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:

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

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: Which statement about medication adherence counseling is within a pharmacy technician's scope?

Reminding patients to take medications as directed and encouraging them to ask the pharmacist questions (Correct answer)
Recommending OTC alternatives if the patient finds the prescription too expensive
Diagnosing the reason for a patient's nonadherence
Adjusting doses based on the patient's reported symptoms

Correct answer: Reminding patients to take medications as directed and encouraging them to ask the pharmacist questions

Technicians can support adherence by reinforcing directions and directing complex questions to the pharmacist.

Question 3: 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 serve as a billing document for the insurance company
To replace verbal counseling by the pharmacist
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 4: 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?

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

Correct answer: 2.5 mL

250 mg ÷ 100 mg/mL = 2.5 mL.

Question 5: What does a pharmacy formulary contain?

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

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 6: A patient picking up warfarin asks why they need regular blood tests. Which response is most appropriate for a pharmacy technician?

Explain INR monitoring ensures the dose keeps blood thin enough without causing dangerous bleeding (Correct answer)
Advise the patient that blood tests are optional for warfarin
Inform the patient that only new patients need INR monitoring
Tell the patient to ask their insurance company

Correct answer: Explain INR monitoring ensures the dose keeps blood thin enough without causing dangerous bleeding

Pharmacy technicians can reinforce that warfarin requires INR monitoring to balance efficacy and bleeding risk, though detailed counseling is referred to the pharmacist.

Question 7: A compounding order calls for a 2.5% hydrocortisone cream — 60 g. The pharmacy has 10% hydrocortisone cream in stock. How many grams of the 10% cream are needed?

10 g
20 g
15 g (Correct answer)
25 g

Correct answer: 15 g

Using C1V1=C2V2: 10% × X = 2.5% × 60 g; X = (2.5 × 60) / 10 = 15 g.

Question 8: A prescription reads 'GTT ii OS TID.' What does 'OS' indicate?

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

Correct answer: Left eye

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

Question 9: The FDA's 'black box warning' (boxed warning) is BEST described as:

The strongest warning the FDA requires, indicating serious or life-threatening risks (Correct answer)
A voluntary manufacturer advisory for minor side effects
A DEA restriction placed on Schedule II medications
A state-level warning mandated by the Board of Pharmacy

Correct answer: The strongest warning the FDA requires, indicating serious or life-threatening risks

A black box warning is the FDA's most serious labeling requirement, reserved for drugs with significant risks of severe or life-threatening adverse effects.

Question 10: 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 11: A medication labeled as a 'first-generation antihistamine' would be expected to cause which side effect not seen with second-generation agents?

Constipation
Dry mouth
Sedation (Correct answer)
Urinary retention

Correct answer: Sedation

First-generation antihistamines (e.g., diphenhydramine) cross the blood-brain barrier causing sedation, unlike second-generation agents like loratadine.

Question 12: A pharmacy technician notices that a batch of medication has been stored incorrectly, exposing it to extreme temperatures. What should the technician do next?

Dispose of the medication immediately without notifying anyone
Continue to dispense the medication if it looks fine
Immediately report the incident to the pharmacist and quarantine the medication (Correct answer)
Dispense the medication but inform the customer of its potential issues

Correct answer: Immediately report the incident to the pharmacist and quarantine the medication

Effective inventory control aims to maintain an optimal stock level, preventing both excessive overstocking (which can lead to waste from expiration or tied-up capital) and understocking (which can result in medication shortages and impact patient care). It balances supply with demand.

Question 13: What does claim adjudication refer to in pharmacy billing?

Verifying a patient's identity at the counter
The insurance plan's process of reviewing and determining payment for a prescription claim (Correct answer)
Printing the patient's receipt
Filling out a prior authorization form

Correct answer: The insurance plan's process of reviewing and determining payment for a prescription claim

Adjudication is the real-time electronic process by which an insurance plan evaluates a submitted claim and returns an approval or rejection with reimbursement details.

Question 14: What are standard precautions in healthcare?

