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Principles And Practice Of Radiation Therapy 4th Edition By Charles M. – Test Bank
 
Sample  Questions

 

Chapter 01: Cancer: An Overview

Washington & Leaver: Principles and Practice of Radiation Therapy, 4th Edition

 

MULTIPLE CHOICE

 

  1. Knowledge of cancer dates back to which of the following?
a. 1600 BC Egypt
b. 1600 AD England
c. 400 BC Greece
d. 1900 AD Germany

 

 

ANS:  A

The first known observations of cancer date back to 1600 BC Egypt.

 

REF:   p. 3

 

  1. Which of the following is not a term for genes involved in the cancer process?
a. Anti-oncogenes
b. Oncogenes
c. Proto-oncogenes
d. Somato-oncogenes

 

 

ANS:  D

Anti-oncogenes, oncogenes, and proto-oncogenes have all been identified as playing a part in the development of tumors. Somato-oncogenes do not exist.

 

REF:   p. 3

 

  1. Tumor-suppressor genes are also known as ___________.
a. anti-oncogenes
b. oncogenes
c. proto-oncogenes
d. somato-oncogenes

 

 

ANS:  A

Although more commonly called tumor-suppressor genes, these genes are also known as anti-oncogenes.

 

REF:   p. 3

 

  1. Which of the following is not a phase of the mammalian cell cycle?
a. G0
b. G1
c. G2
d. G3

 

 

ANS:  D

G0 is a resting phase where cells do not enter mitosis. G1 and G2 are growth phases during the mammalian cell cycle. Although some algae species demonstrate a relatively long phase between nuclear division and cleavage of the cell termed G3, this phase is not part of the mammalian cell cycle.

 

REF:   pp. 3-4

 

  1. Which phase of the mammalian cell cycle is composed of functional cells not preparing for DNA replication?
a. G0
b. G1
c. G2
d. S
e. M

 

 

ANS:  A

G0 is typically depicted outside the cell cycle because cells in this phase are not preparing for DNA synthesis.

 

REF:   pp. 3-4

 

  1. In which phase of the mammalian cell cycle does DNA synthesis occur?
a. G0
b. G1
c. G2
d. S
e. M

 

 

ANS:  D

“S” is representative of synthesis and is the phase in which DNA synthesis occurs.

 

REF:   p. 4

 

  1. Identify the correct order for the phases of the mammalian cell cycle.
a. G1, G2, M, S
b. G1, G2, S, M
c. G1, M, G2, S
d. G1, S, G2, M

 

 

ANS:  D

The typical mammalian cell will move from G1 to S, followed by G2, and then M. Some cells will eventually pause in G0 after M.

 

REF:   pp. 3-4

 

  1. Which of the following is true of anaplastic tumors?
a. Closely resemble the cells of origin
b. Maintain some resemblance of the cells of origin
c. Do not resemble the cells of origin

 

 

ANS:  C

Anaplastic tumors are also known as undifferentiated tumors. Undifferentiated cells do not resemble the normal cells of origin.

 

REF:   p. 4

 

  1. Which of the following is (are) true of benign tumors?
a. Well differentiated
b. Do not metastasize
c. Encapsulated
d. All of the above

 

 

ANS:  D

Benign tumors typically are well differentiated, do not metastasize, and are encapsulated.

 

REF:   p. 4

 

  1. Which of the following factors does not affect the incidence of tumor sites?
a. Informational
b. Environmental
c. Technological
d. Geographic

 

 

ANS:  A

Tumor site incidence is affected by environmental factors such as sun exposure. It is also affected by technological factors such as the advent of more precise imaging modalities. Additionally, tumor site incidence is affected by geographic factors, as exemplified by gastrointestinal cancers in Japan.

 

REF:   pp. 5-6

 

  1. What is defined as the “study of the cause of disease”?
a. Etiology
b. Etymology
c. Epidemiology
d. Entomology

 

 

ANS:  A

Etiology is defined as the “study of the cause of disease.” Etymology is the “study of word origins,” epidemiology is the “study of disease incidence,” and entomology is the “study of insects.”

 

REF:   p. 5

 

  1. What is the “study of disease incidence”?
a. Etiology
b. Etymology
c. Epidemiology
d. Entomology

 

 

ANS:  C

Epidemiology is defined as the “study of disease incidence.” Etiology is the “study of the cause of disease,” etymology is the “study of word origins,” and entomology is the “study of insects.”

 

REF:   p. 6

 

  1. Which of the following make(s) for an effective screening examination?
a. Specific
b. Sensitive
c. Cost-effective
d. Accurate
e. All of the above

 

 

ANS:  E

For a screen tool to be effective, it must be specific, sensitive, accurate, and cost effective.

