Nuclear Medicine Technology
Exam Materials
Course Introduction
Nuclear Medicine Technology is a specialized field within medical imaging that focuses on the use of radioactive substances (radiopharmaceuticals) to diagnose, evaluate, and treat various diseases. This course provides an in-depth understanding of the principles of nuclear physics, radiation safety, and the operation of imaging equipment such as gamma cameras and PET scanners. Students learn patient care procedures, the preparation and administration of radiopharmaceuticals, image acquisition and analysis, and the interpretation of results in collaboration with physicians. Emphasis is placed on both the theoretical knowledge and practical skills necessary for a career as a nuclear medicine technologist, including adherence to ethical standards and protocols for ensuring patient and staff safety.
Recommended Textbook
Nuclear Medicine and PETCT Technology and Techniques 8th Edition by Kristen M. Waterstram
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Page 2
Chapter 1: Mathematics and Statistics
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Sample Questions
Q1) Readers are encouraged to use Microsoft Excel to solve this problem.In a nuclear medicine technology training program, the students wonder if their final exam grade in their training program is related to their subsequent board score on the NMTCB exam.The five students attain the following pairs of scores (exam score, board score) = (72, 60), (84, 74), (88, 71), (68, 60), (91, 79).What is the linear correlation coefficient, r, between exam score and board score?
A)0.99
B)0.95
C)0.86
D)0.75
Answer: B
Q2) Readers are encouraged to use Microsoft Excel to solve this problem.What is the coefficient of variation (CV) of the following five numbers: 6.40, 7.20, 3.50, 9.20, 5.10?
A)34%
B)31%
C)28%
D)12%
Answer: A
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Chapter 2: Cell and Molecular Biology
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Sample Questions
Q1) The process by which a gene is used as a template to transcribe messenger RNA (mRNA) is termed:
A)gene mutation.
B)gene expression.
C)regulation.
D)post-translation modification.
Answer: B
Q2) Which term denotes the process by which a gene is transformed into messenger RNA (mRNA)?
A)Transcription
B)Initiation
C)Translation
D)Synthesis
Answer: A
Q3) The phases of mitosis are
A)interphase, metaphase, synthesis, and replication.
B)telophase, mitosis, interphase, and S-phase.
C)G<sub>0</sub>, G<sub>1</sub>, interphase, and S-phase.
D)prophase, metaphase, anaphase, and telophase.
Answer: D
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Chapter 3: Chemistry/biochemistry
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Sample Questions
Q1) Nitrate has a
A)neutral charge.
B)-3 charge.
C)+1 charge.
D)-1 charge.
Answer: D
Q2) The physical properties of a substance may be affected by a change in conditions.If this occurs, when the substance returns to its original condition, the physical properties
A)result in the formation of one or more "new" substances.
B)will be the same as the initial properties.
C)will still be different because they cannot have their change reversed.
D)result in a change of physical state.
Answer: B
Q3) Avogadro's number is
A)the ratio of the weight of each element in a compound.
B)equal to the atomic mass of an element.
C)the number of atoms or molecules in 1 gaw or gmw.
D)the electron configuration of an element.
Answer: C
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Page 5
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Sample Questions
Q1) A patient is having a reaction to regadenoson.The technologist should ensure the availability of a dose of A)nitroglycerin.
B)aminophylline.
C)morphine.
D)nothing; it has rapid reversal.
Q2) A patient is having a reaction during dipyridamole stress testing manifesting as bronchospasm.The technologist should ensure the availability of a dose of A)nitroglycerin.
B)aminophylline.
C)morphine.
D)nothing; it has rapid reversal.
Q3) A concentration of aluminum of 15 \(\mu\)g/ml in the preparation of a <sup>99m</sup>Tc-labeled radiopharmaceutical
A)would have no affect on a scan.
B)could result in liver uptake.
C)is within the NRC limits.
D)is necessary for proper tagging.
