NucMed Flashcards
1
Q
What length of time should a lactating female who undergoes 18F-FDG PET scanning wait before resuming breast-feeding?
(a)4 h
(b) 24 h
(c) 1 week
(d) Breast-feeding should be discontinued
A
(b) With a physical half-life of 109 min and a biologic half-life of 6 h, the effective half-life for 18F is approximately 1.4 h. Nonetheless, many imaging departments recommend that nursing mothers refrain from nursing for 24 h following a PET study with this isotope, although this varies greatly among labs. Some laboratories recommend as little as 6-h interruption after imaging, so it is completely eliminated from the body in 14 h.
2
Q
Why is it important to know if a patient has an inflammatory condition before performing an 18F-FDG PET scan?
(a)18F-FDG and certain anti-inflammatory medications cause severe reactions when used simultaneously
(b) 18F-FDG can exacerbate inflammatory conditions
(c) Some inflammatory conditions cause areas of increased uptake of 18F-FDG
A
(c) Areas of inflammation often show increased activity on 18F-FDG images.
3
Q
Which of the following has the shortest half-life?
(a)82Rb
(b) 13N
(c) 15O
(d) 18F
A
(a) 82Rb has a half-life of 1.3 min, 13N has a half-life of 10 min, 15O has a half-life of 122.2 s, and 18F has a half-life of 109 min.
4
Q
Which dose and route of administration are the best choices when performing a whole body PET scan with 18F-FDG and a dedicated PET scanner?
(a)2-4 mCi IV
(b) 2-4 mCi IM
(c) 10-20 mCi IV
(d) 10-20 mCi IM
(e) 30-35 mCi IV
A
(c) The dose recommended by the Society of Nuclear Medicine Procedure Guideline for whole-body FDG PET scanning is 10-20 mCi injected intravenously (370 to 740 MBq).
5
Q
Fill in the blank. High blood glucose levels may _____ 18F-FDG uptake in tumors.
(a)Decrease
(b)Increase
A
(a) Increased glucose level can decrease tumor uptake so many institutions reschedule a patient’s PET scan if their blood glucose level exceeds 200 mg/dL.
6
Q
Parenteral nutrition should be discontinued for several hours prior to 18FDG imaging.
(a)True
(b)False
A
(a) Regardless of how a patient receives his or her nutrition, increased glucose level may decrease tumor uptake because glucose will compete with FDG for cellular uptake. Of course, the decision to remove nutrition is up to the clinician.
7
Q
Which of the following is NOT a scintillation crystal found in PET cameras:
(a)Lutetium oxyorthosilicate (LSO)
(b) Bismuth germanate (BGO)
(c) Lead sulfate (PbSO4)
(d) Gadolinium oxyorthosilicate (GSO)
A
(c) Scintillation crystals that have been used in PET cameras include NaI(Tl), LSO, BGO, and GSO. Lead sulfate, PbSo4, is the white powder often seen on the electrodes of car batteries.
8
Q
In the event of a spill of 99mTc to clothes, one should immediately:
(a)Enter a shower fully clothed.
(b) Remove and store the clothes until they decay to background.
(c) Wash the clothes in hot water and then survey them to determine remaining activity.
(d) Remove and destroy the clothing.
A
(b) The first priority in event of a spill is to contain the contamination, i.e., to keep it from being spread. In this case, that would be accomplished by removing the clothing and storing it until the activity has decayed to background level.
9
Q
What is the best way to decrease the radioactive dose to visitors if a patient is surveyed to emit 3 mR/h at bedside?
(a)Have the patient wear lead aprons.
(b) Keep the patient well hydrated and encourage frequent voiding.
(c) Have the visitor sit or stand as far as possible from bedside.
(d) Have the visitor wear lead shielding.
A
(c) The best and simplest way to decrease exposure to a visitor would be to increase the distance form the patient. If the exposure rate is 3 mrem/h at bedside, we can estimate 1 ft. from the patient and we move the visitor to 2 ft. from the patient, the exposure rate at the new distance would be 0.75 merm/h. (The equation in solution to question 5 of this chapter is rearranged to read (I1)(d1)^2 = (I2)(d2)^2 and solved for the new intensity.)
10
Q
A spill of 99mTc increases the exposure rate in a room from 1.7 to 3.15 mR/h. The room is posted with a sign reading “Caution-Radioactive Materials.” What would be the ideal solution?
(a)Change the sign to one reading “Caution-Radiation Area.”
(b) Call the NRC.
(c) Decontaminate the floor with water and cleanser.
(d) Place absorbent paper over the spill and close the room until the activity has decayed.
A
(d) A sign reading “Caution Radioactive Materials” is required wherever radioisotopes are used. The sign reading “Caution Radiation Area” sign is required if the dose rate exceeds 5 mrem/h, so no change in sign posting is needed. However, the spill should be contained, so restricting access to the area until the activity has decayed to background is the best course of action.
11
Q
A technologist has 500 mrem registered on his ring badge in 1 month. What should be done to decrease exposure in the future?
(a)Use lead pigs and syringe shields when preparing radiopharmaceuticals.
(b) Have another technologist elute the generator.
(c) Wear lead aprons.
A
(a) All technologists should use lead vials and syringe shields when working with radiopharmaceuticals.
12
Q
Which of the following is the most effective means of measuring low levels of removable radiation?
(a)By performing an area survey
(b) By performing a wipe test
(c) With a pocket dosimeter
(d) With a TLD
A
(b) Wipe tests are used to detect removable contamination from surfaces such as packages, floors and counters and are achieved by wiping the area in question with a dry wipe and then counting the wipes along with a background sample in a well counter.
13
Q
If a radiopharmaceutical is spilled on the floor, the first priority is to:
(a)Contact the Radiation Safety Officer.
(b) Pour a chelating solution over the area of the spill.
(c) Cover the area with absorbent paper and restrict access around it
(d) Call the housekeeping department to arrange for cleaning.
A
(c) The contamination must be contained as a first priority. Using a chelating agent may change the chemical structure of the substance spilled but will not affect the radioactivity of it. The Radiation Safety Officer should be notified, but first access to the area of the spill must be restricted.
14
Q
Gaseous radiopharmaceuticals may only be used in rooms that:
(a)Have at least one window
(b) Contain an oxygen supply
(c) Are at a positive pressure compared to surrounding rooms
(d) Are at a negative pressure compared to surrounding rooms
A
(d) Airborne radiation, such as aerosols or gases, should be administered in rooms that are at negative pressure to surrounding areas. Depending on the amount of activity and the length of time it is present, special posting may be required (10 CFR 20.1902)
15
Q
A technologist discovers that a patient in the room next to a radioiodine therapy will receive 2.5 mrem/h when lying in his bed which is against the shared wall. What should be done?
(a)Move the bed to the other side of the room.
(b) Discharge the therapy patient.
(c) Discharge the non-therapy patient.
(d) Calculate how long visitors to the non-therapy patient can stay.
(e) Calculate how long the patient may stay in bed each hour.
A
(a) Time, distance, and shielding are the most important factors in reducing exposure; in this case, the simplest solution is to employ an increase in distance to the source of the radiation.
16
Q
Which of the following is not a misadministration?
(a)When a dose of 400 μCi of 99mTc MAA is given rather than 4 mCi
(b) When the correct dose of 111In oxine for cisternogram is injected intravenously
(c) When a patient who should have been injected with 20 mCi of 99mTc HDP for a bone scan receives a capsule containing 250 μCi of 123I intended for a thyroid patient
(d) When a patient who should have received 50 mCi of 131I receives 35 mCi instead
(e) None of the above
A
(e) A misadministration can involve the wrong patient, the wrong radiopharmaceutical, the wrong route of administration, or a dose that differs by more than 20% of the prescribed dose or falls outside the prescribed dose range. Doses that differ from the prescribed dose by more than 5 rem effective dose equivalent, 50 rem to an organ or tissue, or 50 rem shallow dose equivalent to the skin are also misadministrations.
