experience.

Question 9Patient Education and Assessment

When obtaining a breast cancer family history, which relatives are classified as first-degree relatives?

  1. Mother, sister, or daughter. Correct answer.
  2. Aunt, grandmother, or niece.
  3. Mother-in-law or stepsister.
  4. Cousin or great-grandparent.

Explanation

First-degree relatives share approximately half of a person's genes and include parents, siblings, and children. Second-degree relatives include grandparents, aunts, uncles, nieces, nephews, and grandchildren. Relatives by marriage and more distant cousins do not carry the same weight in risk estimation.

Question 10Patient Education and Assessment

Which set of variables is used by the Gail model (Breast Cancer Risk Assessment Tool)?

  1. Age, age at menarche, age at first birth, and number of affected relatives. Correct answer.
  2. Known BRCA1 or BRCA2 mutation status combined with mammographic density.
  3. Serum estrogen and progesterone levels measured on the day of the exam.
  4. Body mass index, alcohol intake, and self-reported physical activity level.

Explanation

The Gail model estimates five-year and lifetime invasive breast cancer risk from age, age at menarche, age at first live birth, number of first-degree relatives with breast cancer, number of prior breast biopsies, atypical hyperplasia, and race/ethnicity. It intentionally excludes genetic mutation status and breast density. Other tools are used when those factors are central.

Question 11Patient Education and Assessment

A report describes a patient as having dense breasts. What does this mean for the patient?

  1. More glandular and fibrous tissue than fat, which can hide cancers. Correct answer.
  2. That her breasts are larger than those of an average woman.
  3. That screening mammography is no longer needed for her.
  4. That breast cancer is already present but was hidden from view.

Explanation

Density refers to the proportion of fibroglandular tissue relative to fat, not to breast size. Dense tissue appears white on the image and can obscure cancers, and it is also associated with a modest increase in risk. Notification laws require that patients be told about dense tissue and discuss supplemental options with their provider.

Question 12Patient Education and Assessment

During history taking, a patient reports spontaneous bloody discharge from one nipple. What is the most appropriate action?

  1. Ask her to express the discharge before the technologist positions her.
  2. Document the discharge and notify the radiologist for diagnostic workup. Correct answer.
  3. Tell her to stop caffeine and return in one year for screening.
  4. Reassure her that nipple discharge is always a normal finding.

Explanation

Spontaneous, unilateral, bloody or clear discharge is a reportable symptom that requires diagnostic evaluation rather than routine screening. The technologist should record the character, color, laterality, and any associated mass or skin change. The radiologist then determines the appropriate imaging and possible duct evaluation.

Question 13Patient Education and Assessment

A screening mammogram leads to a request for additional images. How should this be communicated to the patient?

  1. Wait until her next annual screening to mention the extra views.
  2. Tell her the additional images are needed because she moved during the exam.
  3. Explain that extra views are common and do not by themselves mean cancer. Correct answer.
  4. State only that more pictures are needed, without explaining what that means.

Explanation

Additional views are frequently used to resolve overlapping tissue or confirm a finding, and most recalls do not result in a cancer diagnosis. Clear, honest explanation with a defined next step reduces distress and supports adherence. Blaming the patient or withholding information erodes trust.

Question 14Patient Education and Assessment

During compression a patient says the pressure is very painful. What is the best response?

  1. Stop the examination and reschedule her for a different day.
  2. Tell her that maximal compression is always required for a valid examination.
  3. Skip the mediolateral oblique view to shorten the examination.
  4. Release and readjust to the least compression that holds the breast still. Correct answer.

Explanation

Adequate compression is needed for quality and dose reduction, but it must be balanced against patient tolerance. The technologist should release, reposition, and apply gradual pressure, using the least amount that still immobilizes the breast. Abandoning required views compromises the study.

Question 15Patient Education and Assessment

A patient asks whether her menopausal hormone therapy affects her mammogram. What is the most accurate response?

  1. It can increase breast density and should be listed on the history form. Correct answer.
  2. Hormone therapy makes screening mammography unnecessary after age 50.
  3. Hormone therapy has no effect on breast tissue or on mammographic images.
  4. Hormone therapy must be stopped six months before any mammogram.

