Free PTCB practice test

Correct answer: B

Lipitor is the brand name for atorvastatin calcium, an HMG-CoA reductase inhibitor (statin). Simvastatin (Zocor) and rosuvastatin (Crestor) are other statins, so the shared "-vastatin" ending tells you the class but not the exact drug. Learn each brand with its own generic name.

• A Simvastatin is a statin too, but its brand name is Zocor, not Lipitor.
• B Correct: the Lipitor label lists atorvastatin calcium as the active ingredient.
• C Rosuvastatin is the statin sold as Crestor, so it is a same-class mix-up.
• D Lisinopril is an ACE inhibitor (Zestril); it is not a statin and has no link to Lipitor.

Learn this topic: Brand names, generic names and drug classes: how to match them fast 5-minute lesson

Source: DailyMed: LIPITOR (atorvastatin calcium) tablets, label · DailyMed: ZOCOR (simvastatin) tablets, label · DailyMed: CRESTOR (rosuvastatin) tablets, label · Report a problem with this question

Correct answer: C

The Cozaar label calls losartan an angiotensin II receptor blocker (ARB). The WHO naming stem "-sartan" marks angiotensin II receptor antagonists, so valsartan (Diovan) belongs to the same class. ACE inhibitors end in "-pril" instead.

• A ACE inhibitors such as lisinopril end in "-pril"; losartan blocks the angiotensin II receptor instead.
• B Beta blockers usually end in "-olol" (for example, metoprolol), not "-sartan".
• C Correct: the Cozaar label states that losartan is an angiotensin II receptor blocker (ARB).
• D Calcium channel blockers such as amlodipine end in "-dipine", not "-sartan".

Learn this topic: Brand names, generic names and drug classes: how to match them fast 5-minute lesson

Source: DailyMed: COZAAR (losartan potassium) tablets, label · WHO: The use of stems in the selection of International Nonproprietary Names (INN), 2018 · DailyMed: DIOVAN (valsartan) tablets, label · Report a problem with this question

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 · Report a problem with this question

Correct answer: D

Norvasc is amlodipine, and its label calls it a calcium channel blocker. Toprol-XL (metoprolol succinate) is a beta-adrenergic blocker, Zestril (lisinopril) is an ACE inhibitor, and Plavix (clopidogrel) is a P2Y12 platelet inhibitor. On brand–generic–class items, check all three parts, because a distractor often gets two right and one wrong.

• A The brand and generic match, but metoprolol is a beta-adrenergic blocker, not an ACE inhibitor.
• B The brand and generic match, but lisinopril is an ACE inhibitor; ARBs end in "-sartan".
• C The brand and generic match, but clopidogrel is a P2Y12 platelet inhibitor; apixaban and rivaroxaban are factor Xa inhibitors.
• D Correct: the Norvasc label identifies amlodipine as a calcium channel blocker.

Learn this topic: Brand names, generic names and drug classes: how to match them fast 5-minute lesson

Source: DailyMed: NORVASC (amlodipine besylate) tablets, label · DailyMed: TOPROL-XL (metoprolol succinate) extended-release tablets, label · DailyMed: ZESTRIL (lisinopril) tablets, label · DailyMed: PLAVIX (clopidogrel) tablets, label · Report a problem with this question

Correct answer: D

Federal Medicaid drug-review rules define therapeutic duplication as prescribing and dispensing two or more drugs from the same therapeutic class so that the combined dose risks harm or adds cost without added benefit. The same rule lists drug–drug interactions, drug–disease contraindications and incorrect dosage as separate problems. Pharmacy software screens for all of them before a prescription is filled.

• A This describes a drug–drug interaction, a separate drug-review problem.
• B This describes a drug–disease contraindication, not a duplication.
• C This describes an incorrect drug dosage, a separate drug-review problem.
• D Correct: same-class drugs taken together are the definition of therapeutic duplication.