Using masks during surgery only
Only wearing gloves for known infections
Hand washing after patient contact only
Treating all blood and body fluids as potentially infectious (Correct answer)

Correct answer: Treating all blood and body fluids as potentially infectious

Standard precautions assume all blood and body fluids are potentially infectious, requiring consistent use of barriers (gloves, gowns, masks) and hand hygiene for all patient interactions.

Question 15: A patient presents a prescription for oxycodone 30 mg tablets written by a physician licensed in another state. Under federal law, which statement is correct?

It can be filled if it meets both the issuing state and dispensing state requirements (Correct answer)
It is invalid and cannot be filled
It requires a DEA Form 222 to dispense
It can only be filled if the physician has a DEA number in the dispensing state

Correct answer: It can be filled if it meets both the issuing state and dispensing state requirements

A controlled substance prescription written by an out-of-state prescriber is valid if it meets the legal requirements of both the prescriber's state and the state where it is being filled.

Question 16: 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
75 mL/hr (Correct answer)
60 mL/hr
30 mL/hr

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

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

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 18: A hospital pharmacy is using an automated dispensing cabinet (ADC) for controlled substances. Who is ultimately responsible for ensuring the controlled substances in the ADC are accurately accounted for?

The nurse removing the medication
The hospital administrator
The pharmacy technician who loads the cabinet
The pharmacist-in-charge (Correct answer)

Correct answer: The pharmacist-in-charge

The pharmacist-in-charge (PIC) bears ultimate legal responsibility for the security and accurate record-keeping of all controlled substances in the pharmacy, including those in ADCs.

Question 19: Which medication is used to reverse opioid overdose?

Atropine
Flumazenil
Physostigmine
Naloxone (Correct answer)

Correct answer: Naloxone

Naloxone (Narcan) is a pure opioid receptor antagonist used to rapidly reverse opioid-induced respiratory depression.

Question 20: A pharmacy receives a prescription for Tylenol #3. What controlled substance does it contain in addition to acetaminophen?

Hydrocodone
Tramadol
Oxycodone
Codeine (Correct answer)

Correct answer: Codeine

Tylenol #3 contains acetaminophen 300 mg and codeine 30 mg; the number designates the codeine strength.

Question 21: Which of the following antibiotics works by inhibiting cell wall synthesis?

Azithromycin
Doxycycline
Ciprofloxacin
Cephalexin (Correct answer)

Correct answer: Cephalexin

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

Question 22: Under the Combat Methamphetamine Epidemic Act (CMEA), what is the daily sales limit for pseudoephedrine products per customer?

9 grams
1.8 grams
7.5 grams
3.6 grams (Correct answer)

Correct answer: 3.6 grams

CMEA limits pseudoephedrine sales to 3.6 grams per day per purchaser and 9 grams per 30-day period.

Question 23: What is the most effective way to prevent healthcare-associated infections?

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

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 24: What is the primary purpose of a levigating agent in ointment preparation?

To act as a preservative
To increase viscosity of the base
To reduce particle size and improve uniform distribution of the active ingredient (Correct answer)
To lower the melting point of the ointment

Correct answer: To reduce particle size and improve uniform distribution of the active ingredient

Levigating agents (e.g., mineral oil, glycerin) wet and reduce powder particle size before incorporation into an ointment base.

Question 25: What does co-insurance mean in pharmacy benefits?

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

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 26: What drug class is albuterol (ProAir, Ventolin)?

Short-acting beta-2 agonist (Correct answer)
Anticholinergic bronchodilator
Inhaled corticosteroid
Leukotriene receptor antagonist

Correct answer: Short-acting beta-2 agonist

Albuterol is a short-acting beta-2 agonist (SABA) used for quick relief of acute bronchospasm.

Question 27: What is the difference between generic and brand-name drugs?

There is no difference
Brand names are always better
Generic drugs are less effective
Generic drugs have the same active ingredient but different name and typically lower cost (Correct answer)

Correct answer: Generic drugs have the same active ingredient but different name and typically lower cost

Generic drugs contain the same active ingredients, dosage, and route as brand-name drugs but are marketed under their chemical name at lower cost after patent expiration.

