Radiologic Technology
Chapter Exam Questions
Course Introduction
Radiologic Technology is a comprehensive course designed to introduce students to the principles and practices of medical imaging. The course covers foundational topics such as radiation physics, image acquisition, anatomy, patient positioning, and radiation safety. Students will learn how to operate diagnostic imaging equipment, understand radiographic procedures, and apply safety protocols to protect both patients and healthcare providers. Practical experience, ethical considerations, and professional standards in radiologic sciences are emphasized, preparing students for further clinical training and certification in the field.
Recommended Textbook
Principles and Practice of Radiation Therapy 4th Edition by Washington
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Page 2
Chapter 1: Cancer: An Overview
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Q1) Which of the following is true of anaplastic tumors?
A) Closely resemble the cells of origin
B) Maintain some resemblance of the cells of origin
C) Do not resemble the cells of origin
Answer: C
Q2) Factors that may exclude a patient from having surgery include all except which of the following?
A) Preexisting medical conditions
B) Tumor location
C) Patient preference
D) Classification
Answer: D
Q3) Tumor-suppressor genes are also known as ___________.
A) anti-oncogenes
B) oncogenes
C) proto-oncogenes
D) somato-oncogenes
Answer: A
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Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Q1) Which doctrine contends that individuals are responsible for their own negligent conduct?
A) Doctrine of foreseeability
B) Doctrine of personal liability
C) Doctrine of res ipsa loquitur
D) Doctrine of respondeat superior
Answer: B
Q2) 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
Q3) Allocation of scarce resources is an example of which ethical category?
A) Ethical dilemma
B) Ethical dilemma of justice
C) Ethical distress
D) Locus of authority
Answer: B
Page 4
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Chapter 3: Principles of Pathology
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Q1) When was the microscope introduced?
A) Sixteenth century
B) Seventeenth century
C) Eighteenth century
D) None of the above
Answer: B
Q2) Which of the following is an example of a characteristic of benign tumors?
A) Rapid growth rate
B) Frequent vessel invasion
C) Increased nuclear chromatin
D) Expansive local growth
Answer: D
Q3) Cancers are broadly divided in terms of the malignant neoplastic process as which of the following?
A) Carcinomas and sarcomas
B) Carcinomas and myomas
C) Hyperplasia and metaplasia
D) Sarcomas and pleomorphic forms
Answer: A
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Page 5
Chapter 4: Overview of Radiobiology
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Q1) To produce the same biological effects seen after a single dose of 5,000 cGy, the total dose of a fractionated dose would be _________.
A) less
B) greater
C) equivalent
Q2) Which of the following tissues is least radiosensitive?
A) Bone
B) Kidney
C) Ocular lens
D) Colon
Q3) The TD 5/5 for the whole liver is approximately _____ Gy.
A) 15
B) 20
C) 30
D) 40
Q4) The TD 50/5 for the optic nerve is approximately _____ Gy.
A) 25
B) 35
C) 50
D) 65
Page 6
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Chapter 5: Detection and Diagnosis
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Q1) The chance of developing invasive breast cancer at some time in a woman's life is approximately 1 out of every ______ women.
A) 5
B) 7
C) 8
D) 10
Q2) A subjective indication of a disease or a change in condition as perceived by the patient is a ________.
A) sign
B) symptom
C) syndrome
D) screening
Q3) Mass screening is based on all except which of the following?
A) Specific results obtained
B) Cost-effectiveness
C) Risk to the patient
D) Geographic location
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Page 7
Chapter 6: Medical Imaging
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Q1) A quality radiograph taken at 100 cm using 20 mAs could be replicated at 50 cm using which of the following?
A) 15 mAs
B) 10 mAs
C) 7 mAs
D) 5 mAs
Q2) Components of a modern x-ray tube include which of the following?
A) Cathode filament
B) Rotating anode
C) Glass envelope
D) All of the above
Q3) Beam quality is affected by changes in which of the following?
A) kVp
B) Potential difference in the x-ray tube
C) Voltage
D) All of the above
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Chapter 7: Treatment Delivery Equipment
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Q1) When did installation of the first fully isocentric linear accelerator in the United States occur?
A) 1942
B) 1952
C) 1961
D) 1979
Q2) Depth of maximum dose for a 6-MV machine is how far below the skin surface?
