Pharmacy Technician Certification Exam — Questions and Answers

Question 1: A pharmacy technician notices that a bottle of medication has a beyond-use date that has passed. The technician should:

Relabel it with a new beyond-use date
Continue dispensing as long as the original manufacturer expiration date is valid
Return it to stock without action
Remove it from the dispensing shelf and quarantine it per pharmacy policy (Correct answer)

Correct answer: Remove it from the dispensing shelf and quarantine it per pharmacy policy

Medications that have passed their beyond-use date must be removed from stock and quarantined according to pharmacy policy.

Question 2: An IV is infusing at 50 mL/hr using a 15 gtt/mL drip set. What is the drop rate in gtt/min?

15 gtt/min
20 gtt/min
12.5 gtt/min (Correct answer)
10 gtt/min

Correct answer: 12.5 gtt/min

50 mL/hr × 15 gtt/mL ÷ 60 min/hr = 12.5 gtt/min.

Question 3: A patient is to receive digoxin 0.125 mg daily. The available tablets are 250 mcg. How many tablets per dose?

2 tablets
1 tablet
0.25 tablet
0.5 tablet (Correct answer)

Correct answer: 0.5 tablet

0.125 mg = 125 mcg; 125 mcg ÷ 250 mcg/tablet = 0.5 tablet.

Question 4: What does 'turnover rate' measure in pharmacy inventory management?

The ratio of generic to brand-name drugs dispensed
The number of staff changes per year
How frequently the entire inventory is sold and replaced over a given period (Correct answer)
The percentage of medications returned by patients

Correct answer: How frequently the entire inventory is sold and replaced over a given period

Turnover rate measures how many times the total inventory is sold and replenished in a given time period, indicating purchasing efficiency.

Question 5: A barcode medication administration (BCMA) system is primarily designed to verify which of the following at the point of care?

The five rights of medication administration (Correct answer)
Pharmacy inventory levels
Drug cost and formulary status
Physician order entry accuracy

Correct answer: The five rights of medication administration

BCMA systems scan the patient's wristband and the medication barcode to confirm the right patient, drug, dose, route, and time.

Question 6: What does the term 'lot number' refer to on a pharmaceutical product?

A unique identifier linking units to the same manufacturing batch (Correct answer)
The retail price code assigned by the wholesaler
A code indicating the drug's DEA schedule
The expiration month and year of the product

Correct answer: A unique identifier linking units to the same manufacturing batch

A lot number (batch number) uniquely identifies all units produced in a single manufacturing run, enabling targeted recalls and traceability.

Question 7: Convert 0.125 mg to micrograms (mcg).

125 mcg (Correct answer)
12.5 mcg
1.25 mcg
0.000125 mcg

Correct answer: 125 mcg

1 mg = 1,000 mcg; 0.125 × 1,000 = 125 mcg.

Question 8: What is 'third-party billing' in pharmacy?

Billing a government agency for a drug recall
Billing the prescriber for the medication
Billing a wholesaler for drug costs
Billing an insurance company or payer on behalf of the patient (Correct answer)

Correct answer: Billing an insurance company or payer on behalf of the patient

Third-party billing means the pharmacy submits a claim to the patient's insurance plan, which then reimburses the pharmacy rather than the patient paying the full amount.

Question 9: An order reads 'Vancomycin 1 g IVPB q12h.' The drug is available as 500 mg powder vials. How many vials are needed per dose?

3 vials
4 vials
1 vial
2 vials (Correct answer)

Correct answer: 2 vials

1 g = 1000 mg; 1000 mg ÷ 500 mg/vial = 2 vials per dose.

Question 10: A prescription reads 'Metoprolol succinate 100 mg ER — do not crush.' Why is this instruction critical?

Crushing changes the drug's color
Crushing destroys the extended-release mechanism, releasing the full dose at once (Correct answer)
Crushing causes the drug to become inactive
Crushing makes the drug taste bitter

Correct answer: Crushing destroys the extended-release mechanism, releasing the full dose at once

Crushing an extended-release tablet destroys the controlled delivery system, causing dose-dumping and potential toxicity.

Question 11: What is the first priority in any emergency situation?

Ensure the safety of all personnel (Correct answer)
Contact the media
Write a report
Save equipment

Correct answer: Ensure the safety of all personnel

In any emergency, the first priority is always the safety and well-being of all personnel. Equipment and materials can be replaced; lives cannot.

Question 12: Which drug class is used to prevent rejection after organ transplantation by suppressing T-cell activation?

Calcineurin inhibitors (Correct answer)
Monoclonal antibodies
Corticosteroids
mTOR inhibitors

Correct answer: Calcineurin inhibitors

Calcineurin inhibitors (cyclosporine, tacrolimus) block calcineurin, preventing IL-2 production and T-cell activation.

