Review of Nuclear Medicine Technology Multiple Choice Questions

[Exam 1 Q001] Which option is the exception? Before tracer administration, all of the following preparations are required for a 27-year-old woman referred for total-body bone imaging except:

A) removing attenuating materials from the patient

B) answering the patient's questions

C) ruling out pregnancy

D) explaining the procedure to the patient

E) swab the injection site with alcohol

A - removing attenuating materials from the patient

Why: A can wait until imaging because jewelry affects image attenuation, not tracer distribution. B and D establish understanding before injection; C addresses pregnancy screening and individualized risk assessment; E provides injection-site antisepsis. Pregnancy requires a clinical risk-benefit decision rather than an automatic ban in every circumstance.

Source: Bolus & Glasgow (2018), Exam 1, Q1; question p. 247, answer key p. 323.

[Exam 1 Q002] Which of the following structures normally appear as areas of increased activity on the bone images of children?

A) diaphyses of the long bones

B) breast tissue

C) lumbar spine and cranium

D) costochondral junctions and epiphyseal plates

E) metatarsals

D - costochondral junctions and epiphyseal plates

Why: D identifies active growth centers with increased osteoblastic turnover. A describes shafts, not growth plates; B is soft tissue; C can show normal uptake but is not the characteristic pediatric growth pattern; E does not specifically identify the growing epiphyses.

Source: Bolus & Glasgow (2018), Exam 1, Q2; question p. 247, answer key p. 323.

[Exam 1 Q003] Which option correctly completes this statement? If tracer concentration is visualized in the skeleton, stomach, thyroid, and salivary glands on a bone image, the most likely explanation for these findings is that the:

A) patient was imaged too soon after tracer administration

B) patient's renal function is compromised

C) radiopharmaceutical contained excess free Tc-99m pertechnetate

D) incorrect radiopharmaceutical was administered

E) radiopharmaceutical contained excess free F-18 sodium

C - radiopharmaceutical contained excess free Tc-99m pertechnetate

Why: C explains the classic combination of thyroid, gastric, and salivary activity from free pertechnetate. A causes high soft-tissue background; B delays urinary clearance; D alone does not explain retained normal skeletal labeling; E concerns a different radionuclide and does not cause this pertechnetate distribution.

Source: Bolus & Glasgow (2018), Exam 1, Q3; question p. 247, answer key p. 323.

[Exam 1 Q004] Which option correctly completes this statement? For interpretation of nuclear medicine lung images, a chest x-ray is required to:

A) rule out possible causes of the patient's symptoms

B) determine cardiac size

C) rule out previous lung surgery

D) rule out a pulmonary embolus

E) rule in a pulmonary embolus

A - rule out possible causes of the patient's symptoms

Why: A helps identify alternative explanations such as pneumonia or an effusion and supports V/Q interpretation. B may be incidental; C is better established from history and imaging; D and E overstate what a chest radiograph can do, because it cannot independently exclude or diagnose pulmonary embolism.

Source: Bolus & Glasgow (2018), Exam 1, Q4; question p. 247, answer key p. 323.

[Exam 1 Q005] After Tc-99m MAA, the lung images show multiple small, intense focal hot spots rather than a uniform particle distribution. What injection-related problem best explains them?

A) The image shows lung pathology.

B) There is radioactive contamination on the patient's skin or the camera detector.

C) Blood clotted to MAA particles was injected intravenously.

D) Too many MAA particles were administered to the patient.

E) A left to right shunt occurred in the heart.

C - Blood clotted to MAA particles was injected intravenously.

Why: C explains multiple focal pulmonary hot spots from clumped MAA or labeled blood clots. A usually produces regional perfusion defects; B would require evidence that activity is external; D does not typically create discrete clumps; E concerns excess pulmonary flow rather than this injection artifact.

Figure note: The original figure is represented by a text description in this card; see the cited book page for the image.

Source: Bolus & Glasgow (2018), Exam 1, Q5; question p. 247, answer key p. 323.

[Exam 1 Q006] Which option correctly completes this statement? The purpose of a charcoal filter in a xenon delivery unit is to absorb:

A) bacteria

B) carbon dioxide

C) xenon gas

D) moisture

E) oxygen

C - xenon gas

Why: C is retained by activated charcoal so exhaled radioactive xenon can decay. A is controlled by a bacterial filter; B requires a carbon-dioxide absorber; D requires a moisture trap; E is needed for breathing and should not be removed by this charcoal trap.

Source: Bolus & Glasgow (2018), Exam 1, Q6; question p. 247, answer key p. 323.

[Exam 1 Q007] Radionuclide venography may be performed with which of the following radiopharmaceuticals?

A) Tc-99m pentetate

B) Tc-99m pertechnetate

C) Tc-99m exametazime

D) Tc-99m mebrofenin

E) Tc-99m MAA

E - Tc-99m MAA

Why: E travels through leg veins and subsequently lodges in pulmonary capillaries, permitting venography and perfusion imaging. A is a renal filtration agent; B distributes to pertechnetate-avid tissues; C is used for brain or leukocyte labeling; D is a hepatobiliary tracer.

Source: Bolus & Glasgow (2018), Exam 1, Q7; question p. 247, answer key p. 323.

[Exam 1 Q008] If ectopic thyroid tissue is suspected, the technologist can expect to find it most commonly in which of the following areas?

A) in the brain

B) in the skull

C) in the nasopharynx

D) in the mediastinum

E) behind the optic nerve

D - mediastinum, among these choices

Why: D is the best listed ectopic location because thyroid tissue can extend into the mediastinum. A, B, C, and E are not the usual thyroid migration pathway. The wording is misleading: lingual thyroid at the tongue base is the most common ectopic thyroid location overall, and it is absent from the options.

Answer-key note (Ambiguous wording): Book key: D - in the mediastinum. Lingual thyroid at the tongue base is the most common ectopic site overall and is not listed.

Source: Bolus & Glasgow (2018), Exam 1, Q8; question p. 247, answer key p. 323.

Verification: Institutional clinical study of lingual thyroid and thyroid migration - https://pmc.ncbi.nlm.nih.gov/articles/PMC9895310/

[Exam 1 Q009] Which option correctly completes this statement? During parathyroid imaging, images of the chest as well as the neck are obtained to:

A) correct the image series for patient motion

B) visual ize substernal thyroid tissue

C) visualize ectopic parathyroid tissue

D) diagnose hyperparathyroidism

E) to localize the parathyroid

C - visualize ectopic parathyroid tissue

Why: C explains extending the search along possible embryologic migration sites, including the mediastinum. A requires registration or repeat imaging; B concerns thyroid rather than the target parathyroid tissue; D is established biochemically; E is too general to explain why the chest must be included.

Source: Bolus & Glasgow (2018), Exam 1, Q9; question p. 247, answer key p. 323.

[Exam 1 Q010] When performing a gated equilibrium cardiac study, which of the following anatomical views best separates the right and left ventricles?

A) left lateral

B) left anterior oblique

C) left posterior obiique

D) anterior

E) posterior

B - left anterior oblique

Why: B rotates the septum into view and minimizes overlap of the two ventricles. A is useful for other wall-motion views; C and E do not provide the standard septal separation; D leaves greater right-left ventricular overlap. The precise LAO angle is individualized.

Source: Bolus & Glasgow (2018), Exam 1, Q10; question p. 247, answer key p. 323.

[Exam 1 Q011] Why is fasting requested before a Tl-201 myocardial perfusion stress study?

A) prevent gastrointestinal upsets during exercise

B) minimize tracer uptake in the gastrointestinal tract

C) enhance myocardial tracer uptake

D) standardize test conditions among patients

E) prevent redistribution of the tracer

B - minimize tracer uptake in the gastrointestinal tract

Why: B reduces competing splanchnic activity and overlap near the inferior myocardium. A is an additional comfort concern; C is not the principal stated fasting mechanism; D is a general benefit rather than the tracer-specific reason; E is wrong because fasting does not prevent thallium redistribution.

Source: Bolus & Glasgow (2018), Exam 1, Q11; question p. 248, answer key p. 323.

[Exam 1 Q012] Which of the following agents used for pharmacologic stress testing remain in the plasma for the greatest length of time?

A) dobutamine

B) adenosine

C) nitroglycerin

D) dipyridamole

E) regadenoson

E - regadenoson

Why: E has a terminal plasma half-life of about two hours, exceeding dipyridamole's roughly 35-45 minutes. A is cleared within minutes; B within seconds. C is not a standard stress-inducing agent. D was the longest-lived agent in the older comparison, but the added regadenoson option changes the answer.

