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

Step 1: Convert pounds to kilograms

1 kg = 2.2 lbs

132 lbs ÷ 2.2 = 60 kg

Step 2: Calculate total dose

5 mg/kg × 60 kg = 300 mg

Thus, the correct answer isC. 660 mg.

????Reference:PTCE Calculation Guide, Pediatric Dosage Calculations.

Comprehensive and Detailed Step-by-Step Explanation:

Ahazardous drug spill kitisrequiredunderUSP <800>, which outlinessafe handling practices for hazardous drugs (HDs). The kit must contain:

Disposable scoop and scraper(to safely collect broken glass and contaminated material).

Absorbent pads or spill control pillows(for liquid spills).

Chemotherapy-rated gloves, gown, goggles, and mask(for protection).

A hazardous waste disposal bag(to properly dispose of contaminated materials).

????Explanation of Answer Choices:✅D. A disposable scoop for glass fragments→Correct.Adisposable scoop is essentialto safely removehazardous drug spills containing broken glass.❌A. Permeable, disposable protective garments→ Incorrect. PPE for hazardous drug spills must beimpermeable(e.g., coated gowns).❌B. Sufficient supplies to absorb a spill of about 10,000 mL→ Incorrect.Most spill kits are designed for smaller spills (≤1000 mL), not massive industrial spills.❌C. Reusable absorbent sponges or toweling→ Incorrect.All absorbent materials must be disposable to prevent contamination.

????Reference:

USP <800>: Handling Hazardous Drugs in Healthcare Settings

NIOSH List of Hazardous Drugs (2020 Update)

PTCB Exam: Medication Safety & Hazardous Drug Management

Prilosec (Omeprazole) is a delayed-release proton pump inhibitor (PPI)used forGERD, ulcers, and acid reflux. It comes incapsulescontainingenteric-coated granules, designed to protect the medication from stomach acid and ensure proper absorption.

Prilosec capsules contain enteric-coated granulesthat are safe to sprinkle on soft foodswithout chewing.

Applesauce is an ideal optionbecause it doesnot interfere with drug absorption or stability.

B. Chew and swallow the capsules❌→ Incorrect

Chewing destroys the enteric coating, leading to premature drug release and degradation by stomach acid.

C. Compound the capsules into a topical preparation❌→ Incorrect

Prilosecis not formulated for topical use. The medication must reach the stomach intact for proper effect.

D. Allow the capsules to dissolve under the tongue❌→ Incorrect

Sublingual administration is ineffectivebecauseomeprazole is not absorbed through the mucous membranesand needs enteric protection.

FDA Omeprazole Medication Guide– States that the contents can be sprinkled on applesauce.

ISMP Safe Medication Use Guidelines– Emphasizes proper administration of delayed-release capsules.

PTCB PTCE Exam Content Outline– Covers modified-release formulations and proper drug administration techniques.

Why Can the Capsules Be Opened?Why Not the Other Options?Key References:

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

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:

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:

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:

Comprehensive and Detailed Step-by-Step Explanation:

Underfederal law (21 CFR §1306.25),Schedule III-V controlled substances (e.g., Alprazolam)can be transferred ONCEfor refill purposes between licensed pharmacieswith a shared database.Schedule II drugs (e.g., Methylphenidate, Fentanyl, Hydromorphone) CANNOT be transferred.

????Explanation of Answer Choices:✅A. Alprazolam (C-IV)→Correct.Schedule III-V drugs can be transferred ONCEfor refill purposes.❌B. Methylphenidate (C-II)→ Incorrect.Schedule II drugs cannot be transferred.❌C. Fentanyl (C-II)→ Incorrect.C-II drugs are non-transferablebetween pharmacies.❌D. Hydromorphone (C-II)→ Incorrect.C-II drugs cannot be transferred.

????Reference:

DEA Controlled Substance Act (CSA)

21 CFR §1306.25 – Prescription Transfers

Bupropion (Wellbutrin, Zyban) requires a Medication Guide due to risks of suicidal thoughts and neuropsychiatric effects.

Medication Guides are FDA-required leaflets given with specific medications that have serious risks.

Examples of Medications Requiring a Medication Guide:

Antidepressants (e.g., SSRIs, SNRIs, bupropion) → Suicide risk

NSAIDs → GI bleeding risk

Opioids → Addiction risk

Fluoroquinolones → Tendon rupture risk

????Reference:FDA Medication Guide Requirements, ISMP Patient Safety Guidelines.

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.