TEST BANK For Dental Radiography Principles and Techniques 6th Edition by Joen Iannucci & Laura Jansen Howerton, Verified Chapters 1 - 35, Complete Newest Version.pdf

TEST BANK For Dental Radiography:
Principles and Techniques 6th Edition
by Joen Iannucci & Laura Jansen Howerton
Chapters 1 - 35 | Complete

Chapter 01: Radiation History
Iannucci: Dental Radiography, 6th Edition
MULTIPLE CHOICE
1. Radiation is defined as
a. a form of energy carried by waves or streams of particles.
b. a beam of energy that has the power to penetrate substances and record image
shadows on a receptor.
c. a high-energy radiation produced by the collision of a beam of electrons with a
metal target in an x-ray tube.
d. a branch of medicine that deals with the use of x-rays.
ANSWER: A
Radiation is a form of energy carried by waves or streams of particles. An x-ray is a beam of
energy that has the power to penetrate substances and record image shadows on a receptor.
X-radiation is a high-energy radiation produced by the collision of a beam of electrons with a
metal target in an x-ray tube. Radiology is a branch of medicine that deals with the use of
x-rays.
DIF: Recall REF: Page 2 OBJ: 1
TOP: CDA, RHS, III.B.2. Describe the characteristics of x-radiation
MSC: NBDHE, 2.0 Obtaining and Interpreting Radiographs | NBDHE, 2.1 Principles of radiophysics
and radiobiology
2. A radiograph is defined as
a. a beam of energy that has the power to penetrate substances and record image
shadows on a receptor.
b. a picture on film produced by the passage of x-rays through an object or body.
c. the art and science of making radiographs by the exposure of an image receptor to
x-rays.
d. a form of energy carried by waves or a stream of particles.
ANSWER: B
An x-ray is a beam of energy that has the power to penetrate substances and record image
shadows on a receptor. A radiograph is a picture on film produced by the passage of x-rays
through an object or body. Radiography is the art and science of making dental images by the
exposure of a receptor to x-rays. Radiation is a form of energy carried by waves or streams of
particles.
DIF: Comprehension REF: Page 2 OBJ: 1
MSC: NBDHE, 2.0 Obtaining and Interpreting Radiographs | NBDHE, 2.1 Principles of radiophysics
and radiobiology
3. Your patient asked you why dental images are important. Which of the following is the
correct response?
a. An oral examination with dental images limits the practitioner to what is seen
clinically.
b. All dental diseases and conditions produce clinical signs and symptoms.

c. Dental images are not a necessary component of comprehensive patient care.
d. Many dental diseases are typically discovered only through the use of dental
images.
ANSWER: D
An oral examination without dental images limits the practitioner to what is seen clinically. Many
dental diseases and conditions produce no clinical signs and symptoms. Dental images are a
necessary component of comprehensive patient care. Many dental diseases are typically
discovered only through the use of dental images.
DIF: Application REF: Page 2 OBJ: 2
MSC: NBDHE, 2.0 Obtaining and Interpreting Radiographs | NBDHE, 2.5 General
4. The x-ray was discovered by
a. Heinrich Geissler
b. Wilhelm Roentgen
c. Johann Hittorf
d. William Crookes
ANSWER: B
Heinrich Geissler built the first vacuum tube in 1838. Wilhelm Roentgen discovered the x-
ray on November 8, 1895. Johann Hittorf observed in 1870 that discharges emitted from
the negative electrode of a vacuum tube traveled in straight lines, produced heat, and resulted in
a greenish fluorescence. William Crookes discovered in the late 1870s that cathode rays were
streams of charged particles.
5. Who exposed the first dental radiograph in the United States using a live person?
a. Otto Walkoff
b. Wilhelm Roentgen
c. Edmund Kells
d. Weston Price
ANSWER: C
Otto Walkoff was a German dentist who made the first dental radiograph. Wilhelm Roentgen
was a Bavarian physicist who discovered the x-ray. Edmund Kells exposed the first dental
radiograph in the United States using a live person. Price introduced the bisecting technique in
1904.
6. Current fast radiographic film requires % less exposure time than the initial exposure
times used in 1920.
a. 33
b. 98
c. 73

d. 2
ANSWER: D
Current fast radiographic film requires 98% less exposure time than the initial exposure times
used in 1920.
7. Who modified the paralleling technique with the introduction of the long-cone technique?
a. C. Edmund Kells
b. Franklin W. McCormack
c. F. Gordon Fitzgerald
d. Howard Riley Raper
ANSWER: C
C. Edmund Kells introduced the paralleling technique in 1896. Franklin W. McCormack
reintroduced the paralleling technique in 1920. F. Gordon Fitzgerald modified the paralleling
technique with the introduction of the long-cone technique. This is the technique currently used.
Howard Riley Raper modified the bisecting technique and introduced the bite-wing technique in
1925.
8. Which of the following is an advantage of digital imaging?
a. Increased patient radiation exposure
b. Increased patient comfort
c. Increased speed for viewing images
d. Increased chemical usage
ANSWER: C
Patient exposure is reduced with digital imaging. Digital sensors are more sensitive to x-rays than
film. Digital sensors are rigid and bulky, causing decreased patient comfort. The image from
digital sensors is uploaded directly to the computer and monitor without the need for chemical
processing. This allows for immediate interpretation and evaluation. The image from digital
sensors is uploaded directly to the computer and monitor without the need for chemical
processing.
TOP: CDA, RHS, I.B.2. Demonstrate basic knowledge of digital radiography
9. Which discovery was the precursor to the discovery of x-rays?
a. Beta particles
b. Alpha particles
c. Cathode rays
d. Radioactive materials
ANSWER: C

Beta particles are fast moving electrons emitted from the nucleus of radioactive atoms and are not
associated with x-rays. Alpha particles are emitted from the nuclei of heavy metals and are not
associated with x-rays. Wilhelm Roentgen was experimenting with cathode rays when he
discovered x-rays. Radioactive materials are certain unstable atoms or elements that are in the
process of spontaneous disintegration or decay.
10. Which of the following would you place in the patient’s mouth in order to take dental x-rays?
a. Image
b. Image receptor
c. Radiograph
d. Dental radiograph
ANSWER: B
An image is a picture or likeness of an object. An image receptor is the recording medium (film,
phosphor plate, or digital sensor) that is placed in the patient’s mouth to record the image
produced by the x-rays. A radiograph is an image of two-dimensional representation of a three-
dimensional object. A dental radiograph is the dental image produced on a recording medium.

Chapter 02: Radiation Physics
MULTIPLE CHOICE
1. The fundamental unit of matter is the
a. proton.
b. neutron.
c. electron.
d. atom.
ANSWER: D
A proton is a subatomic particle; the fundamental unit of matter is the atom. A neutron is a
subatomic particle; the fundamental unit of matter is the atom. An electron is a subatomic
particle; the fundamental unit of matter is the atom. The fundamental unit of matter is the
atom.
MSC: NBDHE, 2.0 Obtaining and Interpreting Radiographs | NBDHE, 2.1 Principles of
radiophysics and radiobiology
2. The nucleus of an atom contains
a. protons.
b. neutrons.
c. protons and neutrons.
d. electrons.
ANSWER: C
The nucleus of an atom contains neutrons as well as protons. The nucleus of an atom
contains protons as well as neutrons. The nucleus of an atom contains protons and
neutrons. The nucleus of an atom does not contain electrons; it contains protons and
neutrons.
3. Which subatomic particle carries a negative electrical charge?
a. A neutron
b. A proton
c. An electron
d. A nucleon
ANSWER: C
A neutron does not carry an electrical charge. A proton carries a positive electrical charge.
An electron carries a negative electrical charge. A nucleon carries a positive (proton) or

no (neutron) electrical charge.
4. Which of the following elements is the simplest atom?
a. Hydrogen (H #1)
b. Helium (He #2)
c. Nitrogen (N #7)
d. Oxygen (O #8)
ANSWER: A
Atomic numbers are assigned from simplest to most complex. Hydrogen is the simplest
atom; with a single proton, it has an atomic number of 1. Helium has an atomic number
of 2. Nitrogen has an atomic number of 7. Oxygen has an atomic number of 8.
5. Which of the following statements is true of orbits or shells in the atom?
a. Protons travel around the nucleus in well-
defined shells.
b. An atom contains innumerable shells.
c. The energy level within each shell is the
same.
d. The orbiting shell closest to the nucleus
has the highest energy level.
ANSWER: D
Electrons travel around the nucleus in well-defined shells. An atom contains a maximum of
seven shells. Each of the maximum seven shells within an atom represents a different
energy level. The orbiting shell closest to the nucleus has the highest energy level. The K
shell is the orbiting shell closest to the nucleus.
6. The binding energy or binding force of an electron is
a. determined by the distance between the
neutrons and protons within the nucleus.
b. determined by the distance between the
orbiting electrons and the nucleus.

