NBCE Part 4 Chiro Practice 202 practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q1Which radiographic view best demonstrates the integrity of the pars interarticularis for evaluation of spondylolysis?
✓ Correct answer: D. Oblique view
The oblique view best demonstrates the pars interarticularis by showing the 'Scottie dog' appearance, where a defect in the pars appears as a break in the dog's neck. This view is essential for proper evaluation of spondylolysis.
Q2What is the primary advantage of MRI over plain film radiography in the evaluation of disc pathology?
✓ Correct answer: C. Superior soft tissue contrast
MRI provides superior soft tissue contrast, allowing visualization of disc material, nerve roots, and other soft tissues that are not visible on plain films. This makes it the superior modality for evaluating disc pathology including herniations and degenerative changes.
Q3In a post-traumatic cervical spine radiographic series, what finding would most strongly indicate the need for immediate stabilization and emergency referral?
✓ Correct answer: B. Jefferson fracture
Jefferson fracture (burst fracture of C1) is a serious, unstable fracture that requires immediate stabilization and emergency referral to prevent spinal cord injury. It indicates significant trauma and potential atlantoaxial instability.
Q4Which of the following radiographic findings is most consistent with osteoarthritis of the knee?
✓ Correct answer: A. Joint space narrowing
Joint space narrowing is a hallmark radiographic finding of osteoarthritis. As the articular cartilage deteriorates, the space between the bones narrows, which is clearly visible on radiographs and represents a key diagnostic criterion for osteoarthritis.
Q5A 45-year-old female with acute low back pain reveals no red flags in her history or examination. What is the most appropriate initial imaging approach?
✓ Correct answer: D. No imaging unless symptoms persist beyond 4-6 weeks
For acute low back pain without red flags, clinical guidelines recommend delaying imaging for at least 4-6 weeks to allow for natural resolution. Premature imaging can lead to unnecessary interventions and has not been shown to improve outcomes in uncomplicated cases.
Q6When positioning a patient for an AP lumbosacral view, which of the following techniques helps reduce gonadal exposure to radiation?
✓ Correct answer: C. Use of gonadal shielding
Gonadal shielding using lead shields placed over the reproductive organs significantly reduces radiation exposure to these radiosensitive tissues during radiographic procedures, which is particularly important for patients of reproductive age.
Q7Which radiographic finding is most consistent with advanced ankylosing spondylitis in the spine?
✓ Correct answer: B. Bamboo spine appearance
A bamboo spine appearance (complete fusion of the vertebral bodies) is pathognomonic for advanced ankylosing spondylitis. This occurs due to ossification of the outer fibers of the annulus fibrosus and anterior/posterior longitudinal ligaments.
Q8What is the most appropriate radiation protection principle to follow when determining if a patient requires radiographic imaging?
✓ Correct answer: A. ALARA principle
ALARA (As Low As Reasonably Achievable) is a fundamental radiation protection principle that requires justification of each exposure based on clinical necessity. This ensures patients receive the lowest possible radiation dose while still obtaining diagnostically useful images.
Q9A patient presents with acute neck pain after a motor vehicle accident. Which radiographic view is essential to rule out atlantoaxial instability?
✓ Correct answer: D. Open-mouth odontoid view
The open-mouth odontoid view is essential for evaluating the integrity of the dens and assessing atlantoaxial relationships. It allows visualization of potential fractures or displacements that could indicate instability at the C1-C2 junction following trauma.
Q10Which of the following is NOT a typical radiographic finding in degenerative disc disease?
✓ Correct answer: C. Increased intervertebral disc space
Increased intervertebral disc space is not a typical finding in degenerative disc disease. Instead, DDD typically presents with decreased disc space, osteophyte formation, endplate sclerosis, and possible vacuum phenomenon within the disc.
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