Radiation Therapy Exam Bank
Course Introduction
Radiation Therapy is a comprehensive course that explores the principles, techniques, and clinical applications of using ionizing radiation to treat cancer and other diseases. Students learn about the physics of radiation, treatment planning, patient positioning, and the operation of specialized equipment such as linear accelerators. The course covers radiation biology, safety protocols, and the side effects and management of radiation therapy. Emphasis is placed on interdisciplinary collaboration, ethical considerations, and the critical role of radiation therapists within oncology care teams. Through lectures, laboratory experiences, and clinical simulations, students gain the foundational knowledge and practical skills necessary for safe and effective patient-centered radiation treatment.
Recommended Textbook
Principles and Practice of Radiation Therapy 4th Edition by Washington
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38 Chapters
954 Verified Questions
954 Flashcards
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Chapter 1: Cancer: An Overview
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44 Verified Questions
44 Flashcards
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Sample Questions
Q1) Which of the following is not a term for genes involved in the cancer process?
A) Anti-oncogenes
B) Oncogenes
C) Proto-oncogenes
D) Somato-oncogenes
Answer: D
Q2) Tumors are the result of which of the following?
A) Black bile
B) Necrotic tissue
C) Abnormal cellular proliferation
D) Traumatic injury
Answer: C
Q3) A T<sub>1</sub>N<sub>0</sub>M<sub>X</sub> tumor has how many positive lymph nodes?
A) 0
B) 1
C) 2
D) Unknown Answer: A
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Page 3
Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Q1) What legal document designates an individual as decision maker for a patient who is no longer capable of making decisions?
A) Scope of practice
B) Informed consent
C) Durable power of attorney
D) Living will
Answer: C
Q2) According to the radiation therapist's practice standards, a radiation therapist should meet certain levels of which of the following?
A) Clinical performance
B) Quality performance
C) Professional performance
D) All of the above
Answer: D
Q3) Utilitarianism is an example of which broad group of ethical theories?
A) Teleology
B) Deontology
C) Virtue ethics
Answer: A
Page 4
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Chapter 3: Principles of Pathology
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Q1) Which of the following is the most invasive procedure used to make a diagnosis of cancer?
A) Recovery of exfoliating cells
B) Fine needle aspiration of malignant cells
C) Open biopsy of the tumor
D) Retinoscopy
Answer: C
Q2) Which of the following is a malignant tumor of fat?
A) Chondrosarcoma
B) Ewing's tumor
C) Seminoma
D) Liposarcoma
Answer: D
Q3) The purpose of the staging system for cancer is which of the following?
A) To evaluate the degree of differentiation of tumor
B) To estimate the prognosis of the patient
C) To evaluate the degrees of malignancy
D) To estimate the geographical extent of disease
Answer: D
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Page 5
Chapter 4: Overview of Radiobiology
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Sample Questions
Q1) Fractionation of radiation dose administration to neoplastic tissues has which of the following effects? (Select three.)
A) Reoxygenation of hypoxic tumor cells, thus promotes their sensitivity to subsequent doses
B) Favors repair of radiation injury in normal cells over that of cancer cells
C) Favors repopulation of normal tissues slightly
D) Reduces or blunts the effects of the radiation injury in early responding normal tissues
Q2) What is the typical oxygen enhancement ratio (OER)value for sparsely ionizing radiation?
A) 0.5 to 1.0
B) 1.0 to 2.0
C) 2.5 to 3.0
D) Greater than 3.0
Q3) The TD 50/5 for the optic nerve is approximately _____ Gy.
A) 25
B) 35
C) 50
D) 65
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Chapter 5: Detection and Diagnosis
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Q1) Which of the following statements are incorrect?
A) Ultrasonography uses high-frequency sound waves.
B) CT scans have a higher resolution than radiographs.
C) Magnetic resonance imaging (MRI)scans use ionizing radiation.
D) Most invasive procedures provide some risk to the patient.
Q2) Which of the following is an advantage of digital mammography over conventional mammography with x-ray film?
I.Images are displayed on a computer monitor.
II.Images can be manipulated (lightened or darkened)by the radiologist.
III.Images can be stored and retrieved.
