Free PTCB PTCE Practice Exam with Questions & Answers | Set: 5

TheM-M-R II (Measles, Mumps, and Rubella) vaccinemust bereconstituted only with the manufacturer-supplied diluentto maintain its efficacy and stability.

The manufacturer-provided diluent contains stabilizing agents that preserve the live attenuated virus.

Using normal saline can alter the pH and degrade the vaccine, making it ineffective.

The vaccine must be discarded if reconstituted incorrectlyand not administered.

A. Administer the vaccine as the diluents are equivalent.❌→Incorrect

Normal saline is NOT equivalent to the manufacturer’s diluentand can compromise the vaccine’s potency.

B. Report the incident to the Drug Enforcement Administration (DEA).❌→Incorrect

Vaccine errors should be reported to the CDC’s Vaccine Adverse Event Reporting System (VAERS), not the DEA(which handles controlled substances, not vaccines).

C. Contact the Environmental Protection Agency (EPA) for guidance.❌→Incorrect

The EPA regulates hazardous waste, not vaccine errors.The CDC or vaccine manufacturer should be contacted for guidance.

CDC Vaccine Storage and Handling Guidelines– States thatvaccines must be reconstituted only with manufacturer-supplied diluents.

FDA Guidelines for M-M-R II Vaccine– Confirms that improper reconstitutionrenders the vaccine ineffective.

PTCB PTCE Exam Content Outline– Covers proper vaccine handling and error prevention.

Why Is Normal Saline Not an Acceptable Diluent?Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

The FDA Orange BookprovidesTherapeutic Equivalence (TE) codesto indicate whether a generic drug isequivalentto a brand-name drug.

????Explanation of Answer Choices:✅B. The Orange Book→Correct.Liststherapeutic equivalence (TE) codesfor FDA-approved generics.❌A. Remington→ Incorrect.Pharmacy reference book, not used for TE codes.❌C. SDSs→ Incorrect.Used for chemical safety, not drug equivalence.❌D. Package insert→ Incorrect.Does not contain TE codes.

????Reference:

FDA Orange Book

PTCB Exam: Therapeutic Equivalence

• In medication safety terminology used across pharmacy technician study materials and safety taxonomies, an adverse event (specifically, a preventable adverse drug event) occurs when a medication error reaches the patient and results in harm or has the clear potential for harm (e.g., incorrect patient’s medication taken for several doses).

• By contrast, near misses (or “close calls”) are errors that are intercepted before they reach the patient, such as when a pharmacist catches incorrect directions during counseling (Option A), when a technician detects that a prescription was bagged but not yet verified (Option C), or when a technician finds a prescription placed in the wrong will-call bin before pickup (Option D). These represent process breakdowns with potential for harm but no patient exposure once intercepted.

• Therefore, the scenario most likely to lead to an adverse event is Option B, where the patient has already ingested medication intended for another patient. That constitutes an error that reached the patient, with a meaningful risk of harm, aligning with definitions for preventable adverse drug events.

References (Pharmacy Technician documents/Study Guides):

• NCC MERP (National Coordinating Council for Medication Error Reporting and Prevention) Taxonomy and definitions on medication errors, near misses, and events reaching the patient.

• ISMP (Institute for Safe Medication Practices) medication safety terminology and event classification used in community and institutional pharmacy practice.

• PTCB/ExCPT-aligned Pharmacy Technician Certification study guides: sections on medication safety, event reporting, and error prevention (definitions of “adverse event,” “medication error,” and “near miss/close call”).

• ASHP guidelines on preventing medication errors in community pharmacy workflows (verification steps, counseling interception points, and will-call bin best practices).

Drug interactions (like IV compatibility with heparin)must be evaluated bya pharmacisttoavoid adverse effects.

Pharmacy technicians can answer questions about generic names, drug schedules, and insurance issues but cannot provide clinical recommendations.

????Reference:ASHP Pharmacy Technician Scope of Practice, PTCE Guidelines.

Cytoxan (cyclophosphamide)belongs to thechemotherapy agentdrug classification. It is analkylating agentused to treat various types ofcancer, including:

Leukemia

Lymphoma

Breast cancer

Ovarian cancer

It works byinterfering with DNA replication in rapidly dividing cells, preventing cancer growth.

A. ACE inhibitor❌→Incorrect

ACE inhibitors (angiotensin-converting enzyme inhibitors)are used forhypertension and heart failure(e.g., lisinopril, enalapril).

C. Antibiotic❌→Incorrect

Antibioticstreatbacterial infections(e.g., amoxicillin, azithromycin).

D. Narcotic❌→Incorrect

Narcotics (opioids) are pain relievers(e.g., morphine, oxycodone).Cytoxan is not an opioid.

National Cancer Institute (NCI) Drug Dictionary– ClassifiesCytoxan as an alkylating chemotherapy agent.

PTCB PTCE Exam Content Outline– Covers chemotherapy drugs and their classifications.

FDA Drug Classification Guidelines– Lists Cytoxan as acytotoxic antineoplastic (chemotherapy) drug.