c. weaker for electrons located in inner
shells than in outer shells.
d. determined by the atomic number.
ANSWER: B
The binding energy or binding force of an electron is determined by the distance between
the nucleus and the orbiting electron. The binding energy or binding force of an electron is
determined by the distance between the orbiting electron and the nucleus, not the distance
between the orbiting electrons. The binding energy or binding force of an electron is
stronger for electrons located in inner shells than for outer shells.
DIF: Recall REF: Page 8 OBJ: 2 TOP: CDA, N/A
7. Which of the following statements is true of ionization?
a. An atom that gains an electron will have a
negative charge.
b. An atom that loses an electron will have a
negative charge.
c. An atom that loses an electron will have a
positive charge.
d. An atom that gains an electron has a
negative charge, and an atom that loses an
electron has a positive charge.
ANSWER: D
This answer is not the best answer. An atom that gains an electron has a negative charge;
however, an atom that loses an electron has a positive charge. An atom that loses an
electron will have a positive charge. An atom that loses an electron has a positive charge;
however, an atom that gains an electron has a negative charge. An atom that gains an
electron will have a negative charge, and an atom that loses an electron will have a positive
charge.
TOP: CDA, N/A
8. An ion pair results when
a. a proton is removed from an atom.
b. an electron is removed from an atom.
c. a neutron is removed from an atom.
d. two atoms share a pair of electrons.
ANSWER: B
An ion pair results when an electron is removed from an atom rather than a proton; a
neutron.

9. (1) Radiation is the emission and propagation of energy through space or a
substance in the form of waves or particles. (2) Radioactivity can be defined as the process by
which certain unstable atoms or elements undergo spontaneous disintegration, or decay, in
an effort to attain a more balanced nuclear state.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second
statement is false.
d. The first statement is false; the second
statement is true.
ANSWER: A
Radiation is the emission and propagation of energy through space or a substance in the
form of waves or particles. Radioactivity can be defined as the process by which certain
unstable atoms or elements undergo spontaneous disintegration, or decay, in an effort to
attain a more balanced nuclear state.
10. The spontaneous emission of radiation from the disintegration of unstable
atomic nuclei is
a. beta particle decay.
b. radiation.
c. radioactivity.
d. alpha particle decay.
ANSWER: C
Beta particles are fast-moving electrons emitted from the nucleus of radioactive atoms.
Radioactivity is the process by which certain unstable atoms or elements undergo
spontaneous disintegration, or decay, in an effort to attain a more balanced nuclear state.
Radiation is the emission and propagation of energy through space or a substance in the
form of waves or particles. Radioactivity is the process by which certain unstable atoms or
elements undergo spontaneous disintegration, or decay, in an effort to attain a more
balanced nuclear state. Alpha particles are emitted from the nuclei of heavy metals and exist
as two protons and neutrons, without electrons. Radioactivity is the process by which
certain unstable atoms or elements undergo spontaneous disintegration, or decay, in an
effort to attain a more balanced nuclear state.

11. Which of the following statements is true of ionizing radiation?
a. It is radiation that is capable of producing
ions by removing or adding an electron to
an atom.
b. It is strictly an electromagnetic radiation
and does not involve particles that have
mass.
c. It is strictly particulate radiation and
cannot travel as waves.
d. It can only travel at the speed of light.
ANSWER: A
It is radiation that is capable of producing ions by removing or adding an electron to an
atom. Ionizing radiation involves both particulate and electromagnetic radiation. There are
two groups of ionizing radiation: particulate radiation and electromagnetic radiation.
Electromagnetic radiation, a type of ionizing radiation, travels at the speed of light.
Particulate radiation travels at varying speeds.
12. Cathode rays are derived from which of the following types of particulate
radiation?
a. Electrons
b. Alpha particles
c. Protons
d. Neutrons
ANSWER: A
Cathode rays are derived from electrons. Alpha particles are emitted from the nuclei of
heavy metals. Protons are accelerated particles with a mass of 1 and a charge of +1.
Neutrons are accelerated particles with a mass of 1 and no electrical charge.
13. Electromagnetic radiations
a. are entirely human-made.
b. include x-rays and visible light.
c. are a form of particulate radiation.

ANSWER: B
Electromagnetic radiations are human-made or occur naturally. Electromagnetic radiations
include x-rays and visible light. Electromagnetic radiations are not a form of particulate
radiation. Electromagnetic radiations do not have mass.
14. Which of the following forms of electromagnetic radiation are capable of
ionization?
a. Radio waves
b. Visible light
c. Ultraviolet light
d. X-rays
ANSWER: D
Radio waves are not capable of ionization. Visible light is not capable of ionization.
Ultraviolet light is not capable of ionization. Of the forms of electromagnetic radiation
listed, only x-rays are capable of ionization.
15. Photons are
a. bundles of energy with mass and weight.
b. bundles of energy that travel at the speed
of sound.
c. a component of the particle concept of
electromagnetic radiation.
d. a component of the wave concept of
electromagnetic radiation.
ANSWER: C
Photons are bundles of energy without mass or weight; that travel at the speed of light.
Photons are a component of the particle concept of electromagnetic radiation.
16. Which of the following statements is true of the wave concept of
electromagnetic radiation?
d. have mass.

a. Wavelength refers to the speed of the
wave.
b. Velocity refers to the number of
wavelengths that pass a given point in a
certain amount of time.
c. Frequency is defined as the distance
between the crest of one wave and the
crest of the next.
d. Frequency and wavelength are inversely
related.
ANSWER: D
Velocity refers to the speed of the wave. Frequency refers to the number of wavelengths that
pass a given point in a certain amount of time. Wavelength is defined as the distance between
the crest of one wave and the crest of the next. Frequency and wavelength are inversely
related: if the frequency of the wave is high, the wavelength will be short, and if the
frequency is low, the wavelength will be long.
17. Which of the following forms of electromagnetic radiation has the shortest
wavelength?
a. Radio wave
b. Television wave
c. Radar wave
d. Dental x-ray wave
ANSWER: D
A radio wave has a wavelength as long as 100 meters. A television wave has a wavelength of
approximately 1 meter. A radar wave has a wavelength of 1/100 of a meter. The dental x-ray
wave has a wavelength of 0.1 nanometer, or 0.00000000001 meter.
18. Which of the following components of the x-ray machine would have two
indicator lights?
a. X-ray tube
b. X-ray tubehead
c. The control panel
d. The extension arm
ANSWER: C