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Chapter 5: Radiation Safety in Nuclear Medicine
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Q1) Ionization meters should be used when surveying
A)contamination.
B)large sources of radioactivity.
C)very small sources of radioactivity.
D)background radiation.
Q2) A package with a Transportation Index (TI) of 3 would indicate to the technologist that the package
A)contains 3 mCi of radioactive material.
B)will read 3 mrem on the surface.
C)will read 1 mrem at 3 m.
D)will read 3 mrem at 1 m.
Q3) A right-handed nuclear medicine technologist puts on a ring badge before work.The ring should probably be worn
A)on the right hand with the thermoluminescent dosimeter (TLD) chip facing the palm of the hand.
B)on the right hand with the TLD chip facing the back of the hand.
C)on the left hand with the TLD chip facing the palm of the hand.
D)on the left hand with the TLD chip facing the back of the hand.
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Chapter 6: Patient Care
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Q1) A draw sheet is used with patients to A)protect the bedding from possible patient incontinence.
B)provide added warmth.
C)provide added cushioning.
D)aid in patient transfer.
Q2) When transferring an orthopedic or a neurologically impaired patient into a wheelchair, the technologist should:
A)position the patient's strongest side toward the area to which the patient is being transferred.
B)position the wheelchair at a 90-degree angle with the bed.
C)use restraints for patient safety.
D)hold the patient around his or her waist.
Q3) Before the administration of ROCM, the technologist should know the patient's A)BUN level.
B)creatinine level.
C)T<sub>4</sub> level.
D)alkaline phosphatase level.
Q4) MR contrast media is administered in high doses compared to CT contrast media. A)True B)False
Page 8
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Chapter 7: Department Administration
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Q1) Which legal branch of the federal government has billing compliance program resources?
A)Office of Inspector General
B)Supreme Court
C)Drug Enforcement Agency
D)Food and Drug Administration
Q2) Which term is defined as the aggregate of activities such as design analysis and inspection of defects to ensure adequate quality?
A)Quality improvement
B)Quality assurance
C)Quality control
D)Quality management
Q3) A term used with respect to third-party designation of an institution meeting criteria established by experts in the field is A)registration.
B)certification.
C)credentialing.
D)accreditation.
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9
Chapter 8: Clinical Research
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Q1) What is the code of clinical research practices followed by sponsors and researchers on an international level?
A)HIPAA
B)Good Clinical Practice
C)ALCOA
D)Common Rule
Q2) The Food and Drug Administration governs clinical research performed by
A)the Department of Agriculture.
B)manufacturers of drugs, devices, and biologicals.
C)the Nuclear Regulatory Agency.
D)all investigators.
Q3) Which term is used to denote the type of clinical research that involves the testing of interventions on health-related outcomes?
A)Clinical practice
B)Clinical trial
C)Developmental research
D)Developmental trial
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Chapter 9: Health Informatics in Imaging
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Q1) When using nine-point image smoothing, all of the following is true EXCEPT
A)there is a slight increase in image resolution.
B)there is a slight decrease in image resolution.
C)there is a blending of pixel values.
D)it creates a more aesthetic image.
Q2) The image density for each pixel is determined by A)the gamma-ray counts stored within a pixel.
B)the ratio of the z pulse to the x and y pulse.
C)the counts detected minus the rollover counts.
D)size of the matrices in which the pixels configured.
Q3) The quality of the cardiac data during a MUGA can be compromised by A)breathing.
B)bradycardia.
C)tachycardia.
D)PVCs.
Q4) Dynamic data acquisition during a multiple gated acquisition is linked to the A)P wave.
B)R wave.
C)SA node.
D)Q wave.
Page 11
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Chapter 10: Physics of Nuclear Medicine
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Sample Questions
Q1) Isotopes are different forms of a specific element that have
A)a different number of protons.
B)a different number of neutrons.
C)a different number of electrons.
D)a different atomic mass.
Q2) All of the following are true about bremsstrahlung radiation EXCEPT
A)it occurs when a beta particle is deflected and slowed in its path.