A) I and II
B) II and III
C) I and III
D) I, II, and III
Q3) What was the leading site of new cancer cases in females in 2013?
A) Lung
B) Colon
C) Cervix
D) Breast
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Page 7
Chapter 6: Medical Imaging
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Sample Questions
Q1) Interactions at the anode that produce x-rays may be described as which of the following?
A) Bremsstrahlung radiation
B) Characteristic radiation
C) Compton scattering
D) All of the above
E) Both a and b
Q2) Which technical factor has the most effect on radiographic density?
A) mAs
B) kVp
C) Distance
D) All of the above
Q3) Attenuation is the process by which an x-ray beam ___________________.
A) is focused
B) is reduced in intensity
C) diverges
D) exposes a film
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Chapter 7: Treatment Delivery Equipment
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Sample Questions
Q1) When treating with electrons, the carousel rotates to place a _________________ in the beam to spread it out.
A) collimator
B) cone
C) scattering foil
D) flattening filter
Q2) Which of the following best describes the order in which electron bunches and the resulting x-rays travel through the head of a linear accelerator?
A) Bending magnet, dose chambers, target, flattening filter, wedge
B) Bending magnet, target, dose chambers, primary collimator, wedge, flattening filter
C) Bending magnet, target, primary collimator, flattening filter, wedge, dose chamber
D) Bending magnet, target, primary collimator, flattening filter, dose chamber, multileaf collimator
E) Bending magnet, dose chambers, target, flattening filter, primary collimator, multileaf collimator
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Chapter 8: Treatment Procedures
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Sample Questions
Q1) Which of the following is the measurement of the angle between central rays of two intersecting treatment beams?
A) Wedge angle
B) Hinge angle
C) Isodose angle
D) Central axis angle
Q2) Which of the following clinical situations do not lend themselves to the reproducible placement of localization marks?
I.Mobile skin surfaces
II.Elderly or obese patients
III.Areas covered by dressings
IV.Sloping surfaces such as the breast
A) I and II
B) I and III
C) I, II, and III
D) I, II, III, and IV
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10
Chapter 9: Infection Control in Radiation Oncology Facilities
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Sample Questions
Q1) When should Standard Precautions be used?
A) When exposure to blood is likely
B) When exposure to saliva is likely
C) During all patient care procedures
D) During patient procedures requiring sterile asepsis
Q2) Which of the following describes sources of nosocomial infections?
A) Carpet in a radiation oncology department
B) Fresh or dried flowers
C) Pen used to apply marks used on all patients
D) Both b and c
E) All of the above
Q3) What is the most reliable, available, and economical method of destroying microorganisms?
A) Gas
B) Liquid
C) Heat
D) Radiation
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11
Chapter 10: Patient Assessment
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Sample Questions
Q1) Which of the following is not one of the 10 most commonly used and helpful verbal responses?
A) Reflecting
B) Confronting
C) Repeating
D) Summarizing
Q2) Which of the following is a multidimensional assessment tool to measure pain?
A) Brief Pain Inventory
B) Functional Assessment of Cancer Therapy
C) Quality of Life Index
D) Pain Free Forever Assessment
Q3) __________ pain is the persistence of pain for longer than 3 months with a less well-defined onset.Its cause may not be known.
A) Onset
B) Chronic
C) Sudden
D) Acute
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12
Chapter 11: Pharmacology and Drug Administration
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Sample Questions
Q1) Select potential reasons why a patient may be unable to take oral preparations of a drug.
A) The patient is experiencing nausea and vomiting.
B) The patient has difficulty in swallowing.
C) The patient refuses to swallow medication.
D) All of the above apply.
Q2) Select the organ most commonly used by the body to excrete drugs and their byproducts.
A) Kidneys
B) Lungs
C) Sweat glands
D) All of the above
Q3) Which of the following radioactive isotopes is used in radiation therapy?
A) Strontium 89
B) Technetium 99
C) Fluorine 18
D) Hydrogen 3
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Chapter 12: Applied Mathematics Review
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Sample Questions
Q1) Simplify 5(3b)².
A) 15b<sup>2</sup>
B) 5(9b<sup>2</sup>)
C) 45b<sup>2</sup>
D) Already simplified
Q2) Which of the following numeric expressions is written in scientific notation?
