Mosby RT(T) - Treatment Delivery

The patient's daily treatment record should include: 1. daily dose given 2. cumulative dose 3. monitor units 4. machine warm-up values 5. elapsed days A. 1,2,3 B. 1,2,3,5 C. 3,4,5 D. 1,2,3,4,5

B. 1,2,3,5

When treating areas in the head and neck, the most reproducible position is: A. prone B. supine C. lateral recumbent D. semirecumbent

B. supine

Your patient has been under treatment for one week and has had to have an indwelling catheter port surgically placed. Since the survey he has not been able to lift his arm to fit into the immobilization device. The therapist should: A. love the arm down and set up using anterior markings B. life the arm as much as possible and set up as usual C. find a comfortable position for the arm and resimulate D. put both arms down and remark the patient

C. find a comfortable position for the arm and resimulate

When operating the linear accelerator in the electron beam mode, cone are used primarily to: A. scatter the electron be a, across the treated area B. flatten the isodose lines of the electron beam C. focus electrons so that they are not easily scattered in the air D. raises the point of electronic equilibrium in the patient's tissue

C. focus electrons so that they are not easily scattered in the air

During total central nervous system irradiation, the patient is typically: A. supine with an extended chin B. supine with he chin flexed C. prone with the chin slightly extended D. prone with the chin flexed

C. prone with the chin slightly extended

When adjacent fields are used to treat deep tumors, the fields should be: A. abutted on the skin B. centered at depth of critical tissue C. separated on the skin and overlap at depth D. overlap on the skin and be separated at depth

C. separated on the skin and overlap at depth

During gamma knife radiosurgery, gamma radiation is focused toward the target by: A. Lucite cones attached to the gamma helmet B. intraoperative circular cones attached to the gamma helmet C. several sources with energy directed through collimated spaces in the gamma helmet D. Lucite cones attached to the head frame

C. several sources with energy directed through collimated spaces in the gamma helmet

The therapist may see a patient treated in the seated portion because of: A. shortness of breath and inability to climb onto the table B. weight exceeding the couch limit and claustrophobia C. shortness of breath and/or weight excess couch limit D. anterior only treatment ports

C. shortness of breath and/or weight excess couch limit

The principle reason for tattooing is: A. patient prefer tattoos over marker B. the field size is early demonstrated C. there is an indelible marker for consistent daily alignment D. tattooing prevents allergic reactions to tape

C. there is an indelible marker for consistent daily alignment

The patient's prescription is for a total dose of 66 Gy. Daily fraction sites will be 2 Gy for the first 5 fractions decreasing to 1.5 Gy for the remaining fractions. How many total fractions will this patient receive? A. 29 B. 32 C. 37 D. 42

D. 42

If the lower mantle is treated in a female patient with Hodgkins's disease, gonadal protection may consist of: A. delivering all treatments using posterior ports B. positioning the patient in prone position for all treatments C. placing a lead apron over the ovaries during treatment D. moving the ovaries away from the treatment field

D. moving the ovaries away from the treatment field

Bite block systems may be used in head and neck irradiation for the purpose of: A. keeping the patients mouth open B. protection the teeth from secondary radiation C. facilitation easier treating during treatment D. reducing the volume of oral mucosa in treatment fields

D. reducing the volume of oral mucosa in treatment fields

If the lower mantle is treated for the management of Hodgkin's disease, gonadal protection is: A. unnecessary since the patients are above childbearing age B. desirable since most patients are very young C. impossible because of the patients position D. only necessary in the male patient

B. desirable since most patients are very young

The monitoring ion chamber in the linear accelerator gantry head is intended to: A. modulate beam intensity across the treatment field B. monitor dose rate and symmetry C. collimate the treatment field D. harden the beam

B. monitor dose rate and symmetry

The anterior margin is based on extension into the nasal cavity. The superior noted is at the base of the skull. The posterior margin includes the posterior cervical nodes. The caudal margin is at the inferior aspect of the clavicle. The target volume just described is for treatment of: A. paranasal sinuses B. nasopharynx C. salivary glands D. tonsil

B. nasopharynx

When making a mask using thermoplastic material, extra stretching is: A. always recommended to prevent the mask from being too tight B. not recommended because the mask becomes weak and less effective C. necessary to reduce the effect on skin dose D. necessary for re-forming of the mask if the patient moves

B. not recommended because the mask becomes weak and less effective

In the treatment of seminoma, an external testicular shield should be used for the remaining testicle. This is important since the TD 5/5 for the testes is as low as: A. 1 Gy B. 10 Gy C. 20 Gy D. 40 Gy