17
Q
What is the dose rate limit at the surface of a package bearing a DOT Class I White label?
(a)0.5 mR/h
(b) 2 mR/h
(c) 50 mR/h
(d) 100 mR/h
(e) 200 mR/h
A
(a) A package with such a label may have an exposure rate that does not exceed 0.5 mR/h at the package surface, and there must be no detectable radiation at 1 m from the package.
18
Q
The doorway to the nuclear medicine reception area should be posted with:
(a)Caution: Radiation Area
(b) Caution: High Radiation Area
(c) Grave Danger: Very High Radiation Area
(d) Caution: Radioactive Materials
(e) None of the above
A
(e) The sign “Caution Radioactive Area” is posted wherever radioactive materials are used or stored. Unless patients are being injected in the reception area, a sign is not needed.
19
Q
Which of the following bodies regulates the use of investigational pharmaceuticals?
(a)NRC
(b) DOT
(c) IRB
(d) FDA
A
(d) All the use of investigational pharmaceuticals is regulated by the Food and Drug Administration.
20
Q
What is the best choice for disposal of a vial containing 27 mCi of 99mTc in 2 ml of liquid?
(a)Transfer to an authorized recipient
(b) Incinerate
(c) Bury
(d) Store until decayed to background
(e) Release to the atmosphere through evaporation
A
(d) If the radioactive material has a half-life of 120 days, the material can be disposed of as ordinary trash after decaying in storage. Before disposal, the material must be surveyed and not be greater than background radiation (10 CFR 35.92). Records must be kept of this for 3 years (10 CFR 35.2092) and must include the radionuclide, the date of disposal, the equipment used to survey the material, the background dose rate, and the dose rate at the surface of the container used for disposal, as well as the name of the person disposing of the material.
21
Q
Reports of area surveys must include all of the following except:
(a)A diagram of the areas surveyed
(b) Equipment that was used to perform the survey
(c) Date performed
(d) Initials of the person who performed the survey
(e) List of isotopes used in the area
A
(e) NRC licensees are required to prepare and maintain reports of area surveys for 3 years. A list of isotopes used in the area is not a required part of the report.
22
Q
Which of the following must be kept for 5 years?
(a)Records of misadministrations
(b) Records of dose calibrator linearity
(c) Records of doses assayed before administration
(d) Area survey records
(e) Records of instructions to breast-feeding women who received radiopharmaceuticals
A
(a) Misadministration records must be kept for 5 years. Records of patient dosage, area survey records, and records of instructions given to lactating females must be kept for 3 years.
23
Q
A pregnant technologist receives 350 mrem during her pregnancy according to a film badge worn at waist level. Has the NRC dose limit for the fetus been exceeded?
(a)Yes
(b)No
A
(b) The total dose limit for a fetus is 0.5 rem (10 CFR 20.1208)
24
Q
Which of the following must be done during disposal of a carton in which a shipment of 131I was received?
(a)RSO must be notified.
(b) Carton must be stored for ten half-lives before disposal.
(c) Radioactive labels must be removed or obliterated.
(d) Carton must be discarded with biohazardous waste.
(e) (b) and (c).
A
(c) Cartons that have been used toe ship radioactive material must have radiation labels removed before disposal. If wipe tests show contamination, it must be regarded as radioactive waste and disposed according to the relevant regulations.
25
OSHA requires that personnel exposure records be provided to employees:
(a)Monthly
(b) Quarterly
(c) Annually
(d) Biannually
(c) OSHA requires that employees are advised at least yearly about their exposure records.
26
A technologist is working in a hot lab where the exposure rate is 20 mR/h. What sign should be on the door?
(a)Caution: Radioactive Materials
(b) Caution: Radiation Area
(c) Caution: High Radiation Area
(d) Grave Danger: Very High Radiation Area
(e) None of the above
(b) The sign reading "Caution Radiation Area" sign is required if the dose rate exceeds 5 mrem/h. The sign reading "Caution: High Radiation Area" is not required until the dose rate exceeds 100 mrem/h.
27
Any patient who is treated with 90 Y ibritumomab tiuxetan must be hospitalized for at least 24 h.
(a)True
(b)False
(b) The dose is 0.4 mCi/kg and is not to exceed 32 mCi. In general, patients may be released from hospitalization based on measured dose rates or on the basis of activity administered or retained; the activity below which a patient may be released differs according to the isotope (e.g., 33 mCi for 131I). However, for 90Y, 32P, and 89Sr, the NRC does not require hospitalization because the exposure to the public form doses normally used is minimal.
28
A room containing a 57Co sheet source is posted with a sign reading “Caution-Radioactive Materials.” The exposure rate measured next to the source is 5.2 mR/h. What should be done?
(a)Change the sign to one reading “Caution-Radiation Area.”
(b) Store the source in a leaded container.
(c) Monitor the length of time a technologist can work near the source.
(d) None of the above.
(b) According to the NRC regulations for sing posting, the sign should be changed to "Caution Radiation Area," but a simpler solution would be to store the source in its leaded container.
29
If bleeding occurs during withdrawal of a needle following injection, one should:
(a)Apply a tourniquet
(b) Apply pressure
(c) Alert a physician
(d) Apply ice
(b) Bleeding following an IV injection is halted by applying pressure. In cases of severe or prolonged bleeding, a physician should be alerted.
30
Which of the following should be considered when using patient restraint devices?
(a)Restricted circulation
(b) Attenuation
(c) Comfort
(d) All of the above
(e) (a) and (c) only
(d) Patient restraint devices should not restrict circulation and patient comfort is important. Buckles on straps, etc. may produce attenuation artifacts.
31
If a patient is having seizures, the technologist should:
(a)Try to restrict the patients' movements
(b) Try to grasp the patient's tongue
(c) Start CPR
(d) Clear the area around the patient to minimize the risk of injury
(e) All of the above
(d) Regardless of the seizure type, patients should not be restricted and nothing should be inserted into their mouth as this will increase the risk of injury. Removing objects that could potentially injure the patient and prevention of injury is a priority for the healthcare provider during the seizure. It is not necessary to start CPR in cases of seizure (unless, of course, the seizure is provoked by a stroke or other serious medical condition and the patient's heartbeat and breathing cease).
32
Infectious waste disposal involves:
(a)Leakproof containers
(b) Puncture-resistant containers
(c) The universal symbol for biohazard
(d) All of the above
(e) (a) and (b) only
(d) Infectious waste should be disposed of using the universal biohazard symbol, which is recognized by the World Health Organization and numerous national agencies. Sharps should be disposed of using puncture-resistant containers, and all containers and bags should be leakproof.
33
Gloves should be worn anytime there is contact with:
(a)Blood and body fluids
(b) Broken skin
(c) Mucous membranes
(d) All of the above
(e) (a) and (b) only
(d) While nasal secretions do not require universal precautions, vaginal secretions do, and the vaginal lining is a mucous membrane. Hence, mucous membranes are included in the correct answers. In practice, nuclear medicine technologists rarely have contact with mucous membranes.
34
According to the standard precautions issued by the Centers for Disease Control, when should gloves be changed?
(a)Between procedures on two different patients
(b) Between procedures on the same patient
(c) Every half hour
(d) All of the above
(e) (a) and (b) only
(f) (a) and (c) only
(e) The Centers for Disease Control and Prevention recommends changing gloves between patients and between procedures on a single patient if moving from a contaminated area to a clean area. There is no specific frequency recommendation.
35
Which of the following statements is not true regarding sharp instruments?
(a)Reusable instruments should be cleaned, disinfected, and sterilized before reuse.
(b) Nonreusable sharp instruments should be recapped before disposal into a biohazard container.
