Free PTCB Order Entry practice test
22 original Order Entry questions on pharmacy calculations, sig codes and abbreviations, drug administration equipment and supplies, lot numbers, expiration dates and ndc numbers, returns: dispensable, non-dispensable, expired.
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PTCB Order Entry practice test
- 22 questions
- Order Entry
- 31 min in exam mode
- Practice mode, no timer
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Rx: metformin 500 mg tablets. Sig: 1 tab PO b.i.d. with meals. Disp: #60. What days' supply should be entered for this fill?
Correct answer: B
Days' supply = quantity dispensed ÷ quantity the patient uses per day. b.i.d. means twice a day, so the patient uses 2 tablets daily and 60 ÷ 2 = 30 days. CMS billing guidance uses this divide-by-daily-doses method and warns that a wrong days' supply can cause claim rejections.
- A Dividing by 4 treats b.i.d. (twice a day) as q.i.d. (four times a day).
- B Correct: 60 tablets ÷ 2 tablets a day = 30 days.
- C This counts each tablet as one day and ignores the twice-a-day frequency.
- D This multiplies the quantity by the doses per day instead of dividing.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson
Source: CMS Medicaid Program Integrity, Pharmacy Auditing and Dispensing Job Aid: Billing Oral Products · Clinical Reference Manual: Clinical Abbreviations & Glossary (Washington University School of Medicine, hosted by Loyola Stritch) · DailyMed: Metformin hydrochloride tablets (Laurus Labs) label ·
Rx for a child: amoxicillin for oral suspension 400 mg/5 mL. Sig: 400 mg PO q12h for 10 days. How many mL must be dispensed to complete the course?
Correct answer: C
First find the volume of one dose with a proportion: 400 mg/5 mL = 400 mg/x, so x = 5 mL. Next count doses per day: q12h is every 12 hours, so 2 doses in 24 hours. Quantity = 5 mL × 2 × 10 days = 100 mL.
- A This gives one dose a day; q12h means every 12 hours, which is 2 doses in 24 hours.
- B 80 is the concentration in mg per mL (400 ÷ 5), not a volume to dispense.
- C Correct: each 400 mg dose is 5 mL; 5 mL × 2 doses a day × 10 days = 100 mL.
- D This uses 4 doses a day, which would be q6h, not q12h.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson
Source: DailyMed: Amoxicillin capsules, tablets and for oral suspension label · OpenStax Prealgebra 2e, 6.5 Solve Proportions and their Applications · Clinical Reference Manual: Clinical Abbreviations & Glossary (Washington University School of Medicine, hosted by Loyola Stritch) ·
A child weighs 44 lb. The prescriber orders cephalexin 50 mg/kg/day divided q6h. The pharmacy stocks cephalexin for oral suspension 250 mg/5 mL. Using 1 kg = 2.2 lb, how many mL are in each dose?
Correct answer: B
Weight-based doses use kilograms, so convert first: 44 lb ÷ 2.2 lb/kg = 20 kg. The daily dose is 20 kg × 50 mg/kg = 1,000 mg, and q6h means every 6 hours, or 4 doses a day, so each dose is 250 mg. With 250 mg in 5 mL, each dose is 5 mL.
- A This splits the daily dose into 6 doses; q6h means every 6 hours, which is 4 doses a day.
- B Correct: 44 lb ÷ 2.2 = 20 kg; 20 kg × 50 mg = 1,000 mg a day; ÷ 4 doses = 250 mg, which is 5 mL.
- C This skips the pound-to-kilogram step and multiplies 44 by 50 mg.
- D This is the whole day's 1,000 mg given as a single dose instead of dividing it by 4.
Learn this topic: How to work out days' supply, quantity, dose volume and conversions 5-minute lesson
Source: DailyMed: Cephalexin for oral suspension (Teva) label · OpenStax Prealgebra 2e, 7.5 Systems of Measurement · NIST Guide to the SI (SP 811), Appendix B.8: Factors for Units Listed Alphabetically ·
On a prescription, what does the Sig code b.i.d. mean?
