NRRPT CABT Healthcare Safety Standards & Regulations 3 — Questions and Answers
Question 1: A pregnant radiation worker declares her pregnancy to her employer. Under 10 CFR 20.1208, what is the dose limit for the embryo/fetus for the entire gestation period?
- 5 mSv (Correct answer)
- 1 mSv
- 50 mSv
- 0.5 mSv
Correct answer: 5 mSv
10 CFR 20.1208 limits the dose equivalent to the embryo/fetus to 5 mSv (0.5 rem) during the entire gestation period once pregnancy is declared.
Question 2: In the context of the Joint Commission accreditation standards for radiation safety, what does the term 'sentinel event' most commonly refer to?
- Any unplanned radiation exposure above background levels
- An unexpected occurrence involving death or serious physical harm to a patient (Correct answer)
- An exposure that exceeds occupational dose limits
- A regulatory inspection finding of immediate concern
Correct answer: An unexpected occurrence involving death or serious physical harm to a patient
A sentinel event is defined by The Joint Commission as an unexpected occurrence involving death or serious physical harm, including those caused by radiation misadministration.
Question 3: According to NRC regulations, what is the minimum number of years that exposure records for radiation workers must be maintained?
- 5 years
- 10 years
- Until the worker turns 75 or for 3 years post-employment (whichever is later) (Correct answer)
- Indefinitely
Correct answer: Until the worker turns 75 or for 3 years post-employment (whichever is later)
Per 10 CFR 20.2106, dose records must be retained until the NRC terminates the license or for 3 years after the individual leaves employment, whichever is later, but not less than until age 75.
Question 4: Which federal agency has authority over the transport of radioactive materials in commerce, including hospital radiopharmaceutical deliveries?
- NRC
- EPA
- DOT (Correct answer)
- FDA
Correct answer: DOT
The Department of Transportation (DOT) regulates the packaging, labeling, and transportation of radioactive materials in commerce under 49 CFR Parts 171-180.
Question 5: An NRC inspection finds that a nuclear pharmacy failed to maintain the required records for radioactive drug administration. Under 10 CFR Part 35, what is the primary purpose of these records?
- To ensure billing accuracy for insurance claims
- To document that prescribed doses were properly administered and to support dose reconstruction (Correct answer)
- To satisfy Joint Commission documentation requirements
- To track controlled substance inventory for DEA purposes
Correct answer: To document that prescribed doses were properly administered and to support dose reconstruction
Records required under 10 CFR Part 35 document administered activities, patient identification, and prescribed quantities to verify proper administration and enable dose reconstruction.
Question 6: What action is required when a radiation therapy misadministration results in a dose that differs from the prescribed dose by more than 20% of the total prescribed dose?
- Document internally and review at the next RSC meeting
- Report to the NRC and notify the referring physician and patient (Correct answer)
- File a report only if the patient experiences an adverse health effect
- Suspend radiation therapy services pending internal investigation
Correct answer: Report to the NRC and notify the referring physician and patient
Under 10 CFR 35.3045, medical events (misadministrations) meeting dose threshold criteria must be reported to the NRC within 15 days, and the referring physician and patient must be notified.
Question 7: Which type of dosimeter is most commonly used to provide a permanent legal record of occupational radiation dose in US healthcare facilities?
- Pocket ionization chamber
- Thermoluminescent dosimeter (TLD) or optically stimulated luminescence (OSL) dosimeter (Correct answer)
- Electronic personal dosimeter (EPD)
- Geiger-Müller detector badge
Correct answer: Thermoluminescent dosimeter (TLD) or optically stimulated luminescence (OSL) dosimeter
TLD and OSL dosimeters are the standard passive dosimeters used as legal record dosimeters for occupational monitoring in US healthcare settings because of their accuracy and permanence.
NRRPT CABT Healthcare Safety Standards & Regulations 3
A pregnant radiation worker declares her pregnancy to her employer.
Under 10 CFR 20.1208, what is the dose limit for the embryo/fetus for the entire gestation period?