NMTCB Review Exam 2026 – 100Questions and
Answers NMTCB Nuclear Medicine Technology –
Radiopharmaceutical Dosages, Nuclear
Cardiology & Radiation Protection
Here are100 questions and answers for the NMTCB Nuclear Medicine
Technology certification exam, based on 2026 review materials. These
questions cover the core domains of the exam, including
radiopharmaceuticals, instrumentation, nuclear cardiology, radiation
protection, and clinical procedures .
Section 1: Radiopharmaceuticals and Chemistry (Questions 1-20)
1. In which radiopharmaceutical is Tc-99m left in the valence state of
+7?
A. Sulfur colloid
B. MAA
C. MAG3
D. Sestamibi
Answer: A. Sulfur colloid
Rationale: In sulfur colloid preparation, technetium remains in the +7
oxidation state as pertechnetate (TcO4-) until it is reduced by the acidic
environment and heating process. The other options require reduction to
lower valence states for labeling .
,2. A sulfur colloid kit requires the addition of 1-3 mL containing no
more than 500 mCi of TcO4-. In addition, 1.5 mL of solution A must be
added before boiling, and 1.5 mL of Solution B must be added after
cooling. If the kit is correctly prepared, what is the maximum
concentration of Tc-99m it could contain?
A. 83 mCi/mL
B. 125 mCi/mL
C. 167 mCi/mL
D. 500 mCi/mL
Answer: B. 125 mCi/mL
Rationale: Maximum 1 mL TcO4- containing 500 mCi. Total volume = 1
mL (TcO4-) + 1.5 mL (A) + 1.5 mL (B) = 4 mL. 500 mCi ÷ 4 mL = 125
mCi/mL .
3. Chromatography testing of technetium radiopharmaceuticals is
performed to check for:
A. Aluminum contamination
B. Molybdenum breakthrough
C. Radionuclidic purity
D. Radiochemical purity
Answer: D. Radiochemical purity
Rationale: Chromatography specifically tests radiochemical purity—the
percentage of the radionuclide present in the desired chemical form.
Aluminum contamination and molybdenum breakthrough are tested by
other methods .
,4. Free pertechnetate in a bone scan kit will result in activity in the:
A. Breasts
B. Thyroid
C. Gastric mucosa
D. B and C
Answer: D. B and C
Rationale: Free pertechnetate (TcO4-) concentrates in the thyroid,
salivary glands, and gastric mucosa. This creates undesirable
background activity on bone scans .
5. A diphosphonate kit contains 180 mCi of Tc-99m in 30 mL when it
is prepared at 8:00 AM. Immediately, a 20 mCi dose is withdrawn for
a bone scan. If the patient arrives late at 9:30 AM and half the volume
is accidentally discharged, how much volume from the kit must now
be added to the syringe to correct the dose to 20 mCi? (No other
doses have been withdrawn, and the decay factor for 1.5 hours is
0.841)
A. 1.5 mL
B. 2.0 mL
C. 2.3 mL
D. 2.5 mL
Answer: C. 2.3 mL
Rationale: This requires a multi-step decay and volume calculation.
Initial concentration: 180 mCi/30 mL = 6 mCi/mL. After withdrawing 20
, mCi (3.33 mL), remaining activity: 160 mCi in 26.67 mL = 6 mCi/mL. At
9:30 AM (1.5 hr decay), concentration = 6 × 0.841 = 5.046 mCi/mL. After
accidentally discharging half the syringe volume (assuming full syringe),
the calculation yields approximately 2.3 mL needed .
6. Which of the following is NOT used as an anticoagulant?
A. Heparin
B. EDTA
C. Ascorbic acid
D. ACD solution
Answer: C. Ascorbic acid
Rationale: Ascorbic acid is used as a reducing agent or stabilizer, not as
an anticoagulant. Heparin, EDTA, and ACD (acid-citrate-dextrose)
solution are all anticoagulants used in blood labeling procedures .
7. Tc-99m DTPA has been used for all of the following EXCEPT:
A. Aerosol lung scanning
B. Renal flow study
C. Brain flow study
D. Shunt patency
E. Spleen scanning
Answer: E. Spleen scanning
Rationale: DTPA is a glomerular agent that distributes in extracellular
fluid and is rapidly excreted. Spleen scanning requires sulfur colloid
(phagocytosis by reticuloendothelial cells) or heat-damaged RBCs .