Learn this topic: Therapeutic duplication: when two prescriptions do the same job 5-minute lesson

Source: eCFR: 42 CFR 456.705 Prospective drug review · Report a problem with this question

Correct answer: A

Omeprazole (Prilosec) and pantoprazole (Protonix) are both proton pump inhibitors (PPIs), so taking them together is a same-class duplication. Prescriptions from different prescribers are a common way duplications reach the pharmacy. The technician lets the pharmacist review the alert rather than filling both.

• A Correct: both drugs are proton pump inhibitors, so this is a same-class duplication.
• B No allergy is described; the problem is two drugs from one class.
• C No disease affected by the drug is described; the issue is two PPIs.
• D Nothing suggests the length of therapy is wrong; the problem is two drugs from one class.

Learn this topic: Therapeutic duplication: when two prescriptions do the same job 5-minute lesson

Source: DailyMed: PRILOSEC (omeprazole magnesium) delayed-release oral suspension, label · DailyMed: PROTONIX (pantoprazole sodium) delayed-release tablets and oral suspension, label · eCFR: 42 CFR 456.705 Prospective drug review · Report a problem with this question

Correct answer: B

Percocet and Tylenol both contain acetaminophen, and the Tylenol Drug Facts label says not to use it with any other acetaminophen-containing drug, prescription or nonprescription. The same label warns that severe liver damage may occur above 4,000 mg in 24 hours, and the FDA notes that using more than one acetaminophen product at a time can lead to taking too much. Spotting the overlap is the technician's job; advising the patient is the pharmacist's.

• A The Tylenol label says not to combine it with any other acetaminophen product, prescription or nonprescription.
• B Correct: duplicate acetaminophen is a pharmacist issue, and the technician should flag it.
• C Dosing advice is counseling, which belongs to the pharmacist; timing does not remove the overlap.
• D Recommending a different OTC product is a pharmacist task, outside technician scope.

Learn this topic: Therapeutic duplication: when two prescriptions do the same job 5-minute lesson

Source: DailyMed: PERCOCET (oxycodone hydrochloride and acetaminophen) tablets, label · DailyMed: TYLENOL EXTRA STRENGTH (acetaminophen) caplets, Drug Facts · FDA: Acetaminophen (drug class information) · PTCB: PTCE Content Outline (effective January 6, 2026) · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

Correct answer: D

The Synthroid label says calcium carbonate and ferrous sulfate can bind levothyroxine and reduce its absorption, which can bring back hypothyroidism. It tells patients to take Synthroid at least 4 hours apart from these products. This is a drug–supplement interaction that the pharmacist explains to the patient.

• A Calcium binds levothyroxine and lowers absorption, so taking them together is the problem.
• B The label manages this by spacing the doses; it does not contraindicate calcium.
• C Thirty minutes is too short; the label requires at least 4 hours.
• D Correct: the label says to give Synthroid at least 4 hours apart from calcium carbonate.

Learn this topic: Drug interactions and contraindications: the five types and the big ones 6-minute lesson

Source: DailyMed: SYNTHROID (levothyroxine sodium) tablets, label · Report a problem with this question

Correct answer: C

Warfarin is a vitamin K antagonist, and green leafy vegetables are rich in vitamin K. The warfarin label lists increased vitamin K intake as a cause of a decreased INR response and tells patients to keep a consistent amount of vitamin K and avoid drastic diet changes. Eating much less vitamin K would push the INR the other way.

• A A consistent, balanced diet is what the label recommends to keep the INR stable.
• B Eating less vitamin K tends to raise the INR response, not lower it.
• C Correct: a sudden rise in vitamin K intake can decrease warfarin's effect.
• D Water intake is not a vitamin K source and is not listed as affecting the INR.

Learn this topic: Drug interactions and contraindications: the five types and the big ones 6-minute lesson

Source: DailyMed: JANTOVEN (warfarin sodium) tablets, label · Report a problem with this question

Correct answer: B

The Flagyl label warns that oral metronidazole can cause a disulfiram-like reaction with alcohol: abdominal cramps, nausea, vomiting, headache and flushing. It says to stop alcohol, and products containing propylene glycol, during therapy and for at least three days afterward. The technician brings the patient's question to the pharmacist for counseling.

