Final answer:
When performing an X-ray on an acutely ill patient with a tilted X-ray table, the central ray should be directed perpendicular to the image receptor. The CR should be directed towards the middle of the abdomen to capture air-fluid levels.
Step-by-step explanation:
When performing an X-ray on an acutely ill patient to demonstrate the presence of air-fluid levels, it is requested to have a flag and upright abdomen. However, due to the patient's condition, the X-ray table can only be tilted upright at 70 degrees instead of the desired 90 degrees. In this case, the central ray (CR) should be directed perpendicular to the image receptor in order to obtain the most accurate image. The CR should be directed towards the middle of the abdomen to capture the air-fluid levels effectively.