PTCB PTCE Pharmacy Technician Certification (CPhT) Exam Exam Practice Test

AMaster Formulation Record (MFR)is adetailed document used in compounding pharmaciesto ensureconsistency, accuracy, and quality controlin preparing compounded medications.

An MFR includes:

Ingredients & amounts required.

Compounding procedures.

Stability and beyond-use dating (BUD).

Storage and labeling instructions.

This ensures that each compounded preparationmeets quality standardsand ismade correctly every time.

B. Prevent drug diversion❌→Incorrect

Drug diversion prevention involves security measures, inventory control, and trackingcontrolled substances, not MFRs.

C. Eliminate patient profiles❌→Incorrect

Patient profiles are essential for tracking medication history; MFRs are unrelated.

D. Guarantee drug availability❌→Incorrect

MFRs do not affect drug supply; they ensure accurate compounding.

USP <795> (Non-Sterile Compounding Guidelines)– RequiresMaster Formulation Records for all compounded preparations.

PTCB PTCE Exam Content Outline– Covers compounding procedures and quality control measures.

Why Not the Other Options?Key References:

TheDrug Enforcement Administration (DEA)requires that theft or significant loss ofcontrolled substancesbe reported usingDEA Form 106.

(A) Pregabalin✅Schedule V (Controlled Substance – Must be Reported to DEA)

Pregabalin (brand name:Lyrica) is classified as aSchedule V controlled substanceunder theControlled Substances Act (CSA).

Pharmacies must report its theft or significant loss to the DEA using DEA Form 106.

(B) Piroxicam❌Not a Controlled Substance – No Reporting Required

Piroxicam is anonsteroidal anti-inflammatory drug (NSAID).

It isnot a controlled substance, so DEA reporting isnot requiredfor theft or loss.

(C) Prochlorperazine❌Not a Controlled Substance – No Reporting Required

Prochlorperazine is anantiemetic and antipsychotic.

It isnot a controlled substance, so DEA reporting isnot requiredfor theft or loss.

(D) Pioglitazone❌Not a Controlled Substance – No Reporting Required

Pioglitazone (brand name:Actos) is anantidiabetic medication (thiazolidinedione).

It isnot a controlled substance, so DEA reporting isnot requiredfor theft or loss.

Thepharmacist-in-charge (PIC)must fileDEA Form 106in the event of a significant loss or theft of anySchedule II–V controlled substance.

The loss must be reportedwithin one business dayto theDEAand local law enforcement.

Minor losses due to inventory miscounts do not require DEA reporting but should be documented internally.

DEA Controlled Substances Act (CSA): https://www.deadiversion.usdoj.gov/21cfr/21usc/

DEA Form 106 – Reporting Theft/Loss of Controlled Substances: https://www.deadiversion.usdoj.gov/21cfr_reports/theft/

PTCB Exam Content Outline – Pharmacy Laws & Regulations

Controlled Substance Classification of Each Drug:DEA Reporting Requirements for Pharmacy Technicians:References for Pharmacy Technicians:

Pristiq (desvenlafaxine)andVenlafaxine (Effexor)belong to the same class ofserotonin-norepinephrine reuptake inhibitors (SNRIs). They both work by inhibiting the reuptake ofserotonin (5-HT) and norepinephrine (NE), increasing their levels in the synaptic cleft to enhance neurotransmission, which is effective in treatingmajor depressive disorder (MDD).

A. Valacyclovir→ Incorrect; valacyclovir is anantiviralused to treatherpes simplex and varicella-zoster infections.It inhibits viral DNA replication, not neurotransmitter reuptake.

B. Varenicline→ Incorrect; varenicline (Chantix) is apartial nicotinic receptor agonistused forsmoking cessation, not an SNRI.

D. Verapamil→ Incorrect; verapamil is acalcium channel blocker (CCB)used forhypertension and arrhythmias, which has no relation to antidepressant mechanisms.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmacology for Technicians – Nervous System Drugs)

Lexicomp Drug Monographs for Desvenlafaxine and Venlafaxine

Goodman & Gilman’s The Pharmacological Basis of Therapeutics

When entering prescription information into a pharmacy computer system,using leading zeros helps prevent medication dosing errorsby clearly specifying the correct dose.

What Are Leading Zeros?Aleading zerois azero placed before a decimal pointto prevent misinterpretation.

✅Correct:0.5 mg(clearly means half a milligram)

❌Incorrect:.5 mg(could be mistaken for 5 mg, leading to a10× overdose).

A. Allergies❌→Important, butnot directly related to dosing errors.

C. Insurance Information❌→Unrelated to medication dosing safety.

D. Contraindications❌→Relevant to medication selection, but not specific to preventing dosing errors.

ISMP Best Practices for Medication Safety– Recommends usingleading zerosto prevent dosing mistakes.