Question 13: Which auxiliary label is most appropriate for a prescription of Tetracycline?

Refrigerate after opening
Do not crush or chew
Avoid prolonged exposure to sunlight (Correct answer)
Take with food or milk

Correct answer: Avoid prolonged exposure to sunlight

Tetracycline causes photosensitivity, so patients should be warned to avoid prolonged sun exposure.

Question 14: Which equipment is used to measure small volumes of liquid (< 1 mL) accurately in a compounding pharmacy?

Calibrated oral syringe or micropipette (Correct answer)
Conical flask
Graduated cylinder
Beaker

Correct answer: Calibrated oral syringe or micropipette

Calibrated oral syringes and micropipettes provide the accuracy needed for measuring very small liquid volumes.

Question 15: A 'clean room' anteroom in a sterile compounding facility is typically maintained at which ISO classification?

ISO Class 3
ISO Class 6
ISO Class 5
ISO Class 8 (Correct answer)

Correct answer: ISO Class 8

The anteroom where personnel gown and materials are staged is generally maintained at ISO Class 8.

Question 16: A patient asks why their nitroglycerin tablets must be kept in the original amber glass bottle. The best technician response is:

Tell the patient the instruction is outdated and they can use a plastic bottle
Nitroglycerin is sensitive to light, heat, and moisture, so the original container protects potency—the pharmacist can explain more (Correct answer)
Advise the patient any dark bottle will work
Tell the patient the bottle is only for decoration

Correct answer: Nitroglycerin is sensitive to light, heat, and moisture, so the original container protects potency—the pharmacist can explain more

Nitroglycerin degrades when exposed to light, heat, and moisture, making the original amber glass container essential for potency.

Question 17: What does informed consent require?

Family approval only
Explaining the procedure, risks, benefits, and alternatives to the patient (Correct answer)
Getting any signature on a form
Verbal agreement only

Correct answer: Explaining the procedure, risks, benefits, and alternatives to the patient

Informed consent requires that patients understand the proposed procedure, its risks and benefits, alternatives, and have the opportunity to ask questions before agreeing.

Question 18: Which beyond-use date (BUD) applies to a non-aqueous compounded preparation stored at room temperature?

1 year
6 months or the earliest manufacturer expiration date, whichever is sooner (Correct answer)
14 days
30 days

Correct answer: 6 months or the earliest manufacturer expiration date, whichever is sooner

USP <795> assigns non-aqueous formulations a BUD of 6 months or the earliest component expiration, whichever comes first.

Question 19: Which of the following actions is essential to ensure medication safety during dispensing?

Verifying the patient's name on the prescription label (Correct answer)
Dispensing the medication without checking the dosage
Using an automatic dispensing system without any manual review
Double-checking the medication's expiration date

Correct answer: Verifying the patient's name on the prescription label

Medications exposed to improper storage conditions, such as extreme temperatures, can lose their efficacy or become harmful. The technician's immediate responsibility is to report this to the pharmacist for assessment and to quarantine the affected medication to prevent it from reaching patients.

Question 20: Which class of medications is used to treat osteoporosis by inhibiting osteoclast-mediated bone resorption?

SERMs
Bisphosphonates (Correct answer)
Calcitonin
PTH analogs

Correct answer: Bisphosphonates

Bisphosphonates (e.g., alendronate) bind to bone mineral and inhibit osteoclast activity, reducing bone resorption.

Question 21: A medication order reads 'NS 0.9% 500 mL bolus STAT.' What does 'STAT' indicate?

Give immediately (Correct answer)
Give at the next scheduled time
Give only if necessary
Give over 24 hours

Correct answer: Give immediately

STAT (from Latin 'statim') means immediately, indicating the medication should be given right away.

Question 22: Which type of balance is required by USP for weighing ingredients less than 120 mg in a compounding pharmacy?

Top-loading balance
Class II balance
Triple-beam balance
Class III prescription balance or analytical balance (Correct answer)

Correct answer: Class III prescription balance or analytical balance

A Class III torsion or analytical balance with a sensitivity requirement of 6 mg is needed for weighing small quantities accurately.

Question 23: An order reads 'Heparin 25,000 units in 250 mL D5W — infuse at 1000 units/hr.' What rate (mL/hr) should the pump be set to?

20 mL/hr
15 mL/hr
5 mL/hr
10 mL/hr (Correct answer)

Correct answer: 10 mL/hr

Concentration = 25,000 units / 250 mL = 100 units/mL; rate = 1000 units/hr ÷ 100 units/mL = 10 mL/hr.

Question 24: What is the correct needle angle when withdrawing medication from a vial?