• A The label says to avoid alcohol for the whole course of therapy and for at least 3 days after, not just before the first dose.
• B Correct: the label says to avoid alcohol during and for at least 3 days after therapy.
• C The alcohol warning applies to oral metronidazole, including these capsules.
• D Alcohol causes a disulfiram-like reaction; it does not speed up the drug.

Learn this topic: Drug interactions and contraindications: the five types and the big ones 6-minute lesson

Source: DailyMed: FLAGYL (metronidazole) capsules, label · Report a problem with this question

Correct answer: C

Nitrostat is a sublingual tablet: at the onset of an attack one tablet goes under the tongue or in the buccal pouch and is allowed to dissolve without swallowing. One more tablet may be used every 5 minutes, but the label recommends no more than 3 tablets within 15 minutes. Strengths are 0.3 mg, 0.4 mg and 0.6 mg.

• A Swallowing the tablet is the wrong route; the label directs the patient to let it dissolve without swallowing.
• B Chewing and swallowing treats it like an ordinary oral tablet, but Nitrostat is a sublingual dosage form.
• C Correct: Nitrostat is a sublingual tablet placed under the tongue or in the buccal pouch and allowed to dissolve without swallowing.
• D Nitrostat is not a tablet for oral solution; the label says to place it under the tongue or in the buccal pouch.

Learn this topic: How strength, dosage form and label directions tell a patient how to take a drug 5-minute lesson

Source: DailyMed: NITROSTAT (nitroglycerin) sublingual tablets, Viatris label · Report a problem with this question

Correct answer: B

Volume per dose = dose ÷ concentration: 600 mg ÷ (400 mg/5 mL) = 600 x 5 ÷ 400 = 7.5 mL. Always check whether the concentration is stated per 1 mL or per 5 mL. Amoxicillin for oral suspension is labeled in 125, 200, 250 and 400 mg/5 mL strengths, so reading the strength on the bottle is part of the calculation.

• A This inverts the ratio (400 mg / 600 mg x 5 mL) instead of dividing the dose by the concentration.
• B Correct: 600 mg x (5 mL / 400 mg) = 7.5 mL per dose.
• C This is the total for both daily doses (7.5 mL x 2), not the volume of one dose.
• D This divides 600 by 400 but forgets that the concentration is per 5 mL, not per 1 mL.

Learn this topic: How strength, dosage form and label directions tell a patient how to take a drug 5-minute lesson

Source: DailyMed: Amoxicillin capsules, tablets, chewable tablets and for oral suspension label · Report a problem with this question

Correct answer: D

Most extended-release and many specialty capsules must be swallowed whole: tamsulosin capsules are not to be crushed, chewed or opened, Pradaxa capsules are swallowed whole, and Procardia XL tablets are not chewed, divided or crushed. Omeprazole delayed-release capsules are an exception the label spells out: open the capsule, sprinkle the pellets on a tablespoon of soft applesauce that is not hot and swallow at once without chewing the pellets.

• A The tamsulosin label says the capsules should not be crushed, chewed or opened.
• B The Pradaxa label says to swallow capsules whole, because breaking, chewing or emptying them can increase drug exposure.
• C The Procardia XL label says to swallow the tablets whole and not chew, divide or crush them.
• D Correct: the omeprazole delayed-release capsule label lets patients open the capsule, empty the pellets onto a tablespoon of applesauce and swallow right away without chewing.

Learn this topic: How strength, dosage form and label directions tell a patient how to take a drug 5-minute lesson

Source: DailyMed: Omeprazole delayed-release capsules label · DailyMed: Tamsulosin hydrochloride capsules label · DailyMed: PRADAXA (dabigatran etexilate) capsules, Boehringer Ingelheim label · DailyMed: PROCARDIA XL (nifedipine) extended-release tablets, Pfizer label · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

Correct answer: B

Levothyroxine is L-thyroxine (T4) and is indicated as replacement therapy for hypothyroidism. Its boxed warning says thyroid hormones must not be used to treat obesity or for weight loss. Knowing the condition a drug treats lets the technician spot a mismatch between a drug and the diagnosis on an order.