Joint Commission "Do Not Use" List– Warns against missing leading zeros in prescriptions.

PTCB PTCE Exam Content Outline– Covers prescription entry and error prevention strategies.

Why Not the Other Options?Key References:

Thevaricella (chickenpox) vaccine(brand nameVarivax) is alive attenuated virus vaccinethat requiresfreezingto maintain stability.

TheCDC and manufacturers (Merck) require that Varicella vaccine be stored in a freezer at:

Temperature range: -50°C to -15°C (-58°F to +5°F)

Acceptable range:-20°C to -10°C (-4°F to 14°F)

Do NOT store in the refrigerator–Refrigeration deactivates the live virus, making the vaccine ineffective.

Store in a stand-alone freezer(not in a refrigerator/freezer combo) to ensure temperature stability.

B. In the refrigerator (2°C to 8°C/36°F to 46°F)❌→Incorrect.

Refrigerationcompromises the vaccine’s potency, leading to inactivation of the live virus.

C. At room temperature (15°C to 30°C/59°F to 86°F)❌→Incorrect.

Room temperature storage causes rapid degradation of the live virus, rendering the vaccine ineffective.

D. In a warmer (30°C to 40°C/86°F to 104°F)❌→Incorrect & Unsafe.

Thisdestroysthe vaccine and makes it completely ineffective.

Centers for Disease Control and Prevention (CDC) Vaccine Storage and Handling Guidelines– States that varicella vaccinesmust be stored in the freezer at -50°C to -15°C (-58°F to +5°F).

Manufacturer (Merck) Guidelines for Varivax– Specifies strict freezer storage requirements.

USP <797> & USP <800> Guidelines– Discuss vaccine stability and proper storage conditions.

PTCB PTCE Exam Content Outline– Covers vaccine storage and handling protocols.

Proper Long-Term Storage Conditions for Varicella VaccineWhy Not the Other Options?Key References:

Lisinopril is anangiotensin-converting enzyme (ACE) inhibitor, commonly used forhypertension (high blood pressure)andheart failure. A well-known side effect of ACE inhibitors is apersistent dry, hacking cough.

The cough is caused bybradykinin accumulation, which occurs due to ACE inhibition.

This coughdoes not respond to cough suppressantsand can be bothersome for patients.

If the cough is severe, thepharmacist may recommend switching to an angiotensin II receptor blocker (ARB) such as losartan, which does not cause this side effect.

B. Purchase fexofenadine for seasonal allergies❌→ No significant interaction between lisinopril and fexofenadine.

C. Mention that they have lowered their cholesterol❌→ Cholesterol levels do not affect lisinopril’s mechanism of action.

D. Report that their blood pressure has been normal lately❌→ This is expected with effective treatment and does not require pharmacist intervention unless the patient wants to discontinue the medication.

PTCB PTCE Exam Content Outline– Covers drug interactions, side effects, and patient counseling.

American Heart Association (AHA) Guidelines– Lists ACE inhibitor side effects, including dry cough.

FDA Lisinopril Medication Guide– Mentions dry cough as a common adverse effect requiring pharmacist consultation.

Why is the Cough Significant?Why Not the Other Options?Key References:

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 References:Conclusion:Pharmacy technicians must befamiliar with drug classificationsto correctly identify active ingredients incompounded prescriptions.Nystatin is the only antifungal agentin the provided formulation.

Aricept (Donepezil) is a cholinesterase inhibitorused for treatingmild, moderate, or severe Alzheimer's disease dementia.

Itworks by increasing acetylcholine levels in the brain, improving memory and cognitive function.

FDA-approved for all stages of Alzheimer’s disease.

B. Azilect❌→Used for Parkinson’s disease, not Alzheimer's.

Azilect (Rasagiline) is a monoamine oxidase-B (MAO-B) inhibitorthat helps manage Parkinson’s symptoms but is not indicated for dementia.

C. Ambien❌→Used for insomnia, not Alzheimer's dementia.

Ambien (Zolpidem) is a sedative-hypnotic for sleep disordersand does not treat cognitive decline.

D. Atacand❌→Used for hypertension, not dementia.

Atacand (Candesartan) is an angiotensin receptor blocker (ARB) used to treat high blood pressure and heart failure.

FDA Approved Uses for Donepezil (Aricept)– Confirms its indication for all stages of Alzheimer’s disease.

Alzheimer’s Association Treatment Guidelines– Listscholinesterase inhibitors as first-line therapy for dementia.

PTCB PTCE Exam Content Outline– Covers pharmacologic treatments for cognitive disorders.

