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Free PTCB Pharmacy Technician Certification (CPhT) Exam PTCE Exam Questions

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Question 1

It would be most appropriate to dispose of which of the following medications as hazardous waste?

Correct Answer: C. Methotrexate
Explanation:

Methotrexateis achemotherapy agentand animmunosuppressantused for cancer and autoimmune diseases.

It is classified ashazardous pharmaceutical wasteunderResource Conservation and Recovery Act (RCRA)due to itstoxicity.

It must be disposed of followingEPA guidelines for hazardous waste disposal.

Reference:RCRA hazardous waste disposal regulations;USP <800> guidelines for hazardous drugs.


Question 2

A patient presents the following prescription:

Lisinopril 20 mg tablets

Take 1 tab PO q8h

#30 with 12 refills

In order to fill this prescription, the pharmacy must clarify the:

Correct Answer: A. directions for use.
Explanation:

Before dispensing a prescription, pharmacy technicians and pharmacists must ensure that it iscomplete, clear, and unambiguousto avoid medication errors.

Medication:Lisinopril

Strength:20 mg (Clear)

Route:PO (by mouth) (Clear)

Directions:Take 1 tab PO q8h (every 8 hours)(Needs Clarification)

Quantity:30 tablets (Clear)

Refills:12 (Needs verification but is not the main issue)

Lisinopril is an ACE inhibitorused for hypertension and heart failure.

Standard dosing is once daily (q24h), not every 8 hours (q8h).

A frequency of q8h (three times daily) is unusual and could be a prescribing error.

Pharmacists must verify with the prescriber before dispensing.

(A) Directions for useCorrect -- 'q8h' is incorrect for lisinopril and needs clarification.

(B) Medication strengthIncorrect -- '20 mg' is a standard strength for lisinopril.

(C) Route of administrationIncorrect -- 'PO' (by mouth) is correct.

(D) Number of refillsIncorrect -- While 12 refills is uncommon for chronic medications, it is not the primary issue.

Lisinopril Prescribing Information (FDA): https://www.accessdata.fda.gov

Institute for Safe Medication Practices (ISMP) -- High-Alert Medications:https://www.ismp.org

PTCB Exam Content Outline -- Prescription Processing & Clarification

Analysis of the Prescription:Why the Directions Need Clarification:Analysis of Answer Choices:Reference for Pharmacy Technicians:


Question 3

Which of the following products is acorticosteroid?

Correct Answer: B. Fluocinolone
Explanation:

Comprehensive and Detailed Step-by-Step Explanation:

Corticosteroidsare a class of medications used toreduce inflammation.Fluocinoloneis atopical corticosteroidused foreczema, psoriasis, and allergic reactions.

Explanation of Answer Choices:B. FluocinoloneCorrect.Fluocinolone is a corticosteroidused in skin conditions.A. Progesterone Incorrect.Progesterone is a hormone, not a corticosteroid.C. Methyltestosterone Incorrect.Methyltestosterone is an androgen (male hormone).D. Spironolactone Incorrect.Spironolactone is a potassium-sparing diuretic, not a steroid.

Reference:

FDA Drug Classification Database

USP Drug Information Handbook


Question 4

Which two medications are considered look-alike/sound-alike when written as their brand names?

Correct Answer: B. Citalopram and celecoxib
Explanation:

Look-alike/sound-alike (LASA) medications are drugs that areeasily confused due to similar spelling or pronunciation, which increases the risk of medication errors.

Citalopram(Celexa) Selective serotonin reuptake inhibitor (SSRI) used for depression

Celecoxib(Celebrex) Nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation

Why Are Citalopram and Celecoxib Considered LASA?Both drugs sharesimilar spelling and pronunciation, increasing the chance of errors inprescribing, dispensing, and administration.

Example of potential errors: A patient withdepressionmay mistakenly receiveCelecoxib (NSAID)instead ofCitalopram (antidepressant), leading to untreated depression and unnecessary NSAID use.