(c) Single-use needles should be disposed using puncture-resistant containers.
(d) None of the above.
(b) Single-use sharps should not be recapped before disposal as the proper disposal container is puncture resistant and recapping will increase the risk of puncturing the skin of the user.
36
A nursing mother who undergoes a lung perfusion exam utilizing 4 mCi of 99mTc MAA should:
(a)Continue nursing as usual
(b) Interrupt breast-feeding for 12.6 h
(c) Interrupt breast-feeding for 36 h
(d) Discontinue breast-feeding
(b) The International Commission on Radiological Protection recommends delaying breast-feeding for 12 h after 99mTc-labeled radiopharmaceuticals except for labeled red blood cells, phosphonates, and DTPA for which 4 h of interruption is recommended. Three weeks is recommended after 201Tl-, 67Ga-, and 125I-labeled compounds. It is recommended that breast-feeding be completely discontinued after 131I therapy.
37
Which of the following is true concerning radioactivity and pregnancy?
(a)Radioiodine will cross the placenta.
(b) Hydration and frequent voiding will reduce the fetal absorbed dose.
(c) The NRC total dose allowed to an embryo/fetus from occupational exposure is 0.5 rem.
(d) All of the above.
(d) The use of radiopharmaceuticals is not encouraged during pregnancy. Iodine, and therefore radioiodine, crosses the placenta from the mother to the child, and therefore, radioiodine therapy can damage the baby's thyroid. Women are advised to delay pregnancy for a year following radioiodine therapy. The international Atomic Energy Agency recommends lower doses followed by hydration and frequent voiding to reduce fetal exposure for pregnant women who have undergone examinations using radiopharmaceuticals. Hydration without frequent voiding will increase the dose to the fetus. The total dose equivalent allowed to the fetus from occupational exposure of the mother is 0.5 rem.
38
Which of the following must be performed every 6 months at minimum?
(a)COR
(b) Sealed source leak test
(c) Linearity of the dose calibrator
(d) Area survey of hot lab
(b) Sealed sources must be leak checked during an inventory conducted every 6 months. Leak checks are made by wipe tests of the sealed sources.
39
A dose calibrator must undergo repair or replacement if accuracy or constancy errors are:
(a)Present
(b) Greater than 5%
(c) Greater than 10%
(d) Greater than 20%
(c) According to the NRC, dose calibrators with accuracy or constancy errors >10% must be repaired or replaced.
40
Which instrument should be used to determine the location of a 99mTc spill?
(a)Geiger-Muller (GM) survey meter
(b) Portable ionization chamber
(c) NaI well counter
(d) Pocket dosimeter
(a) Geiger-Muller (GM) survey meters are more sensitive than ionization chamber survey meters by a factor of ~10. This allows them to detect spills with very low levels of contamination.
41
Survey meters must be checked for proper operation against a sealed source:
(a)Before each day of use
(b) Weekly
(c) Monthly
(d) Every 6 months
(a) Before using a GM meter each day the user should perform: (1) battery test - check that needle goes up into region marked BAT TEST, (2) constancy test - hold the detector up against a check source and compare the measurement (minus background) to the expected value.
42
Which of the following would be used to perform a survey of an area in which a small amount of radioactivity is expected to be present?
(a)Ionization chamber
(b) Geiger-Muller counter
(c) Well counter
(d) Single probe counting system
(b) Geiger-Muller meters are designed to detect small amounts of contamination. Ionization chambers are not sensitive enough to use for contamination monitoring.
43
An ionization chamber with a relatively low applied voltage from the anode to the cathode has a low efficiency and is therefore best for measuring:
(a)Low exposure rates
(b) High exposure rates
(c) Background radiation
(d) Absorbed dose
(b) Because of the low voltage, there is no avalanche effect, and therefore no dead time.
44
Most well counters measure radioactivity by the use of:
(a)An applied voltage from anode to cathode
(b) A sodium iodide crystal
(c) A silver halide layer
(d) Thermoluminescent crystals
(b) Thermoluminescent crystals are used for monitoring radiation exposure to occupational personnel. The Geiger-Muller counter uses an applied voltage from anode to cathode. Silver halide coats the film often used in nuclear medicine departments.
45
When measuring samples in a well counter, which one of the following is true?
(a)Sample volumes should be large.
(b) Samples should have high radioactivity.
(c) Sample geometry should be consistent.
(d) Sample containers don't affect the measurement.
(c) Well counters best measure samples containing small amounts of radioactivity and are useful for counting in vitro studies, wipe tests, etc. Samples should have identical geometry, i.e., the volumes, and containers used should be identical for all samples.
46
A locked storage closet next to the radiopharmacy containing phantoms and sealed sources has a measured exposure rate of 3 mR/h. It should be posted with a sign reading:
(a)Caution: Radioactive Materials.
(b) Caution: Radioactive Area.
(c) Caution: High Radiation Area.
(d) Grave Danger: Very High Radiation Area.
(e) No sign is necessary.
(a)
47
Film badges should be worn:
(a)Between the shoulder and waist
(b) Except while doing paperwork
(c) Only during preparation and administration of radiopharmaceuticals
(d) All of the above
(a)
48
According to NRC, an unrestricted area is one in which a person would receive a radiation dose of less than:
a. 2 mrem/hr
b. 5 mrem/hr
c. 10 mrem/hr
d. 20 mrem/hr
e. 50 mrem/hr
a.2 mrem/hr
49
High Radiation Area signs are to be posted in areas where exposures greater than ____________ mrem/hr are measured at 30 cm from the source or from any surface through which the radiation penetrates:
a. 5
b. 10
c. 50
d. 100
e. 500
d.100
50
The first step that a technologist should initiate in a safe environment when an adult patient is determined to be unresponsive is to:
(a)Perform chest compressions.
(b) Establish an airway.
(c) Check for a carotid pulse.
(d) Call for help.
(e) Perform rescue breathing.
(d) American Heart Association standards and guidelines indicate that once verification of cardiac arrest has occurred, the rescuer should call for help first and then initiate CPR.
51
A biohazard warning label would be found on all of the following EXCEPT a:
(a)contaminated sharps container
(b) refrigerator containing potentially infectious material
(c) receptacle for contaminated laundry
(d) unit of blood released for clinical use
(e) uncontaminated sharps container
(d) Biohazard warning labels are attached to any container of regulated materials. These include refrigerators, freezers, and anything used to store, transfer, or ship blood or infectious materials. Labels are not required on containers of blood that have been released for clinical use, such as blood transfusion
52
According to the NRC, imaging rooms should be posted with which of the following signs?
(a)No posting is required.
(b) "Caution: No Food or Drink"
(c) "Caution: Radiation Area"
(d) "Caution: Radioactive Materials"
(e) "Caution: High Radiation Area"
(d) The NRC requires that restricted areas, such as imaging rooms, be posted with specific signs depending on the radiation level present. A "Caution: Radioactive Materials" sign should be posted in areas where certain quantities of radioactive materials are used or stored. There quantities are those exceeding 10 times the quantities specified in Appendix C to 10 CFR Part 20. The quantities for commonly used radionuclides that will result in required posting include: as excess of 10 mCi of 99mTc, 67Ga, 133Xe, or 201 Tl; an excess of 1 mCi of 123I or 111In; more than 10 uCi of 131I.
53
Which of the following exposure rates indicate that a package containing radioactive material must have a category III DOT label?
At package surface - At 1 m
(a)76 mR/hr - 5.5 mR/hr
(b) 56 mR/hr - 3.5 mR/hr
(c) 22 mR/hr - 0.9 mR/hr
(d) 1.5 mR/hr - 1.0 mR/hr
(e) 0.5 mR/hr - No detectable radiation
(b) (AND a) The label types and exposure rate limits for packages containing radio active materials are:
```
Label category - At surface (mR/h) - At 1 m
Category I (white) - <= 0.5 - No detectable radiation
Category II (yellow) - <= 50 - <= 1.0
Category III (yellow) - <= 200 - <= 10
```
54
A patient receives a unit dosage of [89Sr]chloride intended for another patient. Which of the following statements about this situation is TRUE?