A) 0.5 cm
B) 1.5 cm
C) 2.5 cm
D) 5 cm
Q3) Lipowitz metal is composed of which of the following?
A) Tin, bismuth, lead, and cadmium
B) Lead, tungsten, and tin
C) Tin, bismuth, tungsten, and lead
D) Bismuth, cadmium, and lead
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Chapter 8: Treatment Procedures
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Q1) Arrange the following tasks involved in delivering a dose of radiation therapy in the proper order.
I.Complete the treatment record.
II.Initiate the beam-on setting, and monitor the patient and equipment.
III.Align the field using lasers, light field, and surface landmarks.
IV.Prepare the room.
A) I, II, III, IV
B) II, I, III, IV
C) IV, II, I, III
D) IV, III, II, I
Q2) 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
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Chapter 9: Infection Control in Radiation Oncology Facilities
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Q1) Which of the following is the term used to indicate the number of antibodies present in a blood sample?
A) Vaccine
B) Titers
C) Pathogens
D) Antibiotics
Q2) Hepatitis B is a virus transmitted mainly through which of the following?
A) Contact with blood and body fluids
B) Indirect contact with airborne droplets
C) Direct contact with respiratory droplets
D) Common vehicle or fomite exposure
Q3) The person to whom the infectious agent is passed is a(n)_____________.
A) fomite
B) host
C) pathogenic
D) iatrogenic
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11
Chapter 10: Patient Assessment
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Q1) Cachexia is the loss of which of the following?
A) Appetite
B) Self-esteem
C) Quality of life
D) Cognitive dimension
Q2) Marasmus is ____________ malnutrition.
A) calorie
B) protein
C) fat
D) carbohydrate
Q3) 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
Q4) Dry desquamation occurs at _________ cGy.
A) 1,600 to 2,000
B) 4,000 to 6,000
C) 2,000 to 3,000
D) 3,000 to 4,000
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Chapter 11: Pharmacology and Drug Administration
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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 routes of drug administration is not considered a parenteral route?
A) Oral
B) Intradermal
C) Subcutaneous
D) Intrathecal
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13
Chapter 12: Applied Mathematics Review
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Q1) Express log<sub>10</sub> 100 = 2 in exponential notation.
A) 1.0 × 10<sup>2</sup>
B) 102 = 100
C) 2<sup>10</sup> = 100
D) 10 = v100
Q2) How many significant figures are there in 0.0068?
A) Two
B) Three
C) Four
D) Five
Q3) Which of the following numeric expressions is written in scientific notation?
A) 1222 × 10<sup>1</sup>
B) 122.2 × 10<sup>2</sup>
C) 12.22 × 10<sup>3</sup>
D) 1.222 × 10<sup>4</sup>
Q4) Convert 2 Gy into rad.
A) 2 rad
B) 20 rad
C) 200 rad
D) 2000 rad
Page 14
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Chapter 13: Introduction to Radiation Therapy Physics
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Q1) The thickness of some added material required to reduce beam intensity to half its original value is called the __________________.
A) half-life
B) inverse square factor
C) half-value layer (HVL)
D) intensity coefficient
Q2) A mCi (millicurie)equals which of the following?
A) 10<sup>3</sup> Ci
B) 10<sup>-3</sup> Ci
C) 10<sup>-6</sup> Ci
D) 10<sup>6</sup> Ci
Q3) Which of the following is the most common photon interaction that occurs in the energy range used in radiation therapy?
A) Photoelectric
B) Compton
C) Photodisintegration
D) Thomson
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Chapter 14: Aspects of Brachytherapy
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Q1) Which of the following is the radionuclide with the largest average photon energy?
A) Cobalt 60
B) Cesium 137
C) Iridium 192
D) Radium 226
Q2) The term radium substitute in brachytherapy indicates which of the following?
A) An isotope whose dosimetry is based on original radium work
B) An isotope whose dosimetry is more accurate than that of radium
C) Any source implemented when radium is unavailable
D) A source that has a greater average energy than radium
Q3) Areas commonly treated with external applicators include which of the following?
I.Hard palate
II.Skin
III.Orbital cavity
A) I and II
B) I and III
C) II and III
D) I, II, and III
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Chapter 15: Special Procedures
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Q1) Cranial stereotactic treatments began with which of the following?