Question 28: 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
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
Immediately refer the patient to the pharmacist because cutting fentanyl patches can cause rapid, potentially fatal dose release (Correct answer)

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 29: An order is for 0.9% NaCl 250 mL to infuse over 90 minutes. What is the rate in mL/hr?

125 mL/hr
150 mL/hr
167 mL/hr (Correct answer)
200 mL/hr

Correct answer: 167 mL/hr

250 mL ÷ (90/60 hr) = 250 ÷ 1.5 = 166.7 ≈ 167 mL/hr.

Question 30: What is the primary purpose of media-fill testing in a sterile compounding environment?

To measure humidity in the cleanroom
To evaluate the aseptic technique of compounding personnel (Correct answer)
To test for pyrogens in the final product
To verify container closure integrity

Correct answer: To evaluate the aseptic technique of compounding personnel

Media-fill testing uses microbiological growth media to simulate CSP preparation and assess whether personnel aseptic technique can prevent contamination.

Question 31: Which sig code instructs the patient to take medication every 8 hours?

QID
TID (Correct answer)
BID
Q12H

Correct answer: TID

TID (ter in die) means three times daily, which equals every 8 hours when spaced evenly.

Question 32: A patient needs a 2% lidocaine solution. How many mg of lidocaine are in 10 mL?

2 mg
20 mg
2,000 mg
200 mg (Correct answer)

Correct answer: 200 mg

2% = 2 g/100 mL = 20 mg/mL; 20 mg/mL × 10 mL = 200 mg.

Question 33: Which opioid analgesic is available as a transdermal patch?

Hydrocodone
Tramadol
Fentanyl (Correct answer)
Codeine

Correct answer: Fentanyl

Fentanyl is available as a transdermal patch (Duragesic) for chronic, around-the-clock pain management.

Question 34: A technician processes an electronic prescription for hydrocodone/acetaminophen 5/325 mg. As a Schedule II drug, which of the following is true regarding early refills?

It may be refilled after 75% of the days supply has elapsed
It may be refilled up to 5 times within 6 months
It cannot be refilled; a new prescription is required each time (Correct answer)
It may be refilled once with prescriber authorization

Correct answer: It cannot be refilled; a new prescription is required each time

Schedule II controlled substances cannot be refilled; a new valid prescription must be issued for each supply.

Question 35: Which of the following is an example of a Schedule III anabolic steroid that pharmacy technicians may encounter?

Testosterone cypionate injection (Correct answer)
Clonazepam (Klonopin)
Diazepam (Valium)
Zolpidem (Ambien)

Correct answer: Testosterone cypionate injection

Testosterone and other anabolic steroids are classified as Schedule III controlled substances under the Anabolic Steroids Control Act.

Question 36: What is the mechanism of action of beta-blockers such as metoprolol?

Block alpha-1 adrenergic receptors
Inhibit calcium channels
Block beta-adrenergic receptors (Correct answer)
Inhibit ACE enzyme

Correct answer: Block beta-adrenergic receptors

Beta-blockers competitively block beta-adrenergic receptors, reducing heart rate and blood pressure.

Question 37: A patient receives a prescription for an opioid and asks how to safely dispose of unused medication. The technician should:

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

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.

Question 38: What is the maximum BUD for an aqueous oral compounded preparation stored at room temperature under USP <795>?

1 year
6 months
14 days (Correct answer)
30 days

Correct answer: 14 days

USP <795> limits water-containing oral formulations stored at room temperature to a BUD of 14 days.

Question 39: Which practice is required before compounding a batch of sterile preparations to prevent cross-contamination?

Wearing only gloves without a gown
Decontaminating and disinfecting the ISO Class 5 PEC with 70% IPA (Correct answer)
Running HEPA filters at reduced speed
Opening the BSC's sash completely for airflow

Correct answer: Decontaminating and disinfecting the ISO Class 5 PEC with 70% IPA

Surfaces in the PEC must be cleaned with 70% isopropyl alcohol before compounding to eliminate particulate and microbial contamination.

