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PTCB diagnostic test

40 original questions from all four PTCE domains, weighted like the 2026 content outline.

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Free practice test

PTCB quick diagnostic

40 questions
Medications · Federal Requirements · Patient Safety · Order Entry
49 min in exam mode
Practice mode, no timer

Questions are original practice items written to the published exam content, not real exam questions.

A new technician is grouping drugs by their name endings. Which drug belongs to a DIFFERENT therapeutic class from the other three?
Correct answer: B
Omeprazole (Prilosec), pantoprazole (Protonix) and esomeprazole (Nexium) are proton pump inhibitors, and "-prazole" is the stem for these antiulcer drugs. Aripiprazole (Abilify) ends in "-piprazole", a separate stem for psychotropic drugs, and its label calls it an atypical antipsychotic. Always check the whole stem and the label, not just the last few letters.
- A Omeprazole is a proton pump inhibitor, the same class as pantoprazole and esomeprazole.
- B Correct: aripiprazole (Abilify) is an atypical antipsychotic; "-piprazole" is a different stem from the PPI stem "-prazole".
- C Pantoprazole (Protonix) is a proton pump inhibitor like omeprazole and esomeprazole.
- D Esomeprazole (Nexium) is a proton pump inhibitor like omeprazole and pantoprazole.
Learn this topic: Brand names, generic names and drug classes: how to match them fast 5-minute lesson

Source: DailyMed: PRILOSEC (omeprazole magnesium) delayed-release oral suspension, label · DailyMed: PROTONIX (pantoprazole sodium) delayed-release tablets and oral suspension, label · DailyMed: NEXIUM (esomeprazole magnesium) delayed-release capsules, label · DailyMed: ABILIFY (aripiprazole) tablets, label · WHO: The use of stems in the selection of International Nonproprietary Names (INN), 2018 ·
A patient's profile shows Hyzaar 50 mg/12.5 mg daily. A new prescription arrives for losartan 50 mg daily, and the system flags a duplication. Why?
Correct answer: A
Hyzaar is a combination of losartan (an angiotensin II receptor blocker) and hydrochlorothiazide (a diuretic). A separate losartan prescription doubles the ARB the patient already gets inside the combination tablet. Always check every ingredient of a combination product.
- A Correct: Hyzaar contains losartan plus hydrochlorothiazide, so the new losartan duplicates it.
- B Lisinopril is in Zestoretic, not Hyzaar.
- C Losartan is an angiotensin II receptor blocker; the diuretic in Hyzaar is hydrochlorothiazide.
- D Neither product is a statin; Hyzaar treats high blood pressure.
Learn this topic: Therapeutic duplication: when two prescriptions do the same job 5-minute lesson

Source: DailyMed: HYZAAR (losartan potassium and hydrochlorothiazide) tablets, label · DailyMed: ZESTORETIC (lisinopril and hydrochlorothiazide) tablets, label · DailyMed: COZAAR (losartan potassium) tablets, label ·
Viagra (sildenafil) labeling lists a contraindication with which group of drugs?
Correct answer: A
Sildenafil strengthens the blood-pressure-lowering effect of nitrates, so the Viagra label contraindicates its use with organic nitrates or nitrites in any form. Alpha-blockers are a caution, not a contraindication: the patient should be stable on the alpha-blocker and start at a low sildenafil dose. A contraindication means the two should not be used together.
- A Correct: the Viagra label contraindicates use with organic nitrates because of the risk of severe low blood pressure.
- B Alpha-blockers need caution and a low starting dose, but the label does not contraindicate them.
- C Statins are not listed as a contraindication in the Viagra label.
- D Proton pump inhibitors are not listed as a contraindication in the Viagra label.
Learn this topic: Drug interactions and contraindications: the five types and the big ones 6-minute lesson

Source: DailyMed: VIAGRA (sildenafil citrate) tablets, label ·
A prescription for azithromycin 250 mg tablets reads: take 2 tablets (500 mg) on day 1, then 1 tablet (250 mg) once daily on days 2 through 5. How many tablets complete the course?
Correct answer: A
The Zithromax label lists a regimen of 500 mg as a single dose on day 1 followed by 250 mg once daily on days 2 through 5, so the course lasts 5 days. With 250 mg tablets that is 2 + 1 + 1 + 1 + 1 = 6 tablets (1.5 g total). Count tablets day by day whenever the first dose is a loading dose.
- A Correct: 2 tablets on day 1 plus 1 tablet on each of days 2 to 5 (4 tablets) = 6 tablets.
- B This counts one tablet per day for 5 days and misses the second tablet on day 1.
- C This applies the day 1 dose of 2 tablets to all 5 days.
- D This counts only days 2 through 5 and leaves out day 1.
Learn this topic: How strength, dosage form and label directions tell a patient how to take a drug 5-minute lesson

Source: DailyMed: ZITHROMAX (azithromycin) tablets and oral suspension, Pfizer label ·
Which adverse reaction does the lisinopril (Zestril) label list as common in patients treated for hypertension?
Correct answer: D
ACE inhibitors such as lisinopril commonly cause cough; the Zestril label lists headache, dizziness and cough as common adverse reactions in hypertension. A patient who says a blood pressure pill makes them cough is describing a known side effect, which the pharmacist should hear about. Matching a drug to its signature side effect is a core skill in this area.
- A Gynecomastia is the most common adverse reaction of spironolactone, not a listed effect of lisinopril.
- B Tendon rupture is a boxed-warning reaction of fluoroquinolones such as ciprofloxacin.
- C Lactic acidosis is the boxed warning of metformin, not a common lisinopril reaction.
- D Correct: the label lists headache, dizziness and cough as common adverse reactions in hypertension.
Learn this topic: How to tell a common side effect from a severe reaction or a true drug allergy 5-minute lesson

