PTCB Pharmacy Technician Certification Exam Full Practice Test 1 - 90 Questions w/ Explained Answers
Summary
This video presents a full practice test for the PTCB Pharmacy Technician Certification Exam, featuring 90 questions with detailed explanations. It covers a wide range of topics including drug classifications, dosage calculations, medication administration, pharmacy law, sterile compounding techniques, and prescription interpretation. The explanations aim to clarify concepts and provide context for each answer, serving as a comprehensive study tool for aspiring pharmacy technicians.
Key Insights
Warfarin (Coumadin) is a narrow therapeutic index (NTI) medication.
Warfarin, an anticoagulant, is an NTI drug where small dose changes can lead to significant therapeutic failures or adverse events. Regular PT/INR monitoring is crucial. Other NTI drugs include digoxin, phenytoin, levothyroxine, carbamazepine, phenobarbital, and lithium.
The Orange Book is used to determine the therapeutic equivalence of generic drugs.
The Orange Book provides therapeutic equivalence codes (e.g., A-rated) for generic substitution. The Purple Book lists FDA-approved biological products. REMS are risk management strategies for certain drugs. MedWatch is for reporting adverse events.
OBRA (Omnibus Budget Reconciliation Act) mandated patient counseling for Medicaid patients.
OBRA established the requirement for pharmacists to offer counseling on prescription medications to Medicaid patients, thereby promoting patient understanding and adherence.
All listed practices constitute aseptic technique for preparing parenteral products.
Aseptic technique involves using a laminar flow hood, wearing sterile gloves, and cleaning the work area with alcohol before preparing sterile products like IV medications to prevent contamination.
A patient requesting medication information should be directed to a pharmacist.
Pharmacy technicians can answer basic questions found on the label. However, any questions regarding how a medication should be taken or its effects must be referred to a pharmacist.
Tell the customer the pharmacist will help and inform the pharmacist when asked for cold medication advice.
Technicians should not recommend OTC medications. Direct the patient to the pharmacist, who is qualified to provide such advice. Informing the pharmacist ensures they are aware of the patient's inquiry.
Aseptic technique includes using a laminar flow hood, sterile gloves, and cleaning surfaces.
Aseptic technique is crucial for preparing sterile products to prevent microbial contamination. This involves environmental controls (hood), personal protection (gloves, gowns), and proper cleaning procedures.
Sections
Drug Classification and Pharmacology
Citalopram is classified as an SSRI, a type of antidepressant.
Citalopram belongs to the SSRI (Selective Serotonin Reuptake Inhibitors) drug classification. Other examples of SSRIs include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro). Antihistamines are for allergy symptoms (e.g., cetirizine, loratadine, diphenhydramine). Beta blockers (suffix '-olol') manage high blood pressure and irregular heartbeats (e.g., atenolol, metoprolol). ACE inhibitors (suffix '-pril') treat high blood pressure and heart failure (e.g., lisinopril, enalapril).
Propranolol is classified as a beta blocker.
Propranolol is a beta blocker, used for high blood pressure and irregular heartbeats, characterized by the '-olol' suffix. Other drug classes mentioned are ARBs (Angiotensin Receptor Blockers) with '-sartan' suffix (e.g., losartan, valsartan), ACE inhibitors with '-pril' suffix (e.g., lisinopril, enalapril), and PPIs (Proton Pump Inhibitors) with '-prazole' suffix for heartburn (e.g., omeprazole, esomeprazole, pantoprazole).
Antitussives are medications used to suppress cough.
Antitussives are drugs used to suppress cough. Antipyretics treat fever, analgesics reduce pain, and anticoagulants prevent blood clot formation.
Omeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production.
Omeprazole, belonging to the PPI class (suffix '-prazole'), works by blocking the proton pumps in stomach cells responsible for acid production. This reduces stomach acid. Examples of PPIs include esomeprazole (Nexium), lansoprazole (Prevacid), and pantoprazole (Protonix). H2 blockers (suffix '-tidine') also reduce stomach acid by blocking histamine effects (e.g., famotidine, ranitidine, cimetidine).
Benzodiazepines are used for anxiety and sleep.
Benzodiazepines are a class of drugs used for anxiety and sleep. Diuretics are water pills. Analgesics treat pain. Antihypertensives treat high blood pressure.