 

REF:   p. 6

 

  1. What is the “workup”?
a. The initial nursing visit
b. The initial physician visit
c. A series of diagnostic examinations
d. A physical assessment of the patient

 

 

ANS:  C

Although the term workup may be used by different radiation oncology departments in various ways, the generally accepted definition of this term is a series of diagnostic examinations performed after a patient has been diagnosed with a disease or condition. This may be done at the time of the initial physician or nurse visit and may include a physical assessment, but these are only portions of the entire workup.

 

REF:   p. 6

 

  1. Which of the following is not typically part of the workup?
a. Patient demographics
b. Type, location, and size of tumor
c. Normal tissue invasion
d. Presence of metastases

 

 

ANS:  A

The workup includes information about the tumor such as type, size, and location, amount of normal tissue invasion, and presence of metastases. Typically, demographic information is collected at a time other than during the workup by support staff.

 

REF:   pp. 6-7

 

  1. Which imaging modality is beneficial for distinguishing between recurrent disease and other tissue changes post treatment?
a. CT
b. PET
c. Plain films
d. MR

 

 

ANS:  B

Although a CT or MR scan may be used as part of the diagnostic process for ruling out recurrent disease, PET is the only imaging modality listed that can differentiate recurrence from other tissue changes.

 

REF:   p. 7

 

  1. What is the most common tumor staging system?
a. AJCC
b. FIGO
c. TNM
d. UICC

 

 

ANS:  C

TNM is the most commonly used staging system. This system has been adopted by AJCC and UICC. FIGO is the staging system used for gynecologic tumors but has no application to the majority of tumors.

 

REF:   p. 7

 

  1. A T1N0MX tumor has how many positive lymph nodes?
a. 0
b. 1
c. 2
d. Unknown

 

 

ANS:  A

N0 is an indication of no positive lymph nodes.

 

REF:   p. 7

 

  1. Tumors are the result of which of the following?
a. Black bile
b. Necrotic tissue
c. Abnormal cellular proliferation
d. Traumatic injury

 

 

ANS:  C

Once thought to be the result of black bile or traumatic injuries, tumors are now known to be the result of abnormal cellular proliferation. Tumor growth may result in a large central area of necrosis, but this is an effect rather than a cause.

 

REF:   p. 3

 

  1. Tumor grade is a measure of ________.
  2. aggressiveness
  3. differentiation

III. spread

a. I and II
b. I and III
c. II and III
d. I, II, and III

 

 

ANS:  A

Tumor grade is a measure of both aggressiveness and differentiation. Staging is used to describe the tumor’s spread.

 

REF:   pp. 7-8

 

  1. Which of the following biopsy methods results in the removal of the entire tumor?
a. Fine needle aspiration
b. Core needle
c. Incisional
d. Excisional

 

 

ANS:  D

During a fine needle aspiration, only a few cells of the tumor are removed. The same is true of core needle biopsies. Incisional biopsies remove more tumor than either fine needle aspiration or core needle biopsy, but some of the tumor remains. During an excisional biopsy, the entire tumor is removed en bloc.

 

REF:   pp. 8-9

 

  1. Which of the following biopsy methods cannot evaluate tumor architecture?
a. Fine needle aspiration
b. Core needle
c. Incisional
d. Excisional

 

 

ANS:  A

Fine needle aspiration removes cells from a tumor but cannot retain the architecture of the tumor.

 

REF:   pp. 8-9

 

  1. Factors that may exclude a patient from having surgery include all except which of the following?
a. Preexisting medical conditions
b. Tumor location
c. Patient preference
d. Classification

 

 

ANS:  D

The invasive nature of surgical procedures for cancer removal may exclude some patients with preexisting conditions. In addition, the location of some tumors (such as base of skull lesions) may eliminate surgery as a possible treatment option. Furthermore, surgery may be excluded in an attempt to preserve function, as in the treatment of anal cancers. Tumor classification alone is not a contraindication for surgery.

 

REF:   pp. 9-10

 

  1. When compared with surgery, benefits of radiation therapy include all except which of the following?
a. Instantaneous cure
b. Better cosmetic results
c. Preservation of function
d. Noninvasive

 

 

ANS:  A

Individual results will vary based on tumor type and other factors but, as a general rule, radiation therapy provides patients with better cosmetic results than surgery. In addition, radiation therapy is noninvasive and can often preserve function not possible with surgery. However, only surgery can provide an instantaneous cure via total resection.

 

REF:   p. 10

 

  1. Which of the following treatment techniques uses radioactive sources?
a. External beam
b. Intraoperative
c. Brachytherapy
d. IMRT

 

 

ANS:  C

Typically, brachytherapy treatments require a radioactive source, although advances in nanotechnology have resulted in some brachytherapy procedures using miniature x-ray tubes. In times past, radioactive cobalt was used in external beam radiation therapy, but this process is now antiquated.

 

REF:   p. 11

 

  1. Which of the following is not used for brachytherapy treatments?
a. Cesium
b. Cobalt
c. Iodine
d. Iridium

 

 

ANS:  B

Although some reports document the use of cobalt for brachytherapy, it is traditionally used for external beam radiation therapy.