Source: DailyMed: ZESTRIL (lisinopril) tablets label · DailyMed: ALDACTONE (spironolactone) tablets, Pfizer label · DailyMed: Ciprofloxacin tablets, Hikma label · DailyMed: Metformin hydrochloride tablets label ·
While picking up a refill, a patient taking atorvastatin (Lipitor) mentions new, unexplained muscle pain and weakness. What is the best technician action?
Correct answer: B
Statins can cause myopathy and rhabdomyolysis; the Lipitor label instructs patients to promptly report unexplained muscle pain, tenderness or weakness, especially with malaise or fever. A technician who hears this refers the patient to the pharmacist right away. The pharmacist then decides what the patient should do, including whether to contact the prescriber.
- A Unexplained muscle pain can signal myopathy or rhabdomyolysis, which the label treats as serious.
- B Correct: the label tells patients to promptly report unexplained muscle pain, tenderness or weakness, so the pharmacist must be involved.
- C Suggesting an OTC pain reliever bypasses the pharmacist and could mask a reaction the label tells patients to report promptly.
- D Telling a patient to stop a medication is a clinical decision for the pharmacist or prescriber, not the technician.
Learn this topic: How to tell a common side effect from a severe reaction or a true drug allergy 5-minute lesson

Source: DailyMed: LIPITOR (atorvastatin calcium) tablets, Viatris label ·
A patient's profile lists an allergy to penicillin (hives). Which new prescription should the technician flag for the pharmacist before processing?
Correct answer: A
Brand names can hide a drug class: Augmentin is amoxicillin/clavulanate, which its label calls a penicillin-class antibacterial plus a beta-lactamase inhibitor. Its label lists a serious hypersensitivity reaction to other beta-lactams, such as penicillins or cephalosporins, as a contraindication. Any penicillin-class drug for a patient with a documented penicillin allergy goes to the pharmacist.
- A Correct: Augmentin contains amoxicillin, a penicillin-class antibacterial, so it conflicts with a penicillin allergy.
- B Zithromax is azithromycin, a macrolide, not a penicillin.
- C Bactrim DS is sulfamethoxazole and trimethoprim; it matters for a sulfa allergy, not a penicillin allergy.
- D Macrobid is nitrofurantoin, which is not a penicillin.
Learn this topic: How to tell a common side effect from a severe reaction or a true drug allergy 5-minute lesson

Source: DailyMed: AUGMENTIN (amoxicillin/clavulanate potassium) label · DailyMed: ZITHROMAX (azithromycin) tablets and oral suspension, Pfizer label · DailyMed: BACTRIM and BACTRIM DS (sulfamethoxazole and trimethoprim) tablets label · DailyMed: MACROBID (nitrofurantoin monohydrate/macrocrystals) capsules label ·
Which statement matches the labeled indication of sumatriptan tablets (Imitrex)?
Correct answer: D
Sumatriptan is a triptan taken when a migraine starts; the label limits it to acute treatment of migraine with or without aura in adults. The label also says it is not indicated for prevention of migraine attacks or for cluster headache. Acute-versus-preventive is a common indication distinction.
- A The label states sumatriptan is not indicated for the prevention of migraine attacks.
- B The label states sumatriptan tablets are not indicated for cluster headache.
- C Tension-type headache is not a labeled indication; the tablets are labeled only for acute migraine.
- D Correct: Imitrex tablets are indicated for the acute treatment of migraine with or without aura in adults.
Learn this topic: How to match a medication to the condition it is indicated for 5-minute lesson

Source: DailyMed: IMITREX (sumatriptan) tablets, GlaxoSmithKline label ·
Which product is labeled to treat acute episodes of bronchospasm, making it a rescue inhaler?
Correct answer: C
Rescue (quick-relief) and maintenance (controller) drugs have different indications. Albuterol HFA is labeled to treat or prevent bronchospasm, including acute episodes. Fluticasone HFA, tiotropium and montelukast are long-term controllers whose labels say they are not for acute bronchospasm or acute attacks.
- A Fluticasone HFA is a maintenance inhaled corticosteroid, and its label says it is not indicated for relief of acute bronchospasm.
- B Spiriva HandiHaler is a once-daily maintenance treatment for COPD, and its label says it is not a rescue medication.
- C Correct: Ventolin HFA is indicated for the treatment or prevention of bronchospasm and has dosing for acute episodes.
- D Singulair is for prophylaxis and chronic treatment of asthma, and its label says it is not indicated for an acute attack.
Learn this topic: How to match a medication to the condition it is indicated for 5-minute lesson

Source: DailyMed: VENTOLIN HFA (albuterol sulfate) inhalation aerosol, GlaxoSmithKline label · DailyMed: Fluticasone propionate HFA inhalation aerosol label · DailyMed: SPIRIVA HANDIHALER (tiotropium bromide) label · DailyMed: SINGULAIR (montelukast sodium) label ·
Finasteride is sold as Proscar 5 mg and Propecia 1 mg tablets. Which pairing of product and labeled indication is correct?
Correct answer: A
The same active ingredient can carry different indications under different brand names and strengths. Proscar (finasteride 5 mg once daily) treats symptomatic benign prostatic hyperplasia, and Propecia (finasteride 1 mg once daily) treats male pattern hair loss in men only. Matching the strength to the indication helps catch a wrong-product selection.
- A Correct: Proscar 5 mg is labeled for symptomatic benign prostatic hyperplasia, and Propecia 1 mg for male pattern hair loss in men.
- B This reverses the two products; the 5 mg tablet is the BPH product.
- C Propecia is labeled for men only and is not indicated for use in women.
- D Neither finasteride product is labeled for hypertension.
Learn this topic: How to match a medication to the condition it is indicated for 5-minute lesson