The x-ray tube is inside the tubehead; it does not have indicator lights. The x-ray tubehead
contains the x-ray tube; it does not have indicator lights. The control panel has an indicator
light for the on-off switch and an indicator light for the exposure button. The extension
arm is used to position the tubehead; it does not have indicator lights.
TOP: CDA, RHS, III.B.3. Demonstrate understanding of x-ray machine factors that influence
radiation safety
19. Heat is a byproduct of x-ray production. Which component of the x-ray
tubehead dissipates the heat created by the production of x-rays?
a. Metal housing
b. Insulating oil
c. Aluminum discs
d. Lead collimator
ANSWER: B
The metal housing protects the x-ray tube and grounds the high-voltage components.
Insulating oil absorbs heat created by the production of x-rays. Aluminum discs filter out
nonpenetrating, longer-wavelength x-rays. The lead collimator restricts the size of the x- ray
beam.
TOP: CDA, N/A
20. Your patient had x-rays taken in her previous dental office. She notices that
the long metal tube at the end of the x-ray head is longer than it was at the other office.
What explanation would you give for the purpose of the tube, or cone, attached to the x-
ray head?
a. It surrounds the x-ray tube, protects the x-
ray tube, and grounds the high-voltage
components.
b. It seals the oil in the tubehead and acts as
a filter to the x-ray beam.
c. It filters out the nonpenetrating, longer-
wavelength x-rays.
d. It aims and shapes the x-ray beam.
ANSWER: D
The metal housing surrounds and protects the x-ray tube and grounds the high-voltage
components. The tubehead seals the oil in the tubehead and acts as a filter to the x-ray
beam. Aluminum discs filter out the nonpenetrating, longer-wavelength x-rays. The
position-indicating device aims and shapes the x-ray beam.

TOP: CDA, RHS, III.B. Apply the principles of radiation protection and hazards in the operation of
radiographic equipment
21. Within the x-ray tube, electrons are generated by the
a. tungsten filament in the cathode.
b. tungsten filament in the anode.
c. molybdenum cup.
d. copper stem.
ANSWER: A
Within the x-ray tube, electrons are generated by the tungsten filament in the cathode. The
molybdenum cup focuses the electrons into a narrow beam and directs the beam across the
tube toward the tungsten target of the anode. The copper stem functions to dissipate heat
away from the tungsten target.
22. The purpose of the anode is to
a. produce electrons when heated.
b. convert electrons into x-ray photons.
c. absorb heat created by the production of
x-rays.
d. filter out nonpenetrating, longer-
wavelength x-rays.
ANSWER: B
The purpose of the cathode is to produce electrons when heated. The purpose of the anode
is to convert electrons into x-ray photons. The purpose of insulating oil is to absorb heat
created by the production of x-rays. The purpose of aluminum discs is to filter out
nonpenetrating, longer-wavelength x-rays.
23. In the dental x-ray tube, the number of electrons created is controlled by
a. alternating current.
b. direct current.
c. milliamperage.
d. kilovoltage.

ANSWER: C
Alternating current describes a current in which the electrons flow in two opposite
directions. Direct current describes a current in which the electrons flow in one direction
through a conductor. Milliamperage in the dental x-ray tube controls the number of
electrons created that will move through a conductor. Kilovoltage in the dental x-ray tube
controls the electrical force or speed that moves electrons from a negative pole (cathode) to
a positive one (anode).
24. Your x-ray machine runs off 110 volts. Theoretically what would occur if
there was no step-down transformer in the x-ray control panel?
a. Too few electrons would be produced for
the purpose of dental x-rays. 65,000 to
100,000 volts are required to heat the
tungsten filament.
b. Too few electrons would be produced for
the purpose of dental x-rays. 50,000 to
75,000 volts are required to heat the
tungsten filament.
c. Too many electrons would be produced
for the purpose of dental x-rays. Only 3-5
volts are required to heat the tungsten
filament.
d. There would be no interruption in
function of the machine.
ANSWER: C
The step-up transformer is used to increase the voltage to the 65,000 to 100,000 volts
required. 65,000 to 100,000 volts are needed to activate the high-voltage circuit to accelerate
the electrons to the anode. A step-down transformer is used to decrease the voltage from the
incoming 110- or 220-line voltage to the 3 to 5 volts required. The step- up transformer is
used to increase the voltage to the 65,000 to 100,000 volts required. Too many electrons
would be produced for the purpose of dental x-rays. Only 3-5 volts are required to heat the
tungsten filament. A step-down transformer is used to decrease the volts from 110-220 volts
to the required 3-5 volts. Too many electrons would be produced for the purpose of dental
x-rays.

25. Thermionic emission of electrons occurs at the
a. tungsten filament in the anode.
b. tungsten filament in the cathode.
c. copper stem.
d. molybdenum cup.
ANSWER: B
Thermionic emission of electrons occurs at the tungsten filament in the cathode; the copper
stem functions as a heat sink for the tungsten target; the molybdenum cup focuses the
electrons into a narrow beam.
26. Approximately what percentage of the kinetic energy of the electrons is
converted to x-rays at the anode?
a. Less than 1%
b. 25%
c. 50%
d. 100%
ANSWER: A
Less than 1% of the kinetic energy of the electrons is converted to x-rays at the anode. 25%
is incorrect; less than 1% of the kinetic energy of the electrons is converted to x-rays at the
anode. 50% is incorrect; less than 1% of the kinetic energy of the electrons is converted to x-
rays at the anode. 100% is incorrect; less than 1% of the kinetic energy of the electrons is
converted to x-rays at the anode.
27. The lead collimator
a. carries away the heat produced during the
production of x-rays.
b. permits a small number of x-rays to exit
from the x-ray tube.
c. filters the longer-wavelength x-rays from
the beam.
d. restricts the size of the x-ray beam.
ANSWER: D

The copper stem carries away the heat produced during the production of x-rays. The
unleaded glass window portion of the tube permits a small number of x-rays to exit from
the x-ray tube. The aluminum disc filters the longer-wavelength x-rays from the beam.
The lead collimator restricts the size of the x-ray beam.
28. Which of the following statements is true of characteristic radiation?
a. It is also known as braking
(bremsstrahlung) radiation.
b. It only occurs at 70 kV and above.
c. It is the source of the majority of x-rays
that are produced.
d. The high-speed electron passes close to
the nucleus or hits the nucleus of the
tungsten atom.
ANSWER: B
General radiation is known as braking, or bremsstrahlung, radiation. Characteristic radiation
is not the same as general radiation. Characteristic radiation occurs at 70 kV and above.
General radiation is the source of the majority of the x-rays that are produced. The speeding
electron passes close to the nucleus or hits the nucleus of the tungsten atom in general
radiation.
29. Which form of the x-ray beam is most detrimental to the patient and
operator?
a. Primary radiation
b. Secondary radiation
c. Scatter radiation
d. Useful beam
ANSWER: C
Primary radiation is the penetrating x-ray beam produced at the target of the anode.
Secondary radiation is created when the primary beam interacts with matter. Scatter
radiation is the most detrimental to the patient and operator. The useful beam is another
term for primary radiation.

30. Which is the most common possibility when an x-ray photon interacts
with matter?
a. No interaction
b. Absorption or photoelectric effect
c. Compton scatter
d. Coherent scatter
ANSWER: C
No interaction means the photon passed through matter without any interaction.
Absorption (photoelectric effect) accounts for 30% of the interactions with matter from
the dental x-ray beam. Compton scatter accounts for 62% of the interactions with matter
that occur in diagnostic radiography. Coherent scatter accounts for only 8% of the
interactions with matter from the dental x-ray beam.
31. Which of the following four possibilities that can occur when an x-ray
photon interacts with matter is responsible for producing densities on a dental receptor
that make dental radiography possible?
a. No interaction
b. Absorption or photoelectric effect
c. Compton scatter
d. Coherent scatter
ANSWER: A
X-ray photons that pass through a patient without interaction are responsible for producing
the densities on a dental receptor that make dental radiography possible. Absorption or
photoelectric effect is incorrect; x-ray photons that pass through a patient without
interaction are responsible for producing densities on a dental receptor that make dental
radiography possible. Compton scatter is incorrect; x-ray photons that pass through a
patient without interaction are responsible for producing densities on a dental receptor that
make dental radiography possible. Coherent scatter is incorrect; x-ray photons that pass
through a patient without interaction are responsible for producing densities on a dental
receptor that make dental radiography possible.