Answer-key note (Answer differs from key): Book key: D - dipyridamole. The key gives D. Including terminal plasma half-life makes E longer lived.

Source: Bolus & Glasgow (2018), Exam 1, Q12; question p. 248, answer key p. 323.

Verification: Regadenoson prescribing information, pharmacokinetics - https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=057289f4-2e18-4c1e-bed4-6c1858e2ef16

[Exam 1 Q013] SPECT liver imaging with Tc-99m sulfur colloid is performed how soon after tracer administration?

A) immediately

B) 10- 15 min

C) 30-45 min

D) 1-2 hr

E) 3-4 hr

B - 10- 15 min

Why: B allows reticuloendothelial uptake and blood-pool clearance before sulfur-colloid liver SPECT. A is too early for routine delayed images. C, D, and E impose unnecessary delays for this standard examination; they are not required to permit colloid localization.

Source: Bolus & Glasgow (2018), Exam 1, Q13; question p. 248, answer key p. 324.

[Exam 1 Q014] Significantly increased serum bilirubin levels will most li kely cause which of the following to be visualized on hepatobiliary images?

A) kidneys

B) colon

C) lungs

D) spleen

E) pancreas

A - kidneys

Why: A becomes conspicuous when poor hepatic extraction allows more renal tracer excretion. B depends on biliary passage into bowel; C is not the alternate clearance organ; D is not the usual IDA uptake organ; E is not visualized as the consequence of hyperbilirubinemia.

Source: Bolus & Glasgow (2018), Exam 1, Q14; question p. 248, answer key p. 324.

[Exam 1 Q015] Localization of a Meckel's diverticulum can be accomplished with which of the following radiopharmaceuticals?

A) Ga-67 citrate

B) Tc-99m pentetate

C) Tc-99m MAA

D) Tc-99m sulfur colloid

E) Tc-99m pertechnetate

E - Tc-99m pertechnetate

Why: E is concentrated by functioning gastric mucosa in a Meckel diverticulum. A targets inflammation and some tumors; B evaluates renal filtration; C evaluates pulmonary perfusion; D is taken up by reticuloendothelial cells and does not selectively identify ectopic gastric mucosa.

Source: Bolus & Glasgow (2018), Exam 1, Q15; question p. 248, answer key p. 324.

[Exam 1 Q016] In infants, 24 hr images are sometimes performed over what area to demonstrate gastroesophageal reflux?

A) nasopharynx

B) lung fields

C) stomach

D) upper small intestine

E) lower esophagus

B - lung fields

Why: B can show aspiration of refluxed gastric contents on delayed images. A is not the routine aspiration target; C mainly shows retained meal; D shows intestinal transit; E may demonstrate reflux dynamically but does not answer the delayed pulmonary-aspiration purpose of this question.

Source: Bolus & Glasgow (2018), Exam 1, Q16; question p. 248, answer key p. 324.

[Exam 1 Q017] Effective renal plasma flow (ERPF) is measured with which of the following radiopharmaceuticals?

A) Tc-99m pentetate

B) Tc-99m disofenin

C) Tc-99m medronate

D) Tc-99m mertiatide

E) Tc-99m exametazime

D - Tc-99m mertiatide

Why: D is secreted by proximal tubules, so its clearance can estimate effective renal plasma flow with appropriate calibration. A measures GFR; B is hepatobiliary; C targets bone; E is a brain and leukocyte-labeling agent. MAG3 clearance is not numerically identical to true renal plasma flow without a validated model.

Source: Bolus & Glasgow (2018), Exam 1, Q17; question p. 248, answer key p. 324.

[Exam 1 Q018] Evaluating the quality of a bolus injection is best accomplished by which of the following techniques?

A) generating a time- activity curve for the superior vena cava

B) calculating the cardiac transit time

C) determining the heart to lung ratio

D) imaging the injection site for residual activity

E) visually inspecting the bolus

A - generating a time- activity curve for the superior vena cava

Why: A objectively measures the superior-vena-cava bolus width, commonly using FWHM. B measures subsequent transit; C is a distribution ratio; D checks infiltration but not temporal compactness; E is subjective. A narrow input bolus is essential for reliable first-pass measurements.

Source: Bolus & Glasgow (2018), Exam 1, Q18; question p. 248, answer key p. 324.

[Exam 1 Q019] Which of the following is/are not normally visualized on a Ga-67 image acquired 72 hr after tracer administration?

A) nasopharynx

B) lacrimal glands

C) kidneys

D) liver

E) sternum

C - kidneys

Why: C should largely clear from the kidneys by delayed Ga-67 imaging. A and B are recognized physiologic head-and-neck sites; D is a major normal uptake organ; E contains marrow with physiologic uptake. Persistent conspicuous renal activity warrants correlation rather than automatic classification as normal.

Source: Bolus & Glasgow (2018), Exam 1, Q19; question p. 248, answer key p. 324.

[Exam 1 Q020] Which of the following statements about "transmission-based precautions" is false?

A) These precautions are appl ied when a patient is known to be infected with a communicable disease.

B) These precautions replace "standard precautions."

C) These precautions include guidelines for airborne- and droplet-borne diseases.

D) These precautions include guidelines for contact transmitted diseases.

E) These precautions must be implemented in the case of diseases such as varicella, tuberculosis, and mumps.

B - These precautions replace "standard precautions."

Why: B is false because transmission-based precautions are added to standard precautions. A describes their clinical use, including suspected infection; C and D describe recognized transmission categories; E gives appropriate examples. Standard precautions remain applicable to every patient regardless of additional isolation measures.

Source: Bolus & Glasgow (2018), Exam 1, Q20; question p. 248, answer key p. 324.

[Exam 1 Q021] Which of the following statements about pentetreotide is Ime?

A) It exhibits no human antimurine antibody (HAMA) effect.

B) It is a labeled antibody.

C) It is a labeled antigen.

D) It is excreted exclUSively through the kidneys.

E) It is labeled with Tc-99m.

A - It exhibits no human antimurine antibody (HAMA) effect.

Why: A is correct because pentetreotide is a somatostatin-analog peptide rather than a murine antibody. B and C misidentify the molecule; D is too absolute because some hepatobiliary excretion occurs; E names the wrong radionuclide, since the traditional agent is In-111 pentetreotide.

Source: Bolus & Glasgow (2018), Exam 1, Q21; question p. 248, answer key p. 324.

[Exam 1 Q022] Which option correctly completes this statement? The purpose of using acetazolamide in conjunction with a brain agent is to:

A) TranqUilize the patient.

B) Localize brain tumors.

C) Localize the area of the brain from wh ich seizures arise.

D) Evaluate cerebrovascular hematoma.

E) Evaluate cerebrovascular ischemia.

E - Evaluate cerebrovascular ischemia.

Why: E tests cerebrovascular reserve: normal vessels increase flow after acetazolamide, whereas compromised territories respond poorly. A is not its purpose; B concerns tumor localization; C concerns seizure localization; D concerns hemorrhage rather than the vasodilatory reserve response evaluated by this challenge.

Source: Bolus & Glasgow (2018), Exam 1, Q22; question p. 248, answer key p. 324.

[Exam 1 Q023] Which option correctly completes this statement? The technologist's responsibilities during tracer administration for a cisternogram include:

A) ensuring that personnel and the surroundings are not contaminated with radioactivity

B) obtaining consent to perform the procedure

C) delivering antihistamines for any adverse reactions to the procedure

D) testi ng the pressure of the cerebrospinal fluid

E) performing the lumbar puncture

A - ensuring that personnel and the surroundings are not contaminated with radioactivity

Why: A reflects the technologist's responsibility for tracer handling, surveys, and contaminated materials. B is obtained by the responsible procedural clinician under local policy; C is not routine prophylaxis; D and E are invasive clinical actions performed by the appropriately qualified practitioner, not the routine technologist role.

Source: Bolus & Glasgow (2018), Exam 1, Q23; question p. 249, answer key p. 324.

[Exam 1 Q024] Which condition can historically be treated with P-32 sodium phosphate?

A) liver metastases

B) lupus

C) rheumatoid arthritis

D) malignant effusions

E) polycythemia vera

E - polycythemia vera

Why: E is the classic historical use of P-32 sodium phosphate to suppress excessive marrow production. A may involve other targeted therapies; B is not an indication; C relates to different intra-articular treatments; D historically used colloidal P-32, a different formulation and route.

Source: Bolus & Glasgow (2018), Exam 1, Q24; question p. 249, answer key p. 324.

[Exam 1 Q025] Supersaturated potassium iodide solution may be administered to the patient for therapywith which of the following radiopharmaceuticals?

