Free ARRT Cardiac Interventional Radiography Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the ARRT Cardiac Interventional Radiography Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1Before a coronary angiogram with iodinated contrast, a cardiac interventional radiographer reviews the patient's history. Which finding is the strongest predictor of a future allergic-like reaction to the same class of contrast?

   1. A. A history of asthma with intermittent bronchospasm
   2. B. A prior allergic-like reaction to iodinated contrast
   3. C. An unrelated food allergy without contrast exposure
   4. D. Current beta-blocker treatment for cardiac disease

   Answer: B

   Explanation: The ACR states, "A prior allergic-like or unknown type reaction to the same class of contrast medium is considered the greatest risk factor for predicting future adverse events." The previous iodinated contrast reaction is therefore the finding to flag most strongly before this iodinated contrast procedure.

   Reference: ACR Manual on Contrast Media 2026 — Patient Selection and Preparation Strategies, Risk Factors for Adverse Reactions, p. 5

2. 2During coronary fluoroscopy, the radiographer needs to form a tighter rectangular x-ray field around the target vessel. Which component directly shapes that field?

   1. A. The antiscatter grid
   2. B. The adjustable lead shutters
   3. C. The contour wedge filter
   4. D. The spectral shaping filter

   Answer: B

   Explanation: The IAEA describes "Two pairs of adjustable parallel-opposed lead blades (sometimes known as shutters)" that "are used to form a rectangular X ray field". Those blades, rather than image cleanup or equalization components, directly set the rectangular beam boundary.

   Reference: IAEA Quality Assurance and Optimization for Fluoroscopically Guided Interventional Procedures — Section 3.6, Collimator Assembly, p. 18

3. 3During right heart catheterization for suspected cardiogenic shock, mean arterial pressure is 80 mmHg, systolic pressure is 120 mmHg, diastolic pressure is 60 mmHg, and cardiac output is 4.51 L/min. What cardiac power output should the technologist calculate?

   1. A. 0.60 W
   2. B. 0.80 W
   3. C. 1.20 W
   4. D. 1.80 W

   Answer: B

   Explanation: SCAI gives "CPO = MAP*cardiac output/451." Using the stated MAP gives 80 × 4.51 ÷ 451 = 0.80 W. The alternatives result from substituting diastolic pressure, systolic pressure, or their sum for MAP.

   Reference: SCAI SHOCK Quality Improvement Tool — Approach to Identifying Early SCAI SHOCK, formula footnote, p. 1

4. 4During vascular access for a catheterization, a patient becomes pale and diaphoretic. Which paired vital-sign change most directly supports a vasovagal response?

   1. A. Hypotension with tachycardia
   2. B. Hypertension with bradycardia
   3. C. Hypotension with bradycardia
   4. D. Hypertension with tachycardia

   Answer: C

   Explanation: The ACR describes that "Vasovagal reactions are relatively common and characterized by hypotension with bradycardia." This paired finding fits the patient's sudden reaction during catheter placement; the other pairings change one or both defining vital-sign directions.

   Reference: ACR Manual on Contrast Media 2026 — Allergic-Like and Physiologic Reactions to Intravascular Iodinated Contrast Media, Physiologic Reactions, p. 27

5. 5An interventional image includes the bright lung next to the denser mediastinum, causing uneven receptor exposure. Which beam component is designed to equalize this difference?

   1. A. An antiscatter grid
   2. B. A contour wedge filter
   3. C. An iris collimator
   4. D. A flat-panel receptor

   Answer: B

   Explanation: The IAEA says "These filters, also called contour or wedge filters, are partially radiolucent blades used to equalize the X ray flux across the image receptor when there are two or more very different attenuating structures (such as lung and mediastinum) present in the image." The named filter matches this attenuation mismatch; the other items have different imaging functions.

   Reference: IAEA Quality Assurance and Optimization for Fluoroscopically Guided Interventional Procedures — Section 3.6, Collimator Assembly, p. 19

6. 6A right heart catheterization records pulmonary artery systolic pressure of 60 mmHg, pulmonary artery diastolic pressure of 20 mmHg, and right atrial pressure of 10 mmHg. What is the pulmonary artery pulsatility index?

   1. A. 2.0
   2. B. 4.0
   3. C. 6.0
   4. D. 8.0

   Answer: B

   Explanation: SCAI specifies "PAPi = (PA systole – PA diastole)/RA." Subtracting 20 from 60 and dividing by 10 yields 4.0. The other results use diastolic pressure alone, systolic pressure alone, or add the PA pressures before division.

   Reference: SCAI SHOCK Quality Improvement Tool — Optimal Interdisciplinary Shock Communication, formula footnote, p. 3

7. 7A patient receives heparin during PCI. Which laboratory measure should the cath-lab team follow during the procedure to assess the adequacy of anticoagulation?

   1. A. Prothrombin time (PT)
   2. B. Activated partial thromboplastin time (aPTT)
   3. C. International normalized ratio (INR)
   4. D. Activated clotting time (ACT)

   Answer: D

   Explanation: SCAI states, "For patients who receive heparin, an activated clotting time (ACT) should be checked throughout the procedure to monitor adequate anticoagulation". PT, aPTT, and INR are genuine coagulation measures, but ACT is the intraprocedural measure specified for this heparinized PCI setting.

   Reference: SCAI Expert Consensus Update on Best Practices in the Cardiac Catheterization Laboratory — Intraprocedural Anticoagulation Monitoring slide

8. 8While tracking a slowly moving catheter under pulsed fluoroscopy, the current temporal detail is greater than needed. Which imaging adjustment follows the IAEA dose optimization guidance?

   1. A. Decrease the pulse rate while retaining adequate temporal detail
   2. B. Increase the pulse rate while retaining adequate temporal detail
   3. C. Increase the cine frame rate while retaining adequate temporal detail
   4. D. Engage magnification while retaining adequate temporal detail

   Answer: A

   Explanation: The IAEA directs clinicians to "opt for the lowest pulse rate that meets the specific temporal requirements of the clinical procedure" because entrance air kerma relates to pulse rate. Here the catheter is slow enough to permit a lower rate without losing needed temporal information.

   Reference: IAEA Quality Assurance and Optimization for Fluoroscopically Guided Interventional Procedures — Section 3.12.2, Pulsed Fluoroscopy Mode, p. 26

9. 9A radiographer assists with an arm-vein right heart catheterization. The planned medial antecubital entry follows the median cubital vein. Into which named vein does this vessel drain next?

   1. A. Cephalic vein
   2. B. Basilic vein
   3. C. Axillary vein
   4. D. Subclavian vein

   Answer: B

   Explanation: The SCAI anatomy guidance states, "Medial forearm veins, such as the median cubital over the antecubital fossa, drain into the basilic vein, which continues as the axillary vein and then the subclavian vein." The other named vessels are either on a different branch or farther along the route.

   Reference: SCAI Right Heart Catheterization via the Arm: Arm Yourself With Simple Techniques — Venous Anatomy section

10. 10During a cardiac arrest in the interventional suite, the team begins high-quality CPR. What compression rate does the current AHA adult cardiac arrest algorithm specify?

    1. A. 60–80 compressions per minute
    2. B. 80–100 compressions per minute
    3. C. 100–120 compressions per minute
    4. D. 120–140 compressions per minute

    Answer: C

    Explanation: The AHA algorithm instructs rescuers to "Push fast (100-120/min) and allow complete chest recoil." For this adult arrest, the specified compression rate is 100–120 per minute.

    Reference: 2025 American Heart Association Adult Cardiac Arrest Circular Algorithm — High-Quality CPR panel, p. 1