• A Hyperthyroidism means too much thyroid hormone; adding levothyroxine would not treat it.
• B Correct: Synthroid is indicated as replacement therapy in congenital or acquired hypothyroidism.
• C Type 2 diabetes is treated with drugs such as metformin, not thyroid hormone.
• D The boxed warning says thyroid hormones should not be used for obesity or weight loss.

Learn this topic: How to match a medication to the condition it is indicated for 5-minute lesson

Source: DailyMed: SYNTHROID (levothyroxine sodium) tablets, AbbVie label · DailyMed: Metformin hydrochloride tablets label · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

Correct answer: B

Each reconstituted suspension has its own storage condition and discard period, printed in sections 2 and 16 of its label. Amoxicillin-clavulanate potassium suspension is refrigerated and discarded after 10 days, while plain amoxicillin suspension is kept 14 days. The technician writes the storage instruction and the discard date on the bottle when mixing it.

• A Room temperature and 14 days do not match this label, which calls for refrigeration and a 10-day limit.
• B Correct: the label says to store the reconstituted suspension under refrigeration and discard unused suspension after 10 days.
• C Refrigeration is right, but 14 days is the limit for plain amoxicillin or cephalexin suspension, not amoxicillin-clavulanate.
• D Reconstituted oral antibiotic suspensions are not frozen; no such instruction appears on the label.

Learn this topic: Drug stability: how long mixed, opened and in-use products last 5-minute lesson

Source: DailyMed: Amoxicillin and clavulanate potassium for oral suspension (USAntibiotics) label, sections 2 and 16 · DailyMed: Amoxicillin for oral suspension (USAntibiotics) label, sections 2 and 16 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

Correct answer: C

Under 21 CFR 1301.75(b), Schedule II–V controlled substances are stored in a securely locked, substantially constructed cabinet, but pharmacies and institutional practitioners may instead disperse them throughout the noncontrolled stock in a way that obstructs theft or diversion. The dispersal option covers Schedule II drugs too. Some states set stricter rules, but this item asks only about federal law.

• A The Class V safe requirement in 1301.75(e) applies only to a few substances such as carfentanil and etorphine, not to Schedule II drugs in general.
• B The rule lets pharmacies, not only hospitals or other institutional practitioners, disperse controlled substances in stock.
• C Correct: 1301.75(b) lets pharmacies disperse Schedule II–V drugs throughout the noncontrolled stock in a manner that obstructs theft or diversion.
• D The federal dispersal option covers Schedules II, III, IV and V alike; Schedule II is not excluded.

Learn this topic: Medication storage: temperature ranges, light protection and restricted access 5-minute lesson

Source: eCFR 21 CFR 1301.75 Physical security controls for practitioners · Report a problem with this question

Correct answer: D

Once a multiple-dose vial is opened, CDC says to date it and discard it within 28 days, unless the manufacturer states a different date for the opened vial. The beyond-use date can never be later than the manufacturer's original expiration date. Single-dose vials are for one patient only.

• A 24 hours is not the CDC rule for an opened multiple-dose vial.
• B Discarding at the end of a shift is not the CDC rule for an opened multiple-dose vial.
• C The printed expiration date applies to the unopened vial; once opened, a shorter beyond-use date applies.
• D Correct: CDC says an opened (needle-punctured) multiple-dose vial is dated and discarded within 28 days unless the manufacturer states another date.

Learn this topic: Drug stability: how long mixed, opened and in-use products last 5-minute lesson

Source: CDC Injection Safety: Clinical Safety (single-dose and multiple-dose vials) · Report a problem with this question

Correct answer: A

Xalatan has two storage stages: unopened bottles are refrigerated at 2°C to 8°C (36°F to 46°F), and an opened bottle may be kept at room temperature up to 25°C (77°F) for 6 weeks. It is protected from light throughout. Pharmacy stock is unopened, so it goes in the refrigerator.

• A Correct: the label says to protect from light and store unopened bottles under refrigeration at 2°C to 8°C (36°F to 46°F).
• B Room temperature up to 77°F (25°C) is allowed only after a bottle is opened, and only for 6 weeks.
• C Xalatan is refrigerated, not frozen.
• D Unopened bottles need refrigeration, and the label says to protect the product from light.