 

REF:   p. 11

 

  1. High-dose after loading equipment is used in association with which treatment technique?
a. External beam
b. Intraoperative
c. Brachytherapy
d. IMRT

 

 

ANS:  C

High-dose after loading equipment is used during brachytherapy treatments to reduce staff exposure to high doses of radiation.

 

REF:   p. 11

 

  1. Pancreatic cancer may be treated using which technique?
a. Intraluminal
b. Intravascular
c. Intracavitary
d. Intraoperative

 

 

ANS:  D

Although pancreatic cancer can be treated with radiation therapy by a number of different techniques, including 3D conformal, IMRT, and IGRT, it can also be treated using an intraoperative technique. Intraluminal, intravascular, and intracavitary are brachytherapy techniques not used for the treatment of pancreatic cancer.

 

REF:   pp. 10-11

 

  1. Which of the following is a systemic treatment?
a. Surgery
b. Radiation therapy
c. Chemotherapy
d. All of the above

 

 

ANS:  C

Radiation therapy and surgery are localized treatments, whereas chemotherapy is a systemic treatment.

 

REF:   p. 11

 

  1. Which of the following routes of administration is used when treating bladder cancer with chemotherapy?
a. Oral
b. Intra-arterial
c. Intracavitary
d. Intrathecal

 

 

ANS:  C

As described in the text, bladder cancer may be treated by instilling the chemotherapy agent directly into the bladder via a catheter. This process is known as intracavitary chemotherapy.

 

REF:   p. 12

 

  1. Which classification of chemotherapy agents was the first to be identified as having anticancer activities?
a. Alkylating agents
b. Antimetabolites
c. Antibiotics
d. Hormonal agents
e. Nitrosoureas
f. Vinca alkaloids

 

 

ANS:  A

The first chemotherapy agent was nitrous mustard, an alkylating agent.

 

REF:   p. 12

 

  1. Which of the following are not cell cycles specific?
  2. Alkylating agents
  3. Antimetabolites

III. Antibiotics

  1. Hormonal agents
  2. Nitrosoureas
  3. Vinca alkaloids
a. I and II
b. I and III
c. I, III, and V
d. II, IV, and VI
e. II, III, and VI

 

 

ANS:  C

Alkylating agents are not cell cycle specific. Neither are anticancer antibiotics (although they are more effective during certain phases) nor nitrosoureas.

 

REF:   p. 12

 

  1. Which classification of chemotherapy agents is derived from the periwinkle plant?
a. Alkylating agents
b. Antimetabolites
c. Antibiotics
d. Hormonal agents
e. Nitrosoureas
f. Vinca alkaloids

 

 

ANS:  F

Periwinkle plants are part of the genus Vinca and are sometimes called vinca. It is from these plants that vinca alkaloids are derived.

 

REF:   p. 12

 

  1. In which classification are the chemotherapy agent’s lipids soluble and capable of crossing the blood-brain barrier?
a. Alkylating agents
b. Antimetabolites
c. Antibiotics
d. Hormonal agents
e. Nitrosoureas
f. Vinca alkaloids

 

 

ANS:  E

Nitrosoureas are the only classification of chemotherapy agents that are both lipid soluble and capable of passing through the blood-brain barrier.

 

REF:   p. 12

 

  1. Which of the following is a radiosensitizing chemotherapy agent?
a. Cyclophosphamide
b. 5-Fluorouracil
c. Doxorubicin
d. Cisplatin

 

 

ANS:  C

Doxorubicin, also known as Adriamycin, acts a radiosensitizer. Cyclophosphamide, 5-fluorouracil, and cisplatin are not known to enhance the effects of radiation.

 

REF:   p. 14

 

  1. Which of the following acts as a radioprotector?
a. Amifostine
b. Actinomycin D
c. Adriamycin
d. Etoposide

 

 

ANS:  A

Amifostine acts to protect normal tissue against the effects of radiation and is, therefore, considered a radioprotector. Adriamycin is a radiosensitizer. Actinomycin and etoposide are not known to be radioprotectors.

 

REF:   p. 14

 

  1. Injecting monoclonal antibodies is an example of which type of treatment?
a. Surgery
b. Radiation therapy
c. Chemotherapy
d. Immunotherapy

 

 

ANS:  D

Injection of monoclonal antibodies is an example of immunotherapy.

 

REF:   p. 14

 

  1. Which of the following best describes tumor spread?
a. Exophytic
b. Multicentric
c. Dissemination
d. Ulceration

 

 

ANS:  C

Dissemination is defined as the act of spreading or diffusion and is most closely associated with cancer spread. Exophytic is used to describe tumors that grow outward. Multicentric describes tumors with more than one focus. Ulceration is the development of an ulcer and is unassociated with cancer spread.