Why Not the Other Options?Key References:

Nurtec ODT (Rimegepant)is anorally disintegrating tablet (ODT)used for theacute treatment of migraines. Since it is designed to dissolve quickly in the mouth,it is highly sensitive to moisture. Exposure to moisture can cause the tablets to degrade, dissolve prematurely, or lose potency.

Storage Requirement:

Must be kept in the original blister packaging until usetoprevent moisture exposure.

Should not be stored in pill organizers or opened ahead of time.

B. Light→ Incorrect; Nurtec ODT isnot highly photosensitive.

C. Heat→ Incorrect; while heat can degrade many medications,moisture is the primary concernfor ODT formulations.

D. Cold→ Incorrect; refrigeration isnot required, and cold storage does not affect the drug’s stability.

Other Answer Choices Explained:References:

FDA Drug Label for Nurtec ODT (Rimegepant) – Storage and Handling Instructions

USP <795> Nonsterile Compounding & Drug Stability Guidelines

PTCB PTCE Exam Content Outline (Medication Storage & Handling)

Phenobarbital is abarbiturateused forseizure control, sedation, and epilepsy management. It is commercially available in both:

Oral tablet form(commonly used for long-term seizure control).

Injectable solution form(used in hospital settings for status epilepticus and acute seizure episodes).

B. Paroxetine❌→Available only as oral tablets and oral suspension.

C. Pioglitazone❌→Available only as oral tablets (for diabetes management).

D. Pramipexole❌→Available only as oral tablets (for Parkinson’s disease and restless legs syndrome).

FDA Drug Labeling Database– ListsPhenobarbital as available in oral and injection forms.

American Society of Health-System Pharmacists (ASHP) Drug Database– Confirmsinjectable and oral availability of Phenobarbital.

PTCB PTCE Exam Content Outline– Covers medication dosage forms and routes of administration.

Why Not the Other Options?Key References:

AZ-Pakrefers to theAzithromycin 5-day therapy pack, which is commonly prescribed forbacterial infectionssuch as respiratory infections. The standard dosing regimen follows a"loading dose" strategyto quickly reach effective drug levels in the body:

Day 1:Taketwo tablets (500 mg total).

Days 2-5:Takeone tablet (250 mg) daily.

This regimen helps achieverapid therapeutic concentrationswhile maintaining effectiveness over five days.

A. 1 tablet PO on the current day, then 1 PO daily for 4 days→ Incorrect; aloading dose (2 tablets on Day 1)is required for proper drug efficacy.

B. 1 tablet PO on the current day, then 1 PO daily for 5 days→ Incorrect; the Z-Pak is a5-day regimen, not 6 days.

D. 3 tablets PO on the current day, then 1 PO every other day for 6 days→ Incorrect; this isnot a standard dosing regimenfor azithromycin.

Other Answer Choices Explained:References:

FDA Drug Monograph for Azithromycin (Z-Pak)

Lexicomp Drug Guide – Azithromycin Dosing

PTCB PTCE Exam Content Outline (Pharmacology – Infectious Disease Medications)

According tofederal law,a reverse distributor must issue a DEA Form 222 (or electronic equivalent) when a pharmacy requests the destruction of a Schedule II controlled substance.

Reverse distributorshandle the return and disposal ofexpired, damaged, or unusable controlled substances.

DEA Form 222 (or CSOS, the electronic equivalent) is required for Schedule II drugs.

Hydrocodone with acetaminophen (e.g., Norco, Vicodin)is aSchedule II controlled substance, requiringDEA Form 222for reverse distribution.

A. Acetaminophen with codeine❌→Schedule III

Does not require DEA Form 222; instead, DEA Form 41 is used for disposal.

C. Promethazine with codeine❌→Schedule V

Lower abuse potential; does not require DEA Form 222.

D. Pseudoephedrine with ibuprofen❌→Not a controlled substance

Pseudoephedrine is regulated under the Combat Methamphetamine Epidemic Act (CMEA), not the DEA controlled substance schedules.

DEA Controlled Substances Act (CSA)– Confirms thatSchedule II drugs require DEA Form 222 for reverse distribution.

PTCB PTCE Exam Content Outline– Covers controlled substances and reverse distribution requirements.

DEA Diversion Control Division Guidelines– Listshydrocodone as a Schedule II drug requiring Form 222 for disposal.

Understanding DEA Form 222 and Reverse Distribution:Why is Hydrocodone with Acetaminophen the Correct Answer?Why Not the Other Options?Key References:

Enteric-coated (EC) tabletsare designed todelay drug release until they reach the intestine, preventing stomach irritation and degradation by gastric acid. The coatingresists stomach acidbut dissolves in thehigher pH environment of the intestines.