32. (1) X-ray photon production occurs as a result of both general and
characteristic radiation. (2) General radiation accounts for a small number of x-ray
photons produced because it takes high kV to dislodge the electrons from the K shell.
statement is false.
statement is true.
ANSWER: C
The first statement is true; the second statement is false. X-ray photon production occurs
as a result of both general and characteristic radiation; however, it is characteristic radiation
that accounts for a small number of x-ray photons produced because it is through
characteristic radiation that electrons are ejected from the K shell, which results in the
production of x-ray photons.
33. Interaction with the x-ray photon as a result of the photoelectric effect is
harmful to the patient because ionization occurs.
a. The statement is true.
b. The statement is false.
c. The first part of the statement is true, but
the second part of the statement is false.
d. The first part of the statement is false, but
the second part of the statement is true.
ANSWER: A
Both statements are true. Absorption, one of the types of interactions with the x-ray
photon, occurs as a result of the photoelectric effect. It is harmful to the patient because
ionization occurs.
DIF: Comprehension REF: Pages 18-19 OBJ: 11
34. Which would you adjust if you wanted to create a larger electron cloud?
a. Milliamperage
b. Kilovoltage
c. Step-up transformer

ANSWER: A
Milliamperage controls the number of electrons produced in the electron cloud. Kilovoltage
controls the speed or force with which the electron cloud is propelled to the anode. The
step-up transformer increases the incoming voltage from 110-220 volts to 65,000 to 100,000
volts. The step-down transformer decreases the incoming voltage from 110-220 volts to 3-5
volts.
35. Which would you adjust if you wanted to produce characteristic radiation?
a. Milliamperage
b. Kilovoltage
c. Step-up transformer
d. Step-down transformer
ANSWER: B
Milliamperage controls the number of electrons produced in the electron cloud; the number
of electrons does not affect the production of characteristic radiation. The kilovoltage control
would be adjusted. Kilovoltage controls the speed or force with which the electron cloud is
propelled to the anode. Characteristic radiation occurs at 70 kV or higher. The step-up
transformer increases the incoming voltage from 110-220 volts to 65,000 to 100,000 volts.
The step-down transformer decreases the incoming voltage from 110-220 volts to 3-5 volts.
36. Which property of x-rays allows for the image on the receptor?
a. Fluorescence
b. Penetrating power
c. Focusing capability
d. Effect on living tissue
ANSWER: B
X-rays have fluorescence capability, and they can cause substances to fluoresce. However,
this is not a property that produces an image on a receptor. The penetrating power of the x-
ray determines the x-ray’s ability to penetrate matter. The amount of x- rays that pass
through or are that are absorbed creates the image on the receptor. The focusing ability,
which means an x-ray cannot be focused to a point, does not affect the production of an
image on the receptor. X-rays cause biologic changes to living cells; this
d. Step-down transformer

does not affect the production of an image on the receptor.

Chapter 03: Radiation Characteristics Iannucci:
Dental Radiography, 6th Edition
MULTIPLE CHOICE
1. In dental radiography, the term is used to describe the mean
energy or penetrating ability of the x-ray beam.
a. quality
b. quantity
c. intensity
d. wavelength
ANSWER: A
Quality is used to describe the mean energy or penetrating ability of the x-ray beam.
Quantity refers to the number of x-rays produced. Intensity is defined as the product of the
quantity and quality per unit of area per time of exposure. Wavelength determines the
energy and penetrating power of radiation.
TOP: CDA, RHS, III.B.1. Demonstrate knowledge of the factors affecting x-ray production
2. Which of the following statements is true of wavelength in reference to
radiation?
a. X-rays with shorter wavelength have less
penetrating power.
b. X-rays with longer wavelength have less
penetrating power.
c. X-rays with longer wavelength are less
likely to be absorbed by matter.
d. Milliamperage controls the wavelength
and energy of the x-ray beam.
ANSWER: B
X-rays with longer wavelength have less penetrating power and x-rays with shorter
wavelengths have more penetrating power. X-rays with longer wavelength are more likely to
be absorbed by matter. Kilovoltage controls the wavelength and energy of the x- ray beam.
3. is a measurement of force that refers to the potential
difference between two electrical charges.

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a. Exposure time
b. Wavelength
c. Voltage
d. Ampere
ANS: C
Exposure time refers to the interval of time during which x-rays are produced. Wavelength
can be defined as the distance between the crest of one wave and the crest of the next
wave. Voltage is a measurement of force that refers to the potential difference between two
electrical charges. Ampere is the unit of measure used to describe the number of electrons,
or current, flowing through the cathode filament.
DIF: Recall REF: Pages 3-4 OBJ: 1
TOP: CDA, RHS, I.B.1. Describe how to acquire radiographic images using various techniques |
CDA, RHS, III.B. Apply the principles of radiation protection and hazards in the operation of
4. When the kilovoltage is increased
a. electrons move from the anode to the
cathode with more speed.
b. photons move from the anode to the
cathode with more speed.
c. electrons move from the cathode to the
anode with more speed.
d. photons move from the cathode to the
anode with more speed.
ANSWER: C
Electrons move from the cathode to the anode. When the voltage is increased, electrons
move from the cathode to the anode with more speed, striking the target with greater energy
and force.
5. Which of the following statements is true of the use of voltage in dental x-
ray equipment?
a. Dental x-ray equipment requires the use
of 3 to 5 volts.
b. Dental x-ray equipment requires the use
of less than 60 kilovolts.

c. Dental x-ray equipment uses more than 70
kilovolts.
d. Dental x-ray equipment requires the use
of 60 to 70 kilovolts.
ANSWER: D
The filament circuit requires 3 to 5 volts; however, an exposure requires the use of 60 to 70
kilovolts (kV). The use of less than 60 kV does not allow adequate penetration.
Current dental x-ray equipment uses between 60 and 70 kV; requires the use of 60 to 70 kV.
DIF: Recall REF: Pages 24-25 OBJ: 2
6. When contrasted with the use of 70 kV for dental x-rays, the use of 60 kV
produces
a. more penetrating dental x-rays with longer
wavelength.
b. less penetrating dental x-rays with longer
wavelength.
c. more penetrating dental x-rays with
shorter wavelength.
d. less penetrating dental x-rays with shorter
wavelength.
ANSWER: B
The use of 60 kV produces less penetrating dental x-rays with longer wavelengths than 70
kV. The use of 70 kV for dental x-rays produces more penetrating dental x-rays with
shorter wavelength than the use of 60 kV.
DIF: Comprehension REF: Pages 24-25 OBJ: 2
7. The kVp represents
a. the mean x-ray tube voltage.
b. the mean filament voltage.
c. the maximum or peak voltage of an
alternating current.
d. the maximum or peak voltage of a direct
current.