A) Sm-153 lexidronam

B) Sr-89 chloride

C) I-131 sodium iodide

D) I-131 tositumomab

E) Y-90 chloride

D - I-131 tositumomab

Why: D historically required thyroid blockade to reduce uptake of free radioiodine released from I-131 tositumomab. A and B are bone-seeking noniodine agents; C deliberately targets thyroid tissue, so blocking uptake defeats therapy; E is not radioiodinated. This antibody regimen is historical, not a routine current option.

Source: Bolus & Glasgow (2018), Exam 1, Q25; question p. 249, answer key p. 324.

[Exam 1 Q026] 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 - Call for help.

Why: D initiates emergency response after unresponsiveness has been established. A and E depend on the breathing and pulse assessment; B alone does not activate help; C should be coordinated rapidly with checking breathing and response activation. Follow the applicable resuscitation algorithm and obtain an AED promptly.

Source: Bolus & Glasgow (2018), Exam 1, Q26; question p. 249, answer key p. 324.

[Exam 1 Q027] Which option correctly completes this statement? In-111 Pentetreotide should not be administered through an intravenous line containing:

A) water

B) a total parenteral nutrition mixture

C) dextrose

D) glucose

E) 0.9%sodium chloride

B - a total parenteral nutrition mixture

Why: B may destabilize or alter distribution of pentetreotide when infused with a complex parenteral-nutrition mixture. C and D are simple glucose solutions, not total parenteral nutrition; E is a compatible saline flush. A is not a recommendation to inject sterile water intravenously; use approved diluents and compatible lines.

Source: Bolus & Glasgow (2018), Exam 1, Q27; question p. 249, answer key p. 325.

[Exam 1 Q028] Dual-isotope gastric emptying studies use which of the following radiopharmaceuticals for each phase of gastric emptying? Liquid phase Solid phase

A) Liquid: In-111 DTPA; solid: Tc-99m sulfur colloid

B) Liquid: In-111 pentetreotide; solid: Tc-99m sulfur colloid

C) Liquid: Tc-99m sulfur colloid; solid: In-111 DTPA

D) Liquid: Tl-201 thallous chloride; solid: Tc-99m sestamibi

E) Liquid: Tc-99m DTPA; solid: Tc-99m sulfur colloid

A - Liquid: In-111 DTPA; solid: Tc-99m sulfur colloid

Why: A assigns In-111 DTPA to liquid and Tc-99m sulfur colloid to a solid meal. B substitutes a receptor tracer for liquid DTPA; C reverses the labels; D uses cardiac agents; E uses two Tc-99m agents, which cannot be distinguished by photon energy in a simultaneous dual-isotope acquisition.

Source: Bolus & Glasgow (2018), Exam 1, Q28; question p. 249, answer key p. 325.

[Exam 1 Q029] Which option correctly completes this statement? Proper placement of a urine collection bag includes:

A) placing it across the patient's lower legs to keep it near the level of the bladder

B) placing it on the stretcher near the patient's feet so it is out of the field of view of the camera

C) discharging the urine collection bag must be done before the exam begins

D) hanging it from an IVpole and raising it above the level of the bladder

E) hanging it from the imaging table so it is lower than the level of the bladder

E - hanging it from the imaging table so it is lower than the level of the bladder

Why: E promotes gravity drainage and limits reflux of contaminated urine. A puts the bag too high; B does not ensure drainage below bladder level; C is not universally necessary before imaging; D increases reflux risk. Keep tubing unobstructed and use secure positioning without disconnecting the system unnecessarily.

Source: Bolus & Glasgow (2018), Exam 1, Q29; question p. 249, answer key p. 325.

[Exam 1 Q030] Which of the following radiopharmaceuticals can be used to assess vesicoureteral reflux by the indirect method?

A) Tc-99m pertechnetate

B) Tc-99m sulfur colloid

C) Tc-99m pentetate

D) Tc-99m medronate

E) Tc-99m albumill

C - Tc-99m pentetate

Why: C reaches the bladder through renal filtration, allowing indirect reflux assessment during or after a renogram. A is not a standard renal excretory agent for this method; B is colloidal; D accumulates in bone; E remains mainly intravascular. Direct cystography uses a different administration route.

Source: Bolus & Glasgow (2018), Exam 1, Q30; question p. 249, answer key p. 325.

[Exam 1 Q031] A 175-lb patient is prescribed 0.02 microgram/kg of cholecystokinin. If the solution contains 10 micrograms/mL, what volume is required?

A) 0.115 mL

B) 0.129 mL

C) 0.134 mL

D) 0.149 mL

E) 0.159 mL

E - 0.159 mL

Why: E follows 175/2.2 = 79.5 kg; 79.5 x 0.02 = 1.59 micrograms; 1.59/10 = 0.159 mL. A, B, C, and D each deliver less than the calculated amount. This is the question's dose-volume arithmetic; clinical infusion duration is a separate protocol parameter.

Source: Bolus & Glasgow (2018), Exam 1, Q31; question p. 249, answer key p. 325.

[Exam 1 Q032] Which option is the exception? Parenteral administration of a drug or radiopharmaceutical would include all of the following routes except:

A) oral

B) intramuscular

C) subcutaneous

D) intravenous

E) intrathecal

A - oral

Why: A is enteral because the drug is swallowed and enters the gastrointestinal tract. B, C, D, and E bypass the gastrointestinal lumen and are parenteral routes. Intrathecal administration enters cerebrospinal fluid, not the stomach or intestine.

Source: Bolus & Glasgow (2018), Exam 1, Q32; question p. 249, answer key p. 325.

[Exam 1 Q033] Which option correctly completes this statement? The red cell survival test is most often performed on a patient with suspected:

A) hemolytic anemia

B) intestinal malabsorption

C) iron defiCiency anemia

D) pernicious anemia

E) Gl bleed

A - hemolytic anemia

Why: A causes premature red-cell destruction, which a labeled-red-cell survival study measures. B concerns absorption; C concerns iron availability; D commonly concerns vitamin B12 deficiency and intrinsic factor; E is evaluated with bleeding-localization methods rather than primarily a red-cell survival curve.

Source: Bolus & Glasgow (2018), Exam 1, Q33; question p. 249, answer key p. 325.

[Exam 1 Q034] Which option correctly completes this statement? A technologist confirms a referring physician's request for a nuclear medicine procedure for a hospitalized patient by:

A) asking the floor nurse

B) telephoning the patient's physician for confirmation

C) locating the order for the test in the patient's medical record

D) conferring with the nuclear medicine physician

E) asking the patient why s/he came to the nuclear medicine department

C - locating the order for the test in the patient's medical record

Why: C verifies that an actual order exists in the medical record. A and E are indirect reports; B may resolve an unclear order but is not the primary documentation check; D addresses appropriateness or protocol approval rather than confirming the referring clinician's recorded request.

Source: Bolus & Glasgow (2018), Exam 1, Q34; question p. 250, answer key p. 325.

[Exam 1 Q035] Which type of collimator should be used for organ counting during a red cell sequestration study?

A) low-energy, high-sensitivity parallel hole

B) high-energy, low-resolution parallel hole

C) pinhole

D) flat field

E) converging

D - flat field

Why: D provides a relatively uniform counting response over an organ for sequestration measurements. A and B are imaging collimators rather than the intended organ-counting geometry; C magnifies small structures; E changes magnification and sensitivity across the field, complicating quantitative organ comparisons.

Source: Bolus & Glasgow (2018), Exam 1, Q35; question p. 250, answer key p. 325.

[Exam 1 Q036] If a plasma volume has been determined to be 15 L, which of the following events has most likely occurred?

A) completion of a satisfactory study

B) overhydration of the patient

C) dehydration of the patient

D) patient did not fast for the study

E) infiltration of the tracer

E - infiltration of the tracer

Why: E leaves too little tracer in the sampled plasma, making dilution calculations falsely large. A is implausible because 15 L greatly exceeds normal plasma volume; B is insufficient to explain this extreme value; C would decrease true volume; D is not the principal tracer-delivery error.

Source: Bolus & Glasgow (2018), Exam 1, Q36; question p. 250, answer key p. 325.

[Exam 1 Q037] Which option is the exception? 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 - released clinical blood (intended); E can also be exempt if truly clean

Why: D is the specifically recognized exemption for blood released for clinical use. A, B, and C contain or handle potentially infectious material and need appropriate hazard identification. E makes the item ambiguous: a truly clean unused sharps container is not infectious merely because it is a sharps container, although collection containers are commonly pre-labeled.

