Mock Registry Exam Practice Questions

which area of the prostate sits closest to the bladder

base of the prostate

which treatment volume best describes gross tumor and microscopic disease

• ctv

• gtv

• ptv

• itv

ctv

wotf is not true about lithium fluoride thermo luminescent dosimeters

• they have a wide dose response range

• they have an effective atomic number that is close to tissue

• they provide a record as they can be heated up many times w/o removing the dose deposited

• the intensity of light emitted is dependent upon the radiation exposure

they provide a record as they can be heated up many times w/o removing the dose deposited

the number one primary cancer killer in the united states for both men and women combited is

• lung

• colon

• liver

• brain

lung

a patient that is getting 150cGy twice a day for 30 fractions is considered

• hypofractionation

• hyperfractionation

• isofractionation

• standard fractionation

hyperfractionation

what is the standard for handling, storing, printing, and transmitting information in radiation oncology

• TCP/IP

• DICOM

• JPEG

• PNG

DICOM

according to TG-142, the daily xray and electron output constancy tolerance should be below which of the following to be considered passing

• 1%

• 2%

• 3%

• 5%

3%

on a most standard linacs, what is the maximum field size that can be programmed into the machine

• 35×35

• 39.5×39.5

• 40×40

• 45×45

40×40

during a radiation therapy treatment the power goes off to the therapy delivery room. a few moments later power is quickly restored. what would you do

• talk to the patient, wait for record and verify computer to come back on line to see how many monitor units were given

• talk to the patient, go to the linac electronics cabinet, and record the monitor units delivered from the backup monitor unit counter

• talk to the pt, and immediately start tx when the systems come back on line in order to not delay the tx any more

• notify the doctor immediately of the power failure

talk to the patient, go to the linac electronics cabinet, and record the monitor units delivered from the backup monitor unit counter

a pt has a separation of 17.0cm. the patient is being treated with an open 12×12 field to a midplane depth. it is an ap/pa technique. what is the size of the field that would be measured on the pts skin

• 13.1×13.1

• 14.5×14.5

• 11.0×11.0

• 10.0×10.0

11.0×11.0

under most circumstances, in order for the pt’s consent to be valid which of the following are true

• pt must be considered competent to make the decision

• pt consent must be voluntary

• pt must be considered competent to make the decision and pt consent must be voluntary

• pt must be allowed at minimum of 15min to ask questions

pt must be considered competent to make the decision and pt consent must be voluntary

wotf is an adverse effect in radiation therapy

• erythema on a chest wall where 1.0cm bolus was prescribed

• radiation pneumonitis when tx a lung cancer

• pt is diagnosed with mets disease half way through tx

• local tumor failure after 6months of tx

radiation pneumonitis when tx a lung cancer

breast cancer cells that are still confined to the milk ducts and have yet to invade the surrounding tissue is considered

• T2N0

• carcinoma in situ

• T1N1

• T2N1

carcinoma in situ

a pt is being treated supine, head towards the gantry with a AP and PA fields. the pt is on a lung board. prescription is to midplane and both AP/PA have the exact same field parameters. the lung board factor is .972. the monitor units for the AP are 187. what do you expect the monitor units for the PA to be

• 192

• 187

• 182

• 196

192

the most common type of tumor for ovarian cancer is

• germ cell

• epithelial

• stromal

• hemangiomas

epithelial

wotf is not one of the three classic acute radiation syndromes

• multiple organ dysfunction syndrome

• hematopoietic syndrome

• gastrointestinal syndrome

• central nervous syndrome

multiple organ dysfunction syndrome

a pt is being treated with external beam radiation for their lung. the pt complains of esophagitis. what could you recommend

• take small bites, chew the food well, and sip liquids while eating solids to moisten the food

• drinks lots of hot tea

• recommend eating lots of steak for proteins and calories

• eat very large meals three times a day to insure proper caloric intake

take small bites, chew the food well, and sip liquids while eating solids to moisten the food

