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CT practice questions

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First 50 of 199 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 Care and Safety (unofficial placeholder - see needs_review)

A technologist is preparing to inject iodinated contrast for a CT abdomen/pelvis. Which pre-procedure assessment is most important for reducing the risk of contrast-induced acute kidney injury?

  1. Obtaining the patient's most recent serum creatinine and eGFR Correct answer.
  2. Confirming the patient has fasted for at least four hours
  3. Recording the patient's current blood pressure in both arms
  4. Asking whether the patient has any known shellfish allergy

Explanation

Baseline renal function, reflected by serum creatinine and estimated GFR, determines whether iodinated contrast is safe and whether pre-hydration or an alternative study is needed. Renal impairment is the key modifiable risk factor for contrast-induced nephropathy, so this measurement must precede injection. Fasting and blood pressure are relevant to other aspects of care but do not stratify kidney injury risk.

Question 2Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT examination the patient reports a warm flushing sensation and a metallic taste immediately after the contrast injection begins. What is the most appropriate technologist response?

  1. Stop the injection and call a code blue immediately
  2. Remove the IV line and restart it in the opposite arm
  3. Reassure the patient that these are expected transient effects and continue monitoring Correct answer.
  4. Document a severe anaphylactoid reaction in the report

Explanation

A warm flush and metallic taste are common, benign sensations during iodinated contrast administration and typically resolve within seconds to minutes. The technologist should reassure the patient while continuing to watch for true hypersensitivity signs such as urticaria, bronchospasm, or hypotension. Aborting the study or labeling it anaphylaxis would be an overreaction to a normal physiologic response.

Question 3Patient Care and Safety (unofficial placeholder - see needs_review)

Which patient instruction best describes the purpose of breath-holding during a CT chest acquisition?

  1. It minimizes motion artifact so small pulmonary nodules are not blurred Correct answer.
  2. It reduces the radiation dose delivered to the thyroid
  3. It prevents the patient from swallowing oral contrast
  4. It speeds the rotation of the gantry for thinner slices

Explanation

Respiratory motion during a chest CT degrades spatial resolution and can smear small nodules or vessels, mimicking or masking disease. A consistent breath-hold at the same lung volume also prevents misregistration between slices. Breath-holding does not change gantry speed or thyroid dose.

Question 4Patient Care and Safety (unofficial placeholder - see needs_review)

A patient arrives for a CT with an order for oral contrast. Which finding should prompt the technologist to hold the study and consult the radiologist before administration?

  1. The patient has a documented allergy to penicillin
  2. The patient wears removable dentures
  3. The patient has mild osteoarthritis of the knee
  4. The patient reports a suspected bowel obstruction with active vomiting Correct answer.

Explanation

Oral contrast is generally contraindicated or requires careful reconsideration when there is a suspected obstruction with vomiting, because of aspiration risk and the potential for contrast to accumulate proximal to the blockage. The radiologist should determine whether the study can proceed or be modified. Penicillin allergy, dentures, and joint disease do not contraindicate oral contrast.

Question 5Patient Care and Safety (unofficial placeholder - see needs_review)

Which practice most directly reduces radiation dose to the patient during a routine CT abdomen/pelvis?

  1. Using automatic exposure control with appropriate tube current modulation Correct answer.
  2. Administering intravenous contrast to improve tissue contrast
  3. Increasing the pitch to reduce the number of overlapping slices
  4. Reconstructing images with a sharper kernel

Explanation

Automatic exposure control adjusts tube current to the patient's attenuation, lowering dose in thinner or less dense regions while preserving diagnostic quality. This is a core dose-optimization tool in modern CT. Kernel selection and contrast administration affect image appearance, not the radiation burden.

Question 6Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a known history of mild allergic reaction to iodinated contrast requires a CT with contrast. Which premedication approach is commonly used when the study cannot be delayed?

  1. A corticosteroid regimen beginning 13 hours before the scan, often with an antihistamine Correct answer.
  2. Switching to barium intravenous contrast instead
  3. No premedication is ever appropriate for prior reactors
  4. A single dose of oral diphenhydramine 30 minutes before the scan

Explanation

Standard premedication for prior mild contrast reactors uses a corticosteroid such as prednisone over roughly 13 hours, frequently combined with an antihistamine like diphenhydramine. The steroid dampens the delayed hypersensitivity response while the antihistamine addresses immediate symptoms. Barium is never given intravenously.

