100+ Free ARRT RRA Practice Questions

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Within the radiologist-led team, what is the defining scope limitation for a Registered Radiologist Assistant (R.R.A.) performing advanced procedures?

The R.R.A. may provide initial observations but cannot render the final, official interpretation of imaging studies

The R.R.A. may render final interpretations on plain radiographs but not on cross-sectional imaging

The R.R.A. practices fully independently once certified by ARRT

The R.R.A. may only perform procedures on patients under age 18 under radiologist supervision

to track

2026 Statistics

Key Facts: ARRT RRA Exam

Scaled Passing Score

ARRT 2026 R.R.A. Handbook

280

Total Exam Items

ARRT (200 selected + 30+ case study + pilots)

6h 50m

Total Appointment Length

ARRT 2026 R.R.A. Handbook

$225

Application Fee

ARRT Application Fees 2026

Twice yearly

Administration Schedule

ARRT (January and July)

Master's +

Degree Required

ARRT (plus current R.T.(R) + 2 yrs experience)

The ARRT R.R.A. is an advanced-practice credential that requires (1) current ARRT Radiography (R) certification, (2) at least 2 years of full-time post-R.T.(R) clinical experience, (3) completion of an ARRT-recognized RA master's-level educational program with clinical competencies, and (4) a master's or doctoral degree. The 7-hour exam has 280 items across a selected-response session (200 scored) and a case-study session (30+ scored). A scaled score of 75 is required to pass. The application fee is $225. R.R.A.s function under radiologist supervision, performing advanced fluoroscopic and image-guided procedures; they may provide initial observations but do not issue the final interpretation.

Sample ARRT RRA Practice Questions

Try these sample questions to test your ARRT RRA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Within the radiologist-led team, what is the defining scope limitation for a Registered Radiologist Assistant (R.R.A.) performing advanced procedures?

A.The R.R.A. may provide initial observations but cannot render the final, official interpretation of imaging studies

B.The R.R.A. may render final interpretations on plain radiographs but not on cross-sectional imaging

C.The R.R.A. practices fully independently once certified by ARRT

D.The R.R.A. may only perform procedures on patients under age 18 under radiologist supervision

Explanation: Per the ASRT Practice Standards for the Radiologist Assistant and the ACR-ASRT-SIIM Joint Statement, an R.R.A. functions as part of a radiologist-led team. The R.R.A. performs fluoroscopic and image-guided procedures and may provide the supervising radiologist with initial observations, but the final, official interpretation and report remain the sole responsibility of the supervising radiologist. The R.R.A. cannot issue a final report.

2A 68-year-old patient scheduled for a fluoroscopic esophagram has a serum creatinine of 2.8 mg/dL and an eGFR of 24 mL/min/1.73 m². The study will use oral barium sulfate only. Based on the ACR Manual on Contrast Media, what is the correct action?

A.Proceed with the barium esophagram; renal function is not a contraindication to oral barium

B.Cancel the study because the eGFR is below 30

C.Administer IV normal saline at 100 mL/hr for 12 hours before the study

D.Substitute iodinated water-soluble contrast (Gastrografin) for the barium

Explanation: Barium sulfate is inert, not absorbed from an intact GI tract, and is not nephrotoxic. Renal function concerns apply to iodinated IV contrast (contrast-induced acute kidney injury) and, historically, gadolinium-based contrast (nephrogenic systemic fibrosis), not to oral barium. The ACR Manual on Contrast Media places no renal restrictions on barium sulfate use. Water-soluble iodinated agents like Gastrografin are avoided in aspiration risk but are not required by renal function alone.

3A patient develops severe bronchospasm and hypotension 2 minutes after IV iodinated contrast injection during a fluoroscopy-guided procedure. What is the first-line pharmacologic treatment according to the ACR Manual on Contrast Media?

A.Intramuscular epinephrine 0.3 mg (0.3 mL of 1:1,000) in the lateral thigh

B.IV diphenhydramine 50 mg

C.IV hydrocortisone 200 mg

D.Sublingual nitroglycerin 0.4 mg

Explanation: Anaphylactoid reactions with bronchospasm and hypotension constitute severe contrast reactions. The ACR Manual on Contrast Media recommends intramuscular epinephrine 0.3 mg of 1:1,000 concentration (0.3 mL) in the lateral thigh as first-line treatment for adults. IM delivery is preferred over subcutaneous because of faster and more reliable absorption. Antihistamines (diphenhydramine) and steroids (hydrocortisone) are adjuncts, not first-line, because they do not reverse the acute airway and hemodynamic compromise.