A . Lisinopril and MetoprololDifferent drug classes, butnot commonly confused.

Lisinopril(ACE inhibitor for blood pressure)

Metoprolol(Beta-blocker for blood pressure and heart conditions)

C . Acebutolol and AcetazolamideAlthough their names look similar, they haveless common confusion in clinical practice.

Acebutolol(Beta-blocker)

Acetazolamide(Diuretic for glaucoma, altitude sickness)

D . Naproxen and MisoprostolThese are oftenprescribed togetherbut arenot confused with each other.

Naproxen(NSAID for pain)

Misoprostol(Used to protect the stomach from NSAID-induced ulcers)

Institute for Safe Medication Practices (ISMP) LASA List-- ConfirmsCitalopram and Celecoxibas common look-alike/sound-alike drugs.

PTCB PTCE Exam Content Outline-- Covers error prevention strategies, including LASA medications.

FDA Medication Error Prevention Guidelines-- Recommends usingTall Man Lettering(e.g.,CeleXib vs. CitaloPram) to differentiate LASA drugs.

Why Not the Other Options?Key Reference:


Question 5

Federal law restricts the OTC sale of:

Correct Answer: B. Pseudoephedrine
Explanation:

Pseudoephedrineis regulated under theCombat Methamphetamine Epidemic Act (CMEA)of 2005 due to its potential use in methamphetamine production.

It is availableover-the-counter (OTC) but behind the pharmacy counter, and its sale requires:

Proof of ID

Purchase limits (3.6 g per day, 9 g per month)

A log of purchases maintained by the pharmacy

Loratadine, acetaminophen, and naproxendo not have federal restrictions like pseudoephedrine.

Reference:U.S.Combat Methamphetamine Epidemic Act (CMEA)of 2005.


Question 6

Pharmacy staff should always visually inspect nonsterile compounds for which of the following signs of incompatibility?

Correct Answer: C. Precipitation
Explanation:

Pharmacy staff should always visually inspect nonsterile compounds for signs of incompatibility to ensure medication safety and efficacy. The presence ofprecipitationis a key indicator of an incompatibility issue in nonsterile compounded preparations. Precipitation occurs when a solute (drug) comes out of solution, forming visible solid particles. This can result from changes in pH, solvent composition, or chemical interactions between ingredients.

A . Photolysis:

Decomposition of a drug due to light exposure, leading to color changes or potency loss, but it is not a physical incompatibility visible as precipitation.

B . Hydrolysis:

Chemical breakdown of a drug due to water, common in ester and amide-containing drugs, but not a visual incompatibility like precipitation.

D . Oxidation-Reduction:

A chemical reaction that may change drug color or effectiveness but does not typically lead to visible precipitation in nonsterile compounds.

Other Answer Choices Explained:Reference:

USP <795> Pharmaceutical Compounding---Nonsterile Preparations

PTCB PTCE Exam Content Outline (Medication Safety & Quality Assurance)

Remington: The Science and Practice of Pharmacy


Question 7

A local provider has written the following compounded prescription for a patient:

Zinc oxide ointment 20% 60 g

Nystatin ointment 100,000 units/g 60 g

Hydrocortisone ointment 1% 60 g

Cholestyramine powder 10 g

Mineral oil USP 10 mL

Total Weight 200 g

Which of the agents listed is an antifungal agent?

Correct Answer: D. Nystatin
Explanation:

In the providedcompounded prescription, the antifungal agent isnystatin.

Nystatin is a polyene antifungalthat works by binding toergosterolin fungal cell membranes, causing leakage of cellular contents and fungal cell death.

It iscommonly used for fungal infections, particularlycutaneous or mucosal Candida infections(e.g., diaper rash, oral thrush).

A . Cholestyramine. Incorrect. Cholestyramine is abile acid sequestrantused to lowercholesteroland treatdiarrhea(often in combination with other ingredients for skin irritation or wounds).