Source: DailyMed: PROSCAR (finasteride) tablets, Organon label · DailyMed: PROPECIA (finasteride) tablets, Organon label ·
A patient's insulin glargine (Lantus) 10 mL multiple-dose vial was first punctured on October 2. Using the in-use period on the Lantus label, which discard date should be written on the vial?
Correct answer: C
The Lantus storage table gives an in-use (opened) vial 28 days, whether it is refrigerated or kept at room temperature up to 86°F (30°C). To find the discard date, start from the date of first use and add the in-use days: October 2 + 28 days = October 30. The vial is also discarded sooner if the printed expiration date comes first.
- A October 23 is only 21 days after first use; the Lantus in-use period is 28 days.
- B November 13 is 42 days after first use, which is longer than the 28 days the label allows.
- C Correct: an opened Lantus vial may be used for 28 days, and October 2 plus 28 days is October 30.
- D November 27 is 56 days after first use, which is the in-use period for insulin degludec (Tresiba), not Lantus.
Learn this topic: Drug stability: how long mixed, opened and in-use products last 5-minute lesson

Source: DailyMed: Lantus (insulin glargine) label, section 16.2 Storage · DailyMed: Tresiba (insulin degludec) label, section 16 Storage ·
An unopened Humulin N KwikPen was kept at room temperature (below 86°F) for 5 days before the patient's first injection. Based on the storage table and its footnotes in section 16.2 of the Humulin N label, for how many more days may the patient use this pen after that first injection?
Correct answer: A
For Humulin N, the label counts room-temperature time from the moment the product leaves the refrigerator, not from the first injection. The KwikPen has a 14-day room-temperature total and the vial has a 31-day total, both including unopened and in-use time. Subtract the days already spent at room temperature to find what is left.
- A Correct: a Humulin N KwikPen at room temperature may be used for a total of 14 days, counting unopened and in-use time, so 14 − 5 = 9 days remain.
- B 14 days ignores the label note that the 5 unopened days at room temperature count toward the 14-day total.
- C 23 days subtracts the 5 days from 28 days, an in-use period that belongs to other insulins, not the Humulin N pen.
- D 26 days subtracts the 5 days from the 31-day total, which applies to the Humulin N vial, not the KwikPen.
Learn this topic: Drug stability: how long mixed, opened and in-use products last 5-minute lesson

Source: DailyMed: Humulin N (human insulin isophane) label, section 16.2 Storage and Handling ·
Vaccines and medications labeled for refrigerated storage are kept within which temperature range?
Correct answer: D
The refrigerator range on drug labels and in CDC vaccine guidance is 2°C to 8°C (36°F to 46°F). Controlled room temperature is 20°C to 25°C (68°F to 77°F), and the vaccine freezer range is −50°C to −15°C (−58°F to 5°F). Knowing all three lets you match any storage label quickly.
- A 20°C to 25°C (68°F to 77°F) is controlled room temperature, not refrigeration.
- B −50°C to −15°C (−58°F to 5°F) is the freezer range for frozen vaccines such as varicella.
- C 8°C to 15°C (46°F to 59°F) is warmer than a refrigerator; it is not the refrigerated range on labels.
- D Correct: labels and CDC give the refrigerator range as 2°C to 8°C (36°F to 46°F).
Learn this topic: Medication storage: temperature ranges, light protection and restricted access 5-minute lesson

Source: CDC Vaccine Storage and Handling Toolkit (PDF) · DailyMed: Lantus (insulin glargine) label, section 16.2 Storage ·
A patient picking up an epinephrine auto-injector (EpiPen) asks whether it should be kept in the refrigerator. According to the EpiPen label, how should it be stored?
Correct answer: B
EpiPen is stored at controlled room temperature, 20°C to 25°C (68°F to 77°F), with excursions to 15°C to 30°C (59°F to 86°F) permitted, and it is never refrigerated. Epinephrine is light sensitive, so the pen stays in its carrier tube. It is replaced if the solution is discolored, cloudy or has particles.
- A The label says not to refrigerate EpiPen.
- B Correct: the label says to store EpiPen at 20°C to 25°C (68°F to 77°F), not refrigerate it, and keep it in the carrier tube to protect it from light.
- C Epinephrine is light sensitive, so the label says to keep the auto-injector in its carrier tube.
- D The label never calls for refrigeration, for any length of time.
Learn this topic: Medication storage: temperature ranges, light protection and restricted access 5-minute lesson

Source: DailyMed: EpiPen (epinephrine injection) auto-injector label, section 16 Storage and Handling ·
A pharmacy is sorting items for waste pickup. Which item is an acute hazardous (P-listed) waste under federal EPA rules?
Correct answer: A
P-listed wastes are commercial chemical products that EPA lists as acute hazardous wastes in 40 CFR 261.33(e). Warfarin above 0.3% is P001 (at 0.3% or less it is U248), and nicotine is P075, except FDA-approved OTC nicotine patches, gums and lozenges. Under subpart P, a stock bottle, vial or unit-dose package that held a P-listed drug is considered empty once the drug has been removed in the usual way.
- A Correct: warfarin and its salts at concentrations greater than 0.3% are listed as P001, an acute hazardous waste, in 40 CFR 261.33.
- B The P075 nicotine listing expressly excludes patches, gums and lozenges that are FDA-approved OTC nicotine replacement therapies.
- C Under 40 CFR 266.507(a), a unit-dose container emptied by normal practice is considered empty and its residues are not regulated as hazardous waste.
- D Amoxicillin is not on the P list, so it is not an acute hazardous waste.
Learn this topic: Pharmaceutical waste: P-listed drugs, the sewer ban and safe disposal 5-minute lesson