 

REF:   p. 15

 

  1. Which of the following factors is not considered when determining a prognosis?
a. Tumor stage
b. Nodal status
c. Gender
d. All are considered

 

 

ANS:  D

Many factors are considered when a physician determines a prognosis, including tumor site, grade, stage, size, and histology; lymph node status; performance status; and the patient’s age, gender, and race.

 

REF:   pp. 15-16

 

  1. Randomized studies are, by definition, which phase?
a. I
b. II
c. III
d. IV

 

 

ANS:  C

Phase III studies are used to compare an experimental treatment to a standard treatment using a randomized sample.

 

REF:   p. 16

 

  1. Which staff member is most responsible for designing the patient’s treatment plan?
a. Medical physicist
b. Radiation oncologist
c. Dosimetrist
d. Radiation therapist

 

 

ANS:  C

Specific duties will vary between specific departments, but as a general rule the medical dosimetrist is responsible for designing the patient’s treatment plan. The medical physicist or radiation oncologist may oversee this process. In some departments, radiation therapists participate in the treatment planning process.

 

REF:   pp. 16-17

 

  1. Which staff member is most responsible for the quality assurance to the treatment equipment?
a. Medical physicist
b. Radiation oncologist
c. Dosimetrist
d. Radiation therapist

 

 

ANS:  A

Although all members of the cancer treatment team are responsible for quality assurance and the radiation therapists and medical dosimetrists may perform some of the duties specific to treatment equipment quality assurance, the person most responsible is the medical physicist.

 

REF:   pp. 16-17

 

  1. Which of the following is an example of an etiologic factor?
a. Gender
b. Sex
c. Race
d. Social habits

 

 

ANS:  D

An etiologic factor would be one associated with the cause of cancer. Social habits such as smoking and alcohol use have been linked to the cause or elevation of the risk of certain cancers.

 

REF:   pp. 5-6

 

  1. A cancer designated with an N1 classification using the TNM staging system likely indicates which of the following?
a. No positive lymph nodes are involved.
b. Positive lymph nodes are involved at distant sites.
c. Positive lymph nodes are involved near the site.
d. Lymph nodes cannot be accessed.

 

 

ANS:  C

The N category describes the status of lymph node involvement. Nx, N0-N4 are often used. N1 likely indicates that one or more positive lymph nodes are involved close to the original site of malignancy.

 

REF:   p. 7

 

Chapter 03: Principles of Pathology

Washington & Leaver: Principles and Practice of Radiation Therapy, 4th Edition

 

MULTIPLE CHOICE

 

  1. The three most common procedures used to make a diagnosis of cancer are all except which of the following?
a. Incisional
b. Excisional
c. Sputum cytology
d. Needle aspiration

 

 

ANS:  C

Sputum cytology is not one of the three most common procedures used to make a diagnosis of cancer. Sputum is mucus most commonly collected from the respiratory tract for the diagnosis of lung cancer.

 

REF:   pp. 51-52

 

  1. The purpose of the staging system for cancer is which of the following?
a. To evaluate the degree of differentiation of tumor
b. To estimate the prognosis of the patient
c. To evaluate the degrees of malignancy
d. To estimate the geographical extent of disease

 

 

ANS:  D

Tumor stage is a description of the extent of the tumor at the time of diagnosis.

 

REF:   pp. 52-53

 

  1. What is the main difference between benign and malignant neoplasms?
a. Benign neoplasms grow by expansion and remain localized; malignant neoplasms grow by infiltration and metastasize by lymph or blood.
b. Benign neoplasms grow by infiltration and metastasize by expansion and remain localized.
c. Benign neoplasms usually are not encapsulated, compared to malignant neoplasms, which are encapsulated.

 

 

ANS:  A

Benign neoplasms grow by expansion and remain localized, whereas malignant neoplasms grow by infiltration and metastasize via lymph or blood.

 

REF:   p. 46

 

  1. Which of the following is not a specific criterion used in the “T” category to determine the “T” stage?
a. Firmness
b. Depth of invasion
c. Size
d. Surface spread

 

 

ANS:  A

Firmness is not a specific criterion using in determining primary tumor staging.

 

REF:   p. 53

 

  1. Which of the following is not a characteristic of a malignant tumor?
a. Grows by local invasion
b. Can be life threatening
c. Grows rapidly
d. Malignant cells are encapsulated with fibrous tissue

 

 

ANS:  D

Benign tumors are usually encapsulated; malignant growths are not.

 

REF:   p. 46

 

  1. Which of the following would likely be a stage I tumor?
a. T1 N0 M0
b. T2 N1 M0
c. T3 N2 M0
d. T3 N1 M1

 

 

ANS:  A

T1 N0 M0 would likely indicate a stage I tumor, with a small primary tumor that has spread neither locally nor distantly.

 

REF:   p. 53

 

  1. When was the microscope introduced?
a. Sixteenth century
b. Seventeenth century
c. Eighteenth century
d. None of the above

 

 

ANS:  B

The microscope was introduced in the early seventeenth century.