Question 40: Which action is the most appropriate response when a compounding technician discovers a significant calculation error after the CSP has been dispensed?

Correct the log entry to reflect the right amount
Document the error quietly and continue working
Notify the pharmacist immediately and initiate a recall if needed (Correct answer)
Wait to see if the patient reports a problem

Correct answer: Notify the pharmacist immediately and initiate a recall if needed

Immediate pharmacist notification and potential product recall is the correct response to protect patient safety after a dispensing error.

Question 41: 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 prepared in batches of more than 25 units
A CSP involving non-sterile ingredients that have been sterilized

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 42: What is a pharmacy deductible?

The maximum amount an insurance plan will pay annually
A fee charged to activate pharmacy benefits
A penalty for using an out-of-network pharmacy
The amount a patient must pay out-of-pocket before insurance begins covering prescriptions (Correct answer)

Correct answer: The amount a patient must pay out-of-pocket before insurance begins covering prescriptions

A deductible is the set amount a patient must spend on covered medications before the insurance plan starts paying its share.

Question 43: What is coordination of benefits (COB) in pharmacy billing?

Adjusting the days supply on a claim
Combining two prescriptions into one fill
A process that determines payment order when a patient has two insurance plans (Correct answer)
Transferring a prescription between pharmacies

Correct answer: A process that determines payment order when a patient has two insurance plans

COB ensures that when a patient has primary and secondary insurance, both are billed correctly so total payment does not exceed the drug cost.

Question 44: 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:

Accept and shelve the medication since it is still refrigerated temperature
Accept it and monitor for visible degradation before dispensing
Return it immediately without documentation
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 45: Digoxin, used for heart failure and atrial fibrillation, is classified as which type of drug?

Beta-blocker
Cardiac glycoside (Correct answer)
Antiarrhythmic class III
Calcium channel blocker

Correct answer: Cardiac glycoside

Digoxin is a cardiac glycoside derived from the foxglove plant that inhibits Na+/K+ ATPase, increasing myocardial contractility and slowing AV conduction.

Question 46: Why is air injected into a vial before withdrawing medication?

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

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 47: Which of the following is an example of a narrow therapeutic index (NTI) drug requiring close monitoring?

Ibuprofen
Cetirizine
Phenytoin (Correct answer)
Amoxicillin

Correct answer: Phenytoin

Phenytoin has a narrow therapeutic index; small dosage changes can lead to toxicity or subtherapeutic levels, requiring regular drug level monitoring.

Question 48: A patient asks the technician why their antibiotic prescription says 'take until gone' even though they feel better after 3 days. The technician should:

Tell the patient to take the remaining doses only if symptoms return
Advise the patient to call the prescriber and ask for a shorter course
Tell the patient it is fine to stop once symptoms resolve
Reinforce that completing the full antibiotic course is important and refer the patient to the pharmacist for a full explanation (Correct answer)

Correct answer: Reinforce that completing the full antibiotic course is important and refer the patient to the pharmacist for a full explanation

Stopping antibiotics early can lead to treatment failure and antibiotic resistance; completing the full course is essential.

Question 49: Which DEA form is used to report theft or significant loss of controlled substances?

DEA Form 106 (Correct answer)
DEA Form 222
DEA Form 224
DEA Form 41

Correct answer: DEA Form 106

DEA Form 106 must be completed and submitted to report theft or significant loss of controlled substances.

Question 50: What is the correct order for donning PPE?

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

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 51: Environmental surface sampling in a sterile compounding area is performed primarily to:

Verify HEPA filter installation dates
Measure temperature variations in the cleanroom
Assess employee hand hygiene compliance
Monitor for microbial contamination on work surfaces (Correct answer)

Correct answer: Monitor for microbial contamination on work surfaces

Surface sampling detects microbial bioburden on compounding surfaces to ensure the environment remains within acceptable contamination limits.

Question 52: What is an IV admixture?

An IV solution contaminated with particulate matter
A premixed IV solution purchased from a manufacturer
A combination of two incompatible IV drugs in one bag
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 53: Which compounding scenario would require compliance with USP <800> hazardous drug handling guidelines?

