MRSO EXAM 1, 2, 3 & 4 2024 WITH VERSION (A, B, &C), Exams of Nursing

Download MRSO EXAM 1, 2, 3 & 4 2024 WITH VERSION (A, B, &C) and more Exams Nursing in PDF only on Docsity! 1 | P a g e MRSO EXAM 1, 2, 3 & 4 2024 WITH VERSION (A, B, &C) WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+ |NEWEST |LATEST UPDATE | GUARANTEED PASS MRSO EXAM 1 What are the patient limits for the time-varying gradient coils? a. To the comfort of our patient b. 10 G/sec c. 35 G/sec d. To the point a patient has a seizure a. To the comfort of our patient A gad ion is attached to a molecule called a/an? a. Chain b. Ligand c. Ion d. String b. Ligand The B1 field is found where? a. 180 degrees to the B0 b. In the same direction as the B0 c. 90 degrees to the B0 d. Varies from scan to scan c. 90 degrees to the B0 The invisible fields that flow from north to south are called? a. Electrical current b. Voltages c. Radiant fields d. Magnetic flux lines 2 | P a g e d. Magnetic flux lines An energy deposition mode set to NORMAL OPERATION MODE will allow heating in a patient to what? a. 1 degree Celsius b. 0.5 degrees Celsius c. 3 degrees Celsius d. 2 degrees Celsius b. 0.5 degrees Celsius Where are the gradient coils found? a. Under the patient b. At the control panel on the MR unit c. In Zone III d. Surrounding the patient d. Surrounding the patient Which of the following can be used to test if an object is ferrous? I. Metal detector II. Ferromagnetic detection system III. Tester magnetic IV. Radiograph a. I, II, III b. I, II, III, IV c. II, III d. I, II c. II, III In a court case, discovery means what? a. A way to get records on someone named in a case b. All of the choices c. A new turn of events in a court case d. A process of sentencing a defendant a. A way to get records on someone named in a case What is the purpose of resonance? a. To align nuclei with the B0 b. To slow down the precessional frequency of nuclei c. Resonance is not used in MRI d. To tilt nuclei of interest away from the B0 d. To tilt nuclei of interest away from the B0 Which of the following is measured in milliseconds? a. The slew rate 5 | P a g e Gadolinium contains what kind of magnetism? a. Diamagnetic b. Paramagnetic c. Ferromagnetic d. Super paramagnetic b. Paramagnetic Which of the following is true of Zone IV? Select all that apply. a. This area should be monitored by a level 2 MR personnel b. Should be noted with signage c. Contain metal detectors for implant identification d. No unsafe implants may cross the 5-gauss unless the implant is researched and analyzed for risk a, b, d Where will peripheral nerve stimulation be the strongest? a. Further away from isocenter in the gantry b. At the level of the table when it is advanced c. At isocenter d. Outside the gantry near the 5 gauss line a. Further away from the isocenter in the gantry A patient is advanced in the MRI scanner very quickly and experiences a sensation of flashing lights in their visual field. What are they experiencing? a. Nystagmus b. Heating c. Magnetophosphenes d. Magnetohydrodynamic effect c. Magnetophosphenes What is the name for the direction of the vector of the static magnetic field? a. Inverse field b. Equilibrium c. B0 d. B1 c. B0 An object that produces a weakly repulsive force in the presence of a strong magnetic field is called what? a. Superparamagnetic b. Ferromagnetic c. Diamagnetic d. Paramagnetic 6 | P a g e c. Diamagnetic What are the risks associated with translational force? a. Missile effect b. Proximity heating c. Antenna effect d. Peripheral nerve stimulation a. Missile effect Which of the following are recommended by the ACR guidance document in MR safety 2013 in proper scanning of a patient? a. Patient gown b. Written screening sheet c. Metal detector d. Ferromagnetic detection system The gradient coils are responsible for which of the following? Select all that apply. a. Heating b. Rotational force c. Translational force d. Magnetohydrodynamic effect e. Noise f. Peripheral nerve stimulation e. Noise f. Peripheral nerve stimulation Why is magnetic shielding used in an MR unit? a. To reduce heating b. To reduce the e-fields c. To maintain field homogeneity d. To limit the fringe field d. To limit the fringe field What document has established guidelines for MRI safety that are followed today? a. ACR white paper MRI safety b. HIPPA c. FDA guidelines of MRI d. OSHA a. ACR white paper MRI safety Pain at the injection site when gad contrast is administered is considered what? a. Anaphylaxis b. A non-allergic reaction 7 | P a g e c. None of the choices d. Allergic reaction b. a non-allergic reaction Normal kidneys should excrete all gad from a patient how quickly? a. 24 hours b. 6 hours c. 12 hours d. 32 hours a. 24 hours Contrast media will do what to our tissue? a. Shorten T1 relaxation times b. Shorten T1 & T2 relaxation times c. Increase T2 relaxation times and decrease T1 relaxation times d. Shorten T2 relaxation times b. Shorten T1 & T2 relaxation times Resonance occurs when: a. The patient is placed in isocenter and only experiences the static magnetic field. b. The radiofrequencies transmitted are different than the precessional speed of hydrogen c. The radiofrequencies transmitted match the precessional speed of hydrogen d. The radiofrequency is transmitted at 42.6 MHz c. The radiofrequencies transmitted match the precessional speed of hydrogen As blood flows through a vessel, currents can be induced. The degree of this is called? a. Magnetophosphenes b. Flow potential c. Translational forces d. Fringe field b. Flow potential Why are metal detectors not recommended in MRI screening? a. They have varied sensitivity b. They are operator skill dependent c. All of the choices d. They cannot detect small fragments well c. All of the choices The T-wave in the cardiac cycle represents what? 10 | P a g e Passive shield is performed how? a. A magnetically conductive material surrounds the MR unit and this shapes and contains the magnetic field b. Bricks permanent magnets are stacked around the MR unit to contain the fringe field c. Nothing is used with passive shielding d. A coil of wire in the MR unit has a current running through it which produces a magnetic field opposing the B0 a. A magnetically conductive material surrounds the MR unit and this shapes and contains the magnetic field An object that retains a magnetic field as it is removed from a strong magnetic field is called what? a. Paramagnetic b. Ferromagnetic c. Diamagnetic d. Superparamagnetic b. Ferromagnetic The speed that the gradient coils can turn on and off is called what? a. Maximum gradient peak b. Rise time c. Spatial gradient d. Slew rate d. Slew rate The speed that it takes a gradient coil to reach a maximum strength is called what? a. Maximum gradient peak b. Rise time c. Spatial gradient d. Slew rate b. Rise time A patient undergoing an MRI exam is given an icepack to reduce heat. Which of these methods is the patient using to regulate their increased heating? a. Convection b. Conduction c. Radiation d. Evaporation b. Conduction Which of the following are units of measurement for static magnetic fields? a. Tesla and gauss b. Tesla 11 | P a g e c. Gauss d. Decibels a. Tesla & gauss What is the purpose of the static magnetic field? a. To align hydrogen nuclei parallel and anti-parallel to B0 b. To reverse the spin of the hydrogen nuclei c. To produce currents in tissues containing hydrogen nuclei d. To measure the movement of hydrogen nuclei a. To align hydrogen nuclei parallel and anti-parallel to B0 Induction of electrical current in our patient from changing magnetic fields can be described by which of the following? a. Ohm's law b. Fourier equation c. Faraday's law of induction d. Larmor equation c. Faraday's law of induction A patient will change into a gown in this location. a. Zone I b. Zone IV c. Zone II d. Zone III c. Zone II The IEC 60601-2-33 normal operating mode is __________ the energy requirements limited in the first level controlled operating mode. a. Half b. Triple c. Double d. Not comparable to a. Half An object that produces a weakly attractive force in the presence of a strong magnetic field is called what? a. Superparamagnetic b. Ferromagnetic c. Diamagnetic d. Paramagnetic 12 | P a g e d. Paramagnetic The noise heard in MRI is caused by which of the following? a. Lorentz force b. The antenna effect c. Larmor force d. Ohm's force a. Lorentz force What is the purpose of cryogen? a. Reduce the heating produced in the MRI unit during each acquisition b. Eliminate electrical current resistance in the coils of wire that produce the static magnetic field c. Reduce the overall noise produced during acquisition d. Allow the MRI unit to function at the fast speeds necessary to achieve an MRI image b. Eliminate electrical current resistance in the coils of wire that produce the static magnetic field The transmission of radiofrequency waves will cause what? a. Peripheral nerve stimulation b. Magnetohydrodynamic effect c. Patient heating d. Vertigo c. Patient heating What type of gadolinium contrast has been shown to cause falsely low serum calcium laboratory values? There is no correlation Macrocyclic Linear ionic Linear non-ionic Linear non-ionic What is the limit of the static magnetic field for patients <1 month old? 2T 8T 4T 3T 4T Which of the following implants hold the most thermal risk to a patient? Bone screw Pacemaker lead attached to a generator 15 | P a g e A patient's skin is in contact with the gantry. According to the