4A patient with a documented prior moderate reaction to iodinated contrast requires a fluoroscopy-guided procedure that cannot be performed without iodinated contrast. Which ACR premedication regimen is most appropriate for an elective procedure?

A.Prednisone 50 mg PO at 13, 7, and 1 hour before contrast, plus diphenhydramine 50 mg IV/PO/IM 1 hour before contrast

B.Prednisone 10 mg PO 30 minutes before contrast only

C.Methylprednisolone 1 g IV immediately before contrast

D.Diphenhydramine 25 mg PO 15 minutes before contrast only

Explanation: The ACR Manual on Contrast Media elective (Lasser) premedication protocol is prednisone 50 mg PO at 13, 7, and 1 hour before contrast administration, plus diphenhydramine 50 mg IV, IM, or PO 1 hour before contrast. This regimen reduces (but does not eliminate) the risk of breakthrough reactions. For emergent cases, methylprednisolone 40 mg IV or hydrocortisone 200 mg IV every 4 hours until contrast administration plus diphenhydramine is used.

5Which laboratory value is MOST directly used to estimate renal function before administering IV iodinated contrast?

A.Estimated glomerular filtration rate (eGFR) calculated from serum creatinine

B.Blood urea nitrogen (BUN) alone

C.Serum potassium

D.International normalized ratio (INR)

Explanation: eGFR, calculated from serum creatinine using formulas such as CKD-EPI or MDRD, is the most direct estimate of glomerular filtration and is the standard per ACR guidelines for screening patients before IV iodinated contrast. BUN is affected by hydration, protein intake, and GI bleeding and is not a reliable sole measure. Potassium and INR are not measures of renal filtration. Current ACR guidance focuses on eGFR thresholds rather than absolute creatinine values.

6During a moderate sedation procedure, a patient becomes apneic and unresponsive after receiving midazolam and fentanyl. Which pharmacologic reversal sequence is correct?

A.Naloxone to reverse the opioid and flumazenil to reverse the benzodiazepine

B.Flumazenil to reverse the opioid and naloxone to reverse the benzodiazepine

C.Protamine to reverse the opioid and vitamin K to reverse the benzodiazepine

D.Atropine to reverse both drugs

Explanation: Naloxone is a competitive mu-opioid receptor antagonist and reverses opioids such as fentanyl, morphine, and meperidine. Flumazenil is a benzodiazepine receptor antagonist and reverses midazolam, diazepam, and lorazepam. In practice, clinicians typically administer naloxone first for respiratory depression from combined sedation because the opioid is most often the primary respiratory depressant. Protamine reverses heparin; vitamin K reverses warfarin.

7According to the American Society of Anesthesiologists (ASA) definitions used in the RRA content specifications, which sedation level describes a patient who responds purposefully to repeated or painful stimulation and may require assistance maintaining airway patency?

A.Deep sedation/analgesia

B.Minimal sedation (anxiolysis)

C.Moderate sedation (conscious sedation)

D.General anesthesia

Explanation: The ASA Continuum of Depth of Sedation defines deep sedation as a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully to repeated or painful stimulation. Spontaneous ventilation may be inadequate and airway intervention may be required. Moderate sedation allows purposeful response to verbal or light tactile stimulation with maintained airway. General anesthesia causes complete unresponsiveness and usually requires airway support.

8In the informed consent process for a fluoroscopy-guided lumbar puncture, which of the following must be explained to the patient to satisfy legal requirements?

A.The nature of the procedure, its material risks and benefits, alternatives, and the consequences of refusing the procedure

B.Only the steps of the procedure

C.Only the financial cost of the procedure

D.Only the expected duration of the procedure

Explanation: Legally valid informed consent requires disclosure of the nature of the procedure, its material risks and benefits, reasonable alternatives (including no treatment), and the likely consequences of refusal. The patient must also have decision-making capacity and consent voluntarily. Merely describing the steps or cost does not meet the legal standard. The R.R.A. content specifications explicitly list these informed consent components.

9The ARRT 'Ten-Day Rule,' used historically to limit radiation exposure to the abdomen/pelvis of women of childbearing potential, has largely been replaced by which current guidance?