Preparing an antacid suspension from OTC ingredients
Preparing a methotrexate oral solution for a pediatric patient (Correct answer)
Compounding a vitamin C topical cream
Mixing a normal saline IV bag

Correct answer: Preparing a methotrexate oral solution for a pediatric patient

Methotrexate is a NIOSH-listed hazardous drug; all handling and compounding must comply with USP <800> protective requirements.

Question 54: What type of error involves a patient receiving the correct drug but at the wrong dose?

Wrong drug error
Omission error
Dosing error (Correct answer)
Transcription 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 55: 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:

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

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 56: A patient is prescribed a selective serotonin reuptake inhibitor (SSRI). Which of the following belongs to this class?

Venlafaxine
Amitriptyline
Sertraline (Correct answer)
Bupropion

Correct answer: Sertraline

Sertraline (Zoloft) is an SSRI; amitriptyline is a TCA, venlafaxine is an SNRI, and bupropion is an NDRI.

Question 57: What does PPE stand for?

Pre-Planning Exercise
Post-Production Equipment
Personal Protective Equipment (Correct answer)
Professional Performance Evaluation

Correct answer: Personal Protective Equipment

PPE refers to equipment worn to minimize exposure to hazards, including helmets, gloves, eye protection, and safety boots.

Question 58: Which act requires childproof packaging for most prescription medications?

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

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 59: A prescription reads 'Insulin glargine 20 units SC QHS.' When should this medication be administered?

At bedtime (Correct answer)
Twice daily with meals
Every morning before breakfast
Every 12 hours

Correct answer: At bedtime

QHS means 'hora somni,' or at bedtime/hour of sleep.

Question 60: What does 'refill too soon' rejection mean in pharmacy billing?

The drug requires a new prior authorization for each refill
The claim was submitted before the patient's days supply has nearly run out (Correct answer)
The prescription has expired and cannot be refilled
The pharmacy submitted the claim to the wrong insurer

Correct answer: The claim was submitted before the patient's days supply has nearly run out

A 'refill too soon' rejection means the insurance will not yet pay for a refill because the calculated days supply from the previous fill has not been used up.

Question 61: A hospital pharmacy uses 'just-in-time' (JIT) ordering. The primary goal of JIT is to:

Order controlled substances directly from the manufacturer
Automate patient dispensing without pharmacist review
Receive inventory only as it is needed to minimize on-hand stock and storage costs (Correct answer)
Maintain a large safety stock buffer to prevent shortages

Correct answer: Receive inventory only as it is needed to minimize on-hand stock and storage costs

JIT ordering minimizes on-hand inventory and associated carrying costs by receiving goods only when needed for near-term use.

Question 62: A drug concentration is 2 mg/mL. The order calls for 0.5 mg/kg for a 40 kg patient. What volume should be given?

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

Correct answer: 10 mL

0.5 mg/kg × 40 kg = 20 mg total; 20 mg ÷ 2 mg/mL = 10 mL.

Question 63: A barcode medication administration (BCMA) system is primarily designed to verify which of the following at the point of care?

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

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 64: Which of the following is an example of a medication classification that is used to treat bacterial infections?

Antiviral
Antifungal
Antibiotic (Correct answer)
Antihypertensive

Correct answer: Antibiotic

Antibiotics are a specific class of antimicrobial drugs designed to kill or inhibit the growth of bacteria. They are used to treat bacterial infections and are distinct from antivirals (for viruses), antifungals (for fungi), or antihypertensives (for high blood pressure).

Question 65: What is the first priority in any emergency situation?

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

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 66: A drug ending in '-pril' most likely belongs to which antihypertensive class?

Beta-blockers
ACE inhibitors (Correct answer)
ARBs
Calcium channel blockers

Correct answer: ACE inhibitors

The '-pril' suffix is a naming convention for ACE inhibitors (e.g., lisinopril, enalapril, ramipril).

Question 67: What does 'turnover rate' measure in pharmacy inventory management?

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
The ratio of generic to brand-name drugs dispensed

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 68: What does 'geometric dilution' ensure when incorporating a small amount of a potent drug powder into a larger base?