Source: eCFR: 40 CFR 261.33 Discarded commercial chemical products (P and U lists) · eCFR: 40 CFR 266.507 Residues of hazardous waste pharmaceuticals in empty containers ·
A prescriber issues an electronic prescription on October 1, 2026, for 60 tablets of oxycodone (Schedule II). On October 5, the patient asks the pharmacy to fill only 20 tablets for now. Under federal law, by what date must any remaining tablets be dispensed?
Correct answer: B
Under 21 CFR 1306.13(b), a Schedule II prescription may be partially filled at the request of the patient or the prescriber, and the remaining portions must be filled within 30 days of the date the prescription was written (72 hours for an emergency oral prescription). The total dispensed can never exceed the quantity prescribed. A partial fill because the pharmacy is short of stock follows the separate 72-hour rule.
- A This applies the 72-hour rule, which is for a pharmacy that cannot supply the full quantity (or an emergency oral prescription), not a patient-requested partial fill.
- B Correct: remaining portions of a patient-requested partial fill must be filled no later than 30 days after the date the prescription was written: October 1 plus 30 days is October 31.
- C This counts 30 days from the first partial fill; the 30 days run from the date the prescription was written.
- D This counts 90 days from the date written, which is the cap on total supply for a set of multiple Schedule II prescriptions, not a partial-fill deadline.
Learn this topic: Controlled substance prescriptions: schedules, refills, partial fills and transfers 6-minute lesson

Source: eCFR: 21 CFR 1306.13 Partial filling of prescriptions · eCFR: 21 CFR 1306.12 Refilling prescriptions; issuance of multiple prescriptions ·
A retail pharmacy wants to order Schedule II controlled substances from its wholesaler without using DEA's electronic ordering system (CSOS). Which DEA form does it use?
Correct answer: C
Schedule I and II controlled substances must be ordered on a DEA Form 222 or with a digitally signed electronic order through CSOS. Schedules III-V are ordered like other drugs, and the pharmacy keeps the invoice or packing slip as its receiving record. Keep the three form numbers apart: 222 orders, 106 reports theft or loss, 41 records destruction.
- A DEA Form 106 reports a theft or significant loss of controlled substances.
- B DEA Form 41 records the destruction of controlled substances.
- C Correct: a DEA Form 222 (or its electronic CSOS equivalent) is required for each distribution of a Schedule I or II controlled substance.
- D An invoice is the receiving record for Schedule III-V drugs; it cannot be used to order Schedule II drugs.
Learn this topic: Controlled substances from order to destruction: DEA Forms 222, 106 and 41 6-minute lesson

Source: eCFR: 21 CFR 1305.03 Distributions requiring a Form 222 or a digitally signed electronic order · DEA Diversion Control Division: Controlled Substance Ordering System (CSOS) · DEA Pharmacist's Manual (2022 edition) ·
A prescription for tramadol (Schedule IV) is issued and first filled on February 1, 2026, with 5 refills. Refills were dispensed on March 3, April 2, May 2 and June 1. The patient returns on August 15, 2026, for the last refill. Under federal law, what should happen?
Correct answer: D
Both federal limits apply to Schedule III and IV prescriptions: 5 refills and 6 months from the date of issue, whichever comes first. Here only 4 refills were used, but the 6-month limit ended on August 1, 2026, so the last refill is void. Oral refill authorizations and partial fills cannot stretch past 6 months; the prescriber must issue a new prescription.
- A An unused refill does not matter once 6 months have passed since the date of issue (August 1, 2026).
- B Partial fills of Schedule III-V prescriptions also cannot be dispensed more than 6 months after the date of issue.
- C Oral authorization can add refills only within the 5-refill, 6-month limit; it cannot extend the window past 6 months.
- D Correct: the prescription could not be filled after August 1, 2026, so the patient needs a new prescription.
Learn this topic: Controlled substance prescriptions: schedules, refills, partial fills and transfers 6-minute lesson

Source: eCFR: 21 CFR 1306.22 Refilling of prescriptions · eCFR: 21 CFR 1306.23 Partial filling of prescriptions ·
During a pharmacy's biennial controlled substance inventory, which opened container must be counted exactly rather than estimated?
Correct answer: D
A pharmacy takes a complete controlled substance inventory at least every 2 years (the biennial inventory). For opened containers, Schedule I and II drugs need an exact count, while Schedule III, IV and V drugs may be estimated unless the container holds more than 1,000 tablets or capsules. Inventory records are kept for at least 2 years.
- A An opened Schedule IV container may be estimated unless it holds more than 1,000 tablets or capsules.
- B Opened Schedule III-V containers holding 1,000 units or fewer may be estimated.
- C An opened Schedule IV bottle of this size may be estimated.
- D Correct: opened containers of Schedule I or II drugs always require an exact count.
Learn this topic: Controlled substances from order to destruction: DEA Forms 222, 106 and 41 6-minute lesson