A) 8.333 × 10<sup>4</sup>
B) 83.33 × 10<sup>3</sup>
C) 833.3 × 10<sup>2</sup>
D) 8333 × 10<sup>1</sup>
Q3) Which of the following is not a fundamental SI unit?
A) Time
B) Distance
C) Weight
D) Electrical current
Q4) Express log<sub>2</sub> 16 = 4 in exponential notation.
A) 4 = v16
B) 42 = 16
C) 1.6 = 10<sup>2</sup>
D) 2<sup>4</sup> = 16
Page 14
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Chapter 13: Introduction to Radiation Therapy Physics
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Sample Questions
Q1) Who proposed the first model of the atom?
A) Bohr
B) Thomson
C) Rutherford
D) Planck
Q2) The condition in which the half-life of the parent isotope is much greater than the half-life of the daughter isotope is called __________________.
A) transient equilibrium
B) transient attenuation
C) secular attenuation
D) secular equilibrium
Q3) Which statement is not true?
A) The nucleus of the atom consists of protons and neutrons.
B) Protons and photons are collectively called nucleons.
C) Protons are positively charged particles.
D) Neutrons are neutral with no electric charge.
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Chapter 14: Aspects of Brachytherapy
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Sample Questions
Q1) The average or mean life of iridium 192 is __________ days.
A) 51
B) 74
C) 107
D) 148
Q2) Regarding question 20, why is brachytherapy the treatment of choice?
A) It has a high energy.
B) It is more effective than stereotactic and proton therapy procedures.
C) Vision is spared due to a lack of radiation-induced changes.
D) It is less expensive for the patient.
Q3) An autoradiograph is taken to ________________________.
A) determine the energy of the source
B) check source placement in the patient
C) verify uniformity of source
D) determine source strength
Q4) The radioisotope used to treat uveal melanoma of the eye is
A) iridium 192
B) cesium 137
C) gold 198
D) iodine 125
16
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Chapter 15: Special Procedures
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Sample Questions
Q1) Forced shallow breathing technique is used to control which of the following?
A) Compression
B) Imaging
C) Motion
D) Interfraction dose
Q2) Turning the radiation on and off when the target is within the treatment volume represents which of the following?
A) A fiducial system
B) Gated treatments
C) A 4DCT data set
D) Forced shallow breathing
Q3) Radiation therapists and radiation oncologists prefer the kV images because the _______________________.
A) contrast is better
B) metal artifacts are reduced
C) timing is more efficient
D) resolution is not an issue
Q4) Cone beam CT, TomoTherapy, and CT-on rails correct for _________ motion.
A) interfraction
B) intrafraction
Page 17
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Chapter 16: Particle Therapy
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Sample Questions
Q1) The proton beam is focused and shaped by devices in which of the following?
A) Magnet
B) Nozzle
C) Compensator
D) Accelerator
Q2) The tumor types treated in the earliest years of proton therapy included those in or near which of the following? (Select two.)
A) Eye
B) Spine
C) Brain
D) Liver
Q3) What are the typical therapeutic proton beam energies?
A) 6 to 25 MeV
B) 10 to 50 MeV
C) 50 to 250 MeV
D) 300 to 500 MeV
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Chapter 17: Radiation Safety and Protection
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Sample Questions
Q1) The annual dose equivalent limit to the lens of the eye for educationally exposed individuals is ____ mSv.
A) 0.5
B) 1
C) 5
D) 50
Q2) The annual dose equivalent limit to the heart for occupationally exposed individuals is ____ mSv.
A) 50
B) 100
C) 150
D) 500
Q3) The average annual dose received by the general public from all naturally occurring radiation sources is ____ mSv.
A) 3
B) 2
C) 1
D) 0.5
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Chapter 18: Patient Safety in Radiation Oncology
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Sample Questions
Q1) According to Harold Freudenberger, physical signs of burnout would not include which of the following?
A) Headaches
B) Insomnia
C) Fatigue
D) Alopecia
Q2) Which of the following would be a key driving force for the development of staff exhibiting "initiating" and "enhancing" behaviors during culture change efforts?