IEC, what is the limit for the static magnetic field for clinical MRI? 400 mT 200 mT 8 T 4 T 8 T In order for the static magnetic field to be a true threat, an object could? Select all that apply. Contain steel or iron Be electrically conductive Contain 316L stainless steel Enter the MR environment Contain steel or iron Enter the MR environment Which of the following is true of the MR screening process according to the ACR Manual on MRI Safety? Select all that apply. A written MR screening process is acceptable by a level 1 MR personnel as long as a level 2 MR personnel provides a verbal or interactive MR screening as well A patient should be screened by at least one level 2 MR personnel verbally or interactively Level 1 and 2 MR personnel need to have a more comprehensive MR screening process than used with patients A patient should be MR screened twice A written MR screening process is acceptable by a level 1 MR personnel as long as a level 2 MR personnel provides a verbal or interactive MR screening as well A patient should be screened by at least one level 2 MR personnel verbally or interactively A patient should be MR screened twice What can be done to reduce pressure in an MR scan room during a quench with a defective room vent and a door that opens into the scan room? A patient is in the room. Break the window to zone IV Open the door to zone IV Drill a hole into the wall to zone IV Wait 20 minutes for the pressure to dissipate Break the window to zone IV A patient is exposured to 99dBA and has earplugs with an NRR of 29. What is the level of noise the patient will experience? 16 | P a g e 88dBA 90dBA 70dBA 85dBA 88dBA An MR fetus study is being performed. What field strength should be used to scan this patient according to the FDA? < 4.0 T Only 0.5 T >3.0 T >8.0 T < 4.0 T Select all that will produce/influence magnetophosphenes from the static magnetic field. Rate of motion through a magnetic field Weight of patient Strength of field strength Patient sex Strength of field strength Rate of motion through a magnetic field A patient is complaining of discomfort from high SAR during a fast spin echo. What can be done to make them more comfortable? Decrease the TR Decrease the echo train length Increase the receiving bandwidth Increase the flip angle Decrease the echo train length A patient has an external fixation device that is labeled as MR conditional. All the conditions are met and you scan the patient. The patient says that the external fixation device starts vibrating. This is caused by which of the following? Time-varying gradient field All of the choices Static magnetic field Time-varying RF field Time-varying gradient field 17 | P a g e A patient is having an MR brain scan in first-level controlled mode with a receive-only coil. We know that the whole body SAR for a head will not exceed which of the following? 8 W/kg 2.0 W/kg 4.0 W/kg 3.2 W/kg 3.2 W/kg A patient is having an MR lumbar spine scan in normal mode. We know that the whole body SAR will not exceed which of the following? 4.0 W/kg 1.0 W/kg 2.0 W/kg 3.0 W/kg 2.0 W/kg A patient is complaining of severe discomfort and tingling during a GRASS sequence in normal control mode. What can be done to make the patient more comfortable? Increase the echo train length Scan in first level control mode Increase the flip angle Use a spin echo sequence Use a spin echo sequence All the zones need to be represented with signage except? Zone 2 Zone 1 Zone 3 All need to be represented, but zone 1 may be optional depending on the auditing body Zone 4 All need to be represented, but zone 1 may be optional depending on the auditing body When evaluating for concerns associated with the time-varying gradient field, which implant listed below is of most concern? All the choices Hip replacement Cardiac pacemaker MR Conditional insulin pump 20 | P a g e Macrocyclic In order for the time-varying RF field to be a threat, an object could? Select all that apply. Be electrically conductive Non-ferrous and non-metallic Form a conductive loop Be >2cm in size Form a conductive loop Be >2cm in size Be electrically conductive What is the best way to prevent NSF? Select the single best answer. NSF cannot be prevented Hydrate patient prior to gadolinium injection Perform dialysis on the patient prior to the gadolinium contrast injection Don't give gadolinium contrast to patients who are in renal failure Don't give gadolinium contrast to patients who are in renal failure A patient had an MRI a month ago and had suffered a moderate allergic reaction. The patient is in need of another MR with contrast tomorrow. How can we reduce the risk of this... Give a half dose of GBCM Give steroids to the patient 6 hours before their exam Have a code blue team on standby in zone IV for the duration of the exam Give the patient Xanax prior to the exam Give steroids to the patient 6 hours before their exam The magnetohydrodynamic effect will influence what? P wave T wave S wave R wave T wave During a malfunctioned quench what would we expect to see? Select all that apply. Decrease in room pressure Increase in temperature Explosion risk Changing magnetic field 21 | P a g e Explosion risk Changing magnetic field Transient dyspnea: Is associated with chronic obstructive pulmonary disease and noted after the administration of any GBCM. Describes the manifestation of transient severe respiratory motion-related artifact in the arterial phase after the administration of gadoxetate disodium. Is an acute reaction after the administration of gadoxetate disodium and requires immediate intervention Is seen in repeat contrast reactions Describes the manifestation of transient severe respiratory motion-related artifact in the arterial phase after the administration of gadoxetate disodium. The ICNIRP states that moving through a field strength above ______ may be high enough to produce vertigo and other sensory perceptions like nausea or magnetophosphenes. 1.0 T 2.0 T 3.0 T 4.0 T 2.0 T What is the half wavelength for a 1.5 T unit? 60 cm 25 cm 5 cm 12 cm 25 cm When evaluating for concerns associated with the time-varying gradient field, which implant listed below is the most concerning? Epicardial pacing leads AAA repair Deep brain stimulator Cardiac stent Deep brain stimulator 22 | P a g e Which of the following increases the odds that a patient will develop NSF after injection of gadolinium contrast? Select all the apply. Hypertension Migraines Patients over 60 years older Renal disease Hypertension Patients over 60 years older Renal disease What type of contrast is Dotarem? Ionic, macrocylic Non ionic, macrocylic Ionic, non ionic Linear, macrocylic Ionic, macrocylic Gadolinium contrast has been found in the body in what form? Select all that apply. Free gadolinium is not bound to anything Water soluble Non-water soluble Water soluble Non-water soluble Which of the following are considered long-term effects of gadolinium contrast media? Select all that apply. Nephrogenic systemic fibrosis Anaphylaxis Gadolinium associated plaques Emesis Nephrogenic systemic fibrosis Gadolinium associated plaques Which of the following will produce the largest artifact in the MR environment? Cobalt cardiac stent Titanium clip Steel L-spine cage Nickel alloy AAA repair 25 | P a g e Contains thin coiled copper wires Produce large artifacts Contains thin coiled copper wires A sequence is run with peak unweighted sound pressure of 120dB. Is this within IEC regulation? No Yes Yes Which of the following will influence translational force? Select all that apply. Spatial gradient magnetic field Strength of the magnetic field strength Magnetic susceptibility Mass of the object Spatial gradient magnetic field Strength of the magnetic field strength Magnetic susceptibility Mass of the object Which of the following is used to calculate renal function? Select all that apply. Creatinine Platelet count Patient white blood cell count D-dimer Creatinine When advancing a patient into the bore, a patient with a pain pump complains of discomfort and like the device is moving within them. Once you stop moving the table, the discomfort stops as well. This is most likely caused by what? Ohm's law Lorentz forces Lenz forces Lenz forces This individual manages day-to-day MR safety issues, enforces policies, and provides MR safety knowledge. MRMD MRSE MRSO 26 | P a g e MRSO If a cryogen comes in contact with skin, what will happen? Combust Frostbite/necrosis Nothing, in its gas form Explode Frostbite/necrosis All the following except what makes a patient more prone to an allergic reaction to gadolinium? Prior Gadolinium Reaction High Blood Pressure Seasonal Allergies Allergy to CT contrast High Blood Pressure What is true of an MR screening sheet? Select all that apply. All the answers must be marked "yes" or "no" Anyone entering zone 2 must have a sheet filled out prior to entering it A Level 1 and 2 personnel will have a different sheet filled out than a patient All the answers must be marked "yes" or "no" Which of the following is true of gadolinium-associated plaques? Select all that apply. This is a common occurrence in MRI It is the same thing as NSF It is not related to renal compromised patients It occurs when gadolinium is ingested It is not related to renal compromised patients An Essure coil is made of 316L stainless steel, platinum, iridium, and nickel-titanium alloy. Which of the following statements is true? An Essure coil is non-ferrous and may demonstrate some artifact when imaging the implant. An Essure coil is ferrous and will demonstrate some artifacts when imaging the implant. An Essure coil is ferrous and may demonstrate some torquing while in the static magnetic field. An Essure coil is non-ferrous and may demonstrate some artifact when imaging the implant. 