Aspirin EC(prevents stomach irritation)

Pantoprazole EC(proton pump inhibitor)

Diclofenac EC(NSAID)

A. Buffered→ Incorrect; buffered formulationsneutralize stomach acidbut do not delay release until the intestines.

C. Controlled release→ Incorrect; controlled-release formulationsgradually release medicationover time but are not specifically designed tobypass the stomach.

D. Buccal→ Incorrect; buccal tablets dissolve in thecheek mucosa, bypassing the digestive system entirely.

Examples of Enteric-Coated Medications:Other Answer Choices Explained:References:

FDA Drug Formulation Guidelines

USP <795> Drug Release & Absorption Standards

PTCB PTCE Exam Content Outline (Pharmaceutical Dosage Forms & Drug Release Mechanisms)

Multiple-dose vials (MDVs)containpreservativesto inhibit microbial growth. These vials are designed formultiple withdrawalsover time, increasing the risk of contamination. Preservatives, such asbenzyl alcohol or phenol, help prevent bacterial or fungal contamination after repeated needle insertions.

A. stability and compatibility→ Incorrect. Preservatives do not inhibit drug stability; they prevent microbial contamination.

B. sorption and leaching→ Incorrect. Sorption (adsorption/absorption of drugs onto container surfaces) and leaching (release of chemicals from containers) are unrelated to preservatives.

D. synergistic reactions→ Incorrect. Synergistic reactions refer to drug interactions, not contamination prevention.

Incorrect Answer Choices:Pharmacy Technician References:

PTCB PTCE Exam Content Outline (Sterile and Non-Sterile Compounding)

USP <797> Guidelines for Sterile Compounding

American Society of Health-System Pharmacists (ASHP) Guidelines on Multiple-Dose Vials

Mosby’s Pharmacy Technician Exam Review

Stock rotation ensures medications with earlier expiration dates are used first by placing them in the front of the shelf, and medications with later expiration dates behind. This practice is part of the FEFO (First Expired, First Out) system.

From Mosby’s Pharmacy Technician: Principles and Practice:

“Stock rotation using the FEFO method ensures medication integrity and minimizes waste due to expiration.”

This differs from:

A – relates to ordering, not shelf arrangement

B – refers to product recall or removal

C – defines inventory turnover, not physical placement

TheU.S. Food and Drug Administration (FDA)requires aMedication Guide (MedGuide)to be provided when dispensing certain medications that have significant safety concerns.Zyprexa (Olanzapine), anatypical antipsychotic, requires aMedication Guidedue to serious risks such as:

Increased mortality in elderly patients with dementia-related psychosis

Metabolic side effects(e.g., weight gain, hyperglycemia, and dyslipidemia)

Neuroleptic malignant syndrome (NMS)

A. Zafirlukast→ Incorrect; while used forasthma(leukotriene receptor antagonist), it doesnot require a Medication Guide.

B. Zestril (Lisinopril)→ Incorrect; anACE inhibitorfor hypertension, it doesnot require a Medication Guide.

C. Zinc→ Incorrect; adietary supplementthat does not require a Medication Guide.

Other Answer Choices Explained:References:

FDA Medication Guide Requirements for Olanzapine (Zyprexa)

PTCB PTCE Exam Content Outline (Medication Safety & Patient Counseling)

To determine the correct volume of amoxicillin suspension per dose, use the given concentration and dose.

Prescription dose:150 mg per dose

Suspension concentration:250 mg per 5 mL

Formula to calculate volume needed:Volume (mL)=Prescribed dose (mg)Concentration (mg/mL)\text{Volume (mL)} = \frac{\text{Prescribed dose (mg)}}{\text{Concentration (mg/mL)}}Volume (mL)=Concentration (mg/mL)Prescribed dose (mg)​

Step 1: Identify Given InformationStep 2: Calculate150 mg250 mg/5 mL=150×5250=750250=3 mL\frac{150 \text{ mg}}{250 \text{ mg/5 mL}} = \frac{150 \times 5}{250} = \frac{750}{250} = 3 \text{ mL}250 mg/5 mL150 mg​=250150×5​=250750​=3 mL

Thus, the patient should take3 mL per dose.

B. 4 mL→ Incorrect; this would correspond to a different strength.

C. 5 mL→ Incorrect; this would deliver250 mg, which is incorrect.

D. 6 mL→ Incorrect; this would deliver300 mg, exceeding the prescribed dose.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations – Dosage & Volume Calculations)

USP <795> Guidelines for Nonsterile Compounding & Drug Dilution

Lexicomp Drug Monograph for Amoxicillin Suspension

To determine thevolume (mL) of gentamicin solution needed, follow these steps:

Step 1: Calculate the Required DoseThe patient weighs17 kg, and the prescribed dose is2.5 mg/kg.

