Radiation Health and Safety

Which of the following is a true statement regarding pregnant patients and exposure to radiation?

• Dental images are not exposed until the second trimester.

• ADA guidelines recommend postponing dental images during pregnancy.

• Lead aprons prevent exposure to the fetus.

• Exposure time is decreased for pregnant patients.

• Lead aprons prevent exposure to the fetus.

Divergence of the x-ray beam is reduced by using the/an _____

• 8-inch PID

• paralleling technique

• bisecting technique

• short cone technique

• paralleling technique

The maximum permissible dose (MPD) for occupationally exposed workers is:

• 0.005 Sv/year

• 0.05 Sv/year

• 0.5 Sv/year

• 5.0 Sv/year

• 0.05 Sv/year

Which of the following represents the optimum desired occupational dose?

• 0 rem/year

• 0.01 rem/year

• 1 rem/year

• 0.05 rem/month

• 0 rem/year

Which of the following would be an acceptable practice for an operator of dental x-ray equipment?

• wearing a film badge only at work

• holding the film while fully draped with a lead apron

• standing Behind the patient, 6 feet away

• holding the tubehead to prevent drifting

• wearing a film badge only at work

Which of the following does a film badge monitor?

• natural radiation exposures

• patient exposures

• radiographer's daily occupational radiation exposures

• total office staff radiation exposures

• radiographer's daily occupational radiation exposures

What tooth structure is the most difficult to view on a dental image?

• pulp

• cementum

• dentin

• enamel

• cementum

Which of the following is an accurate statement about safe operating procedures?

• Pregnant operators must not expose dental images.

• All states require all dental staff members wear dosimeters.

• Dosimeters monitor operator exposure to x-rays.

• ALARA applies to patients but not operators.

• Dosimeters monitor operator exposure to x-rays.

There is a new dental x-ray machine in the office. The length of the position indicating device (PID) is changing from 16 to 8 inches. How does this affect the intensity of the x-ray beam? What adjustment needs to be made to keep the density of the images consistent?

• The resultant beam will be one-half as intense. You will need to increase the exposure time.

• The resultant beam will be one-quarter as intense. You will need to increase the exposure time.

• The resultant beam will be two times as intense. You will need to decrease the exposure time.

• The resultant beam will be four times as intense. You will need to decrease the exposure time.

• The resultant beam will be four times as intense. You will need to decrease the exposure time.

Which type of position indicating device (PID) does not produce scatter radiation?

• rectangular

• round

• conical

• both a and b

• both a and b

The dental office is open 4 days a week. You change chemicals in two automatic processors every 4 weeks. When using a stepwedge to test developer strength, a total of films _____ should be taken each time the chemicals are changed.

• a. 8

• 16

• 20

• 32

• 32

A reference radiograph is used to compare

• densities

• film freshness

• processing time

• fixer solution freshness

• densities

The coin test is used to check for

• light leaks in the darkroom

• proper functioning of the dental x-ray unit

• proper safelighting

• proper film density

• proper safelighting

Extraoral intensifying screens should be checked periodically for

• fixer contamination

• developer contamination

• dirt and scratches

• gelatin buildup

• dirt and scratches

When densities differ by more than two steps on a stepwedge, which protocol should be followed?

• Replace the processing solutions.

• Stir the contents of the developer and continue to process.

• Increase the heat in the tank by 2 degrees.

• Increase kV.

• Replace the processing solutions.

On average, processing solution should be changed

• once a day

• once a week

• every 3-4 weeks

• every 3-4 months

• every 3-4 weeks

According to the CDC, barriers should be used to cover which of the following?

• phosphor imaging plate

• film

• sensor

• sensor and phosphor imaging plate

• sensor and phosphor imaging plate

This radiograph is mounted labially. What is the radiopaque restoration on tooth #19 in this image?

• composite restoration with an overhang on the mesial surface

• amalgam restoration with an overhang on the mesial surface

• composite restoration with an overhang on the distal surface

• amalgam restoration with an overhang on the distal surface

• amalgam restoration with an overhang on the mesial surface

What process is occurring in this image?

• external resorption

• physiologic resorption

• internal resorption

• extrusion

• physiologic resorption

Which structure appears in this panoramic image?

• orthodontic appliances

• orthodontic bands

• metal framework for two partial dentures

• fused gold crowns

• metal framework for two partial dentures

What landmark is indicated by the arrows?