Explanation

Exogenous hormones can increase fibroglandular density, which may reduce mammographic sensitivity, and long-term use is associated with a small increase in breast cancer risk. Current hormone use, dose, and duration should be recorded on the history form. Abrupt discontinuation solely for imaging is not required.

Question 16Patient Education and Assessment

A patient with breast implants asks what will be different about her mammogram. What should she be told?

  1. Mammography is contraindicated once implants have been placed.
  2. Only breast MRI can be used to evaluate tissue around implants.
  3. Implants do not change the standard imaging routine at all.
  4. Additional views are taken with the implant displaced so more tissue is visible. Correct answer.

Explanation

Implant-displacement (Eklund) technique pushes the implant back against the chest wall while pulling breast tissue forward into the compression paddle. This allows more fibroglandular tissue to be imaged than standard views alone. Mammography remains safe and is not contraindicated in patients with implants.

Question 17Patient Education and Assessment

A patient reports a prior lumpectomy followed by radiation therapy. Why is this history important to document?

  1. Her insurance authorization number and primary care address.
  2. The site and date of surgery and radiation, so post-treatment change is not misread. Correct answer.
  3. Whether she was satisfied with her surgeon and the facility.
  4. Nothing; records from before the surgery are no longer relevant.

Explanation

Post-surgical scars, clips, and radiation change can mimic or mask recurrence on mammography. Knowing the exact site and dates allows the radiologist to compare with prior studies and to target additional views appropriately. This history therefore directly affects interpretation.

Question 18Patient Education and Assessment

A breastfeeding patient needs imaging for a new lump. What is the most appropriate information to give her?

  1. Only contrast-enhanced MRI is acceptable during lactation.
  2. She must wean completely before any breast imaging is performed.
  3. Mammography is absolutely contraindicated while she is breastfeeding.
  4. The exam can be done; she should empty the breast first and ultrasound may be used. Correct answer.

Explanation

Diagnostic mammography can be performed during lactation when clinically indicated, and the breast should be emptied beforehand to reduce discomfort and improve image quality. Ultrasound is often used first in a lactating patient with a focal complaint. Weaning is not a prerequisite for imaging.

Question 19Patient Education and Assessment

After teaching a patient how to prepare for her biopsy, the technologist asks her to restate the instructions in her own words. This technique is called:

  1. Teach-back, which confirms understanding rather than recall of words. Correct answer.
  2. Having a family member sign a form acknowledging the teaching.
  3. Giving the patient a printed brochure at the end of the visit.
  4. Repeating the same instructions more loudly and slowly.

Explanation

Teach-back asks the patient to explain or demonstrate the information in her own words, which reveals gaps in understanding. It shifts responsibility for clear communication to the educator. Providing written material or a signature alone does not confirm comprehension.

Question 20Patient Education and Assessment

A patient has asked to be contacted by telephone with her imaging results. What is the best practice?

  1. Read the report to whoever answers her telephone.
  2. Leave a call-back number with no clinical detail, per her documented preference. Correct answer.
  3. Leave the full findings on voicemail because it saves a return call.
  4. Refuse to contact the patient by telephone under any circumstance.

Explanation

Results communication should follow the patient's documented preference while protecting confidentiality. A message that identifies the caller and requests a return call avoids disclosing clinical information to others. Detailed findings are then shared directly with the patient.

Question 21Patient Education and Assessment

Which personal or family history most strongly warrants referral for genetic counseling and possible BRCA testing?

  1. An aunt diagnosed with breast cancer at age 68.
  2. A cousin diagnosed with breast cancer at age 61.
  3. A grandmother diagnosed with breast cancer at age 72.
  4. A mother diagnosed with breast cancer at age 42. Correct answer.

Explanation

Early-onset breast cancer in a first-degree relative is a recognized indication for genetic risk evaluation, because young age at diagnosis suggests possible inherited predisposition. Later-onset disease in more distant relatives carries much less weight. A formal risk assessment determines whether testing is offered.