 

REF:   p. 42

 

  1. All except which of the following are organelles?
a. Mitochondria
b. Endoplasmic reticulum
c. Ribosomes
d. Plasma membrane

 

 

ANS:  D

All of the above are organelles except the plasma membrane.

 

REF:   p. 53

 

  1. Characteristics of malignant tumors include all except which of the following?
a. They have rapid growth.
b. They are encapsulated.
c. They metastasize frequently.
d. There is frequent vessel invasion.

 

 

ANS:  B

Benign tumors are usually encapsulated; malignant tumors are not.

 

REF:   p. 46

 

  1. Agents causing inflammation include which of the following?
  2. Hypoxia
  3. Chemicals

III. Ionizing radiation

  1. Allergic reactions
a. I and II
b. I, II, and III
c. II, III, and N
d. I, II, III, and IV

 

 

ANS:  D

Each of these agents may cause inflammation.

 

REF:   pp. 43-45

 

  1. Inflammation is characterized by which of the following?
  2. Redness
  3. Warmth

III. Swelling

  1. Pain
a. I and II
b. I and III
c. II, III, and IV
d. I, II, III, and IV

 

 

ANS:  D

All of these are characteristics of inflammation.

 

REF:   pp. 43-44

 

  1. Cancers are broadly divided in terms of the malignant neoplastic process as which of the following?
a. Carcinomas and sarcomas
b. Carcinomas and myomas
c. Hyperplasia and metaplasia
d. Sarcomas and pleomorphic forms

 

 

ANS:  A

Cancers are divided into carcinomas, referring to malignant tumors originating from epithelial cells, and sarcomas, which refer to malignant tumors originating from nonepithelial cells, usually from connective or nerve tissue.

 

REF:   p. 47

 

  1. Which of the following is a malignant tumor of fat?
a. Chondrosarcoma
b. Ewing’s tumor
c. Seminoma
d. Liposarcoma

 

 

ANS:  D

Liposarcoma refers to a malignant tumor composed of fat cells.

 

REF:   p. 47

 

  1. Which of the following is a malignant tumor of epithelial origin?
a. Rhabdomyosarcoma
b. Squamous cell carcinoma
c. Osteoma
d. Malignant angiosarcoma

 

 

ANS:  B

Squamous cell carcinoma indicates a malignant tumor that developed from epithelial cells.

 

REF:   p. 47

 

  1. Which of the following is the most invasive procedure used to make a diagnosis of cancer?
a. Recovery of exfoliating cells
b. Fine needle aspiration of malignant cells
c. Open biopsy of the tumor
d. Retinoscopy

 

 

ANS:  C

Open biopsy (the most invasive of the three recovery procedures) is accomplished under direct vision. The tumor is surgically removed totally or partly. Retinoscopy is not a biopsy procedure.

 

REF:   pp. 51-52

 

  1. A(n) ______________ is a term used to describe a gene that accelerates growth.
a. oncogene
b. tumor-suppressor gene
c. nucleoside
d. nucleotide

 

 

ANS:  A

The function of an oncogene is to accelerate cell growth.

 

REF:   p. 55

 

  1. Etiology is defined as the study of which of the following?
a. Understanding of disease
b. Socioeconomic facts of disease
c. Cause of disease
d. Stratification of disease

 

 

ANS:  C

The study of the cause of disease is termed etiology.

 

REF:   p. 47

 

  1. Irreversible changes in a cell are indicated by all except which of the following?
a. Cellular swelling
b. Nucleus appears fragmented
c. Nucleus is enzymatically destroyed
d. Upon staining, cell appears as a series of color alterations
e. None of the above

 

 

ANS:  A

All of the above are indicators of irreversible changes, except cellular swelling, which is a hallmark indicator of reversible damage.

 

REF:   p. 43

 

  1. Hodgkin’s disease is a neoplasm that typically involves the _________.
a. brain
b. lung
c. lymph nodes
d. liver

 

 

ANS:  C

Hodgkin’s disease typically involves the lymph nodes.

 

REF:   p. 48, table 3-2

 

  1. The cancer of chimney sweeps identified by Percival Pott in mid-eighteenth-century England was related to which of the following chemicals?
a. Hydrocarbons
b. Asbestos
c. Arsenic
d. Nitrosamines

 

 

ANS:  A

The cancer of chimney sweeps was related to hydrocarbons.

 

REF:   p. 47

 

  1. Which of the following is an example of a characteristic of benign tumors?
a. Rapid growth rate
b. Frequent vessel invasion
c. Increased nuclear chromatin
d. Expansive local growth

 

 

ANS:  D

Benign tumors tend to expand, whereas malignant tumors invade. Malignant tumors also have a rapid growth rate, frequently invade regional blood vessels, and demonstrate increased nuclear chromatin.