Correct answer: D
b.i.d. is short for the Latin bis in die, meaning twice a day. Its relatives are t.i.d. (three times a day) and q.i.d. (four times a day). A q followed by a number of hours, such as q2h, means every that many hours.
- A Every 2 hours would be written q2h.
- B Every other day is the error-prone QOD, which should be written out.
- C At bedtime is the error-prone hs, which should be written out.
- D Correct: b.i.d. comes from the Latin bis in die, twice a day.
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) · MedlinePlus: Appendix B: Some Common Abbreviations ·
Which label direction correctly translates the Sig: 1 tab PO q6h prn pain?
Correct answer: A
Translate each part: tab = tablet, PO (per os) = by mouth, q6h = every 6 hours, prn (pro re nata) = as needed. Every 6 hours allows up to 4 doses in 24 hours. The label should use plain words, never the abbreviations.
- A Correct: PO is by mouth, q6h is every 6 hours, and prn is as needed.
- B q6h is every 6 hours, which is 4 doses in 24 hours, not 6.
- C Under the tongue is SL (sublingual), not PO.
- D prn means as needed, so scheduled around-the-clock dosing is wrong.
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) · MedlinePlus: Appendix B: Some Common Abbreviations ·
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 patient's prescription calls for 35 units of U-100 insulin per injection, drawn from a vial. The pharmacy stocks U-100 insulin syringes in 0.3 mL, 0.5 mL and 1 mL sizes. What is the smallest syringe that holds the full 35-unit dose in a single injection?
Correct answer: B
U-100 insulin contains 100 units in each mL, so a U-100 insulin syringe holds 100 units per mL of barrel: 0.3 mL holds 30 units, 0.5 mL holds 50 units and 1 mL holds 100 units. A 35-unit dose (0.35 mL) overfills a 0.3 mL syringe, so the 0.5 mL syringe is the smallest that fits. Insulin is measured with syringes marked in units, never with a syringe marked only in mL.
- A A 0.3 mL U-100 syringe holds only 30 units, so 35 units would not fit in one draw.
- B Correct: 35 units of U-100 insulin is 0.35 mL, and the 0.5 mL syringe (50 units) is the smallest size that holds it.
- C A 1 mL syringe holds the dose, but it is not the smallest size that does, and smaller barrels are easier to read for small doses.
- D A tuberculin syringe is marked in mL, not units; insulin syringes marked in units are used to measure insulin.
Learn this topic: Drug administration supplies: syringes, pens, spacers and more 5-minute lesson
Source: DailyMed: LANTUS (insulin glargine) injection label (Sanofi) · Open RN Nursing Skills 2e, 18.2 Basic Concepts (Administration of Parenteral Medications), CC BY 4.0 ·
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 LANTUS SoloStar pen contains 300 units of insulin glargine. Its instructions call for a 2-unit safety test before every injection. A patient injects 22 units once daily. How many full 22-unit doses can the patient get from one pen?
Correct answer: B
Each injection uses the dose plus the safety test: 22 + 2 = 24 units. Dividing 300 units by 24 units gives 12.5, so the pen delivers 12 full doses; the leftover cannot make a full 13th dose. Supply math for insulin pens must include the priming or safety-test units the labeling requires.
- A 11 comes from counting 4 units of priming per injection (300 / 26 = 11.5), which is more than the labeled 2-unit safety test.
- B Correct: 300 units / (22 + 2) units per injection = 12.5, so 12 full doses.
- C 13 comes from ignoring the safety test (300 / 22 = 13.6) or from rounding 12.5 up; a partial dose is not a full dose.
- D 15 comes from subtracting the safety test instead of adding it (300 / 20 = 15).