Question 22Patient Education and Assessment

A 42-year-old woman at average risk asks when she should begin screening mammography. Which response best reflects current United States guidance?

  1. She must wait until age 50 because earlier screening has no benefit.
  2. Screening is not recommended for women under 60 years of age.
  3. Offer screening now, at 40, with shared decision-making. Correct answer.
  4. Screening begins at 30 for every woman regardless of risk.

Explanation

Major United States guidelines now support offering screening mammography beginning at age 40, with decisions individualized through shared decision-making. At 42, this patient is within the recommended screening range. Age 30 screening is reserved for higher-risk groups.

Question 23Patient Education and Assessment

A patient is concerned about radiation from mammography. Which statement best communicates the actual risk?

  1. The dose is low, roughly equal to a few weeks of natural background radiation. Correct answer.
  2. The dose accumulates, so each prior mammogram doubles the total risk.
  3. The dose is about the same as a computed tomography scan of the chest.
  4. Mammography uses sound waves, so there is no radiation exposure.

Explanation

The average glandular dose from a screening mammogram is very low, on the order of a few weeks of natural background radiation. This low dose is weighed against the substantial mortality benefit of early detection. Mammography does use ionizing radiation, so the comparison should be accurate.

Question 24Patient Education and Assessment

A patient with a new palpable lump arrives with an order for a screening mammogram. Why should the order be changed before imaging?

  1. Screening examinations do not include breast compression.
  2. A diagnostic exam lets the radiologist image the lump and give results promptly. Correct answer.
  3. Diagnostic examinations use no ionizing radiation at all.
  4. Screening images cannot be interpreted when a lump is present.

Explanation

A palpable symptom converts the study from screening to diagnostic, which permits tailored views, ultrasound correlation, and radiologist supervision with timely communication of results. Screening protocols are designed for asymptomatic patients and may not characterize the area of concern. The distinction is about intent and workup, not about radiation.

Question 25Patient Education and Assessment

Which statement best follows plain-language principles for patient education?

  1. We will acquire craniocaudal and mediolateral oblique projections of both breasts.
  2. We will take two pictures of each breast, and the machine will press for a few seconds. Correct answer.
  3. Protocol requires adequate immobilization of the breast tissue bilaterally.
  4. Bilateral mammographic acquisition with compression will be performed.

Explanation

Plain language uses common words, short sentences, and concrete descriptions rather than technical terminology. Saying "two pictures" and "press for a few seconds" conveys the same information a patient needs without jargon. Technical terms such as projections, immobilization, and acquisition are appropriate for documentation but not for patient teaching.

Question 26Patient Education and Assessment

A patient scheduled for a screening mammogram asks whether she may apply her usual antiperspirant before the appointment. What is the best response?

  1. Apply it as usual, because modern deodorants do not affect mammography.
  2. Use a talcum powder instead, since powder is invisible on mammograms.
  3. Apply it only under the arm on the side that will not be imaged.
  4. Skip it; it can create artifacts on the image. Correct answer.

Explanation

Antiperspirants, powders, and lotions can contain metallic particles that mimic calcifications or obscure breast tissue on the image, sometimes requiring repeat exposures. Patients should be asked to wash the area and not reapply these products before the examination.

Question 27Patient Education and Assessment

Which explanation best describes why firm breast compression is used during mammography?

  1. It shortens the exposure by increasing the source-to-image distance.
  2. It prevents the breast from moving during the exposure only.
  3. It eliminates the need for two views of each breast.
  4. It reduces radiation dose and improves image sharpness. Correct answer.

Explanation

Compression thins the breast, so less radiation is needed and scatter is reduced, which improves contrast and sharpness. It also immobilizes the breast, but dose reduction and image quality are the primary technical reasons.

Question 28Patient Education and Assessment

During positioning, the technologist should protect a patient's modesty by:

  1. Keeping the door open so the patient does not feel confined.
  2. Completing the examination quickly without explaining each step.
  3. Exposing only the breast being imaged and offering a drape. Correct answer.
  4. Allowing the patient to remain fully dressed during positioning.