A. 1 Gy

If the intended dose for treatment is 180 cGy and a shadow tray with a factor of 0.97 is accidentally inserted, what actual dose is received by the patient? A. 175 cGy B. 179 cGy C. 186 cGy D. 200 cGy

A. 175 cGy

Prophylactic cranial irradiation for ALL is administered to a total dose of: A. 1800 cGy B. 3000 cGy C. 4500 cGy D. 6000 cGy

A. 1800 cGy

In treating tumors of the lung, the threshold dose for radiation pneumonitis is _______ cGy. A. 2000 to 2500 B. 3000 to 3500 C. 4000 to 4500 D. 5000 to 5500

A. 2000 to 2500

The external testicular shield used when treating Seminoma is intended to protect the remaining testicle from: A. Internal scatter B. Primary beam C. Radioactivity D. Contaminated hands

A. Internal scatter

Customized headrests are more likely comfortable than commercial headrests because they conform to the: A. Posterior neck and occiput B. Amterior neck and mandible C. Lateral neck and shoulders D. Posterior neck and tragus

A. Posterior neck and occiput

The linear scales on the treatment table are used as an aid for: A. Translation of patient position on the table B. Verifying filament voltage C. Verifying gantry readout accuracy D. Documentation of treatment dose

A. Translation of patient position on the table

The back pointer is used to determine: A. beam exit point B.percent depth dose C. gantry angles D. beam entrance point

A. beam exit point

Dense metal accessories should be placed at a suitable distance from the patient's skin surface in order to prevent contamination from secondary (select two): A. electrons B. neutrons C. lead D. radon

A. electrons and B. neutrons

While treating a patient with painful boney metastasis, it is desirable to: A. eliminate clothing in the area of treatment B. raises clothing so that marks are visualized C. keep the sheet and blanket under the patient for comfort D. keep the patient on the gurney to prevent heightened pain

A. eliminate clothing in the area of treatment

When treating superficial lesions, a thin sheet with an opening for the treatment field may be placed on the patient skin for: A. field shaping B. cone placement C. patient comfort D. isocenter marking

A. field shaping

When treating primary brain malignancies, setup makings should be placed on the: A. immobilization mask B. patients scalp C. areas that have been shaved D. anterior and lateral neck

A. immobilization mask

Wedge filters are most often constructed of: A. lead or steel B. lucite or aluminum C. superflab or superstuff D. polystyrene or carbon fiber

A. lead or steel

When treating the floor of the mouth, a bite block may be used to: A. move the palate away from the treatment fields B. move the palate into the treatment fields C. depress and move the tongue into the treatment fields D. project and move the teeth away from the treatment fields

A. move the palate away from the treatment fields

If an error in dose delivery occurs, the therapist should: A. notify the attending physician and dosimetrist B. take no action until the end of the day C. take action based on the anatomical area treated D. tell the patient and make up the error the next day

A. notify the attending physician and dosimetrist

Feathering or shifting the match line of abutting fields is principally done in order to: A. prevent overdose to underlying tissue B. increase dose to underlying tissue C. reduce dose to the GTV D. increase dose to the GTV

A. prevent overdose to underlying tissue

Patients treated for rectal carcinoma are often treated: A. prone to reduce skin reactions in the gluteal fold B. supine to reduce skin reactions in the gluteal fold C. in the lateral decubitus position to reduce small bowel volume irradiated D. prone to allow for easier breathing

A. prone to reduce skin reactions in the gluteal fold

The preferred position for total skin electron therapy is: A. standing B. sitting C. knee-chest D. supine

A. standing

A suitable position for a patient needed total skin irradiation would be: A. standing with the arms raised and legs spread B. sitting with arms resting on the arms of the chair C. standing facing the gantry D. standing on a platform with arms at the sides

A. standing with the arms raised and legs spread

Suitable material for skin sparing, customized compensators include all of the following except: A. superflab B. lead C. Lucite D. cerrobend

A. superflab

Patients receiving radiation in the management of primary lung cancer will likely be positioned: A. supine with both arms elevated B. supine with the arm on the effected side elevated C. price with both arms up around head D. prone with both arms at sides

A. supine with both arms elevated

The usual position for the treatment of the intact breast is: A. supine with the ipsilateral arm up and chin turned away from the affected side B. supine with the contralateral arm up and chin turned away from the affected side C. prone with both arms up and head turned to the right D. prone with ipsilateral arm up and chin turned toward affected side