Source: eCFR: 21 CFR 1304.11 Inventory requirements · eCFR: 21 CFR 1304.04 Maintenance of records and inventories ·
The pharmacy's electronic logbook shows that a customer bought 2.4 grams of pseudoephedrine base at this pharmacy earlier today. She now asks for more boxes of a product that contains 0.72 grams of pseudoephedrine base per box. Under federal law, what is the greatest number of whole boxes the pharmacy may sell her today?
Correct answer: C
The 3.6-gram daily limit counts every sale to the same purchaser on that calendar day, not just the current transaction. Subtract what was already sold today from 3.6 grams, divide by the base content per package, and round down, because a partial box cannot be sold.
- A 9 comes from using the 9-gram 30-day limit instead of the 3.6-gram daily limit: (9 - 2.4) / 0.72 = 9.2.
- B 5 ignores the 2.4 grams she already bought today: 3.6 / 0.72 = 5.
- C Correct: 3.6 - 2.4 = 1.2 grams remain; 1.2 / 0.72 = 1.67, so only 1 whole box fits under the limit.
- D 2 rounds 1.67 up; 2 boxes add 1.44 grams and bring her total to 3.84 grams, over the 3.6-gram limit.
Learn this topic: How federal law restricts pseudoephedrine sales and REMS drugs 5-minute lesson

Source: eCFR 21 CFR Part 1314: Retail Sale of Scheduled Listed Chemical Products · DEA Diversion Control: Training Required to Sell Drug Products Containing Ephedrine, Pseudoephedrine, and Phenylpropanolamine (retail) ·
A pharmacy receives an urgent drug recall letter for one lot of an antihypertensive tablet. The letter asks pharmacies to stop dispensing that lot and return it. What should the technician do first?
Correct answer: A
Under 21 CFR 7.49, a recall communication identifies the product, lot numbers and codes and gives instructions, and each consignee should carry out those instructions immediately. In the pharmacy that means matching lot numbers, removing the recalled lot from dispensing stock, keeping it separate and labeled, and returning it as the letter directs. Any patient-level action follows the recall's stated depth and the pharmacist's direction.
- A Correct: a recall notice identifies lots so pharmacies can find the affected stock, stop dispensing it and set it aside for return as instructed.
- B Only the listed lot is recalled; pulling every lot is unnecessary and can cause a needless shortage.
- C Contacting patients is done only if the recall strategy calls for it, and telling a patient to stop a medicine is clinical advice for the pharmacist or prescriber.
- D A consignee should carry out the recall instructions immediately; waiting for the Enforcement Report delays removal.
Learn this topic: How FDA drug recalls work and what the pharmacy does 4-minute lesson

Source: eCFR 21 CFR Part 7, Subpart C: Recalls (Including Product Corrections) · FDA: Understanding Drug Recalls: What to Know and What to Do ·
While checking in an order from the wholesaler, a technician finds a bottle whose label looks different from usual and whose seal appears to have been opened. Under the DSCSA, what should happen to the bottle?
Correct answer: C
A suspect product is one the pharmacy has reason to believe may be counterfeit, diverted, stolen, intentionally adulterated or otherwise unfit for distribution. Under the DSCSA, the dispenser must quarantine it, in a clearly identified separate area or by other procedures that keep it from being dispensed, and promptly investigate with its trading partners. If it is cleared it may be dispensed; if it is illegitimate, notification steps follow.
- A Shelving it lets a possibly counterfeit or adulterated drug reach a patient; suspect product must be kept away from saleable stock.
- B Sending it back with no record skips the required quarantine and investigation.
- C Correct: suspect product is quarantined from product intended for dispensing and promptly investigated, with the pharmacist leading the investigation.
- D Destroying it removes the evidence needed to investigate and may be wrong if the product turns out to be legitimate.
Learn this topic: How the DSCSA tracks prescription drugs and what the pharmacy must do 5-minute lesson

Source: 21 U.S.C. 360eee-1 (LII): DSCSA pharmaceutical distribution supply chain requirements · 21 U.S.C. 360eee (LII): DSCSA definitions · FDA: Pharmacists: Utilize DSCSA Requirements to Protect Your Patients ·
Which is the correct way to write a dose of one-half milligram on a pharmacy label?
Correct answer: C
Always put a zero before the decimal point when a dose is less than 1 (a leading zero), and never add a trailing zero after a whole number (write 5 mg, not 5.0 mg). A 'naked' decimal such as .5 mg can be misread as 5 mg, a 10-fold overdose. ISMP also advises a space between the number and the unit.
- A .5 mg has no leading zero, so a missed decimal point turns it into 5 mg.
- B .50 mg has no leading zero, and the extra zero adds nothing; it can be misread as 50 mg.
- C Correct: a leading zero, no extra zeros and a space before the unit.
- D Running the number and unit together is error-prone because the 'm' can be mistaken for a zero.
Learn this topic: Which habits stop medication errors before they reach the patient? 5-minute lesson

Source: ISMP's List of Error-Prone Abbreviations, Symbols, and Dose Designations (2015 PDF) ·
A label is printed as 'warfarin 5.0 mg tablets.' If the decimal point is missed, how could the strength be misread?
Correct answer: B
A trailing zero after a whole number (5.0 mg) is on ISMP's error-prone list and the Joint Commission's Do Not Use list, because a missed decimal turns 5.0 into 50, a 10-fold overdose. Write whole-number doses without a decimal: 5 mg. Warfarin is also a high-alert drug, which makes this error especially dangerous.
- A Reading 0.5 mg would require a leading zero that is not there; a missed decimal makes the number bigger, not smaller.
- B Correct: without the decimal point, 5.0 reads as 50, a 10-fold overdose.
- C Losing a decimal point does not change the unit from mg to mcg.
- D Missing the decimal in 5.0 merges the digits into 50, not 500.
Learn this topic: Which habits stop medication errors before they reach the patient? 5-minute lesson

