Prometric Exam Questions for Radiographers 2026: 15 Practice MCQs with Answers and Rationale

The radiographer Prometric paper checks that you can produce a diagnostic image at the lowest reasonable dose and keep the patient safe while you do it. Expect radiation physics and protection, positioning and image quality, patient care and contrast media, and cross-sectional modalities. Most Gulf authorities set 100 to 150 single-best-answer MCQs over 2 to 3 hours, with a pass mark of about 60%.

The fifteen questions below follow that blueprint. Allow about 70 seconds per item. The exam rewards candidates who understand why an exposure factor or projection is chosen, not those who memorise lists.

For eligibility, titles and the syllabus by authority, read the Prometric exam for radiographers guide. For timed papers, use the Radiographer question bank.

Radiation physics and protection

Question 1

The source-to-image distance is doubled and nothing else changes. The intensity of the beam at the receptor becomes:

1. Half
2. One quarter
3. Double
4. Four times

Answer: B. By the inverse square law, intensity is inversely proportional to the square of the distance. Doubling the distance reduces intensity to one quarter, so mAs must be increased about four times to keep the same receptor exposure.

Question 2

Increasing the mAs while keeping kVp constant mainly increases:

1. The penetrating power of the beam
2. The quantity of x-ray photons produced
3. The focal spot size
4. Geometric unsharpness

Answer: B. mAs controls the number of photons and therefore receptor exposure and patient dose. kVp controls photon energy, which affects penetration and subject contrast.

Question 3

Using the 15% rule, a radiographer increases kVp by 15%. To keep the same receptor exposure while reducing patient dose, the mAs should be:

1. Doubled
2. Halved
3. Unchanged
4. Increased by 15%

Answer: B. A 15% rise in kVp roughly doubles receptor exposure, so halving the mAs keeps exposure the same. Entrance dose falls, at the cost of slightly lower contrast.

Question 4

Under ICRP recommendations, the occupational effective dose limit for a radiation worker is:

1. 1 mSv per year
2. 20 mSv per year averaged over five years, with no single year above 50 mSv
3. 100 mSv per year
4. 500 mSv per year

Answer: B. 20 mSv a year averaged over five years is the occupational limit; 1 mSv a year is the limit for members of the public. National regulators adopt these limits, and your dosimeter record is reviewed against them.

Question 5

A grid is generally recommended when the body part is thicker than about:

1. 2 cm
2. 5 cm
3. 10 cm
4. 25 cm

Answer: C. Above about 10 cm of tissue, and usually above 60–70 kVp, scatter degrades contrast enough to justify a grid. A grid needs a higher mAs, so it is not used for thin extremities.

Positioning and image quality

Question 6

Why is a routine PA chest radiograph taken at a source-to-image distance of about 180 cm?

1. To increase patient dose
2. To reduce magnification of the heart and improve sharpness
3. To increase scatter
4. To show the ribs below the diaphragm

Answer: B. A long SID makes the beam closer to parallel, reducing magnification and penumbra. The PA projection also places the heart near the receptor. The image is taken at full inspiration so that the lungs and costophrenic angles are clearly shown.

Question 7

A patient has tenderness in the anatomical snuffbox after a fall. Which additional projection best shows the scaphoid?

1. PA wrist with radial deviation
2. PA wrist with ulnar deviation
3. Lateral elbow
4. AP forearm

Answer: B. Ulnar deviation elongates the scaphoid and opens the spaces around it, making a waist fracture easier to see. Scaphoid fractures are often occult at first, so a negative image with clinical suspicion leads to immobilisation and review or further imaging.

Question 8

A lateral cervical spine radiograph in a trauma patient does not show C7–T1. The next step is to:

1. Accept the image
2. Obtain a swimmer's (cervicothoracic) lateral or proceed according to the trauma protocol, often CT
3. Ask the patient to flex the neck
4. Remove the cervical collar and repeat

Answer: B. An adequate lateral must show the whole cervical spine down to the top of T1. Never move the neck or remove the collar without medical clearance. Many trauma pathways now go straight to CT.

Question 9

What are the two standard screening mammography projections?