15 degrees
30 degrees
180 degrees (straight down)
45 to 90 degrees with bevel up (Correct answer)

Correct answer: 45 to 90 degrees with bevel up

Inserting the needle at 45–90 degrees with the bevel up allows smooth entry through the vial stopper and minimizes coring, which could introduce rubber particles into the solution.

Question 25: What is the purpose of a biological safety cabinet (BSC) in pharmacy compounding?

To sterilize non-sterile ingredients before use
To protect the operator and environment from hazardous drug exposure during compounding (Correct answer)
To measure the potency of chemotherapy drugs
To store hazardous drugs at controlled temperatures

Correct answer: To protect the operator and environment from hazardous drug exposure during compounding

A BSC uses vertical HEPA-filtered airflow to contain aerosols and protect the technician and cleanroom environment when compounding hazardous drugs like chemotherapy.

Question 26: Medications stored in the pharmacy must be kept at the manufacturer's recommended temperature. Which temperature range is considered 'controlled room temperature' (CRT)?

15°C to 25°C (59°F to 77°F) (Correct answer)
2°C to 8°C (36°F to 46°F)
−25°C to −10°C (−13°F to 14°F)
30°C to 40°C (86°F to 104°F)

Correct answer: 15°C to 25°C (59°F to 77°F)

USP defines controlled room temperature as 20°C to 25°C with allowable excursions between 15°C and 30°C.

Question 27: What is the primary purpose of a prior authorization (PA) in pharmacy billing?

To expedite dispensing
To confirm the pharmacy's license
To obtain insurance approval before dispensing a specific medication (Correct answer)
To verify the patient's identity

Correct answer: To obtain insurance approval before dispensing a specific medication

A prior authorization requires the prescriber to obtain insurance approval before a non-formulary or specialty drug will be covered.

Question 28: What is the primary purpose of providing a medication guide (MedGuide) to a patient?

To inform patients of serious risks associated with certain FDA-regulated medications (Correct answer)
To replace verbal counseling by the pharmacist
To serve as a billing document for the insurance company
To document that the patient picked up their prescription

Correct answer: To inform patients of serious risks associated with certain FDA-regulated medications

FDA-required MedGuides communicate serious risks, contraindications, and safe-use information for high-risk medications.

Question 29: A powder for reconstitution says: 'Add 9.3 mL water to yield 10 mL of 100 mg/mL suspension.' If a dose of 250 mg is needed, how many mL are given?

3 mL
2 mL
2.5 mL (Correct answer)
1.5 mL

Correct answer: 2.5 mL

250 mg ÷ 100 mg/mL = 2.5 mL.

Question 30: What does the PCN number on an insurance card identify?

Processor Control Number used to route claims (Correct answer)
Prescription Code Number for the drug
Pharmacy Chain Number for the dispensing location
Patient Control Number for identification

Correct answer: Processor Control Number used to route claims

The PCN (Processor Control Number) works alongside the BIN to further direct claims to the correct benefit plan within an insurance processor.

Question 31: If a drug has a concentration of 400 mg/250 mL and must run at 2 mg/min, what mL/hr rate should be set?

90 mL/hr
30 mL/hr
60 mL/hr
75 mL/hr (Correct answer)

Correct answer: 75 mL/hr

Concentration = 400/250 = 1.6 mg/mL; 2 mg/min ÷ 1.6 mg/mL = 1.25 mL/min × 60 = 75 mL/hr.

Question 32: What does a pharmacy formulary contain?

A list of licensed pharmacies
A record of patient prescriptions
A list of drugs covered by an insurance plan (Correct answer)
A schedule of pharmacist salaries

Correct answer: A list of drugs covered by an insurance plan

A formulary is an insurance plan's approved list of covered medications, often organized into tiers that affect the patient's copay.

Question 33: What USP chapter governs the compounding of sterile preparations in US pharmacies?

USP 795
USP 800
USP 825
USP 797 (Correct answer)

Correct answer: USP 797

USP 797 sets standards for sterile compounding including environmental controls, personnel training, and beyond-use dating to prevent contamination and patient harm.

Question 34: A pharmacy technician is receiving a refrigerated drug shipment. The temperature log shows the product was exposed to 45°F during transit. The technician should:

Return it immediately without documentation
Accept it and monitor for visible degradation before dispensing
Accept and shelve the medication since it is still refrigerated temperature
Quarantine the product and notify the pharmacist before accepting it (Correct answer)

Correct answer: Quarantine the product and notify the pharmacist before accepting it

Products with temperature excursions must be quarantined and reviewed by the pharmacist; acceptability depends on manufacturer guidance.

Question 35: What is the purpose of a risk assessment?