Temazepam is a Schedule IV controlled substance, often used for sleep.
Temazepam is classified as a DEA Schedule IV medication, commonly used as a benzodiazepine for sleep (brand name Restoril). Schedule I drugs have no medical use and high abuse potential. Schedule II drugs have a high abuse potential and include narcotics and stimulants. Schedule III drugs have moderate to low dependence potential. Schedule IV drugs have low dependence potential, like sleep aids and benzodiazepines. Schedule V drugs have even lower abuse potential, typically for cough or nerve pain.
Simvastatin's trade name is Zocor.
Zocor is the trade name for simvastatin. All listed medications (atorvastatin, simvastatin, rosuvastatin, lovastatin) are HMG-CoA reductase inhibitors, indicated for high cholesterol, and share the '-statin' suffix.
Cozar (losartan) is an Angiotensin Receptor Blocker (ARB).
Cozar, with the generic name losartan, is an ARB, indicated for high blood pressure and identified by the '-sartan' suffix. Zestril (lisinopril) is an ACE inhibitor ('-pril' suffix). Tenormin (atenolol) is a beta blocker ('-olol' suffix). Norvasc (amlodipine) is a calcium channel blocker ('-dipine' suffix). All are used for hypertension.
Enalapril is an ACE inhibitor.
Enalapril (brand name Vasotec) is an ACE inhibitor, characterized by the '-pril' suffix, used for hypertension and heart failure. Atenolol (Tenormin) is a beta blocker ('-olol'). Glipizide (Glucotrol) is a sulfonylurea for diabetes. Rosuvastatin (Crestor) is an HMG-CoA reductase inhibitor ('-statin').
Cetirizine (Zyrtec) is an H1 antagonist (antihistamine).
Cetirizine (Zyrtec) is an H1 antagonist, commonly known as an antihistamine. Famotidine (Pepcid) is an H2 blocker for heartburn. Methylprednisolone (Medrol) is a steroid. Montelukast (Singulair) is a leukotriene inhibitor.
Acyclovir is an antiviral medication.
Acyclovir (brand name Zovirax) is an antiviral, recognized by its '-vir' suffix. Fluconazole (Diflucan) is an antifungal ('-azole' suffix). Azithromycin (Zithromax) is a macrolide antibiotic. Cephalexin (Keflex) is a cephalosporin antibiotic.
Warfarin (Coumadin) is a narrow therapeutic index (NTI) medication.
Warfarin, an anticoagulant, is an NTI drug where small dose changes can lead to significant therapeutic failures or adverse events. Regular PT/INR monitoring is crucial. Other NTI drugs include digoxin, phenytoin, levothyroxine, carbamazepine, phenobarbital, and lithium.
Analgesics are medications used for pain relief.
Analgesics are drugs that reduce pain. Antipyretics treat fever, antitussives suppress cough, and anticonvulsants prevent or treat seizures.
Nitroglycerin is a vasodilator used for chest pain.
Nitroglycerin (NTG) is a vasodilator for chest pain, sensitive to light, heat, and moisture. Hydroxyzine (Advil, Vistaril) is an antihistamine. Atenolol (Tenormin) is a beta blocker. Lisinopril (Printeville, Zestril) is an ACE inhibitor.
Buccal administration means dissolving medication in the cheek.
Buccal administration involves dissolving medication in the cheek (e.g., nicotine gum). Sublingual (SL) is dissolving under the tongue (e.g., nitroglycerin). Transdermal is applied to the skin (patches). Otic is for the ear (ear drops). Intravenous (IV) is into a vein. Intramuscular (IM) is into a muscle. Subcutaneous (SQ/SC) is under the skin.
Dosage Calculations and Conversions
There are 150 milliliters in five ounces.
Using the conversion factor of 1 ounce = 30 milliliters, 5 ounces equals 150 milliliters (5 oz * 30 ml/oz = 150 ml).
Four 500 milligram doses of ampicillin can be obtained from a 2 gram vial.
Convert 2 grams to milligrams (2 g * 1000 mg/g = 2000 mg). Divide the total available milligrams by the dose size: 2000 mg / 500 mg/dose = 4 doses.
A 5 ml syringe should be used to measure 2.5 milliliters for accuracy.