Learn this topic: Medication storage: temperature ranges, light protection and restricted access 5-minute lesson

Source: DailyMed: Xalatan (latanoprost) ophthalmic solution label, section 16 Storage · Report a problem with this question

Correct answer: B

Subpart P requires every container of non-creditable hazardous waste pharmaceuticals at a healthcare facility (pharmacies included) to be labeled "Hazardous Waste Pharmaceuticals." The containers must also be structurally sound, kept closed and secured against unauthorized access. Non-creditable means the drug has no reasonable expectation of manufacturer credit (for example, residues, contaminated PPE or spill clean-up).

• A Biohazard labeling belongs to infectious medical waste, not to the hazardous waste pharmaceutical containers that subpart P covers.
• B Correct: 40 CFR 266.502(e) requires each container of non-creditable hazardous waste pharmaceuticals to be labeled or clearly marked with this exact phrase.
• C Controlled substance destruction follows DEA rules; this phrase is not the EPA label required for hazardous waste pharmaceutical containers.
• D Non-creditable waste has no reasonable expectation of manufacturer credit, so it is not return-to-supplier stock and this is not the required label.

Learn this topic: Pharmaceutical waste: P-listed drugs, the sewer ban and safe disposal 5-minute lesson

Source: eCFR: 40 CFR 266.502 Standards for healthcare facilities managing non-creditable hazardous waste pharmaceuticals · eCFR: 40 CFR 266.500 Definitions for this subpart · Report a problem with this question

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 · Report a problem with this question

Correct answer: A

For a theft or significant loss of controlled substances, a pharmacy must notify its DEA Field Division Office in writing within one business day of discovery and then file a complete, accurate DEA Form 106 (online) within 45 days. The clock starts at discovery, not at the date of the theft. Losses in transit from a supplier are reported by the supplier.

• A Correct: 21 CFR 1301.76(b) requires written notice to the DEA Field Division Office within 1 business day of discovery and a complete DEA Form 106 within 45 days.
• B DEA Form 41 records destruction, not theft, and the deadlines are reversed.
• C Two steps are required: a written notice within 1 business day and a complete Form 106 within 45 days.
• D Thefts and significant losses must be reported when they are discovered, not saved for the inventory.

Learn this topic: Controlled substances from order to destruction: DEA Forms 222, 106 and 41 6-minute lesson

Source: eCFR: 21 CFR 1301.76 Other security controls for practitioners · eCFR: 21 CFR 1301.74 Other security controls for non-practitioners · DEA Diversion Control Division: Theft/Loss Reporting · Report a problem with this question

Correct answer: B

At a collection receptacle, the ultimate user (or another authorized non-registrant) puts the drugs in personally. Under 21 CFR 1317.75(c), the collector must not let the customer hand the drugs to any person, and once deposited they are not counted, sorted or inventoried. Receptacles take Schedule II-V controlled substances (and non-controlled drugs if the collector chooses), never Schedule I or illicit drugs.

• A Collected drugs may not be counted, sorted or inventoried, and staff may not take them from the customer.
• B Correct: only the ultimate user may deposit the drugs; the collector may not let the customer transfer them to anyone, including staff.
• C A patient's dispensed drugs may not enter the pharmacy's own inventory, and staff may not accept them by hand.
• D The pharmacy may not take possession of the customer's drugs, and wholesaler returns are for the pharmacy's own stock.

Learn this topic: Controlled substances from order to destruction: DEA Forms 222, 106 and 41 6-minute lesson

Source: eCFR: 21 CFR 1317.75 Collection receptacles · eCFR: 21 CFR 1317.30 Authorization to collect from non-registrants · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

Correct answer: B

Under the Combat Methamphetamine Epidemic Act (21 CFR 1314.20), a regulated seller such as a pharmacy may not sell one purchaser more than 3.6 grams of pseudoephedrine, ephedrine or phenylpropanolamine base in a calendar day, regardless of the number of transactions. Separately, a purchaser may not buy more than 9 grams of base in a 30-day period, and mobile retail vendors and mail-order sellers are held to 7.5 grams per 30 days. All limits are counted in grams of base, not grams of salt or number of boxes.

