October 7, 2015

The Limited Scope of Practice in Radiography (LSPR) Exam

Whether you are starting a career as a radiology technician or at an entry-level radiology position, you need to understand the differences between certifications, licensure and permission to practice within your state. In its most basic form, radiography is the process of taking images using radiation, however the scope and practice of this field is evolving. People working in radiology have a host of media to choose from – they may specialize in computed tomography, or CT, magnetic resonance imaging, or MRI, digital mammography or regular x-ray technology. Successfully passing the exam for the Limited Scope of Practice in Radiography, or LSPR, grants you statewide permission to practice in this occupation.

State Mandated

The degree of training required for the LSPR exam varies by state, as does the content of the examination. Each state board of health contains a radiology component. There are still states that do not require a license, certificate or any formal training prior to using x-ray machines for medical purposes. However, more states are employing LSPR testing to all candidates who wish to gain a position in radiology. Check with your state board of health to see if your state requires this testing.


The American Registry of Radiologic Technologists manages LSPR testing for more than half of the state boards of health. Although the ARRT controls application and subsidizes the tests out to Pearson VUE for administration, the state board of health remains in control of licensure distribution and setting the pass/fail rates for the test. Upon completion of the test, the ARRT will forward your score of correct answers on the completed modules. The state board is responsible for choosing which of ARRT’s limited scope of practice modules to use, tailoring the test content to each state’s specific needs.

The Limited Scope of Practice in Radiography is not to be confused with the national certification exam, also offered by ARRT. The LSPR is state regulated, although application and testing are controlled by ARRT. The national certification exam is completely voluntary, and leads to the designated initials RT – Registered Technologist used behind the professional’s name upon registration of their passed certification. Passing the LSPR does not result in a title or certification; passing this test results in the ability to legally practice limited radiography within your state. You can apply for and take both tests, if you are eligible for the national certification exam through ARRT.

Computerized Testing

The LSPR exam is offered in a computerized testing format. The length of this multiple-choice style examination will depend on how many modules your state requires for testing completion. After application and exam fees are paid to your state board of health radiology component, you will receive a notification that you are eligible to schedule your testing. Candidates are allowed a 90-day window to schedule, after which they must repay and reapply unless they obtained an extension. The Pearson VUE computer testing centers are located across the nation, as well as in specific sites in Canada, Europe, Asia and Australia. In accordance with the American Disability Act, Pearson VUE offers consideration to those candidates who have special medical needs, but you must inform the testing center of this prior to test day.

LSPR Eligibility

LSPR EligibilityIf you are considering a career in the field of radiology, you will need to start by contacting your state board of health. Each state board regulates this field and may mandate passing a licensure test prior to practicing in radiography. Most states use the test format created by the American Registry of Radiologic Technologists, or the ARRT, called the Limited Scope of Practice in Radiography exam. This test will ascertain your basic level of knowledge and skills within the practice, radiology safety, equipment use and patient care. After passing the LSPR exam you are eligible for state licensure in radiography, with a limited scope of practice within your specialty, such as the spine or chest.

As radiographic technician’s licensure is granted on a state-by-state basis, you must contact your state board of health radiology safety division for specific guidelines within your jurisdiction. However, the majority of states follow basic eligibility requirements prior to licensure within the state in any capacity. Applicants must be a legal resident and national citizen with proof of both including a birth certificate, social security number and a document proving state residency, such as a driver’s license. Applicants must also possess a high school diploma or equivalent, such as a GED. Some states will require a passport photo and at least two forms of signed identification during the application process. You must pass a background check, including fingerprinting, and have no criminal record. If you do have a criminal record contact your state board before you apply to determine your eligibility or appeals process. The state board of health will regulate this process, as some boards do not require fingerprinting and background checks until after the examination is passed, but prior to the actual license being granted.