To assign work shifts
To calculate financial budgets
To track inventory levels
To identify potential hazards and determine mitigation measures (Correct answer)

Correct answer: To identify potential hazards and determine mitigation measures

Risk assessments identify potential hazards, evaluate the likelihood and severity of harm, and determine appropriate controls to minimize risk.

Question 36: A pharmacy technician notices a medication label states 'protect from light.' Which storage solution is most appropriate?

Store at room temperature without any special precautions
Store at 2°C–8°C in the refrigerator
Store in a locked controlled substance cabinet
Store in amber or opaque containers away from direct light sources (Correct answer)

Correct answer: Store in amber or opaque containers away from direct light sources

Medications that require light protection should be stored in amber or opaque containers and kept away from direct light to prevent photodegradation.

Question 37: Which type of automated dispensing cabinet (ADC) feature helps prevent selection errors by only opening the correct bin when a medication is requested?

Guided access (single-drawer or pocket) (Correct answer)
Manual override mode
Batch dispensing mode
Open-cabinet access

Correct answer: Guided access (single-drawer or pocket)

Guided access restricts opening to only the specific bin or pocket for the requested medication, reducing pick errors.

Question 38: When a compounded preparation is found to be out of specification during quality testing, what is the required action?

Dispense it anyway and document the deviation
Retest until it passes
Discard it without documentation
Quarantine and investigate before any release decision (Correct answer)

Correct answer: Quarantine and investigate before any release decision

Out-of-specification results require quarantine of the batch and a formal investigation into the root cause before any disposition decision is made.

Question 39: Which of the following describes a 'narrow therapeutic index' (NTI) drug from a legal/regulatory standpoint?

A drug that requires a triplicate prescription
A drug approved only for hospital use
A drug classified as Schedule II by the DEA
A drug where small changes in dose or blood level can cause serious adverse effects or therapeutic failure (Correct answer)

Correct answer: A drug where small changes in dose or blood level can cause serious adverse effects or therapeutic failure

NTI drugs have a narrow margin between effective and toxic doses, requiring careful monitoring; many states require pharmacist notification before generic substitution.

Question 40: Which of the following drug schedules is most likely to have the highest potential for abuse?

Schedule III
Schedule I (Correct answer)
Schedule IV
Schedule II

Correct answer: Schedule I

Under the Controlled Substances Act, Schedule I drugs are classified as having the highest potential for abuse and dependence, with no currently accepted medical use in the United States. This makes them the most strictly regulated category among controlled substances.

Question 41: What does co-insurance mean in pharmacy benefits?

Having two insurance plans simultaneously
A percentage of the drug cost the patient pays after meeting the deductible (Correct answer)
A fixed dollar amount paid per prescription
A discount card used at the pharmacy

Correct answer: A percentage of the drug cost the patient pays after meeting the deductible

Co-insurance is the patient's percentage share of the drug cost (e.g., 20%) after their deductible has been met, as opposed to a fixed copay.

Question 42: What is HIPAA?

Health Insurance Portability and Accountability Act — protects patient privacy (Correct answer)
A type of insurance plan
A hospital ranking system
A medical diagnosis code

Correct answer: Health Insurance Portability and Accountability Act — protects patient privacy

HIPAA establishes national standards for protecting patient health information, ensuring privacy and security of medical records.

Question 43: A state board of pharmacy inspector asks to see the pharmacy's biennial controlled substance inventory. Under DEA regulations, this inventory must be performed:

Every month for Schedule II drugs only
Every January 1st of each calendar year
Every two years on or around the same date (Correct answer)
Only when a new pharmacist-in-charge is appointed

Correct answer: Every two years on or around the same date

DEA regulations require a biennial (every two years) physical inventory of all controlled substances in Schedules II through V.

Question 44: Insulin glargine (Lantus) is classified as which type of insulin?

Intermediate-acting
Short-acting
Rapid-acting
Long-acting (Correct answer)

Correct answer: Long-acting

Insulin glargine is a long-acting basal insulin with an onset of 1-2 hours and duration of approximately 24 hours with no pronounced peak.

Question 45: A 'tall man lettering' strategy (e.g., hydrOXYzine vs. hydrALAzine) is used on drug labels primarily to:

Distinguish look-alike/sound-alike drug names (Correct answer)
Meet FDA labeling requirements
Improve label readability for elderly patients
Indicate the drug's mechanism of action

Correct answer: Distinguish look-alike/sound-alike drug names

Tall man lettering differentiates look-alike/sound-alike (LASA) drug names to reduce medication errors.

Question 46: Which act requires childproof packaging for most prescription medications?

Kefauver-Harris Amendment
Poison Prevention Packaging Act (PPPA) (Correct answer)
Durham-Humphrey Amendment
Drug Quality and Security Act

Correct answer: Poison Prevention Packaging Act (PPPA)

The Poison Prevention Packaging Act of 1970 mandates child-resistant packaging for most prescription and certain OTC medications.