Uniform distribution of the drug throughout the preparation (Correct answer)
Faster dissolution of the drug
Sterilization of the final product
Lower particle size of the drug

Correct answer: Uniform distribution of the drug throughout the preparation

Geometric dilution progressively doubles the mixture to ensure the potent drug is evenly distributed before full incorporation.

Question 69: Under the DSCSA (Drug Supply Chain Security Act), pharmacies must be able to trace a recalled drug product back through how many prior transactions?

The entire supply chain back to the manufacturer (Correct answer)
Three transactions
One transaction only
Six transactions

Correct answer: The entire supply chain back to the manufacturer

The DSCSA requires full track-and-trace capability across the entire pharmaceutical supply chain from manufacturer to dispenser.

Question 70: Insulin glargine (Lantus) is classified as which type of insulin?

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

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 71: A pharmacy uses an automated dispensing cabinet (ADC) for controlled substances. Which statement about ADC management is correct?

ADCs eliminate the need for DEA record-keeping
ADC records are not considered official pharmacy records
Only pharmacists may restock ADCs with any medication
ADCs must be reconciled regularly and discrepancies reported immediately (Correct answer)

Correct answer: ADCs must be reconciled regularly and discrepancies reported immediately

ADCs must be regularly reconciled and any discrepancies in controlled substances must be immediately reported and investigated.

Question 72: When a medication is found to be counterfeit or adulterated in a pharmacy, the technician should:

Continue dispensing until the supply runs out
Quarantine the product and report it to the pharmacist, who will notify the FDA (Correct answer)
Return it to the wholesaler without notifying authorities
Destroy the medication and document the destruction

Correct answer: Quarantine the product and report it to the pharmacist, who will notify the FDA

Counterfeit or adulterated medications must be quarantined, reported to the pharmacist, and reported to the FDA through MedWatch.

Question 73: Which of the following best describes the purpose of a medication error report in a pharmacy?

To notify the patient that they received the wrong medication
To document the error for future legal cases
To identify the cause of the error and prevent future occurrences (Correct answer)
To punish the person responsible for the error

Correct answer: To identify the cause of the error and prevent future occurrences

Medication error reports are crucial tools for quality improvement in healthcare. Their primary purpose is not punitive, but rather to analyze the root causes of errors, such as system failures, workflow issues, or human factors. By understanding these causes, pharmacies can implement corrective actions and systemic changes to enhance patient safety and prevent similar errors from happening again.

Question 74: Which term describes the unintended transfer of a drug residue from one product batch to another during compounding?

Cross-contamination (Correct answer)
Mislabeling
Dilution error
Adulteration

Correct answer: Cross-contamination

Cross-contamination occurs when residue from one compound inadvertently contaminates a subsequent batch, which is a critical quality and safety concern.

Question 75: Which of the following is a key purpose of maintaining a perpetual inventory for Schedule II controlled substances?

To satisfy insurance billing requirements
To track the profit margin on each controlled substance
To automate reordering from the DEA
To provide a continuously updated record of stock to detect diversion (Correct answer)

Correct answer: To provide a continuously updated record of stock to detect diversion

A perpetual inventory provides a real-time running count that helps detect theft or diversion of Schedule II controlled substances.

Question 76: 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?

5 mL/hr
15 mL/hr
20 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 77: A technician is preparing a 1:1000 epinephrine solution. How many mg of epinephrine are in 1 mL?

1 mg (Correct answer)
100 mg
0.1 mg
10 mg

Correct answer: 1 mg

A 1:1000 ratio means 1 g per 1000 mL, which equals 1 mg per mL.

Question 78: A patient is prescribed both a fluoroquinolone antibiotic and an antacid. The technician should counsel the patient to separate these doses by at least:

15 minutes
30 minutes
2 hours (Correct answer)
1 hour

Correct answer: 2 hours

Multivalent cations in antacids chelate fluoroquinolones and reduce their absorption by up to 90%; a 2-hour separation minimizes this interaction.

