500 board-style questions for the CNMT and ARRT(N) exams across all five domains, each with a worked explanation — so the gaps show up now, not on exam day.
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Which of the following is a deterministic effect of radiation?
Radiation Safety · Radiopharmaceuticals · Instrumentation & QC · Clinical Procedures · Patient Care
The NMTCB nuclear medicine exam is a computer adaptive test: 90 questions in one hour and fifty-five minutes, taken at an IQT testing center. NMTCB uses a form of adaptive testing called computerized classification testing, so the items differ from candidate to candidate and some unscored pretest questions are mixed in. You cannot skip a question or go back to one you have already answered.
NMTCB publishes the approximate content distribution as:
| Content area | Approx. share |
|---|---|
| Clinical procedures | 40% |
| Pharmaceutical and radiopharmaceutical agents | 25% |
| Instrument operations and quality control | 15% |
| Radiation safety and regulations | 13% |
| Radiation physics and detection | 7% |
Source: NMTCB nuclear medicine exam information and the NMTCB 2025 annual examination report. Always check the board’s own page before you sit — outlines change.
The ARRT nuclear medicine exam is not adaptive. It is a fixed form of 230 questions — 200 scored and 30 unscored pilot questions — with 230 minutes of test time, and you can flag questions and come back to them. ARRT publishes the number of scored questions per category rather than a percentage. A new specification takes effect on 1 February 2027, so the split depends on your exam date:
| Content category | Through 31 Jan 2027 | From 1 Feb 2027 |
|---|---|---|
| Procedures | 118 | 117 |
| Image production (instrumentation) | 33 | 30 |
| Safety (physics, radiobiology, regulations) | 25 | 27 |
| Patient care | 24 | 26 |
| Total scored | 200 | 200 |
What changed in the 2027 revision is covered in ARRT(N) exam changes, February 2027, and the two credentials are compared side by side in NMTCB vs ARRT(N).
Source: ARRT Examination Content Specifications for Nuclear Medicine Technology (January 2021 and January 2026 editions) and the ARRT primary eligibility pathway handbook. Check arrt.org for the specification in force on your exam date.
Plainly: it does not mirror either weighting. The bank holds 100 questions in each of five domains — radiation safety, radiopharmaceuticals, instrumentation and QC, clinical procedures, and patient care — so coverage is even rather than exam-weighted.
That is deliberate. An evenly split bank makes a weak area obvious, because your score in each domain is measured over the same number of questions. A bank weighted 40% toward clinical procedures would bury a patient care gap. Use the readiness diagnostic to find the weak domain, then weight your own revision toward whichever exam you are actually sitting.
One mapping note: patient care is its own scored ARRT category, worth 24 of 200 questions (26 from February 2027). NMTCB does not list it separately — that material sits inside its clinical procedures and radiation safety areas.
The two exams cover the same ground even though they weight it differently. These are the topics board-level questions keep returning to in each area.
Radiation physics, radiobiology and the regulations that govern a nuclear medicine department: the ALARA principle, occupational and public dose limits, NRC licensing, receiving, packaging and labeling radioactive material, surveys and wipe tests, spill response, and patient release. Detection principles — Geiger-Müller counters, ionization chambers and scintillation detectors — sit alongside. NMTCB weights safety and regulations at 13% with radiation physics and detection a further 7%; ARRT(N) scores 25 safety questions under the current specification and 27 from February 2027.
About 25% of the NMTCB exam: radiochemistry, localization mechanisms, preparation, quality control and dosing. High-yield topics include the Mo-99/Tc-99m generator and its eluate testing (Mo-99 breakthrough and aluminum ion), why stannous ion is needed to reduce pertechnetate before most kits will label, radionuclidic, radiochemical and chemical purity, and the biodistribution of the everyday agents — MDP, sestamibi, MAA, DTPA, MAG3, DMSA, sulfur colloid, mebrofenin and HMPAO.