Learn this topic: Drug administration supplies: syringes, pens, spacers and more 5-minute lesson
Source: DailyMed: LANTUS (insulin glargine) injection label (Sanofi) ·
In the NDC 0173-0682-20 printed on a VENTOLIN HFA carton, what does the middle segment, 0682, identify?
Correct answer: D
An NDC has three segments: labeler code, product code and package code (21 CFR 207.33). The middle segment is the product code, which changes when the drug, its strength, dosage form or similar product details change. In 0173-0682-20, 0173 is the labeler, 0682 is the product and 20 is the package.
- A The labeler is the first segment, 0173, which FDA assigns to the firm.
- B Package size and type are identified by the last segment, 20.
- C The lot number is printed separately on the label; it is not part of the NDC.
- D Correct: the middle segment is the product code, which identifies the specific drug, strength and dosage form.
Learn this topic: How to read an NDC, a lot number and an expiration date 5-minute lesson
Source: eCFR: 21 CFR 207.33 What is the National Drug Code (NDC), how is it assigned, and what are its requirements? · eCFR: 21 CFR 207.35 What changes require a new NDC? · DailyMed: VENTOLIN HFA (albuterol sulfate) inhalation aerosol label (GlaxoSmithKline) ·
VENTOLIN HFA is listed as NDC 0173-0682-20 (18 g canister, 200 actuations) and NDC 0173-0682-24 (8 g canister, 60 actuations). What does the difference in the last segment tell you?
Correct answer: C
The last NDC segment is the package code, which identifies the package size and type. Both NDCs share the labeler code (0173) and product code (0682), so they are the same albuterol product in different canister sizes. A change only in package size or type calls for a new package code, not a new product code (21 CFR 207.35).
- A The labeler code (0173) is identical in both NDCs.
- B Strength is tied to the product code, and 0682 is the same in both.
- C Correct: only the package code differs, so this is one product in two package sizes.
- D Lot numbers are not part of the NDC; a new lot does not change the NDC.
Learn this topic: How to read an NDC, a lot number and an expiration date 5-minute lesson
Source: eCFR: 21 CFR 207.33 What is the National Drug Code (NDC), how is it assigned, and what are its requirements? · eCFR: 21 CFR 207.35 What changes require a new NDC? · DailyMed: VENTOLIN HFA (albuterol sulfate) inhalation aerosol label (GlaxoSmithKline) ·
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) ·
What does a reverse distributor do for a pharmacy?
Correct answer: D
A reverse distributor receives prescription drugs a pharmacy cannot use, such as expired or unwanted stock, to process or verify manufacturer credit and arrange destruction (40 CFR 266.500). For controlled substances the reverse distributor must be registered with DEA, and stock reaches it by pick-up or by carrier delivery to its registered location (21 CFR 1317.15).
- A Delivering new stock is the job of a wholesaler (forward distributor), not a reverse distributor.
- B DEA and FDA inspect; a reverse distributor is a business that handles returns.
- C Repackaging is done by repackagers; reverse distributors handle products leaving the pharmacy.
- D Correct: reverse distributors take back unusable stock to process manufacturer credit and arrange its destruction.
Learn this topic: Returns: dispensable vs non-dispensable stock and reverse distributors 5-minute lesson
Source: eCFR: 40 CFR 266.500 Definitions for subpart P (potentially creditable, reverse distributor) · eCFR: 21 CFR 1317.15 Reverse distributor registration requirements and authorized activities ·
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 ·
A pharmacy is sending expired oxycodone tablets (Schedule II) to a DEA-registered reverse distributor. Under federal law, what document is required for this transfer?
Correct answer: C
Every distribution of a Schedule I or II controlled substance needs a DEA Form 222 or its electronic equivalent, and transfer to a reverse distributor is not one of the exceptions (21 CFR 1305.03). The reverse distributor, as the receiving registrant, issues the order form to the pharmacy. The registrant that destroys the drugs records it on DEA Form 41; Form 106 is for theft or significant loss.
