CSPT Hazardous Drug Compounding 4 — Questions and Answers
Question 1: Which ventilation principle is required in a C-PEC used for hazardous drug compounding to protect personnel?
- Positive pressure airflow away from the worker
- Inward airflow that captures contaminants before reaching the operator (Correct answer)
- Laminar airflow directed toward the compounding surface
- Recirculating HEPA-filtered air with no exhaust
Correct answer: Inward airflow that captures contaminants before reaching the operator
Containment primary engineering controls (C-PECs) for hazardous drugs use inward (negative pressure) airflow to capture and contain contaminants, protecting the operator.
Question 2: A pharmacy receives a new medication. Which resource is the FIRST to consult to determine if it requires hazardous drug handling precautions?
- The drug's package insert
- NIOSH List of Antineoplastic and Other Hazardous Drugs (Correct answer)
- State Board of Pharmacy regulations
- The manufacturer's safety data sheet (SDS)
Correct answer: NIOSH List of Antineoplastic and Other Hazardous Drugs
The NIOSH List of Hazardous Drugs is the primary reference used to classify whether a drug requires special handling precautions in healthcare settings.
Question 3: When compounding a hazardous drug, a technician accidentally spills a small amount on the C-PEC work surface. What is the correct immediate action?
- Continue working and clean up after the batch is complete
- Remove all items, don a second pair of gloves, and use the HD spill kit (Correct answer)
- Notify the pharmacist and leave the area immediately
- Wipe the spill with a standard alcohol wipe and resume compounding
Correct answer: Remove all items, don a second pair of gloves, and use the HD spill kit
A spill inside the C-PEC requires stopping work, donning additional PPE, and using the designated hazardous drug spill kit per USP <800> protocols.
Question 4: Under USP <800>, what is the minimum required air pressure relationship between the hazardous drug buffer room and the ante-room?
- Buffer room must be positive relative to ante-room
- Buffer room must be negative relative to ante-room (Correct answer)
- Both rooms must be at equal (neutral) pressure
- Pressure relationship depends on the specific drug being compounded
Correct answer: Buffer room must be negative relative to ante-room
USP <800> requires the hazardous drug buffer room to maintain negative pressure relative to the ante-room to prevent contamination from escaping into adjoining areas.
Question 5: Which of the following is classified as a Group 2 hazardous drug under NIOSH criteria?
- Cyclophosphamide (antineoplastic)
- Warfarin (reproductive risk only, non-antineoplastic) (Correct answer)
- Methotrexate (antineoplastic)
- Doxorubicin (antineoplastic)
Correct answer: Warfarin (reproductive risk only, non-antineoplastic)
NIOSH Group 2 includes non-antineoplastic drugs that meet one or more hazard criteria; warfarin poses a reproductive risk, placing it in Group 2.
Question 6: A technician must transport a completed hazardous IV preparation from the cleanroom to the patient care unit. How should it be packaged?
- In a standard zip-lock bag with a hazardous drug label
- In a sealed, clearly labeled, leak-proof container or bag (Correct answer)
- Uncovered on a medication cart with warning signage
- Wrapped in sterile gauze inside a standard medication tray
Correct answer: In a sealed, clearly labeled, leak-proof container or bag
Hazardous drug preparations must be transported in sealed, leak-proof, clearly labeled containers to prevent accidental exposure during transit.
Question 7: What is the purpose of performing a surface sampling (wipe test) in areas where hazardous drugs are handled?
- To verify sterility of compounded preparations
- To detect and quantify surface contamination with hazardous drug residue (Correct answer)
- To measure airborne particulate counts in the cleanroom
- To confirm HEPA filter integrity in the C-PEC
Correct answer: To detect and quantify surface contamination with hazardous drug residue
Wipe testing detects residual hazardous drug surface contamination, helping verify that cleaning and decontamination procedures are effective.