LOOK AT QUESTION 19 TOO LONG

a pt was stimulated and iso was placed with having an AP SSD of 83.25. the PA SSD is 87.75. the doctor decides to prescribe to midplane with a midplane setup. what is the new AP SSD

• 71

• 85.5

• 87.75

• 90

85.5

a 16Mev beam has the following beam characteristics: dmax is 3.1cm, 90% depth is 5.2cm, 80% depth is 5.7cm, surface is covered by 93%. the doctor wants to prescribe to the 90% isodose line. the doctor wants your input on how much bolus they should use. the doctor wants to make sure skin gets at least 100% coverage. how much bolus do you tell the doctor that they need to use

• no bolus needed

• 0.5cm

• 1.0cm

• 1.5cm

no bolus needed

a pt is coming for treatment and experiences a grand mal seizure. what should you do

a. call for help and make sure the pt doesnt hurt themselves by placing the patient on the floor and a pillow under their head

b. call for help and make sure the pt doesnt hurt htemselves by holding them down and restraining them on the floor

c. call for help and try to find something soft to place in their mouth that way they wont bite their tongue farther injuring themselves

d. call for help and do nothing

a

linac in viro dosimetry can be performed with wotf

a. bubble chamber

b. Geiger-muller detector

c. diode

d. survery meter

c

which treatment option is considered a systemic approach to tx

a. xrt

b. surgery

c. brachytherapy

d. chemotherapy

d

a known object of 24cm was placed on the pt. when you measure this object on the simulation film, you measure 31cm. what was the source to image distance that this film was taken at?

a. 100cm

b. 77cm

c. 129cm

d. 69cm

c

at a minimum, how many cameras and what type of audio system are needed for a radiation therapy treatment vault?

a. 2 closed circuits and a two way voice communication system

b. 3 closed circuits and a two way voice communication system

c. 3 closed circuits and a one way voice communication system

d. 2 closed circuits and a one way voice communication system

a

in general, the modality of choice for diagnosing brain tumors is

a. CT

b. MRI

c. PET scan

d. head xray

b

wotf is considered malignant

a. schwannomas

b. lipomas

c. fibromas

d. neurofibrosarcomas

d

what are the proper order of parts that an electron beam travels in a linac? please start with electron beam and end with the patient

electron, primary collimator, scattering foil, ion chamber, secondary collimator, electron cone, patient

a record and verify system is used to?

a. store beam data that the treatment planning can use to model treatment beams

b. store treatment parameters and treatment history about a pts treatment

c. store brachytherapy source models to model radioactive sources

d. store CT scanner HU to CT density curves

b

when is solid radioactive material allowed to be thrown out as a normal trash

a. when the material has gone through at least 5 half lives and the material can no longer be distinguished from background radiation

b. when the material has gone through at least 10 half lives and the material can no longer be distinguished from background radiation

c. when the material has gone through at least 20 half lives and the material can no longer be distinguished from background radiation

d. when the material has gone through at least 6 half lives and the material is emitting less then 2% of its original radioactivity

b

what is the most important step in preventing the spread of germs

a. hand washing

b. using a surgical mask

c. antiobotic use

d. vaccinations

a

based on TG66, the following QA should be done daily on a CT simulator

a. spatial resolution

b. contrast resolution

c image noise

d. all of the above

c

mycosis fungoids is?

a. almost always curable with xrt alone

b. incurable

c. always curable with xrt, sx, and chem

d. almost always curable with topical steriods

b

protons can be advantageous over photons because of the following

a. bradd peak

b. skin dose increases

c. low biological effectiveness

d. all of the above

a

all linear accelerator vaults are required to have the following except

a. audio communications

b. visual monitors

c. lead aprons

d. radiation detector inside the room

c

when treating a prostate with seminal vesicles only, wotf is usually not a critical organ of concern

a. kidney

b. bowel

c. rectum

d. femurs

a

a pt is prone and going to be treated 100SSD to a depth of 5.0cm. the field size is 14×8. you think you setup to 100SSD but the ODI is off. the patient is really setup to 97SSD. what is the field size on the skin

a. 13.6 × 7.8

b. 14 × 8

c. 14.4 × 8.2

d. 12.9 × 7.4

a

the first step of the grieving process is

a. shock and denial

b. despair and depression

c. anger

d. acceptance

a

you are alone during a simulation and you cannot find the simulation camera. you are about done with the simulation but would like to take the setup photos. what would be a reasonable approach?

