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Exam Review

Key Facts: ARRT CT Exam

195

Total Questions (165 scored + 30 pilot)

ARRT Postprimary Handbook (2026)

215 min

Appointment Time (195 min test)

ARRT Postprimary Handbook (2026)

75

Passing Scaled Score

ARRT scoring model

$225

Exam Fee

ARRT fee schedule (2026)

74.7%

First-Attempt Pass Rate

ARRT Annual Exam Report 2025

4 domains

Scored Content Areas

ARRT CT content specifications

ARRT's CT content specifications (effective September 1, 2026) list 165 scored questions plus 30 unscored pilot items (195 total): Patient Care 21, Safety 21, Image Production 52 and Procedures 71. Candidates get 195 minutes of test time in a 215-minute appointment, and the passing scaled score is 75. ARRT's postprimary fee schedule lists CT at $225. ARRT's Annual Exam Report for 2025 lists a 74.7% first-attempt pass rate for CT candidates.

Sample ARRT CT Practice Questions

Try these sample questions to review concepts for the ARRT CT exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Case 001 (Patient Screening): A 58-year-old male presents for a contrast-enhanced abdominal CT. His medical history includes type 2 diabetes managed with metformin. His most recent eGFR is 28 mL/min/1.73 m². What is the most appropriate course of action?
A.Proceed with iodinated contrast as planned since metformin can be resumed immediately after.
B.Withhold the contrast and consult the ordering physician before proceeding.
C.Administer half the normal contrast dose to reduce kidney risk.
D.Replace iodinated contrast with gadolinium-based contrast for the CT scan.
Explanation: An eGFR of 28 mL/min/1.73 m² indicates severely reduced kidney function (Stage 4 CKD). Administering iodinated contrast in this setting poses a significant risk of contrast-induced nephropathy (CIN) and lactic acidosis when combined with metformin. The technologist should withhold contrast and consult the ordering physician, who may choose a non-contrast study, alternative imaging, or nephrology consultation. Option A is dangerous because proceeding without modification ignores the renal risk. Option C (half dose) is not a validated risk-reduction strategy and still exposes compromised kidneys. Option D is incorrect because gadolinium-based agents carry their own serious risk (nephrogenic systemic fibrosis) in patients with low eGFR and are not appropriate CT contrast agents.
2Case 002 (Contrast Allergy): A 45-year-old female is scheduled for a CT pulmonary angiography (CTPA) to rule out pulmonary embolism. She reports a prior moderate allergic reaction (hives and facial swelling) to iodinated contrast during a previous CT. What is the recommended pre-medication protocol?
A.Administer 50 mg oral prednisone at 13 hours, 7 hours, and 1 hour before contrast injection plus 50 mg oral diphenhydramine 1 hour before.
B.Give 25 mg IV diphenhydramine immediately before injection without corticosteroids.
C.Use a different brand of iodinated contrast without pre-medication since the allergy is brand-specific.
D.Cancel the CTPA entirely and order a ventilation-perfusion scan instead.
Explanation: The ACR recommends a 13-7-1 hour oral corticosteroid regimen (e.g., prednisone 50 mg at each interval) plus an antihistamine (diphenhydramine 50 mg, 1 hour prior) for patients with prior moderate contrast reactions who require repeat iodinated contrast. Option B omits corticosteroids, which are the cornerstone of prophylaxis. Option C is incorrect because contrast allergies are not reliably brand-specific, and switching brands alone does not constitute adequate risk reduction. Option D may be considered if pre-medication is not feasible, but when the clinical question (PE) is urgent and pre-medication can be accomplished, CTPA with prophylaxis is the standard approach.
3Case 003 (Informed Consent): A technologist is preparing to administer IV iodinated contrast for a CT of the abdomen and pelvis. Which element is NOT typically required as part of informed consent for contrast administration?
A.Description of the purpose of the contrast injection.
B.Possible risks including allergic reaction and contrast-induced nephropathy.
C.A guarantee that no adverse reaction will occur.
D.The patient's right to refuse the contrast injection.
Explanation: Informed consent requires disclosure of the purpose, risks, benefits, and alternatives, along with acknowledgment that the patient may refuse. No healthcare provider can guarantee the absence of adverse reactions — doing so would be both ethically and legally inappropriate. Options A, B, and D are all legitimate components of the informed consent process for contrast-enhanced CT procedures.
4Case 004 (NPO Guidelines): A 72-year-old patient is scheduled for a contrast-enhanced CT of the chest at 10:00 AM. The patient ate breakfast at 7:30 AM. According to current ACR guidelines regarding fasting before IV contrast, what should the technologist do?
A.Reschedule the exam for later in the day to ensure a full 8-hour fast.
B.Proceed with the exam since current ACR guidelines do not mandate routine fasting before IV iodinated contrast.
C.Administer an antiemetic before the contrast injection to prevent aspiration.
D.Convert the study to a non-contrast CT to avoid aspiration risk.
Explanation: The ACR Manual on Contrast Media states that there is no evidence supporting mandatory NPO requirements before IV iodinated contrast administration. Routine fasting is no longer recommended. Option A would unnecessarily delay potentially urgent diagnostic imaging. Option C is not standard practice for routine contrast-enhanced CT. Option D would compromise diagnostic quality without clinical justification. The technologist should proceed with the contrast-enhanced study as ordered.
5Case 005 (Emergency Response): During a contrast-enhanced CT scan, a 50-year-old patient develops stridor, facial edema, and a drop in blood pressure to 70/40 mmHg within 2 minutes of injection. What is the FIRST medication that should be administered?
A.IV diphenhydramine 50 mg.
B.Intramuscular epinephrine 0.3 mg (1:1,000 concentration) in the anterolateral thigh.
C.IV methylprednisolone 125 mg.
D.Sublingual nitroglycerin 0.4 mg.
