ExCPT Test Pharmacy Operations 1 — Questions and Answers
Question 1: What are the three segments of a National Drug Code (NDC) number?
- Prescriber ID, drug name, and expiration date
- Labeler, product, and package size (Correct answer)
- DEA schedule, lot number, and manufacturer
- Insurance bin, group number, and member ID
Correct answer: Labeler, product, and package size
The NDC is an 11-digit identifier split into three segments: the labeler code (manufacturer/distributor), the product code (drug name, strength, and dosage form), and the package size code. It uniquely identifies every drug product sold in the US.
Question 2: What is the purpose of auxiliary labels on a prescription bottle?
- To replace the main prescription label when space is limited
- To indicate the drug's controlled substance schedule
- To provide supplemental warnings or administration instructions (Correct answer)
- To show the pharmacy's NPI number
Correct answer: To provide supplemental warnings or administration instructions
Auxiliary labels are supplemental stickers added to the prescription bottle to communicate important safety information such as 'Take with food,' 'May cause drowsiness,' or 'Avoid prolonged sun exposure.' They reinforce safe medication use beyond what the main label states.
Question 3: What does the prescription sig code 'QID' instruct?
- Every other day
- At bedtime only
- Every four hours around the clock
- Four times daily (Correct answer)
Correct answer: Four times daily
QID derives from the Latin 'quater in die,' meaning four times daily. Pharmacy technicians must accurately interpret sig codes — confusing QID (four times daily) with Q4H (every four hours) could result in a dangerous dosing error.
Question 4: What is a prior authorization (PA) in the context of pharmacy benefits?
- A pharmacist's written approval before a technician can fill a controlled substance
- Approval that a prescriber must obtain from the insurance plan before a medication will be covered (Correct answer)
- A patient's signed consent form acknowledging medication risks
- An advance refill approval granted by the pharmacy manager
Correct answer: Approval that a prescriber must obtain from the insurance plan before a medication will be covered
Prior authorization requires the prescriber to submit clinical justification to the insurance company before the plan will cover a specific medication. PAs are commonly required for expensive, non-formulary, or brand-name drugs.
Question 5: A pharmacy technician notices that a prescription for a Schedule II controlled substance is written on plain paper rather than an official tamper-resistant prescription pad. What is the correct action?
- Fill the prescription if the quantity is small
- Fill it and add a note to the patient's profile
- Bring the prescription to the pharmacist immediately without filling it (Correct answer)
- Call the patient to verify the prescription details
Correct answer: Bring the prescription to the pharmacist immediately without filling it
Schedule II controlled substances require a valid, tamper-resistant prescription in most states. A prescription that does not meet legal requirements must be escalated to the supervising pharmacist — technicians should never independently decide to fill or reject a suspicious controlled substance prescription.
Question 6: What is the primary benefit of a unit dose dispensing system used in institutional (hospital) pharmacy?
- It allows patients to self-select their medications from a dispensing cabinet
- It packages each individual dose separately to reduce medication errors and waste (Correct answer)
- It eliminates the need for pharmacist verification before dispensing
- It combines multiple medications into one tablet for convenience
Correct answer: It packages each individual dose separately to reduce medication errors and waste
In a unit dose system, each dose is pre-packaged individually — typically in a blister pack or single-use container — and labeled with the drug name, strength, lot number, and expiration date. This reduces the risk of medication errors, contamination, and drug waste compared to bulk dispensing.