ANSWER: C
The kVp represents the maximum or peak x-ray tube voltage of an alternating current.
DIF: Recall REF: Page 24 OBJ: 1 | 2
8. When kilovolt is increased, a
a. lower energy x-ray beam with increased
penetrating ability results.
b. lower energy x-ray beam with decreased
c. higher energy x-ray beam with increased
d. higher energy x-ray beam with decreased
ANSWER: C
A higher energy x-ray beam with increased penetrating ability results. When kilovolt peak
is increased, a higher energy x-ray beam with increased penetrating ability results.
9. (1) Density is the overall darkness or blackness of a dental image. (2)
When the kilovoltage is increased while other exposure factors remain constant, the
resultant image exhibits a decreased density and appears lighter.
statement is false.
statement is true.
ANSWER: C
The first statement is true; however, when the kilovolt is increased while other exposure
factors remain constant, the resultant image exhibits an increased density and appears darker.
Both statements are true. Density is the overall darkness or blackness of a dental image. The
first statement is true; however, the second statement is false.

10. When lower kilovoltage settings are used, an image with will result.
a. high contrast
b. low contrast
c. many shades of gray
d. there is no change in contrast
ANSWER: A
When low kilovoltage settings are used, an image with high contrast will result; an image
with few shades of gray will result (high contrast).
11. An image with “low” contrast
a. is useful for the detection of periodontal or
periapical disease and has many shades of
gray.
b. is useful for the detection and progression
of dental caries and has many shades of
gray.
c. is useful for the detection of periodontal
or periapical disease and has many black
and white areas.
d. is useful for the detection and progression
of dental caries and has many black and
white areas.
ANSWER: A
An image with low contrast has many shades of gray and is useful for the detection of
periodontal or periapical disease. An image with high contrast has many black and white
areas and is useful for the detection and progression of dental caries. An image with low
contrast is useful for the detection of periodontal or periapical disease, but it has many
shades of gray.

12. Exposure time is measured in
a. kV.
b. milliamperage.
c. density.
d. impulses.
ANSWER: D
kV is a measure of voltage. Milliamperage is a measure of the number of electrons flowing
through the cathode filament. Density is a measure of the darkness of the film. Exposure
time is measured in impulses; one impulse occurs every 1/60 of a second on older machines
and every 1/100 of a second on newer machines.
13. The quantity of the x-rays produced is controlled by
a. voltage.
b. kilovoltage.
c. kilovoltage peak.
d. milliamperage.
ANSWER: D
Voltage controls the maximum penetrating power of the electrons. Kilovoltage is the term
for 1000 volts as dental exposures require large amounts of voltage. Kilovoltage peak
represents the maximum voltage available and is only found with alternating current
machines. The quantity of the x-rays produced is controlled by milliamperage.
14. Milliamperage regulates the of electrons produced at the
cathode filament.
a. quality
b. quantity
c. speed
d. power
ANSWER: B
Voltage regulates the quality (speed or power) of electrons produced at the cathode filament.
Milliamperage regulates the quantity of electrons produced at the cathode

filament.
15. In regard to increasing density
a. an increase in either kV or mA will
increase density.
b. an increase in kV will increase density,
but an increase in mA will not increase
density.
c. an increase in mA will increase density,
but an increase in kV will not increase
density.
d. neither an increase in kV nor an increase
in mA will increase density.
ANSWER: A
In regard to increasing density, an increase in either kV or mA will increase density.
DIF: Comprehension REF: Pages 25, 27 OBJ: 3 | 5
16. Which of the following changes will increase x-ray beam intensity?
a. Decreasing the kilovoltage
b. Decreasing the milliamperage
c. Decreasing the exposure time
d. Decreasing the source-to-film distance
ANSWER: D
Decreasing the kilovoltage will decrease x-ray beam intensity. Decreasing the milliamperage
will decrease x-ray beam intensity. Decreasing the exposure time will decrease x-ray beam
intensity. Decreasing the source-to-film distance will increase x-ray beam intensity.
DIF: Comprehension REF: Pages 27, 28 OBJ: 6

17. According to the inverse square law, the intensity of radiation is
proportional to the from the source of radiation.
a. directly; distance
b. directly; square of the distance
c. inversely; distance
d. inversely; square of the distance
ANSWER: D
The intensity of radiation is inversely proportional to the square of the distance from the
source of radiation.
DIF: Comprehension REF: Page 27 OBJ: 1 | 7
18. According to the inverse square law, if the length of the PID is halved, the
resultant beam is as intense.
a. four times
b. twice
c. half
d. one quarter
ANSWER: D
According to the inverse square law, if the length of the PID is halved, the resultant beam is
four times as intense.
19. Aluminum filters are used to remove -energy,
wavelength x-rays.
a. low; longer
b. high; longer
c. low; shorter
d. high; shorter
ANSWER: A
Aluminum filters are used to remove low-energy, longer wavelength x-rays.

20. Aluminum filters
a. remove more penetrating x-rays from the
beam.
b. decrease the mean penetrating ability of
the x-ray beam.
c. remove high-energy x-rays from the
beam.
d. reduce the intensity of the x-ray beam.
ANSWER: D
Aluminum filters remove less penetrating x-rays from the beam. Aluminum filters increase
the mean penetrating ability of the x-ray beam. Aluminum filters remove low- energy x-
rays from the beam. Aluminum filters reduce the intensity of the x-ray beam.
21. You have been using a dental x-ray machine that has a 4-inch PID. Your
new machine has an 8-inch PID. Given that all exposure factors remain the same,
according to the inverse square law, the resultant beam would be as
intense.
a. four times
b. twice
c. half
d. one quarter
ANSWER: D
According to the inverse square law, if the length of the PID is doubled, the resultant beam
is one quarter as intense.
22. (1) As kilovoltage, milliamperage, and time increase, x-ray beam intensity
decreases. (2) As distance and filtration increase, the intensity of the x-ray beam increases.

statement is false.
statement is true.
ANSWER: B
Both statements are false; 1. An increase in kilovoltage, milliamperage, and/or time will
increase the intensity of the x-ray beam. 2. An increase in distance and/or filtration will
decrease the intensity of the x-ray beam.
23. You have taken your first dental image on your patient. The contrast is high
and you are looking for periodontal disease. You are using a DC machine and you have
control of your settings. You have a 60- to 70-kV range and a 6- to 8-mA range. You had the
kV set at 60, the mA set at 7, and the impulses set at 6/100. While leaving all other settings
the same, which setting would you adjust to create better contrast for detecting periodontal
disease?
a. Increase kV to 70.
b. Increase mA to 8.
c. Decrease mA to 6.
d. Increase time to 7/100.
ANSWER: A
The only factor that affects contrast is kV. kV affects the penetrating ability of the x-ray
beam. A higher kV creates a lower contrast image (more shades of gray) while a lower kV
creates a higher contrast image (more black and white). A low-contrast image is preferred for
detecting periodontal and periapical diseases. A high-contrast image is preferred for detecting
caries. Increasing mA affects density, not contrast. Decreasing mA affects density, not
contrast. Increasing and decreasing time affect density, not contrast.
DIF: Application REF: Page 25 OBJ: 2 | 5
24. You are going to take dental images on your patient. He is larger than
average. What machine setting adjustment should you make prior to taking dental
images?

a. Increase kV.
b. Increase mA.
c. Increase impulses.
d. You don’t need to make any adjustments.
ANSWER: C
Although an increase in kV will increase density, it is recommended that the only setting you
change is impulses. Although an increase in mA will increase density, it is recommended that
the only setting you change is impulses. It is recommended that impulses be increased when
taking dental images on a patient who is larger than average. Failure to do so will result in an
image that is too light and may require retakes or an adjustment of the enhancement
software.