To ensure the most accurate measurement, use a syringe that is larger than, but closest to, the desired volume. A 5 ml syringe is more accurate for measuring 2.5 ml than a 10 ml syringe.
To prepare 100 grams of 2% hydrocortisone ointment, mix 67g of 2.5% and 33g of 1%.
This is an allegation problem. Using the tic-tac-toe method: High concentration (2.5%), Low concentration (1%), Desired concentration (2%). Differences: |2.5 - 2| = 0.5 (for 1% strength), |1 - 2| = 1 (for 2.5% strength). Total parts = 0.5 + 1 = 1.5. Amount of 2.5% needed = (1 / 1.5) * 100g = 66.7g (round to 67g). Amount of 1% needed = (0.5 / 1.5) * 100g = 33.3g (round to 33g).
The total daily dose for a patient weighing 150 lbs receiving gentamicin 5 mg/kg/day is 341 mg.
Convert patient weight to kilograms: 150 lbs / 2.2 lbs/kg = 68.2 kg. Calculate the daily dose: 68.2 kg * 5 mg/kg = 341 mg.
The flow rate for infusing 1000 ml D5W over 8 hours with a 20 gtts/ml drip factor is 42 drops per minute.
Calculation: (1000 ml / 8 hours) * (20 gtts / 1 ml) * (1 hour / 60 minutes) = 41.67 gtts/min. Rounded up to 42 gtts/min.
Six hundred milligrams of clindamycin are in 60 grams of 1% clindamycin gel.
1% gel means 1 gram of drug per 100 grams of product. Convert 1 gram to milligrams: 1 g = 1000 mg. So, 1000 mg per 100 g. In 60 grams: (1000 mg / 100 g) * 60 g = 600 mg.
There are 9 grams of sodium chloride in 1000 ml of Normal Saline (NS).
Normal Saline (NS) is 0.9% sodium chloride, meaning 0.9 g per 100 ml. In 1000 ml: (0.9 g / 100 ml) * 1000 ml = 9 g.
Three grams of hydrocortisone powder are in four ounces of 2.5% hydrocortisone ointment.
Convert 4 ounces to grams: 4 oz * 30 g/oz = 120 g. 2.5% means 2.5 g per 100 g. Amount of hydrocortisone = (2.5 g / 100 g) * 120 g = 3 g.
To compound 250 ml of a 200 mg/5 ml suspension, 20 tablets of 500 mg ampicillin are needed.
Total milligrams needed: (200 mg / 5 ml) * 250 ml = 10,000 mg. Number of tablets: 10,000 mg / 500 mg/tablet = 20 tablets.
The retail price of a prescription with an AWP of $24.96, 5% markup, and $6.50 dispensing fee is $32.71.
Markup amount: $24.96 * 0.05 = $1.25. Price before dispensing fee: $24.96 + $1.25 = $26.21. Retail price: $26.21 + $6.50 = $32.71.
One-fourth grain of phenobarbital is equivalent to 16.2 milligrams.
Using the conversion 1 grain = 64.8 mg: (1/4) gr * 64.8 mg/gr = 16.2 mg.
A 135 lb patient requires 1.5 grams per dose of ceftriaxone at 50 mg/kg/day every 12 hours.
Convert weight to kg: 135 lbs / 2.2 lbs/kg = 61.4 kg. Daily dose: 61.4 kg * 50 mg/kg = 3070 mg. Dose per administration (every 12 hours): 3070 mg / 2 doses = 1535 mg. Convert to grams: 1535 mg / 1000 mg/g = 1.535 g (round to 1.5 g).
Four hundred milligrams of active ingredient are in five milliliters of amoxicillin 8% suspension.
8% suspension means 8 g per 100 ml. Convert to mg/ml: (8 g / 100 ml) * (1000 mg / 1 g) = 80 mg/ml. In 5 ml: 80 mg/ml * 5 ml = 400 mg.
To infuse NS at 100 ml/hr for 12 hours, 1.2 liters are needed.
Total volume: 100 ml/hr * 12 hours = 1200 ml. Convert to liters: 1200 ml / 1000 ml/L = 1.2 L.
Twelve hundred milliliters of fluid are needed for a 12-hour infusion at 100 ml/hr.
Total volume calculation: 100 ml/hour * 12 hours = 1200 ml. This is equivalent to 1.2 liters.