Explanation

Only the breast being examined should be exposed, and the rest of the patient should be covered with a gown or drape. Privacy is maintained by closing doors, using screens, and explaining each step before it occurs.

Question 29Patient Education and Assessment

A patient with an implanted cardiac pacemaker is concerned that mammography will harm the device. What is the most accurate information?

  1. Only the breast on the opposite side from the device may be imaged.
  2. The device must be switched off by her cardiologist before the examination.
  3. Mammography is contraindicated for anyone who has a pacemaker.
  4. Mammography is safe; the device is outside the imaging field. Correct answer.

Explanation

A pacemaker generator lies in the chest wall, outside the breast tissue that is imaged, so standard mammography can be performed safely. The technologist should document the device and position the patient carefully to avoid pressure on it.

Question 30Patient Education and Assessment

For a premenopausal woman with no breast symptoms, when is mammography generally best tolerated?

  1. During the week before her menstrual period.
  2. During menstruation, when the breast is softest.
  3. At mid-cycle, when hormone levels are highest.
  4. During the week after her menstrual period. Correct answer.

Explanation

Breast tenderness is typically least in the week following menses, when hormonal stimulation is low. Scheduling then allows better compression and greater comfort.

Question 31Patient Education and Assessment

A patient asks whether the mammogram will tell her for certain that she does not have cancer. What is the best response?

  1. Yes, if both standard views of each breast are normal.
  2. Yes, a normal mammogram reliably rules out breast cancer in all women.
  3. No; mammography can miss some cancers. Correct answer.
  4. No; only a breast MRI can exclude breast cancer in every case.

Explanation

Mammography has a false-negative rate, particularly in dense breasts, so a normal result does not guarantee the absence of cancer. Any new lump or symptom should be evaluated even when the mammogram is normal.

Question 32Patient Education and Assessment

A patient who is deaf and communicates by lip reading arrives for her mammogram. Which approach is best?

  1. Rely on her companion to relay all instructions.
  2. Speak loudly and directly into her ear.
  3. Postpone the examination until a sign language interpreter is available.
  4. Face her at eye level and use written instructions as needed. Correct answer.

Explanation

Lip readers need to see the speaker's face clearly, so the technologist should face the patient at eye level with good lighting and supplement speech with written instructions. An interpreter is arranged when requested or when communication cannot otherwise be achieved.

Question 33Patient Education and Assessment

Which instruction about dress is most helpful to a patient before a mammogram?

  1. Wear a supportive sports bra to hold the breasts during positioning.
  2. Wear only a hospital gown provided when she arrives.
  3. Wear a two-piece outfit so she removes only her top. Correct answer.
  4. Wear a dress so the breast can be exposed more easily.

Explanation

A two-piece outfit lets the patient undress from the waist up and keep her skirt or trousers on, which preserves modesty and comfort. Bras must be removed for imaging regardless of style.

Question 34Patient Education and Assessment

Why is it important to obtain a patient's prior mammograms before interpreting a new study?

  1. Old studies are required for insurance billing only.
  2. Comparison shows whether a finding is new or stable. Correct answer.
  3. Prior images eliminate the need for current images.
  4. Prior images allow the technologist to skip compression.

Explanation

Comparison with earlier studies lets the radiologist determine whether a finding is new, increasing, or unchanged over time. Stability often spares the patient unnecessary additional imaging or biopsy.

Question 35Patient Education and Assessment

Which statement best reflects current guidance on breast self-examination?

  1. Self-examination must be performed on the same date each month to be valid.
  2. Know how the breasts normally look and feel, and report changes. Correct answer.
  3. Self-examination should replace mammography in women under 40.
  4. Monthly self-examination in the shower is required for all women over 20.

Explanation

Current guidance emphasizes breast self-awareness rather than a formally taught monthly self-examination, because regular self-exam has not been shown to reduce mortality. Patients should recognize what is normal for them and report new changes promptly.

Question 36Patient Education and Assessment

A patient scheduled for screening reports that her breasts have been painful and lumpy before her periods for years. What should the technologist do?

  1. Reschedule the appointment for the middle of her cycle.
  2. Cancel the examination because pain makes imaging unreliable.
  3. Document the history and continue the scheduled examination. Correct answer.
  4. Tell her that the pain means she does not need imaging.