A.Asking about the date of the last menstrual period and possibility of pregnancy, with imaging decisions based on clinical benefit and fetal dose estimates

B.Requiring a serum beta-hCG test before every fluoroscopic procedure regardless of region

C.Delaying all imaging of females between ages 10 and 55 until day 10 of the cycle

D.Refusing to image any woman of childbearing age without written spousal consent

Explanation: The Ten-Day Rule (scheduling non-emergent pelvic imaging only in the first 10 days of the menstrual cycle) has been superseded by the NCRP, ACR, and ICRP approach: ask about possible pregnancy and LMP, and make the imaging decision based on clinical benefit weighed against estimated fetal dose. Most diagnostic procedures result in fetal doses well below levels associated with deterministic effects (<50 mGy). Blanket hCG testing is not required, and the Ten-Day Rule is no longer recommended by major radiological bodies.

10Which dose quantity is the most appropriate indicator of potential skin injury during a prolonged fluoroscopic procedure?

A.Reference air kerma (cumulative air kerma at the interventional reference point)

B.Computed tomography dose index (CTDIvol)

C.Dose length product (DLP)

D.Nuclear medicine administered activity in millicuries

Explanation: Reference air kerma (cumulative air kerma at the interventional reference point, measured in mGy) is the fluoroscopy dose metric most closely related to peak skin dose and therefore the most useful for tracking potential deterministic skin injury. The FDA requires displays of cumulative air kerma and kerma-area product (KAP, also called DAP) on fluoroscopic equipment. CTDIvol and DLP are CT metrics. KAP correlates with stochastic risk but not directly with peak skin dose.

About the ARRT RRA Exam

The ARRT Registered Radiologist Assistant (R.R.A.) exam is an advanced-practice credential for radiographers who have completed a master's degree RA program. It assesses knowledge needed to perform fluoroscopic and image-guided procedures under radiologist supervision, including patient assessment, contrast media, pharmacology, sedation, radiation protection, and case-based procedure management.

Questions

280 scored questions

Time Limit

6 hours 50 minutes (Session 1: 4 hours, 240 min / Session 2: 2 hours, 120 min)

Passing Score

Scaled score of 75

Exam Fee

$225 (ARRT)

ARRT RRA Exam Content Outline

28%

Patient Care — Patient Management

Ethics, medical law, patient communication, medical history, medical data review, patient monitoring, lab values, infection control, IV therapy, oxygen therapy, urinary catheterization, procedure complications, medical records (38 selected-response items)

Patient Care — Pharmacology

Drug terminology, classifications, indications and contraindications, anesthetics and sedation (ASA guidelines, midazolam, fentanyl, naloxone, flumazenil), contrast media (osmolality, NSF, extravasation, premedication), resuscitation drugs (18 selected-response items)

14%

Safety — Patient Safety, Radiation Protection, and Equipment Operation

Radiation dose quantities, ACR/NRC/NCRP/ICRP standards, dose monitoring, methods to reduce patient and occupational exposure, MRI safety, fluoroscopy equipment, radiation biology, HIPAA, MQSA, quality improvement (28 selected-response items)

21%

Procedures — Abdominal Section

General abdomen, gastrointestinal, hepatobiliary/pancreas/spleen, urinary, reproductive tracts — anatomy, patient assessment, paracentesis, fluoroscopic GI studies (esophagram, UGI, SBFT, barium enema), nephrostomy, biliary drainage, HSG, pathophysiology (41 selected-response items)

13%

Procedures — Thoracic Section

General thoracic, cardiac, pulmonary, breast and axilla — thoracentesis, chest tube placement, pulmonary fluoroscopy, cardiac imaging, breast procedures, related medical devices and pathophysiology (25 selected-response items)

13%

Procedures — Musculoskeletal and Endocrine Sections

Joint aspiration, joint injection, arthrography (shoulder, hip, knee, elbow, wrist, ankle), bursa procedures, soft tissue biopsy, thyroid biopsy, MSK/endocrine pathophysiology (25 selected-response items)

13%

Procedures — Neurological, Vascular, and Lymphatic Sections

Lumbar puncture, myelography (cervical, thoracic, lumbar), extremity venography, central venous access (non-tunneled, PICC, port injection), lymph node biopsy, pathophysiology of CNS and vascular disease (25 selected-response items)

How to Pass the ARRT RRA Exam

What You Need to Know

Passing score: Scaled score of 75
Exam length: 280 questions
Time limit: 6 hours 50 minutes (Session 1: 4 hours, 240 min / Session 2: 2 hours, 120 min)
Exam fee: $225

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ARRT RRA Study Tips from Top Performers

1Master the ACR Manual on Contrast Media — know extravasation management, premedication protocols (Lasser protocol), NSF risk by gadolinium group, metformin guidance, and anaphylaxis treatment (IM epinephrine 0.3 mg)