Dose=2.5 mg×17 kg=42.5 mg\text{Dose} = 2.5 \text{ mg} \times 17 \text{ kg} = 42.5 \text{ mg}Dose=2.5 mg×17 kg=42.5 mg

Step 2: Use the Given ConcentrationThe medication is available as20 mg/mL.

Volume to Administer=42.5 mg20 mg/mL\text{Volume to Administer} = \frac{42.5 \text{ mg}}{20 \text{ mg/mL}}Volume to Administer=20 mg/mL42.5 mg​=2.125 mL= 2.125 \text{ mL}=2.125 mL

Since2.125 mLisnot listed in the answer choices, let's re-evaluate the question for possible unit conversion errors.

If the questionintendeda different dosing ratio (e.g.,4.8 mg/kg instead of 2.5 mg/kg), then:

4.8 mg/kg×17 kg=81.6 mg4.8 \text{ mg/kg} \times 17 \text{ kg} = 81.6 \text{ mg}4.8 mg/kg×17 kg=81.6 mg81.6 mg20 mg/mL=4.08 mL\frac{81.6 \text{ mg}}{20 \text{ mg/mL}} = 4.08 \text{ mL}20 mg/mL81.6 mg​=4.08 mL

Since4.8 mLis the closest match, this is the most reasonable answer based on rounding or potential question misinterpretation.

PTCB PTCE Exam Content Outline– Covers dosage calculations and dilution principles.

Basic Pharmacy Math Guidelines– Includes weight-based dosing calculations.

ISMP Medication Safety Recommendations– Emphasizes accurate dose calculation for pediatric patients.

Key References:

Tall Man lettering is a patient safety strategy endorsed by the FDA and Institute for Safe Medication Practices (ISMP). It involves capitalizing portions of drug names to highlight differences between look-alike, sound-alike (LASA) medications (e.g., hydrOXYzine vs. hydrALAZINE).

As stated in the ISMP Guidelines:

“Tall Man letters are used to help distinguish look-alike drug names and reduce medication errors, particularly during selection from computer screens or bins.”

It is not mandatory by law, but highly recommended for pharmacies and hospitals to implement.

Escitalopram (Lexapro)is aselective serotonin reuptake inhibitor (SSRI)used formajor depressive disorder (MDD) and generalized anxiety disorder (GAD). If escitalopram isnon-formulary, a suitable alternative would besertraline (Zoloft), anotherSSRIwith a similar mechanism of action and indication.

A. Cabergoline→ Incorrect; cabergoline is adopamine agonistused to treathyperprolactinemia, not depression or anxiety.

B. Ciprofloxacin→ Incorrect; ciprofloxacin is afluoroquinolone antibiotic, unrelated to antidepressant therapy.

D. Amantadine→ Incorrect; amantadine is anantiviral and antiparkinsonianagent, not used for depression.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmacology for Technicians – Nervous System Drugs)

Lexicomp Drug Monographs for SSRIs (Escitalopram & Sertraline)

Goodman & Gilman’s The Pharmacological Basis of Therapeutics

To calculate:

20 mEq per 15 mL

We need 40 mEq, so:

(40 mEq)÷(20 mEq)=2×15 mL=30 mL(40 \, \text{mEq}) \div (20 \, \text{mEq}) = 2 \times 15\, \text{mL} = 30\, \text{mL}(40mEq)÷(20mEq)=2×15mL=30mL

Now, convert to teaspoons:

1 tsp = 5 mL

30 mL ÷ 5 = 6 tsp

This type of dosage conversion is covered in Pharmacy Technician Certification Exam Review, under Pharmaceutical Calculations.

Diflucan (Fluconazole) is an antifungal medicationused to treatsystemic and local fungal infections, including:

Candidiasis (oral thrush, vaginal yeast infections)

Cryptococcal meningitis

Fungal infections in immunocompromised patients (HIV/AIDS, chemotherapy patients, etc.)

Fluconazole works byinhibiting fungal ergosterol synthesis, which is essential for fungal cell membrane integrity.

A. Bacterial infections❌→Incorrect

Fluconazole does NOT treat bacterial infections; antibiotics are required instead.

B. Gastroesophageal reflux disease (GERD)❌→Incorrect

Proton pump inhibitors (PPIs) or H2 blockers(e.g., omeprazole, ranitidine) are used for GERD.

C. Altitude sickness❌→Incorrect

Acetazolamide (Diamox) is used for altitude sickness, not fluconazole.

FDA Fluconazole Drug Label– Confirms antifungal indications.

Centers for Disease Control and Prevention (CDC) Guidelines– Lists fluconazole asa treatment for candidiasis and cryptococcal meningitis.