(a)Because the patient received only a unit dosage of 89Sr, no report to the NRC is required.
(b) According to the NRC, this does not constitute a medical event, but a departmental record should be maintained.
(c) The situation describes a medical event that has to be reported only to the nuclear medicine supervisor and the authorized user.
(d) No report is necessary since it does not reach the dose threshold for reporting.
(e) The situation describes a medical event requiring notification of the NRC.
(e) A licensee must notify the NRC of medical events, which are defined as an administration of a licensed material that results in an effective equivalent dose (EDE) greater than 5 Rem, a dose to an organ or tissue that is greater than 50 Rem, or shallow dose exposure (SDE) to the skin greater than 50 Rem because of any of the following:
The total dosage delivered differs from the prescribed dosage by 20% or more.
The total dosage falls outside the prescribed range.
The wrong radioactive drug was administered.
The radioactive drug was administered by the wrong route.
The radioactive dosage was administered to the wrong person.
When a medical event (misadministration) occurs, the NRC requires the licensee to notify the NRC, the referring physician, and the involved individual, unless the referring physician determines, on the basis of medical judgment, that such notification would be harmful to the patient.
55
A vial of 133 Xe has been decayed in storage for 2 months. When the vial is monitored with a survey meter, the reading is twice the background radiation level. What should the technologist do next?
(a)Remove any radiation symbols from the vial, then dispose of it.
(b) Perform a wipe check.
(c) Return the vial to storage.
(d) Vent the radioactivity left in the vial into a fume hood.
(e) Dispose of the vial as biohazardous waste.
(c) According to NRC regulations, decay in storage of radioactive materials requires that the materials remain in storage until the radioactivity is indistinguishable form background radiation, using a survey meter on the most-sensitive scale and without any shielding in place.
56
According to the NRC, wipe tests of areas where radiopharmaceuticals are prepared or administered must be performed:
(a)on a reasonable schedule
(b) every day on which radiopharmaceuticals are used
(c) weekly
(d) only if contamination occurs
(e) monthly
(a) NRC regulations required a survey of areas where radiopharmaceuticals that require a written directive are prepared or administered. This would include therapeutic radiopharmaceuticals and dosages of 131I greater than 30 uCi.
As of October 2002, the NRC no longer requires daily surveys and weekly wipe tests. Instead, it allows facilities to establish a survey and wipe test schedule. The schedule must be reasonable, based on the need to determine radiation levels, concentrations or quantities of radioactive materials, and potential radiological hazards.
57
When opening packages containing radioactive material, which of the following steps should be performed first?
(a)Perform a survey using Geiger counter.
(b) Wipe-test the package receiving area.
(c) Put on disposable gloves.
(d) Wipe-test the package for contamination.
(e) Verify the package contents against the packing slip.
(c) Because it has not been determined that the package is free of contamination, gloves should be put on before the package or its contents are handled.
58
During cleanup of a radioactive spill, decontamination of the area must continue until wipe checks reveal that:
(a)The exposure rate of the area is less than 3 mRem/hr.
(b) The exposure rate of the area cannot be distinguished from background activity.
(c) The contamination is reduced to a small area.
(d) No one would receive the maximum allowable total effective dose equivalent (TEDE) if he/she remained in the area.
(e) No more contamination can be removed from the area.
(e) Decontamination of a radioactive spill should continue until the residual radioactivity is below the action level set by the licensee or until no further contamination can be removed by cleaning the area. If residual radioactivity is present after thorough decontamination, the area should be covered as a reminder for personnel to limit their time in that area.
59
Personnel must wear a radiation monitoring device during work hours if they are:
(a)exposed to radiation at any time during work hours
(b) exposed to radiation above background levels
(c) likely to exceed 10% of the annual maximum allowable occupational exposure
(d) likely to exceed the annual maximum allowable occupational exposure
(e) a radiologic technologist
(c) The NRC requires monitoring of occupationally exposed individuals if they are likely to exceed 10% of the annual allowable limit for external exposure of internal uptake.
60
If a source of radioactive contamination produced an exposure rate of 3 mR/hr, how long will it take for the exposure rate to drop to a background exposure rate of 0.05 mR/hr
(a)5 half-lives
(b) 6 half-lives
(c) 7 half-lives
(d) 8 half-lives
(e) 9 half-lives
If a source of radioactive contamination produced an exposure rate of 3 mR/hr, how long will it take for the exposure rate to drop to a background exposure rate of 0.05 mR/hr
(a)5 half-lives
(b) 6 half-lives
(c) 7 half-lives
(d) 8 half-lives
(e) 9 half-lives
61
According to the NRC, records of surveys must be retained for how many years?
(a)as long as the facility's license is in effect
(b) 7 years
(c) 5 years
(d) 4 years
(e) 3 years
(e)According to the NRC, the results of all surveys must be retained for three years.
62
Which of the following materials is recommended for shielding syringes containing positron-emitting radionuclides?
(a)lead
(b) tungsten
(c) gold
(d) steel
(e) plastic-lined lead
(b) Tungsten is recommended, because it will absorb more radiation than the same thickness of lead.
63
Which of the following instruments should be used to determine whether all removable contamination has been eliminated?
(a)Geiger-Mueller counter
(b) well counter
(c) dose calibrator
(d) uptake probe
(e) cutie pie (ionization chamber)
(b)When Geiger counter readings no longer decrease as the cleanup progresses, a wipe test, which is measured in a well counter, is performed. If the wipe test shows activity does not exceed background levels, then all removable contamination has been eliminated. If nonremovable activity remains, shielding of the spill area may be necessary.
64
A patient undergoing an imaging procedure indicates to the technologist that a seizure is impending. The most appropriate action for the technologist is to:
(a)Instruct the patient to breathe deeply to help increase oxygen levels in the brain.
(b) Ignore the patient's concerns because the timing of seizures cannot be predicted.
(c) Stop the imaging procedure and have the patient lie on the floor with a pillow supporting the head.
(d) Increase the number of physical restraints on the patient to prevent patient movement and injury.
(e) Instruct the patient to hold their breath for as long as they can.
(c) A seizure patient may experience a warning that a seizure is about to occur. The technologist should assist the patient to the floor and away from objects that may injure the patient during the seizure. A pillow will cushion the patient's head from the floor.
65
According to NRC regulations, records of written directives must be maintained for how long?
(a)1 years
(b) 3 years
(c) 5 years
(d) 10 years
(e) indefinitely
(b) The NRC requires that records of written directives be maintained for three years.
66
According to the NRC, a written directive must be prepared for administration of which of the following radiopharmaceuticals?
(a)1 mCi [111In]oxine
(b) 5 mCi [201Tl]chloride
(c) 10 mCi [67Ga]citrate
(d) 5 mCi [131I]sodium iodide
(e) 30 mCi [99mTc]sestamibi
(d) According to the NRC, a written directive is required for any dosage of [131I]sodium iodide greater than 30 uCi or for any therapy dosage of an unsealed byproduct material.
67
According to the NRC, a written directive is required for the administration of all of the following radiopharmaceuticals EXCEPT:
(a)35 mCi [131I]sodium iodide
(b) 15 mCi [32P]sodium chromate
(c) 15 mCi [32P]sodium phosphate
(d) 10 mCi [89Sr]chloride
(e) 20 mCi [18F]FDG
(e) The NRC requires a written directive before administration of 131I in quantities greater than 30 mCi and any other unsealed byproduct material that is used for therapy. [32P]sodium phosphate and [89Sr]chloride are used for therapy, whereas [18f]FDG is used for diagnostic purposes.