There are a number of educational programs for entry-level radiology positions. Most states require proof of education within the field, which may include a vocational certification program, a community college course in radiology resulting in an associate’s degree, or a diploma program for radiology technicians. There are a limited number of universities offering a bachelor’s within this field. Check with your state health board to ascertain specific educational requirements. If a degree of certification is required for testing, ensure that the school you attend is accredited by a governing body in radiography, such as The Joint Review Committee on Education in Radiologic Technology. Furthermore, if English is not your native language you must be fluent – the test is only offered in English and there are no exceptions for those speaking foreign languages.

Job experience is not required for the LSPR eligibility in most states, considering the fact that one cannot practice as a radiology technician until they have passed the examination. Working within a healthcare position may help you during your test, as it can familiarize you with medical terminology and hierarchy. You might also consider taking community college courses in medical terminology, anatomy and physiology, patient care, radiation and pathology, although they are not required for testing eligibility.

LSPR Exam Content

The Limited Scope of Practice in Radiology or LSPR exam is the entry-level test used for radiology technicians to practice within a state. The majority of state health boards require students to pass this exam before working in any imaging department capacity. This test proves that you possess the fundamental knowledge needed to safely obtain radiographic images within your area of specialty – including specialties in the spine, chest, extremities, skull and feet. Although there are some states that do not govern this process, studying for and obtaining your license as a limited scope radiology technician may give you the upper hand in choosing your work environment, hours and pay scale.

A portion of the LSPR exam content varies from state to state. The exam modules are created and administered by the American Registry of Radiologic Technologists, or ARRT. However, each state may choose which specialty modules they want included in their licensure testing. The basic exam for a limited scope of practice in radiology must include the four core principle modules, which amount to 100 multiple-choice style questions. These core modules test your basic competency, safety and general knowledge of radiation safety, patient education, operation of equipment and imaging production. You are given one hour and 40 minutes to complete this core module, with additional times allotted for specialty modules.

The largest percentage of core module questions focus on image production and evaluation. The testable content may include technical factors, such as contrast or image distortion, or patient factors, including movement, positioning and physical mass. You must have a firm grasp of the physics of radiology including light speed and measurement. Image receptors, processing and evaluation are included in this large testing module.

The second largest portion of core testing content includes radiation protection and safety. This section tests your knowledge of regarding the biological effects of radiation on each system. You must demonstrate knowledge of the protective factors such as shielding, beam size and restriction, positioning and how the image receptors, like digital versus film, affect all of the above. The test may include questions on radiation protection with the use of lead and shielding, as well as measurements of exposure.

The final core section tests on patient care and education within this scope of practice. This section includes the legal rights of the patient as well as ethical considerations in radiography careers. A few questions are dedicated to patient transfers, communication, infection control and other basic patient care and education principles.

Dependent on your state of residence, up to five additional modules may be introduced into your LSPR exam, with between 20 and 25 questions per module. These specialty modules for the radiography exam include the chest, extremities, skull and sinuses, spine, and podiatry. Test content within each module will contain questions on positioning, anatomy, technological considerations and equipment as pertains to each anatomical site.

Preparing for the LSPR Exam

The Limited Scope of Practice in Radiography, or LSPR exam is used to qualify applicants for a position as a radiology technician, and is governed by each state. Most, but not all, of the 50 states require a license to operate radiographic equipment, such as an x-ray machine. This license proves that the operator has the basic knowledge needed to safely take images within their area of practice, such as a chest x-ray or images of the spine.Preparing for the LSPR Exam

The LSPR exam is not free, as there are fees associated with application, testing and re-testing if needed and a fee for obtaining the state licensure once you have passed the examination. To keep your testing fees to a minimum, prepare for this exam and do not apply to take the LSPR until you are ready to sit for the test. After your application is accepted and approved, you only have a 90-day window to schedule and take your exam, before you must reapply and start the process over. Be sure to inform the Pearson VUE testing center of any disabilities prior to the actual test day, so that accommodations can be made accordingly. If you must cancel or reschedule your exam, it must be done at least 24 hours before your test time or your testing fees may be nonrefundable.