Answer-key note (Ambiguous choices): Book key: D - unit of blood released for clinical use. The key gives D; the added uncontaminated-container alternative is also problematic.

Source: Bolus & Glasgow (2018), Exam 1, Q37; question p. 250, answer key p. 325.

[Exam 1 Q038] Which option correctly completes this statement? The total blood volume may be calculated by dividing the plasma volume measured with labeled albumin by the:

A) hematocrit

B) plasmacrit

C) corrected hematocrit

D) corrected plasmacrit

E) hemoglobin

D - corrected plasmacrit

Why: D accounts for the plasma fraction after the appropriate hematocrit correction: blood volume = plasma volume/(1 - corrected hematocrit). A and C use the red-cell fraction instead; B omits the required correction in this method; E is a concentration and is not the required plasma fraction.

Source: Bolus & Glasgow (2018), Exam 1, Q38; question p. 250, answer key p. 325.

[Exam 1 Q039] Which option correctly completes this statement? If radioactivity in the circulation from a previous nuclear medicine test is unaccounted for, results of a plasma volume determination will be:

A) falsely decreased

B) falsely elevated

C) positive

D) impossible to predict

E) unaffected

A - falsely decreased

Why: A follows the dilution relationship: uncorrected pre-existing plasma counts increase the denominator and falsely decrease calculated plasma volume. B predicts the opposite direction; C is not a quantitative volume result; D ignores the known direction of bias; E would apply only if background activity were properly subtracted.

Source: Bolus & Glasgow (2018), Exam 1, Q39; question p. 250, answer key p. 325.

[Exam 1 Q040] Which option correctly completes this statement? The recommended amount of captopril to be given orally an hour before renal imaging in a hypertension study is:

A) 10- 15 mg

B) 15-20 mg

C) 25-50 mg

D) 55-100 mg

E) 105-110 mg

C - 25-50 mg

Why: C is the conventional adult oral captopril range used before ACE-inhibitor renography. A and B are below the stated standard range; D and E are unnecessarily high for this protocol. Blood pressure, hydration, medications, and the prescribing clinician's protocol must also be considered.

Source: Bolus & Glasgow (2018), Exam 1, Q40; question p. 250, answer key p. 326.

[Exam 1 Q041] Imaging with In-111 pentetreotide routinely includes what area(s) of the body?

A) head and chest

B) chest

C) abdomen

D) head to upper femurs

E) lower extremities

D - head to upper femurs

Why: D surveys from head to proximal thighs for somatostatin-receptor-positive disease. A and B miss the abdomen and pelvis; C misses extra-abdominal disease; E alone misses the most relevant sites. Additional targeted or distal-extremity views are obtained when clinically indicated.

Source: Bolus & Glasgow (2018), Exam 1, Q41; question p. 250, answer key p. 326.

[Exam 1 Q042] A patient scheduled for scintimammography has symptoms involVing her left breast. Which of the following sites is the best choice for injection of the radiopharmaceuticaP?

A) subcutaneous in the left breast

B) right carotid artery

C) right antecubital area

D) left hand

E) left carotid artery

C - right antecubital area

Why: C uses the arm opposite the symptomatic breast, limiting ipsilateral injection-site or nodal contamination of interpretation. A is the wrong administration route; B and E are invasive arterial routes; D is ipsilateral and could produce misleading left axillary activity after infiltration.

Source: Bolus & Glasgow (2018), Exam 1, Q42; question p. 250, answer key p. 326.

[Exam 1 Q043] Based on the net counts data shown here: Right lung: 175,362 Left lung 325,672 what is the percentage perfusion to the right lung?

A) 30%

B) 35%

C) 54%

D) 65%

E) 77%

B - 35%

Why: B follows 175,362/(175,362 + 325,672) x 100 = 35.0%. D is approximately the left-lung fraction; A underestimates the right fraction; C and E overestimate it. Both lungs must be included in the denominator using comparable background-corrected counts.

Source: Bolus & Glasgow (2018), Exam 1, Q43; question p. 250, answer key p. 326.

[Exam 1 Q044] Which option correctly completes this statement? If 375 mCi Tc-99m are present on the column of a Mo-99/Tc-99m generator, and after elution, 342 mCi Tc-99m are assayed in the elution vial, the approximate elution efficiency of the generator is:

A) 110%

B) 91%

C) 33%

D) 11%

E) 5%

B - 91%

Why: B follows 342/375 x 100 = 91.2% recovery. A reverses the ratio and suggests more recovery than was available; C, D, and E substantially underestimate recovery. Elution efficiency compares recovered daughter activity with the activity available on the generator.

Source: Bolus & Glasgow (2018), Exam 1, Q44; question p. 250, answer key p. 326.

[Exam 1 Q045] 250 kilobecquerels are equivalent to how many microcuries?

A) 0.25 uCi

B) 0.55 uCi

C) 6.76 uCi

D) 9.25 uCi

E) 10.35 uCi

C - 6.76 uCi

Why: C follows 1 microcurie = 37 kBq, so 250/37 = 6.76 microcuries. A confuses kilobecquerels with an activity in millicurie-type proportions; B, D, and E do not satisfy the 37 kBq-per-microcurie conversion. Keep the kilo and micro prefixes explicit.

Source: Bolus & Glasgow (2018), Exam 1, Q45; question p. 250, answer key p. 326.

[Exam 1 Q046] If a Mo-99/Tc-99m generator is eluted on Monday at 0600. the maximum Tc-99m activity could next be eluted at what time?

A) 0600 on Tuesday

B) 1200 on Monday

C) 1800 on Monday

D) 0600 on Wednesday

E) 1200 on Tuesday

A - 0600 on Tuesday

Why: A is about 24 hours later, near the usual maximum Tc-99m ingrowth after a complete elution. B and C allow incomplete daughter regrowth; D waits long enough for substantial parent decay; E is later than the next usual peak. This is a generator-ingrowth approximation.

Source: Bolus & Glasgow (2018), Exam 1, Q46; question p. 251, answer key p. 326.

[Exam 1 Q047] According to the NRC, Mo-99 contamination in Tc-99m eluate must be measured how often?

A) weekly

B) daily

C) only after the first elution

D) yearly

E) after each elution

E - each elution

Why: E matches the current NRC requirement to test each generator elution for Mo-99 breakthrough. A, B, and D use calendar intervals that can miss individual eluates; C reflects the older first-elution requirement in this edition. Test results must satisfy the limit at administration as well.

Answer-key note (Updated requirement): Book key: C - only after the first elution. The key gives C, reflecting the former first-elution rule.

Source: Bolus & Glasgow (2018), Exam 1, Q47; question p. 251, answer key p. 326.

Verification: 10 CFR 35.204, generator radionuclidic contamination - https://www.ecfr.gov/current/title-10/chapter-I/part-35/subpart-D/section-35.204

[Exam 1 Q048] I f these results shown were obtained when Tc-99m eluate was assayed for Mo-99 breakthrough at 0600, immediately after elution: Mo-99 10 uCi Tc-99m: 416 mCi which of the following statements about this elution at 1700 is true?

A) The eluate should not be used to label compounds with Tc-99m.

B) The eluate does not contain sufficient Tc-99m activity.

C) The eluate does not contain sufficient Mo-99 activity.

D) The eluate must not be administered to patients.

E) The eluate may be administered to patients.

E - The eluate may be administered to patients.

Why: E remains permissible: initially 10/416 = 0.024 microcurie Mo-99 per mCi Tc-99m, and after 11 hours the ratio is about 0.076, below 0.15. A and D incorrectly reject it; B lacks a prescribed activity requirement; C is wrong because Mo-99 is contamination, not the useful dose.

Source: Bolus & Glasgow (2018), Exam 1, Q48; question p. 251, answer key p. 326.

[Exam 1 Q049] A technologist performs an aluminum ion breakthrough test on Tc-99m eluate and obtains the following results: When the indicator paper is spotted with aluminum ion solution, a faint red color is observed, but when the paper is spotted with eluate, no color change is observed. These results indicate?

A) absence of radionuclidic impurities in the eluate

B) absence of free Tc-99m pertechnetate

C) the aluminum ion concentration in the eluate is below the U.S. Pharmacopeia (USP) limit

D) the aluminum ion solution contains less aluminum than the eluate

E) the eluate should be discarded

C - the aluminum ion concentration in the eluate is below the U.S. Pharmacopeia (USP) limit

Why: C follows because the eluate produces less color than the aluminum reference. A concerns radionuclidic purity, a different test; B concerns radiochemical purity; D reverses the color comparison; E would be appropriate for an excessive impurity, which these observations do not demonstrate.