68
According to NRC regulations, which of the following cannot be disposed of in the sewage system?
(a)unused [123I]sodium iodide capsules
(b) feces from a patient who received [131I]therapy
(c) spit from an aerosol [99mTc]pentetate
(d) urine from a renal test
(e) disposable diaper of a child who has received [67Ga]
(a) According to NRC regulations, only patient excreta are exempt from any limits when discarded into the sewage system. Disposal limits for other radioactive waste are based on the solubility and rate of waste water discharge from a facility.
69
In performing a room survey with a G-M counter, the technologist should first:
(a)perform a battery check on the counter
(b) calibrate the unit
(c) measure each area designated on the survey diagram
(d) perform a wipe test on each designated area
(e) measure the room background
(a) To ensure that the batteries are functional, a battery check should be performed immediately before taking any measurements with a survey meter.
70
A technologist monitors the empty carton from a shipment of [131I]sodium iodide. The container measures 0.08 mR/hr, and room background measures 0.07 mR/hr. The technologist should next:
(a)Notify the RSO.
(b) Dispose of the container as radioactive waste.
(c) Wipe test the container for removable contamination.
(d) Obliterate any radiation symbols and dispose of teh container in regular trash.
(e) Notify the NRC.
(d) the exposure rate of the packing material is approximately the same as room background, so the carton may be disposed of in the regular trash after any radiation symbols are removed or obliterated.
71
A patient received 5 mCi of [131I]sodium iodide for treatment of hyperthyroidism. The patient should adhere to all of the following instruction EXCEPT:
(a)Minimize close contact with others.
(b) Remain at home at least 30 days.
(c) Use separate personal utensils for first week after therapy.
(d) Drink plenty of liquids.
(e) Wash hands after using the toilet
(b) Patients should be given instructions to follow for 3-7 days that will minimize spread of contamination and radiation exposure to others.
72
If a patient must be hospitalized in isolation after receiving a high activity of 131I, which of the following signs must be placed on the door of the isolation room?
(a)"Authorized Personnel Only"
(b) "Caution: Airborne Radioactivity"
(c) "Reverse Isolation Procedures Required"
(d) Length of time a visitor may stay in the room
(e) Sign-in sheet to record name and age of each visitor
(d) If a person is hospitalized after administration of a therapeutic dosage of 131I, the door of the room must have signage that indicates the length of time a visitor may stay.
73
According to the NRC, written instructions must be provided to a patient who has received radionuclide therapy when:
(a)the patient is a female of childbearing age
(b) the patient resides with children younger than 18 years of age
(c) the patient is under the age of 18 years old
(d) every patient must receive instructions, regardless of dosage
(e) another individual may receive an exposure greater than 0.1 Rem (1mSv) from the patient
(e) NRC regulations state that written instructions for precautions must be provided to the patient or the patient's parent or guardian if any individual is likely to exceed 0.1 Rem (1 mSv) exposure from the therapy patient.
74
Radionuclide - Calculated value - Measure value
57Co - 80.6 uCi -71.0 uCi
137Cs - 62.3 uCi - 55.9 uCi
On the basis of these results, which of the following statement is TRUE?
(a)The wrong radionuclides were used to perform his test.
(b) The instrument should be repaired or replaced.
(c) Too much radioactivity was used to perform his test.
(d) The instrument accurately measures radionuclides of different energies.
(e) Insufficient radioactivity was used to perform this test.
(b) The standard of practice for performing a dose calibrator accuracy test calls for the use of at least two long-lived reference sources. The measured value should be within +-10% of the calculated value. If the instrument fails to meet this standard, it should be repaired or replaced.
75
When the radiation level coming from a radioiodine therapy patient in isolation is measured, it should be measured:
(a)every day
(b) every day at the same time
(c) at the same distance from the patient each time
(d) every day and at the same distance from the patient each time
(e) at different distances from the patient each time
(d) It is important to monitor a radioiodine therapy patient daily to determine the earliest possible release from isolation. The measurement should be performed using the same instrument and counting geometry each time the radiation level is monitored to permit comparison of measurements
76
Patient preparation for 131I therapy for thyroid cancer includes all of the following EXCEPT:
(a)ruling out pregnancy
(b) diet restrictions
(c) reviewing isolation requirements
(d) discontinuing breast-feeding
(e) administering oral potassium iodide
(e) In preparation for 131I therapy for thyroid cancer, the patient will have to be instructed about the requirements and limitations associated with being in isolation. If the patient is female, a pregnancy test MUST BE PERFORMED IMMEDIATELY BEFORE THE RADIOIODINE IS ADMINISTERED. PREGNANCY IS AN ABSOLUTE CONTRAINDICATION to 131I therapy. If the woman is breast-feeding, she must discontinue this activity. Oral potassium iodide may be administered to personnel who are exposed to airborne radioiodine as a means of preventing tracer uptake in the thyroid gland.
77
Patient preparation for a 131I therapy includes:
(a)a low-iodine diet for 1 week before the therapy
(b) a high-iodine diet for 1 week before the therapy
(c) a low-carbohydrate diet fro 3 days before the therapy
(d) not consuming any salt for 1 week before the therapy
(e) not consuming potassium for 1 week before the therapy
(a) Patient preparation for 131I therapy includes a low iodine diet for 1 week prior to therapy to help increase the ability of the thyroid gland or metastatic cancer as a whole to uptake the radioactive 131I versus stable iodine. This will allow for a better uptake of the 131I.
78
Which of the following steps is performed before the administration of [90Y]ibritumomab tiuxetan therapy?
(a)determining PSA level
(b) fasting for 8 hr
(c) NPO from midnight before the study
(d) intravenous hydration for 4 hr
(e) whole-body imaging with [111In]ibritumomab tiuxetan
(e) Before administration of [90Y]ibritumomab tiuxetan therapy, a whole-body image is performed with [111In]ibritumomab tiuxetan to assess the biodistribution of the antibody and to identify areas of normal tissue that may be at risk of exposure to a high radiation dose because of proximity to the tumor.
79
According to NRC regulations, reports of medical events sent to the NRC must include all of the following information EXCEPT:
(a)whether the patient or a relative was notified
(b) a description of the incident
(c) the patient's name
(d) the referring physician's name
(e) why the event occurred
(c) According to the NRC, reports of medical events made to the NRC should contain the following information: names of all individuals involved in the event except the patient, whether the patient or a relative was notified, a description of the incident and why it occurred, the effect on the patient, and remedial actions to prevent recurrence. The patient must NOT be identified to the NRC.
80
According to NRC regulations, which of the following signs should be posted on the door of a radiopharmacy laboratory in which radiation levels have been measured to be 7.5 mR/hr?
(a)"Caution: Radiation Area"
(b) "Caution: Radiation Materials"
(c) No posting is required.
(d) "Caution: High Radiation Area"
(e) "Caution: Very High Radiation Area"
(a) The NRC requires that restricted areas, such as a radiopharmacy lab, be posted with specifically worded signs depending on the radiation level present. A "Caution: Radiation Area" sign should be posted when an individual could receive more than 5 mRem in an hour.
81
To comply with NRC regulations, personnel radiation exposure records must be maintained:
(a)for 3 years
(b) indefinitely
(c) for 5 years
(d) for 5 years
(e) for 7 years
(b) According to the NRC, personnel radiation exposure records must be retained indefinitely.
82
Which of the following materials is the best choice for shielding 32P?
(a)lead
(b) aluminum
(c) plastic
(d) No shielding is required for 32P
(e) tungsten
(c) 32P is a pure beta-emitting radionuclide. When it is placed in shielding material of a higher atomic number (Z), such as lead or aluminum, bremsstrahlung radiation is produced. this type of x-radiation results from the deceleration of beta particles as they approach the positively charged nuclei of the shielding material. As the beta particles slow down, they lose energy that is emitted as an x-ray. Shielding materials of lower atomic number, such as plastic, minimize the production of bremsstrahlung radiation.