27 | P a g e Which of the following is true of gadolinium and breastfeeding mothers? Select all that apply. Available data suggest that breast-feeding should be pumped and discarded for 24 hours after the intravenous dose 20% of the intravascular dose would be excreted into the breast milk within the first 24 hours Gadolinium is found in breast milk in a stable and chelated form It is thought that gadolinium contrast may alter the taste of breast milk Gadolinium is found in breast milk in a stable and chelated form It is thought that gadolinium contrast may alter the taste of breast milk Which of the following IUD contain ferrous material? Select all that apply. Mirena IUD Copper T Copper 7 None of the choices None of the choices Which of the following agents yields the best chance for transmetalation to occur? Linear ionic Linear non-ionic Macrocyclic ionic Macrocyclic non-ionic Linear non-ionic A patient is complaining of severe discomfort during a DWI sequence. What can be done to make the patient more comfortable? Increasing image matrix Perform an SSFP sequence instead Perform a fast spin echo Shortening the TR Perform a fast spin echo Guidewires can produce heating in the patient due to which of the following? Reflective burn A loop of conductive tissue Antenna effect Proximity burn 30 | P a g e Heating in the pacemaker leads not connected to a generator is higher at 3.0 T than 1.5 T Small metallic passive objects are safe at 3.0 T and not at 1.5 T Ferrous objects show more attraction at 3.0 T vs 1.5 T Implants that are safe at 3.0 T do not mean that they are safe at 1.5 T A large ferrous object is stuck against the MRI unit and no one is in harm's way. What should you do? Pull the object off of the unit yourself There is no need to report this event since it did not hurt anyone Contact trained personnel to remove the object All of the choices Contact trained personnel to remove the object What are ways to reduce the negative effects associated with the time-varying gradient field? Select all that apply. Decrease the acquisition speed (switching magnetic fields) Decrease the strength of the gradient field magnetic slope (gradient amplitude) Increase the field strength Increase the number of RF pulses Decrease the acquisition speed (switching magnetic fields) Decrease the strength of the gradient field magnetic slope (gradient amplitude) The quench vent outside the MR facility is inspected by who? MRMD Manufacturer engineer Facility engineer MR Technologist Facility engineer When handling a code in the MR environment, which of the following are NOT best practices according to the ACR? All the choices should not be done The patient must be removed from zone 4 before calling a code It is suggested that a patient be brought to zone 2 but can be in zone 3 if necessary to resuscitate the patient 31 | P a g e A patient should be completely stable prior to removing a patient from zone 4 A patient should be completely stable prior to removing a patient from zone 4 A patient is complaining of discomfort during a single shot fast spin echo sequence. What can be done to make them more comfortable? Scan only in the axial plane Increase the phase encoding resolution Use parallel imaging Decrease the TR Use parallel imaging Which of the following is most likely experienced by the patient being exposed to a fast time-varying gradient field? Burn Tingling Lenz's effect Translational force Tingling Which of the following issues are most likely to occur when exposing a neurostimulator to RF and cause the most immediate threat to our patient? Rotational force Translational force Burns Magnophosphenes Burns Why is it recommended to tape or wrap gauze around jewelry? To reduce contact with the skin To make sure rotational force does not occur To make sure translational force does not occur To reduce the magnetic susceptibility To reduce contact with the skin All the following are true of screening patients with a ferromagnetic detector except? A ferrous object must be moving through the ferromagnetic detector field in order to be detected. Any objects that are metal or electrically conductive will be detected by a ferromagnetic detector. 32 | P a g e They provide a higher level of detecting MR threats when compared to a metal detector. It will only detect objects that are attracted to a magnetic field. Any objects that are metal or electrically conductive will be detected by a ferromagnetic detector. The ICNIRP sets an occupational dose of ____ to the head and torso. Spatial peak magnetic flux density of 4 T Spatial peak magnetic flux density of 1 T Spatial peak magnetic flux density of 2 T Spatial peak magnetic flux density of 6 T Spatial peak magnetic flux density of 2 T What is the name of the gradient coil used to produce sagittal and coronal images? a. Transverse coil b. Golay coil c. Maxwell coil d. Receiver coil b. Golay coil ("saddle coil") Which of the following is able to handle the most RF heating? a. elderly b. adult c. obese adult d. neonate d. neonate Which of the following techniques can be used to increase the echo spacing? Select all that apply. a. Increase the TR b. Decrease receiving bandwidth c. Increase receiving bandwidth d. Use a receive only coil e. Increase field of view f. Increase flip angle b, e Decreasing the receiving bandwidth will be lengthening the sample time. This may force us to increase our TE as well as the TR. Increasing the field of view will also allow for longer echo spacing. The differences in magnetic field strength as you approach the MRI unit is termed what? 35 | P a g e d. A coil of wire in the MR unit has a current running through it which produces a magnetic field opposing the B0. A coil of wire is used with a current of wire running through it to produce a magnetic field. This is placed opposing the vector of the static magnetic field. This will cancel out some of the magnetic field felt outside of the gantry. Which of the following is the most common symptom post-gad contrast injection? a. Hives b. Swelling c. Emesis d. Headache d. Headache Which of the following are considered anaphylactoid reactions? a. Tachycardia b. Hives c. Difficulty breathing d. Abdominal pain a, c Which of the following are true? Select all the correct answers. a. MRI promotes female offspring in working MR technologists b. MRI can cause infertility c. None d. MRI has been associated with teratogenesis e. MRI can cause an increase in spontaneous abortion c. None Which of the following considerations for pregnancy are found in MRI? Select all that apply. a. Pregnant patients can be scanned in their first, second and third trimester b. Contrast media is safe to be delivered c. A pregnant MR tech may enter the zone IV, but not be present during acquisition d. When an ultrasound exam will not help in diagnosing the patient. a, c, d Contrast media has been detected across the blood/placenta barrier. Which of the following are true of non-MR personnel? 36 | P a g e a. They must understand the MR environment b. They must pass an MR safety screening process before entering Zone III c. They must pass a MR safety screening process before entering Zone IV d. They may enter Zone III for any reason, but cannot enter Zone IV b. They must pass an MR safety screening process before entering Zone III Which of the following can freely enter Zone III and IV, but not escort a patient into these zones? a. MR personnel level I b. MR personnel level II c. Patient d. Non-MR personnel a. MR personnel level I What does a cryogen do to the static magnetic field? a. Maintains homogeneity b. Makes it stronger c. Reduces heat produced during acquisition d. Makes it weaker b. Makes it stronger Because a cryogen eliminates resistance in the static magnetic field coil of wires, large magnetic fields can be obtained. Which of the following can be used to reduce Lenz's force risks to an object? a. Do not scan the patient because this is unsafe b. Advance the patient slowly in the MR unit c. Advance the patient fast into the MR unit d. Have the patient approach the gantry at a 45 degree angle b. Advance the patient slowly into the MR unit What are the reasons we would quench an MR unit? Select all that apply. a. Large ferrous object is pinning a patient b. Fire in MRI room c. Code blue d. At the end of a shift a, b Which of the following are considered time-varying magnetic fields? a. RF b. Static magnetic field 37 | P a g e c. RF and changing gradient magnetic field d. Changing gradient magnetic field c. RF and changing gradient magnetic field The RF is an oscillating magnetic field transmitted at a specific frequency. The changing gradient magnetic field is produced from the gradient coils and will produce a strong magnetic field on one side of the patient and a weak magnetic field on the other side of the patient. Heating is common in which of the following? Select all that apply. a. Insulated wire b. Devices with sharp points or edges c. Areas outside the RF field d. Round small objects a, b A tester magnet should be how strong? a. Equal or greater than 500 gauss b. Greater than 3000 gauss c. Equal or greater than 1000 gauss d. 1.5 Tesla c. Equal or greater than 1000 gauss Which of the following