A) Positive feedback
B) Low staff levels
C) Burdensome reporting system
D) Limited access to training
Q3) Which of the following is one tool used to depict how different processes change over time?
A) Fishbone diagram
B) Control chart
C) Pareto chart
D) Histogram
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Chapter 19: Quality Improvement in Radiation Oncology
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Q1) The recommended frequency for checking the audio-visual system in the treatment room is _______________.
A) daily
B) weekly
C) monthly
D) yearly
Q2) In the mid-1980s, the Occupational Safety and Health Administration (OSHA)mandated a policy on __________________.
A) biohazard disposal procedures
B) preventing injuries
C) mold room procedures
D) blood-borne pathogens
Q3) Peer review plays a part in several QA programs in radiation oncology.Select the program(s)listed here that incorporate peer review as part of QA.
A) Weekly chart review
B) Weekly film review
C) Current patient case review
D) New patient planning conference
E) All of the above
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Chapter 20: Surface and Sectional Anatomy
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Q1) The asthenic body type represents what percentage of the general population?
A) 5%
B) 10% to 12%
C) 30% to 35%
D) 50%
Q2) Where is Rotter's node located?
A) Supraclavicular triangle
B) Infraclavicular fossa
C) Anterior aspect of the neck
D) Axilla
Q3) Which of the following structures or landmarks is associated with the bifurcation of the trachea?
A) Tip of the scapula
B) Tip of the xiphoid process
C) Sternal angle
D) Both a and b
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Chapter 21: Simulator Design
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Q1) Light photons are produced and transmitted electronically through to a video image at which of the following?
A) Output phosphor
B) Tube housing
C) Photocathode
D) Focusing lenses
Q2) A(n)_________ ring allows the CT x-ray tube to rotate in a continuous motion without the concern of cables becoming tangled.
A) spiral
B) slip
C) aperture
D) electrical power
Q3) The patient couch tabletop is created out of this material, which has a low density and low x-ray absorption.
A) Plastic carbonate
B) Carbon fiber
C) Steel
D) Polystyrene
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23
Chapter 22: Computed Tomography Simulation
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Q1) When using intravenous (IV)contrast to enhance the anatomy of the brain, the best interval for contrast administration should be before the scan by _____________.
A) 30 seconds
B) 60 seconds
C) 30 minutes
D) 60 minutes
Q2) A contraindication for administering barium-based contrast to a patient with a history of long-term steroid therapy would be an increased risk of _______________.
A) aspiration
B) colon perforation
C) difficulty in holding an enema
D) allergic reaction
Q3) What is a maximum intensity projection, or MIP?
A) Measurement of table translation
B) Result of noise on an image
C) Relationship between the matrix size and the pixel size on an image
D) Fused scan that shows the maximum amount of tumor movement during the respiratory cycle
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24
Chapter 23: Photon Dosimetry Concepts and Calculations
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Q1) The intensity of a radiation beam is measured at 10 mR/hr at a distance of 20 cm.What will be the intensity of this beam at 30 cm?
A) 22.5 mR/hr
B) 4.44 mR/hr
C) 6.67 mR/hr
D) 15 mR/hr
Q2) Find the PDD at 19 cm of an 18-MV beam of radiation that has a 12 × 12 cm treatment field.
A) 56%
B) 55.6%
C) 53.7%
D) 51.7%
Q3) Absorbed dose at a given depth divided by the dose in air dose at a fixed reference is the definition of which of the following?
A) TAR
B) TMR
C) TPR
D) PDD
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Chapter 24: Photon Dose Distributions
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Q1) Which of the following is the palpable, visible, or demonstrable extent and location of malignant growth and is the volume of known disease?
A) GTV
B) CTV
C) PTV
D) Treated volume
Q2) The process of identifying structures, target volumes, or normal tissues, by creating contours around them, is often called _____________________.
A) organ segmentation
B) virtual simulation
C) intensity modulation
D) heterogeneity correction
Q3) In which tissue heterogeneity correction method are both the field size and the depth "scaled" to account for the presence of heterogeneities?
A) Power law TAR method
B) Generalized Batho correction
C) Equivalent TAR method
D) Delta volume method
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Chapter 25: Electron Beams in Radiation Therapy
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Q1) Which processes are responsible for electron interactions with matter?