83
A technologist is measuring room background with an end-window G-M survey meter. The meter shows the following reading:
(needle at 0.1 and knob at x100)
What should the technologist do next?
(a)Adjust the scale of the meter.
(b) Record the meter reading as the room background.
(c) Choose another area of the room to measure background.
(d) Recalibrate the survey meter.
(e) Check the probe for contamination.
(a) Before any measurements are taken with a survey meter, the meter should be set on the lowest scale. If the needle of the meter reaches the endpoint at the higher end of the scale, the scale should be adjusted upward until the needle registers a value between zero and the high endpoint of the scale.
84
During a routine room survey for radioactive contamination, a technologist identifies an area on the floor that exceeds the trigger level. Which of the following should the technologist do next?
(a)Determine the identity of the radionuclide present in the contaminated area.
(b) Ascertain the source of the contamination.
(c) Perform a dose calibrator background determination.
(d) Cover the area until it has decayed to background level.
(e) Perform a wipe test to determine if the contamination is removable.
(e) The trigger level is the exposure rate at which decontamination is performed. this level is set by each licensee with the assistance of the radiation safety officer. A wipe test will determine whether the contamination is removable. If the contamination is removable, decontamination of the site should be carried out until he exposure rate is below the trigger level
85
Nurses caring for 131I therapy patients who require isolation should be advised that the major sources of contamination include the patient's:
(a)feces, urine, and blood
(b) urine, saliva, and perspiration
(c) blood and urine
(d) sputum and blood
(e) feces and blood
(b) For up to about 1 week after administration of [131I]sodium iodide, iodine that is not bound to thyroid hormone is found in the urine, perspiration, sputum, and saliva. These body fluids are the major sources of contamination from an 131I therapy patient.
86
According to NRC regulations, a technologist cannot use a diagnostic dosage that exceeds 20% of the dosage prescribed by the authorized user unless:
(a)There is no other radiopharmaceutical available.
(b) The patient weighs more than 20% over the standard reference weight.
(c) The authorized user approves the individual dosage.
(d) The patient's physician approves the individual dosage.
(e) The radiologist or nuclear medicine physician approves the individual dosage.
(c) According to NRC regulations, a dosage cannot be administered if the activity falls outside the range established by the authorized user or differs from the prescribed dosage by 20% or more, unless the authorized user directs the dosage to be administered.
87
If a woman who is breast-feeding needs 131I therapy for treatment of thyroid cancer, how long must she suspend breast-feeding?
(a)48 hr
(b) 1 week
(c) She may not resume it with this child.
(d) Suspension of breast-feeding is not necessary in this case.
(e) 72 hr
(c) According to the NRC, a woman who is breast-feeding should completely cease breast-feeding after she has received [131I]sodium iodide.
88
According to the NRC, wipe-test results must be reported as:
(a)cpm
(b) mR/hr
(c) dpm
(d) mRem/hr
(e) mCi/mL
(c) According to the NRC, wipe test results must be reported in dpm.
89
A package containing radiopharmaceuticals is delivered before the nuclear medicine department opens. According to the NRC, the package must be checked in and monitored:
(a)as soon as the department opens
(b) within 3 hr after the department opens
(c) within 6 hr after the department opens
(d) within 24 hr of the time of delivery
(e) within 48 hr of the time of delivery
(b) NRC regulations state that packages containing radioactive material must be monitored no later than 3 hr after delivery during regular working hours or within 3 hr of opening the department for the workday if the package was delivered after hours.
90
Which of the following radiation safety measures should be used when performing 89Sr therapy?
(a)use of lead vial and syringe shields
(b) monitoring patient radiation levels daily
(c) use of absorbent paper in isolation room
(d) monitoring patient radiation levels weekly
(e) urinary catheterization for incontinent patients
(e) It is recommended that incontinent patients receiving [89Sr]chloride be catheterized to minimize the spread of contamination. Because 89Sr is primarily a beta emitter (less than 1% gamma emission), it is not necessary to place patients in isolation or monitor them with a survey meter. Lead shielding should not be used with this beta emitter because bremsstrahlung radiation will be produced in the shielding.
91
According to NRC regulations, records of patient dosage determinations must be retained for how long?
(a)7 years
(b) 5 years
(c) 10 years
(d) indefinitely
(e) 3 years
(e) The NRC requires that patient unit dosage records be retained for 3 years.
92
The NRC defines an unrestricted area as one in which an individual will receive less than how many milliRems in an hour?
(a)2 mRem
(b) 5 mRem
(c) 50 mRem
(d) 100 mRem
(e) 500 mRem
(a) According to the NRC, an unrestricted area is one in which access is not limited by or under control of a licensee and one in which an individual will receive less than 2 mRem in any hour.
93
The NRC requires that all of the following information be included in unit dosage measurement records EXCEPT the:
(a)date of measurement
(b) time of measurement
(c) patient's name
(d) radiopharmaceutical name
(e) dose calibrator make and model number
(e) According to the NRC, dosage measurement records must include the radiopharmaceutical, the patient's name of identification number (if one assigned), the prescribed dosage, the determined dosage (or notation that the dosage is less than 30 uCi or 1.1 MBq), the date and time of the measurement, and the name of the person who measured the dosage.
94
According to the NRC, a written directive for the administration of [89Sr]chloride must include all of the following information EXCEPT:
(a)patient's Social Security number
(b) radiopharmaceutical name
(c) route of administration
(d) signature of an authorized user
(e) patient's name
(a) A written directive for administration of a therapeutic dosage other than [131I]sodium iodide must include the patient's name, the radioactive drug, the route of administration, and the dosage to be administered. It must be dated and signed by the authorized user before the dosage is administered.
95
Which of the following monitoring techniques should be employed to rule out internal contamination after handling a radioiodine solution?
(a)thyroid uptake 24 hr after handling the solution
(b) urine counts 2-4 hr after handling the solution
(c) plasma counts 24 hr after handling the solution
(d) pocket dosimeter reading
(e) G-M meter reading
(a) Iodine is taken up into the thyroid gland whether it is ingested, inhaled, or absorbed through the skin. Therefore, using an uptake probe to measure radioiodine uptake the day after handling a radioiodine solution is the method of choice.
96
When surveying for contamination, which of the following diagrams depicts the correct position of the probe of an end-window G-M meter in relation to the surface being monitored?
(a)tilted
(b) 1/2" away
(c) directly on the surface
(d) 6" away
(c) The flat end-window of a G-M meter is the area sensitive to radiation. Therefore, when surveying for surface contamination, the end of the probe should be placed directly over the area being surveyed. To avoid contaminating the probe, the probe should not touch the surface and should be kept approximately 1.5 inch from the surface.
97
The first step in the radioactive decontamination of personnel is to:
(a)Immediately place the contaminated person in a shower.
(b) Wash contaminated areas of the skin with soap and water.
(c) Remove the contaminated person from the site of the spill.
(d) Remove any articles of contaminated personal or protective clothing.
(e) Establish hot and cold zones.
(d) Most contamination may be eliminated by removing personal clothing or protective garb, such as gloves or lab coats. Once contaminated clothing is removed, decontamination of skin surfaces should begin.
98
According to NRC regulations, a written directive must be retained:
(a)for 1 year
(b) indefinitely
(c) for 5 years
(d) for 3 years
(e) for 7 years
(d) According to the NRC, written directives must be retained for 3 years.
99
According to the NRC, patient dosage records must be retained for how many years?
(a)3 year
(b) 1 years
(c) 5 years
(d) as long as the facility's license is in effect
(e) 7 years
(a) According to the NRC, patient dosage records must be retained for 3 years.