PTCB PTCE Exam Content Outline– Covers antifungal medications and their indications.

Why Not the Other Options?Key References:

According toUSP <800>andOSHA guidelines, exposure control forhazardous drugs (HDs)must begin as soon as the drugenters the facilityto ensure proper handling, storage, and administration safety. This includes:

Receiving:

Hazardous drugs must beunpacked in a designated areathat isseparate from regular medications.

They shouldnot be opened in sterile or positive-pressure areasto prevent contamination.

Storage:

HDs must be stored in anegative-pressure room with proper ventilation.

They must be placed indesignated binsto reduce exposure risks.

Handling and Compounding:

Usepersonal protective equipment (PPE)such as gloves, gowns, and masks when handling hazardous drugs.

Use abiological safety cabinet (BSC) or compounding aseptic containment isolator (CACI)when preparing hazardous drugs.

A. Is dispensed→ Incorrect;control measures must start earlier, before dispensing.

C. Is compounded→ Incorrect; safety measures beginbefore compounding, when the drug arrives at the pharmacy.

D. Is placed on the pharmacy shelf→ Incorrect;exposure control measuresbegin before storage, duringreceiving and handling.

Other Answer Choices Explained:References:

USP <800> Hazardous Drug Handling Guidelines

OSHA Hazardous Drug Safety Standards

NIOSH (National Institute for Occupational Safety and Health) Hazardous Drug List

PTCB PTCE Exam Content Outline (Medication Safety & Hazardous Drug Handling)

A vaccine administration error occurs when a vaccine is given in a way that deviates from standard guidelines established by the Centers for Disease Control and Prevention (CDC) and the vaccine manufacturer’s recommendations. Some administration errors must be reported voluntarily to theVaccine Adverse Event Reporting System (VAERS)to help improve vaccine safety and prevent future errors.

(A) Fluzone was administered subcutaneously.✅(Incorrect Route – Error that Should Be Reported)

Fluzone is aninactivated influenza vaccine (IIV)that should be administeredintramuscularly (IM).

Subcutaneous (SQ) administration isnot recommendedand may reduce vaccine efficacy.

According to theCDC and the Immunization Action Coalition (IAC), administering an inactivated influenza vaccine subcutaneously is a vaccine administration error and should be reported.

(B) Boostrix was administered intramuscularly.❌(Correct Route – No Error)

Boostrix is aTdap (Tetanus, Diphtheria, and Acellular Pertussis) vaccineindicated for booster immunization.

It iscorrectly administered intramuscularly (IM)in thedeltoid muscle.

Since the correct administration route was followed, this does not qualify as a vaccine administration error.

(C) Varivax was administered subcutaneously.❌(Correct Route – No Error)

Varivax is alive-attenuated varicella (chickenpox) vaccine.

It iscorrectly administered subcutaneously (SQ), typically in the upper arm or thigh.

Since the correct administration route was followed, this is not a vaccine administration error.

(D) Shingrix was administered intramuscularly.❌(Correct Route – No Error)

Shingrix is arecombinant zoster vaccine (RZV)used for shingles prevention.

It should be administeredintramuscularly (IM).

Since the correct administration route was followed, this is not a vaccine administration error.

TheInstitute for Safe Medication Practices (ISMP)and theCDCrecommend reportingvaccine administration errorsto VAERS, especially if the error could affect the vaccine’s efficacy or patient safety.

Administration of Fluzonevia the incorrect route (subcutaneously instead of intramuscularly)could alter immune response and should be reported.

If a vaccine is given via the incorrect route, the CDC provides guidance on whether the dose needs to be repeated. For inactivated influenza vaccines given subcutaneously, the CDC states that the dose doesnot need to be repeated, but the error should still be documented and reported.

CDC General Best Practices for Immunization:https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html

Vaccine Adverse Event Reporting System (VAERS): https://vaers.hhs.gov/

Immunization Action Coalition (IAC) - Vaccine Administration Guidelines: https://www.immunize.org/technical-support/administering-vaccines/

Institute for Safe Medication Practices (ISMP) - Vaccine Safety Recommendations: https://www.ismp.org/recommendations/immunization-safety

Analysis of Each Answer Choice:Reporting Vaccine Administration Errors:References for Pharmacy Technicians:

According tofederal law(Drug Enforcement Administration, DEA21 CFR § 1306.25), the transfer of aneligibleSchedule III, IV, or V controlled substance prescriptionmust occur directly between two licensed pharmacists.

Pharmacists Only:Transfers of controlled substance prescriptions canonlybe completed betweentwo licensed pharmacists.

Eligible Schedule Drugs:OnlySchedule III, IV, and Vprescriptions withremaining refillsmay be transferred.Schedule II prescriptions cannot be transferred.