A) Cyber knife
B) Proton accelerator
C) Gamma knife
D) SBRT
Q2) Which of the following is the motion management method that defines an internal target volume?
A) OBI
B) compression
C) conservative
D) MIP
Q3) Stereotactic treatments have been improved on linear accelerators because of which of the following advances?
A) High-quality in-room imaging
B) Tighter mechanical specifications
C) Small field treatments
D) Only a and b
Q4) Cone beam CT, TomoTherapy, and CT-on rails correct for _________ motion. A) interfraction
B) intrafraction
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Chapter 16: Particle Therapy
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Q1) Custom compensators used in proton therapy are often made of which of the following?
A) Brass
B) Steel
C) Acrylic
D) Tungsten
Q2) Which of the following is the most reliable method for verifying beam clearance before a patient is treated?
A) Utilization of three-dimensional (3D)room models
B) Performance of manual verification
C) Use of room blueprints and computer plans
D) Robust review of treatment plans
Q3) What do the results of a clinical study completed at MD Anderson indicate regarding when adaptive planning is strongly indicated?
A) The first week of therapy is completed.
B) The first day of therapy is completed.
C) The patient loses significant weight.
D) A high Z prosthesis is in the beam path.
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18
Chapter 17: Radiation Safety and Protection
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Q1) The annual dose equivalent limit to the heart for occupationally exposed individuals is ____ mSv.
A) 50
B) 100
C) 150
D) 500
Q2) The average annual dose received by the general public from radon is ____ mSv.
A) 3
B) 2
C) 1
D) 0.5
Q3) Slow neutrons have a quality factor of _________.
A) 1
B) 5
C) 10
D) 20
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Page 19
Chapter 18: Patient Safety in Radiation Oncology
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Q1) A culture of safety in the radiation oncology department requires the participation of which of the following?
I.Physicians
II.Physicists
III.Radiation therapists
A) I, II
B) II, III
C) I, III
D) All of the above
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
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20
Chapter 19: Quality Improvement in Radiation Oncology
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Q1) The output constancy of all electron energies on the linear accelerator are recommended to be checked ________________.
A) daily
B) twice weekly
C) once weekly
D) once Monthly
Q2) Appropriate use of CQI assists the health care organization in responding to all except which of the following?
A) Increased competition
B) Escalating costs
C) Quality concerns
D) Development of individual performance
Q3) The ASRT have developed practice standards for radiation therapists.They are divided into what three sections?
A) Cognitive, affective, and psychomotor standards
B) Clinical, quality, and professional performance standards
C) Education, professional self-assessment, and ethical behavior standards
D) Patient care, treatment delivery, and Total Quality Management (TQM)standards
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21
Chapter 20: Surface and Sectional Anatomy
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Q1) Which portion of the spinal column is composed of four fused vertebrae?
A) Coccyx
B) Sacrum
C) Symphysis pubis
D) Lumbar vertebrae
Q2) The movement of lymph through the lymphatic system is caused by which of the following?
A) The motion of the adjacent muscles
B) A primitive two-chamber heart located in the posterior portion of the mediastinum
C) Hydrostatic and osmotic pressure differences in the body
D) Both a and c
Q3) Which organ begins at the lower border of the cricoid cartilage and travels through the diaphragm to the cardiac sphincter?
A) Trachea
B) Bronchus
C) Esophagus
D) None of the above
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Chapter 21: Simulator Design
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Q1) The conventional simulator can define treatment fields by using which of the following?
A) Blades
B) Wires
C) OID
D) Collimator assembly
Q2) The matrix size is determined by the number of ___________.
A) voxels
B) Hounsfield units
C) detectors on the scanner
D) pixels
Q3) CT numbers are also known as which of the following?
A) Hounsfield units
B) Godfrey units
C) Attenuation coefficient units
Q4) The CT number for water is _____________.
A) -1000
B) -100
C) 0
D) 1000
Page 23
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Chapter 22: Computed Tomography Simulation
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Q1) Which of the following is the window width on a CT image?