100
If a technologist receives dosimeter readings that are nearly equal to the NRC limits, which of the following is the most appropriate action?
(a)The technologist must cease working in a radiation area.
(b) The technologist can work in a radiation area but must limit exposure.
(c) The RSO must reassign the technologist to non-radiation exposure work areas.
(d) The RSO must give the technologist a written warning.
(e) The RSO must review the technologist's work habits.
(e) If an occupationally exposed worker has an exposure reading that approaches the NRC limits, the RSO is required to review the individual's work habits to determine what changes can be made to decrease exposure.
101
According to the NRC, records of survey meter calibration are retained for how long?
(a)7 years
(b) 5 years
(c) as long as the instrument is in use
(d) as long as the facility license is in effect
(e) 3 years
(e) The NRC requires that survey meter calibration records be retained for 3 years. It does not require records for daily constancy tests.
102
According to the NRC, how often must survey meters be calibrated?
(a)daily
(b) before each use
(c) annually
(d) monthly
(e) bi-annually
(c) According to NRC regulations, survey meters must be calibrated before first use, annually, and after each repair.
103
A post-surgery patient is in the nuclear medicine department for a study. The technologist notices that the patient's surgical dressing shows signs of drainage. The most appropriate action for the technologist is to:
(a)Reinforce the dressing with additional gauze and notify the appropriate medical personnel.
(b) Remove the old dressing and replace it with a fresh one.
(c) Terminate the study and transport the patient back to his/her room.
(d) Complete the nuclear medicine procedure and ignore the dressing.
(e) Remove the dressing and drain the wound.
(a) The technologist should report the drainage and reinforce the original dressing with additional dressing until appropriate medical personnel are available to address the patient's needs.
104
According to NRC regulations, which of the following signs should be posted in unrestricted areas?
(a)"Caution: Radioactive Materials"
(b) "Authorized Personnel Only"
(c) No posting is required.
(d) "Caution: Radiation Area"
(e) "Caution: High Radiation Area"
(c) According to the NRC, an unrestricted area is one in which access is not limited by or under control of a license. Unrestricted areas are not posted.
105
According to the NRC, decay in storage records must include the date that the radioactive material was:
(a)calibrated
(b) received
(c) placed in storage
(d) disposed
(e) produced
(d) According to the NRC, records of radioactive materials that are allowed to decay in storage must include the date of disposal, survey instrument used, background level of radiation, radiation level at the surface of the waste container, and name of the individual who performed the survey.
106
According to the NRC, areas where therapeutic radiopharmaceuticals are prepared or administered must be surveyed:
(a)weekly
(b) monthly
(c) quarterly
(d) after each therapeutic dosage is prepared or administered
(e) at the end of each day a therapeutic dosage is prepared or administered
(e) NRC regulations require a survey of areas where radiopharmaceuticals that require a written directive are prepared for administered. This would include therapeutic radiopharmaceuticals and dosages of 131I greater than 30 uCi. the survey is to be performed at the end of the day. As of October 2002, the NRC no longer requires daily surveys and weekly wipe tests. Instead it allows facilities to establish a survey and wipe test schedule. the schedule must be reasonable, based on the need to determine radiation levels, concentrations or quantities of radioactive materials, and potential radiological hazards.
107
According to the NRC, the NRC and the final delivery carrier must be notified if the exposure rate at the surface of a package containing radioactive materials exceeds:
(a)100 mR/hr
(b) 2,000 mR/hr
(c) 1,000 mR/hr
(d) 200 mR/hr
(e) 10 mR/hr
(d) According to the NRC, both the NRC and the final delivery carrier must be notified if the exposure rate of a radioactive package is in excess of 200 mR/hr at the package surface or in excess of 10 mR/hr at 3 ft from the package surface.
108
Contamination on the surface of the skin is best removed by:
(a)flushing the area with hot water
(b) cleansing the area with lukewarm water and detergent
(c) scrubbing the area with a stiff brush
(d) rubbing the area with an abrasive cleanser
(e) cleansing the area with hydrogen peroxide
(b) Decontamination of the skin should be attempted with a mild detergent and lukewarm water to avoid irritating the skin. Abrasive materials, scrubbing, and hot water all can increase absorption of the radioactivity through the skin.
109
According to NRC regulations, which of the following concerning restricted areas is TRUE?
(a)Patient rooms become restricted areas after the patient has received a radiopharmaceutical.
(b) Only areas where radiopharmaceuticals are stored must be designated as restricted areas.
(c) Radiation area monitors are required in restricted areas.
(d) Restricted areas must be locked when authorized personnel are not present.
(e) Everyone entering or leaving a restricted area must be surveyed.
(d) The NRC requires that access to restricted areas must be limited to prevent individuals from being exposed to radiation or radioactive materials that may cause undue risk. To control access, restricted areas must be locked when authorized staff are not present.
110
Which of the following must be performed before a package containing radioactive materials can be returned to a vendor?
(a)Confirm that the exposure rate does not exceed background levels.
(b) Perform a wipe test to assure there is no surface contamination.
(c) Cover each individual vial with a waterproof covering.
(d) Notify the NRC that a shipment is being made.
(e) Performing a calibration check on the dose calibrator.
(b) DOT regulations require that a survey of the package be performed to verify that there i no surface contamination before shipping packages containing radioactive materials.
111
Which of the following personnel monitors would be appropriate for use when monitors are changed at 3 mo intervals?
(a)TLD or OSL
(b) TLD
(c) OSL
(d) film badge
(e) pocket dosimetry
(a) Either a TLD or an OSL can be used because the accuracy of the reading is not affected by time. The film in a film badge may begin to fog within this period of time. which may result in inaccurate exposure readings.
112
Which of the following instruments is most appropriate for detecting low-level accidental contamination?
(a)thermoluminescent dosimeter
(b) cutie pie (ionization chamber)
(c) Geiger-Mueller counter
(d) pocket dosimeter
(e) optically stimulated luminescence dosimetry
(c) The Geiger-Mueller (G-M) counter is best suited for detecting low-level contamination because it is sensitive to exposure rates just above background, although the readings are not as accurate as those obtained with an ionization chamber. The G-M has a quicker response time compared with the ionization chamber. Although a pocket dosimeter can give an immediate reading, it cannot be used to localize contamination.
113
Which of the following radiation monitoring devices is best suited to survey a patient who has received 150 mCi of 131I for therapy?
(a)pocket ionization chamber
(b) portable ionization chamber
(c) Geiger-Mueller counter
(d) dose calibrator
(e) liquid scintillation counter
(b) A portable ionization chamber, sometimes referred to as a cutie pie, is used to measure areas of high photon intensity. This instrument gives a direct measurement of the total number of ion pairs produced per unit time and, therefore, is more accurate than a Geiger-Mueller counter when surveying a large amount of radioactivity.
114
Which of the following area posting signs would NOT normally be found in a hospital?
(a)"Grave Danger: Very High Radiation Area"
(b) "Caution: Radiation Area"
(c) "Caution: High Radiation Area"
(d) "Caution: Radioactive Materials"
(e) "Caution: Very High Radiation Area"
(a) In areas where personnel would receive life-threatening doses of radiation such as levels over 500 R/hr, the sign "Grave Danger: Very High Radiation Area" would be used. It is unlikely that materials with an activity of lethal dose levels would be stored on the premises of a hospital.
115
Which of the following type of survey instruments would be best to use to survey a spill for removable contamination in a hot lab area where radioisotopes are being stored?
(a)G-M detector
(b) personal pocket dosimeter
(c) well counter with a wipe test
(d) dose calibrator with a wipe test
(e) cutie pie
(c) G-M detectors are used to survey large areas for contamination that may not always be removable. Pocket dosimeters are used to measure personnel exposure. Dose calibrators are used to measure activity in patient doses. Scintillation probes can be used to detect removable and non-removable contamination at a higher efficiency than G-M detectors because of its use of a sodium iodide-thallium crystal. Most often, wipe tests with a well counter are used to check for removable contamination.