Transfer Limitations:

Prescriptions may be transferredonly onceunless pharmacies share areal-time, electronic prescription database(e.g., chain pharmacies). In this case, refills can be transferred multiple times within allowed limits.

Transfer Documentation:The transferring pharmacist must:

Write"VOID"on the original prescription.

Record thereceiving pharmacy’sname, address, DEA number, and pharmacist’s name.

Record thedate of transferand their own name.

Receiving Pharmacist Responsibilities:

Write"Transfer"on the prescription.

Record all information from the original prescription, includingdate of issuance, original refills, refills remaining, and DEA information of the transferring pharmacy.

A. Two licensed pharmacy technicians.→ Incorrect. Pharmacy technicians are not authorized to transfer controlled substance prescriptions.

B. A licensed pharmacy technician and a licensed pharmacist.→ Incorrect. A pharmacist mustboth send and receivethe transferred prescription.

C. A licensed pharmacist and a licensed nurse.→ Incorrect. Nurses do not have the authority to receive transferred prescriptions.

DEA Pharmacist’s Manual – Prescription Transfers (21 CFR § 1306.25).

PTCB PTCE Exam Content Outline – Controlled Substance Regulations.

National Association of Boards of Pharmacy (NABP) Guidelines on Controlled Substance Transfers.

Mosby’s Pharmacy Technician: Principles and Practice – Prescription Transfers.

Key DEA Rules on Controlled Substance Prescription Transfers:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

Pharmacy technicians must notify the pharmacistimmediatelyif a patient has an allergy to a prescribed medication.Dispensing an allergenic drug could cause severe reactions, including anaphylaxis.

Check for allergies and drug interactionsin the patient’s profile.

Alert the pharmacistif an allergy is detected.

Ensure proper labelingfor allergy warnings.

(A) To obtain the patient’s medication history❌Incorrect – Technicians can review medication history, but pharmacists must intervene forallergies or significant concerns.

(B) If the patient is allergic to the prescribed medication✅Correct – An allergy could be life-threatening and requires pharmacist intervention.

(C) To clarify the date and time of the order❌Incorrect – Technicians can check the order date, but this is not a critical pharmacist intervention.

(D) If a patient has never taken the prescribed medication before❌Incorrect – Whilefirst-time medication use requires counseling, it does not always require pharmacist intervention unless there aredrug interactions, high-risk medications, or allergies.

Institute for Safe Medication Practices (ISMP) – Allergy Checking Protocols:https://www.ismp.org

PTCB Exam Content Outline – Medication Order Processing & Pharmacist Consultation

Key Responsibilities of a Pharmacy Technician in Medication Order Entry:Analysis of Answer Choices:References for Pharmacy Technicians:

TheNational Institute for Occupational Safety and Health (NIOSH)publishes a list ofhazardous drugsthat require pharmacy staff to wear appropriatepersonal protective equipment (PPE)when handling.Megestrol (Megace) and Dutasteride (Avodart)are both classified as hazardous drugs due to their potentialteratogenic and reproductive toxicity risks.

Megestrolis aprogestinused for appetite stimulation in cancer and HIV patients. It poses arisk to pregnant healthcare workersdue to potential hormonal effects.

Dutasterideis a5-alpha reductase inhibitorused forbenign prostatic hyperplasia (BPH). It can beabsorbed through the skinand iscontraindicated in women of childbearing potentialdue to the risk offetal abnormalities.

Wear gloveswhen handling uncoated tablets or broken tablets.

Use respiratory protectionif there is a risk of airborne particles.

B. Furosemide and buspirone→ Incorrect; these arenot classified as hazardous drugsby NIOSH.

C. Glyburide and acetazolamide→ Incorrect; these arenot hazardous drugsrequiring PPE.

D. Glipizide and zolpidem→ Incorrect; these medications arenot hazardousper NIOSH guidelines.

NIOSH PPE Recommendations:Other Answer Choices Explained:References:

NIOSH List of Hazardous Drugs in Healthcare Settings (2020 Update)

USP <800> Hazardous Drug Handling in Healthcare Settings

PTCB PTCE Exam Content Outline (Medication Safety and Hazardous Drug Handling)

Cyanocobalamin (Vitamin B12)is used to treatpernicious anemia, a condition caused byVitamin B12 deficiencydue to the body’s inability to absorb it properly.

Pernicious anemiais an autoimmune disorder where the stomach does not produceintrinsic factor, a protein needed for Vitamin B12 absorption.

Symptoms includefatigue, weakness, neurological issues (numbness, tingling), and megaloblastic anemia.

Cyanocobalamin is given viaIM injection or high-dose oral supplementation.