Question 7Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT-guided biopsy, the patient becomes diaphoretic, pale, and reports feeling faint while lying supine. What is the most appropriate first action?

  1. Immediately administer intravenous epinephrine
  2. Increase the table height to improve access
  3. Continue the procedure and document the symptoms afterward
  4. Elevate the patient's legs and assess vital signs while pausing the procedure Correct answer.

Explanation

These signs suggest a vasovagal reaction, which is managed by pausing the procedure, supine positioning with leg elevation to improve venous return, and monitoring vital signs. Most episodes resolve with these measures. Epinephrine is reserved for true anaphylaxis, not simple vasovagal syncope.

Question 8Patient Care and Safety (unofficial placeholder - see needs_review)

A female patient of childbearing age is scheduled for a CT abdomen/pelvis. She states her last menstrual period was five weeks ago and she is unsure whether she could be pregnant. What is the most appropriate course of action?

  1. Cancel the study permanently and refer her to MRI without notifying the radiologist
  2. Proceed with the scan because CT is always safe in pregnancy
  3. Inform the radiologist so the indication, pregnancy status, and possible alternatives can be evaluated before scanning Correct answer.
  4. Ask the patient to sign a waiver and scan without further discussion

Explanation

When pregnancy status is uncertain, the radiologist must weigh the medical necessity of the CT against fetal radiation risk and consider alternatives such as ultrasound or MRI. The technologist's role is to communicate the uncertainty, not to decide unilaterally. A documented discussion protects both the patient and the care team.

Question 9Patient Care and Safety (unofficial placeholder - see needs_review)

A patient is scheduled for a CT colonography. Which bowel preparation instruction is most appropriate?

  1. No preparation is needed because CO2 insufflation clears stool
  2. A high-fiber diet on the morning of the exam to distend the colon
  3. Only a single glass of water two hours before the scan
  4. A clear liquid diet and a prescribed laxative regimen the day before the exam Correct answer.

Explanation

CT colonography requires a clean colon so residual stool is not mistaken for polyps. A clear liquid diet with a prescribed laxative preparation the day before is standard. Fiber or no preparation leaves debris that degrades the exam, and CO2 distends but does not clean the colon.

Question 10Patient Care and Safety (unofficial placeholder - see needs_review)

Which action best protects a patient with a known seizure disorder during a CT head without sedation?

  1. Administer a sedative without a physician order
  2. Keep the room quiet, minimize stimulation, and maintain continuous observation during the scan Correct answer.
  3. Restrain the patient's arms tightly to the table
  4. Turn off the patient monitoring to reduce electrical interference

Explanation

Reducing sensory stimulation and maintaining direct observation help prevent and promptly detect seizure activity during the brief scan. The technologist should also ensure the patient is not left alone and that emergency equipment is available. Sedation requires a physician order, and disabling monitoring removes the ability to detect deterioration.

Question 11Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a documented anaphylactic reaction to iodinated contrast is scheduled for a CT that absolutely requires contrast. Which element is essential in the care plan?

  1. Proceeding without any premedication because the benefit outweighs the risk
  2. Premedication plus immediate availability of resuscitation equipment and personnel Correct answer.
  3. Replacing contrast with a saline bolus to simulate enhancement
  4. Using a lower-osmolarity agent alone as sufficient protection

Explanation

For prior severe reactors, premedication is combined with readiness to treat a breakthrough reaction, including airway equipment, epinephrine, and trained staff. Lower-osmolarity agents reduce but do not eliminate risk. Saline does not provide contrast enhancement.

Question 12Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT examination the technologist notes the patient's IV site is swelling and the patient reports pain at the site. What is the most appropriate immediate action?