116
An uptake probe is what type of detector?
(a)Geiger-Muller counter
(b) proportional counter
(c) ionization chamber
(d) scintillation detector
(e) cutie pie
(d) To count radioactivity in a person, a probe system is often used. The probe consists of a sodium iodide crystal with PMT, electronics, and collimator.
117
The difference between a direct radiation survey and a wipe check radiation survey is that:
(a)There is none.
(b) One is qualitative and one is not.
(c) One is quantitative and one is not.
(d) One breaks bonds and the other does not.
(e) One gives an instant reading and one does not.
(e) The direct radiation survey will give an instant reading, while the wipe check does not give an instant reading.
118
For an occupational worker who has received 14,000 mRem of exposure to the eyes in 1 year on his/her eye dose dosimeter, which course of action would be appropriate?
(a)Recommend eye chelation therapy.
(b) Review ALARA standards to reduce exposure because because s/he is close to exceeding their annual eye dose limit.
(c) Review ALARA standards to reduce exposure because s/he has exceeded his/her annual eye dose limit.
(d) Recommend s/he use leaded eyeglasses to reduce exposure.
(e) Recommend s/he use thyroid shields.
(b) An occupational radiation worker is allowed up to 15,000 mRem/yr dose to the eye. Since this worker is close to but not exceeding the yearly dose, a review of the ALARA concept and a dedicated reduction in eye exposure in the future is recommended.
119
A nuclear medicine department has an action level of 500 mRem per month whole-body exposure. If you were the NRC inspector, what would you recommend to this site?
(a)Reduce their action level to at least 410 mRem per month to be compliant with annual possible levels of exposure.
(b) Reduce their action level to at least 450 mRem per month to be in compliance with annual possible levels of exposure.
(c) Increase their action level to 5000 mRem per month
(d) Nothing, everything is fine
(e) Reduce their action level to at least 430 mRem per month to be compliant with annual possible levels of exposure.
(a) It is recommended that a radiation occupational worker who is using radiation stay under 410 mRem per month. This limit will keep the worker's radiation levels within the NRC regulations of 5,000 mRem per year whole-body dose.
120
In doing a room survey, you discover that a therapy patient's room has removable contamination above acceptable levels. What is the acceptable level?
(a)<367 Bq/100 cm^2
(b) <200 MBq/100 cm^2
(c) <12,000 Bq/100 cm^2
(d) <200 Bq/100 cm^2
(e) <15,000 Bq/100 cm^2
(a) To stay in compliance with NRC regulations, the room radiation levels must be below this level of removable contamination: <367 Bq/100cm^2 or 22,000 dpm/100cm^2
121
You suspect that a low-level B emitter has been spilled on a countertop. Which of the following survey techniques would be best?
(a)wipe-check with a SCA/MCA-type meter
(b) scintillation probe-type meter
(c) wipe-check with a G-M-type meter
(d) pancake probe G-M-type meter
(e) wipe-check with a pocket dosimeter
(a) Performing a wipe check with a SCA/MCA would be the best method because it is able to detect the low energies form the beta emitter.
122
Form X or NRC Form 3 includes all of the following EXCEPT:
(a)The employer must abide by the state and federal regulations.
(b) The worker is required to become familiar with the regulations and operating procedures for the work engaged in.
(c) The worker must abide by the state and federal regulations.
(d) The employer will make available to the worker a copy of all applicable state and federal regulations, licenses, and operating procedures pertaining to the work.
(e) The employer is not required to post any notices of violations of the regulations involving radiological working conditions.
(e) According to the NRC, the employer is required to post any notices or violations of the regulations to employees.
123
The triblade radiation symbol must be which of the following colors on a yellow background?
(a)green
(b) red
(c) purple
(d) brown
(e) gray
(c) Radiation warning signs consist of a purple, magenta, or black tri-blade symbol on a yellow background.
124
When a DOT II radioactive label on a package reads 9 mR/hr at 1 m, what is the appropriate action to take?
(a)Log in the package as you normally would.
(b) Contact the regional office of the NRC.
(c) Inform the vendor that the wrong label was on the container.
(d) Notify the DOT that a "shipment event" has occurred.
(e) Notify the DOT that a "medical event" has occurred.
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(c) If a package reads 9 mRem/hr at 1 meter, it should have a DOT yellow III shipping label. A DOT Yellow II shipping label is limited to a reading of 1 mRem/hr at 1 m. When a package arrives with the wrong label, the vendor should be contacted.
DOT I (white)
At contact, not more than 0.5 mR/hr
At 3 feet (1 m), no detectible radiation (NDR)
DOT II (yellow)
At contact, not more than 50 mR/hr
At 3 feet (1 m), not more than 1 mR/hr
DOT III (yellow)
At contact, not more than 200 mR/hr
At 3 feet (1 m), not more than 10 mR/hr
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125
Gas amplification is a phenomenon associated with instruments that operate in which region of the gas curve for radiation detectors?
(a)recombination
(b) ionization
(c) proportional
(d) continuous discharge
(e) G-M
(c) Within the proportional region of the characteristic voltage curve for gaseous detectors, charged particles collide with gas molecules to produce additional ionization events. This additional ionization results in an amplified current that is proportional to the number of original ion pairs created by the incident radiation. Because ions collide with gas to create an amplified current, this occurrence is called gas amplification.
126
Which of the following is/are medical event(s) according to the NRC?
(a)A second dose of [99mTc]MAA is administered after the first is inadvertently infiltrated.
(b) [99mTc]DTPA for renal function imaging is requested by the referring physician, but [99mTc]mertiatide is prescribed by the nuclear medicine physician.
(c) A [131I]sodium iodide (15 mCi) is prescribed for therapy, but 19 mCi are administered.
(d) A myocardial perfusion dose is given to a therapy patient by mistake.
(e) A second dose of [99mTc]medronate is administered after the first is inadvertently infiltrated.
(c) Since this is a therapy dose, it must be within +-20% of the prescribed dose. 20% of 15 mCi is 3 mCi, and 3 + 15 = 18 mCi. 18 mCi is thus the maximum that can be given, so 19 mCi would be considered a medical event in this case.
127
The medium that interacts with radiation (sensitive volume) in a pocket dosimeter is:
(a)NaI
(b) LiF
(c) Al2O3
(d) gas
(e) liquid
(d) Pocket dosimeters are ionization chambers. Ionization chamber instruments are operated in the ionization region of the gas amplification curve and are filled with gas.
128
The dose response in humans at around 2 Sv is:
(a)permanent hair loss
(b) permanent sterility
(c) GI syndromes
(d) CNS syndrome
(e) radiation sickness
(e) At a minimum whole-body dose of 2 Sv (200 Rem), radiation sickness will be observed.
129
All of the following organs are very sensitive to radiation-induced carcinogenesis EXCEPT:
(a)active bone marrow
(b) thymus gland
(c) thyroid gland
(d) female breast
(e) lungs
(b) The organs that are most sensitive to radiation-induced carcinogenesis are the active bone marrow, thyroid, female breasts, and lungs.
130
Chances of congenital abnormalities are high if the fetal irradiation is during which gestational age?
(a)pre-implantation
(b) first trimester
(c) second trimester
(d) third trimester
(e) post-partum
(b) Irradiation during organogenesis is the period of most concern. For this reason, it is often noted that radiation should be particularly limited during the first trimester.
131
According to the NRC, records of surveys must be retained for how long?
(a)1 year
(b) 3 years
(c) 5 years
(d) 10 years
(e) indefinitely
(b) Records of surveys must be retained for 3 years.
