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The RTM exam has 145 questions and runs 2 hours 30 minutes.
These 10 free RTM questions are organized by exam domain, so you can see how each part of the Registered Technologist - Mammography blueprint is tested. Reveal the answer and explanation under each question.
At a risk-counseling visit, an asymptomatic 34-year-old learns that her estimated lifetime breast-cancer risk is 28%, calculated with a model based mainly on family history. She has no contraindication to MRI. Which screening plan matches American Cancer Society recommendations for this risk level?
Correct answer: A - Annual mammography plus annual contrast-enhanced breast MRI, starting now
A patient with a final BI-RADS 2 assessment reads that her breasts are heterogeneously dense and asks, "Does that mean the mammogram found cancer and I need a biopsy?" Which explanation accurately separates the two findings?
Correct answer: D - "BI-RADS 2 is benign, not a biopsy recommendation. Dense tissue can mask a small mass and increases cancer risk."
A facility changes its approved screening protocol from separately acquired 2-D mammography plus digital breast tomosynthesis (DBT) to synthesized 2-D images plus DBT. The DBT acquisition settings and breast views remain unchanged. The dose reduction comes from:
Correct answer: C - Eliminating the separate conventional 2-D exposure
Four mammography units are tested using the large ACR digital mammography phantom under the 2018 ACR Digital Mammography Quality Control Manual. Considering both object visibility and artifacts, which result meets the phantom image-quality criteria?
Correct answer: A - 3 fibers, 4 speck groups, 3 masses; no clinically significant artifact
A magnification view is planned to resolve fine calcification detail. The source-to-image distance is 66 cm, and the calcification plane is 22 cm above the image receptor. Available focal spots measure 0.1 mm and 0.3 mm; motion is not limiting with either exposure. Which focal-spot choice gives the smaller geometric unsharpness, and what is that unsharpness at the receptor?
Correct answer: D - 0.1-mm focal spot; 0.050-mm unsharpness
A technically adequate left MLO image has a posterior nipple line (PNL) of 10.2 cm. The left CC PNL measures 9.6 cm. The CC includes posterior fat and medial and lateral tissue, with sharp detail and no obstructing folds. The nipple is in profile on MLO but not on CC; no pectoral muscle appears on CC. With no additional clinical finding requiring another view, how should the CC image be handled?
Correct answer: B - Accept it; these quality findings do not require a repeat.
Several grouped calcifications look smudgy and rounded on a CC magnification image. On a true lateral magnification image, the same calcifications form sharply defined, dependent teacup-shaped layers. What accounts for this change in appearance?
Correct answer: D - Calcium sedimenting within fluid-filled microcysts
For triangulation, the technologist aligns a right MLO image and a true ML image with the nipple shadows at the same height. The same lesion lies higher relative to the nipple on ML than on MLO. Which localization and true lateral projection would place this lesion nearer the image receptor for additional detail imaging?
Correct answer: B - Medial location; lateromedial (LM) projection
During upright stereotactic biopsy positioning, before any needle has entered the breast, a patient becomes pale, sweaty, and nauseated. She says she is about to faint. Her pulse is 46/min and blood pressure is 84/50 mm Hg; she remains responsive. The technologist should first:
Correct answer: C - Stop, release compression, position her supine with legs elevated, and summon immediate clinical help.
Diagnostic mammography has been ordered after targeted ultrasound for a persistent lump in a 36-year-old who is breastfeeding. She arrives with uncomfortably full breasts and asks how to prepare for the mammogram. What advice supports completion of the indicated examination?
Correct answer: B - Breastfeed or express milk shortly before the mammogram, then proceed.
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