10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The BCNP exam has 150 questions and runs 3 hours 45 minutes.
These 10 free BCNP questions are organized by exam domain, so you can see how each part of the Board Certified Nuclear Pharmacist blueprint is tested. Reveal the answer and explanation under each question.
Three patients injected from the same Tc-99m medronate preparation have unexpectedly prominent thyroid, salivary-gland, and gastric activity on their bone scans. Skeletal uptake is reduced, without disproportionate liver or spleen uptake. Mo-99 breakthrough was within limits. Which explanation best accounts for this pattern?
Correct answer: C - Unbound Tc-99m pertechnetate from inadequate labeling
At 08:00, a Tc-99m generator eluate contains 0.10 µCi of Mo-99 per mCi of Tc-99m. A dose made from that eluate is scheduled for 14:00. Use physical half-lives of 66 hours for Mo-99 and 6 hours for Tc-99m; neglect Tc-99m ingrowth from the trace Mo-99. The administration limit is 0.15 µCi/mCi. What ratio and use decision apply at 14:00?
Correct answer: B - Approximately 0.19 µCi/mCi; administration is not permitted.
An F-18 FDG batch produced under 21 CFR Part 212 passes every required release test except that its sterility culture is still in progress. Sterility testing began two hours after production. Aseptic-processing records and filter-integrity results are acceptable, and a designated qualified individual has reviewed the batch documentation. Which disposition is appropriate?
Correct answer: C - Authorize final release by dated signature while the sterility culture continues.
Release testing of a Tc-99m diphosphonate uses two validated chromatography systems. In the acetone system, only free pertechnetate reaches the front: 400 of 10,000 total net counts are at the front. In the saline system, only hydrolyzed-reduced technetium remains at the origin: 600 of 20,000 total net counts are at the origin. These are the only radioactive impurities, and the product specification requires radiochemical purity of at least 95%. Determine the purity and disposition.
Correct answer: D - 93.0%; withhold release.
A child's lung-perfusion prescription specifies 40 MBq of Tc-99m macroaggregated albumin with 50,000-100,000 particles. At the intended administration time, the available uniformly resuspended preparation contains 80 MBq/mL and 400,000 particles/mL. Which strategy can satisfy both prescription requirements without changing the ordered activity?
Correct answer: B - Obtain a preparation with more Tc-99m activity per particle.
Before his second scheduled Ra-223 dichloride administration, a man with symptomatic bone-metastatic castration-resistant prostate cancer has an absolute neutrophil count of 1.3 × 10^9/L, platelets of 78 × 10^9/L, and hemoglobin of 11.2 g/dL. He has no known visceral metastases, active bleeding, or other clinical reason to modify treatment. How do these results affect today's dose?
Correct answer: A - The blood counts meet the criteria for a subsequent administration.
An oncology FDG PET study shows intense, symmetric uptake throughout skeletal muscle and poor lesion-to-background contrast. Preparation records show that glucose fell from 248 to 146 mg/dL after rapid-acting insulin given two hours before FDG. The patient remained resting and warm. Why did an acceptable glucose reading at injection fail to prevent this pattern?
Correct answer: B - Recent insulin increased FDG transport into skeletal muscle.
During myocardial perfusion testing, a patient develops a generalized convulsive seizure shortly after regadenoson. The emergency team is managing the airway and seizure. A clinician proposes aminophylline, which the department uses for other severe regadenoson reactions. What drug-specific advice should the pharmacist give?
Correct answer: C - Avoid aminophylline because it may increase regadenoson-associated seizure risk.
After a syringe supplier changes, I-123 assays in the new syringe model differ from those in the pharmacy's validated reference container. The difference changes with syringe fill volume. Reference-source constancy and activity-range linearity checks pass, and all comparisons are corrected to the same time. The most informative next quality-control investigation is:
Correct answer: D - Characterize the new syringe's volume-dependent geometry response.
Following I-131 therapy, an individualized assessment estimates that the maximum total effective dose equivalent to any other individual will be 2.4 mSv. The patient can follow the planned precautions, and there is no separate clinical reason for admission. Which statement correctly applies 10 CFR 35.75 to this patient?
Correct answer: A - Release is permitted with written instructions for reducing exposure to others.
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