are considered short term effects of gad contrast media? Select all that apply. a. Swelling b. Emesis c. Hives d. NSF a, b, c The spatial magnetic gradient has the most influence on which of the following? a. Heating b. Peripheral nerve stimulation c. Noise d. Translational force d. Translational force The degree that a tissue demonstrates T1 & T2 relaxation refers to what? a. Viscosity b. Chelation c. Relaxivity d. Osmolarity 40 | P a g e Which of the following is measured in T/m/s? a. Spatial gradient b. Maximum gradient peak c. The rise time d. The slew rate d. The slew rate What is the name of the gradient coil used to produce axial images? a. Transverse coil b. Receiver coil c. Golay coil d. Maxwell coil d. Maxwell coil Which of the following is measured in mT/m? a. Rise time b. Slew rate c. Maximum gradient peak d. Spatial gradient c. Maximum gradient peak What is a deposition in a court case? a. A testimony of what happened b. The verdict in the case c. The opening words in a court case d. The reason why a defendant is on trial a. A testimony of what happened The vectors of the static magnetic field can be produced in what direction? a. Horizontal b. Vertical or horizontal c. Diagonal d. Vertical b. Vertical or horizontal Which of the following histories may increase the change for gad contrast reaction? Select all that apply. a. History of general allergies b. Currently recovering from a cold c. History of heart disease d. History of a reaction to iodinated contrast 41 | P a g e a, d Which of the following will produce the greatest possibility of peripheral nerve stimulation using the same slew rate? a. 120mm field of view b. 350mm field of view c. 256 x 256 image matrix d. 192 x 192 image matrix a. 120mm field of view This individual must understand the risks associated with the MRI environment: a. Level 2 personnel b. Level 1 personnel c. The patient d. Non-MR personnel a. Level 2 personnel The e-fields associated with RF causes what? a. Burning b. Translational force c. Peripheral nerve stimulation d. Rotational force a. Burning There are two types of heat being produced from the RF. One is due to eddy currents produced in tissues near the RF transmitter and the other is produced by the magnetic field interacting with objects in our patient. A tech walks in the MRI room to check on the patient and sticks their head into the scanner quickly. What can occur from this movement through the static magnetic field? Select all that apply. a. Nausea b. Magnetophosphenes c. Vertigo d. Elevated BP a, b, c Energy deposition is limited to what in the first level controlled operating mode? a. 3 degrees Celsius b. 0.5 degree Celsius c. 1 degree Celsius d. 2 degrees Celsius c. 1 degree Celsius 42 | P a g e Which of the following concerns can be caused by the time-varying gradient magnetic field? a. All of the choices b. Arrhythmia c. Muscle fatigue d. Anaphylaxis b. Arrhythmia Which of the following is true of stainless steel? Select all correct answers. a. It is not used in medicine b. All are non-ferrous c. All will demonstrate rotational force d. All will cause artifacts in our image d. All will cause artifact in our image 3 types of stainless steel: Austenitic: non-ferrous that is most commonly used. Ferritic: ferrous metal; not common Martensitic: ferrous metal used in medicine. High levels of carbon and can be tempered. Resistant to corrosion. Which of the following are true of Zone III? Select all that apply. a. An area for patients to wait b. A key lock system is recommended c. Accessed by level 1 & 2 personnel d. Might cause harm to patient implants b, c Rotational force is strongest where? a. On the table b. At the control panel on the MR unit c. Isocenter d. It is uniform everywhere c. Isocenter What types of cryogen are used in a duel cryogen system? a. Helium and hydrogen b. Helium and nitrogen c. Helium and carbon dioxide d. Helium and oxygen b. Helium and nitrogen Uses helium to keep the superconducting wires cold and nitrogen is a backup to keep the helium in its liquid state to reduce the burn off of helium. 45 | P a g e a. Resonant circuitry b. Micro Metal effect c. Electrical conductivity d. Near field effects a, c, d Near field effects will cause proximity burns. Resonant circuitry will cause burning in insulated wires in or on a patient. This includes the antenna effect. Electrical conductivity is caused when a coil touches a patient. What is the unit of measurement used to measure the spatial magnetic gradient? a. dB/dt b. dB/dx c. W/kg d. Gauss b. dB/dx "d" = change "B" = static field strength "x" = distance dB/dx = spatial magnetic gradient What is the ICNIRP occupational workers dose magnetic flux limit for the extremities? a. 14 Tesla b. 400 mT c. 2 Tesla d. 8 Tesla d. 8 Tesla How much more heating does a 360 degree RF pulse have than a 180 degree RF pulse? a. 2 times more b. Equal heating c. 3 times more d. 4 times more d. 4 times more What group issued the ACR white paper MRI safety? a. Food and drug association. b. OSHA c. EPA d. American college of radiology blue ribbon panel on MR safety. 46 | P a g e d. American college of radiology blue ribbon panel on MR safety. This individual must have an in-depth understanding of the risks associated with the MRI environment? a. level 1 personnel b. level 2 personnel c. non-MR personnel d. the patient b. level 2 personnel Which of the following statements is true of non-MR personnel? a. They must pass an MR safety screening process before entering zone IV. b. They must pass an MR safety screening process before entering zone III. c. They may enter zone III for any reason but cannot enter zone IV. d. They must understand the MR environment. b. They must pass an MR safety screening process before entering zone III. Which of the following are reasons why metal detectors are not recommended in MR implant detection? a. They vary in sensitivity b. They cannot detect small ferromagnetic objects. c. They cannot discriminate an implant with magnetic properties or not. d. All the choices. d. All the choices. Which of the following can enter zone III and IV but not escort a patient into these zones? a. MR personnel level 1 b. MR personnel level 2 c. Non-MR personnel d. Patient a. MR personnel level 1 Which of the following is considered level 1 MR personnel? a. MR tech aid b. MR tech c. The person being scanned d. A patients family member wanting to sit with the patient. a. MR tech aid What organization has produced the terms used in MR labeling (MR safe, conditional ect...) a. ASTM international b. ACR c. OSHA d. EPA a. ASTM international 47 | P a g e A tester magnet should be how strong? a. Equal or greater than 1000 gauss b. Equal or greater than 500 Gauss c. Greater than 3000 gauss d. 1.5 Tesla a. Equal or greater than 1000 gauss What does the the yellow triangle with mr in the center represent? a. MR conditional b. MR safe c. MR compatible d. MR unsafe a. MR conditional Sound level is limited by the international standard IEC 60601-2-33 to what dba during acquisition? a. 60db b. 99db c. 120db d. 200db b. 99db The victim in a criminal case is referred to as? a. The plantiff b. The defendent c. The accused d. The victim a. The plantiff A tort case results in which of the following if the defendant is found guilty? a. Paying for damages b. Paying a fine to the government c. Serving a sentence d. None a. Paying for damages What is a deposition in a court case? a. A testimony of what happened. b. The final verdict in a case. c. The reason why a defendant is on trial. d. The opening words in a court case. a. A testimony of what happened. What is defined in the captain of the ship doctrine? a. It defines the fact that there is a person who is responsible for the care of another. 50 | P a g e a. Spatial magnetic gradient. Translational force is typically the strongest where? a. By the control panel n the MR unit. b. Isocenter c. Along th table d. At every 10cm from isocenter a. By the control panel n the MR unit. What is the unit of measurement used to measure the spatial magnetic gradient? a. dB/dx b. dB/dt c. W/kg d. Gauss a. dB/dx The spatial magnetic gradient has the most influence on which of the following? a. Translational force b. Peripheral nerve stimulation c. Noise d. Heating a. Translational force Active shield is performed how? a. A magnetically conductive material surrounds the MR unit, shapes and contains the magnetic field. b. A coil of wire in the MR unit has a current running through it which produces a magnetic field opposing the B0. c. Bricks of permanent magnets are stacked around the MR unit to contain the fringe field. d. Nothing is used with active shielding. b. A coil of wire in the MR unit has a current running through it which produces a magnetic field opposing the B0. Rotational force is strongest where? a. Isocenter b. At the control panel on the MR unit. c. On the table d. It is uniform everywhere a. Isocenter How do we calculate the maximal spatial gradient? a. dB/dx *B b. dB/dt *W/kg c. B d. W/kg 51 | P a g e a. dB/dx *B The vectors of the static magnetic field can be produced in what direction? a. Vertical b. Horizontal c. Diagonal d. Vertical or Horizontal d. Vertical or Horizontal 4T/m is equal to what? a. 400 G/cm b. 40 G/cm c. 4000 G/cm d. 4 G/cm a. 400 G/cm Which of the following will be able to handle the most RF heating? a. Neonates b. Adult c. Obese adult d. Elderly patient a. Neonates Which of the following statements is true? a. Larger patients will heat up