2Memorize reversal agent dosing: naloxone 0.04-0.4 mg IV for procedural opioid reversal; flumazenil 0.2 mg IV up to 1 mg total for benzodiazepines

3Know the 13 mandatory RA entry-level clinical activities (paracentesis, esophagram, UGI, small bowel, BE, NG/OG tube, cystography/VCUG, thoracentesis, shoulder/hip arthrogram, LP, myelogram, PICC) — each is fair game for case-study items

4Study radiation protection quantitative facts: 50 mSv/year occupational limit, 1 mSv/year public limit, 5 mSv pregnancy limit, inverse square law (1/d²), pulsed fluoro dose reduction

5Review the ASRT Practice Standards for the Radiologist Assistant and the ACR-ASRT-SIIM Joint Statement on RA scope — R.R.A.s provide initial observations but NOT final interpretations

6Practice with real lab value ranges: eGFR thresholds, BUN/creatinine, INR, platelet counts, Light's criteria for pleural fluid

7Understand SIR bleeding-risk categories and periprocedural anticoagulation management (2019 consensus guidelines)

8Study the ACR Appropriateness Criteria 1-9 rating scale and how to apply it for specific clinical indications

Frequently Asked Questions

What is the ARRT Registered Radiologist Assistant (R.R.A.) exam?

The R.R.A. exam is ARRT's advanced-practice credentialing examination for experienced radiographers who have completed a master's-level Radiologist Assistant educational program. It assesses the knowledge and cognitive skills required to perform fluoroscopic and image-guided procedures under radiologist supervision as part of a radiologist-led team.

What are the eligibility requirements for the ARRT R.R.A. exam?

Candidates must (1) hold current ARRT certification and registration in Radiography, (2) complete an ARRT-recognized RA educational program (including didactic and clinical components), (3) have at least 2 years of full-time, professional-level patient-related experience after earning the Radiography credential, (4) earn a master's or doctoral degree from an ARRT-recognized accredited institution, and (5) comply with ARRT Standards of Ethics. You have 3 years after program completion to earn the degree and apply.

What is the format and time limit of the R.R.A. exam?

The R.R.A. exam has two sessions. Session 1 is 240 minutes (4 hours) for approximately 200 scored selected-response items plus 30 pilot items. Session 2 is 120 minutes (2 hours) for 30+ scored case-study items plus 20+ pilot items. Total appointment length is 6 hours 50 minutes (including tutorial, NDA, and survey). Format includes multiple-choice, multiple-selection, sorted lists, and case studies. The exam is delivered at Pearson VUE test centers.

What score do I need to pass the ARRT R.R.A. exam?

You need a scaled score of 75 (on a 1-99 scale) to pass. ARRT uses scaled scoring rather than raw percentage so different forms of the exam are equated for difficulty. A scaled score of 75 represents the same level of performance regardless of which exam version you took. Section scores are reported on a 0.1-9.9 scale for content-area review but do not determine pass/fail.

How much does the ARRT R.R.A. exam cost?

The R.R.A. application fee is $225 (postprimary credential fee) as of 2026. This includes the exam and initial certification. Annual renewal for ARRT credentials changed to $65 starting January 2026 (up from $30), covering all credentials held. Fees do not include costs of the RA master's program itself, continuing education, or Continuing Qualifications Requirements activities.

How many times is the R.R.A. exam offered each year?

Unlike most ARRT exams, the R.R.A. exam is offered only twice per year — typically the second week of January and the second week of July. Application deadlines fall approximately 8 weeks before each administration. Candidates have a three-year, three-attempt eligibility window to pass.

What is the difference between an R.R.A. and a radiologist?

A radiologist is a physician (MD or DO) who has completed medical school, residency, and often fellowship; radiologists render the final interpretation of imaging studies. An R.R.A. is an advanced-practice radiographer who performs procedures under radiologist supervision as part of a radiologist-led team. Per ASRT Practice Standards and the ACR Practice Parameter, R.R.A.s may provide initial observations to the supervising radiologist but do NOT issue the final official interpretation or report.

What are Continuing Qualifications Requirements (CQR) for R.R.A.s?

R.R.A.s (along with post-2011 primary-pathway ARRT credential holders) must complete Continuing Qualifications Requirements every 10 years. CQR includes a structured self-assessment aligned with current content specifications, followed by targeted learning activities to address identified gaps. This is separate from the annual renewal and the 24-CE-credit biennial continuing education requirement that applies to all ARRT registrants.