Source: ISMP's List of Error-Prone Abbreviations, Symbols, and Dose Designations (2015 PDF) · ECRI/ISMP: List of Error-Prone Abbreviations · ECRI/ISMP: High-Alert Medications in Community/Ambulatory Care Settings · ISMP List of High-Alert Medications in Community/Ambulatory Care Settings (2021 PDF, copy hosted by SCCHC) · The Joint Commission Official "Do Not Use" List (PDF copy hosted by UTMB) ·
Which customer request should a pharmacy technician refer to the pharmacist?
Correct answer: D
Recommending an OTC product takes clinical judgment, so it belongs to the pharmacist, especially for young children. FDA does not recommend OTC cough and cold medicines for children younger than 2, and makers label these products 'Do not use in children under 4 years of age.' Store hours, refill status and contact details are routine technician tasks.
- A Store hours are general information a technician can give.
- B Checking refill status is a routine technician task.
- C Updating contact information is routine data entry.
- D Correct: an OTC recommendation, especially for a young child, needs the pharmacist.
Learn this topic: Which situations must a pharmacy technician hand to the pharmacist? 5-minute lesson

Source: PTCB: 2026 Certified Pharmacy Technician Knowledge Reference (PDF) · FDA Consumer Update: Should You Give Kids Medicine for Coughs and Colds? ·
A patient who uses Humulin R U-500 vials asks to buy a box of standard U-100 insulin syringes. Why should the technician bring in the pharmacist?
Correct answer: A
Humulin R U-500 holds 500 units per mL, 5 times as much insulin per mL as U-100. Its label says to measure vial doses only with a U-500 syringe, because a U-100 syringe can give a 5-fold overdose and life-threatening low blood sugar. All insulin is high-alert, and U-500 gets special emphasis on ISMP's acute-care list.
- A Correct: U-500 is 5 times more concentrated than U-100, so a U-100 syringe misreads the dose and can cause a 5-fold overdose.
- B The label calls for a dedicated U-500 syringe, not a tuberculin syringe.
- C The label says not to use U-500 in an insulin pump; it is injected with a U-500 syringe (vials) or the U-500 KwikPen.
- D U-500 is 5 times stronger, not weaker, so the error would be an overdose.
Learn this topic: Which drugs are high-alert, and why are look-alike names dangerous? 5-minute lesson

Source: DailyMed: Humulin R U-500 (insulin human) label · ISMP Medication Safety Alert! Acute Care, Jan 11, 2024: high-alert medication list updated for 2024 (PDF; list on last page) ·
A prescription reads 'insulin glargine 10U subcutaneously at bedtime.' Why is the 'U' error-prone?
Correct answer: D
ISMP and the Joint Commission's Do Not Use list say to write 'units,' never 'U' or 'u.' A handwritten U can look like a 0 or a 4 (4U read as 40) or like 'cc,' leading to 10-fold or larger overdoses. Insulin is already a high-alert drug, so this abbreviation is especially dangerous on insulin orders.
- A ISMP lists 'IU,' not 'U,' as mistaken for IV; the main danger of 'U' is being read as a number.
- B 'UD' (as directed) is the abbreviation misread as unit dose; 'U' is misread as 0 or 4.
- C 'U' does not stand for urine on prescriptions; the danger is a misread number.
- D Correct: 'U' can be read as a 0, turning 10U into 100, a 10-fold overdose.
Learn this topic: Which habits stop medication errors before they reach the patient? 5-minute lesson

Source: ISMP's List of Error-Prone Abbreviations, Symbols, and Dose Designations (2015 PDF) · ECRI/ISMP: List of Error-Prone Abbreviations · The Joint Commission Official "Do Not Use" List (PDF copy hosted by UTMB) ·
About 10 minutes after receiving a flu shot from the pharmacist, a teenager waiting near the counter says she feels lightheaded. What should the technician do first?
Correct answer: B
Fainting (syncope) after vaccination is most common in adolescents and young adults, and a fall can cause serious injuries such as skull fracture. CDC advises that teens and adults be seated or lying down for vaccination, suggests observing patients for 15 minutes afterward, and says a patient who faints should be watched until symptoms resolve. Any post-vaccination symptom needs the pharmacist, because serious allergic reactions also usually start within minutes.
- A Sending her off while symptomatic risks a fall away from help, and the pharmacist has not assessed her.
- B Correct: seating or lying her down prevents a fall injury, and the pharmacist must assess the reaction.
- C Walking a lightheaded patient raises the risk of fainting and falling.
- D Ignoring the symptom skips the pharmacist assessment the situation needs.
Learn this topic: Which situations must a pharmacy technician hand to the pharmacist? 5-minute lesson