Question 47: What does 'QID' mean in prescription abbreviations?

Once a day
Twice a day
Four times a day (Correct answer)
Every other day

Correct answer: Four times a day

QID stands for 'quater in die' (Latin), meaning four times a day.

Question 48: Which drug class is contraindicated in patients with a sulfa allergy due to the sulfonamide moiety in its structure?

Thiazide diuretics (Correct answer)
ACE inhibitors
Beta-blockers
Calcium channel blockers

Correct answer: Thiazide diuretics

Thiazide diuretics contain a sulfonamide group and may cause cross-reactivity in patients with documented sulfa allergies.

Question 49: Which agency enforces the Occupational Safety and Health Administration (OSHA) hazardous drug handling standards in pharmacies?

DEA
FDA
OSHA itself (Correct answer)
State Board of Pharmacy

Correct answer: OSHA itself

OSHA enforces its own hazardous drug handling regulations, including requirements for PPE and safe handling of antineoplastic agents in pharmacy settings.

Question 50: A patient using an albuterol metered-dose inhaler (MDI) asks when they need a refill. What is the best way to determine this?

Float the canister in water to check how much is left
Order a refill only when the patient feels no medication coming out
Track doses used since actuations are counted on the dose counter or by number of doses listed on the label (Correct answer)
Shake the canister and listen for liquid sounds

Correct answer: Track doses used since actuations are counted on the dose counter or by number of doses listed on the label

The float test is no longer recommended; dose counters or tracking actuations used against labeled doses is the accurate method.

Question 51: A prescription reads 'GTT ii OS TID.' What does 'OS' indicate?

Both eyes
Left eye (Correct answer)
Right eye
Left ear

Correct answer: Left eye

'OS' is the Latin abbreviation for 'oculus sinister,' meaning left eye.

Question 52: A prescription reads "Lidocaine 5% cream, apply a thin layer to the affected area every 12 hours as needed for pain." How should the technician prepare this medication for the patient?

Dispense a 5% patch for transdermal use
Dispense a 5% ointment for oral use
Dispense a 5% cream for topical use (Correct answer)
Dispense a 5% solution of lidocaine

Correct answer: Dispense a 5% cream for topical use

The abbreviation "PO" stands for "per os," meaning by mouth or orally, and "once" indicates a single dose. Therefore, the order instructs to dispense a 150 mg oral tablet of Fluconazole to be taken one time only.

Question 53: A patient receiving a new prescription for an antidepressant has not been offered pharmacist counseling. Under most state laws, what must the pharmacy provide?

An offer to counsel by the pharmacist for all new prescriptions (Correct answer)
Counseling only for Schedule II controlled substances
Counseling only if the drug costs over $50
A printed drug monograph with no verbal offer required

Correct answer: An offer to counsel by the pharmacist for all new prescriptions

OBRA '90 requires pharmacies that receive Medicaid to offer counseling on new prescriptions; most states extend this to all patients.

Question 54: What is an IV admixture?

A combination of two incompatible IV drugs in one bag
An IV solution contaminated with particulate matter
A premixed IV solution purchased from a manufacturer
A sterile preparation made by adding one or more medications or nutrients to a base IV solution (Correct answer)

Correct answer: A sterile preparation made by adding one or more medications or nutrients to a base IV solution

An admixture is created when a pharmacy technician aseptically adds drugs (e.g., antibiotics, electrolytes) to a base IV fluid such as normal saline or dextrose.

Question 55: A customer wishes to purchase a pseudoephedrine-containing product without a prescription. Under CMEA, what must the pharmacy logbook record at the point of sale?

Only the product name and quantity
Customer's insurance card number and date of birth
Customer's pharmacist consultation notes
Customer's name, address, date of sale, product name, and quantity purchased (Correct answer)

Correct answer: Customer's name, address, date of sale, product name, and quantity purchased

CMEA requires the logbook to capture the purchaser's name, address, date and time of sale, product name, and quantity sold, along with the purchaser's signature.

Question 56: A patient requests a 90-day supply of a Schedule III medication. The maximum days' supply a pharmacy can dispense on a single written prescription is:

180 days
60 days
90 days (Correct answer)
30 days

Correct answer: 90 days

Schedule III and IV prescriptions may be dispensed for up to a 90-day supply per fill and refilled up to 5 times within 6 months.

Question 57: Which of the following best describes a low-risk compounded sterile preparation (CSP) under USP 797?