• coronoid process

• condyle

• internal oblique ridge

• zygomatic process of the maxilla

• coronoid process

Using a digital imaging system, an image has just been taken, but there is no image on the screen and the computer program did not advance to the next image space. Which of the following may be the problem and what is the solution?

• x-ray machine is turned off; turn on machine

• PID not aligned with receptor; align PID with receptor

• sensor is placed in backward; replace receptor in film holder correctly

• All of the above

• All of the above

How does the median palatine suture appear in a dental image?

• almond-shaped radiolucency between teeth #8 and #9

• thin radiolucent vertical line between teeth #8 and #9

• radiopaque vertical line above teeth #8 and #9

• pair of radiopaque diagonal lines beginning by the apices of the maxillary centrals and ending above the apices of the maxillary canines

• thin radiolucent vertical line between teeth #8 and #9

Film should be stored in which of the following places?

• dark room

• cool, dry area

• well-ventilated area

• in the refrigerator

• cool, dry area

Which structure would not be seen as a maxillary landmark on a panoramic image?

• styloid process

• external auditory meatus

• incisive canal

• mental foramen

• mental foramen

The patient chart should consist of all of the following except:

• signed informed consent

• duplicate images

• signed HIPAA release

• original records

• duplicate images

How does static electricity appear on a developed

• black dots

• clear dots

• scratches

• black branching lines

• black branching lines

An informed consent consists of all of the following except:

• number and type of exposures

• permission to release records to a dentist or physician

• potential harm if images are not taken

• reason for the images

• permission to release records to a dentist or physician

The radiography room is being prepared for a patient. On which of the following should barriers be placed?

• headrest, control panel, beam alignment device

• computer keyboard, work area, sensor cord

• phosphor plate, PID and tubehead, exposure control button

• sensor, computer mouse, x-ray unit on/off button

• phosphor plate, PID and tubehead, exposure control button

Failure to obtain informed consent is an example of:

• negligence

• common law

• statutory law

• standard of care

• negligence

The dental record is a legal document. Which of following methods can be used to record patient information in the patient chart?

• written in ink

• written in pencil

• data recorded on a computer

• written in ink or data recorded on a computer

• written in ink or data recorded on a computer

Which of the following agencies enforces regulations to protect the safety of dental employees from hazardous materials in the dental office?

• Environmental Protection Agency (EPA)

• Occupational Safety and Health Administration (OSHA)

• Centers for Disease Control and Prevention (CDC)

• Organization for Safety, Asepsis, and Prevention (OSAP)

• Occupational Safety and Health Administration (OSHA)

Chemical-resistant gloves are used to perform which of the following?

• set up the radiography room

• remove barriers

• disinfect surfaces

• process film

• disinfect surfaces

Films are being taken to the daylight loader for automatic processing. Which of the following would not be done when developing film using a daylight loader?

• place film in feed slot with ungloved hands

• use clean gloves to open film packets

• lift lid to daylight loader and place cup with exposed film packets in daylight loader

• place dirty or used gloves through the cuff assembly

• place dirty or used gloves through the cuff assembly

Current infection control guidelines come from the

• Centers for Disease Control and Prevention

• American Dental Association

• Occupational Safety and Health Administration

• CDC, ADA, and OSHA

• CDC, ADA, and OSHA

Which is the method used to prevent cross-contamination during use of a digital sensor?

• heat sterilization

• disinfection or barrier

• barrier technique and disinfection

• cold sterilization

• barrier technique and disinfection

The disinfectant required with the use of a digital sensor is an EPA registered

• high-level disinfectant

• intermediate-level disinfectant

• low-level disinfectant

• sterilant

• intermediate-level disinfectant

In addition to the barrier technique, which of the following is an infection control measure for the wire connections from the sensor to the digital image unit?

• wiping down with soapy water solution

• wiping down with an intermediate-level disinfectant

• wiping down with a high-level hospital-grade disinfectant

• no specific infection control measures are required for the cords

• wiping down with a high-level hospital-grade disinfectant

Which of the following statements is correct regarding use of masks and protective eyewear during dental imaging procedures?

• Face masks are required, but protective eyewear is not.

• Protective eyewear is required, but face masks are not.

• Protective eyewear and face masks are optional.

• All PPE, including face masks and protective eyewear, must be worn at all times. Standard precautions apply.