1. AP and lateral
2. Craniocaudal (CC) and mediolateral oblique (MLO)
3. Spot compression and magnification
4. Axillary tail and cleavage views

Answer: B. The CC and MLO views together show the most breast tissue, and the MLO includes the pectoral muscle and axillary tail. Spot and magnification views are additional problem-solving views.

Patient care and contrast media

Question 10

Before a pelvic radiograph in a woman of child-bearing age, the radiographer must first:

1. Proceed without asking, because the dose is small
2. Confirm and document pregnancy status according to local protocol
3. Always use a lead apron over the pelvis
4. Delay all imaging by one month

Answer: B. Justification requires knowing whether the patient may be pregnant. Departments use a pregnancy-status check (such as the 28-day or 10-day rule) and refer uncertain cases to the referring doctor and radiologist.

Question 11

Which result should be checked before intravenous iodinated contrast in a patient with diabetes and known kidney disease?

1. Serum amylase
2. eGFR or serum creatinine
3. Haemoglobin
4. Serum calcium

Answer: B. Reduced kidney function raises the risk of contrast-associated kidney injury. Departments set eGFR thresholds for extra precautions, such as hydration or review of metformin, according to their own policy.

Question 12

An adult develops wheeze, facial swelling and hypotension two minutes after contrast injection. The first drug to give is:

1. Oral antihistamine
2. Intramuscular adrenaline 0.5 mg (0.5 mL of 1 mg/mL)
3. Intravenous furosemide
4. Oral steroid

Answer: B. This is anaphylaxis. Call for help, stop the injection and give intramuscular adrenaline into the anterolateral thigh, repeated after 5 minutes if needed, with oxygen and fluids. Antihistamines and steroids are secondary.

CT, MRI and ultrasound

Question 13

On the Hounsfield scale, water and air are approximately:

1. Water 0 HU, air −1000 HU
2. Water 100 HU, air 0 HU
3. Water −1000 HU, air 0 HU
4. Water 1000 HU, air −100 HU

Answer: A. The scale is defined so that water is 0 HU and air is about −1000 HU. Fat is around −100 HU, soft tissue +30 to +60 HU and dense bone several hundred to over +1000 HU.

Question 14

Which is an absolute contraindication to entering the MRI scanner room, unless proven safe?

1. A titanium hip replacement
2. A cardiac pacemaker that is not MR-conditional
3. Dental fillings
4. A previous caesarean section

Answer: B. A non-conditional pacemaker can malfunction, heat or move in the magnetic field. Ferromagnetic aneurysm clips, some cochlear implants and metallic foreign bodies in the eye are other classic contraindications. Every patient is screened before entering.

Question 15

On ultrasound, a gallstone typically appears as:

1. An anechoic structure with posterior enhancement
2. An echogenic focus with posterior acoustic shadowing that moves with position
3. A hypoechoic solid mass with internal blood flow
4. A thin-walled cyst with no echoes

Answer: B. Stones reflect most of the beam, producing a bright focus and a clean shadow behind it, and they usually move when the patient changes position. A polyp does not shadow or move.

How to use these questions

• Know your exposure factors cold. Questions on kVp, mAs, distance, grids and dose appear in every paper.
• Revise positioning by region. Make a one-page list of criteria for a correct image for each common projection.
• Do not skip patient care. Contrast reactions, pregnancy checks, infection control and MRI safety are easy marks that many candidates lose.
• Practise under time. Use the Radiographer bank, or the Radiography Technician bank if you hold a diploma, and avoid the common preparation mistakes.

Licensing details are in the DHA licence for radiographers and on the SCFHS, QCHP and DOH radiography exam pages. Pay by country is in radiographer salary. When you are ready, join the radiographer talent pool.

Frequently asked questions

How many questions are in the Prometric radiographer exam?

Usually 100 to 150 MCQs over 2 to 3 hours, depending on the authority and title. Your eligibility notice states the exact format.

What is the pass mark for the radiography exam?

About 60% for most Gulf authorities, sometimes reported as a scaled score.

Are CT and MRI questions included for general radiographers?

Yes, at a basic level: safety, principles and common appearances. Dedicated CT, MRI or sonography titles have more detailed modality content.

Is the radiography technician exam different?

It covers the same areas with a more practical focus and fewer physics and interpretation questions.

Are these real exam questions?

No. They are original practice questions written to the published blueprint. Real exam content is confidential.