A) The range of numbers displayed on a CT image
B) The number of columns and rows of pixels demonstrated on an image
C) An unwanted image characteristic
D) The central Hounsfield unit of all the CT numbers displayed on an image
Q2) 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
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) A patient is treated on a 6-MV machine at 100 cm SSD.The collimator setting is 15 × 15.There is no blocking used for this treatment.The prescription states that a dose of 3000 cGy is to be delivered to a depth of 3 cm in 10 fractions using a posterior treatment field using the nonisocentric method of calculation.The patient central axis separation is 20 cm.What is the MU setting for the treatment? Reference dose rate (RDR)for a 15 cm equivalent square is 0.993 cGy/MU.
A) 315
B) 321
C) 319
D) 317
Q2) A patient is being treated on the 6-MV beam to an opposed lateral whole brain (midline).The collimator setting is 14 × 18 with no blocks.The dose is 4000 cGy/20 fractions.The separation is 22 cm.What is the dose delivered to Dmax?
A) 200 cGy
B) 212 cGy
C) 150 cGy
D) 61.9 cGy
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Chapter 24: Photon Dose Distributions
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Q1) The internal target volume (ITV)is the __________.
A) GTV + CTV
B) CTV + IM
C) PTV - GTV
D) ITV + SM
Q2) Which of the following is the most favorable situation for the overall goal of radiation therapy?
A) Radiosensitive tumor and radiosensitive normal tissue
B) Radiosensitive tumor and radioresistant normal tissue
C) Radioresistant tumor and radioresistant normal tissue
D) Radioresistant tumor and radiosensitive normal tissue
Q3) In the convolution algorithm, primary fluence is represented by what symbol?
A) D(r)
B) \(\psi\)(r)
C) K
D) dV
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Chapter 25: Electron Beams in Radiation Therapy
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Q1) Which processes are responsible for the majority of energy loss for electron energy ranges useful in radiation therapy?
I.Collisional processes
II.Radiation processes
III.Gradient processes
A) I only
B) II only
C) III only
D) I and II
Q2) According to the Association of Physicists in Medicine (AAPM)Task Group 25 report, what distance is considered an extended source-skin distance (SSD)for electron beams?
A) Greater than 100 cm SSD
B) Greater than 110 cm SSD
C) Greater than 115 cm SSD
D) Greater than 130 cm SSD
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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) Which communication standards are routinely applied in radiation therapy EMRs?
I.HL7
II.DICOM
III.PACS
A) I and II
B) II and III
C) I and III
Q3) The complexity of linear accelerators needs the integration of which of the following to guide and monitor the physical settings required for the delivery of complex treatment plans?
A) Verification and record systems
B) IMRT
C) DICOM
D) PACS
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Page 28
Chapter 27: Bone, Cartilage, and Soft Tissue Sarcomas
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Q1) What is the most common site of metastasis from a primary bone cancer?
A) Brain
B) Bowel
C) Lung
D) Bone
Q2) Primary treatment for osteogenic sarcoma 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
Q3) Overall, STS requires which dose of radiation to achieve local control and long-term survival?
A) Low
B) Medium
C) High
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29
Chapter 28: Lymphoreticular System Tumors
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Q1) Which of the following chemotherapy regimens is not used to treat HD?
I.CHOP
II.MOPP
III.ABVD
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) Which of the following organs is most closely associated with the lymphatic system?
A) Heart
B) Spleen
C) Pancreas
D) Liver
Q3) 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
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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) In which gland is oxytocin produced?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Q3) Which of the following is the primary thyroid tumor with the worst prognosis?
A) Follicular
B) Papillary
C) Medullary
D) Anaplastic
Q4) What is the most common form of thyroid cancer seen in irradiated individuals?
A) Follicular
B) Papillary
C) Medullary
D) Lymphoma
Page 31
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Chapter 30: Respiratory System Tumors
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Q1) Which of the following symptoms is not associated with Horner syndrome?
A) Ipsilateral miosis
B) Ptosis
C) Exophthalmos
D) Anhidrosis
Q2) What is the total dose delivered to a primary lung cancer?
A) 3000 cGy
B) 4000 cGy
C) 5000 cGy
D) Greater than 6000 cGy
Q3) One symptom associated with superior vena cava syndrome is orthopnea.Orthopnea is ____________________.