a. call the treatment machine and have a therapist bring you the treatment machine digital camera

b. use your cell phone to take the setup photos, that way you dont have to leave the patient on the table alone

c. let the pt go home and forget the setup photos

d. walk to the tx machine and take the tx machines digital camera

a

wotf is a medial event

a. omitting a 2% couch factor on a PA beam

b. accidentally submitting a port film that is 5mm off before treatment

c. treating an electron cone field with the wrong energy from the prescription

d. after treating a midplane patient realizing that the seperation was different from the calculation by 2.0cm

c

wotf allows for the most consistent table coordinates between treatments

a. pt indexing to the table

b. better immobilization devices

c. KV imaging

d. doing daily cone beam CTs

a

based on the TD5/5 which structure is the most radio resistant structure

a. bladder

b. lung

c. spinal cord

d. small intestine

a

wotf of these structures is considered a serial organ

a. heart

b. lung

c. brain

d. cord

d

pts that have low red blood cells bc of xrt treatment may suffer from

a. hemophilia

b. anaemia

c. thrombophilia

d. leukopenia

b

the most common site for prostate cancer to metastasis to is

a. bones

b. brain

c. lung

d. liver

a

as slice thickness decreases, and all other variables remain the same, wotf is also true

a. noise increases

b. noise decreases

c. dose to the pt increases

d. dose to the pt decreases

a

a person is exposed to 1.1Gy of proton particles with an average quality factor of 10, what would be the dose equivalent

a. 110 rads

b. 1.1 rem

c. 1100 becquerel

d. 11 sieverts

d

what is the most common gynecologic malignancy

a. carcinoma of the endometrium

b. carcinoma of the cervix

c. carcinoma of the vulva

d. carcinoma of the vagina

a

drenching night sweats could be a clinical presentation of which disease

a. oligoendrogiomas

b. seminoma

c. rhabdomyosarcoma

d. lymphoma

d

what is the TD5/5 for the whole brainstem

a. 6000

b. 5500

c. 5000

d. 4500

c

when could the BRAT diet be recommended

a. when pts need help maintaining weight during tx

b. when pts have diarrhea

c. when pts are having trouble swallowing

d. when pts have constipation

b

for an adult what is the correct order in which to give CPR

give chest compressions, then clear the airway, then breathe for the person

what term best describes a pt lying on their right side

a. right lateral decubitus

b. right medial decubitus

c. oblique decubitus

d. prone

a

wotf field sizes will produce the least amount of scatter

a. 15.3 × 18.2

b. 10 × 10

c. 6 × 29.9

d. 33.3 × 26.3

c

under most staging systems, a stage 4 cancer usually indicates

a. tumor is confined to the local area

b. tumor is confined to local area and regional lymph nodes

c. metastatic disease

d. local failure has occured

c

the most common mode of tumor spread from cancer of the anal cancer is

a. regional lymph nodes

b. distal lymph nodes

c. medical transplantation

d. blood stream

a

occupational exposure of a declared pregnant women should not exceed

a. 5mSv

b. 50mSv

c. 5 rem

d. 5000 mrem

a

grade 4 tumor cells indicate

a. undifferentiated

b. moderately differentiated

c. well differentiated

d. grade cannot be assed

a

you are treating a whole brain with parallel opposed laterals. for the right lateral the gantry is 270 degrees and the collimator is 25 degrees. what do you expect the left lateral set up to be