Explanation

Cyclic breast pain and lumpiness are common and are not usually a sign of malignancy, so the history is recorded and the examination proceeds. Documenting symptoms ensures the interpreting radiologist has the full clinical picture.

Question 37Patient Education and Assessment

A patient asks how digital breast tomosynthesis differs from a standard mammogram. What should she be told?

  1. It produces images only of the skin surface.
  2. It replaces the need for breast compression.
  3. It creates thin slice images from multiple low-dose exposures. Correct answer.
  4. It uses no radiation, unlike a standard mammogram.

Explanation

Tomosynthesis acquires multiple low-dose projection images as the x-ray tube moves, and these are reconstructed into thin slices through the breast. This can reduce tissue overlap and improve lesion visibility, but compression and radiation exposure still apply.

Question 38Patient Education and Assessment

A 35-year-old woman with a known BRCA1 mutation asks what breast screening she needs. What is the best information?

  1. No imaging until age 50 because her breasts are dense.
  2. Annual MRI plus mammography, usually starting by age 30. Correct answer.
  3. Ultrasound alone every year.
  4. Mammography alone every 2 years beginning at age 40.

Explanation

BRCA mutation carriers are at high lifetime risk and are generally screened with annual breast MRI in addition to mammography, often beginning around age 30. Screening decisions are made with the patient's high-risk clinician.

Question 39Patient Education and Assessment

A patient mentions that a benign biopsy 5 years ago showed atypical ductal hyperplasia. Why is this important to document?

  1. It has no bearing on imaging decisions.
  2. It means she no longer needs screening mammography.
  3. It raises her cancer risk and may change screening recommendations. Correct answer.
  4. It requires that only her contralateral breast be imaged.

Explanation

Atypical ductal hyperplasia is a proliferative lesion associated with an elevated risk of subsequent breast cancer. Documenting it allows the radiologist to tailor surveillance and consider risk-reduction discussion.

Question 40Patient Education and Assessment

Before an ultrasound-guided core needle biopsy, a patient reports taking warfarin. What is the technologist's most appropriate action?

  1. Notify the radiologist so the medication can be managed first. Correct answer.
  2. Proceed without informing the radiologist.
  3. Cancel the biopsy and schedule surgery instead.
  4. Instruct her to stop the warfarin for 5 days.

Explanation

Anticoagulation increases bleeding risk with core biopsy, and management decisions belong to the radiologist in consultation with the prescribing clinician. The technologist's role is to identify the medication and report it promptly.

Question 41Patient Education and Assessment

After a stereotactic core biopsy, the patient should be instructed to:

  1. Exercise the arm vigorously to prevent stiffness.
  2. Apply heat to the biopsy site several times daily.
  3. Keep the dressing dry and avoid strenuous activity for a few days. Correct answer.
  4. Take aspirin for pain and remove the dressing the same day.

Explanation

Post-biopsy care aims to limit bleeding and promote healing, so the dressing is kept dry as directed and heavy lifting or vigorous exercise is avoided for a few days. Acetaminophen is generally preferred over aspirin, which can increase bleeding.

Question 42Patient Education and Assessment

A man presents with a palpable subareolar lump and an order for mammography. What should the technologist know?

  1. Only ultrasound should be performed in men.
  2. Male patients should be imaged with the same views as a female screening.
  3. Male breast tissue can be imaged with standard mammographic views. Correct answer.
  4. Mammography is not useful in men because of small breast size.

Explanation

Male breast tissue can be examined with standard craniocaudal and mediolateral oblique views, often supplemented with a true lateral or angled views as needed. The examination is diagnostic rather than a bilateral screening study.

Question 43Patient Education and Assessment

A patient who had a right mastectomy is scheduled for a left screening mammogram. What should be done?

  1. Image the remaining breast and document the mastectomy. Correct answer.
  2. Cancel because screening is not possible after mastectomy.
  3. Image the mastectomy site with additional views.
  4. Image only the mastectomy side.