- A Form 41 records destruction by the registrant that destroys the drug; here the reverse distributor will destroy it.
- B Form 106 reports theft or significant loss of controlled substances, not transfers.
- C Correct: transferring Schedule II drugs requires a DEA Form 222 or its electronic (CSOS) equivalent.
- D An invoice-type record is enough for Schedule III-V, but Schedule II transfers require Form 222.
Learn this topic: Returns: dispensable vs non-dispensable stock and reverse distributors 5-minute lesson
Source: eCFR: 21 CFR 1305.03 Distributions requiring a Form 222 or a digitally signed electronic order · eCFR: 21 CFR 1305.12 Procedure for executing DEA Forms 222 · eCFR: 21 CFR 1317.05 Registrant disposal · eCFR: 21 CFR 1304.21 General requirements for continuing records (record of destruction, DEA Form 41) · eCFR: 21 CFR 1301.76 Other security controls (theft or loss, DEA Form 106) ·
A patient picking up an ADVAIR DISKUS asks for a spacer like the one her son uses with his albuterol HFA inhaler. Which statement is correct?
Correct answer: D
A spacer is a tube that fits on the mouthpiece of a metered-dose inhaler (MDI); a valved holding chamber is a spacer with a one-way valve. The ADVAIR DISKUS is a dry powder inhaler, and its patient instructions say not to use it with a spacer device. Questions about how the patient should take the medicine go to the pharmacist.
- A Spacers are designed for MDIs; the Diskus labeling specifically says not to use a spacer with it.
- B Spacers are used with metered-dose inhalers such as albuterol HFA, not with nebulizers.
- C Valved holding chambers with masks are used with MDIs for children and others who need them, not with the Diskus.
- D Correct: spacers and valved holding chambers are made for MDIs, and the Diskus instructions say not to use a spacer.
Learn this topic: Drug administration supplies: syringes, pens, spacers and more 5-minute lesson
Source: AAAAI: Spacers and Valved Holding Chambers (VHCs) for Use with Metered Dose Inhalers (MDIs) · DailyMed: ADVAIR DISKUS (fluticasone propionate and salmeterol) label (GlaxoSmithKline) ·
A billing system requires NDCs in the 11-digit (5-4-2) HIPAA format. Which is the correct conversion of the 10-digit NDC 0173-0682-20?
Correct answer: A
The HIPAA standard 11-digit NDC always has a 5-digit labeler code, a 4-digit product code and a 2-digit package code. To convert a 10-digit NDC, add a leading zero to the segment that is short. 0173-0682-20 is a 4-4-2 NDC, so the zero goes in front of the labeler code: 00173-0682-20.
- A Correct: the 4-digit labeler code gets a leading zero to make the 5-4-2 layout.
- B Adding the zero after the labeler digits changes the labeler code itself; padding zeros go in front.
- C The product code is already 4 digits; the short segment here is the labeler code.
- D The package code is already 2 digits; a 5-4-2 layout never has a 3-digit package code.
Learn this topic: How to read an NDC, a lot number and an expiration date 5-minute lesson
Source: Federal Register (Mar. 5, 2026): Revising the National Drug Code Format and Drug Label Barcode Requirements (final rule) · eCFR: 21 CFR 207.33 What is the National Drug Code (NDC), how is it assigned, and what are its requirements? · DailyMed: VENTOLIN HFA (albuterol sulfate) inhalation aerosol label (GlaxoSmithKline) ·
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| Domain | Share of the exam | About this many scored questions |
|---|---|---|
| Medications | 35% | 28 |
| Federal Requirements | 18.75% | 15 |
| Patient Safety and Quality Assurance | 23.75% | 19 |
| Order Entry and Processing | 22.5% | 18 |
The PTCE has 90 multiple-choice questions (80 scored) in 110 minutes. The question counts are our arithmetic; PTCB publishes only the shares.
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