Chapter 04: Radiation Biology
MULTIPLE CHOICE
1. (1) All ionizing radiations cause damage to living tissues. (2) Although
very little radiation is used in dentistry, damage to the cells does occur.
statement is false.
statement is true.
ANSWER: A
All ionizing radiations are harmful and produce biologic changes in living tissue. The amount
of radiation used in dental radiography is small, but biologic damage does occur. The
amount of radiation used in dental radiography is small, but biologic damage does occur. All
ionizing radiations are harmful and produce biologic changes in living tissue.
TOP: CDA, RHS, III.C.2. Demonstrate understanding of x-radiation biology
radiophysics and radiobiology | NBDHE, 2.2 Principles of radiologic health
2. What specific mechanism of radiation injury may result in the formation
of hydrogen peroxide when x-ray energy is absorbed by patients?
a. An ejected high-speed electron may interact
with other atoms within absorbing tissues.
b. Free radical formation created by the
ionization of water may occur.
c. Unequal charge distribution may result in
negative electrical potential.
d. Creation of a magnetic field may cause
polarization.
ANSWER: B
This is an example of ionization; hydrogen peroxide may be formed as a result of free
radical formation. Free radical formation created by the ionization of water may occur.
Hydrogen peroxide may be formed as a result of the recombination of free radicals created
by the ionization of water.

3. Which of the following statements is true regarding the direct theory of
radiation injury?
a. It involves absorption of an x-ray photon
by water within a cell.
b. It involves the formation of toxins that
damage the cell.
c. It involves damage to the critical areas of a
cell through direct contact with the x-ray
photon.
d. It involves the formation of free radicals.
ANSWER: C
The indirect theory of radiation injury involves absorption of an x-ray photon by water
within a cell. The indirect theory of radiation injury involves the formation of toxins that
damage cells. The direct theory of radiation injury involves a direct hit to and absorption of
an x-ray photon within critical areas of a cell. The indirect theory of radiation injury involves
the formation of free radicals.
4. The indirect theory proposes that
a. toxins are created from the formation of
free radicals.
b. ionizing radiation strikes critical areas
within cells.
c. direct injuries occur more frequently than
indirect injuries.
d. changes occur to the deoxyribonucleic
acid (DNA) of a cell.
ANSWER: A
The indirect theory proposes that free radicals combine to form toxins. The direct theory
proposes that ionizing radiation directly hits critical areas within cells. Indirect injuries occur
more frequently than direct injuries. The direct theory proposes that the deoxyribonucleic
acid (DNA) of a cell is damaged during radiation exposure.
5. According to the dose-response curve, when dose and damage are plotted
on a graph, a relationship is seen.
a. nonlinear, nonthreshold

b. linear, nonthreshold
c. nonlinear, threshold
d. linear, threshold
ANSWER: B
When dose and damage are plotted on a graph, a linear, nonthreshold relationship is seen.
6. A nonthreshold dose-response curve suggests that
a. radiation exposure below the threshold
will not damage tissues.
b. radiation exposure below the threshold is
safe for living tissue.
c. radiation exposure above the threshold
amount causes some damage to tissues.
d. radiation exposure, no matter how small,
causes damage to living tissue.
ANSWER: D
A nonthreshold dose-response curve suggests that no matter how small the amount of
radiation received, some biologic damage occurs.
7. Stochastic biologic effects from radiation
a. are directly related to exposure and effect.
b. occur as a result of exposure, but severity
is not determined by dose.
c. have a dose threshold.
d. cause significant damage to cell or cell
death.
ANSWER: B
Nonstochastic biologic effects from radiation are directly related to exposure and effect.
Stochastic biologic effects from radiation occur as a direct function of dose.
Nonstochastic biologic effects from radiation have a dose threshold; stochastic biologic
effects from radiation do not have a dose threshold. Nonstochastic biologic effects cause
significant damage to a cell or cell death.

8. Which of the following is an example of stochastic effects?
a. Erythema
b. Cancer
c. Hair loss
d. Radiation sickness
ANSWER: D
Erythema is an example of a nonstochastic effect. Cancer is an example of a stochastic
effect. Hair loss is an example of a nonstochastic effect. Radiation sickness is an example of
a nonstochastic effect.
9. Your patient was out in the hot, bright sun yesterday. While in the sun she
began experiencing pain and noticed her skin had turned bright red. Shortly after arriving
home, she began to experience chills, nausea, severe pain, and blistering. Why would your
patient experience the symptoms so quickly?
a. The latent period was decreased by the
increased dose and dose rate.
b. The latent period was increased by the
increased dose and dose rate.
c. The latent period was decreased by the
increased area of tissue irradiated and the
number of sensitive cells.
d. The latent period was not affected.
ANSWER: A
The latent period is shortened or lengthened based on the total dose and rate of radiation.
The less radiation received and the slower the dose rate, the longer the latent period. The
more radiation received and the faster the dose rate, the shorter the latent period.
10. Cellular injuries following the latent period may include (1) cell death, (2)
cessation of mitotic activity, and/or (3) abnormal mitotic activity.
a. 1, 2, 3
b. 1, 2
c. 1, 3
d. 1 only

ANSWER: A
Cellular injuries following the latent period may include cell death, cessation of mitotic
activity, or abnormal mitotic activity.
11. refers to the total amount of radiation that is received or
absorbed.
a. Total dose
b. Dose rate
c. Amount of tissue irradiated
d. Cell sensitivity
ANSWER: A
Total dose refers to the quantity of radiation received or the total amount of radiation
energy absorbed. Dose rate is the rate at which exposure to radiation occurs and
absorption takes place. Amount of tissue irradiated refers to the areas of the body
exposed. Cell sensitivity refers to the susceptibility of the particular type of cell to
radiation.
DIF: Comprehension REF: Page 33 OBJ: 1 |
4 TOP: CDA, RHS, III.C.2. Demonstrate understanding of x-radiation biology
12. (1) More radiation damage takes place with high dose rates (2) because a
rapid delivery of radiation does not allow time for cellular damage to be repaired.
statement is false.
statement is true.
ANSWER: A
More radiation damage takes place with high dose rates, because a rapid delivery of radiation
does not allow time for cellular damage to be repaired.
13. Which types of cells are more sensitive to radiation: (1) rapidly dividing,
(2) slowly dividing, (3) young, and/or (4) old?
a. 1 and 3

b. 1 and 4
c. 2 and 3
d. 2 and 4
ANSWER: A
Rapidly dividing, young cells are most sensitive to radiation.
14. Which of the following is associated with long-term radiation effects?
a. Symptoms include diarrhea, hair loss, and
hemorrhage.
b. Small amounts of radiation absorbed over
a long period
c. Acute radiation syndrome
d. The injury period in the sequence of
radiation injury is seen within minutes,
days, or weeks of radiation exposure.
ANSWER: B
Symptoms of short-term radiation effects include diarrhea, hair loss, and hemorrhage. Long-
term radiation effects are associated with small amounts of radiation absorbed over a long
period. Short-term radiation effects are associated with large amounts of radiation absorbed
over a short time. Short-term radiation effects are associated with acute radiation syndrome.
Clinical effects that are seen within minutes, days, or weeks of the radiation exposure are
termed short-term effects.
(ARS)?
15. Which of the following is a sign or symptom of acute radiation syndrome
a. Genetic defects
b. Birth abnormalities
c. Hair loss
d. Cancer
ANSWER: C
Genetic defects are considered a long-term effect of radiation exposure. Birth abnormalities
are considered a long-term effect of radiation exposure. Hair loss is considered a short-term
effect of radiation exposure and is a symptom of acute radiation syndrome (ARS). Cancer is
considered a long-term effect of radiation exposure.