B)there is a low probability of occurrence when shielding beta particles with lead.
C)its probability increases when shielding betas with materials that have a high Z number.
D)it is the method used to produce x-rays in computed tomography (CT) scanners.
Q3) Assuming the biological half-life of <sup>99m</sup>Tc-MAA is 3 hours, what would be the effective half-life?
A)0.3 hour
B)0.5 hour
C)2 hours
D)3 hours
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Page 12
Chapter 11: Instrumentation
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Sample Questions
Q1) Which detector is confined for use in detecting radiation where the exposure levels are below 2000 mR/hr?
A)Ionization chamber
B)Dose calibrator
C)GM meter
D)Body badge
Q2) The 360-degree orbit is most often used in SPECT studies EXCEPT for scans of
A)the brain.
B)the heart.
C)the liver.
D)bone.
Q3) For a parallel-hole collimator, spatial resolution degrades as
A)the source-to-collimator distance increases.
B)the source-to-collimator distance decreases.
C)the collimator holes decrease in size.
D)the collimator holes increase in number.
Q4) In SPECT/CT imaging, it is best if the patient does shallow breathing throughout the scan.
A)True
B)False
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Chapter 12: CT Physics and Instrumentation
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Q1) What is a reconstruction kernel?
A)A unit of data in a reconstructed CT image
B)The entire data set used to produce reconstructed images in CT
C)A measurement used to determine the data set used for CT reconstruction
D)An algorithm that defines the clinical application and amount of image smoothing applied in the reconstruction
Q2) In x-ray tubes, the types of reactions that produce x-rays include
A)Bremsstrahlung and scatter.
B)Bremsstrahlung and characteristic.
C)characteristic and scatter.
D)characteristic and refraction.
Q3) Which of the following may be used to reduce streaking artifacts when scanning anatomy with high-density objects?
A)Bow-tie filter
B)Adaptive detector array
C)Thinner collimation
D)Decreased kVp
Q4) Thin collimation has an advantage because it results in faster scanning time.
A)True
B)False
Page 14
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Chapter 13: Pet Instrumentation
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Q1) With PET radionuclides, the higher the energy particle,
A)the greater the mean range for the travel of the positron.
B)the shorter the mean range for the travel of the positron.
C)won't have an effect on the mean range for the travel of the positron.
D)it reduces the mean range for the travel of the positron.
Q2) The BGO crystal
A)is efficient at rejecting scatter photons because of its narrow window.
B)is efficient at rejecting scatter photons because of its wide window.
C)is not efficient at rejecting scatter photons because of its narrow window.
D)is not efficient at rejecting scatter photons because of its wide window.
Q3) The standard uptake value is useful in
A)performing attenuation correction.
B)calculating scatter correction.
C)differentiating between malignant and benign tissue.
D)determining the time span between injection and scan.
Q4) All of the following have been used as crystals for PET imaging EXCEPT A)BGO.
B)LSO.
C)LYSO.
D)YBGO.
Page 15
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Chapter 14: Principles of Magnetic Resonance Imaging
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Sample Questions
Q1) All of the following are true regarding the gyromagnetic ratio EXCEPT
A)it is a constant.
B)it relates angular momentum and magnetic moment.
C)it is characteristic of each nuclei.
D)it relates the number of spin-up and spin-down nuclei.
Q2) T2 refers to the recovery of transverse magnetization.
A)True
B)False
Q3) Diamagnetic substances exhibit
A)no magnetic properties outside of the magnetic field but within an external magnetic field they are slightly repelled and have a negative magnetic susceptibility.
B)no magnetic properties outside of the magnetic field but within a magnetic field they are slightly attracted and have a positive magnetic susceptibility.
C)a strong attraction when exposed to an external magnetic field and can act as a projectile.
D)magnetic properties outside of a magnetic field but within a magnetic field the magnetism is neutralized.
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Chapter 15: Clinical Petct in Oncology
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Q1) Which of the following diagnoses requires a head-to-toe PET scan?