B . Hydrocortisone. Incorrect. Hydrocortisone is acorticosteroidused to reduceinflammation and itching, but it does not kill fungi.

C . Zinc oxide. Incorrect. Zinc oxide is askin protectantused fordiaper rash and minor burns, but it is not an antifungal.

Lexicomp Drug Database -- Nystatin Mechanism of Action.

FDA Drug Label for Nystatin -- Antifungal Properties.

PTCB PTCE Exam Content Outline -- Compounded Preparations and Active Ingredients.

Mosby's Pharmacy Technician: Principles and Practice -- Dermatologic Compounding.

Why Is Nystatin an Antifungal?Why the Other Answer Choices Are Incorrect:Pharmacy Technician Reference:Conclusion:Pharmacy technicians must befamiliar with drug classificationsto correctly identify active ingredients incompounded prescriptions.Nystatin is the only antifungal agentin the provided formulation.


Question 8

A pharmacy is notified that an oral solution has been recalled due to temperature excursions during transport. The first step pharmacy staff should take is to:

Correct Answer: A. remove any affected product from dispensing stock.
Explanation:

When adrug recalloccurs due totemperature excursions(exposure to temperatures outside the manufacturer's recommended range during transport or storage), the pharmacy mustimmediately remove all affected productfrom its inventory to prevent dispensing compromised medication.

Remove the Affected Product:Quarantine the recalled drug to ensure it is not dispensed.

Verify the Recall Details:Confirm the lot number, expiration date, and reason for the recall using FDA or manufacturer recall notices.

Document the Recall Action:Log details in the pharmacy's recall records for compliance.

Follow Manufacturer or FDA Instructions:Some recalls require returning the product, while others require disposal according to hazardous waste guidelines.

Notify Patients and Providers (If Necessary):If the medication has already been dispensed, further action may be needed depending on recall severity.

B . Contact patients who received a therapeutically equivalent product. Incorrect. The recall applies to thespecificaffected lot, not all similar medications. Pharmacists would first verify which patients received the recalled drugbefore contacting them.

C . Switch patients from the oral solution to oral capsules. Incorrect. The recall does not automatically require a formulation change. The pharmacy must verify availability of unaffected stock or alternative treatments before making substitutions.

D . Contact all prescribers who recently prescribed the product. Incorrect. While prescribersmayneed notification if the recall affects patient treatment, thefirst stepis ensuring the recalled product is removed from stock to prevent further dispensing.

PTCB PTCE Exam Content Outline -- Medication Safety and Recall Procedures.

FDA Drug Recall Guidelines (www.fda.gov).

USP <1079> Good Storage and Distribution Practices for Pharmaceuticals.

National Association of Boards of Pharmacy (NABP) Recall Compliance Standards.

Manufacturer Recall Notices (Example: Pfizer, Eli Lilly, etc.).

Mosby's Pharmacy Technician: Principles and Practice -- Recall Classifications and Actions.

Steps to Follow in a Drug Recall:Why the Other Answer Choices Are Incorrect:Pharmacy Technician Reference:


Question 9

Vistarilis a brand name for:

Correct Answer: D. Hydroxyzine
Explanation:

Vistaril = Hydroxyzine, anantihistamine used for anxiety, nausea, and allergies.

Meclizine (Antivert) is also an antihistaminebut is used primarily formotion sickness and vertigo.

Reference:FDA Approved Drug List, PTCE Medication Guide.


Question 10

According to the manufacturer, which of the following medications must be dispensed in its original container?

Correct Answer: B. Linaclotide
Explanation:

Linaclotide (brand name: Linzess)must be dispensed in its original containerbecause:

It is highly moisture-sensitive, and removing it from its original container may lead to degradation.

The manufacturer provides a desiccantin the original packaging toprotect against humidity.

A . FurosemideDoes not require original container.

While furosemide tablets should be stored properly,they do not require dispensing in the original container.

C . ValsartanDoes not require original container.