Five milliliters of potassium chloride solution are needed for a dose of 10 mEq.
Using the concentration 2 mEq/ml: (10 mEq) / (2 mEq/ml) = 5 ml.
To obtain 150 ml of a 1:1000 solution, 30 ml of a 1:200 stock solution is required.
Target drug amount: (1 g / 1000 ml) * 150 ml = 0.15 g. Volume from stock: (0.15 g) / (1 g / 200 ml) = 30 ml. The remaining volume (150 ml - 30 ml = 120 ml) would be diluent.
To get a 7.5% cream when 5% and 10% creams are in stock, mix them in a 1:1 ratio.
Allegation calculation: Desired (7.5), High (10), Low (5). Differences: |10 - 7.5| = 2.5 (for low concentration), |5 - 7.5| = 2.5 (for high concentration). Ratio of low to high is 2.5:2.5, which simplifies to 1:1.
A 1:1 solution is the most concentrated ratio strength.
Ratio strength indicates grams of drug per milliliter. 1:1 means 1g drug per 1ml solution, the highest concentration among 1:1, 1:10, 1:100, and 1:1000.
To give a dose of 500 mg amoxicillin suspension, 6.25 ml is needed if the concentration is 400 mg/5 ml.
Set up a proportion: (400 mg / 5 ml) = (500 mg / x ml). Cross-multiply: 400x = 2500. Solve for x: x = 2500 / 400 = 6.25 ml.
Three hundred milliliters of total volume is needed for Keflex suspension.
1 teaspoon = 5 ml. Dose = 1.5 tsp = 7.5 ml. Doses per day = 24 hours / 6 hours = 4 doses. Total volume = 7.5 ml/dose * 4 doses/day * 10 days = 300 ml.
One hour and forty minutes are required for a patient to receive 1 gram of vancomycin at 10 mg/minute.
Convert dose to mg: 1 g = 1000 mg. Time needed: 1000 mg / (10 mg/min) = 100 minutes. Convert to hours and minutes: 100 minutes = 1 hour and 40 minutes.
A tapered dose of 32 tablets is needed for a specific prescription sequence.
Break down the prescription: (3 bid * 2 days = 12 tabs) + (3 qd * 2 days = 6 tabs) + (2 bid * 2 days = 8 tabs) + (1 bid * 2 days = 4 tabs) + (1 qd * 1 day = 2 tabs) = 32 tablets total.
Three thousand milliliters is equivalent to three 1-liter bags of NS.
Total volume needed: 125 ml/hr * 24 hours = 3000 ml. Convert to liters: 3000 ml / 1000 ml/L = 3 L. This requires three 1-liter bags.
Pharmacy Law and Regulations
Norco (hydrocodone/acetaminophen) is a DEA Schedule II drug and cannot have refills.
DEA Schedule II medications cannot have refills. Ativan (lorazepam), Tylenol #3 (acetaminophen/codeine), and Lyrica (pregabalin) are Schedule IV, III, and V respectively, and allow refills (5 refills in 6 months).
DEA Schedule II drugs like Adderall have a high potential for abuse and dependence.
DEA Schedules categorize drugs based on medical use and abuse potential. Schedule I: no medical use, high abuse potential (illegal drugs). Schedule II: high abuse potential (narcotics, stimulants like Adderall). Schedule III: moderate dependence. Schedule IV: low dependence (benzodiazepines, sleep meds). Schedule V: lower abuse potential (cough/nerve pain meds).
Class 3 drug recalls are the least serious and unlikely to cause adverse reactions.
Recall classes: Class 1 (most serious, potential for severe health issues/death), Class 2 (may cause temporary health concerns), Class 3 (least serious, unlikely adverse reactions).
The NDC number is not required on repackaged unit doses.
Unit dose packaging requires drug name, strength, expiration date, and lot number for traceability. The NDC (National Drug Code) is not mandatory for individual unit doses.
BC4217323 is an invalid DEA number because the checksum digit is incorrect.
DEA numbers follow a specific format (2 letters, 7 numbers). The checksum digit is calculated, and if it doesn't match the last digit of the DEA number, the number is invalid. For BC4217323, the calculated checksum is 0, not 3.
The FD&C Act (Food, Drug, and Cosmetic Act) regulates drug and medical device safety.
