NRRPT CABT Healthcare Safety Standards & Regulations 4 — Questions and Answers
Question 1: Under 10 CFR Part 35, which of the following best describes a 'medical event' (formerly misadministration) in radiation therapy?
- Any treatment session that differs by more than 5% from the plan
- A dose or dosage that differs from the prescribed by specific thresholds causing or able to cause harm (Correct answer)
- Any equipment malfunction during a treatment session
- A failure to complete a full course of prescribed radiation therapy
Correct answer: A dose or dosage that differs from the prescribed by specific thresholds causing or able to cause harm
A medical event under 10 CFR 35.3045 involves a dose or dosage that differs from the prescription by defined thresholds (e.g., >20% of total dose) with potential to cause harm.
Question 2: In a Agreement State, what is the relationship between state radiation control regulations and NRC regulations?
- State regulations must be identical to NRC regulations
- States may have regulations that are compatible with and no less stringent than NRC regulations (Correct answer)
- NRC regulations automatically supersede all state regulations
- States may adopt any radiation regulations without NRC oversight
Correct answer: States may have regulations that are compatible with and no less stringent than NRC regulations
Agreement States must maintain regulatory programs that are compatible with and at least as stringent as NRC regulations, giving states flexibility to be more protective but not less.
Question 3: A hospital's radiation therapy department discovers a brachytherapy source is unaccounted for. Under NRC regulations, when must this loss be reported?
- Within 30 days of discovering the loss
- Within 4 hours if dose rate exceeds certain limits; within 24 hours for other cases (Correct answer)
- At the next Radiation Safety Committee meeting
- Only if the source is not found within 7 days
Correct answer: Within 4 hours if dose rate exceeds certain limits; within 24 hours for other cases
Per 10 CFR 20.2201, lost or stolen licensed material must be reported within 4 hours (if dose rate thresholds are met) or within 24 hours for quantities above certain levels.
Question 4: Which standard of care document published by the National Council on Radiation Protection (NCRP) addresses radiation protection for medical personnel in fluoroscopy suites?
- NCRP Report No. 116
- NCRP Report No. 168
- NCRP Report No. 147
- NCRP Report No. 151 (Correct answer)
Correct answer: NCRP Report No. 151
NCRP Report No. 151 provides guidance on radiation protection in fluoroscopy, including protective garment requirements, dose reduction techniques, and personnel monitoring.
Question 5: What does the 'as low as reasonably achievable' (ALARA) principle require healthcare radiation workers to do?
- Keep all doses below regulatory limits regardless of cost or practicability
- Make every reasonable effort to maintain exposures as far below dose limits as practical (Correct answer)
- Eliminate all radiation exposure from medical procedures
- Use maximum shielding in all clinical radiation procedures
Correct answer: Make every reasonable effort to maintain exposures as far below dose limits as practical
ALARA, codified in 10 CFR 20.1101, requires licensees to make every reasonable effort to reduce doses below regulatory limits considering technology, economics, and practical benefits.
Question 6: Which regulatory body oversees the approval and licensing of radiopharmaceuticals used in nuclear medicine departments?
- NRC
- FDA (Correct answer)
- EPA
- DOT
Correct answer: FDA
The FDA approves radiopharmaceuticals as drugs or biologics under the Federal Food, Drug, and Cosmetic Act before they can be commercially manufactured and distributed for patient use.
Question 7: Under 10 CFR Part 19, radiation workers have the right to request which of the following from their employer?
- Transfer to a non-radiation job without loss of pay
- A copy of their personal dose records and the NRC's applicable regulations (Correct answer)
- An independent radiation safety inspection by a third party
- Exemption from monitoring if they believe their doses are low
Correct answer: A copy of their personal dose records and the NRC's applicable regulations
10 CFR 19.13 gives workers the right to request their individual dose data and a copy of NRC regulations and the facility's license from the licensee.
NRRPT CABT Healthcare Safety Standards & Regulations 4
Under 10 CFR Part 35, which of the following best describes a 'medical event' (formerly misadministration) in radiation therapy?