Source: CDC: Preventing and Managing Adverse Reactions (General Best Practice Guidelines for Immunization) · PTCB: 2026 Certified Pharmacy Technician Knowledge Reference (PDF) ·
A patient received glipizide instead of the prescribed glyburide. The pharmacy holds a root cause analysis (RCA). Which question best matches the purpose of an RCA?
Correct answer: D
A root cause analysis is a team review that asks what happened, why it happened and how to prevent it from happening again. The VA's patient-safety program describes it as focusing on the how and the why, not the who, and CMS guidance says RCA should focus on systems rather than individual performance. Repeatedly asking why (the five whys) leads to fixable causes such as look-alike names stored side by side.
- A RCA asks how and why the system failed, not who to blame; personnel issues are handled in a separate review.
- B Shifting blame to the patient does not identify the process weaknesses that allowed the wrong drug to be dispensed.
- C Skipping reporting defeats the purpose of RCA, which is to learn from events and close calls to prevent repeats.
- D Correct: RCA digs into how and why the event happened, asking why at each level, to find process and system causes to fix.
Learn this topic: How do pharmacies report errors and adverse events? 5-minute lesson

Source: VA National Center for Patient Safety: Root Cause Analysis · CMS: Guidance for Performing Root Cause Analysis (RCA) with Performance Improvement Projects · FDA: Name Differentiation Project (Tall Man lettering list) ·
A prescription reads: amoxicillin 500 mg capsules, take 1 capsule by mouth three times daily for 10 days. The filled vial holds 20 capsules, and the label directions match the prescription. Which error occurred?
Correct answer: C
Check quantity with dose per administration x doses per day x days: 1 x 3 x 10 = 30 capsules. Twenty capsules would run out on day 7, so the patient could not finish the course. A label can be perfect and the fill still wrong, so the count is checked against the directions.
- A Each dose is still 1 capsule of 500 mg, as prescribed; the count is the problem.
- B Amoxicillin 500 mg capsules are a real product and match the prescription.
- C Correct: 1 capsule x 3 times daily x 10 days = 30 capsules, so 20 is a quantity error.
- D Twenty capsules at 3 a day last only about 6 to 7 days, not 10.
Learn this topic: How do you spot the main types of prescription errors? 5-minute lesson

Source: DailyMed: Amoxicillin tablets, capsules and for oral suspension (label) ·
A hospital pharmacy technician must put on a gown, a mask, goggles and gloves before entering a patient room. Following the CDC sequence for putting on PPE, which item goes on last?
Correct answer: C
CDC's donning order is gown, mask or respirator, goggles or face shield, then gloves. Gloves go last so their cuffs cover the gown's wrists and stay clean while the other items are adjusted. Removal follows a different order that starts with the most contaminated items.
- A The gown goes on first so it can be fully fastened at the neck and waist.
- B The mask goes on second, after the gown.
- C Correct: gloves go on last so they can extend over the wrists of the gown.
- D Goggles or a face shield go on third, before gloves.
Learn this topic: How do pharmacy technicians prevent infection and contamination? 5-minute lesson

Source: CDC: Sequence for Putting On and Removing Personal Protective Equipment (PPE) ·
A handwritten prescription reads: ii gtt AS q.i.d. for 7 days. Which label direction is correct?
Correct answer: C
Decode each part: lower-case Roman numeral ii = 2, gtt = drops, AS = left ear, q.i.d. = four times a day. ISMP lists AD, AS and AU as error-prone because they are mistaken for the eye codes OD, OS and OU, so the label spells out 'left ear'. If an ear or eye code is unclear, the technician flags it for the pharmacist.
- A Left eye is OS; AS (left ear) is easily misread as OS, which is why ISMP lists it as error-prone.
- B Lower-case ii is the Roman numeral 2, not the number 11.
- C Correct: ii = 2, gtt = drops, AS = left ear, q.i.d. = four times a day.
- D Right ear is AD, and q.i.d. means four times a day, not once.
Learn this topic: How to read Sig codes, Roman numerals and medical terms on a prescription 5-minute lesson

Source: Clinical Reference Manual: Clinical Abbreviations & Glossary (Washington University School of Medicine, hosted by Loyola Stritch) · ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations (PDF) · ISMP (ECRI): List of Error-Prone Abbreviations ·
A prescription is written for levothyroxine 0.088 mg. Levothyroxine tablets are labeled in micrograms. Which tablet strength matches the order?
Correct answer: C
Milli means one-thousandth and micro means one-millionth, so 1 mg = 1,000 mcg. To change mg to mcg, multiply by 1,000 (move the decimal point 3 places to the right): 0.088 mg = 88 mcg. Levothyroxine tablets come in microgram strengths such as 75, 88 and 100 mcg.
- A This moves the decimal point the wrong way.
- B This multiplies by 100 instead of 1,000.
- C Correct: 0.088 mg × 1,000 mcg/mg = 88 mcg.
- D This multiplies by 10,000, moving the decimal point one place too far.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson

Source: NIST Office of Weights and Measures: Metric (SI) Prefixes · DailyMed: Levothyroxine sodium tablets (Alvogen) label ·
An insulin label says to store unopened pens in a refrigerator at 2 °C to 8 °C. What is the upper limit, 8 °C, in degrees Fahrenheit?
Correct answer: D
To change Celsius to Fahrenheit, multiply by 1.8 (9/5) and then add 32: °F = (°C × 1.8) + 32. Here 8 × 1.8 = 14.4, and 14.4 + 32 = 46.4 °F. The Lantus label rounds this range to 36 °F to 46 °F.
- A This multiplies by 1.8 but forgets to add 32.
- B This multiplies by 5/9 instead of 9/5 before adding 32.
- C This uses the Fahrenheit-to-Celsius formula, (°F − 32) ÷ 1.8, in the wrong direction.
- D Correct: (8 × 1.8) + 32 = 14.4 + 32 = 46.4 °F.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson

Source: NIST Office of Weights and Measures: SI Units – Temperature · OpenStax Prealgebra 2e, 7.5 Systems of Measurement · DailyMed: Lantus (insulin glargine) injection label ·
A pediatric prescription lists the patient's weight as 18 kg. The profile must also show pounds. Using 1 kg = 2.2 lb, what is the weight in pounds?
Correct answer: A
One kilogram is about 2.2 pounds, so kilograms → pounds means multiply by 2.2 and pounds → kilograms means divide by 2.2. A quick check: the number of pounds is always bigger than the number of kilograms, so 18 kg must be more than 18 lb.
- A Correct: 18 kg × 2.2 lb/kg = 39.6 lb.
- B This divides by 2.2, which converts pounds to kilograms, the opposite direction.
- C This adds 2.2 instead of multiplying by it.
- D This uses 2 lb per kilogram instead of 2.2.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson

Source: OpenStax Prealgebra 2e, 7.5 Systems of Measurement · NIST Guide to the SI (SP 811), Appendix B.8: Factors for Units Listed Alphabetically ·
A prescription written with Roman numerals says Disp: #XLV. How many tablets should be dispensed?
Correct answer: A
Roman numerals add when a numeral is followed by an equal or smaller one, and subtract when a smaller numeral comes before a larger one. XL = 50 − 10 = 40, and V adds 5, so XLV = 45. The key values are I = 1, V = 5, X = 10, L = 50, C = 100, D = 500 and M = 1,000.
- A Correct: XL = 50 − 10 = 40, plus V = 5, so XLV = 45.
- B This drops the X and reads only L + V.
- C This adds the X instead of subtracting it; a smaller numeral before a larger one is subtracted.
- D This writes 40 and 5 side by side instead of adding them.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson

Source: OpenStax Contemporary Mathematics, 4.2 Early Numeration Systems ·
A prescription for a blood pressure tablet reads: 1 tab PO QD. Which label direction is correct?
Correct answer: C
QD means every day, but it is on ISMP's error-prone list and The Joint Commission's 'Do Not Use' list because a misread period or tail can make it look like q.i.d. The correction is to write 'daily'. Pharmacy labels and screens should never carry QD.
- A Four times daily is q.i.d.; misreading QD as q.i.d. is the error ISMP warns about.
- B Every other day is QOD, a different error-prone abbreviation.
- C Correct: QD intends every day, and the label should say 'daily'.
- D Copying QD onto the label repeats an abbreviation that should never be used.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson

Source: ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations (PDF) · ISMP (ECRI): List of Error-Prone Abbreviations · Clinical Reference Manual: Clinical Abbreviations & Glossary (Washington University School of Medicine, hosted by Loyola Stritch) ·
A hospital technician is preparing to draw up a medication supplied in a glass ampule. Which needle should be attached to the syringe to withdraw the drug?
Correct answer: D
Drugs are withdrawn from glass ampules with a blunt fill filter needle: the filter keeps tiny glass fragments out of the syringe and the blunt tip lowers needlestick risk. The filter needle is never used to inject; it is replaced with a needle of the right gauge and length for the route before the dose is given.
- A Drawing up with the injection needle skips the filter, so glass particles from the broken ampule could enter the syringe.
- B Access spikes are made for vials with rubber stoppers, and they do not filter glass from an open ampule.
- C Oral syringes are for doses given by mouth, not for preparing an injection from an ampule.
- D Correct: a blunt fill filter needle traps glass particles while drawing from the ampule and is swapped out before injection.
Learn this topic: Drug administration supplies: syringes, pens, spacers and more 5-minute lesson

Source: Open RN Nursing Skills 2e, 18.2 Basic Concepts (Administration of Parenteral Medications), CC BY 4.0 ·
A vaccine vial is labeled "EXP 11/2026" with no day shown. Through what date may it be used?
Correct answer: C
When an expiration date shows only a month and year, CDC explains that the product may be used through the last day of that month. A vial labeled 11/2026 is good through November 30, 2026, and expires as December 1 begins. If a specific day is printed, the product is good only through the end of that day.
- A October 31 is the month before the labeled month; the product is good through the labeled month.
- B November 11 treats the month number as a day; 11/2026 is a month and year, so the product is good through the end of November.
- C Correct: a month-and-year date means the product may be used through the last day of that month.
- D December 1 is the first day the product is expired, not the last day it may be used.
Learn this topic: How to read an NDC, a lot number and an expiration date 5-minute lesson

Source: CDC: Vaccine Storage and Handling Toolkit (July 2026) ·
A patient brings back an unopened bottle of atorvastatin he picked up last week, saying he no longer needs it. According to FDA's compliance policy, what should happen to the tablets?
Correct answer: B
FDA's Compliance Policy Guide 460.300, a non-binding FDA guidance document, says a pharmacist should not return drugs to stock once they have been out of the pharmacist's possession, because their strength, quality, purity and identity can no longer be assured. Many state boards of pharmacy ban the practice outright. The returned bottle is set aside as non-dispensable and handled by pharmacy policy, and the pharmacist decides the next step.
- A An unopened bottle has still left the pharmacy's control, so its storage and handling cannot be assured.
- B Correct: FDA's compliance policy guidance is that drugs that have been out of the pharmacist's possession are not returned to stock.
- C An in-date lot does not prove the drug was stored properly while it was out of the pharmacy.
- D Re-dispensing a returned drug is the practice FDA's compliance policy warns against.
Learn this topic: Returns: dispensable vs non-dispensable stock and reverse distributors 5-minute lesson

Source: FDA CPG Sec. 460.300 Return of Unused Prescription Drugs to Pharmacy Stock ·

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