The FD&C Act established the FDA and oversees drug safety, purity, and labeling. The CSA (Controlled Substances Act) regulates controlled drugs by schedule. HIPAA protects patient privacy. PPPA mandates child-resistant packaging.
The Orange Book is used to determine the therapeutic equivalence of generic drugs.
The Orange Book provides therapeutic equivalence codes (e.g., A-rated) for generic substitution. The Purple Book lists FDA-approved biological products. REMS are risk management strategies for certain drugs. MedWatch is for reporting adverse events.
DEA Form 222 is required to order Schedule II drugs.
DEA Form 222 is used for ordering Schedule II substances. DEA Form 41 is for destruction of controlled substances. DEA Form 106 is for reporting loss/theft. DEA Form 224 is for pharmacy registration.
OBRA (Omnibus Budget Reconciliation Act) mandated patient counseling for Medicaid patients.
OBRA established the requirement for pharmacists to offer counseling on prescription medications to Medicaid patients, thereby promoting patient understanding and adherence.
Pseudoephedrine must be sold behind the counter due to the Combat Methamphetamine Epidemic Act (CMEA).
CMEA requires pseudoephedrine to be kept behind the counter with purchase limits (3.6g/day, 9g/month) and logbook requirements. Chlorpheniramine, diphenhydramine, and phenylephrine are generally OTC.
DR (Delayed Release) is a sig code indicating a time-released medication.
DR (Delayed Release) and ER (Extended Release) indicate time-released medications. IR (Immediate Release) releases medication quickly. EC (Enteric Coated) protects the stomach. ODT (Orally Disintegrating Tablet) dissolves in the mouth.
Copay is the patient's out-of-pocket cost after insurance payment.
Copay is the fixed amount a patient pays for a prescription after insurance covers its portion. Deductible is the amount paid before insurance kicks in. Premium is the insurance plan cost. Reimbursement is payment back for expenses.
Formulary is the list of drugs covered by an insurance company.
A formulary is an insurance company's list of covered drugs, often with tiered copays. Formulation refers to the drug's dosage form. Inventory is stock on hand. AWP is Average Wholesale Price.
Twenty hours of continuing education (CE) every two years are required for CPHT recertification.
CPHTs need 20 hours of CE every two years, including at least one hour each in pharmacy law and patient safety.
Drug Preparation and Handling
A 5-micron filter is needed to safely withdraw medication from an ampoule.
A 5-micron filter needle or straw is used to filter out any glass particles when withdrawing medication from a broken ampoule, preventing contamination.
Work in a laminar flow hood should be performed at least 6 inches inside the hood.
To maintain a sterile environment and prevent contamination from room air, all manipulations within a laminar flow hood must occur at least 6 inches from the front edge.
Gloves are personal protective equipment (PPE) for compounding.
Personal Protective Equipment (PPE) includes items like gloves, masks, gowns, and goggles worn to protect the compounder from hazardous materials and prevent contamination of the product.
Antibiotics are typically administered via IVPB (intravenous piggyback).
IVPB is a method for administering smaller volumes of medication (like antibiotics) through a secondary IV line connected to the primary line. Fluid replacement is usually primary IV. Vaccines are typically IM or SC.
Laminar flow hoods should remain on continuously and are cleaned side-to-side from back to front.
Laminar flow hoods should not be turned off to maintain a sterile environment. Cleaning should be done side-to-side, moving from the back (near the filter) towards the front. Never spray cleaning solutions directly into the filter.
All listed practices constitute aseptic technique for preparing parenteral products.
Aseptic technique involves using a laminar flow hood, wearing sterile gloves, and cleaning the work area with alcohol before preparing sterile products like IV medications to prevent contamination.
A Luer-lock tip on a syringe provides a secure, screw-on connection for a needle.
A Luer-lock tip ensures a secure connection between a syringe and needle by twisting and locking. Slip-tip connections are pushed on. Eccentric tips are offset. Disposable refers to single-use.
An 8-ounce bottle is needed to dispense 200 milliliters of liquid.
Convert 200 ml to ounces: 200 ml / 30 ml/oz = 6.7 oz. An 8-ounce bottle (approx. 240 ml) is the appropriate size to accommodate this volume.
T 26 gauge needle has the smallest diameter among the options.