 

REF:   p. 46

 

  1. Which of the following describes the cell membrane?
a. Contains genetic DNA
b. Contains organelles
c. Is a permeable structure
d. Is the powerhouse of the cell

 

 

ANS:  C

The cell or plasma membrane is a permeable structure that allows certain nutrients into the cell.

 

REF:   p. 43|p. 53

 

  1. Which of the following describes the accidental leakage of intravenous drugs into the surrounding tissues?
a. Permeation
b. Metastasis
c. Extravasation
d. Hypoxia

 

 

ANS:  C

Extravasation is the accidental leakage of intravenous drugs into the tissue surrounding the venipuncture site.

 

REF:   p. 45

 

  1. Homeostasis refers to a constant or stable ____________.
a. internal environment
b. external environment
c. temperature and pressure
d. nutritional supply

 

 

ANS:  A

Homeostasis is the ability of the cell or host to maintain range of normal function. Normal function includes nutrition, protection, communication, mobility, and production.

 

REF:   p. 43

 

  1. Cellular swelling is the hallmark of reversible damage and occurs as the damaged cellular membrane fails to properly regulate the concentration of ___________.
a. sodium
b. water
c. hydrogen
d. oxygen

 

 

ANS:  A

Cellular swelling indicates the cell’s failure to properly regulate the concentration of sodium.

 

REF:   p. 43

 

Chapter 11: Pharmacology and Drug Administration

Washington & Leaver: Principles and Practice of Radiation Therapy, 4th Edition

 

MULTIPLE CHOICE

 

  1. Select the organ most commonly used by the body to excrete drugs and their byproducts.
a. Kidneys
b. Lungs
c. Sweat glands
d. All of the above

 

 

ANS:  A

Although the body may use all the organs listed to excrete drugs, the kidney is most commonly used. In addition to the organs listed, the tear ducts, salivary glands, intestines, and mammary glands are used.

 

REF:   p. 241

 

  1. Select the most serious allergic reaction to a drug.
a. Light rash
b. Hives
c. Nausea
d. Cardiac or respiratory arrest

 

 

ANS:  D

The most severe reaction may result in a patient’s death and requires immediate intensive treatment.

 

REF:   p. 242

 

  1. Which of the following are included in the “six rights” of drug safety?
  2. Identify the right patient.
  3. Identify the right medication and right dose.

III. Identify the right time.

  1. Identify the route.
a. I, II, and III
b. I, III, and IV
c. II, III, and IV
d. I, II, III, and IV

 

 

ANS:  D

In addition to the five rights, there is also a requirement that the delivery of the medication be documented in the patient’s chart.

 

REF:   p. 243

 

  1. What is the first duty of a therapist if a patient has an adverse reaction to a drug?
a. Locate emergency supplies.
b. Begin cardiopulmonary resuscitation (CPR).
c. Call a code.
d. Observe the patient carefully.

 

 

ANS:  C

A therapist should follow the health care facility’s emergency code procedure immediately.

 

REF:   p. 243

 

  1. Select potential symptoms of an anaphylactic reaction to a drug.
  2. Nausea and vomiting
  3. Diarrhea

III. Urticarial

  1. Symptoms of vascular shock
a. I, II, and III
b. I, III, and IV
c. II, III, and IV
d. I, II, III, and IV

 

 

ANS:  D

In addition to all of the symptoms listed, a patient may experience shortness of breath or symptoms of an airway obstruction.

 

REF:   p. 243

 

  1. Select the drugs that may be prescribed to relieve anxiety.
  2. Ativan
  3. Valium

III. Librium

  1. Prozac
a. I, II, and IV
b. I, II, and III
c. II, III, and IV
d. I, II, III, and IV

 

 

ANS:  B

Antianxiety drugs are used to relieve anxiety and muscle spasms. Prozac is an example of an antidepressant.

 

REF:   p. 244

 

  1. In which part of the body is barium sulfate used as a contrast agent?
a. Gastrointestinal tract
b. Bronchography
c. Myelography
d. Cardiovascular

 

 

ANS:  A

Barium sulfate may be administered orally or rectally to visualize the gastrointestinal tract.

 

REF:   p. 245

 

  1. Select potential reasons why a patient may be unable to take oral preparations of a drug.
a. The patient is experiencing nausea and vomiting.
b. The patient has difficulty in swallowing.
c. The patient refuses to swallow medication.
d. All of the above apply.

 

 

ANS:  D

In addition to the reasons listed, patients may also be unable to take medication by mouth because of a decreased level of consciousness or from being intubated.

 

REF:   p. 248

 

  1. What type of medication administration bypasses the gastrointestinal tract?
a. Topical administration
b. Parenteral administration
c. Mucous membrane administration
d. Administration via the rectum

 

 

ANS:  B

Parenteral administration of medication is introduced into the body without being absorbed into the gastrointestinal tract. It typically means “by injection.”