Question 79: What is a 'step therapy' requirement in pharmacy insurance?

A stepwise dosing schedule for a new medication
A protocol requiring patients to try a lower-cost drug before covering a higher-cost alternative (Correct answer)
A process for incrementally increasing an insurance copay
A requirement to obtain multiple prescriptions at once

Correct answer: A protocol requiring patients to try a lower-cost drug before covering a higher-cost alternative

Step therapy requires a patient to try a preferred (usually generic or lower-cost) drug first, and only covers the higher-cost drug if the first option fails.

Question 80: What is a drug contraindication?

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

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 81: Which of the following describes an 'open formulary' in a health system pharmacy?

A formulary where any drug may be prescribed without restriction (Correct answer)
A formulary managed exclusively by the DEA
A formulary limited to a selected list of approved medications
A formulary that prohibits generic substitutions

Correct answer: A formulary where any drug may be prescribed without restriction

An open formulary allows prescribers to order any drug without restriction, while a closed formulary limits prescribing to an approved drug list.

Question 82: What is HIPAA?

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

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 83: A patient mentions they have been self-medicating with St. John's Wort for depression. Why is this important information for the pharmacist to know?

Herbal supplements never interact with prescription drugs
St. John's Wort has significant drug interactions, including reducing the effectiveness of many prescription medications (Correct answer)
The pharmacist only needs to know about prescription medications
St. John's Wort is FDA-approved and has no interactions

Correct answer: St. John's Wort has significant drug interactions, including reducing the effectiveness of many prescription medications

St. John's Wort is a potent CYP450 inducer that can reduce plasma levels of many drugs, including oral contraceptives and antiretrovirals.

Question 84: Which of the following drug schedules is most likely to have the highest potential for abuse?

Schedule I (Correct answer)
Schedule IV
Schedule III
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 85: What does informed consent require?

Getting any signature on a form
Verbal agreement only
Explaining the procedure, risks, benefits, and alternatives to the patient (Correct answer)
Family approval 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 86: A patient asks a technician whether it is safe to take ibuprofen with their blood pressure medication. The technician should:

Tell the patient ibuprofen is always safe with any blood pressure drug
Look up the answer online and advise the patient
Refer the patient to the pharmacist for a drug interaction consultation (Correct answer)
Call the prescriber on the patient's behalf without involving the pharmacist

Correct answer: Refer the patient to the pharmacist for a drug interaction consultation

Drug interaction questions require pharmacist expertise; technicians must refer these inquiries rather than answer independently.

Question 87: Medications stored in the pharmacy must be kept at the manufacturer's recommended temperature. Which temperature range is considered 'controlled room temperature' (CRT)?

2°C to 8°C (36°F to 46°F)
−25°C to −10°C (−13°F to 14°F)
15°C to 25°C (59°F to 77°F) (Correct answer)
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 88: When a DEA-registered pharmacy permanently closes, controlled substances must be transferred or surrendered. Which DEA form is used to record the destruction of controlled substances by an authorized collector?

DEA Form 363
DEA Form 41 (Correct answer)
DEA Form 222
DEA Form 106

Correct answer: DEA Form 41

DEA Form 41 (Registrants Inventory of Drugs Surrendered) is used to document the surrender or destruction of controlled substances.

Question 89: A morphine PCA is programmed at 1 mg/mL with a maximum dose of 10 mg over 4 hours. What maximum volume can be delivered in 4 hours?

12 mL
8 mL
4 mL
10 mL (Correct answer)

Correct answer: 10 mL

10 mg ÷ 1 mg/mL = 10 mL maximum in 4 hours.

Question 90: What is aseptic technique in sterile compounding?

Autoclaving all equipment before use
Filtering all IV bags through a 0.2 micron membrane
Using antibiotics to sterilize IV solutions
A set of practices designed to prevent microbial contamination during preparation of sterile products (Correct answer)

Correct answer: A set of practices designed to prevent microbial contamination during preparation of sterile products

Aseptic technique includes proper garbing, hand washing, LAFW cleaning, and handling critical sites without contamination to ensure sterile product integrity.

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%

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