  1. Increase the injection rate to clear the obstruction
  2. Stop the injection, assess the site, and manage the extravasation per protocol Correct answer.
  3. Apply heat immediately and resume the injection
  4. Continue the scan and document the finding afterward

Explanation

Swelling and pain at the IV site indicate extravasation, and the injection must stop immediately to limit tissue injury. The technologist should assess the extent, elevate the limb, apply cold compresses per protocol, and notify the radiologist. Increasing the rate or resuming the injection would worsen the injury.

Question 13Patient Care and Safety (unofficial placeholder - see needs_review)

A patient scheduled for CT with IV contrast takes metformin for type 2 diabetes and has an eGFR of 35 mL/min/1.73 m². What is the most appropriate technologist action?

  1. Instruct the patient to double the metformin dose after the scan
  2. Refuse to perform any CT on the patient
  3. Proceed with contrast without notifying anyone because metformin is unrelated
  4. Notify the radiologist so the metformin and contrast protocol can be addressed before injection Correct answer.

Explanation

Reduced eGFR plus metformin raises concern for metformin-associated lactic acidosis if contrast worsens renal function, so institutional protocols often call for holding metformin and checking renal function. The radiologist and prescribing clinician should decide the timing. The technologist should escalate rather than proceed or refuse unilaterally.

Question 14Patient Care and Safety (unofficial placeholder - see needs_review)

Which patient is at greatest risk of aspiration during a CT study requiring oral contrast?

  1. A 30-year-old with a sprained ankle
  2. A 75-year-old with a recent stroke and difficulty swallowing Correct answer.
  3. A 45-year-old with well-controlled hypertension
  4. A 22-year-old with a mild sunburn

Explanation

Dysphagia after stroke greatly increases the risk of aspirating oral contrast, which can cause pneumonitis or airway obstruction. Such patients require a swallowing assessment or an alternative route before oral contrast is given. The other patients have no swallowing impairment.

Question 15Patient Care and Safety (unofficial placeholder - see needs_review)

A patient scheduled for CT with IV contrast reports a history of asthma and prior wheezing after contrast. What is the most appropriate action?

  1. Inform the radiologist so premedication and asthma control can be considered Correct answer.
  2. Proceed without any additional precautions
  3. Cancel all future contrast studies for this patient
  4. Administer oral corticosteroids without an order

Explanation

Asthma and prior contrast-related bronchospasm increase the risk of a hypersensitivity reaction, so the radiologist should decide whether premedication or an alternative is needed. The technologist should communicate the history rather than act independently. Blanket cancellation is unnecessary and giving steroids without an order exceeds scope.

Question 16Patient Care and Safety (unofficial placeholder - see needs_review)

Which practice best reduces the radiation dose to a pediatric patient undergoing CT?

  1. Increasing the number of phases to improve diagnostic confidence
  2. Using adult protocols to ensure image quality
  3. Repeating the scan whenever motion is suspected
  4. Applying size-based protocols with reduced tube current and appropriate collimation Correct answer.

Explanation

Children are more radiosensitive and have a longer lifetime to accumulate risk, so size-specific protocols that lower tube current and tighten collimation are essential. Adult protocols deliver unnecessarily high dose. Extra phases and repeat scans add dose without clear benefit.

Question 17Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a pacemaker is scheduled for a CT study. Which statement is most accurate regarding CT and implanted cardiac devices?

  1. CT is absolutely contraindicated for any patient with a pacemaker
  2. CT will erase the pacemaker's programming in all cases
  3. The pacemaker must always be reprogrammed before every CT
  4. CT is generally safe for modern pacemakers, but the device should be identified and the radiologist informed Correct answer.

Explanation

CT does not use strong static magnetic fields like MRI, so modern pacemakers are generally compatible, but device identification and communication with the radiologist remain prudent, especially for scans near the chest. Routine reprogramming is not required. Absolute contraindication is incorrect.

Question 18Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT study, the technologist notices the patient's IV line has a blood return and the site looks clean. What does this finding most likely indicate?

  1. The contrast has extravasated into tissue
  2. The IV is patent and properly positioned Correct answer.
  3. The patient is having an allergic reaction
  4. The IV has infiltrated and must be removed

Explanation

A blood return with a clean site indicates the catheter tip is within the vein and the line is patent, which is desirable before contrast injection. Infiltration and extravasation produce swelling and pain, not a clean site with blood return. Allergic reactions present with systemic symptoms.