A)Lymphoma
B)Melanoma
C)Colorectal cancer
D)Mesothelioma
Q2) If an injection of contrast media is going to follow an injection of FDG, the technologist should use
A)a butterfly needle to inject.
B)an 18- to 20-gauge intracatheter.
C)an indwelling central catheter.
D)a port-a-cath.
Q3) PET has proved to be effective as a screening tool for colorectal cancers.
A)True
B)False
Q4) An inpatient who is receiving total parental nutrition is scheduled for PET exam at 3:00 PM.Those responsible for his care should
A)discontinue the feeding 2 hours before the study.
B)discontinue the feeding 4 hours before the study.
C)discontinue the feeding 6 to 8 hours before the study.
D)not have to discontinue this type of feeding.
Page 17
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Chapter 16: Central Nervous System
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Q1) A patient is scheduled for a SPECT brain procedure.Before the radiopharmaceutical is administered, the patient should
A)be well hydrated.
B)be placed in a quiet, dimly lit room.
C)have received Lugol's solution.
D)have undergone a CT scan of the brain.
Q2) Which radiopharmaceutical is used for ictal SPECT imaging?
A)(<sup>99m</sup>)Tc-HMPAO
B)(<sup>111</sup>)In-labeled DTPA
C)(<sup>99m</sup>)Tc-pertechnetate
D)(<sup>18</sup>)F-FDG
Q3) All of the following are true about acetazolamide or its use in brain imaging EXCEPT
A)it acts as a vasodilator.
B)it causes increased perfusion.
C)it serves to localize an epileptogenic focus.
D)it improves diagnostic accuracy in cerebral vascular disease.
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18
Chapter 17: Endocrine System
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Q1) When using a <sup>99m</sup>Tc-MIBI double-phase study for imaging the parathyroid gland, after the early phase, the technologist should repeat images
A)20 to 30 minutes after injection.
B)40 to 60 minutes after injection.
C)90 to 120 minutes after injection.
D)24 hours after injection.
Q2) The radionuclide therapy used for the treatment of either hyperthyroidism or thyroid carcinoma is
A)<sup>123</sup>I.
B)<sup>125</sup>I.
C)<sup>131</sup>I.
D)<sup>123</sup>I-MIBG.
Q3) When a patient is administered <sup>99m</sup>Tc-pertechnetate for a thyroid scan, the technologist should take the static images
A)immediately upon injection.
B)5 to 10 minutes after injection.
C)15 to 20 minutes after injection.
D)30 minutes after injection.
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Chapter 18: Respiratory System
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Q1) Which ventilation agent has the longest half-life?
A)(<sup>99m</sup>)Tc-DTPA Aerosol
B)(<sup>133</sup>)Xe
C)(<sup>99m</sup>)Tc MAA
D)All have equal half-lives
Q2) The volume of air breathed out in a normal breath is called
A)total lung capacity.
B)functional residual capacity.
C)residual volume.
D)tidal volume.
Q3) The diameter of macroaggregated albumin (MAA) particles is
A)0.05 to 0.10 µm.
B)0.5 to 5 µm.
C)10 to 90 µm.
D)1 to 2 m.
Q4) The diameter of a normal capillary is approximately
A)0.05 to 0.1 µm.
B)7 to 10 µm.
C)30 to 40 µm.
D)45 µm.
Page 20
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Chapter 19: Cardiovascular System
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Q1) Systole represents the
A)period of ventricular relaxation.
B)period of ventricular contraction.
C)period of atrial contraction.
D)cardiac output.
Q2) When fusing PET and CT or SPECT and CT images of the heart, misregistration can be overcome by taking several steps, including
A)equating the acquisition time between CT and PET or SPECT.
B)blurring the CT data.
C)acquiring PET or SPECT images over a longer period of time.
D)blurring the PET or SPECT data.
Q3) The major categories of radiopharmaceuticals used in cardiac imaging include all of the following EXCEPT
A)perfusion tracers.