Explanation: This patient is experiencing anaphylaxis (stridor, angioedema, and hypotension). The first-line treatment for anaphylaxis is intramuscular epinephrine (0.3 mg of 1:1,000 concentration) administered in the anterolateral thigh. Option A (diphenhydramine) treats urticaria and itching but does not reverse bronchospasm or hypotension and is considered adjunctive therapy. Option C (methylprednisolone) has a delayed onset and is used to prevent biphasic reactions, not as first-line treatment. Option D (nitroglycerin) is a vasodilator and would worsen hypotension — it is indicated for chest pain, not anaphylaxis.
6Case 006 (Patient Positioning): A technologist is positioning a patient for a non-contrast head CT to evaluate for acute hemorrhagic stroke. What is the correct patient positioning to minimize radiation to the lens of the eye?
A.Supine with the head tilted chin-down so the scan plane is parallel to the orbitomeatal line.
B.Supine with the head hyperextended so the scan plane is angled above the orbits.
C.Prone with the forehead resting on the table.
D.Lateral decubitus to reduce motion artifact.
Explanation: For a standard head CT, the patient is positioned supine with the chin tucked slightly so the gantry angle (or scan plane) is parallel to the orbitomeatal line (OML) or the infraorbitomeatal line. This orientation minimizes direct radiation exposure to the lens of the eye, which is one of the most radiosensitive structures. Option B (hyperextension) would direct the primary beam through the lenses. Option C (prone) is not standard for routine head CT and compromises airway access. Option D (lateral decubitus) is not used for standard head CT acquisitions.
7Case 007 (Contrast Extravasation): While injecting 100 mL of iodinated contrast at 4 mL/s through a 20-gauge antecubital IV, the technologist notices swelling at the injection site on the contrast injector pressure waveform. What is the FIRST action?
A.Continue the injection at a slower rate to complete the study.
B.Stop the injection immediately, disconnect the tubing, and aspirate residual contrast if possible.
C.Apply a warm compress to the site and continue the injection.
D.Increase the injection rate to push past the obstruction.
Explanation: When contrast extravasation is detected, the injection must be stopped immediately to limit the volume of extravasated contrast. The tubing should be disconnected and any residual contrast aspirated if possible. The affected extremity should then be elevated and monitored. Option A would increase the extravasation volume and tissue damage. Option C is partially correct for post-extravasation management (warm or cold compresses may be applied afterward), but continuing the injection is inappropriate. Option D could cause compartment syndrome by forcing more contrast into the subcutaneous tissue.
8Case 008 (CTDIvol): A routine adult head CT is performed with a CTDIvol of 75 mGy displayed on the scanner console. The ACR CT Dose Index Registry median for this exam type is approximately 57 mGy. What should the technologist do?
A.Accept the dose because it is below the regulatory limit of 100 mGy.
B.Document the dose and notify the supervising radiologist or physicist, as the CTDIvol exceeds the ACR reference level.
C.Repeat the scan at lower dose to bring the average down.
D.Delete the dose report to avoid regulatory documentation of the higher dose.
Explanation: The ACR Dose Index Registry provides reference levels (typically the 75th percentile of the national distribution) to help facilities benchmark their doses. A CTDIvol of 75 mGy significantly exceeds the ACR reference level of approximately 57 mGy for adult head CT, triggering the need for investigation. The technologist should document the dose and notify the radiologist or physicist for protocol review. Option A is incorrect because there is no single "regulatory limit" of 100 mGy; ALARA requires continuous optimization. Option C is inappropriate because repeating the scan adds more radiation. Option D is unethical and violates dose tracking requirements.
9Case 009 (ALARA Principle): A CT technologist is scanning a thin 55 kg adult female for an abdominal CT. The default protocol is set for an 80 kg reference patient. Applying the ALARA principle, what is the most appropriate adjustment?
A.Use the default 80 kg protocol since it produces diagnostic images for all body habitus.
B.Reduce the tube current (mA) to account for the smaller body habitus while maintaining diagnostic image quality.
C.Increase the kVp by 20% to ensure adequate penetration.
D.Double the pitch to compensate for the smaller patient size.
Explanation: ALARA (As Low As Reasonably Achievable) requires dose optimization based on patient size. For a smaller patient, less radiation is needed to achieve diagnostic image quality. Reducing tube current (mA) is the most direct way to lower dose proportionally to body habitus; many modern scanners use automatic tube current modulation (ATCM) to accomplish this. Option A wastes dose on a smaller patient. Option C would increase dose without justification — smaller patients actually need less penetration. Option D (doubling pitch) would reduce dose but also alters coverage speed and may degrade image quality through z-axis blurring.
10Case 010 (DLP and Effective Dose): A CT chest-abdomen-pelvis scan records a DLP of 1,200 mGy·cm. To estimate the effective dose in millisieverts (mSv), the DLP is multiplied by an appropriate conversion factor (k-factor). For a chest-abdomen-pelvis scan, using an approximate k-factor of 0.015 mSv/(mGy·cm), what is the estimated effective dose?
A.8 mSv.
B.12 mSv.
C.18 mSv.
D.24 mSv.
Explanation: Effective dose = DLP × k-factor = 1,200 mGy·cm × 0.015 mSv/(mGy·cm) = 18 mSv. The k-factor is a region-specific conversion factor derived from Monte Carlo simulations; the chest-abdomen-pelvis region uses an approximate weighted k-factor of 0.015. Option A (8 mSv) represents a calculation error. Option B (12 mSv) would correspond to a k-factor of 0.010, which is too low for this scan region. Option D (24 mSv) would correspond to a k-factor of 0.020, which is too high for a combined chest-abdomen-pelvis scan.