Question 19Patient Care and Safety (unofficial placeholder - see needs_review)

A patient scheduled for CT reports claustrophobia and is anxious about the scanner. Which intervention is most appropriate first?

  1. Administer general anesthesia in the CT room
  2. Immediately cancel the study and refer to psychiatry
  3. Physically restrain the patient without explanation
  4. Explain the procedure, offer a short scan with reassurance, and use comfort measures Correct answer.

Explanation

Clear explanation, reassurance, and comfort measures such as a calm environment or a hand to hold often allow anxious patients to complete a short CT. Cancellation or restraint should be avoided when less restrictive measures may succeed. General anesthesia requires appropriate personnel and is not a first-line measure.

Question 20Patient Care and Safety (unofficial placeholder - see needs_review)

Which action best demonstrates proper patient identification before a CT examination?

  1. Using two identifiers, such as name and date of birth, verified against the order Correct answer.
  2. Calling the patient's name from the doorway
  3. Assuming the previous shift identified the patient correctly
  4. Relying on the room number assigned to the patient

Explanation

Two independent identifiers verified against the order are the standard for safe patient identification and prevent wrong-patient errors. Calling a name alone is unreliable because multiple patients may respond. Room numbers and assumptions do not constitute verification.

Question 21Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a known latex allergy is scheduled for CT. Which preparation is most appropriate?

  1. Use standard latex gloves because contact is brief
  2. Proceed without any special precautions
  3. Use latex-free gloves, tubing, and supplies and inform the team Correct answer.
  4. Ask the patient to bring their own gloves

Explanation

For latex-allergic patients, all equipment that may contact the patient should be latex-free, and the care team should be informed to prevent accidental exposure. Brief contact can still trigger a reaction. Standard latex gloves and no precautions are unsafe.

Question 22Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT examination the patient becomes unresponsive and pulseless. What is the technologist's priority action?

  1. Initiate the emergency response, begin CPR, and call for help Correct answer.
  2. Lower the table and wait for the radiologist to arrive
  3. Document the event before assisting
  4. Finish the scan to obtain diagnostic images

Explanation

Cardiac arrest requires immediate activation of the emergency response system and initiation of CPR; completing the scan or documenting first wastes critical time. The technologist should call for help and begin basic life support while awaiting the code team. Waiting passively delays lifesaving intervention.

Question 23Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with severe renal impairment requires a CT with contrast. Which strategy best balances diagnostic need with safety?

  1. Administer contrast without any adjustment
  2. Consult the radiologist about minimizing contrast volume, hydrating, and considering alternatives Correct answer.
  3. Give oral contrast instead of IV contrast to achieve vascular enhancement
  4. Use the highest possible contrast volume to ensure enhancement

Explanation

In severe renal impairment, the team should minimize contrast volume, ensure hydration, and consider non-contrast or alternative imaging when possible. This balances diagnostic yield against the risk of further renal injury. High-volume contrast or unadjusted administration increases risk, and oral contrast cannot provide vascular enhancement.

Question 24Patient Care and Safety (unofficial placeholder - see needs_review)

A patient is receiving IV contrast through a peripheral IV in the antecubital fossa. Which factor most increases the risk of extravasation during power injection?

  1. A large-bore catheter in a straight, stable vein
  2. A catheter that flushes easily with a blood return
  3. A small-gauge catheter in a fragile vein with the arm positioned across the body Correct answer.
  4. A catheter secured with tape and a transparent dressing

Explanation

Small-gauge catheters in fragile veins, especially with the arm positioned awkwardly, are more prone to dislodgement and rupture during high-flow power injection. Large-bore, stable, well-secured catheters with good blood return are preferred. Proper securement reduces risk.

Question 25Patient Care and Safety (unofficial placeholder - see needs_review)

A technologist is asked to perform a CT on a patient who does not speak the same language and has no interpreter present. Which approach best supports informed consent and safety?

  1. Proceed using gestures and assume the patient understands
  2. Skip the explanation because the order already authorizes the study
  3. Ask another patient in the waiting room to translate
  4. Arrange a qualified medical interpreter before obtaining consent and explaining the procedure Correct answer.