the most. b. Smaller patients will heat up the most c. Larger patients are ferromagnetic d. Induction occurs in smaller patients. a. Larger patients will heat up the most. How much more heating does a 360 degree RF pulse have than a 180 degree pulse? a. 4 times more b. 3 times more c. 2 times more d. Equal heating a. 4 times more The electric fields associated with RF causes what? a. Burning b. Peripheral nerve stimulation c. Translational force d. Rotational force a. Burning 52 | P a g e When discussing the distance from an RF transmitter and the biological effects witnessed,which of the following describe the area where burns can occur in proximity closest to the transmitter? a. Near field b. Far field c. Circular polarization d. Danger zone a. Near field Energy deposition is limited to what in first level controlled operating mode? a. 0.5 deg Celsius b. 1 deg Celsius c. 2 deg Celsius d. 3 deg Celsius b. 1 deg Celsius Which of the following mechanisms of patient burning is associated with the antenna effect? a. Proximity burning b. Far field c. Ferrous induction d. Resonant circuitry d. Resonant circuitry _____diameter loop formed by tissue or devices with a ____diameter contact point will increase the chance for patient burns. a. Large; narrow b. Narrow; large c. Large; large d. Narrow; narrow a. Large; narrow Which of the following is a heat sink in MRI? a. Ice pack b. Insulated wire c. Ferrous object d. All of the choices a. Ice pack Which of the following will increase patient heating? a. Increasing the echo train length. b. Decreasing the TE c. Increasing the TR d. Decreasing the flip angle a. Increasing the echo train length. 55 | P a g e c. 300 W/kg d. 1 deg Celsius a. What the patient can tollerate. Which of the following pulse sequences will produce the greatest chance for peripheral nerve stimulation? a. Conventional spin echo b. Gradient echo c. EPI d. Fast spin echo c. EPI Which of the following will produce the lowest chance for peripheral nerve stimulation? a. Conventional spin echo. b. Gradient echo c. EPI d. Fast spin echo a. Conventional spin echo. Lorentz force in MRI is responsible for which of the following? a. Noise b. Heating c. Missile effect d. All of the choices a. Noise The NRR is a unit of measurement used to measure what? a. Function of hearing protection. b. Potential of heating c. Peripheral nerve stimulation d. Translational force a. Function of hearing protection. Which of the following is the most common symptom post gadolinium contrast injection? a. Headache b. Emesis c. Hives d. Swelling a. Headache A patient develops hives after a gadolinium injection. This is considered what? a. Allergic reaction b. Non-allergic reaction 56 | P a g e c. Anaphylaxis d. None of the choices. a. Allergic reaction What is the difference between an allergic reaction to contrast media and an anaphylactic reaction? a. Anaphylactic reactions are more serious. b. Allergic reactions are more serious. c. Anaphylactic reactions are non-allergic reactions. d. Allergic and anaphlactic reactions are the same. a. Anaphylactic reactions are more serious. A ligand that attaches a gadolinium ion in a chain like molecure is called what? a. Linear b. Macrocyclic c. Polarized d. Captured a. Linear A macrocyclic agent refers to a gadolinium ion that is what? a. caged in b. Attached to a linear chain c. Polarized d. Small a. caged in Which of the following is true of a gadolinium contrast osmolarity? a. It is greater than blood. b. It is less than blood. c. It is equal to blood. d. It is less than water. a. It is greater than blood. The degree that a tissue demonstrates T1 and T2 relaxation post contrast injection refers to what? a. Relaxivity b. Viscosity c. Osmolarity d. Chelation a. Relaxivity When a T1 weighted image is performed on a vial of gadolinium contrast, how will it appear? a. Bright b. Dark c. Gray d. Blue 57 | P a g e b. Dark The detection of gadolinium in the drinking water is called? a. Anthropogenic b. Gadolinium retention c. Teratogenesis d. NSF a. Anthropogenic What does a cryogen do to the static magnetic field? a. It makes it stronger. b. Maintains homogeneity. c. Reduces heat produced during acquisition. d. It makes it weaker. a. It makes it stronger. What is the cryogen used in MRI? a. Helium b. Oxygen c. Hydrogen d. Carbon dioxide a. Helium What types of cryogen is used in a duel cryogen system? a. Helium and nitrogen. b. Helium and oxygen. c. Helium and carbon dioxide d. Helium and hydrogen a. Helium and nitrogen. In order for cryogen to not harm a patient, what needs to happen? a. The cryogen needs to be vented outside. b. The cryogen needs to be warmed to room temp. c. The cryogen must be filtered to make it safe to breath. d. The cryogen should be vented underground. a. The cryogen needs to be vented outside. If a cryogen touches a patient's skin, what would happen? a. Frostbite/tissue necrosis b. 2nd degree burn c. Infection d. It would freeze solid. a. Frostbite/tissue necrosis 60 | P a g e a. Body size b. Surface area c. Pulse sequence used. Which of the following will influence the amount of heating produced from the RF? a. Flip angle b. Field strength c. Implant outside of the gantry d. Patient weight. a. Flip angle b. Field strength d. Patient weight. Which of the following are mechanisms of patient burning in MRI due to the RF transmitter? a Near field effects b. Resonant circuitry c. Electrical conductivity d. Micro metal effect a Near field effects b. Resonant circuitry c. Electrical conductivity Heating is common in which of the following? a. In devices with sharp points or edges b. In round small objects c. In insulated wire d. Inareas outside the RF field. a. In devices with sharp points or edges c. In insulated wire Which of the following techniques can be used to increase the echo spacing? a.Increase receiving bandwidth b. Increase field of view c. Decrease receiving bandwidth d. Increase flip angle e. Increase TR f. Use a receive only coil b. Increase field of view c. Decrease receiving bandwidth The rapid turning on and off of the gradient coil can produce which of the following? a. Magnetophosphenes b. Large amounts of heating c. Peripheral nerve stimulation 61 | P a g e d. Reactions to contrast media e. Magnetohydrodynamic effect a. Magnetophosphenes c. Peripheral nerve stimulation Which of the following are considered short term affects of gadolinium contrast media? a. Nephrogenic systemic fibrosis b. Hives c. Swelling d. Emesis b. Hives c. Swelling d. Emesis Which of the following are considered long term effects of gadolinium contrast media? a. Nephrogenic systemic fibrosis b. Anaphylaxis c. Gadolinium associated plaques d. Emesis a. Nephrogenic systemic fibrosis c. Gadolinium associated plaques Which of the following histories may increase the chance for a gadolinium contrast reaction? a. History of a reaction to iodinated contrast b. History of heart disease c. History of seasonal allergies d. Currently recovering from a cold. a. History of a reaction to iodinated contrast c. History of seasonal allergies Which of the following are considered anaphylaxtoid reactions? a. Difficulty breathing b. Abdomen pain c. Hives d. Tachycardia a. Difficulty breathing d. Tachycardia Which of the following is true of a gadolinium contrast media? a. Gadolinium has 7 unpaired electrons b. Gadolinium is paramagnetic c. Gadolinium demonstrated ferrous properties when placed in a strong static magnetic field d. Gadolinium will shorten T1 relaxation times 62 | P a g e a. Gadolinium has 7 unpaired electrons b. Gadolinium is paramagnetic d. Gadolinium will shorten T1 relaxation times Gadolinium deposition is commonly seen in which of the following? a. Dentate nucleus b. Globulus pallidus c. Achilles tendon b. Heart a. Dentate nucleus b. Globulus pallidus Which of the following is used to calculate renal function? a. D-dimer b. Creatinine c. Patient Height d. Patient sex b. Creatinine d. Patient sex What are reasons that we would quench a MR unit? a. Fire in MRI room b. Code Blue c. Large ferrous object is pinning a patient. d. At the end of a shift. a. fire in MRI room c. Large ferrous object is pinning a patient. Which of the following are risks associated with the cryogen in a superconducting unit. a. Hypothermia b. Nausea c. Asphyxia d. Explosion a. Hypothermia c. Asphyxia Which of the following are physiologic factors that occur from an anaphylactic reaction? Select all that apply. a. Elevated creatinine levels b. Vasodilation c. Bronchial smooth muscle contraction d. Increased vascular permeability b, c, d 65 | P a g e b. Diaphragm contractions Peripheral nerve stimulation that affects the diaphragm can cause it to contract in patients. This can cause problems for our patient making it difficult to breathe. Typically, where is the area surrounding the MR unit with the highest spatial magnetic gradient field? a. At the 5 Gauss line b. MR table c. Isocenter d. MR table control panel d. MR table control panel When we reach isocenter, no spatial gradient is detected. When performing an MR pelvis, which of the following would cause the most artifact in our exam? a. Titanium hip replacement b. Ureter stent c. Dacron iliac graft d. IUD a. Titanium hip replacement Which of the following stainless steels are non-ferrous? a. Martenistic b. Austenitic c. Ferritic d. Duplex b. Austenitic Which of the following will create localized patient heating? a. None of the choices b. Body RF coil c. Receive only coil d. Transmit-receive coil