Needle gauge indicates diameter; a higher gauge number corresponds to a smaller diameter. Thus, a 26-gauge needle is the smallest.
Pharmacy Practice and Patient Care
Brand names are assigned by the drug manufacturer.
The brand name is the proprietary name a manufacturer gives to a drug (e.g., Tylenol). The generic name is the official, non-proprietary name of the active ingredient (e.g., acetaminophen). The chemical name describes the structure. NDC is a unique identifier.
Metoprolol and Sertraline should be refilled for a patient requesting Lopressor and Zoloft.
Lopressor is the brand name for metoprolol (a beta blocker). Zoloft is the brand name for sertraline (an SSRI antidepressant). Atenolol is a beta blocker (Tenormin), and citalopram is an SSRI (Celexa).
A suspension is a mixture where drug particles float in a liquid and require shaking.
Suspensions contain undissolved particles that settle and need shaking (e.g., amoxicillin suspension). Solutions have dissolved drugs and don't need shaking. Elixirs contain alcohol. Emulsions mix immiscible liquids.
A patient requesting medication information should be directed to a pharmacist.
Pharmacy technicians can answer basic questions found on the label. However, any questions regarding how a medication should be taken or its effects must be referred to a pharmacist.
The first part of an NDC (0093) indicates the manufacturer (Teva).
The NDC has three parts: Labeler Code (manufacturer), Product Code (drug, strength, dosage form), and Package Code (package size). For 0093-314705, 0093 is Teva, 314705 identifies the specific product and strength.
Staying focused on the task minimizes dispensing errors.
Practices to reduce errors include staying focused, minimizing distractions, organizing the workspace, using Tall Man Lettering for look-alike/sound-alike drugs, storing similar drugs separately, and verifying NDC numbers.
The sig code 'icap q8h prn' translates to 'take one capsule every eight hours as needed'.
Decoding sig codes: i = one, cap = capsule, q8h = every eight hours, prn = as needed. Other examples: tid = three times a day, qid = four times a day, ac = before meals, pc = after meals, hs = at bedtime, cf = with food.
A 75 ml bottle is needed for a 7-day supply of Amoxil 400 mg/5 ml, taken 1 tsp BID.
Dose = 1 tsp (5 ml). Doses per day = 2 (BID). Daily volume = 5 ml * 2 = 10 ml. Total volume = 10 ml/day * 7 days = 70 ml. Dispense a 75 ml bottle.
Nine teaspoonfuls are equivalent to three tablespoonfuls.
Conversion: 1 tablespoon = 3 teaspoons. Therefore, 3 tablespoons * 3 teaspoons/tablespoon = 9 teaspoons.
SIG code 'i gtt os hs' means 'place one drop in the left eye at bedtime'.
Decoding: i=one, gtt=drop, os=left eye, hs=at bedtime. Other eye/ear abbreviations: ou=both eyes, od=right eye; au=both ears, ad=right ear, as=left ear.
Tell the customer the pharmacist will help and inform the pharmacist when asked for cold medication advice.
Technicians should not recommend OTC medications. Direct the patient to the pharmacist, who is qualified to provide such advice. Informing the pharmacist ensures they are aware of the patient's inquiry.
General Pharmacy Knowledge
K is the chemical symbol for Potassium.
K represents Potassium. Other common symbols include Na for Sodium, Fe for Iron, and Ca for Calcium.
Controlled room temperature is defined as 20-25 degrees Celsius (68-77 degrees Fahrenheit).
Storage temperatures: Controlled Room Temperature = 20-25°C (68-77°F). Refrigeration = 2-8°C (36-46°F).
D5W contains 25 grams of dextrose in a 500 ml bag.
D5W means 5% dextrose in water. 5% = 5 grams per 100 ml. For a 500 ml bag: (5 g / 100 ml) * 500 ml = 25 g.
The trade name for Simvastatin is Zocor.
Zocor is the brand name for simvastatin. Other statins mentioned are Lipitor (atorvastatin), Crestor (rosuvastatin), and Mevacor (lovastatin).
Aseptic technique includes using a laminar flow hood, sterile gloves, and cleaning surfaces.
Aseptic technique is crucial for preparing sterile products to prevent microbial contamination. This involves environmental controls (hood), personal protection (gloves, gowns), and proper cleaning procedures.
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