A CSP compounded outside a cleanroom for immediate use
A CSP made using simple aseptic transfers of sterile ingredients in an ISO Class 5 environment (Correct answer)
A CSP involving non-sterile ingredients that have been sterilized
A CSP prepared in batches of more than 25 units

Correct answer: A CSP made using simple aseptic transfers of sterile ingredients in an ISO Class 5 environment

Low-risk CSPs involve simple aseptic manipulations of sterile ingredients and have the shortest assigned beyond-use dates due to minimal but possible contamination risk.

Question 58: Polyethylene glycol (PEG) suppository bases are classified as which type?

Fatty or oleaginous base
Emulsion base
Hydrogel base
Water-soluble base (Correct answer)

Correct answer: Water-soluble base

PEG bases are water-soluble and dissolve in rectal fluid rather than melting at body temperature.

Question 59: Which type of water is required for sterile compounding preparations?

Distilled water
Sterile Water for Injection (SWFI) (Correct answer)
Tap water filtered through 0.45 micron
Purified water

Correct answer: Sterile Water for Injection (SWFI)

SWFI meets USP standards for pyrogen limits and sterility required in sterile compounding.

Question 60: Which of the following antibiotics works by inhibiting cell wall synthesis?

Ciprofloxacin
Azithromycin
Doxycycline
Cephalexin (Correct answer)

Correct answer: Cephalexin

Cephalexin is a first-generation cephalosporin that inhibits bacterial cell wall synthesis by binding penicillin-binding proteins.

Question 61: What is HIPAA?

A medical diagnosis code
A type of insurance plan
Health Insurance Portability and Accountability Act — protects patient privacy (Correct answer)
A hospital ranking system

Correct answer: Health Insurance Portability and Accountability Act — protects patient privacy

HIPAA establishes national standards for protecting patient health information, ensuring privacy and security of medical records.

Question 62: A pharmacy technician may accept a new oral prescription order ONLY if:

The state board allows technicians to take verbal orders independently
The prescription is for a non-controlled substance
The prescriber calls directly and the pharmacist is present to take it over immediately (Correct answer)
The technician is nationally certified (CPhT)

Correct answer: The prescriber calls directly and the pharmacist is present to take it over immediately

In most states, technicians cannot independently accept new verbal prescription orders; a pharmacist must be immediately available to receive and verify the order.

Question 63: A drug with the suffix '-mab' is classified as which type of biologic medication?

Fusion protein
Small molecule inhibitor
Recombinant protein
Monoclonal antibody (Correct answer)

Correct answer: Monoclonal antibody

The '-mab' suffix denotes monoclonal antibodies (e.g., adalimumab, trastuzumab, infliximab), a naming convention used by the WHO.

Question 64: What is the most effective way to prevent healthcare-associated infections?

Wearing gloves at all times
Taking antibiotics
Cleaning the floor
Proper hand hygiene (Correct answer)

Correct answer: Proper hand hygiene

Hand hygiene (washing with soap and water or using alcohol-based hand rub) is the single most effective measure for preventing the spread of infections in healthcare settings.

Question 65: A Schedule IV prescription for alprazolam may be refilled a maximum of how many times within 6 months of the original date of issue?

5 times (Correct answer)
Unlimited times
3 times
0 times

Correct answer: 5 times

Schedule III and IV prescriptions may be refilled up to 5 times within 6 months from the date written.

Question 66: What is a side effect?

An expired medication
A dosing error
An unintended effect of a medication beyond its intended action (Correct answer)
The intended therapeutic effect

Correct answer: An unintended effect of a medication beyond its intended action

Side effects are unintended responses to a medication that occur alongside the desired therapeutic effect.

Question 67: What is the role of a wetting agent in suspensions?

To prevent oxidation of the drug
To reduce the contact angle between the powder and liquid, promoting uniform dispersion (Correct answer)
To serve as the active pharmaceutical ingredient
To increase the viscosity of the suspension

Correct answer: To reduce the contact angle between the powder and liquid, promoting uniform dispersion

Wetting agents like polysorbate 80 lower surface tension, helping hydrophobic powders become uniformly dispersed in the liquid vehicle.

Question 68: If a prescription reads: <br> "Fluconazole 150 mg PO once" <br> How should the pharmacy technician interpret this order?

Dispense a 150 mg oral tablet to be taken daily
Dispense a 150 mg oral tablet to be taken once (Correct answer)
Dispense 150 mg injectable fluconazole to be taken once
Dispense 150 mg oral suspension to be taken daily

Correct answer: Dispense a 150 mg oral tablet to be taken once

Verifying the patient's name on the prescription label against their identity is a critical safety measure to prevent dispensing medication to the wrong person. This step is paramount in preventing medication errors and ensuring the right patient receives the correct treatment.

Question 69: What is the purpose of an end-product potency test in pharmacy compounding?