Computerized test taking can be harrowing if you are not prepared. Consider taking a demonstration test through Pearson VUE, which are offered online. Keep in mind, your LSPR exam will be completed in a computerized testing center, not in the comfort of your home. However, taking the practice computerized tests online may help increase your comfort level with reading and answering questions on a computer screen. Increasing familiarity with this type of test may help alleviate some anxiety on test day. There are specific rules and regulations for each Pearson VUE testing center; make sure you contact the center prior to your test to learn what you may and may not bring with you to the center. For instance, although it is needed for the exam, you may not bring your own calculator to this test. One will be provided for you at the center.

The LSPR exam content originates with the American Registry of Radiologic Technologists, or ARRT. This organization does not provide or endorse any testing material for the LSPR exam, however they do list a content outline for both the core and specialty modules that is updated annually. For more information on the content of this test see the article titled, “LSPR Exam Content”. Review the exam content thoroughly to locate any areas that require special study attention. Before you begin studying you may also wish to take a pretest, which can help you focus your study efforts on areas of weakness. ARRT offers demonstration questions for this exam but does not offer a pretest. Many different types are available online at a nominal fee, however, these also are not endorsed by ARRT.

Consider purchasing study packages or tools online. Many third-party companies offer study content specific to the LSPR exam including study manuals, flashcards, CD-ROMs and practice tests online. Choose a study method that meets your schedule and needs, then develop a study plan as your exam date gets closer. Try allotting a certain amount of study time daily, followed by a pretest. Refocus your areas of concentration on your weaker areas in accordance with the pretest results.

Radiography Technologist Careers

Careers in the field of radiography offer a diverse lot of occupational specialties. You may work in imaging specialties, such as cardiovascular diagnostic or interventional units, in myriad types of facilities and in a leisurely diagnostic or a trauma-paced critical care unit. Radiography technicians, also known as radiology techs, come from many different backgrounds and educational ranks. These careers may start as an in-hospital transfer or following a certification LSPR course at a vocational college. These professionals monitor the safe usage of ionizing rays, or x-rays, to take images of the body while protecting from overexposure hazards.

Radiographers may start their careers in many different ways. You may go to school for a certification or earn an associate’s degree in radiology. Many community colleges offer programs for radiology technicians, or you could choose a specialty within radiology, such as nuclear medicine, and get trained within that field. Ensure that the educational facility you choose is accredited by The Joint Review Committee on Education in Radiology Technology, otherwise you may be unable to take a national certification exam with the American Registry of Radiologic Technologists, or ARRT. Those who do not receive formal training in radiology may still find themselves within the field; you might get transferred from another unit within the hospital or start a job in a clinic where radiography is your primary duty and learn as you go.

Whether you start your career in radiology or are transplanted there, you must consider the laws governing your scope of practice within the field. Almost 3/4 of the states mandate testing and state licensure before you may practice as a radiology technician. Although it may not be mandated by the state, hospitals may use licensure and certification as a hiring standard, choosing only those candidates who show professionalism and drive within the field through accreditation.

The majority of state licensure tests for the Limited Scope of Practice in Radiography are given by ARRT. ARRT maintains limited powers in the state licensure testing and is only responsible for arranging the test and offering each state test content modules to choose from. After a candidate takes the exam, scores are sent directly to the state board of health or radiology, whereas a pass/fail rate is set by the state. If you successfully pass you exam, you are granted permission to practice as a radiology technician within your state. Individuals may choose to take their certification further, by electing to take the ARRT national certification exam for radiology technicians. Passing this exam and registering with ARRT enables candidates to use the initials R.T. after their name, which stands for Registered Technologist. You must maintain these credentials with recertification and continuing education biannually.

There are a plethora of work environments for radiology technicians in medical settings. Traditionally, these professionals worked in a hospital radiology department administering x-rays for diagnostic procedures. As imaging technology advances, technologists branch out into the specialties offered by emerging science, such as nuclear medicine, computed tomography (CT) and magnetic resonance imaging (MRI). Radiology techs may work in outpatient diagnostic centers, physician’s offices or in the traditional hospital setting.