a. gantry is 335, collimator is 90

b. gantry is 270, collimator is 335

c. gantry is 90, collimator is 25

d. gantry is 90, collimator is 335

d

how many half value layers must a photon block be

what is the idea behind universal precautions

a. to treat bodily fluids carefully if only the pt is known to have a disease

b. to treat all bodily fluids as if they contain disease

c. to make sure all HIV pts are clearly identified to all care givers

d. to wear gloves all the time

b

on most linear accelerators, what is the biggest cone size you can insert into the machine for an electron treatment

a. 20 × 20

b. 40 ×40

c. 25 ×25

d. 35 × 35

c

wotf is a stochastic effect

a. gene mutation

b. skin erythema

c. sterility

d. alopecia

a

the most common clinical presentation for esophageal cancer is

a. esophagitis

b. dysphagia

c. dyspnea

d. esophageal varices

b

in order for a block to have a little penumbra as possible, what must be the requirements of the block

a. block edge must be as straight as possible

b. block edge must be diverging

c. block must be at least 5 half values layers in thickenes

d. block must be contain cadium

b

a pt is being given chemo that is considered a radio sensitizer. treatment for external radiation should being

a. 1 week after chemo has started

b. 2 weeks after chemo has started

c. both chemo and external rad should start at or near the same time

d. external rad should be completed before chemo has started

c

based on NRC guidelines, what is considered an acceptable amount of radiation for unrestricted area

a. 10 mrem per month

b. 15 mrem per week

c. 25 mrem per year

d. 500 mrem per year

c

what is the best material to absorb neutrons

a. carbon based materials

b. hydrogen based materials

c. concrete based materials

d. lead based materials

b

a field size of 23.2 × 17.6 is being used for treatment. what is the field size equivalent square

a. 20.0

b. 23.2

c. 17.6

d. 10.0

a

which area of the brain is associated with maintaining balance and equilibrium

a. cerebellum

b. cerebrum

c. corpus callosum

d. temporal lobes

a

a patient has a seperation of 40.0cm. the pt is setup to midplane. the pt is being treated on a 100SAD machine. the target to blocking tray distance is 57.0cm. how much clearance is there between the blocking tray and the pts skin

23cm

iodine contrast is considered toxic to what organ

a. kidneys

b. small bowel

c. large bowel

d. thyroid

a

when patients are not being treated on a linear accelerator, and no operator is around, which of the following is a must

a. user should be logged out of the linac console

b. the linac controls should be locked and key removed

c. the linac vault door must be loced

d. power to the linac must be shut off

b

this is the most common used contrast medium for MRIs

a. iodine

b. barium

c. gadolinium

d. thorotrast

c

wotf is the most common type of skin cancer in the US

a. melanoma

b. basal cell

c. squamous cell

d. kaposi’s sarcoma

b

to check for kidney function before a CT simulation, which blood test may be administered

a. BUN

b. glucose

c. hematocrit

d. mean corpusular volume

a

during a treatment you noticed you wrote down the incorrect note in the patients hard chart. to correct this what is the appropriate action

a. cross out and date the new change

b. use permanent marker to cover old incorrect info, date the change, and initial

c. single line cross out, date the change, and initial

d. leave old incorrect information above, write new changes, initial, and date the change

c

stereotactic techniques in immobilization, QA before treatment, QA requirements, and imagining are best used for

a. hyperfractionation tx

b. standard fractionation tx

c. high dose single fractionation tx

d. brain tx

c

the main risk factor for mesothelioma is

a. smoking

b. asbestos

c. coal dust

d. tuberculosis

b

wotf is not good lifting mechanics

a. keep back straight

b. keep object far away from the body

c. avoid twisting

d. keep the lift smooth

b

as you increase your field size but keep your monitor units the same, what happens to the dose being measured