16. Which of the following statements is true of somatic effects of irradiation?
a. Changes are not transmitted to future
generations.
b. Changes are in the genetic cells of the
individual.
c. Mutations occur that affect the health of
offspring.
d. Damage cannot be repaired.
ANSWER: A
Somatic effects are not transmitted to future generations. Changes in genetic cells of the
individual are a genetic effect. Mutations that affect the health of offspring are a genetic
effect. Genetic damage cannot be repaired.
17. Which of the following cells would be the most sensitive to x-rays?
a. Nerve
b. Bone
c. Muscle
d. Blood
ANSWER: D
A nerve cell is more radioresistant than a blood cell. A bone cell is more radioresistant than
a blood cell. A muscle cell is more radioresistant than a blood cell. Blood cells are more
radiosensitive than bone, muscle, or nerve cells.
18. Which of the following is the least sensitive to x-rays?
a. Bone marrow
b. Salivary glands
c. Lymphoid tissue
d. Intestines
ANSWER: B
Bone marrow is considered to be radiosensitive. Salivary glands are considered to be
radioresistant tissues. Lymphoid tissue is considered to be radiosensitive. Intestines are

considered to be radiosensitive.
19. Precautions should be taken during dental imaging procedures to which of
the following critical organs in the head and neck region? (1) skin, (2) thyroid gland, (3) lens
of the eye, and (4) bone marrow
a. 1, 2, 3, 4
b. 1, 2, 3
c. 1, 2, 4
d. 2, 4
ANSWER: A
Critical organs exposed during dental imaging procedures in the head and neck region
include skin, thyroid gland, lens of the eye, and bone marrow. Skin, thyroid gland, and
lens of the eye are true; however, bone marrow is also correct. Skin, thyroid gland, and
bone marrow are true; however, lens of the eye is also correct. Thyroid gland and bone
marrow are true; however, skin and lens of the eye are also correct.
20. The traditional unit of dose is called
a. the roentgen (R).
b. the radiation absorbed dose (rad).
c. the roentgen equivalent in man (rem).
d. the gray (Gy).
ANSWER: B
The roentgen is the traditional unit of exposure for x-rays; the traditional unit of dose is the
rad. The traditional unit of dose is called the rad. The rem is the traditional unit of the dose
equivalent; the traditional unit of dose is the rad. The gray is the SI unit equivalent to the
rad; the traditional unit of dose is the rad.
21. One gray is equivalent to rad(s).
a. 1
b. 10
c. 100

ANSWER: C
One gray is equivalent to 100 rads.
22. The SI equivalent of the rem is
a. the rad.
b. the gray.
c. the sievert.
d. the roentgen.
ANSWER: C
The SI equivalent of the rem is the sievert; the rad is a traditional unit of radiation
measurement; the gray is the SI equivalent of the radiation measurement; the roentgen is the
traditional unit of radiation measurement.
23. You could be exposed to each of these radiation sources in your daily
activities. Which of these sources is human-made?
a. Radon gas
b. Atomic fallout
c. Terrestrial radiation
d. Radioactive potassium
ANSWER: B
Radon gas is an example of natural background radiation. Naturally occurring background
radiation includes radon gas, cosmic radiation, radioactive potassium, and terrestrial
radiation; atomic fallout is a form of artificial radiation. Terrestrial radiation is an example of
background radiation. Radioactive potassium is an example of background radiation.
24. Uranium is an example of radiation.
a. terrestrial
b. cosmic
c. artificial
d. 1000

ANSWER: A
Uranium is an example of terrestrial radiation; cosmic radiation originates from the stars and
sun. Uranium is a form of naturally occurring terrestrial background radiation.
Computer screens, a consumer product, are an example of artificial or human-made
radiation. Water supplies containing radon that a person consumes are an example of
internal radiation.
25. is/are the single largest contributor to artificial
radiation exposure (0.00053 Sv/year).
a. Consumer products
b. Medical radiation
c. Fallout from atomic weapons
d. The nuclear fuel cycle
ANSWER: B
Consumer products contribute 0.00009 Sv/year, less than medical radiation. Medical
radiation is the single largest contributor to artificial radiation exposure. Fallout from
atomic weapons contributes <0.00001 Sv/year, less than medical radiation. The nuclear
fuel cycle contributes <0.00001 Sv/year, less than medical radiation.
26. Which of the following statements is true of the average dose of
background radiation received by an individual in the United States?
a. The average dose of background radiation
a person living in the United States receives
each year is 6.2 mSv.
b. Geographic areas at higher elevations are
associated with increased amounts of
cosmic radiation.
c. Geographic areas that contain more
radioactive materials are associated with
increased amounts of cosmic radiation.
d. A wood home has a higher natural
radiation level than a brick home.
ANSWER: B
The average dose of background radiation a person living in the United States receives
d. internal

each year is 3.1 mSv. Geographic areas at higher elevations are associated with increased
amounts of cosmic radiation. Geographic areas that contain more radioactive materials are
associated with increased amounts of terrestrial radiation. The type of home construction
affects background radiation exposure; a brick home has a higher natural radiation level
than a home made of wood.
27. The potential risk of dental radiography inducing a fatal cancer in an
individual is about the risk of a person developing cancer spontaneously.
a. 1/10
b. 1/100
c. 1/1000
d. 1/1,000,000
ANSWER: C
The potential risk of dental radiography inducing a fatal cancer in an individual is about
1/1000 the risk of a person developing cancer spontaneously.
28. A 1 in 1 million risk of a fatal outcome is associated with which of the
following activities?
a. Riding 10 miles on a bike
b. Riding 300 miles in an auto
c. Riding 1000 miles in an airplane
d. All three of the above activities
ANSWER: D
A 1 in 1 million risk of a fatal outcome is associated with riding 10 miles on a bike. A 1 in 1
million risk of a fatal outcome is associated with riding 300 miles in an auto. A 1 in 1 million
risk of a fatal outcome is associated with riding 1000 miles in an airplane. A 1 in 1 million
risk of a fatal outcome is associated with riding 10 miles on a bike, 300 miles in an auto, or
1000 miles in an airplane.
29. Risk estimates suggest (1) that death is more likely to occur from common
activities than from dental imaging procedures and (2) that cancer is much more likely to be
unrelated to dental imaging radiation exposure.

statement is false.
statement is true.
ANSWER: A
Risk estimates suggest that death is more likely to occur from common activities than from
dental imaging procedures and that cancer is much more likely to be unrelated to radiation
exposure.
30. The use of F-speed film instead of D-speed film reduces the absorbed dose
by %.
a. 10
b. 25
c. 50
d. 60
ANSWER: D
The use of F-speed film instead of D-speed film reduces the absorbed dose by 60%.
31. Your patient is concerned about radiation exposure. Which of the
following explanations would you give to your patient to help calm her concerns?
a. I will be using a digital sensor; this will
reduce x-ray exposure by 30% over the
use of conventional film.
b. I am using this collimator attachment,
which will decrease the x-ray dose you
receive by 60-70%.
c. I will be using the bisecting technique for
receptor placement, which will reduce
exposure.

ANSWER: B
Use of digital radiographs rather than F-speed film will decrease patient exposure to
radiation during dental imaging procedures by 50%-90%. Rectangular collimation will
decrease patient exposure to radiation during dental imaging procedures by 60% to 70%.
The bisecting technique uses a shorter source-to-receptor distance, which will increase
patient exposure to radiation. The paralleling technique, which uses a longer source-to-
receptor distance, will reduce patient exposure to radiation during dental radiographic
procedures. Erythema occurs after the absorption of 250 rads (2.5 Gy) in a 14-day period.
That is equal to 500 dental films.
32. Which of the following combinations will result in the lowest absorbed
dose for the patient from a 20-film series of dental radiographs?
a. Round collimation with digital sensor
b. Rectangular collimation with digital
sensor
c. Round collimation with F-speed film
d. Rectangular collimation with F-speed film
ANSWER: B
The lowest absorbed dose for the patient from a 20-film series of dental radiographs will
result from the use of rectangular collimation with a digital sensor. The lowest absorbed
dose for the patient from a 20-film series of dental radiographs will result from the use of
rectangular collimation with F-speed film.
33. Your patient is receiving radiation treatments for breast cancer. She reports
having a burning sore throat and great difficulty swallowing. Which stage of the radiation
injury sequence is your patient in?
a. Injury
b. Recovery
c. Latent
d. Cumulative effects
d. A sign of excessive radiation exposure to
the skin is reddening or erythema. I would
have to take more than 30 exposures using
film, not digital, during a 14-day period to
cause reddening. I will only be taking 20
digital x-rays.