Explanation

Informed consent and procedure explanation require effective communication, which a qualified medical interpreter provides. Using untrained bystanders or gestures risks misunderstanding and invalidates consent. A physician order does not replace the patient's informed participation.

Question 26Patient Care and Safety (unofficial placeholder - see needs_review)

A patient arrives for a CT chest with IV contrast and states she is 8 weeks pregnant. The referring clinician is unavailable. Which action is most appropriate for the technologist to take first?

  1. Discuss the pregnancy with the radiologist and defer the contrast study until the risk-benefit decision is documented Correct answer.
  2. Proceed with the scan because the referring clinician ordered it
  3. Perform the study without contrast and discharge the patient without documentation
  4. Cancel the appointment and tell the patient CT is never performed in pregnancy

Explanation

When pregnancy is disclosed, the technologist should notify the radiologist so the medical necessity and risk-benefit decision is made and documented before exposure, especially for a study involving the abdomen or pelvis. The technologist does not independently authorize or refuse the examination.

Question 27Patient Care and Safety (unofficial placeholder - see needs_review)

Which instruction best prepares an adult outpatient for a CT abdomen/pelvis with oral contrast?

  1. Arrive 60 to 90 minutes early to drink oral contrast so adequate bowel opacification is achieved Correct answer.
  2. Take a laxative the morning of the scan instead of oral contrast
  3. Fast for at least 8 hours and drink nothing at all before the scan
  4. Drink oral contrast immediately before entering the scan room

Explanation

Oral contrast needs time in the bowel to reach and opacify the stomach and intestinal loops, so patients typically arrive well before the scan to drink it over a set interval. Complete fasting is not required for oral contrast alone and would not produce opacification.

Question 28Patient Care and Safety (unofficial placeholder - see needs_review)

A patient is scheduled for CT with IV contrast and reports a prior reaction of hives and facial swelling after iodinated contrast. What is the most appropriate next step?

  1. Switch to oral contrast only, regardless of the clinical indication
  2. Proceed at full dose because hives are not a serious reaction
  3. Cancel all future contrast studies permanently
  4. Notify the radiologist so a premedication or alternative plan can be determined before the study Correct answer.

Explanation

A prior hypersensitivity reaction, particularly with angioedema, warrants radiologist review to select premedication, an alternative agent, or a different study. The decision is a physician risk-benefit judgment, not a technologist's unilateral choice.

Question 29Patient Care and Safety (unofficial placeholder - see needs_review)

Which practice most effectively reduces radiation dose to a pediatric patient during a CT abdomen?

  1. Applying size-based, weight-adjusted scanning parameters and limiting the scan range to the indication Correct answer.
  2. Repeating the scan to confirm findings in every case
  3. Using the adult protocol with the same kVp and mAs
  4. Increasing pitch only while keeping all other parameters at adult settings

Explanation

Pediatric dose reduction relies on adjusting kVp and mAs to patient size and restricting the scanned volume to what the clinical question requires. These measures lower dose without sacrificing diagnostic quality.

Question 30Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT with IV contrast, the patient reports a metallic taste, flushing, and warmth spreading from the injection site. What is the most appropriate interpretation?

  1. This is anaphylaxis requiring epinephrine
  2. This is a mild, expected physiologic response to contrast that usually resolves without treatment Correct answer.
  3. This indicates a vasovagal reaction requiring leg elevation
  4. This indicates contrast extravasation requiring immediate line removal

Explanation

Warmth, flushing, and a metallic taste are common mild physiologic responses to iodinated contrast and typically resolve spontaneously. The technologist should reassure the patient while continuing to monitor.

Question 31Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a documented severe reaction to gadolinium-based contrast is scheduled for a CT with iodinated contrast. How should the technologist interpret the allergy history?

  1. The gadolinium allergy guarantees a reaction to iodinated contrast
  2. Iodinated contrast should be withheld indefinitely because of any contrast allergy
  3. The two agents are different, so the iodinated contrast history should still be reviewed and the radiologist informed of all prior reactions Correct answer.
  4. The patient should receive gadolinium instead for the CT

Explanation

Gadolinium-based and iodinated contrast agents are chemically distinct, but any prior contrast reaction should be reported to the radiologist so risk is assessed appropriately. The technologist should not assume cross-reactivity or ignore the history.