d. Transmit-receive coil Eddy currents are produced from which of the following? a. Moving MR table b. Gradient magnetic field c. All of the choices d. Static magnetic field b. Gradient magnetic field 66 | P a g e As gradient coils are activated and deactivated, currents can be produced in conductive materials in our MR unit. These are eddy currents and cause artifact in our images. Which of the following is true if we increase the image matrix from 256 x 256 to 512 x 512? a. We use a weak time-varying gradient magnetic field b. We reduce patient heating c. We reduce peripheral nerve stimulation d. We use a stronger time-varying gradient magnetic field d. We use a stronger time-varying gradient magnetic field Larger image matrix will produce higher resolution exams. The size of the image matrix is dependent on the phase encoding gradient coil. When we increase the image matrix, we increase the amplitude of our gradient coil. The slew rate influences which of the following? a. Both the minimal TE and image matrix size b. The size of the image matrix c. The minimal matrix size d. Shorter echo spacing d. Shorter echo spacing The speed of the gradient coils activating and deactivating will affect the speed of our scanner. Faster slew rates will decrease the minimal TE & TR. The faster our gradient coils can turn on & off means that the rise time is faster. This will allow our echo spacing to shorten and therefore promote faster imaging. What zone is the quench pipe located where it vents outside? a. Zone II b. Zone III c. Zone IV d. Zone I c. Zone III A MR tech is distracted by another patient and brings a non-MR compatible O2 tank in the room which severely injures a patient. This is an example of what? a. Malpractice b. Negligence c. Infraction d. Tort a. Malpractice When performing an abdominal MRI, which of the following would be the biggest artifact issue in the area we are scanning? 67 | P a g e a. Femur rodding with titanium b. Aortic aneurysm repair with stainless steel mesh c. Sternal wires with stainless steel d. Lumbar 4-5 fusion with stainless steel b. Aortic aneurysm repair with stainless steel mesh A patient is warming up during their exam. What can be done to reduce the heating? Select all that apply. a. Use parallel imaging b. Using a conventional gradient sequence c. Increasing the TR d. Increase the ETL e. Decrease phase encoding f. Increase slices a, b, c, e Parallel imaging will collect multiple lines of K space per each coil element. This reduces heating. The number of TR we need depends on the number of phase encoding lines that need to be filled in our K space. That means we need to deliver more RF pulses to fill more lines of K space. By reducing our phase encoding, we can reduce heating. If we increase the slices we need to collect, we will need to fill more K spaces. This means that more RF pulses are delivered during each TR. A phase encoding line is filled after every one of these 180 degree RF refocusing pulses. When discussing the distance from an RF transmitter and the biological effects witnessed, which of the following describes the area where the most energy is absorbed in implants? a. Danger zone b. MR table c. Near field d. Patient's abdomen c. Near field Which of the following are responsible for testing the safety of implants? a. EPA b. HIPPA c. FDA d. ASTM d. ASTM ASTM is responsible for labeling of implants as MR safe, MR conditional, and MR unsafe. FDA doesn't do testing; reviews other testing to determine safety of objects. 70 | P a g e d. Oxygen Transmetallization describes what? a. Whan a gad ion is lost in the body and another metal is picked up by the ligand b. When gad contrast is retained in parts of the brain such as the dentate nucleus c. When other metals are combined to be used as a contrast media. d. This occurs when a gad contrast is ingested a. When a gad ion is lost in the body and another metal is picked up by the ligand. A patient is undergoing an MR brain and has pacing wires. What would make this exam safe to perform? Select all that apply. a. Use only spin echo sequences b. Ice pack on the patient chest c. Using a transmit-receive brain coil d. It is not safe ever e. Increase the flip angle f. Increase TR c. Using a transmit-receive brain coil Which of the following are considered biological effects of the static magnetic field? a. All of the choices b. Rotational forces c. Translational forces d. Magnetohydrodynamic effect d. Magnetohydrodynamic effect Rotational and translational forces are mechanical, not biological Which of the following organizations is responsible for researching the effects of MRI environment on humans? a. ICNIRP b. JCAHO c. FDA d. ACR a. ICNIRP (International Commission on Non-Ionizing Radiation Protection) ACR - Safety policies When concerned with only the static magnetic field, which of the following is true of an object that deflects 30 degrees with a spatial gradient of 440g/cm? Your patient will be experiencing a maximum of 71 | P a g e 440g/cm during their scan. a. It is undetermined when discussing the static magnetic field. b. It is conditional only when discussing the static magnetic field. c. It is MR safe only when discussing the static magnetic field d. It is unsafe only when discussing the static magnetic field c. It is MR safe only when discussing the static magnetic field We are currently subjected to 1 gravity (G) force in normal conditions. A deflection of 45 degrees indicates that the translational force is equal to gravity we are currently experiencing. Anything less than 45 degrees of deflection will have translational force that is less than the effects of the current gravity experienced. This means that the implant will not cause any more harm than what gravity can cause on the implant. Areas of our image affected by a strong time-varying magnetic field produced from the gradient coils will produce which of the following? a. Slower precessional speeds b. More net magnetism c. Faster precessional speeds d. All of the choices c. Faster precessional speeds Sneezing from an injection of gad contrast is considered what? a. Non-allergic reaction b. None of the choices c. Anaphylaxis d. Allergic reaction d. Allergic reaction A ligand that cages a gad ion is referred to as? a. Linear b. Captured c. Macrocyclic d. Polarized c. Macrocyclic A patient is sweating profusely during an MR pelvis exam. What can be done to reduce this heating? Select all that apply. a. Increase the concentrations/number of acquisitions b. Decrease TR 72 | P a g e c. Scan the patient feet first d. Use fat sat sequences e. Use a gradient echo sequence a, e The process where a gad ion breaks away from the ligand, and a phosphate and zinc ion attach to the ligand is called? a. Transmetallization b. Gad deposition c. Anthropogenic d. Chelation a. Transmetallization Which of the following will reduce patient heating? Select all that apply. a. Decreasing the bandwidth b. Increase TR c. Increase flip angle d. Using saturation bands e. Increase duration of RF exposure a, b Which of the following can be given to a patient to relieve the symptoms of an allergic reaction? Select all that apply. a. Epinephrine b. Advil c. Diphenhydramine d. Corticosteriod a, c, d A patient has a carotid stent and is having an MR knee performed. In terms of patient heating, is this patient safe to scan? a. Yes b. No c. Yes, only if that patient is less than 200 lb d. Yes, only with a heat sink a. Yes Which of the following are true of unresponsive patients? Select all that apply. a. Areas of scars of unknown origin in the chest and spine region must be radiographed. b. Must be examined by a level 2 personnel 75 | P a g e c. Zone III All of the following are true except? a. They must be supervised by a level 2 personnel for the entirety of the exam. b. They must be verbally or interactively screened before entering the MR suite. c. They can be screened and accompanied by a level 1 personnel into zone IV. d. They should remove any ferrous objects prior to the MR exam. c. They can be screened and accompanied by a level 1 personnel into zone IV. What does the green square with green MR in the center mean? a. MR Safe b. MR Conditional c. MR Compatible d. MR Unsafe a. MR Safe Which of the following is a true statement? a. A level 1 personnel may scan a patient to relieve a level 2 personnel. b. A level 1 or a level 2 personnel should be available to help MR personnel in zone IV in non-emergent situations. c. A pregnant patient may not undergo an MR exam. d. All level 2 personnel are MR technologists. b. A level 1 or a level 2 personnel should be available to help MR personnel in zone IV in non-emergent situations. The accused in a criminal case is referred to as? a. The defendant b. The plaintiff c. The criminal d. The victim a. The defendant A criminal case usually results in which of the following if the defendant is found guilty? a. Paying for damages b. Serving a sentence c. Paying a fine d. Serving a sentence and/or paying a fine d. Serving a sentence and/or paying a fine Which of the following are categories of a crime? a. Misdemeanor b. Infraction c. Felony d. All of the choices 76 | P a g e d. All of the choices If a standard of care is not delivered to a patient and did not result in injury, it is called what? a. Negligence b. Malpractice c. Felony d. Tort a. Negligence If a standard of care is not delivered to a patient that resulted in injury to that patient it is called what? a. Negligence b. Malpractice c. Infraction