I.Collisional processes
II.Radiation processes
III.Gradient processes
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) What is the depth of the 90% isodose line of a 9-MeV electron beam?
A) 2.25 cm
B) 3 cm
C) 4.5 cm
D) 9 cm
Q3) Which treatment energy for electrons is most likely to use a scanning beam technique rather than a scattering foil?
A) 4 MeV
B) 12 MeV
C) 20 MeV
D) 25 MeV
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Page 27
Chapter 26: Electronic Charting and Image Management
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Q1) What is the most widely used mechanism for data entry?
A) Voice recognition systems
B) Keyboard and mouse
C) Scanners
D) Signature pads
Q2) What is an information system designed for the collection, management, and analysis of data on a person with a malignant disease?
A) Data gathering
B) DICOM
C) Cancer registry
D) PACS
Q3) Electronic medical records (EMRs)provide which benefits over paper-based records?
I.Improved efficiency
II.Enhanced patient privacy and security
III.Improved accessibility to medical information
A) I and II
B) I and III
C) II and III
D) I, II, and III
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Chapter 27: Bone, Cartilage, and Soft Tissue Sarcomas
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Q1) Most STSs generally spread through _________________.
I.the lymphatic system
II.direct invasion and extension
III.hematogenous spread
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) Treatment for malignant fibrous histiocytoma involves which of the following?
I.Radiation therapy
II.Surgery
III.Chemotherapy
A) I and II
B) I and III
C) II and III
D) I, II, and III
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Chapter 28: Lymphoreticular System Tumors
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Q1) What is the standard dose delivered for the treatment of NHL?
A) 1600 to 2000 cGy
B) 2600 to 3000 cGy
C) 3000 to 4500 cGy
D) 4600 to 5000 cGy
Q2) Which treatment field for HD includes the axillary lymph node chain?
A) Mantle
B) Inverted-Y (abdominal portion)
C) Inverted-Y (pelvic portion)
D) All of the above
Q3) Which of the following organs is most closely associated with the lymphatic system?
A) Heart
B) Spleen
C) Pancreas
D) Liver
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Chapter 29: Endocrine System Tumors
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Q1) In which gland is cortisol produced?
A) Parathyroid
B) Pituitary
C) Thyroid
D) Adrenal
Q2) Which of the following is the primary thyroid tumor with the worst prognosis?
A) Follicular
B) Papillary
C) Medullary
D) Anaplastic
Q3) Which endocrine gland contains a medulla and a cortex?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Q4) In which gland is prolactin (PRL)produced?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Page 31
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Chapter 30: Respiratory System Tumors
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Q1) Which of the following syndromes is commonly associated with Pancoast tumors?
A) Paraneoplastic syndrome
B) Down syndrome
C) Tourette syndrome
D) Horner syndrome
Q2) Why should a patient's arms be positioned above his or her head during radiation treatments of a primary lung cancer?
A) Patient comfort
B) Avoid treating normal tissue
C) Capture an additional device charge
D) Physician preference
Q3) Assume the initial treatment portals are AP/PA; after about how many fractions does the typical lung cancer patient start receiving oblique boost treatments?
A) 10
B) 20
C) 30
D) 40
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Chapter 31: Head and Neck Cancers
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Q1) Radiation therapy of which of the following cancers does not include regional lymph nodes?
A) Early staged parotid
B) Early staged larynx
C) Early staged nasopharynx
D) All of the above include regional lymph nodes
Q2) Which salivary gland is associated with the Stensen duct?
A) Parotid
B) Submandibular
C) Sublingual
D) Minor
Q3) What defines the inferior radiation field border for the treatment of a low=staged larynx cancer?
A) Superior aspect of the hyoid
B) Cricoid cartilage
C) Clavicles
D) C7-T1 intervertebral space
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Chapter 32: Central Nervous System Tumors
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Q1) What defines the inferior radiation field border for the treatment of the whole brain for palliation?
A) 1-cm flash
B) Superior orbital ridge
C) External auditory meatus
D) Both b and c
Q2) Patients treated to the cranium should be advised to protect their heads from direct sunlight because the sun _____________________________.