Question 32Patient Care and Safety (unofficial placeholder - see needs_review)

Before a CT with IV contrast, which laboratory value is most relevant to assessing the risk of contrast-induced kidney injury?

  1. Platelet count
  2. Serum creatinine or eGFR Correct answer.
  3. Hemoglobin
  4. Serum potassium

Explanation

Renal function, reflected by serum creatinine or estimated glomerular filtration rate, determines whether iodinated contrast can be safely given. Potassium, hemoglobin, and platelets do not assess contrast-related renal risk.

Question 33Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a known seizure disorder is scheduled for a CT head without sedation. Which action best supports safety during the study?

  1. Confirm the patient has taken prescribed antiseizure medication and keep the environment calm and monitored Correct answer.
  2. Withhold all communication about the scan to reduce anxiety
  3. Ask the patient to hold still even if an aura begins
  4. Restrain the patient's head with tape before scanning

Explanation

Confirming medication compliance and maintaining a calm, monitored environment reduces the likelihood of a seizure during scanning. Restraint and withholding information increase stress and risk.

Question 34Patient Care and Safety (unofficial placeholder - see needs_review)

A patient is scheduled for CT angiography and has a peripheral IV in a hand vein. Which factor most increases the risk of contrast extravasation?

  1. Warming the contrast to body temperature before injection
  2. A small-gauge catheter in a distal vein with high injection pressure Correct answer.
  3. Use of a power injector with a pressure limit set by protocol
  4. A large-bore catheter in a proximal vein

Explanation

Small-gauge catheters in distal veins are more prone to extravasation when high flow rates and pressures are used for CT angiography. Proximal large-bore access is preferred for high-rate injections.

Question 35Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT-guided biopsy, the patient becomes pale, diaphoretic, and reports feeling faint while supine. What is the most appropriate initial response?

  1. Stop the procedure, assess the patient, and consider elevating the legs if vasovagal symptoms are confirmed Correct answer.
  2. Increase the table height and continue the procedure
  3. Administer oral fluids immediately and resume
  4. Ignore the symptoms because they are expected during biopsy

Explanation

These findings suggest a vasovagal reaction, so the procedure should pause while the patient is assessed and supported, often with leg elevation to improve venous return. Continuing without assessment risks syncope and injury.

Question 36Patient Care and Safety (unofficial placeholder - see needs_review)

A patient scheduled for CT with IV contrast takes metformin and has an eGFR of 35 mL/min/1.73 m². What is the most appropriate action?

  1. Proceed without any communication because metformin is unrelated to contrast
  2. Double the metformin dose to offset contrast effects
  3. Stop metformin permanently without consulting the prescriber
  4. Notify the radiologist so the need to hold metformin after contrast can be assessed Correct answer.

Explanation

In reduced renal function, metformin may need to be withheld after iodinated contrast to reduce the risk of lactic acidosis, and the decision should involve the radiologist and prescriber. The technologist should not alter the medication independently.

Question 37Patient Care and Safety (unofficial placeholder - see needs_review)

A technologist notices the patient's IV site is swelling and the patient reports pain during a contrast injection. What is the immediate priority?

  1. Remove the IV and send the patient home without documentation
  2. Stop the injection, assess the site, and follow the extravasation protocol Correct answer.
  3. Continue the injection to complete the study
  4. Increase the injection rate to finish faster

Explanation

Swelling and pain during injection suggest extravasation, so the injection must stop immediately and the facility extravasation protocol followed. Continuing the injection worsens tissue injury.

Question 38Patient Care and Safety (unofficial placeholder - see needs_review)

A female patient of childbearing age is scheduled for a CT abdomen/pelvis and states her last menstrual period was five weeks ago. What is the most appropriate action?

  1. Ask about pregnancy status and notify the radiologist before scanning Correct answer.
  2. Tell the patient to reschedule in nine months
  3. Perform the scan without discussion to avoid delay
  4. Proceed because pregnancy is impossible at five weeks

Explanation

A missed or recent period raises the possibility of pregnancy, so pregnancy status should be clarified and the radiologist informed before a pelvic CT. The technologist should not assume pregnancy status either way.

