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The RTN exam has 230 questions and runs 3 hours 50 minutes.
These 10 free RTN questions are organized by exam domain, so you can see how each part of the Registered Technologist - Nuclear Medicine Technology blueprint is tested. Reveal the answer and explanation under each question.
While fasting for an oncology FDG PET examination, a patient with diabetes becomes tremulous and diaphoretic. Capillary glucose is 61 mg/dL. The patient is fully alert and swallows normally; IV access has not yet been established. An approved hypoglycemia treatment protocol and oral glucose are immediately available. What should happen before further PET preparation?
Correct answer: D - Give 15 g oral glucose; recheck in 15 minutes.
An adult who has received I-131 therapy is medically ready for discharge and has 50 mCi of retained activity. A documented, patient-specific assessment predicts a total effective dose equivalent of 2.6 mSv to the most-exposed household member and lower doses to everyone else. The patient can reliably follow the proposed precautions. Under 10 CFR 35.75, which statement correctly applies the NRC release requirements?
Correct answer: C - Release is permitted with written instructions to reduce exposure to others.
Morning gamma-camera testing reveals a localized cold band on the extrinsic flood image. An intrinsic flood obtained without the collimator is uniform. Repeating the extrinsic acquisition with a spare collimator and the same flood source produces a uniform image. Where is the fault most likely located?
Correct answer: B - In the collimator used for the initial flood
For a technically satisfactory equilibrium gated blood-pool study, a fixed left-ventricular ROI contains 100 pixels. Gross counts are 6,000 at end diastole and 3,600 at end systole. A separate 50-pixel background ROI contains 500 counts in each corresponding frame. All frames have equal duration. After accounting for the different ROI areas, what is the background-corrected left-ventricular ejection fraction, rounded to the nearest whole percent?
Correct answer: A - 48%
Stress and rest Tc-99m sestamibi SPECT images show the same inferior-wall defect, but inferior-wall motion and systolic thickening are normal. An immediate prone acquisition, obtained without another injection, shows normal inferior-wall uptake. Projection review shows neither patient motion nor interfering subdiaphragmatic activity. Which explanation best reconciles these findings?
Correct answer: C - Diaphragmatic soft-tissue attenuation
A neonate is prescribed 14.8 MBq of Tc-99m MAA, with a maximum of 50,000 particles. At 08:00, a prepared suspension contains 592 MBq and 800,000 particles in 4.0 mL. Administration is scheduled for 14:00. Use a 6.0-hour physical half-life; no material has been withdrawn, the suspension is uniformly mixed, and it remains within its validated use period. Which withdrawal volume and particle count correctly document the prescribed dose?
Correct answer: A - 0.20 mL containing 40,000 particles
A patient develops a painful, tender thyroid after a recent respiratory illness. TSH is suppressed, free T4 is elevated, and 24-hour I-123 thyroid uptake is 1% against the laboratory's reference interval of 10%-30%. The patient reports no thyroid medication, iodine supplements, or recent iodinated contrast. The elevated circulating thyroid hormone most likely results from:
Correct answer: B - Release of stored hormone from damaged follicles
Three-phase Tc-99m MDP imaging is performed for an erythematous, swollen foot in an adult with diabetes and no recent trauma or surgery. Flow is increased, and blood-pool images show diffuse soft-tissue hyperemia. Three-hour images show no corresponding focal increase in osseous uptake. Which process is favored by this pattern?
Correct answer: D - Cellulitis of the affected foot
At three hours after Tc-99m PYP administration, SPECT/CT confirms diffuse myocardial uptake equal in intensity to rib uptake, with no residual ventricular blood-pool activity. The heart-to-contralateral-chest ratio is 1.45. Serum immunofixation detects a monoclonal IgG-kappa protein. Which conclusion is justified when these results are considered together?
Correct answer: A - The amyloid type remains unresolved despite the positive PYP findings.
An oncology FDG PET examination shows unexpectedly intense, symmetric uptake throughout the major skeletal-muscle groups. Blood glucose was 118 mg/dL at tracer administration. Review of the medication record reveals that rapid-acting insulin was given 25 minutes before FDG to correct an earlier elevated glucose reading. What best accounts for the altered distribution?
Correct answer: C - Insulin-driven skeletal-muscle uptake of FDG
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