Source: Bolus & Glasgow (2018), Exam 1, Q49; question p. 251, answer key p. 326.

[Exam 1 Q050] Which option is the exception? All of the following procedures may be performed with Tc-99m sulfur colloid except:

A) gastric-emptying study

B) gastroesophageal reflux study

C) gastrointestinal-bleeding localization

D) Meckel's diverticulum localization

E) bone marrow imaging

D - Meckel's diverticulum localization

Why: D requires pertechnetate uptake by gastric mucosa rather than reticuloendothelial colloid uptake. A and B use labeled meals; C can historically use sulfur colloid for active bleeding; E uses marrow reticuloendothelial uptake. Different formulations and administration routes serve these different examinations.

Source: Bolus & Glasgow (2018), Exam 1, Q50; question p. 251, answer key p. 326.

[Exam 1 Q051] Based on the day's clinic schedule shown here: Patient Procedure Patient A Thyroid uptake and image Patient B Therapy for hyperthyroidism Patient C Cisternogram the technologist should prepare or order which of the following radiopharmaceuticals?

A) I-123 sodium iodide, I-131 sodium iodide, and In-111 DTPA

B) In-111 oxine and I-123 sodium iodide

C) I-123 sodium iodide, Tc-99m sulfur colloid, and Tc-99m MAA

D) I-131 sodium iodide and In-111 chloride

E) I-131 human serum albumin, I-131 sodium iodide, and Tc-99m pertechnetate

A - I-123 sodium iodide, I-131 sodium iodide, and In-111 DTPA

Why: A pairs I-123 with thyroid imaging, I-131 with thyroid therapy, and In-111 DTPA with cisternography. B lacks the therapy and CSF agents; C substitutes unrelated colloid and MAA; D uses indium chloride rather than DTPA; E substitutes albumin and pertechnetate for the required combination.

Source: Bolus & Glasgow (2018), Exam 1, Q51; question p. 251, answer key p. 326.

[Exam 1 Q052] If an MAA kit must be reconstituted with 3.5 mL of Tc-99m pertechnetate, what are the consequences if only 2.0 mL are added to the kit?

A) Patients will receive more MAA particles per milliliter of Tc-99m MAA

B) Patients will receive more pertechnetate per milliliter of recommended patient dose.

C) Patients wi ll receive the recommended number of particles if the correct activity is administered.

D) The resulting perfusion lung images will have the appearance of decreased tracer uptake.

E) Patients will receive fewer MAA particles per milliliter of Tc-99m MAA.

A - Patients will receive more MAA particles per milliliter of Tc-99m MAA

Why: A is true per milliliter because the same particle number occupies a smaller volume. B confuses activity with particle concentration; C depends on the total activity and does not answer the per-milliliter change; D is not the predictable image consequence; E gives the opposite concentration change. Dose particle number also depends on activity concentration.

Source: Bolus & Glasgow (2018), Exam 1, Q52; question p. 251, answer key p. 327.

[Exam 1 Q053] Reconstituted "cold" pyrophosphate is administered to the patient in which red blood cell labeling method(s)?

A) in vitro method

B) both the in vivo method and the modified in vivo method

C) modified in vivo method

D) both the in vitro method and the in vivo method

E) in vivo method

B - both the in vivo method and the modified in vivo method

Why: B covers the in vivo and modified in vivo methods, where stannous pyrophosphate is administered to the patient before pertechnetate labeling. A uses an ex vivo kit instead; C and E each omit one valid method; D incorrectly includes the in vitro method.

Source: Bolus & Glasgow (2018), Exam 1, Q53; question p. 251, answer key p. 327.

[Exam 1 Q054] Wh ich of the following radiopharmaceutical kit formulations is light-sensitive?

A) sestamibi

B) oxidronate

C) mertiatide

D) exametazime

E) pertechnetate

C - mertiatide

Why: C is the intended light-sensitive MAG3 kit; protect it according to its product instructions. A and B are not the characteristic kit tested here; D has its own stability and handling requirements but is not the keyed formulation; E is the radionuclide solution rather than the named light-sensitive ligand kit.

Source: Bolus & Glasgow (2018), Exam 1, Q54; question p. 251, answer key p. 327.

Verification: TechneScan MAG3 prescribing information, light protection - https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0571c18b-1d5e-47bd-bddf-54d74ce1b442

[Exam 1 Q055] When performing radiochromatography on a radiopharmaceutical sample, the solvent front is located 8.5 cm from the origin and the radiochemical impurity is at the origin. What is the Rf value of the radiochemical impurity?

A) -0.5

B) 0

C) 1.0

D) 8.5

E) 0.85

B - 0

Why: B follows Rf = distance traveled by impurity/distance traveled by solvent = 0/8.5 = 0. A is impossible for this definition; C means migration to the solvent front; D reports a distance rather than a ratio; E would require impurity migration away from the origin.

Source: Bolus & Glasgow (2018), Exam 1, Q55; question p. 252, answer key p. 327.

[Exam 1 Q056] According to the USP, most Tc-99m-labeled radiopharmaceuticals should have a radiochemical purity of at least what percentage to be administered to patients?

A) 98%

B) 95%

C) 90%

D) 88%

E) 85%

C - 90%

Why: C is the book's general teaching threshold of at least 90%. A and B are higher thresholds that may apply to particular products; D and E are below 90%. This general statement does not override a product-specific release criterion, which must come from the applicable label or validated protocol.

Source: Bolus & Glasgow (2018), Exam 1, Q56; question p. 252, answer key p. 327.

[Exam 1 Q057] A technologist must administer 8 mCi Tc-99m mebrofenin to a patient at 1100. On the basis of this vial label information: Calibration: 0700, August 4 Total activity: 100 mCi Total volume: 8.5 mL Concentration: ll.8 mCi/mL Expiration: 1500, August 4 what volume of Tc-99m mebrofenin should be administered to the patient?

A) 1.1 mL

B) 0.92 mL

C) 0.68 mL

D) 0.52 mL

E) 0.13 mL

A - 1.1 mL

Why: A follows a four-hour Tc-99m decay factor of about 0.63: 11.8 x 0.63 = 7.43 mCi/mL, so 8/7.43 = 1.08 mL. C ignores decay; B, D, and E do not provide 8 mCi at 1100. Round to the offered 1.1 mL.

Source: Bolus & Glasgow (2018), Exam 1, Q57; question p. 252, answer key p. 327.

[Exam 1 Q058] A technologist must administer 37 MBq Tl-201 thallous chloride at 1000 on February 16. On the basis of this vial label information: Calibration: 1200, February 14 Total activity: 222 MBq Total volume: 4.0 mL Concentration: 55.5 MBq/mL Expiration: 1200, February 17 what volume should be administered to the patient?

A) 1.0 mL

B) 0.96 mL

C) 0.84 mL

D) 0.44 mL

E) 0.23 mL

A - 1.0 mL

Why: A follows approximately 46 hours of Tl-201 decay: concentration falls from 55.5 to about 35.8 MBq/mL, requiring about 1.03 mL for 37 MBq. B and C underdeliver slightly; D and E underdeliver substantially. The nearest offered volume is 1.0 mL.

Source: Bolus & Glasgow (2018), Exam 1, Q58; question p. 252, answer key p. 327.

[Exam 1 Q059] A technologist needs 4 mCi Tl-201 thallous chloride at 0800 on June 29. The label on the radiopharmaceutical vial contains this information: Total activity: 10.0 mCi Total volume: 5.5 mL Assay: 1200, July 1 What volume is required to obtain the necessary activity on June 29?

A) 3.6 mL

B) 1.35 mL

C) 0.74 mL

D) 0.28 mL

E) 0.13 mL

B - 1.35 mL

Why: B follows reverse decay correction: 52 hours before calibration, Tl-201 concentration is about 2.98 mCi/mL, so 4/2.98 = 1.34 mL. A is too large; C, D, and E are too small. An earlier administration time requires less volume than at the later calibration time.

Source: Bolus & Glasgow (2018), Exam 1, Q59; question p. 252, answer key p. 327.

[Exam 1 Q060] Which radiopharmaceutical is used to label red blood cells with Tc-99m?

A) Tc-99m albumin

B) Tc-99m pertechnetate

C) Tc-99m sui fu r colloid

D) Tc-99m pyrophosphate

E) Tc-99m exa metazime

B - Tc-99m pertechnetate

Why: B supplies Tc-99m that can enter stannous-treated red cells and bind hemoglobin. A labels albumin; C targets reticuloendothelial tissue; D supplies the stannous pretreatment ligand but labeled pyrophosphate is not the cell-labeling radionuclide solution; E is used for leukocyte labeling and brain perfusion.