Why Not the Other Options?Key References:

DEA requires a full inventory of all controlled substances every 2 years (biennial inventory).

Schedule II drugs requirea separate recordfrom Schedules III–V.

????Reference:DEA Controlled Substance Inventory Regulations (21 CFR 1304.11).

ANarrow Therapeutic Index (NTI) drugis a medication in whichsmall differences in dose or blood concentrationcan lead to serioustoxicityorsubtherapeutic effects. These drugs requirecareful dosing and monitoringto avoid adverse effects or treatment failure.

Small Margin of Safety:The difference between theminimum effective concentration (MEC)and theminimum toxic concentration (MTC)is very narrow.

Requires Therapeutic Drug Monitoring (TDM):Blood levels of the drug must be regularly monitored to maintain efficacy while avoiding toxicity.

High Risk of Adverse Effects:Even minor dosage adjustments or variations in patient metabolism can cause toxicity.

Strict Pharmacokinetic and Pharmacodynamic Considerations:Factors likerenal and hepatic function, drug interactions, and patient weightsignificantly impact the drug’s effect.

Warfarin (Coumadin) → Risk of bleeding.

Digoxin → Risk of toxicity affecting the heart.

Phenytoin → Risk of severe neurological effects.

Levothyroxine → Risk of under- or over-treatment of thyroid disorders.

Theophylline → Risk of respiratory or cardiac toxicity.

Carbamazepine → Risk of serious neurological side effects.

A. Shorter window of guaranteed stability.→ Incorrect. NTI drugs do not necessarily have a shorter shelf-life or stability concerns compared to other drugs. Stability depends on formulation and storage conditions.

B. Incompatibility with therapeutic monitoring.→ Incorrect. NTI drugsrequiretherapeutic monitoring, not the opposite.

C. Synergistic effect on other medications.→ Incorrect. While NTI drugs can interact with other drugs, not all exhibit a synergistic effect (where combined drugs produce a greater effect than expected).

PTCB PTCE Exam Content Outline – Medication Safety and Quality Assurance(Monitoring NTI drugs).

FDA Narrow Therapeutic Index Drug List(Guidelines on NTI medications).

Lexicomp and Micromedex Drug Databases(Provide monitoring recommendations for NTI drugs).

USP <800> Hazardous Drugs and USP <797> Sterile Compounding Guidelines(Ensure safe handling and dispensing of NTI drugs).

Mosby’s Pharmacy Technician: Principles and Practice(NTI drug classification and monitoring).

Key Characteristics of NTI Drugs:Examples of NTI Drugs:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

Comprehensive and Detailed Step-by-Step Explanation:

Acetaminophen (Tylenol)is metabolized by theliver.Excessive doses or concurrentalcohol useincreases the risk ofliver damage (hepatotoxicity).

????Explanation of Answer Choices:✅D. Alcoholic beverages→Correct. Alcohol and acetaminophen together can causesevere liver damage.❌A. Citrus fruits→ Incorrect. Citrus does not interfere withacetaminophen metabolism.❌B. Leafy greens→ Incorrect. Leafy greens affectwarfarin, notacetaminophen.❌C. Dairy products→ Incorrect. Dairy does not interact withacetaminophen.

????Reference:

FDA Acetaminophen Warnings

PTCB Medication Safety Guidelines

For aqueous solutions such as water, proper volumetric technique requires placing the graduated cylinder at eye level and reading the bottom of the meniscus to avoid parallax error and obtain an accurate measurement. Reading at the top of the meniscus or holding the cylinder above eye level produces inaccurate results. This technique is standard in compounding and measurement guidance used in pharmacy training.

References (Pharmacy Technician documents/Study Guides):

• USP <795> Pharmaceutical Compounding—Nonsterile Preparations: Accurate measurement and meniscus reading for liquids.

• USP general laboratory technique guidance used in pharmacy education (volumetric measurement best practices).

• PTCB/ExCPT Compounding sections: Use of graduated cylinders and meniscus reading.

To calculate how muchamoxicillin suspensionwill be used in the first5 days, we follow these steps:

Amoxicillin concentration:250 mg per5 mL

Dosage:1 tsp (5 mL) three times daily (tid)

Duration:First5 days

Step 1: Identify Given InformationStep 2: Calculate Total Daily Volume5 mL×3=15 mL per day5 \text{ mL} \times 3 = 15 \text{ mL per day}5 mL×3=15 mL per day

Step 3: Multiply by 5 Days15 mL/day×5 days=75 mL15 \text{ mL/day} \times 5 \text{ days} = 75 \text{ mL}15 mL/day×5 days=75 mL

Thus, the patient will use75 mLof medication in the first5 days.

A. 25 mL→ Incorrect; this would be correct if taken onlyonce dailyinstead ofthree times daily.

B. 50 mL→ Incorrect; this is the correct amount for3.3 days, not 5 days.

D. 150 mL→ Incorrect; this is thefull 10-day course, not just the first 5 days.

Other Answer Choices Explained:References:

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

USP <795> Nonsterile Compounding Guidelines

Lexicomp Drug Monograph for Amoxicillin Suspension