• Protective eyewear and face masks are optional.

Film contaminated with saliva should be

• placed in a high-level disinfectant solution to prevent cross-contamination

• wiped off and placed in a disposable cup

• wiped free of saliva with an intermediate-level disinfectant

• wiped free of saliva with alcohol

• wiped off and placed in a disposable cup

Which of the following is placed in the daylight loader of an automatic film processor prior to opening the film packets?

• an empty cup 

• powdered gloves

• powder-free gloves

• an empty cup and powder-free gloves

• an empty cup and powder-free gloves

The current patient was running, slipped and hit a picnic table with his front teeth. He fractured tooth number 9. Which image is preferred to evaluate this tooth?

• occlusal

• bitewing

• periapical

• Panoramic

• periapical

In which situation would extraoral radiography not be used?

• to evaluate growth and development

• to evaluate impacted teeth

• to diagnose dental caries

• to evaluate the extent of large lesions

• to diagnose dental caries

All of the following must be documented in the patient record when exposing dental images except:

• exposure settings

• reason for the images

• number and type of images

• diagnosis from the images

• exposure settings

You are mounting film with the orientation dot face up (convex side is facing you). Which method of mounting is being used and how are you viewing the film?

• Lingual mounting; you are viewing the patient's x-ray images as if you were inside his or her mouth looking out. The patient's left side is on your left side, and the patient's right side is on your right

• Labial mounting; you are viewing your patient's x-ray images as if you were inside his or her mouth looking out. Your patient's left side is on your left side, and your patient's right side is on your right

• Lingual mounting; you are viewing your patient's x-ray images as if you were facing your patient. Your patient's left side is on your right side, and your patient's right side is on your left side.

• Labial mounting you are viewing your patient's x-ray images as if you were facing your patient. Your patient's left side is on your right side, and your patient's right side is on your left side.

• Labial mounting you are viewing your patient's x-ray images as if you were facing your patient. Your patient's left side is on your right side, and your patient's right side is on your left side.

You were replenishing the chemicals and mixed the chemicals, putting developer in the fixer and fixer in the developer. What occurred that alerted you that you had made a mistake?

• strong ammonia smell

• sediment of white crystals

• clear amber color

• green deposits in the developer

• strong ammonia smell

You are in charge of the quality control procedures for  dental office, which of following should be performed on a daily basis?

• a. Check the phosphor plates for artifacts.

• b. Run a test film to check processor solutions.

• c. Process an unexposed film to check the film.

• d. Check the scanner using an unexposed phosphor plate.

• b. Run a test film to check processor solutions.

What radiolucent landmark is circled on the dental image?

• mental foramen

• lingual foramen

• mandibular canal

• genial tubercles

• lingual foramen

Which of the following is not a factor in a missing apical area in a radiograph?

• The receptor was not placed high enough in the palate.

• The receptor was not placed low enough in the floor of the mouth.

• The horizontal angulation was incorrect.

• The patient was unable to completely close on the bite block.

• The horizontal angulation was incorrect.

Which of the following conditions exists on this image?

• a fixed bridge between the second premolar and second molar

• open contacts between maxillary premolars

• open contacts between the molars 

• pulp stone on the second molar

• open contacts between maxillary premolars

Which image is shown in this film?

• frontal sinus

• sphenoidal sinus

• ethmoidal sinus

• maxillary sinus

• maxillary sinus

Which of the following would appear most radiopaque?

• composite

• amalgam

• pulp

• enamel

• amalgam

In this panoramic image, which of the following statements is true?

• The permanent mandibular second molars are erupted.

• There is no evidence of mandibular third molars.

• Unerupted maxillary canines are present.

• The primary maxillary first molars are still present.

• Unerupted maxillary canines are present.

Which of the following affects the sharpness of a dental image?

• tungsten filament

• milliamperage

• focusing cup position

• focal spot size

• focal spot size

Distortion of an image describes which of the following characteristics?

• characteristics of the beam of energy

• radiolucent characteristics

• geometric characteristics

• radiopaque characteristics

• geometric characteristics

An underdeveloped film may be caused by which error?

• inadequate development time

• solution that is too warm

• excessive development time

• concentrated developer solution

• inadequate development time

The purpose of the intensifying screen in a panoramic cassette is to reduce:

• exposure time

• mounting time

• radiation exposure

• ghosting

• radiation exposure

The office has just started using digital radiography. Analog film was used previously. Exposure time will be:

• about the same as for film

• increased

• decreased

• Unchanged

• decreased

What exposure control selections) controls the quality of the x-ray beam?