a. dose will remain the same

b. dose will decrease

c. dose will increase until a certain threshold then will start to decrease

d. dose will increase

d

wotf is the least likely tx option for early stage prostate cancer

a. chemo

b. external beam rad

c. surgery

d. watchful waiting

a

under what tx paradigm would pt positioning and immobilization be most critical

a. 200cGy per fx with 25fx

b. 2400cGy per fx with 1fx

c. 900cGy per fx with 3 fx

d. 300cGy per fx with 10fx

b

a pt is being given chemo during tx. half way during the radiation therapy treatment, the infusion pump alarm sounds, what should you do

a. call for the chemo nurse to take a look at the infusion pump

b. ignore the alarm until the entire xrt is delivered, then address the issue

c. look at the infusion pump youself and follow the on screen instructions

d. plug in the infusion pump as the alarm means it is probably a low battery

a

after doing a simulation and giving the patient tattoos, where should the tattoo needle equipment be placed

a. in the garbage

b. clean with alcohol then place back in the package to be reused

c. sent to sterile processing so it can be sterilized then reused

d. in the sharps containter

d

in relationship to the prostate, the seminal vesicles are

a. inferior and posterior of the prostate

b. inferior only of the prostate

c. superior only of the prostate

d. superior and to the left of the prostate

c

photon energies in the photo electric range are best attenuated with what kind of materials

a. materials that have large amounts of hydrogen

b. materials that have large amount of carbon

c. materials that have a large density

d. materials that have large atomic number

d

you are doing a calculation in lung. the doctor requests that you use an equivalent depth for the hand calculation. you determine that you are going through 5cm of tissue and 3cm of lung. what depth would you use for your calculations

a. 8cm

b. 4.7cm

c. 5.9cm

d. 8.9cm

c

a nosocomial infection is an infection that is

a. contracted in public

b. contracted when a person isn’t vaccinated

c. contracted during sexual intercourse

d. contracted when a person is in the hospital

d

what causes the most cellular damage when compared to each other

a. photons

b. electrons

c. alpha particles

d. beta particles

c

wotf is TMR NOT dependent upon

a. distance

b. field size

c. energy

d. depth

a

wotf is the most sensitive to radiation

a. brain

b. spinal cord

c. bone marrow

d. epidermis

c

a three field technique is being used. AP, RT LAT, LT LAT. the AP is weighted 3 times more then each lateral. if 180cGy is to be delivered to iso center, what dose does the AP contribute

a. 72cGy

b. 108cGy

c. 36cGy

d. 144cGy

b

according to TG-40, the daily simulator localizing laser tolerance is which of the following

a. 1.0mm

b. 1.5mm

c. 2.0mm

d. 3.0mm

c

wotf is true about high dose per fraction treatments

a. the probability of late side effects increase

b. the probability of late side effects decrease

c. it is best used on tumors what a high alpha/beta ratio

d. the probability of late side effects stay the same

a

you have a single 15W x 40L field that needs to be treated to 130SSD to a depth of 6.0cm. the prescription requires 10MV photon beam. the PDD for this field size and depth is 84.5. what should be your new PDD using mayneord’s F factor?

a. 83.2

b. 85.7

c. 86.8

d. 85.2

wotf is true about controlled areas

a. controlled areas must receive less radiation then uncontrolled areas

b. a controlled areas has a maximum annual exposure of 50mSv

c. controlled areas are open to the public after hours

d. all of the above

a

the purpose of staging cancer is

a. helps medical professionals assess the extent of the cancer so they can treat the disease in an appropriate manner

b. helps to indicate a prognosis for the pt

c. allows the comparison of local treatment results with national data based on common criteria

d. all of the above

d

a machine is calibrated to deliver 1cGy for a 10 × 10 field at 100SSD plus dmax. what is the target to calibration factor that should be used for your monitor unit calculation for a 6MV photon beam for 100SAD treatments

a. .985

b. 1.030

c. 1.071

d. 1.015

b

you are setting up a prone pt to 100SSD. the depth prescribed is 5.0cm. the ODI is faulty. even though you read an SSD of 100, the patient is really set up to 97.5SSD. what would be the result

a. overdose by ~5%

b. overdose by ~2.5%

c. underdose by ~5%

d. underdose by ~2.5%

a