d. Tort b. Malpractice A technologist is on their cellphone while a patient is being scanned. The patient is trying to get a hold of the technologist but the tech doesn't notice. This is an example of what? a. Negligence b. Malpractice c. Felony d. Tort a. Negligence A MR technologist is distracted by another patient and brings a non-MR compatible o2 tank in the room which severely injures a patient. This is an example of what? a. Negligence b. Malpractice c. Felony d. Tort b. Malpractice Which of the following organizations is responsible for defining the limits of the mri environment on occupational works? a. ICNIRP b. JCAHO c. FDA d. ACR a. ICNIRP What is a risk with a non-ferrous pain pump? a. Lenz's force b. Translation force 77 | P a g e c. Rotational force d. All of the choices a. Lenz's force When concerned with only the static magnetic field, which of the following is true of an object that deflects 30 degree's with a spatial gradient of 440g/cm? The patient will be experiencing a maximum of 440g/cm during their scan. a. It is MR safe only when discussing the static magnetic field. b. It is conditional only when discussing the static magnetic field. c. It is unsafe only when discussing the static magnetic field. d. It is undetermined when discussing the static magnetic field. a. It is MR safe only when discussing the static magnetic field. Which of the following stainless steels is non-ferrous? a. Austenitic b. ferritic c. martensitic d. duplex a. Austenitic Which of the following are considered biological effects of the static magnetic field? a. Translational forces b. Rotational forces c. Magnetohydrodynamic effect d. all of the choices c. Magnetohydrodynamic effect How do you determine the total force of a ferrous object that is attracted to the MR unit? a. By the static field strength and the spatial magnetic gradients. b. By the static magnetic field strength c. By the speed of the gradient coils and the static magnetic field. d. Using the SAR a. By the static field strength and the spatial magnetic gradients. Typically, where is the area surrounding the MR unit with the highest spatial magnetic gradient field? a. Isocenter b. MR table control panel c. MR table d. At the 5 gauss line b. MR table control panel Which of the following will produce the largest artifact in MRI? a. Ferromagnetic objects b. Paramagnetic objects 80 | P a g e Loops created with tissue or devices can cause which of the following harmful effects? a. missile effect b. burning c. peripheral nerve stimulation d. lenz's force b. burning Which of the following will create localized patient heating? a. transmit-receive coil b. body RF coil c. receive only coil d. none of the choices a. transmit-receive coil Which of the following can be used to reduce a proximity burn? a. patient barrier from gantry b. unwind loops in wires c. increase TR d. use ECG gating a. patient barrier from gantry Which of the following are risks associated with a linearly placed pacing wire within a patient? a. Resonant heating b. radiant heating c. loop induction d. near field burning. a. Resonant heating which of the following will reduce the risk of patient burning in a pacing wire? a. place the pacing wire outside the RF field b. don't scan patient c. place an ice pack on patient's chest d. advance patient into scanner head first a. place the pacing wire outside the RF field An obese patient is laying in the MR gantry and has bare skin touching the sides of the bore. What is she at risk of? a. proximity burning b. peripheral nerve stimulation c. missile effect d. magnetophosphenes a. proximity burning 81 | P a g e A patient has a medication patch on them with a foil backing. This patient is at risk of what? a. burning b. peripheral nerve stimulation c. magnohydrodynamic effect d. missile effect a. burning A patient has a removed vagus stimulator with the leads left in and is having a MR knee scan performed with a transmit-receive coil. In terms of patient heating is it low risk? a. Yes b. No c. Yes, only with a heat sink d. Yes, only if patient is less than 200lb a. Yes A patient has a carotid stent and is having a MR knee scan performed. In terms of patient heating, can this patient be scanned with a relatively low risk? a. yes b. no c. yes, only with a heat sink d. yes, only if patient is less than 200lbs a. yes Which of the following can reduce the risk of patient burns caused by the antenna effect? a. place a barrier between tissue or electrical devices and skin. b. use only spin echo sequences c. avoid scanning a patient with a transceiver coil d. All of the choices a. place a barrier between tissue or electrical devices and skin. Areas in our image affected by a strong time-varying magnetic field produced from the gradient coils will influence hydrogen nuclei how? a. by producing faster precessional speeds b. by producing slower precessional speeds c. by increasing net magnetism d. All of the choices a. by producing faster precessional speeds The slew rate influences which of the following? a. the minimal matrix size b. shorter echo times c. the size of the image matrix d. both the minimal TE and the image matrix size 82 | P a g e b. shorter echo times Which of the following is true if we increase the image matrix from 256x256 to 512x512. a. we use a weak time-varying gradient magnetic field b. we use a stronger time-varying gradient magnetic field. c. we reduce peripheral nerve stimulation d. we reduce patient heating b. we use a stronger time-varying gradient magnetic field. Which of the following will produce the least possibility of peripheral nerve stimulation when using the same slew rate? a. 192x192 image matrix b. 80mm field of view c. 320x320 image matrix d. 120mm field of view a. 192x192 image matrix Which of the following concerns can be caused by the time-varying gradient magnetic field? a. diaphragm contractions b. anaphylaxis c. difficulty swallowing d. all of the choices a. diaphragm contractions Which of the following pulse sequences will produce the greatest chance for peripheral nerve stimulation? a. conventional spin echo b. gradient echo c. inverse recovery d. fast spin echo b. gradient echo Which of the following will produce the greatest chance for peripheral nerve stimulation? a. conventional spin echo b. gradient echo c. EPI d. fast spin echo c. EPI The noise heard in MRI is primarily produced by which of the following? a. static magnetic field b. gradient coils c. RF transmitter d. all of the choices 85 | P a g e b. macrocyclic The number of particles found in one liter of a solution is defined as what? a. Osmolarity b. Viscosity c. Relaxivity d. Density a. Osmolarity A contrast media with a high relaxivity will do what when compared to a contrast media with a lower relaxivity? a. it will produce more signal b. it will produce less signal c. it will produce more image noise d. it will improve resolution a. it will produce more signal A disease that may be connected with delivering gadolinium contrast to patients with compromised renal function is called? a. Nephrogenic systemic fibrosis b. Gadolinium deposition c. Cancer d. Migraines a. Nephrogenic systemic fibrosis In the process of a gadolinium ion breaking away from the ligand, what is it called when a phosphate or a zinc ion attaches to the ligand? a. Transmetallation b. Gadolinium deposition c. Chelation d. Anthophgenic a. Transmetallation A disease that causes fibrosis of the skin and organs of a patient who receives unstable contrast media is called? a. Nephrogenic system fibrosis b. Musculoskeletal fibrosis c. Gadolinuim deposition d. Fibromyalgia a. Nephrogenic system fibrosis A patient receives many doses of gadolinium over their lifetime. They come in for an MR brain and T1 shortening is seen pre-contrast in the dentate nuclei and basal ganglia. what is this called? a. Retained gadolinium 86 | P a g e b. NSF c. Anthropogenic d. Magnetohydrodynamic effect a. Retained gadolinium Transmetallization describes what? a. when a gadolinium ion is lost in the body and another metal is picked up by the ligand. b. when other metals are combined to be used as a contrast media. c. when gadolinium contrast is retained in parts of the brain such as the dentate nucleus. d. when a gadolinium contrast is ingested a. when a gadolinium ion is lost in the body and another metal is picked up by the ligand. A patient is set to have an MRI knee scan with and without contrast and has labs drawn. The results show that the patient has a GFR of 25. It is highly suggested that what occurs? a. gadolinium is not given b. a half dose of gadolinium is given c. a full dose of gadolinium can be given unless the patient is allergic to gadolinium. d. The patient should not undergo an MRI. a. gadolinium is not given When does a cryogen become an issue in MRI to a patient? a. it it is released into the MR scan room. b. when it is vented outside c. When the release of cryogen influences the strength of the static magnetic field. d. if the cryogen gets very cold. a. it it is released into the MR scan room. The change in pressure in the MRI scan room can do what to the patient? a. rupture the eardrum b. cause the room to shake c. throw the patient around the room d. form magnetic field around the scan table. a. rupture the eardrum What can be done to reduce pressure in an MR scan room during a quench with a faulty vent and a door that opens into the scan room? a. break the window to zone IV b. open the door to zone IV c. Drill a hole into the