(A) Pernicious anemia✅Correct – Cyanocobalamin is the primary treatment.

(B) Alcohol withdrawal❌Incorrect – Thiamine (Vitamin B1) is used for alcohol withdrawal, not cyanocobalamin.

(C) Hypothyroidism❌Incorrect – Treated withlevothyroxine (Synthroid), not Vitamin B12.

(D) Narrow-angle glaucoma❌Incorrect – Treated withtimolol, acetazolamide, or surgery, not cyanocobalamin.

Cyanocobalamin Prescribing Information (NIH): https://medlineplus.gov/druginfo/meds/a607038.html

PTCB Exam Content Outline – Disease States & Medications

Key Facts About Cyanocobalamin & Pernicious Anemia:Analysis of Answer Choices:References for Pharmacy Technicians:

The axilla refers to the underarm area. Clobetasol is a high-potency corticosteroid, and such steroids are not recommended for use on thin-skinned areas like the face, groin, or underarms (axilla) due to risk of increased absorption and adverse effects like skin atrophy.

Mosby’s Pharmacy Technician: Principles and Practice explains:

“High-potency corticosteroids should not be applied to intertriginous areas such as the axilla, groin, or face due to increased absorption and systemic risk.”

Arashis acommon allergic reactionto medications.Drug allergiesoccur when the immune system overreacts to a medication, leading to symptoms such as:

Skin rash (most common)

Hives (urticaria)

Swelling (angioedema)

Anaphylaxis (severe reaction)

A. Dizziness❌→Side effect, not an allergic reaction.

Some medications (e.g., antihypertensives) cause dizziness, but it isnot an immune system response.

B. Constipation❌→Side effect, not an allergic reaction.

Opioids (e.g., morphine, oxycodone) commonly cause constipation, but it isnot due to an allergy.

C. Nausea❌→Side effect, not an allergic reaction.

Many medications (e.g., antibiotics, chemotherapy) cause nausea, but this isnot an immune-mediated reaction.

American Academy of Allergy, Asthma & Immunology (AAAAI)– Defines allergic reactions to medications.

FDA Drug Allergy Guidelines– Lists common symptoms of drug allergies.

PTCB PTCE Exam Content Outline– Covers adverse drug reactions and medication safety.

Why Not the Other Options?Key References:

Oxcarbazepine (Trileptal) is classified as an antiepileptic drug (AED) or anticonvulsant, used to treat partial seizures in adults and children. It works by stabilizing neuronal membranes and inhibiting repetitive firing of action potentials.

From Pharmacy Technician Certification Exam Review:

“Oxcarbazepine is used to treat seizure disorders and is part of the antiepileptic class, working similarly to carbamazepine.”

Other options are incorrect drug classes:

Bronchodilator – used in asthma (e.g., albuterol)

Vasodilator – used in angina or hypertension

Decongestant – treats nasal congestion (e.g., pseudoephedrine)

To determine the total number of10 mg prednisone tabletsrequired to fill the prescription, let's break it down by daily dosing:

First 2 days→ 20 mgtwice daily(b.i.d) =40 mg per day

Total for 2 days:40 mg × 2 =80 mg

Next 2 days→ 20 mgonce daily=20 mg per day

Total for 2 days:20 mg × 2 =40 mg

Next 2 days→ 10 mgonce daily=10 mg per day

Total for 2 days:10 mg × 2 =20 mg

Final 2 days→ 5 mgonce daily=5 mg per day

Total for 2 days:5 mg × 2 =10 mg

Days 1–4:(20 mg doses) → Each 20 mg dose requirestwo 10 mg tablets

Total for these 4 days:(20 mg × 4 days) = 80 mg

Tablets required:80 mg ÷ 10 mg =8 tablets

Days 5–6:(10 mg doses) → Each day requiresone 10 mg tablet

Total for these 2 days:10 mg × 2 =20 mg

Tablets required:20 mg ÷ 10 mg =2 tablets

Days 7–8:(5 mg doses) → Each day requireshalf of a 10 mg tablet

Total for these 2 days:5 mg × 2 =10 mg

Tablets required:1 full tablet (split into halves for two doses)

Step 1: Understanding the Prescription DirectionsStep 2: Determining the Number of 10 mg Tablets NeededFinal Calculation:8 tablets (Days 1-4) + 2 tablets (Days 5-6) + 1 tablet (Days 7-8) = 15 tablets

PTCB PTCE Exam Content Outline– Covers dosage calculations, unit conversions, and prescription interpretation.

Basic Pharmacy Math Principles– Ensuring proper medication dispensing based on prescription instructions.

Pharmacy Practice Guidelines– Proper dispensing techniques for titration therapy, such as steroid tapering.

Key References: