It depends on how they deploy Windows in the 1st place and it varies depending on the version of Windows.
See Bill's links on Volume licensing.
They can distribute images which contain the key in an answer file included with the image, manage licenses through a key management server or just enter the key during a single installation. It depends on the individual circumstances.
On the Side question, not necessarily. An image is the snapshot of the entire computer drive at a fixed point in time so could be termed as being a backup but with limited flexibility.
Properly managed backups can be selective, only storing the data files you need without including stuff you don't and sequentially managed so you can restore a specific version of file or files from particular points in time. If you start off repairing a computer by reinstalling Windows your backup does not need the Windows files. Trying to do that through imaging would be cumbersome at least. To get that same "point in time" feature through images would require vast amounts of storage.