wall to zone IV d. Wait 20 minutes for the pressure to dissipate a. break the window to zone IV A nurse accidentally brings an MR unsafe cart into the room and it gets stuck to the MR unit pinning a patient against the scanner. The cart is large and the nurse can not get around it. What do you do? 87 | P a g e a. quench the magnet. b. try to move the cart. c. call for a group of people to move the cart. d. call a code blue a. quench the magnet. A fire breaks out in the MR room, cannot be controlled and poses a serious threat. Which of the following would be the safest to do first? a. quench the magnet b. wait for firefighters c. leave the area d. non of the choices a. quench the magnet A quench is performed and a malfunction of the quench vent causes cryogen to leak in the room. The patient is in danger from which of the following? a. asphyxiation b. frostbite c. hypothermia d. all of the choices d. all of the choices After an emergent quench has begun, how long does it take for the magnetic field to be reduced to a safe level? a. approximately 30-60 seconds b. approximately 15 min c. approximately 3 min d. approximately 1 hour a. approximately 30-60 seconds A non-emergent quench can take approximately how long? a. 1 min b. 20 sec c. 5-15 min d. 2-4 min c. 5-15 min The roaring sound heard during a quench is caused by what? a. the massive volume of helium boiling off through the quench vent. b. the sound of the ignition of the coils of wire used to heat the cryogen. c. The sound of the system shutting down d. I a loud noise is heard, something is going wrong and you should evacuate. a. the massive volume of helium boiling off through the quench vent. 90 | P a g e c. body shape and size d. type of RF coil a. the tissue conductivity b. the tissue permeability c. body shape and size d. type of RF coil Which of the following will reduce patient heating? Select all that apply. a. using saturation bands b. increase flip angle c. increase duration of RF exposure d. increase TR e. decrease the bandwidth d. increase TR e. decrease the bandwidth A patient is warming up during their exam. What can be done to reduce the heating? Select all that apply. a. use parallel imaging b. decrese phase encoding c. increase slices d. increase the ETL e. increase the TR f. using a conventional gradient sequence a. use parallel imaging b. decrease phase encoding e. increase the TR f. using a conventional gradient sequence A patient is sweating profusely during a MR pelvis exam. What can be done to reduce this heating? Select all that apply. a. use fat saturation sequences b. increase the concatenations/number of acquisitions c. use a gradient echo sequence d. decrease TR e. scan the patient feet first b. increase the concatenations/number of acquisitions c. use a gradient echo sequence Which of the following is considered an allergic reaction to gadolinium contrast media? Select all that apply. a. hives b. headache 91 | P a g e c. emesis d. swelling a. hives d. swelling Which of the following are physiologic factors that occur from an anaphylactic reaction? Select all that apply. a. elevated creatinine levels b. increased vascular permeability c. vasodilation d. bronchiole smooth muscle contraction b. increased vascular permeability c. vasodilation d. bronchiole smooth muscle contraction Which of the following can be given to a patient to relieve the symptoms of an allergic reaction? select all that apply. a. advil b. diphenhydramine c. corticosteroid d. epinephrine b. diphenhydramine c. corticosteroid d. epinephrine Which of the following is true of a gadolinium contrast media? Select all that apply. a. gadolinium has 7 unpaired electrons b. gadolinium is paramagnetic c. gadolinium is toxic to humans d. Gadolinium will lengthens T1 relaxation times. a. gadolinium has 7 unpaired electrons b. gadolinium is paramagnetic c. gadolinium is to Peripheral nerve stimulation can be described by which of the following? a. Faraday's law of induction b. Ohm's law c. Lenz's law d. Planks Law b. Faraday's law of induction (describes the induction of electrical current in the presence of a changing magnetic field). 92 | P a g e Lenz's force describes the opposing forces created. Ohm's law deals with the resistance of current along a wire. Gad contrast has been found in the body in what form? Select all that apply. a. Water-soluble b. Non-water soluble a, b Which of the following would we expect to be the loudest sequence? a. GRASS b. Fast spin echo c. Conventional gradient sequence d. FLAIR a. GRASS The FLAIR and fast spin echo are considered spin echo sequences; they do not have extremely fast changing gradient, so will not produce as much noise. Which of the following has a steeper spatial magnetic gradient? a. Vertical B0 b. Horizontal B0 a. Vertical B0 The strongest gradient strength will reach maximum strength how far from isocenter? a. 5-20 cm b. 20-40 cm c. 30-60 cm d. 5-15 cm c. 30-60 cm Which of the following is true of gad and breastfeeding mothers? Select all that apply. a. Gad is found in breast milk in a stable and chelated form b. It is thought that gad contrast may alter the taste of breastmilk. c. Available data suggests that breastmilk should be pumped and discarded for 24 hours after the IV dose d. 20% of the intravascular dose would be excreted into the breastmilk within the first 24 hours. a, b Which of the following will influence peripheral nerve stimulation? a. Static magnetic field b. Magnetic field at isocenter 95 | P a g e b. Receiver coil c. Patient mass d. Controlled operation a, b, c, d Which of the following will demonstrate translational force? Select all that apply. a. A titanium hip replacement b. A steel aneurysm clip c. A cobalt heart stent d. Gad contrast b. A steel aneurysm clip Cobalt, titanium and gad are non-ferrous. They will not demonstrate translational force. Steel is and will translate and rotate in the presence of a static magnetic field. Which of the following are bioeffects associated with the time-varying gradient magnetic field? Select all that apply. a. Peripheral nerve stimulation b. Heating c. Magnetohydrodynamic effect d. Magnetophosphenes a, d There's been no evidence of heating associated with the time-varying gradient fields. Magnetophosphenes and peripheral nerve stimulation have to do with a fast changing magnetic field. We find this with the time-varying gradient field. Magnetohydrodynamic effect has to do with the static magnetic field and flow potential. Which of the following is true of a 3T MRI? Select all that apply. a. It will produce more stimulation at isocenter than other field strengths. b. Will have a larger maximum spatial gradient than a 1.0 T unit c. It will have a higher whole body SAR limit in normal mode than the normal mode at a 1.5 T d. Have more chance for peripheral nerve stimulation than at 1.5T b. Will have larger maximum spatial gradient than a 1.0 T unit. Passive metallic implants <2cm are not expected to heat up during image acquisition. a. True b. False a. True The strength of the gradient field will reach a maximum strength of what? a. 10-30 mT b. 40-60 mT c. 20-40 mT d. 0-20 mT 96 | P a g e c. 20-40 mT (0.04 T = 40 mT) Which of the following describes the translational magnetic field demonstrated to a patient at a specific location? a. dB/dt b. dB/dx c. dB/dt*B b. dB/dx The static magnetic limit for the general public for any body part is set to what? a. 4T b. 400 mT c. 2T d. 200 mT b. 400 mT (0.4T) The quench vent outside the MR facility is inspected by whom? a. MR tech b. Manufacturer engineer c. Facility engineer d. MRMD c. Facility engineer (The quench vent in the MR room is inspected by the manufacturer engineer) What type of gad contrast has been shown to cause falsely low serum calcium laboratory values? a. Linear ionic b. Linear non-ionic c. Macrocyclic d. There is no correlation b. Linear non-ionic Pregnant patient should never receive contrast. a. True b. False b. False We are scanning a cardiac MRI. What body part would we expect to experience peripheral nerve stimulation? a. Knee b. Foot 97 | P a g e c. Heart d. Head d. Head To date, most mechanical valves are unsafe at field strength of 3.0 T. a. True b. False b. False All tested heart valves are conditional at field strengths of 4.7 T or less Where would you expect to see the most heating on the IVC filter? a. the end of the wires b. the middle of the wires c. at the top of the filter a. the end of the wires (smallest diameter) Which of the following will increase the chance that an implant will cause a burn in our patient? Select all that apply. a. A tattoo that uses yellow ink is within the RF field b. A bullet is within the RF field c. Part of a temporary epicardial pacing wire is outside the patient's body. d. A hip replacement is found in the RF field c. Part of a temporary epicardial pacing wire is outside the patient's body. All the zones need to be represented with signage except: a. Zone I b. All the zones must be represented with signage c. Zone II d. Zone IV e. Zone III b. All the zones must be represented with signage Which of the following is true of gad retention? Select all that apply. a. Seen in bone and brain tissue b. Seen in renal compromised patients c. Result in transmetallization d. Every linear agent produces the same amount of retention in the brain a. Seen in bone & brain tissue Why is it recommended to tape or wrap gauze around jewelry? a. To make sure translational force does not occur b. To reduce contact with the skin