A) enhances radiation-induced side effects
B) causes lower white cell blood counts
C) enhances feelings of nausea
D) lowers tolerance to anti-inflammatory medications
Q3) What is the most common CNS tumor in children?
A) Medulloblastoma
B) Metastatic lesion
C) Astrocytoma
D) Craniopharyngioma
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Chapter 33: Digestive System Tumors
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Q1) A three-field technique using hinge angles of 120 degrees can be used in the treatment of which cancer?
A) Esophageal
B) Gastric
C) Rectal
D) Hepatic
Q2) Which of the following cancers has the highest incidence of cancer-related deaths in the United States?
A) Esophagus
B) Stomach
C) Colorectal
D) Anal
Q3) What is the most common histologic type of cancers that occur in the lower third of the esophagus?
A) Adenocarcinoma
B) Transitional cell carcinoma
C) Squamous cell carcinoma
D) Renal cell carcinoma
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Chapter 34: Gynecological Tumors
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Q1) Bolus may be used when treating which of the following cancers?
A) Ovarian
B) Cervical
C) Vaginal
D) Vulvar
Q2) Which is true of a cervical cancer with a stage II classification?
I.The cancer invades beyond the uterus but not to the pelvic sidewalls.
II.The cancer extends to the lower third of the vagina.
III.Bladder or rectum involvement is possible.
A) I
B) II
C) III
D) I, II, and III
Q3) Who has the most significant risk of developing ovarian cancer?
A) 35-year-old woman with one child
B) 35-year-old woman with five children
C) 65-year-old woman with one child
D) 65-year-old woman with five children
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Chapter 35: Male Reproductive and Genitourinary Tumors
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Q1) A total dose of 2500 cGy in fractions of 160 cGy is used to treat which male reproductive cancer?
A) Penis
B) Testicle
C) Prostate
D) Bladder
Q2) Cancer of which of the following male reproductive system components is most common?
A) Penis
B) Testicle
C) Prostate
D) Urethra
Q3) Which of the following treatment techniques can be used to treat the prostate?
A) 4-field box
B) IMRT
C) Brachytherapy
D) All of the above
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Page 37
Chapter 36: Breast Cancer
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Sample Questions
Q1) Which of the following increases the risk for developing breast cancer?
A) Breast implants
B) Late menarche
C) Early menarche
D) Early oophorectomy
Q2) What is the standard dose delivered to the SCV field?
A) 4000 to 4600 cGy
B) 4500 to 5000 cGy
C) 5000 to 5600 cGy
D) 6000 to 6600 cGy
Q3) Which of the following techniques may be used to adequately irradiate the internal mammary (IM)lymph nodes while limiting the exposure to other organs?
A) Anterior posterior (AP)6 MV only
B) Anterior posterior (AP)photon/electron combination
C) Anterior posterior (AP)6 MeV only
D) Extended medial tangent
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Chapter 37: Pediatric Solid Tumors
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Q1) What is the most common intracranial tumor in children?
A) Medulloblastoma
B) Metastatic lesion
C) Astrocytoma
D) Craniopharyngioma
Q2) The most common pediatric cancer is _________________.
A) medulloblastoma
B) retinoblastoma
C) acute leukemia
D) Wilms' tumor
Q3) Rhabdomyosarcomas are cancers of which organ?
A) Kidney
B) Bone
C) Brain
D) Mesenchymal
Q4) Which pediatric cancer has the best overall survival?
A) ALL
B) Neuroblastoma
C) Wilms' tumor
D) HD
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Chapter 38: Skin Cancers and Melanoma
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Q1) What is the most widely used staging system for melanoma?
A) TNM
B) Breslow
C) Clarke
D) ATCG
Q2) What is the medical term for a mole?
A) Actinic keratosis
B) Nevus
C) Telangiectasia
D) Xeroderma pigmentosum
Q3) Which of the following is the correct order to the layers of the skin from deep to superficial?
A) Stratum granulosum, stratum spinosum, stratum lucidum, stratum basale, stratum corneum
B) Stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale
C) Stratum basale, stratum granulosum, stratum spinosum, stratum corneum, stratum lucidum
D) Stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, stratum corneum
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