Question 39Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a pacemaker is scheduled for a CT study. Which statement is most accurate?

  1. The pacemaker must be removed before CT
  2. Most modern pacemakers are compatible with CT, but the device status and any magnet mode considerations should be reviewed Correct answer.
  3. CT is absolutely contraindicated for any patient with a pacemaker
  4. CT always reprograms the pacemaker

Explanation

CT does not generally use strong static magnetic fields like MRI, so most pacemakers are compatible, though device status and potential magnet mode effects should be reviewed. Removal is not required for CT.

Question 40Patient Care and Safety (unofficial placeholder - see needs_review)

A patient reports claustrophobia and anxiety before a CT scan. Which intervention is most appropriate?

  1. Explain the procedure, allow a support person if policy permits, and use comfort measures such as a call bell and reassurance Correct answer.
  2. Cancel the scan and refer the patient elsewhere
  3. Sedate the patient without a physician order
  4. Tell the patient the scanner is open and there is nothing to fear, then proceed quickly

Explanation

Explaining the procedure and offering comfort measures reduces anxiety and improves cooperation. Sedation requires a physician order, and cancellation is unnecessary when supportive measures are available.

Question 41Patient Care and Safety (unofficial placeholder - see needs_review)

A patient does not speak the same language as the technologist and no interpreter is present. Which action is most appropriate before obtaining informed consent for contrast?

  1. Arrange qualified interpretation services before proceeding with consent Correct answer.
  2. Ask another patient in the waiting room to interpret
  3. Use gestures to explain the risks and proceed
  4. Proceed without consent because the order was signed

Explanation

Informed consent requires that the patient understand the information, so qualified interpretation must be arranged when a language barrier exists. Gestures and untrained interpreters do not ensure comprehension.

Question 42Patient Care and Safety (unofficial placeholder - see needs_review)

A patient is scheduled for CT colonography. Which bowel preparation instruction is most appropriate?

  1. Complete a prescribed bowel cleansing regimen and follow dietary restrictions before the study Correct answer.
  2. Eat a high-fiber meal the morning of the scan
  3. Drink only oral contrast the night before
  4. No preparation is needed for CT colonography

Explanation

CT colonography requires a clean colon, achieved with a prescribed bowel cleansing regimen and dietary restrictions. Without preparation, residual stool can mimic polyps.

Question 43Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a documented anaphylactic reaction to iodinated contrast requires a CT that absolutely needs contrast. Which approach is most appropriate?

  1. Proceed without any premedication or physician review
  2. Use a lower dose without physician input
  3. Have the radiologist determine an appropriate premedication or alternative plan and ensure resuscitation equipment is available Correct answer.
  4. Cancel the study permanently

Explanation

A prior anaphylactic reaction requires physician-directed premedication or an alternative strategy, with resuscitation capability immediately available. Technologists should not independently modify the plan.

Question 44Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with severe renal impairment is scheduled for a CT with contrast. Which laboratory finding most strongly supports the need for a risk-benefit discussion with the radiologist?

  1. eGFR of 25 mL/min/1.73 m² Correct answer.
  2. Normal serum potassium
  3. Normal hemoglobin
  4. eGFR of 95 mL/min/1.73 m²

Explanation

An eGFR of 25 indicates severe renal impairment and increases the risk of contrast-induced kidney injury, warranting radiologist review. Normal potassium and hemoglobin do not reflect renal risk.

Question 45Patient Care and Safety (unofficial placeholder - see needs_review)

A technologist is preparing a patient for CT with IV contrast. Which assessment finding most strongly suggests the IV should be replaced before injection?

  1. The IV site is red, warm, and tender to palpation Correct answer.
  2. The IV flushes without resistance
  3. The IV has a blood return
  4. The IV site is clean, dry, and without tenderness

Explanation

Redness, warmth, and tenderness suggest phlebitis or infiltration, so the IV should be replaced before contrast injection. A clean, patent IV with blood return is acceptable.

Question 46Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT examination the patient becomes unresponsive and pulseless. Which action should the technologist take first?