• time

• kilovoltage

• milliamperage

• both a and c

• kilovoltage

Which of the following is a true statement regarding radiation and patient protection?

• X-ray images are routinely prescribed for 6-month recall patients.

• Round collimators are preferred over rectangular collimators.

• A patient may hold the image receptor in place when XCPs are not available.

• The benefit of dental x-ray images outweighs the risk of ionizing radiation.

• The benefit of dental x-ray images outweighs the risk of ionizing radiation.

Which of the following is a dose equivalent measurement?

• coulombs per kilogram

• rad

• roentgen

• Sievert

• Sievert

Which traditional measurement and metric measurement are equal?

• roentgen and sievert

• rad and gray

• rem and coulombs per kilogram

• sievert and rad

• rad and gray

Which of the following represents the maximum permissible dose (MPD) for the general public?

• 0.05 rem/month

• 0.1 rem/year

• 5 rem/year

• 20 rem

• 0.1 rem/year

Which of the following is a true statement regarding pediatric exposures to radiation?

• Uncooperative children require panoramic exposures.

• Pediatric patients do not require images.

• Immature tissues of pediatric patients are less susceptible to radiation than the tissues of adult patients.

• A child may be seated in a parent's lap for exposures.

• A child may be seated in a parent's lap for exposures.

Which of the following refers to operator protection during dental imaging procedures?

• Avoid the primary beam.

• Use a lead apron.

• Determine the need for dental images.

• Avoid retakes.

• Avoid the primary beam.

During the exposure of a dental image, the operator:

• stands more than 6 feet away and at a right angle to the tubehead

• stands in front of and parallel to the primary beam

• stands within 6 feet of and parallel to the primary beam

• stands in back of the patient's head

• stands more than 6 feet away and at a right angle to the tubehead

Multiple shades of gray on an image are controlled by which component of the x-ray machine?

• mA

• kV

• timer

• collimator

• kV

During the production of x-rays, how much energy is lost as heat?

• 1%

• 8%

• 70% 

• 99%

• 99%

Which of the following causes cellular damage from x-radiation?

• ionization

• milliamperage

• kilovoltage potential

• filtration

• ionization

Which statement is true as it relates to the direct theory of radiation injury?

• Cell damage results when ionizing radiation directly hits critical areas or targets within the cell.

• Direct injuries from exposure to ionizing radiation occur frequently but seldom do noticeable damage.

• Most x-ray photons are absorbed by the cell and cause little or no damage.

• Indirect injuries occur at the same rate as direct injuries from exposure to ionizing radiation.

• Cell damage results when ionizing radiation directly hits critical areas or targets within the cell.

Which of the following changes describes the development of cataracts in a person who has been exposed to excessive radiation? 

• genetic

• generational

• short term

• somatic

• somatic

Which of the following requires less exposure for the patient?

• large silver halide crystals

• small silver halide crystals

• phosphor storage plates

• pixels

• pixels

Which of the following would actually increase exposure time to a patient?

• exposing a panoramic image instead of four bitewings

• decreasing target-to-image receptor distance

• decreasing kV by 10%

• using the bisecting angle technique

• decreasing kV by 10%

Which of the following statements best describes the primary beam of energy?

• It includes primary, secondary, and scatter radiation.

• It contains short waves.

• It is unfiltered.

• It is measured in coulombs per kilogram.

• It contains short waves.

Which of the following is the acronym for the principle that governs exposure to radiation?

• NCRP

• ALARA

• MPD

• ANSI

• ALARA

Which of the following best describes acute exposures to radiation?

• genetic

• chronic

• short term

• leukemia

• short term

Which of the following has fairly low sensitivity to x-rays, but is a concern because of its risk of exposure due to its location?

• lens of the eye

• oral mucosa

• bone marrow

• thyroid gland

• thyroid gland

When should a full adult series of dental images be considered for a child or adolescent?

• 7 years old

• 9 years old

• 12 years old

• when clinical evidence of generalized disease is present and the adolescent has first and second molars

• when clinical evidence of generalized disease is present and the adolescent has first and second molars

After processing four bitewing films, the fourth film exits the processor and is completely black at one end of the image. What is the reason for the black portion of the image?