 

REF:   p. 249

 

  1. For injections administered by the intradermal route, the syringe should be positioned _________ to the skin.
a. at a 45-degree angle
b. at a 90-degree angle
c. almost parallel
d. almost perpendicular

 

 

ANS:  C

The syringe should be positioned almost parallel to the skin for intradermal injections.

 

REF:   p. 250

 

  1. Contrast agents used for the imaging procedure known as cholecystography should be administered by which of the following routes?
a. Oral
b. Intravenous
c. Intramuscular
d. Intradermal

 

 

ANS:  A

The oral route of administration is used to give contrast agents such as ipodate sodium and iopanoic acid in cholecystography.

 

REF:   p. 247, table 11-1

 

  1. Which of the following routes of drug administration is not considered a parenteral route?
a. Oral
b. Intradermal
c. Subcutaneous
d. Intrathecal

 

 

ANS:  A

Parenteral administration means that the medication bypasses the gastrointestinal tract.

 

REF:   p. 249

 

  1. The abbreviation BID stands for which of the following?
a. After meals
b. Before meals
c. Twice daily
d. Once daily

 

 

ANS:  C

BID is the abbreviation for the Latin bis in di’e, which stands for twice a day.

 

REF:   p. 252, table 11-3

 

  1. An allergic reaction to the administration of certain drugs may cause urticaria. Urticaria describes ________________.
a. pain
b. hives
c. nausea
d. fainting

 

 

ANS:  B

Urticaria, or hives, is a possible allergic reaction to ionic iodine compounds.

 

REF:   p. 247

 

  1. Intrathecal administration means that medications are injected directly into which of the following?
a. Brain
b. Spinal canal
c. Bone joint
d. Urinary bladder

 

 

ANS:  B

Intrathecal administration means that medications are injected directly into the spinal canal.

 

REF:   p. 249

 

  1. Drugs in the anesthetic category are intended to suppress which of the following?
a. Muscle spasms
b. Allergic response
c. Sensation of feeling
d. Blood pressure

 

 

ANS:  C

Anesthetics suppress the sensation of feeling by acting on the central nervous system.

 

REF:   p. 244

 

  1. Which of the following radioactive isotopes is used in radiation therapy?
a. Strontium 89
b. Technetium 99
c. Fluorine 18
d. Hydrogen 3

 

 

ANS:  A

Strontium 89 is a radioactive isotope used in radiation therapy. All of the other isotopes listed can be used in radiologic imaging.

 

REF:   p. 245

 

  1. Radiolucent contrast agents are those that ______________________.
a. appear dark on x-ray
b. appear white on x-ray
c. have high atomic numbers
d. absorb x-ray photons easily

 

 

ANS:  A

Radiolucent contrast agents have low atomic numbers, are easily penetrated by x-ray photons, and appear dark on x-ray.

 

REF:   p. 245

 

  1. Opioid medications are prescribed for the purpose of which of the following?
a. Preventing nausea and vomiting
b. Treating allergic reactions
c. Reducing inflammation
d. Relieving pain

 

 

ANS:  D

Narcotic analgesics are given for moderate to severe pain and are derived from opium.

 

REF:   p. 244

 

  1. The name given to a medication by the manufacturer is called its _______________ name.
a. trade
b. brand
c. generic
d. chemical

 

 

ANS:  C

The generic name of a drug is the named coined by the original manufacturer.

 

REF:   p. 241

 

Chapter 21: Simulator Design

Washington & Leaver: Principles and Practice of Radiation Therapy, 4th Edition

 

MULTIPLE CHOICE

 

  1. The central axis of the beam is ________________________.
a. always located in the center of the treatment field
b. the only area that is nondivergent
c. aligned with the isocenter
d. both a and c
e. both b and c
f. a, b, and c

 

 

ANS:  E

The central axis of the beam always passes through the isocenter and is nondivergent. If asymmetric jaws are used, the central axis will not be the center of the field.

 

REF:   p. 449

 

  1. The conventional simulator can define treatment fields by using which of the following?
a. Blades
b. Wires
c. OID
d. Collimator assembly

 

 

ANS:  B

The wires of the conventional simulator define the treatment field as delineated by the physician. The blades represent the radiation field.

 

REF:   p. 431

 

  1. In the conventional simulator, the _____________ represent(s) the radiation field.
a. blades
b. wires
c. OID
d. collimator assembly

 

 

ANS:  A

The blades, also called the beam-restricting diaphragms, delineate the radiation field.

 

REF:   p. 431

 

  1. Which of the following represents the path of a photon when it enters the image intensifier?
a. Input phosphor, electrostatic lenses, photocathode, anode, output screen
b. Input phosphor, photocathode, electrostatic lenses, anode, output screen
c. Input phosphor, anode, electrostatic lenses, photocathode, output screen
d. Anode, input phosphor, electrostatic lenses, photocathode, output screen

 

 

ANS:  B

The photons hit the input phosphor, which converts the x-rays to light. The light is then absorbed by the photocathode, which converts the light to electrons. The electrostatic lenses help the electrons focus to the anode. The output screen converts the electrons into an electrical signal that is transmitted to a screen.