  1. Leave the patient to find help alone
  2. Document the event and wait for the radiologist
  3. Activate the emergency response system and begin CPR Correct answer.
  4. Complete the remaining scan series

Explanation

Unresponsiveness without a pulse indicates cardiac arrest, so emergency activation and CPR must begin immediately. Scanning and documentation are secondary to resuscitation.

Question 47Patient Care and Safety (unofficial placeholder - see needs_review)

A patient arrives for a CT of the chest without contrast and reports a history of asthma and a previous mild reaction to iodinated contrast. Which premedication regimen is most appropriate before this noncontrast study?

  1. Prednisone 50 mg orally 13 hours, 7 hours, and 1 hour before the scan plus diphenhydramine 50 mg orally 1 hour before the scan.
  2. Methylprednisolone 40 mg IV 30 minutes before the scan alone.
  3. No premedication is required because no iodinated contrast will be administered. Correct answer.
  4. Diphenhydramine 50 mg orally 1 hour before the scan alone.

Explanation

Premedication is used to reduce the risk of an acute hypersensitivity reaction when iodinated contrast must be given to a patient with a prior reaction. If the examination does not require contrast, there is no exposure to the allergen and no benefit from corticosteroids or antihistamines. Giving premedication in this setting adds medication risk without any protective value.

Question 48Patient Care and Safety (unofficial placeholder - see needs_review)

A patient scheduled for CT pulmonary angiography has a documented allergy to shellfish and reports hives after eating shrimp. The ordering provider asks whether iodinated contrast can be given. Which statement is most accurate?

  1. Shellfish allergy mandates the use of gadolinium-based contrast instead of iodinated contrast for CT.
  2. Shellfish allergy is a reliable predictor of iodinated contrast reaction and contrast must be withheld.
  3. Shellfish allergy requires premedication with diphenhydramine only before contrast administration.
  4. Shellfish allergy is not a contraindication to iodinated contrast, but the prior hives should be documented and the patient monitored. Correct answer.

Explanation

Allergy to shellfish is a food allergy and is not a recognized independent risk factor for iodinated contrast media reactions. The hives after shrimp indicate a food allergy, not a prior contrast reaction, and do not by themselves require withholding contrast. The reaction history should still be documented and the patient observed during injection.

Question 49Patient Care and Safety (unofficial placeholder - see needs_review)

During a CT examination, a patient with an implanted cardiac pacemaker reports palpitations and the technologist notes irregular heartbeats on the monitor. Which action should the technologist take first?

  1. Increase the table speed to shorten the examination and reduce radiation exposure.
  2. Stop the scan, assess the patient, and notify the supervising radiologist and the patient's cardiology team. Correct answer.
  3. Administer a beta-blocker from the emergency cart to slow the heart rate.
  4. Continue the scan to completion because pacemaker malfunction is not a CT safety concern.

Explanation

New palpitations or arrhythmia during a CT in a patient with a pacemaker may indicate device malfunction or an acute cardiac event and requires immediate interruption of the study. The technologist should stop scanning, assess vital signs and symptoms, and involve the radiologist and cardiology. Resuming or completing the scan without evaluation could delay treatment of a serious arrhythmia.

Question 50Patient Care and Safety (unofficial placeholder - see needs_review)

A patient with a known seizure disorder is scheduled for CT of the head and neck with iodinated contrast. The patient is awake and has no intravenous access. Which action best supports safety during contrast administration?

  1. Schedule the scan without contrast because iodinated contrast is contraindicated in seizure disorders.
  2. Place a functioning intravenous line before the study and keep seizure rescue medication readily available. Correct answer.
  3. Use a smaller volume of contrast injected by hand to reduce the risk of seizure.
  4. Withhold all anti-seizure medications on the morning of the scan to avoid contrast interactions.

Explanation

A secure intravenous line is needed both for contrast injection and for immediate access if a seizure or other adverse event occurs. Seizure rescue medication should be available, and the patient's regular anti-seizure medications should be continued unless the prescribing clinician directs otherwise. Iodinated contrast is not contraindicated in seizure disorders, but the study should be performed with appropriate monitoring and access.