B)blood pool tracers.
C)glucose and fatty acid analogs.
D)phosphorous analogs.
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21
Chapter 20: Gastrointestinal System
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Q1) The <sup>99m</sup>Tc-labeled red blood cell technique for imaging a gastrointestinal bleed is preferred by investigators for A)active bleeds.
B)intermittent bleeds.
C)patients with cirrhosis.
D)patients bleeding profusely.
Q2) In a normal hepatobiliary study, one would expect to see the A)gastrointestinal (GI) tract by 30 minutes and gallbladder by 45 to 60 minutes. B)gallbladder by 30 minutes and the GI tract by 45 to 60 minutes.
C)GI tract by 15 minutes and the gallbladder by 30 minutes.
D)gallbladder by 15 minutes and the GI tract by 30 minutes.
Q3) Technetium-99m-sulfur colloid and <sup>99m</sup>Tc-albumin colloid are the radiopharmaceuticals most commonly used for imaging the A)salivary glands.
B)liver and spleen.
C)gallbladder.
D)small intestine.
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Chapter 21: Genitourinary System
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Q1) After the injection of furosemide in a diuretic renal imaging study, the washout activity from the collecting system has a clearance half-time of less than 10 minutes.This is most likely indicative of a(n) A)obstruction.
B)polycystic kidney.
C)dilated but unobstructed kidney.
D)normal kidney.
Q2) A patient is scheduled for a diuretic renal imaging study.The technologist prepares the radiopharmaceutical and A)furosemide.
B)captopril.
C)adenosine.
D)saline.
Q3) Absolute renal function typically refers to the A)blood flow images followed by a sequence of static images. B)ERPF or GFR.
C)evaluation of a renal transplant.
D)relative renal function.
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23
Chapter 22: Skeletal System
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Q1) A patient is entering the osseous phase of a routine three-phase bone scan.The technologist should
A)prepare the room for a dynamic study.
B)begin to take blood pool images.
C)begin to take 2- to 3-hour delayed images.
D)take 5- to 24-hour delayed images.
Q2) Patients having a bone scan should be hydrated between injection and delayed imaging in order to
A)increase heterionic exchange.
B)aid clearance of the radiopharmaceutical from body.
C)aid the osseous phase of the study.
D)increase clarity of the blood pool image.
Q3) In the evaluation of primary bone neoplasms, bone scans
A)are the first step in diagnosis.
B)are used to detect disease elsewhere.
C)are used instead of radiographs for diagnosis.
D)demonstrate the primary bone neoplasm as a photopenic area.
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Chapter 23: Inflammatory Tumoroncology Imaging and Therapy
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Q1) Which organ is the most common site of metastasis for cancers of the abdominal organs?
A)Liver
B)Lungs
C)Bone
D)Brain
Q2) Patient preparation for a <sup>99m</sup>Tc-depreotide study includes
A)hydration prior to and following injection.
B)administration of a thyroid blocking agent.
C)IV administration of a glucose solution.
D)a laxative at 24 hours prior to imaging.
Q3) Following the injection of <sup>67</sup>Ga-citrate, imaging can begin
A)immediately.
B)at 1 hour.
C)at 3 hours.
D)at 6 hours.
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25
Chapter 24: Hematopoietic System
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Q1) Anemia could be the result of all of the following EXCEPT
A)suppression of bone marrow activity.
B)hemolysis.
C)iron deficiency.
D)erythrogenesis.
Q2) The values for a patient that has a 2% standard are: Standard = 9500 cpm
Urine sample = 658 cpm
Urine sample volume = 4 mL
Total urine volume = 1300 mL
The percent excretion for this patient is A)15%.
B)23%.
C)45%.
D)56%.
Q3) When blood is collected with an anticoagulant, the whole blood separates into A)red blood cells (RBCs) and white blood cells (WBCs).
B)plasma and formed elements.
C)serum and cells.
D)platelets and serum.
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