• developer solution was too weak

• processing chemicals were too cold

• darkroom door was opened too early

• receptor was not exposed to radiation

• darkroom door was opened too early

You are using a complete series of dental images to educate your patient on the value of radiography. According to HIPAA, what should not be present in or on the film mount?

• the date

• the patient's name

• radiographs showing impacted teeth

• radiographs showing dental caries

• the patient's name

How should you dispose of the used developer solution?

• Put it in a leakproof biohazard bag.

• Flush it down the sanitary drain sewer.

• Place it in the septic system.

• Place it in a special container to be picked up by a special service.

• Flush it down the sanitary drain sewer.

Which of the following should not be disposed of through a waste management system?

• unused developer

• film

• lead foil

• Stabe bite block

• Stabe bite block

You can dispose of the fixer solution and rinse water into sanitary drain systems when

• they are mixed with equal parts of distilled

• the temperature is equal to that of the room

• the solutions have evaporated by half

• all of the silver has been removed

• all of the silver has been removed

Which method is used to dispose of silver that has been recovered from used fixer and rinse water solutions?

• have it picked up and disposed of by an appropriate waste management service

• in the septic tank

• in the sanitary sewer

• in a biohazard bag

• have it picked up and disposed of by an appropriate waste management service

Who/what determines who can expose dental images in the dental office?

• Occupational Health and Safety Association (OSHA)

• American Dental Association (ADA)

• individual states

• dentist

• individual states

You are destroying old patient records. How do you dispose of the dental radiographs?

• as regulated waste

• as hazardous waste

• as normal office waste

• have them collected by an approved waste removal

• as normal office waste

Which interaction with x-rays causes the radiopaque areas on a dental image?

• Compton's scatter

• photoelectric effect

• coherent scatter

• no interaction

• photoelectric effect

You have a package of outdated dental film. How should you dispose of it?

• Put it in the trash receptacle.

• Store it for 6 years, then discard in regular trash.

• Shred it and place it in a biohazard bag.

• Contact an approved waste removal service.

• Contact an approved waste removal service.

Exposed film and phosphor plates should be collected and transferred to the darkroom in or scanning area.

• the lab coat pocket

• the operator's hand

•  a cup

• the bracket tray

•  a cup

Infection control practiced during exposure involves all of the following except

• the beam alignment device is placed on the uncovered countertop after the procedure

• the exposed film or phosphor plates are dried after use

• the beam alignment device is reassembled as needed

• the exposed film or phosphor plates are placed in a cup

• the beam alignment device is placed on the uncovered countertop after the procedure

Infection control practices during processing involve which of the following?

• transport

• assembly of beam alignment devices

• checking kV settings

• steadying the tubehead

• transport

During dental imaging procedures, exposure to pathogens occurs most frequently from which of the following?

• touch

• transfer

• splash, spatter, and droplet

• a and b

• a and b

Which of the following is a single-use item used in a dental imaging procedure?

• face mask

• lead apron

• beam alignment device

• phosphor plate

• face mask

Which describes proper storage of a lead apron?

• folding and placing it on the chair for reuse

• hanging it between uses

• rolling it

• Any method may be used.

• hanging it between uses

You are at greatest risk of contracting your patient's hepatitis C virus from which source?

• your gloves

• the film packet

• the lead apron

• the beam alignment device

• the film packet

Which of the following is not classified as a noncritical instrument?

• beam alignment device

• position indicating device of the dental x-ray tubehead

• exposure button

• lead apron

• beam alignment device

In trying to explain to a patient about the sequence of injury, you use example of a sunburn. What stage of injury is being described?

• recovery

• latent period

• period of injury

• cumulative effect

• period of injury

Phosphor plates are cleaned with which of the following disinfectants?

• low-level disinfectant

• intermediate-level disinfectant

• high-level disinfectant

• disinfectant specifically for phosphor plates

• disinfectant specifically for phosphor plates

An instrument that contacts mucous membranes but does not penetrate soft tissue or bone is considered

• critical

• semicritical

• noncritical

• semicritical and noncritical

• semicritical

Which statement is correct concerning the use of gloves during a dental imaging procedure?

• Gloves must be washed before use, to remove powder residue.

• Gloves must be sterile for all procedures.

• New gloves must be worn for each patient.

• Gloves must be worn only when contact with saliva is anticipated.

• New gloves must be worn for each patient.