Gamma camera components (crystal, photomultiplier tubes, collimators), acquisition modes from planar to SPECT/CT, and the QC that keeps images trustworthy: intrinsic and extrinsic uniformity floods, bar phantom resolution, center of rotation, energy peaking, and dose calibrator constancy, accuracy, linearity and geometry. Understand how uncorrected non-uniformity — a failing photomultiplier tube, for example — becomes a ring artifact in SPECT, and the resolution-versus-sensitivity trade-off between LEHR, LEAP, medium- and high-energy collimators.
The largest domain on both exams: 40% of NMTCB questions and 118 of 200 ARRT(N) scored questions (117 from February 2027). It spans every organ system — bone (normal variants, superscan), cardiac (stress and rest perfusion, pharmacologic stress, gated SPECT, ejection fraction), renal (DTPA versus MAG3, diuretic renography), hepatobiliary (morphine augmentation, sincalide), thyroid (I-123 versus I-131, uptake), parathyroid, V/Q, brain perfusion, infection imaging with labeled leukocytes and gallium, and tumor imaging including somatostatin receptor and PSMA agents.
ARRT(N) scores patient care as its own category — 24 questions now, 26 from February 2027 — while NMTCB folds it into procedures and safety. Expect patient identification and consent, pregnancy and breastfeeding precautions, pediatric dosing, venipuncture and infiltration, vital signs and emergencies, contrast reactions on hybrid studies, and the patient side of therapy with I-131, Ra-223, Y-90 and Lu-177.
Most candidates who struggle on boards did not run out of study time — they spent it on the wrong material in the wrong order.
Practice questions before notes. Reading a review book cover to cover before attempting questions is slow. Questions reveal the gaps notes cannot predict: work a 25-question block in one domain, then read around the topics you missed.
Learn the explanation, not just the answer. A bone scan question can ask about normal biodistribution, superscan criteria, renal excretion, imaging delay or the effect of free pertechnetate. Memorizing “bone scan = MDP” earns one of those; understanding the agent earns all five.
Weight your review toward clinical procedures. At 40% of the NMTCB and well over half of the ARRT(N) scored questions, it is very hard to make up a weak procedures score elsewhere.
Find your weak domain early. Most candidates have one domain well below the rest. Finding it in week two of an eight-week plan leaves time to fix it; finding it the night before does not. The 8-week NMTCB study plan is built around exactly this.
NMTCB. You sit at an IQT testing center and have one hour and fifty-five minutes for 90 questions. Because the test is adaptive, a run of harder questions usually means the algorithm is working, not that you are failing. You see a preliminary pass or fail at the test site, and your final score is mailed about three weeks later. NMTCB scores on a scale where 375 is the pass mark.
ARRT(N). The appointment is four hours and ten minutes: 230 minutes for the 230 questions plus a short tutorial, a non-disclosure agreement and a survey. You can flag questions and return to them. You see a preliminary score on screen when you finish; ARRT reports scaled scores from 1 to 99, and 75 is a pass. ARRT asks for two forms of ID whose names match your application exactly, so check that well before exam day.
If you do not pass, NMTCB lets you apply to retake as soon as two weeks after a first failure, and ARRT allows three attempts within a three-year window. Retaking the NMTCB covers the full rules and a retake plan.
i passed!! this app WILL help — don’t memorize each answer, truly understand the why behind each question. Passed the NMTCB(N), September 2026
A set of free NMTCB and ARRT(N) questions across all five domains, with every answer and explanation on the page.
Free NMTCB practice questions with answers →
A week-by-week schedule weighted to the NMTCB content outline, with 4- and 12-week variants.
8-week NMTCB and ARRT(N) study plan →
There is a separate bank of 500 questions for the ARRT CT and NMTCB(CT) exams, built the same way.
There is a separate bank of 206 questions for the NMTCB PET specialty exam, weighted to its published content outline.
NMTCB PET practice questions →
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