Answers NMTCB Nuclear Medicine Technology –
Radiopharmaceutical Dosages, Nuclear
Cardiology & Radiation Protection
Here are100 questions and answers for the NMTCB Nuclear Medicine
Technology certification exam, based on 2026 review materials. These
questions cover the core domains of the exam, including
radiopharmaceuticals, instrumentation, nuclear cardiology, radiation
protection, and clinical procedures .
Section 1: Radiopharmaceuticals and Chemistry (Questions 1-20)
1. In which radiopharmaceutical is Tc-99m left in the valence state of
+7?
A. Sulfur colloid
B. MAA
C. MAG3
D. Sestamibi
Answer: A. Sulfur colloid
Rationale: In sulfur colloid preparation, technetium remains in the +7
oxidation state as pertechnetate (TcO4-) until it is reduced by the acidic
environment and heating process. The other options require reduction to
lower valence states for labeling .
,2. A sulfur colloid kit requires the addition of 1-3 mL containing no
more than 500 mCi of TcO4-. In addition, 1.5 mL of solution A must be
added before boiling, and 1.5 mL of Solution B must be added after
cooling. If the kit is correctly prepared, what is the maximum
concentration of Tc-99m it could contain?
A. 83 mCi/mL
B. 125 mCi/mL
C. 167 mCi/mL
D. 500 mCi/mL
Answer: B. 125 mCi/mL
Rationale: Maximum 1 mL TcO4- containing 500 mCi. Total volume = 1
mL (TcO4-) + 1.5 mL (A) + 1.5 mL (B) = 4 mL. 500 mCi ÷ 4 mL = 125
mCi/mL .
3. Chromatography testing of technetium radiopharmaceuticals is
performed to check for:
A. Aluminum contamination
B. Molybdenum breakthrough
C. Radionuclidic purity
D. Radiochemical purity
Answer: D. Radiochemical purity
Rationale: Chromatography specifically tests radiochemical purity—the
percentage of the radionuclide present in the desired chemical form.
Aluminum contamination and molybdenum breakthrough are tested by
other methods .
,4. Free pertechnetate in a bone scan kit will result in activity in the:
A. Breasts
B. Thyroid
C. Gastric mucosa
D. B and C
Answer: D. B and C
Rationale: Free pertechnetate (TcO4-) concentrates in the thyroid,
salivary glands, and gastric mucosa. This creates undesirable
background activity on bone scans .
5. A diphosphonate kit contains 180 mCi of Tc-99m in 30 mL when it
is prepared at 8:00 AM. Immediately, a 20 mCi dose is withdrawn for
a bone scan. If the patient arrives late at 9:30 AM and half the volume
is accidentally discharged, how much volume from the kit must now
be added to the syringe to correct the dose to 20 mCi? (No other
doses have been withdrawn, and the decay factor for 1.5 hours is
0.841)
A. 1.5 mL
B. 2.0 mL
C. 2.3 mL
D. 2.5 mL
Answer: C. 2.3 mL
Rationale: This requires a multi-step decay and volume calculation.
Initial concentration: 180 mCi/30 mL = 6 mCi/mL. After withdrawing 20
, mCi (3.33 mL), remaining activity: 160 mCi in 26.67 mL = 6 mCi/mL. At
9:30 AM (1.5 hr decay), concentration = 6 × 0.841 = 5.046 mCi/mL. After
accidentally discharging half the syringe volume (assuming full syringe),
the calculation yields approximately 2.3 mL needed .
6. Which of the following is NOT used as an anticoagulant?
A. Heparin
B. EDTA
C. Ascorbic acid
D. ACD solution
Answer: C. Ascorbic acid
Rationale: Ascorbic acid is used as a reducing agent or stabilizer, not as
an anticoagulant. Heparin, EDTA, and ACD (acid-citrate-dextrose)
solution are all anticoagulants used in blood labeling procedures .
7. Tc-99m DTPA has been used for all of the following EXCEPT:
A. Aerosol lung scanning
B. Renal flow study
C. Brain flow study
D. Shunt patency
E. Spleen scanning
Answer: E. Spleen scanning
Rationale: DTPA is a glomerular agent that distributes in extracellular
fluid and is rapidly excreted. Spleen scanning requires sulfur colloid
(phagocytosis by reticuloendothelial cells) or heat-damaged RBCs .