A) difficulty breathing
B) a bluish color of the skin
C) difficulty swallowing
D) inability to lie flat
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Chapter 31: Head and Neck Cancers
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Q1) What is the most common form of larynx cancer?
A) Adenocarcinoma
B) Basal cell
C) Squamous cell
D) Transitional cell
Q2) What is the name of the leaf-shaped cartilage that protects the larynx?
A) Glottis
B) Epiglottis
C) Pharynx
D) Larynx
Q3) After what dose of radiation does xerostomia typically first occur?
A) 1000 to 2000 cGy
B) 2000 to 3000 cGy
C) 3000 to 4000 cGy
D) 4000 to 5000 cGy
Q4) What is the most common histologic type of head and neck cancer?
A) Adenocarcinoma
B) Transitional cell carcinoma
C) Squamous cell carcinoma
D) Renal cell carcinoma
Page 33
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Chapter 32: Central Nervous System Tumors
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Q1) Which of the following beam arrangements is most typical for treatment of a malignant primary brain tumor?
A) Parallel opposed whole brain fields
B) Small fields with 1 to 3 cm margins
C) Oblique fields to include the supraorbital ridge
D) Large fields with 5 to 10 cm margins
Q2) Which of the following is most significant to the prognosis of brain tumors?
A) Tumor size
B) Lymph node involvement
C) Metastases
D) Grade
Q3) 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
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34
Chapter 33: Digestive System Tumors
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Sample Questions
Q1) 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
Q2) Which of the following is the region of the esophagus between thoracic vertebrae 5 and 8?
A) Upper thoracic
B) Middle thoracic
C) Lower thoracic
D) Gastroesophageal junction
Q3) Which of the following cancer sites can be treated with endocavitary radiation therapy?
A) Esophagus
B) Stomach
C) Rectum
D) Liver
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Chapter 34: Gynecological Tumors
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Sample Questions
Q1) 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
Q2) What is the common name for the female external genitalia?
A) Vulva
B) Mons pubis
C) Labia
D) Perineum
Q3) Bolus may be used when treating which of the following cancers?
A) Ovarian
B) Cervical
C) Vaginal
D) Vulvar
Q4) Pap testing is a screening tool used to detect which cancer?
A) Ovarian
B) Cervical
C) Vaginal
D) Vulvar
Page 36
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Chapter 35: Male Reproductive and Genitourinary Tumors
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Sample Questions
Q1) 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
Q2) Which cancer can be treated using a water bath to provide dose homogeneity by compensating for the irregular surface with tissue-equivalent material?
A) Penis
B) Testicle
C) Prostate
D) Bladder
Q3) A total dose of 7200 cGy in fractions of 180 cGy is used to treat which male reproductive cancer?
A) Prostate
B) Testicle
C) Penis
D) All of the above
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Chapter 36: Breast Cancer
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Sample Questions
Q1) What T stage is a breast cancer that is a 1-cm tumor in the upper outer quadrant?
A) Tis
B) T1
C) T2
D) T3
E) T4
Q2) The lower border of the breast extends to which rib?
A) Fifth
B) Sixth
C) Seventh
D) Eighth
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) Pituitary adenomas in children that are not successfully managed by surgery and hormonal suppression may be treated with radiation using which of the following?
A) Single-field electrons
B) Multiple-field photons
C) HDR brachytherapy
D) Multiple-field electrons
Q2) Wilms' tumors are cancers of which organ?
A) Kidney
B) Bone
C) Skeletal muscle
D) Smooth muscle
Q3) Which area is least likely to develop rhabdomyosarcoma?
A) Testis
B) Head and neck
C) Lower extremity
D) Upper extremity
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Chapter 38: Skin Cancers and Melanoma
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Sample Questions
Q1) What do the ABCDs of melanoma represent?
A) Adenocarcinoma, basal cell carcinoma, carcinoma in situ, dermatoma
B) Abrasion, bruise, cut, dimpling
C) Asymmetry, border, color, diameter
D) Appearance, blackness, contour, depth
Q2) What is the most widely used staging system for melanoma?
A) TNM
B) Breslow
C) Clarke
D) ATCG
Q3) Bolus may be used with electron therapy to _______________.
I.compensate for missing tissue
II.maximize surface dose
III.reduce underlying tissue dose
A) I, III
B) II, III
C) I, II
D) I, II, III
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