ANSWER: A
Signs and symptoms of radiation exposure occur during the injury period. Repair of
damaged tissues occurs during the recovery period. The latency period occurs between
the radiation exposure and the onset of clinical signs. The unrepaired damage that
accumulates as a result of repeated radiation exposure is known as cumulative effects.
34. Your patient is concerned about being exposed to dental x-rays. Which of
the following could you tell your patient to alleviate her fears?
a. We take x-rays once a year, it is safe, and
that is all your insurance will pay for.
b. Your risk of getting cancer from dental x-
rays is only 2 times greater than getting
cancer spontaneously.
c. The risks from dental imaging are not
significantly greater than the risks of other
everyday activities in modern life.
d. Three fourths of the radiation exposure
you will have throughout your life will
come from background radiation.
ANSWER: C
Dental images should be prescribed for a patient only when the benefit of disease detection
outweighs the risk of biologic damage. The potential risk of dental imaging inducing a fatal
cancer in an individual has been estimated to be approximately 3 in 1 million. The risk of a
person developing cancer spontaneously is much higher, or 3300 in 1 million. The risks
from dental imaging are not significantly greater than the risks of other everyday activities in
modern life. One half of the radiation exposure you will have throughout your life will
come from background radiation. In the United States, the average person is exposed to a
total of 6.2 mSv of radiation per year (3.1 mSv from natural sources + 3.1 mSv from
human-made sources = 6.2 mSv total).
DIF: Application REF: Page 38 OBJ: 10 | 11
35. Explain to your patient the steps, in order, in the formation of hydrogen
peroxide, a toxin that will cause damage to living tissues.
1. Free radicals combine
2. Free radical formation
3. Cellular dysfunction and biologic damage

4. X-ray photons are absorbed by water
a. 1, 2, 3, 4
b. 4, 2, 1, 3
c. 2, 1, 4, 3
d. 2, 4, 1, 3
ANSWER: B
X-ray photons are absorbed by water, Free radical formation, Free radicals combine, Cellular
dysfunction and biologic damage.
36. The bombing at Nagasaki and Hiroshima took place in 1945; an increase in
the incidence of cancer was noted in 1956. Which effects apply to the cancer incidence?
a. Short-term, somatic
b. Long-term, somatic
c. Short-term, genetic
d. Long-term, genetic
ANSWER: B
Examples of short-term effects are nausea, vomiting, diarrhea, and hair loss. Short-term
effects occur hours, days, weeks after a large dose exposure; somatic effects occur in non-
reproductive cells (to the person exposed); genetic effects occur in future generations..
Long-term effects occur years or decades after an exposure. Long-term effects are usually
repetitive and in small doses; somatic effects occur in non-reproductive cells (to the person
exposed); genetic effects occur in future generations. Cancer is an example of a long-term
effect. Long-term effects occur years or decades after an exposure.

Chapter 05: Radiation Protection Iannucci:
Dental Radiography, 6th Edition
MULTIPLE CHOICE
1. Which of the following should you do prior to taking x-rays to protect
your patient from radiation exposure?
a. Proper film processing
b. Proper prescribing of radiographs
c. A lead apron
d. A thyroid collar
ANSWER: B
Proper film processing is an example of a patient protection technique used after x-ray
exposure. Proper prescribing of radiographs is an example of a patient protection technique
used before x-ray exposure. A lead apron is an example of a patient protection technique
used during x-ray exposure. A thyroid collar is an example of a patient protection technique
used during x-ray exposure.
TOP: CDA, RHS, III.C.3. Identify ways to reduce x-radiation exposure to patients (ALARA) MSC:
NBDHE, 2.2 Principles of radiologic health
2. The “Guidelines for Prescribing Dental Radiographs” state that
a. dentulous adult recall patients at increased
risk for caries should have posterior bite-
wing examinations at 12- to 24-month
intervals.
b. x-rays are not taken on patients who are
pregnant unless absolutely necessary.
c. edentulous adults should have posterior
bite-wing examinations at 12- to 36-
month intervals.
d. dentulous adult recall patients who are not
at increased risk for caries should have
posterior bite-wing examinations at 24- to
36-month intervals.
ANSWER: D
Dentulous adult recall patients at increased risk for caries should have posterior bite-wing
examinations at 6- to 18-month intervals. The recommendations for prescribing radiographs
do not need to be altered for pregnancy. Edentulous adults do not need bite- wing
radiographs. The “Guidelines for Prescribing Dental Radiographs” state that dentulous adult
recall patients who are not at increased risk for caries should have posterior bite-wing
examinations at 24- to 36-month intervals.

TOP: CDA, RHS, III.A. Identify current ADA guidelines for frequency of exposure to radiation
MSC: NBDHE, 2.2 Principles of radiologic health
3. Inherent filtration in the dental x-ray tubehead
a. includes filtration that takes place when the
primary beam passes through the glass
window of the x-ray tube, the insulating oil,
and the tubehead seal.
b. includes the placement of aluminum discs
in the path of the x-ray beam between the
collimator and the tubehead seal.
c. alone meets the standards regulated by
state and federal law.
d. is equivalent to approximately 5.0 mm of
aluminum.
ANSWER: A
Inherent filtration in the dental x-ray tubehead includes filtration that takes place when the
primary beam passes through the glass window of the x-ray tube, the insulating oil, and the
tubehead seal. Added filtration includes the placement of aluminum discs in the path of the
x-ray beam between the collimator and the tubehead seal. Inherent filtration alone does not
meet the standards regulated by state and federal law. Inherent filtration is equivalent to
approximately 0.5 to 1.0 mm of aluminum.
radiation safety MSC: NBDHE, 2.2 Principles of radiologic health
4. Added filtration in the dental x-ray tubehead
a. refers to the placement of tungsten discs in
the path of the x-ray beam between the
collimator and the tubehead seal.
b. filters out shorter-wavelength x-rays from
the x-ray beam.
c. results in a lower-energy beam.
d. results in a more penetrating useful beam.
ANSWER: D
Refers to the placement of aluminum discs in the path of the x-ray beam between the
collimator and the tubehead seal. Filters out longer wavelength x-rays from the x-ray
beam. Results in a higher energy beam. Added filtration in the dental x-ray tubehead
results in a more penetrating useful beam.
5. State and federal laws require that dental x-ray machines operating above

70 kVp have a minimum total (inherent plus added filtration) of mm of aluminum
filtration.
a. 1.5
b. 2.0
c. 2.5
d. 5.0
ANSWER: C
State and federal laws require that dental x-ray machines operating above 70 kVp have a
minimum total (inherent plus added filtration) of 2.5 mm of aluminum filtration.
6. The collimator
a. is always round.
b. restricts the size and shape of the x-ray
beam.
c. is a solid piece of aluminum.
d. is fitted within the copper stem beneath
the molybdenum cup.
ANSWER: B
The collimator may have either a round or a rectangular opening. The collimator restricts
the size and shape of the x-ray beam. The collimator is a lead plate; the filter is aluminum.
The collimator is fitted directly over the opening of the machine housing where the x-ray
beam exits the tubehead.
7. A circular collimator produces a cone-shaped beam that is
inch(es) in diameter.
a. <1
b. 1.25
c. 2.75
d. 5.0
ANSWER: C
A circular collimator produces a cone-shaped beam that is 2.75 inches in diameter.
8. A rectangular collimator

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RECEIVE ALL CHAPTERS IN PDF FORMAT

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