 

REF:   p. 431

 

  1. Conventional simulators are designed to simulate the ____________, geometric, and optical properties of a variety of treatment units.
a. x-ray
b. mechanical
c. comfort
d. linear design

 

 

ANS:  B

A benefit of a conventional simulator is that it can simulate the same conditions of treatment units, which include mechanical, geometrical, and optical properties.

 

REF:   p. 431

 

  1. Light photons are produced and transmitted electronically through to a video image at which of the following?
a. Output phosphor
b. Tube housing
c. Photocathode
d. Focusing lenses

 

 

ANS:  A

The light photons are converted from electrons at the output phosphor, which is then converted into an electronic image on a television screen.

 

REF:   pp. 440-441

 

  1. The patient couch tabletop is created out of this material, which has a low density and low x-ray absorption.
a. Plastic carbonate
b. Carbon fiber
c. Steel
d. Polystyrene

 

 

ANS:  B

Tabletop manufacturers use carbon fiber for the table, which enables the radiation to pass through the table with minimal attenuation.

 

REF:   p. 436

 

  1. __________ takes into consideration how an area on the other side of an irradiated wall is going to be used.
a. Workload
b. Occupancy factor
c. Use factor
d. Barrier factor

 

 

ANS:  B

Occupancy factor will vary if the room adjacent to the simulator is a closet or has an employee there for 40 hours per week.

 

REF:   p. 347

 

  1. ___________ takes into consideration how much a machine will run in a normal week.
a. Workload
b. Occupancy factor
c. Use factor
d. Barrier factor

 

 

ANS:  A

The workload is defined as the current (mA) multiplied by the time (minutes) a department expects to run the machine in the normal week.

 

REF:   p. 346

 

  1. Where are positioning lasers located?
  2. Side (lateral)
  3. Overhead

III. Sagittal

  1. Coronal
a. I and II
b. I, II, and III
c. II and III
d. All of the above

 

 

ANS:  B

The positioning lasers located on the side, overhead, and sagittal align at the isocenter. These lasers are used to mark the patient for setup in the treatment room.

 

REF:   p. 449

 

  1. Most computed tomography (CT) scanners today are _______-generation imaging systems.
a. first
b. second
c. third
d. fourth

 

 

ANS:  C

In the third-generation scanners, the x-ray tube and detector array continue to rotate around the patient.

 

REF:   p. 433

 

  1. A(n) _________ ring allows the CT x-ray tube to rotate in a continuous motion without the concern of cables becoming tangled.
a. spiral
b. slip
c. aperture
d. electrical power

 

 

ANS:  B

The slip ring is similar to the metal on the ceiling of a bumper car ride. The power to the CT is conducted by the metal brushes on the ring.

 

REF:   p. 434

 

  1. Which of the following details the difference in completing an axial scan as compared to spiral CT?
a. Aperture size is larger in an axial scanner.
b. Detector size is larger in the spiral CT scanner.
c. Gantry is rotating in a diagonal.
d. Table moves for the spiral CT.

 

 

ANS:  D

In a spiral CT scanner, the table moves during the scan, creating a helical pattern that looks like a Slinky.

 

REF:   pp. 433-434

 

  1. CT numbers are also known as which of the following?
a. Hounsfield units
b. Godfrey units
c. Attenuation coefficient units

 

 

ANS:  A

A CT number is also called a Hounsfield unit after Sir Godfrey Hounsfield, who developed the first clinical CT scanner.

 

REF:   p. 440

 

  1. The CT number for dense bone is _________.
a. –1000
b. –100
c. 0
d. 1000

 

 

ANS:  D

The CT values range from –1000 for air to 1000 for bone.

 

REF:   p. 440

 

  1. The CT number for water is _____________.
a. –1000
b. –100
c. 0
d. 1000

 

 

ANS:  C

The CT value for water is 0, which is the middle of the range of numbers.

 

REF:   p. 440

 

  1. The matrix size is determined by the number of ___________.
a. voxels
b. Hounsfield units
c. detectors on the scanner
d. pixels

 

 

ANS:  D

The number of pixels determines the matrix size. The larger the number matrix, the better is the resolution.

 

REF:   pp. 440-441

 

  1. As the field of view increases and the matrix size remains constant, the spatial resolution ____________.
a. increases
b. decreases
c. stays the same

 

 

ANS:  B

As the field of view increases, each individual pixel increases in size, which results in less detail.

 

REF:   pp. 440-441

 

  1. The Hounsfield unit for fat would be _________________.
a. +1000
b. -500
c. -100
d. 100

 

 

ANS:  C

The CT number or Hounsfield unit for fat is -100.

 

REF:   p. 440