Free PTCB PTCE Practice Exam with Questions & Answers | Set: 3

Needlegauge (G)refers to thediameter of the needle’s lumen(opening).The higher the gauge number, the smaller the needle diameter.

Lower gauge (e.g., 13G, 18G)→Larger needle(wider opening)

Higher gauge (e.g., 27G)→Smaller needle(narrower opening)

Common Needle Gauges and Their Uses:Gauge (G)

Needle Diameter (mm)

Common Use

13G

2.4 mm

IV drug administration (large-bore)

18G

1.2 mm

Drawing thick medications (e.g., oil-based injections)

20G

0.9 mm

General intramuscular (IM) injections

27G

0.4 mm

Subcutaneous (SC) or intradermal (ID) injections (e.g., insulin, vaccines)

Since27Gis the highest gauge listed, it corresponds to thesmallestneedle diameter, making it the correct answer.

A. 13G❌→ One of the largest gauges, used for IV fluids or blood transfusions.

B. 18G❌→ Large needle used for thick medications likedepot injections or contrast agents.

C. 20G❌→ Common forintramuscular injectionsbut larger than 27G.

PTCB PTCE Exam Content Outline– Covers needle gauges, injection routes, and proper medication administration.

USP <797> & USP <800>– Provide sterile compounding guidelines, including appropriate needle gauge selection.

CDC Vaccine Administration Guidelines– Recommend25-30Gfor subcutaneous and intradermal injections.

Why Not the Other Options?Key References:

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:

Comprehensive and Detailed Step-by-Step Explanation:

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Explanation of Answer Choices:✅C. 20→Correct.2 tablets per day × 10 days = 20 tablets.❌A. 5→ Incorrect. Under-dose.❌B. 10→ Incorrect. Under-dose.❌D. 40→ Incorrect. Over-dose.

????Reference:

USP <795> Pharmaceutical Calculations

PTCB Exam: Dosing Conversions

Comprehensive and Detailed Step-by-Step Explanation:

To calculate the percentage ofpsylliumin the final preparation:

Formula:

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Sincepsylliummakes up500 gout of1000 g (1 kg)of the bulk laxative, it accounts for50%of the total formulation.

????Reference:

USP <795>Compounding Standards

PTCE ExamPharmaceutical Calculations

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:

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 References:

Comprehensive and Detailed Step-by-Step Explanation:

Stock rotation (First In, First Out - FIFO)ensures thatolder medications are used before newer stock, reducing expired medication dispensing.

????Explanation of Answer Choices:✅C. Rotating stock on a regular basis→Correct.FIFO method reduces waste and errors.❌A. Verifying each lot number→ Incorrect.Lot numbers do not indicate expiration dates.❌B. Using the newest medications first→ Incorrect.Older stock should be used first.❌D. Using the last in, first out method→ Incorrect.Opposite of the correct practice.

????Reference:

USP <1079>: Medication Storage and Inventory Control

PTCB Exam: Inventory Management

Comprehensive and Detailed Step-by-Step Explanation:

Adispensing erroroccurs when a pharmacy provides amedication that differs from the prescribed order.This may involvewrong drug, dose, form, or incorrect labeling.

????Explanation of Answer Choices:✅D. Received by the patient→Correct.Adispensing error is an error in what the patient actually receives, not what they request.❌A. Requested by the patient→ Incorrect.A patient request does not determine dispensing errors.❌B. On the plan formulary→ Incorrect.Formulary status affects insurance, not dispensing accuracy.❌C. Supplied by the wholesaler→ Incorrect.Errors in supply do not qualify as dispensing errors.

????Reference:

ISMP Guidelines on Medication Errors

PTCB Medication Safety Guidelines

Handling and internal transport of hazardous waste in the workplace require compliance with OSHA standards, including Hazard Communication and HAZWOPER (29 CFR 1910.120) training for personnel involved in hazardous waste operations. While external shipment of hazardous materials involves DOT/EPA rules, within pharmacy and healthcare settings, technicians moving hazardous waste containers to storage must have OSHA-mandated training. DEA pertains to controlled substances, FDA regulates drug approval/labeling, and ISMP is a safety organization but does not mandate training.

References (Pharmacy Technician documents / Study Guides):

• USP <800> Hazardous Drugs—Handling in Healthcare Settings: personnel training expectations and references to OSHA standards for safe handling.

• OSHA Hazard Communication Standard and HAZWOPER training requirements as cited in pharm tech safety modules.

• PTCB/ExCPT study materials on hazardous drugs/waste handling and applicable regulatory bodies

Risedronate (Actonel) is a bisphosphonate used for osteoporosis.

It can causehypocalcemia (low calcium levels)byinhibiting bone resorption.

Patients must take it witha full glass of water and remain upright for 30 minutesto preventesophageal irritation.

????Reference:FDA Bisphosphonate Warnings, PTCB Drug Counseling Guidelines.