A. supine with the ipsilateral arm up and chin turned away from the affected side

What is a girl of image guided radiation therapy? A. to treat smaller volumes to higher doses B. to decrease treatment time C. to address positioning variation and treatment delivery D. to document electronic portal imaging accuracy

A. to treat smaller volumes to higher doses

The prescription reads 1.2 Gy t.i.d. to a total dose of 14.4 Gy for a total body irradiation case. How many days are required to fill this prescription? A. 2 B. 4 C. 6 D. 12

B. 4

Lucite is often used as the material for positioning devices. One major concern when this material is in the path of the treatment beam is: A. Electron contamination B. Beam attenuation C. Decreased rigidity D. Acquired radioactivity

B. Beam attenuation

The target volume includes the regional nodes. The caudal margin is the inferior border of the obturator foramen. The cephalad margin is L5. The lateral margins are 1 cm beyond the true pelvis. The nodes included are the external and internal iliacs. The target volume just described is for the treatment of: A. Kidney B. Bladder C. Stomach D. Testis

B. Bladder

Electron contamination of high energy photon beams may result from photon interactions with the: A. Room air B. Collimators C. Bolus D. Lucite trays

B. Collimators

When the patient is positioned supine with feet in toward the gantry, and the digital readout is 340 degrees, the proper be a, projection would be called: A. RAO B. LAO C. RPO D. LPO

B. LAO

When irradiating extremities, a strip of soft tissue should be spared in order to: A. Prevent obstruction of blood flow from the distal portion of the limb B. Prevent obstruction of lymphatic flow from the distal portion of the limb C. Prevent destruction of bone at the distal portion of the limb D. Prevent radiation pneumonitis

B. Prevent obstruction of lymphatic flow from the distal portion of the limb

During the course of radiation therapy, patients should ideally be weighed; A. Daily B. Weekly C. Monthly D. As needed

B. Weekly

Reducing target margins: A. increases morbidity rates B. allows higher dose delivery C. facilitates easier targeting D. prohibits higher dose delivery

B. allows higher dose delivery

Patients should be weighed and remeasured through the treatment axis periodically so that: A. nutritional status can be monitored B. anatomical variations can be monitored C. weight maintenance can be encouraged D. TJC requirements are met

B. anatomical variations can be monitored

To ensure the patient's safety and accuracy of treatment, the patient must be monitored. How is this achieved during treatment? A. verbal instructions to the patient B. audiovisual intercommunication system C. watching the patient through a window D. restraining the patient before leaving the room

B. audiovisual intercommunication system

When using thermoplastic materials, the skin dose effect depends on the: A. beam energy B. beam energy and mask thickness C. mask thickness D. accelerator model

B. beam energy and mask thickness

During radiation treatment to the thorax, the arm position should be: A. wherever the patient is conformable B. consistent throughout the treatment course C. consistent throughout the treatment fraction D. above the head

B. consistent throughout the treatment course

There preferred material for the patient couch as part of the CT simulator or linear accelerator is carbon fiber. This material is preferred due to its (select two): A. transparency B. radiolucency C. radio-opacity D. low attenuation

B. radiolucency and D. low attenuation

If multiple, adjacent areas are being treated, the patient should: A. move only between treatment areas B. remain in the same position for all fields C. be treated to only one area each day D. be positioned supine

B. remain in the same position for all fields

When a patient is receiving treatment through multiple ports, the patient should: A. move between fields B. remain in the same position for all fields C. be treated with one field per day D. be supine for anterior/posterior fields only

B. remain in the same position for all fields

The principle purpose of immobilization devices is to: A. keep the patient comfortably positioned B. reproduce and maintain position C. prevent patient fro falling from the PSA D. facilitate faster setup times

B. reproduce and maintain position

Adults undergoing total body irradiation may be treated at an extended distance while assuming the position of: A. supine with arms folded on the PSA B. semirecumbent, with the knees bent on a gurney C. Trendelenberg position on the gurney D. Sims's position on a gurney

B. semirecumbent, with the knees bent on a gurney

When treating metastatic brain disease with no immobilization mask, and central axis markings are placed, they should be placed on: A. the scape after parting the hair B. shaved areas of the scalp C. the anterior and lateral neck D. the glabella and lateral cants

B. shaved areas of the scalp

The main reason for tattooing is to indicate: A. the location of the tumor B. the location of treatment fields C. critical organs in relation to fields D. half distance between field borders

B. the location of treatment fields

Patients undergoing irradiation for breast cancer can be positioned: 1. supine 2. lithotomy 3. prone 4. lateral oblique A. 1 B. 1,3 C. 1,3,4 D. 1,2,3,4

C. 1,3,4

The treatment time for a field requiring 350 monitor units while the linear accelerator dose rate is 220 monitor units/minute is: A. 0.394 minutes B. 0.629 minutes C. 1.59 minutes D. 2.52 minutes

C. 1.59 minutes

The majority of radiation therapy treatments involving linear accelerators are normally delivered using a source to axis distance of: A. 50cm B. 80cm C. 100cm D. 120cm

C. 100cm

Treatment machine accessories composed of dense metal should be kept at least ____________ cm away from the patient's skin surface. A. 5 B. 10 C. 15 D. 20

C. 15

The precise daily reproduction of patient position depends on: 1. patient age 2. type of treatment machine 3. anatomical site treated 4. patients overall health A. 1,2 B. 2,3 C. 3,4 D. 1,4

C. 3,4

Total dose for prophylactic cranial irradiation for small cell lung carcinoma is typically: A. 2000 cGy B. 3000 cGy C. 3600 cGy D. 4500 cGy

C. 3600 cGy

Which modalities are commonly used for IGRT? A. CT and MRI B. PET and MRI C. CT and Ultrasound D. Ultrasound and MRI

C. CT and Ultrasound

If a 30 degree wedge is left out of two to five treatments, the central axis dose is: A. Decreased and the distribution affected B. Decreased and dose distribution is not affected C. Increased and the distribution affected D. Increased and dose distribution is not affected

C. Increased and the distribution affected

Bite blocks may be used in head and neck photon irradiation to: A. Open the patient's mouth for easier breathing B. Protect the oral cavity from secondary scatter C. Protect the oral cavity from the primary beam D. Include the submandibular and Submental lymph nodes

C. Protect the oral cavity from the primary beam

Which of the following devices indicate the beam exit point? A. machinist dial B. optical distance indicator C. back/front pointer D. mechanical distance indicator

C. back/front pointer

Your patient treated for adenocarcinoma of the rectum is positioned prone on the belly board. The belly board is used to: A. immobilize the patient B. immobilize the bowel C. displace the bowel D. displace the bladder

C. displace the bowel

Misalignment of treatment fields many result from all of the following except: A. weight loss B. swelling C. dose rate change D. patient motion

C. dose rate change

The usual position for breast treatment includes elevation of the arm on the affected side. This angle of elevation should primarily depend on the patients ability to: A. elevate the arm and the angle of the medial tangent B. move through the CT simulator bore C. elevate the arm and evaluate how the skin folds upon elevation D. elevate the arm and keep the chest slope under 20 degrees

C. elevate the arm and evaluate how the skin folds upon elevation

To achieve a neutral head position for a large patient with a large, barrel chest, the therapist may use a/an: A. styrofoam block under the shoulders B. rolled town behind the neck C. high headrest D. low headrest

C. high headrest

Reproducing the position of the feet during pelvic irradiation is important because a change in foot position may cause shifting of: A. internal pelvic anatomy B. surface markings C. internal anatomy and surface markings D. acetabulum and femur

C. internal anatomy and surface markings

In which of the following diseases is it important to include regional lymphatics? A. T1 glottic larynx carcinoma B. giloblasoma multiforme C. nasopharynx carcinoma D. ostelocarcinoma of the femur

C. nasopharynx carcinoma

Upon arriving at the cancer center, you notice that the audiovisual monitoring system is not functioning. The best course of action would be to: A. notify engineering and treat until repairman arrives B. notify physics and treat until repairman arrives C. notify engineering and do not treat until repairs are completed D. notify radiation oncology and treat until repairman arrives

C. notify engineering and do not treat until repairs are completed

Which of the following sites is most likely to show bone metastasis? A. humerus B. femur C. thoracic spine D. cervical spine

C. thoracic spine

When extremities are irradiated for the management of primary bone malignancy, it is important to spare a potion of: A. tissue along the entire extremity to prevent obstruction of blood flow B. bone to prevent obstruction of lymphatic flow C. tissue along the extremity to prevent obstruction of lymphatic flow D. muscle on each side to prevent obstruction of blood flow

C. tissue along the extremity to prevent obstruction of lymphatic flow

Patients treated while sitting upright are limited to tenement of the: A. pelvis B. whole abdomen C. upper torso D. extremities

C. upper torso

The ability to displace the small bowel away from the pelvic fields depends on: A. the volume of waste in the patient's bowel B. whether the patient has had previous radiation C. whether the patient has had previous pelvic surgery D. the patients body habits

C. whether the patient has had previous pelvic surgery

To avoid electron contamination, accessories should be kept at least ___________ away from the patient. A. 5 cm B. 10 cm C. 12 cm D. 15 cm

D. 15 cm

If the hand or forearm needs to be irradiated with anterior and posterior fields for soft tissue sarcoma, the patient could reasonably be: A. Sitting facing the PSA with the affected arm on the couch B. Supine on the PSA with the affected arm tucked close to the torso C. Standing facing the gantry with the affected arm on the couch D. Supine on the PSA with elbow bent, forearm and hand abducted

D. Supine on the PSA with elbow bent, forearm and hand abducted`

The operator's console should how all of following except: A. monitor units B. dose rate C. treatment time D. absorbed dose

D. absorbed dose

Mechanical errors may be reduced by: A. performing regular quality assurance on equipment B. allowing periodic overhaul by equipment engineers C. daily observation of equipment performance D. all of the above

D. all of the above

Field placement errors may be due to: A. patient position B. shifting skin markings C. table top sag D. any of the above

D. any of the above

Custom shielding blocks that are divergent reduce: A. beam shadowing B. side scatter C. transmission D. beam edge cutoff

D. beam edge cutoff

Electronic portal imaging is a method by which beam alignment is checked: A. after the first treatment B. by the physician at the end of the day C. after a few monitor units after the first week D. before the first treatment and periodically thereafter

D. before the first treatment and periodically thereafter

When treating a patient with prostate cancer, which of the following factors would not cause prostate movement? A. respiration B. rectal volume C. patient position variation D. cecum volume

D. cecum volume

Which of the following can not produce a 3- dimensional image? A. CT B. MRI C. ultrasound D. electronic portal image

D. electronic portal image

Regional lymph nodes for the carcinoma of the prostate include all but one of the following: A. obturator B. external iliac C. common iliac D. epigastric

D. epigastric

While setting up a patient, the table continues rising after release of the enabling switch. The therapist should immediately: A. help the patient off the table B. call for assistance C. click the enabler twice D. hit the emergency "off" button

D. hit the emergency "off" button

A breast bridge may be use to: A. elevate the chest wall B. immobilize the effected arm C. separate the breast tissue from the chest wall D. immobile the breast tissue

D. immobile the breast tissue

While treating early to midstaged vulvar cancer, the patient may be positioned in the frog-legged position in order to avoid: A. decrease dose in the labial folds B. increased dose in the gluteal region C. decreased dose to the inguinal nodes D. increased dose in the inguinal fold

D. increased dose in the inguinal fold

Placing markers on the central axis only is: A. sufficient for daily realignment and targeting B. sufficient when target margins are small C. adequate when treating small fields D. insufficient for daily realignment and targeting

D. insufficient for daily realignment and targeting

A procedure used in which an implant is made using a trocar, with radioactive sources introduced into the trocar and then trocar is removed is called: A. self-attenuation B. interstitial preloading C. intracavitary microloading D. interstitial afterloading

D. interstitial afterloading

For treatment of soft tissue sarcoma on the calf of the leg, it would be reasonable to position the patient: A. prone with both legs together and immobilized with a foot band B. lateral decubitus with the affected leg elevated as high as possible C. supine with both legs together and immobilized with a foot band D. lateral decubitus with the affected leg moved away from the opposite leg and parallel to the couch

D. lateral decubitus with the affected leg moved away from the opposite leg and parallel to the couch

Suitable bolus materials would include all of the following except: A. superflab B. gauze saturated with water C. tightly packed rice bags D. lead pellets

D. lead pellets

Positioning the patient in the prone position means that the patient is: A. lying on the back B. lying on the back with the upper body slightly elevated C. lying on the back with the lower body slightly elevated D. lying on the abdomen

D. lying on the abdomen

An approach that addresses issues associated with inspiration and expiration is known as: A. rotational arc therapy B. step-and-shoot technique C. IMRT D. respiratory gating

D. respiratory gating

Standard wedges are used to: A. modulate beam intensity across the field B. scatter the raw electron beam across the treated area C. monitor the dose rate and beam symmetry D. tilt isodose lines so that dose is adequately distributed throughout the target volume

D. tilt isodose lines so that dose is adequately distributed throughout the target volume

The prescription says to deliver 450 cGy/fraction to the whole brain. Upon reading the prescription you should: A. calculate the MU and treat the patient B. review the chart and modify the prescription C. ask another therapist to check your MU calculation D. verify the daily dose with the physical before administration

D. verify the daily dose with the physical before administration