Source: Bolus & Glasgow (2018), Exam 1, Q60; question p. 252, answer key p. 327.

[Exam 1 Q061] Which of the following radiopharmaceuticals is used to label white blood cells with Tc-99m?

A) Tc-99m bicisate

B) Tc-99m sulfur colloid

C) Tc-99m pertechnetate

D) Tc-99m sestamibi

E) Tc-99m exametazime

E - Tc-99m exametazime

Why: E is lipophilic HMPAO and can label leukocytes ex vivo. A is a brain-perfusion tracer not the standard leukocyte-labeling kit; B targets reticuloendothelial tissue; C does not selectively label white cells; D is chiefly a perfusion and tumor-imaging agent.

Source: Bolus & Glasgow (2018), Exam 1, Q61; question p. 252, answer key p. 328.

[Exam 1 Q062] When Tc-99m exametazime is used to label white blood cells, which of the following reagents is omitted from its preparation?

A) Tc-99m pertechnetate

B) 0.9%sodium chloride

C) heparin

D) methylene blue stabi Iizer

E) ACD solution

D - methylene blue stabi Iizer

Why: D is omitted in the leukocyte-labeling preparation described because the stabilized cerebral-imaging formulation is unsuitable for that labeling method. A supplies radioactivity; B provides isotonic diluent; C and E are associated with anticoagulation or cell handling. Follow the specific leukocyte-labeling procedure rather than substituting a brain-imaging preparation.

Source: Bolus & Glasgow (2018), Exam 1, Q62; question p. 252, answer key p. 328.

[Exam 1 Q063] If 4 millicuries of Tl-201 thallous chloride is the prescribed unit dosage, which of the following dose calibrator measurements, according to the NRC, verifies that a dosage within acceptable limits has been dispensed into the syringe? L 3.5 mCi II 4.0 mCi IlL 4.3 mCi IV. 4.5 mCi

A) I only

B) II only

C) II or III only

D) I, II, or I II only

E) I, II, III, or IV

E - I, II, III, or IV

Why: E includes all four values within 20% of 4 mCi: the accepted interval is 3.2-4.8 mCi under the question's assumptions. A, B, C, and D each omit at least one acceptable value. A prescriber-specified range or authorization can alter the applicable dispensing limits.

Source: Bolus & Glasgow (2018), Exam 1, Q63; question p. 252, answer key p. 328.

[Exam 1 Q064] Which option correctly completes this statement? In labeling red blood cells with radiochromium, the order of components to be added to the vial containing ACD solution is:

A) radiochromium, ACD, patient blood, ascorbic acid

B) radiochromium, patient blood, ascorbic acid

C) radiochromium, ascorbic acid, patient blood

D) patient blood, radiochromium, ascorbic acid

E) ascorbic acid, radiochromium, patient blood

D - patient blood, radiochromium, ascorbic acid

Why: D first collects blood into anticoagulant, then adds chromium for labeling, then ascorbic acid to reduce unbound chromium and stop further labeling. A redundantly adds anticoagulant out of sequence; B puts chromium before collection; C reduces chromium too early; E prevents effective initial labeling.

Source: Bolus & Glasgow (2018), Exam 1, Q64; question p. 253, answer key p. 328.

[Exam 1 Q065] If a unit dosage of Tc-99m MAA contains 148 MBq and 325,000 particles in 0.75 mL at 1,000, approximately how many particles will be contained in 148 MBq at 1,600?

A) 162,500

B) 325,000

C) 433,333

D) 522,000

E) 650,000

E - 650,000

Why: E follows one Tc-99m half-life: activity per particle halves in six hours, so twice as many particles are needed for the same 148 MBq. A halves the count incorrectly; B ignores decay; C and D increase it by insufficient amounts. Particle number does not decay with activity.

Source: Bolus & Glasgow (2018), Exam 1, Q65; question p. 253, answer key p. 328.

[Exam 1 Q066] If a unit dosage of radioactivity contains 45 mCi in 1.2 mL, how many milliliters must be removed so 35 mCi remain in the syringe?

A) 0.93 mL

B) 0.78 mL

C) 0.27 mL

D) 0.13 mL

E) 0.02 mL

C - 0.27 mL

Why: C follows concentration 45/1.2 = 37.5 mCi/mL; removing 10 mCi requires 10/37.5 = 0.267 mL. A is approximately the volume to retain, not remove; B, D, and E do not remove the required 10 mCi. The syringe should retain about 0.933 mL.

Source: Bolus & Glasgow (2018), Exam 1, Q66; question p. 253, answer key p. 328.

[Exam 1 Q067] If a radiopharmaceutical kit must be reconstituted with 30 mCi contained in 5 mL and the eluate has an activity of 350 mCi in 7 mL, how many milliliters of preservative-free saline must be added?

A) 0.6 mL

B) 4.4 mL

C) 4.9 mL

D) 5.2 mL

E) 6.0 mL

B - 4.4 mL

Why: B follows 350/7 = 50 mCi/mL, so 30 mCi occupies 0.6 mL and saline needed is 5 - 0.6 = 4.4 mL. A is the eluate volume; C, D, and E give an incorrect final reconstitution volume.

Source: Bolus & Glasgow (2018), Exam 1, Q67; question p. 253, answer key p. 328.

[Exam 1 Q068] What is the minimal centrifugation time needed if a protocol specifies 5000 g for 5 min, but the maximum relative centrifugal force that can be obtained is 2500 g?

A) 2 min

B) 2.5 min

C) 7.5 min

D) 10 min

E) 12.5 min

D - 10 min

Why: D follows the question's equal-force-time assumption: 5000 x 5 = 2500 x 10. A and B are too short; C is shorter than the calculated 10 minutes; E is longer. Actual cell-processing performance must still follow the validated centrifugation procedure, not force-time substitution alone.

Source: Bolus & Glasgow (2018), Exam 1, Q68; question p. 253, answer key p. 328.

[Exam 1 Q069] 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 - "Caution: Radioactive Materials"

Why: D is the general radioactive-material posting contemplated by the book. B is an additional work-area restriction; C and E depend on measured radiation-area thresholds; A is not universally valid. Patient rooms and other circumstances can qualify for posting exceptions, so this is not an unconditional rule for every imaging room.

Source: Bolus & Glasgow (2018), Exam 1, Q69; question p. 253, answer key p. 328.

[Exam 1 Q070] 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

A and B - both require Yellow-III

Why: Both A and B meet Yellow-III criteria because the surface rates exceed 50 mR/hr and the one-meter rates exceed 1 mR/hr. C and D fall within Yellow-II limits; E fits White-I. The key's B is valid, but it incorrectly excludes A from a single-answer item.

Answer-key note (Multiple correct choices): Book key: B - 56 mR/hr 3.5 mR/hr. The key gives B only.

Source: Bolus & Glasgow (2018), Exam 1, Q70; question p. 253, answer key p. 329.

Verification: 49 CFR 172.403, radioactive-package label categories - https://www.ecfr.gov/current/title-49/subtitle-B/chapter-I/subchapter-C/part-172/subpart-E/section-172.403

[Exam 1 Q071] If a point source produces an exposure rate of 30 mR/hr at a distance of 15 cm, what is the exposure rate at 40 cm from the source?

A) 4.2 mR/hr

B) 85 mR/hr

C) 1l.2 mR/hr

D) 22 mR/hr

E) 25 mR/hr

A - 4.2 mR/hr

Why: A follows inverse square: 30 x (15/40)^2 = 4.22 mR/hr. B and C exceed the correct result; D and E decrease the rate too little. Distance increases by more than twofold, so the exposure rate must drop by more than fourfold.

Source: Bolus & Glasgow (2018), Exam 1, Q71; question p. 253, answer key p. 329.

[Exam 1 Q072] If the half-value layer (HVL) for I-131 in lead is 0.3 cm, what is the minimum thickness of lead that is required to reduce the exposure rate of an 131 1 source from 12 mR/hr to less than 2 mR/hr?

A) 0.3 cm

B) 0.6 cm

C) 0.75 cm

D) 0.9 cm

E) 1.2 cm

D - 0.9 cm

Why: D gives three HVLs: 12 to 6 to 3 to 1.5 mR/hr. A leaves 6; B leaves 3; C, if 0.75 cm, leaves about 2.12 and misses the target; E works but is not the minimum offered thickness. The exact continuous threshold is just above 0.775 cm.

Source: Bolus & Glasgow (2018), Exam 1, Q72; question p. 253, answer key p. 329.

[Exam 1 Q073] A patient receives a unit dosage of Sr-89 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 Sr-89, 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 - The situation describes a medical event requiring notification of the NRC.

Why: E is the intended therapeutic wrong-patient medical event, assuming the regulatory absorbed-dose thresholds are exceeded. A and D incorrectly presume a unit dose is harmless; B incorrectly dismisses reporting; C omits NRC notification. Wrong-patient administration and the applicable radiation-dose thresholds both matter under current rules.

Source: Bolus & Glasgow (2018), Exam 1, Q73; question p. 253, answer key p. 329.

Verification: 10 CFR 35.3045, medical-event criteria and reports - https://www.ecfr.gov/current/title-10/chapter-I/part-35/subpart-M/section-35.3045

[Exam 1 Q074] Which option correctly completes this statement? According to NRC regulations, the annual occupational dose limit to the eye is:

A) 150 mSv

B) 100 mSv

C) 75 mSv

D) 50 mSv

E) 5 mSv

A - 150 mSv

Why: A equals 15 rem, the U.S. NRC annual occupational lens-dose limit. B and C are lower values but not this limit; D is the whole-body occupational effective-dose limit; E is not the adult lens limit. Do not substitute a different organization's advisory lens limit for the NRC value asked here.

Source: Bolus & Glasgow (2018), Exam 1, Q74; question p. 253, answer key p. 329.

[Exam 1 Q075] A vial of 1l3Xe 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 - Return the vial to storage.

Why: C follows the release requirement that residual activity be indistinguishable from background with an appropriate unshielded survey. A and E dispose of material prematurely; B cannot establish acceptable residual contained activity; D releases xenon rather than continuing controlled decay storage. Elapsed half-lives alone do not authorize disposal.

Source: Bolus & Glasgow (2018), Exam 1, Q75; question p. 254, answer key p. 329.

[Exam 1 Q076] 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 - on a reasonable schedule

Why: A reflects the performance-based NRC requirement for suitable surveys on a reasonable schedule. B may be required by a facility's license or written program; C and E are not universally sufficient; D ignores routine contamination risk. Follow the license and radiation-safety procedures in addition to the general regulation.

Source: Bolus & Glasgow (2018), Exam 1, Q76; question p. 254, answer key p. 329.

[Exam 1 Q077] A GM meter indicates 1.7 on its scale and is set to x0.1. What exposure rate should be recorded?

A) 0.017 mR/hr

B) 0.17 mR/hr

C) 1.7 mR/hr

D) 17 mR/hr

E) 170 mR/hr

B - 0.17 mR/hr

Why: B is obtained by applying the selected multiplier to the meter's indicated scale value. A is tenfold low; C is tenfold high; D is hundredfold high; E is thousandfold high. Read the correct scale and range before reporting a survey value.

Figure note: The original figure is represented by a text description in this card; see the cited book page for the image.

Source: Bolus & Glasgow (2018), Exam 1, Q77; question p. 254, answer key p. 329.

[Exam 1 Q078] 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 - Put on disposable gloves.

Why: C protects the hands before handling potentially contaminated packaging. A and D are subsequent monitoring steps; B assesses the work surface rather than first protecting the operator; E verifies documentation after safe handling precautions. Package surveys should follow the required receipt procedure and timing.

Source: Bolus & Glasgow (2018), Exam 1, Q78; question p. 254, answer key p. 329.

[Exam 1 Q079] Which option correctly completes this statement? 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 - No more contamination can be removed from the area.

Why: E identifies the practical endpoint of removing transferable contamination, with the remaining area surveyed and controlled appropriately. A and B confuse exposure rate with removable contamination; C only describes extent; D does not establish cleanliness. Persistent fixed activity may require restriction, shielding, or decay rather than endless ineffective cleaning.

Source: Bolus & Glasgow (2018), Exam 1, Q79; question p. 254, answer key p. 330.

[Exam 1 Q080] Which option correctly completes this statement? 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 - likely to exceed 10%of the annual maximum allowable occupational exposure

Why: C is the adult monitoring threshold: likely receipt of more than 10% of an applicable annual occupational limit. A and B would include trivial exposures; D waits until excessive exposure is likely; E makes job title rather than dose potential the criterion. Different lower thresholds apply to some other groups.

Source: Bolus & Glasgow (2018), Exam 1, Q80; question p. 254, answer key p. 330.

[Exam 1 Q081] A patient can be released after receiving a therapeutic radiopharmaceutical if no other individual is likely to receive an exposure dose, from being exposed to the patient, exceeding how many Rems?

A) 0.5 Rem

B) 0.7 Rem

C) 2.5 Rem

D) 5.0 Rem

E) 7.0 Rem

A - 0.5 Rem

Why: A is 0.5 rem, or 5 mSv, to any other individual under the NRC release criterion. B, C, D, and E all exceed that limit. Written precautions are separately required when another person's dose is likely to exceed the specified instruction threshold.

Source: Bolus & Glasgow (2018), Exam 1, Q81; question p. 254, answer key p. 330.

[Exam 1 Q082] If a source of radioactive contamination produces 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

B - 6 half-lives

Why: B follows 3/(2^6) = 0.0469 mR/hr, below 0.05. A leaves 0.0938, still too high. C, D, and E allow additional decay but are not the first sufficient whole-half-life count. Solve 3/0.05 = 60, then find the smallest integer n with 2^n at least 60.

Source: Bolus & Glasgow (2018), Exam 1, Q82; question p. 254, answer key p. 330.

[Exam 1 Q083] 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 - 3 years

Why: E is the usual NRC retention period for these routine survey records. B, C, and D are longer than required here; A applies to certain different lifetime records, not every routine survey. Distinguish routine survey documentation from decommissioning-related records with different retention requirements.

Source: Bolus & Glasgow (2018), Exam 1, Q83; question p. 254, answer key p. 330.

[Exam 1 Q084] 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

Why: B is dense tungsten, useful for compact shielding of 511-keV photons. A can provide attenuation but generally needs a less practical thickness; C is costly; D is less effective per unit thickness; E is primarily a beta-shielding arrangement and does not provide the same compact PET attenuation. Shield geometry and actual hand exposure still matter.

Source: Bolus & Glasgow (2018), Exam 1, Q84; question p. 254, answer key p. 330.

[Exam 1 Q085] If a nuclear medicine technologist needs a diagnostic x-ray, how should this exposure be included in his/her occupational exposure record?

A) The technologist should wear his/her radiation dosimeter during the x-ray examination.

B) The exposure from the x-ray examination must not be included in the occupational exposure record.

C) The RSO will supply a separate dosimeter for the technologist to wear during the x-ray examination.

D) Apocket dosimeter should be used.

E) The RSO will estimate the probable exposure and add it to the technologist's permanent record.

B - The exposure from the x-ray examination must not be included in the occupational exposure record.

Why: B excludes personal medical exposure from the occupational dose record. A and D can wrongly attribute a patient exposure to work; C still creates the same misclassification; E also adds an excluded exposure. Occupational monitoring tracks work-related radiation, not the worker's diagnostic examination as a patient.

Source: Bolus & Glasgow (2018), Exam 1, Q85; question p. 255, answer key p. 330.

[Exam 1 Q086] Which option correctly completes this statement? According to the standard of practice, if the results of a dose calibrator geometric variation test demonstrate that the measured values exceed the values by 12- 15%, the technologist should:

A) Replace the instrument.

B) Use a correction factor to determine true activities.

C) Perform a chi-square analysis.

D) Use the actual dose calibrator activity readings.

E) Have the instrument repaired.

B - Use a correction factor to determine true activities.

Why: B corrects a demonstrated geometry-dependent response when an approved correction approach is appropriate. A and E assume the chamber must be replaced or repaired; C tests statistical variability, not geometry bias; D leaves a known 12-15% error uncorrected. A correction factor must match the specific geometry.

Source: Bolus & Glasgow (2018), Exam 1, Q86; question p. 255, answer key p. 330.

[Exam 1 Q087] A long-lived Co-57 reference is checked on the Co-57, Tc-99m, I-123, I-131, Xe-133, and Tl-201 dose-calibrator settings against each setting's decay-corrected baseline. Which quality-control property is being assessed?

A) constancy

B) chi-square analysis

C) linearity

D) geometric variation

E) accuracy

A - constancy

Why: A is the intended constancy procedure when a long-lived source is checked reproducibly on multiple settings against each setting's established baseline. B measures statistical consistency; C varies activity; D varies volume or container; E requires a known correct activity on the appropriate nuclide setting, not arbitrary cross-setting readings.

Source: Bolus & Glasgow (2018), Exam 1, Q87; question p. 255, answer key p. 330.

[Exam 1 Q088] Which option correctly completes this statement? ACs-137 reference standard is counted daily with a scintillation spectrometer, using the same gain, window, and high voltage setting. On the basis of these data: Date Net counts per minute July 15 12,555 July 16 12,534 July 17 12,613 July 20 10,678 on July 20, the technologist should:

A) Use the spectrometer for clinical studies.

B) Arrange for repair of the instrument.

C) Change the gain setting.

D) Change the fine gain setting.

E) Recalibrate the operating voltage.

E - Recalibrate the operating voltage.

Why: E addresses a shifted operating plateau or high-voltage response before condemning the instrument. A ignores a substantial drop; B is premature without basic troubleshooting; C and D move the energy selection rather than first establishing the appropriate operating voltage. Recheck the source geometry and instrument setup as well.

Source: Bolus & Glasgow (2018), Exam 1, Q88; question p. 255, answer key p. 330.

[Exam 1 Q089] According to the standard of practice, how often should dose calibrator linearity testing be performed?

A) annually

B) quarterly

C) monthly

D) daily

E) hourly

B - quarterly

Why: B is the conventional quarterly linearity schedule used in this text. A is too infrequent for that schedule; C and D are more frequent than the stated routine requirement; E is impractical. Current NRC rules refer to nationally recognized standards or manufacturer instructions rather than making every listed interval universal law.

Source: Bolus & Glasgow (2018), Exam 1, Q89; question p. 255, answer key p. 330.

[Exam 1 Q090] An intrinsic flood has a localized edge indentation or cold region consistent with a single failed photomultiplier tube. What component requires repair or replacement?

A) Replace the crystal.

B) Redo reference map calibration.

C) Repair the collimator.

D) Replace a photomultiplier tube.

E) Replace thex,Y localization board.

D - Replace a photomultiplier tube.

Why: D addresses the localized photomultiplier-related sensitivity defect shown in the intrinsic flood. A would fit crystal damage; B cannot reliably correct a failed component; C cannot explain an intrinsic defect because the collimator is removed; E would produce a different localization-related pattern.

Figure note: The original figure is represented by a text description in this card; see the cited book page for the image.

Source: Bolus & Glasgow (2018), Exam 1, Q90; question p. 255, answer key p. 330.

[Exam 1 Q091] Which of the following sources is the most appropriate for assessing dose calibrator constancy?

A) Cs-137

B) Co-57

C) I-123

D) I-131

E) Tc-99m

A - Cs-137

Why: A is Cs-137, a long-lived reference suitable for reproducible daily constancy checks. B can be usable for some checks but decays much faster; C and D are comparatively short-lived iodine sources; E decays in about six hours. A long physical half-life reduces correction uncertainty and replacement frequency.

Source: Bolus & Glasgow (2018), Exam 1, Q91; question p. 255, answer key p. 330.

[Exam 1 Q092] Which of the following statements about the effect of the filter-cutoff frequency is true?

A) The lower the cutoff frequency, the smoother the image.

B) The higher the cutoff frequency, the noisier the image.

C) Adjusting the cutoff frequency will not affect image appearance.

D) The cutoff frequency cannot be adjusted after the image has been acquired.

E) The lower the cutoff frequency, the noisier the image.

A and B - lower cutoff smooths; higher cutoff retains more noise

Why: A and B are both true: lowering cutoff removes high spatial frequencies and smooths the image, while raising it retains more noise and detail. C denies a real effect; D wrongly prohibits reprocessing; E reverses the relationship. The keyed E directly contradicts the book's own explanation.

Answer-key note (Answer differs from key): Book key: E - The lower the cutoff frequency, the noisier the image.. The key gives E, which reverses the relationship and contradicts the explanation.

Source: Bolus & Glasgow (2018), Exam 1, Q92; question p. 255, answer key p. 330.

[Exam 1 Q093] Temporal resolution is related to which of the following acquisition parameters?

A) percentage energy window

B) matrix size

C) framing rate

D) collimator

E) crystal size

C - framing rate

Why: C determines how finely time is divided; shorter frames improve temporal resolution. A selects photon energies; B changes spatial sampling; D changes spatial resolution and sensitivity; E affects detection characteristics. These other settings do not directly define the acquisition's frame duration.

Source: Bolus & Glasgow (2018), Exam 1, Q93; question p. 255, answer key p. 331.

[Exam 1 Q094] It would be appropriate to apply temporal smoothing in which of the following studies?

A) gated-equilibrium cardiac function study

B) SPECT study of the brain

C) SPECT study of the liver

D) thyroid image

E) whole-body bone image

A - gated-equilibrium cardiac function study

Why: A contains ordered frames across the cardiac cycle, allowing smoothing between adjacent times. B and C are primarily spatial tomographic datasets; D and E are static or whole-body spatial images. Excessive temporal smoothing can blur genuine rapid motion and alter functional measurements.

Source: Bolus & Glasgow (2018), Exam 1, Q94; question p. 256, answer key p. 331.

[Exam 1 Q095] If an image is acquired into a 128 x 128 matrix on a scintillation camera with a 350 mm diameter field of view, what are the dimensions of each pixel?

A) 2.73 x 2.73 mm

B) 3.14 x 3.14 mm

C) 5.92 x 5.92 mm

D) 651 x 651 mm

E) 783 x 783 mm

A - 2.73 x 2.73 mm

Why: A follows 350 mm/128 = 2.734 mm per pixel in each dimension. B and C are too large; D and E are far larger than the entire field and cannot be correct pixel sizes. Matrix dimension is a linear count, not the total number of pixels.

Source: Bolus & Glasgow (2018), Exam 1, Q95; question p. 256, answer key p. 331.

[Exam 1 Q096] 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 - well counter

Why: B counts wipes with high sensitivity and therefore assesses removable activity. A measures radiation directly but does not alone distinguish removable from fixed activity; C measures much larger activities; D has an organ-counting geometry; E is an exposure-rate instrument with insufficient sensitivity for small wipe samples.

Source: Bolus & Glasgow (2018), Exam 1, Q96; question p. 256, answer key p. 331.

[Exam 1 Q097] Which of the following matrix sizes and acquisition modes would be most appropriate for a blood flow study of the feet?

A) 64 x 64 word

B) 64 x 64 byte

C) 256 x 256 byte

D) 256 x 256 word

E) 512 x 512 byte

B - 64 x 64 byte

Why: B offers rapid acquisition with a small matrix and sufficient byte depth for low-count flow frames. A stores more counts per pixel than needed here; C and E oversample low-count frames; D combines an unnecessarily large matrix and word depth. Prevent overflow if actual counts exceed byte capacity.

Source: Bolus & Glasgow (2018), Exam 1, Q97; question p. 256, answer key p. 331.

[Exam 1 Q098] A daily uniformity flood for a scintillation camera should contain a minimum of how many counts?

A) 10,000

B) 1-2 million

C) 3-5 million

D) 6-10 million

E) 20-30 million

C - 3-5 million

Why: C is the book's routine minimum range of three to five million counts for a daily flood. A and B provide inadequate count statistics for that standard; D and E may be used for higher-statistics evaluations but exceed the minimum asked. Follow the camera's specified QC acquisition requirements.

Source: Bolus & Glasgow (2018), Exam 1, Q98; question p. 256, answer key p. 331.

[Exam 1 Q099] As a pinhole collimator is moved farther away from the thyroid, how will it affect the image?

A) The gland will appear larger.

B) The image will be flipped.

C) The gland will appear smaller.

D) There is no change in size or orientation.

E) Right and left are reversed.

C - The gland will appear smaller.

Why: C follows pinhole magnification: increasing object-to-aperture distance reduces image size. A predicts the opposite; B and E describe inversion that is intrinsic to pinhole geometry, not newly caused by this distance change; D incorrectly predicts no magnification change.

Source: Bolus & Glasgow (2018), Exam 1, Q99; question p. 256, answer key p. 331.

[Exam 1 Q100] During geometric variation testing of a dose calibrator, activity in a 1 mL syringe measures 253 uCi when the expected reading is 212 uCi. Which of the following correction factors should be applied to the measured reading?

A) 23.3

B) 4.1

C) 1.19

D) 0.84

E) 0.51

D - 0.84

Why: D follows correction factor = expected/measured = 212/253 = 0.838. Multiplying the displayed activity by 0.84 restores the expected value. A and B greatly overcorrect; C approximates the inverse ratio; E is too small. The factor is dimensionless and specific to this syringe geometry.

Source: Bolus & Glasgow (2018), Exam 1, Q100; question p. 256, answer key p. 331.