Valsartan tablets arestable outside the original container.

D . SertralineDoes not require original container.

Sertraline (Zoloft)can be repackagedwithout stability issues.

FDA Linzess Storage Guidelines-- States that Linzessmust be stored in its original container with desiccant.

USP <797> & <800> Guidelines-- Cover proper storage and handling of moisture-sensitive drugs.

PTCB PTCE Exam Content Outline-- Includes special drug storage requirements.

Why Not the Other Options?Key Reference:


Question 11

What type ofmedication erroris described asa mistake in prescribing, dispensing, or planned medication administration that is detected and corrected before reaching the patient?

Correct Answer: D. Potential error
Explanation:

A potential error is a mistake that is identified and corrected before it reaches the patient.

Example:A technician fillshydralazineinstead ofhydroxyzine, but the pharmacist catches the mistake before dispensing.

Reference:ISMP Medication Error Categories, PTCE Pharmacy Error Prevention Guide.


Question 12

Carvedilolmay be a suitable therapeutic substitution for:

Correct Answer: B. Labetalol
Explanation:

Carvedilol (Coreg) and labetalol are both non-selective beta-blockersused to treathypertension and heart failure.

Therapeutic substitutionis allowed whentwo drugs have similar effects but different chemical structures.

Carvedilol is often used in place of labetalol, especially in heart failure patients.

Why Other Options Are Incorrect:

A . Albuterol?Abronchodilator for asthma/COPD, not a beta-blocker.

C . Tramadol?Apain reliever (opioid-like), not a beta-blocker.

D . Estradiol?Ahormone replacement therapy, not a beta-blocker.

Reference:PTCE Medication Classification Guide, FDA Beta-Blocker Comparisons.


Question 13

What volume (in mL) of adexamethasone injection (20 mg/mL)is required to administer a30 mg dose?

Correct Answer: C. 1.5
Explanation:

Formula: Dose Concentration = Volume (mL)

30 mg 20 mg/mL = 1.5 mL

Reference:PTCB Calculation Guide, Pharmacy Dosage Conversions.


Question 14

Which of the following isleast likelyto causesignificant patient harmif used in error?

Correct Answer: A. Topical creams
Explanation:

Comprehensive and Detailed Step-by-Step Explanation:

Amedication erroroccurs when a patientreceives the wrong drug, dose, or administration method, which can result inadverse effects.High-risk medicationsinclude:

Injectable insulins(risk of hypoglycemia, coma).

Antineoplastic (chemotherapy) agents(toxic at incorrect doses).

Oral anticoagulants (e.g., warfarin, apixaban)(can causefatal bleeding).

Explanation of Answer Choices:A. Topical creamsCorrect.While topical medicationscan cause localized irritation or allergies, theyrarely cause systemic toxicitywhen used improperly.B. Injectable insulins Incorrect.Can cause life-threatening hypoglycemia.C. Antineoplastic agents Incorrect.High risk of toxicity and organ damage.D. Oral anticoagulants Incorrect.Incorrect dosing can lead to fatal bleeding.

Reference:

ISMP List of High-Alert Medications

FDA Guidelines on Medication Errors

PTCB Exam: Medication Safety & Risk Management


Question 15

Which type of injection administers a medication into theskin?

Correct Answer: D. Intradermal
Explanation:

Intradermal (ID) injectionsare deliveredinto the dermis (just below the epidermis).

Used forallergy testing, tuberculosis (TB) testing, and some vaccines.

Theneedle angle is 10--15 degrees, and only asmall volume (0.1 mL -- 0.5 mL)is injected.

Why Other Options Are Incorrect:

A . Intraperitoneal?Injected into theperitoneal cavity, used in animal research.

B . Intravenous (IV)?Injected into aveinfor rapid drug action.

C . Intramuscular (IM)?Injecteddeep into the muscle(e.g., vaccines, pain medications).

Reference:CDC Injection Guidelines, PTCE Exam Study Guide.