About the ARRT CT Exam

ARRT CT is a postprimary credential for technologists advancing into computed tomography practice. The exam blueprint covers patient care, radiation safety, CT image production, and procedure-specific protocol decisions. The four scored domains emphasize imaging procedures most heavily, followed by image production, while patient care and safety are weighted equally.

Exam sponsor: ARRT. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

165 questions

Time Limit

195 minutes test time (215-minute appointment)

Passing Score

Scaled score 75

Exam / Certification Fees

$225

Exam sponsor website

Reported exam pass rate: 74.7%. first attempt (ARRT Annual Exam Report 2025) This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

21 scored (12.7%)

Patient Care

Patient assessment, contrast media administration, communication, and emergency response in CT settings

21 scored (12.7%)

Safety

Radiation protection, dose optimization (ALARA, DLP, CTDIvol), equipment safety, and regulatory compliance

52 scored (31.5%)

Image Production

Acquisition parameters (kVp, mA, pitch, slice thickness), image processing, reconstruction, artifact recognition, and quality control

71 scored (43%)

Imaging Procedures

Head/neck/spine, chest/abdomen/pelvis, musculoskeletal, vascular, and interventional CT protocols

Preparing for the ARRT CT Exam

What You Need to Know

  • Passing score: Scaled score 75
  • Exam length: 165 questions
  • Time limit: 195 minutes test time (215-minute appointment)
  • Exam / certification fees: $225 Official sources

Using Our Practice Resources

  • Work through all 200 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

ARRT CT: Suggested Study Strategy

1Weight your study by blueprint: Imaging Procedures (43%) and Image Production (31.5%) together represent about 74.5% of scored items
2Master CT acquisition parameter tradeoffs: pitch, slice thickness, kVp, mA, and reconstruction kernel effects on image quality
3Practice dose optimization scenarios using CTDIvol, DLP, and size-specific dose estimate (SSDE) calculations
4Drill protocol selection for common clinical indications across all body regions
5Run timed mixed sets to build pacing for 195 total items in 195 minutes of test time

Frequently Asked Questions

How many questions are on the ARRT CT exam?

ARRT's 2026 Postprimary Eligibility Pathway Handbook lists 195 total questions for CT: 165 scored items plus 30 pilot (unscored) items. Candidates are not told which questions are pilot items.

How long is the ARRT CT exam appointment?

ARRT lists a 215-minute (3 hours 35 minutes) appointment for CT, with 195 minutes of test time for 195 items (about one minute per item). The rest of the appointment covers an 8-minute tutorial, a 2-minute non-disclosure agreement and a 10-minute survey.

What score do I need to pass ARRT CT?

ARRT reports a passing scaled score of 75 for CT. Candidate results are reported on ARRT's scaled-score model rather than a raw percent-correct score.

What are the ARRT CT content domain weights?

Under the content specifications effective September 1, 2026, ARRT's CT blueprint has four scored domains: Patient Care (21 questions, 12.7%), Safety (21 questions, 12.7%), Image Production (52 questions, 31.5%), and Procedures (71 questions, 43.0%). Imaging Procedures carries the heaviest weight.

How much is the ARRT CT exam fee?

ARRT's current postprimary fee schedule lists CT at $225. Confirm current pricing directly in your ARRT account before you apply.

What is the ARRT CT pass rate?

ARRT's Annual Exam Report lists a 74.7% first-attempt pass rate for CT candidates in 2025. This is lower than Radiography (85.8%), making thorough preparation important.