Explanation

The remaining breast continues to carry cancer risk and should be screened, and the history of mastectomy belongs in the documentation. The reconstructed or mastectomy side is imaged only when there is a specific clinical indication.

Question 44Patient Education and Assessment

A patient does not want her prior mammograms released to the current facility. What is the best action?

  1. Refuse to perform the examination.
  2. Ask the radiologist to interpret without prior comparison.
  3. Document the refusal and proceed with the examination. Correct answer.
  4. Obtain the films without her knowledge.

Explanation

The patient controls release of her records, so her decision is documented and the current examination is completed. Documentation protects the facility and alerts the radiologist that comparison images are unavailable.

Question 45Patient Education and Assessment

A patient arrives for mammography with a nipple piercing. What is the best approach?

  1. Image through the jewelry without comment because metal does not affect mammography.
  2. Ask her to remove it and proceed without documenting the removal.
  3. Ask her to remove it; if she cannot, document it and image carefully. Correct answer.
  4. Cancel the examination until the jewelry is permanently removed.

Explanation

Metal jewelry can obscure tissue and create artifact, so the patient is asked to remove it when possible. If it cannot be removed, the technologist documents its presence and positions carefully to obtain the best diagnostic images.

Question 46Patient Education and Assessment

A transgender woman who has been on estrogen therapy for several years asks about breast screening. What is the most appropriate response?

  1. She should have an annual breast MRI beginning at age 25.
  2. Individualize screening based on hormone use, risk factors, and guidelines. Correct answer.
  3. She needs no breast imaging at all because she does not have ovaries or native breast tissue.
  4. She should be screened exactly like a cisgender man of the same age.

Explanation

Transgender women who develop breast tissue with hormone therapy may be at increased breast cancer risk, and screening recommendations depend on duration of hormone use, age, and other risk factors. Decisions should be individualized with the patient's clinician rather than applying male or female schedules automatically.

Question 47Patient Education and Assessment

A 41-year-old woman at average risk asks whether she should start screening now. Which response best reflects current practice?

  1. Guidelines differ; she should discuss benefits and harms with her clinician. Correct answer.
  2. Screening before age 50 is never recommended for any woman.
  3. Screening should begin only after her first mammogram is abnormal.
  4. She must begin annual MRI immediately as her primary screening test.

Explanation

Major organizations differ on the recommended starting age for average-risk women, and the choice involves trade-offs between earlier detection and false positives. Shared decision-making with her clinician reflects current practice.

Question 48Patient Education and Assessment

When explaining the benefit of screening mammography, which statement best supports informed decision-making?

  1. Screening reduces your risk by 20%, so you are 20% less likely to die.
  2. Screening guarantees that you will not die of breast cancer.
  3. Screening doubles your chance of survival compared with not being screened.
  4. About 1 to 2 deaths are prevented per 1,000 women screened over 10 years. Correct answer.

Explanation

Absolute numbers communicate benefit more accurately than relative risk percentages, which tend to overstate the effect. Stating events per 1,000 women lets the patient weigh the benefit against the harms of false positives and overdiagnosis.

Question 49Patient Education and Assessment

A patient's adult daughter calls and asks for her mother's mammogram results. What is the best response?

  1. Tell her to come in person to collect the report.
  2. Results can be released only to the patient or someone she has authorized. Correct answer.
  3. Give the results because she is an immediate family member.
  4. Read the report to her if the patient is over 65 years old.

Explanation

Imaging results are protected health information and may be disclosed only to the patient or to a person the patient has authorized in writing. Family relationship alone does not permit release.

Question 50Patient Education and Assessment

A patient with severe kyphosis cannot stand upright at the mammography unit. What is the best approach?

  1. Ask her to lie on the floor for the examination.
  2. Perform only a single view of each breast.
  3. Adapt positioning and pad the unit as needed for the best views. Correct answer.
  4. Refuse to image because proper views cannot be obtained.

Explanation

Patients with musculoskeletal deformity can often be imaged by modifying the technologist's stance, using cushions for support, and adapting the unit's height and angle. The goal is to obtain the most diagnostic views the patient can tolerate and to document any limitations.