To check sterility of the final container
To verify the product's color and odor
To measure the viscosity of the preparation
To confirm the correct amount of active ingredient is present (Correct answer)

Correct answer: To confirm the correct amount of active ingredient is present

Potency testing verifies that the compounded preparation contains the labeled amount of active pharmaceutical ingredient within acceptable limits.

Question 70: A hospital pharmacy uses a pneumatic tube system. What is its primary function?

To track controlled substance usage
To rapidly transport medications and specimens between departments (Correct answer)
To automate medication counting
To sterilize IV admixtures

Correct answer: To rapidly transport medications and specimens between departments

Pneumatic tube systems use pressurized air to transport small packages (medications, lab specimens) quickly between locations within a facility.

Question 71: Which drug class is primarily used to treat type 2 diabetes by increasing insulin sensitivity in peripheral tissues?

Thiazolidinediones (Correct answer)
Meglitinides
Sulfonylureas
Alpha-glucosidase inhibitors

Correct answer: Thiazolidinediones

Thiazolidinediones (e.g., pioglitazone) work as insulin sensitizers by activating PPAR-gamma receptors in adipose and muscle tissue.

Question 72: A patient using a fentanyl transdermal patch asks the technician if they can cut the patch to lower the dose. The technician should:

Tell the patient cutting in half is a safe and common practice
Immediately refer the patient to the pharmacist because cutting fentanyl patches can cause rapid, potentially fatal dose release (Correct answer)
Tell the patient to use medical scissors and the cut portion is still effective
Advise the patient to apply the cut patch and see how they feel

Correct answer: Immediately refer the patient to the pharmacist because cutting fentanyl patches can cause rapid, potentially fatal dose release

Cutting fentanyl patches disrupts the drug delivery system and can cause dangerous, rapid release of the full opioid dose.

Question 73: What is a drug contraindication?

A drug recommendation
A positive drug interaction
A dosage calculation
A condition that makes a particular treatment inadvisable (Correct answer)

Correct answer: A condition that makes a particular treatment inadvisable

A contraindication is a specific situation where a drug should not be used because it may be harmful to the patient.

Question 74: What is the primary purpose of a laminar airflow workbench (LAFW)?

To sterilize equipment using UV light
To store sterile IV bags at proper temperature
To provide a sterile ISO Class 5 environment by passing air through a HEPA filter (Correct answer)
To control room temperature during compounding

Correct answer: To provide a sterile ISO Class 5 environment by passing air through a HEPA filter

The LAFW uses a HEPA filter to remove particles from air and direct it over the work surface in a unidirectional flow, creating a sterile compounding zone.

Question 75: A compounded preparation's label must include all of the following EXCEPT:

The prescriber's DEA number (Correct answer)
Beyond-use date
Name and strength of the active ingredient
Directions for use

Correct answer: The prescriber's DEA number

The DEA number is not a required label element for compounded preparations unless the preparation is a controlled substance prescription.

Question 76: A beyond-use date (BUD) for a non-sterile aqueous preparation compounded from commercial drug products and stored at room temperature should not exceed:

90 days
6 months
30 days
14 days (Correct answer)

Correct answer: 14 days

Per USP <795>, non-sterile aqueous preparations compounded from manufactured drug products have a BUD of no more than 14 days when refrigerated or at room temperature.

Question 77: Why is air injected into a vial before withdrawing medication?

To dilute the medication before withdrawal
To sterilize the vial contents
To create positive pressure that helps draw the liquid into the syringe (Correct answer)
To test the vial for leaks

Correct answer: To create positive pressure that helps draw the liquid into the syringe

Injecting a volume of air equal to the desired withdrawal volume creates positive pressure inside the vial, making it easier to draw out the liquid without pulling in air bubbles.

Question 78: Which document must accompany a transfer of Schedule II controlled substances between two DEA-registered pharmacies?

A standard pharmacy purchase order
DEA Form 41
DEA Form 106
DEA Form 222 or CSOS electronic order (Correct answer)

Correct answer: DEA Form 222 or CSOS electronic order

Transfers of Schedule II substances between DEA registrants require a DEA Form 222 (paper) or an equivalent CSOS electronic order.

Question 79: The term 'DAW-1' on a prescription means:

Dispense generic equivalent as allowed
Drug awaiting formulary approval
Dispense as written — no generic substitution per prescriber (Correct answer)
Dispense as written — patient requests brand

Correct answer: Dispense as written — no generic substitution per prescriber

DAW-1 (Dispense As Written code 1) indicates the prescriber mandates the brand-name product and no generic substitution is permitted.

Question 80: A pharmacy receives a shipment where the invoice quantity does not match the physical count. What is the FIRST step the technician should take?

Return the entire shipment without documentation
Dispense from the shipment and adjust records later
Notify the pharmacist and contact the wholesaler to report the discrepancy (Correct answer)
Accept the shipment and update the perpetual inventory to match the invoice

Correct answer: Notify the pharmacist and contact the wholesaler to report the discrepancy

Discrepancies between invoice and physical count must be reported to the pharmacist and wholesaler before the inventory is accepted.

Question 81: A patient opts out of child-resistant packaging for their prescription. What documentation is required?

No documentation is needed — verbal opt-out is sufficient
DEA approval for the exemption
A signed waiver from the patient or their caregiver on file (Correct answer)
A physician's written order

Correct answer: A signed waiver from the patient or their caregiver on file

PPPA allows patients or caregivers to request non-child-resistant packaging, but a signed request must be kept on file to document the waiver.

Question 82: When a patient's address changes, updating it in the pharmacy system is important primarily because:

State law requires addresses be updated every 90 days
Insurance companies require address changes monthly
The prescriber needs the new address on file
Correct address ensures medication deliveries reach the patient and emergency contacts can be verified (Correct answer)

Correct answer: Correct address ensures medication deliveries reach the patient and emergency contacts can be verified

Accurate demographic data ensures deliveries succeed, enables emergency contact, and supports accurate billing.

Question 83: How many grams of dextrose are in 500 mL of D5W (5% dextrose in water)?

10 g
5 g
25 g (Correct answer)
50 g

Correct answer: 25 g

5% = 5 g/100 mL; 5 g × (500/100) = 25 g.

Question 84: What is the correct order for donning PPE?

Mask, gloves, gown, eye protection
Gown, mask, eye protection, gloves (Correct answer)
Gloves, gown, mask, eye protection
Any order is acceptable

Correct answer: Gown, mask, eye protection, gloves

The correct donning sequence is gown first, then mask/respirator, eye protection/face shield, and gloves last. This prevents contamination during application.

Question 85: What type of error involves a patient receiving the correct drug but at the wrong dose?

Dosing error (Correct answer)
Omission error
Transcription error
Wrong drug error

Correct answer: Dosing error

A dosing error occurs when the correct medication is administered but the quantity or strength differs from what was prescribed.

Question 86: Which practice helps prevent medication errors related to look-alike/sound-alike (LASA) drugs?

Using tall-man lettering and physical separation of LASA drugs (Correct answer)
Storing LASA drugs alphabetically on the same shelf
Dispensing LASA drugs without a verification check
Relying on technicians to memorize all LASA pairs

Correct answer: Using tall-man lettering and physical separation of LASA drugs

Tall-man lettering (e.g., hydrALAzine vs. hydrOXYzine) and physical separation are proven strategies to reduce LASA medication errors.

Question 87: A pharmacy technician is conducting a physical count during the annual inventory. The purpose of comparing the physical count to the book inventory is to:

Identify shrinkage, errors, or diversion of stock (Correct answer)
Determine the pharmacy's total revenue for the year
Generate the pharmacy's tax return
Automatically reorder any medications that are out of stock

Correct answer: Identify shrinkage, errors, or diversion of stock

Comparing physical counts to recorded book inventory identifies discrepancies that may indicate errors, theft, or diversion.

Question 88: When performing a visual inspection of a compounded sterile preparation (CSP), which finding would require immediate rejection?

A fill volume 1 mL below the expected 250 mL
A label printed in a slightly smaller font
Slightly amber color in a naturally colored solution
Particulate matter floating in the solution (Correct answer)

Correct answer: Particulate matter floating in the solution

Visible particulate matter in a sterile preparation is a critical quality defect and the preparation must be rejected immediately.

Question 89: What is the BIN number on a pharmacy insurance card used for?

To look up drug pricing
To identify the patient's date of birth
To verify the pharmacist's license
To route prescription claims to the correct insurance processor (Correct answer)

Correct answer: To route prescription claims to the correct insurance processor

The BIN (Bank Identification Number) is a 6-digit number used to route electronic prescription claims to the correct insurance processor.

Question 90: A patient receives a prescription for an opioid and asks how to safely dispose of unused medication. The technician should:

Tell the patient to throw leftover opioids in the household trash without precautions
Advise the patient to save unused opioids for future pain episodes
Tell the patient disposal information is not available at the pharmacy
Direct the patient to an FDA-approved drug take-back location and mention that some can be flushed per FDA flush list (Correct answer)

Correct answer: Direct the patient to an FDA-approved drug take-back location and mention that some can be flushed per FDA flush list

Safe opioid disposal via DEA take-back events or authorized drop-boxes prevents diversion and environmental harm.

Pharmacy Technician Certification Exam

The PTCE certifies pharmacy technicians through the Pharmacy Technician Certification Board (PTCB), validating knowledge in medications, federal requirements, patient safety, and order processing.

Questions

110 min

Time Limit

1400%

To Pass

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