• A 1.8 grams is half the daily limit; it is not a federal threshold.
• B Correct: a regulated seller may not sell more than 3.6 grams of pseudoephedrine base to one purchaser in a calendar day, however many transactions there are.
• C 7.5 grams is the 30-day limit for mobile retail vendors and mail-order sellers, not the daily limit.
• D 9 grams is the purchaser's 30-day buying limit, not the daily sales 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) · Report a problem with this question

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) · Report a problem with this question

Correct answer: A

The iPLEDGE REMS requires the pharmacy to get an authorization from the REMS before each isotretinoin fill and forbids dispensing after the date the REMS provides. For a patient who can get pregnant who misses this window, the prescriber must repeat the pregnancy test and report it before a new authorization can be issued. The pharmacy reverses the expired authorization and returns the drug to inventory.

• A Correct: the pharmacy may not dispense after the date the REMS provides; a patient who misses the window needs a repeat pregnancy test through the prescriber.
• B Certification of the prescriber and pharmacy is necessary but does not override the dispensing deadline set by the REMS.
• C The REMS has no partial-fill workaround; dispensing after the REMS date is not allowed at all.
• D Pharmacist counseling cannot replace the missing pregnancy test and a valid REMS authorization.

Learn this topic: How federal law restricts pseudoephedrine sales and REMS drugs 5-minute lesson

Source: REMS@FDA: Isotretinoin iPLEDGE Shared System REMS · FDA: What's in a REMS? · Report a problem with this question

Correct answer: C

FDA assigns every recall a class based on the health hazard. Class I means a reasonable probability of serious adverse health consequences or death; Class II means temporary or medically reversible problems, or a remote chance of serious harm; Class III means harm is not likely. The Roman numeral rises as the danger falls.

• A This describes a Class III recall, the least serious class.
• B This describes a Class II recall.
• C Correct: Class I is the most serious class, with a reasonable probability of serious adverse health consequences or death.
• D This describes a market withdrawal, which is not a recall.

Learn this topic: How FDA drug recalls work and what the pharmacy does 4-minute lesson

Source: FDA: Recalls Background and Definitions · eCFR 21 CFR Part 7, Subpart C: Recalls (Including Product Corrections) · Report a problem with this question

Correct answer: D

Recall class follows the degree of hazard: Class I (serious harm or death is reasonably probable), Class II (temporary or reversible harm possible, serious harm remote) and Class III (harm not likely). FDA gives minor labeling errors, defective packaging and incorrect expiration dates as examples of Class III drug recalls. Class III recalls are generally carried out at the wholesale level.

• A Labeling errors can lead to recalls; FDA lists minor labeling errors as an example of a Class III recall.
• B Class I requires a reasonable probability of serious harm or death, which this error does not carry.
• C Class II involves possible temporary or medically reversible harm; this error is not likely to cause harm at all.
• D Correct: a recall in which use of the product is not likely to cause adverse health consequences is Class III.

Learn this topic: How FDA drug recalls work and what the pharmacy does 4-minute lesson

Source: FDA: Understanding Drug Recalls: What to Know and What to Do · FDA: Recalls Background and Definitions · Report a problem with this question

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 · Report a problem with this question

Correct answer: A

The DSCSA product identifier is a standardized graphic printed in both human-readable form and on a machine-readable data carrier (a barcode). It contains the standardized numerical identifier, which is the NDC plus a unique serial number, along with the lot number and expiration date. It lets each package be identified and verified as it moves through the supply chain.

• A Correct: the product identifier carries the standardized numerical identifier (NDC plus serial number), the lot number and the expiration date.
• B Patient and prescriber details belong on the prescription label, not on the manufacturer's package.
• C Seller names and invoice details are part of transaction records, not the product identifier.
• D A DEA number and storage conditions are not part of the DSCSA product identifier.

Learn this topic: How the DSCSA tracks prescription drugs and what the pharmacy must do 5-minute lesson

Source: 21 U.S.C. 360eee (LII): DSCSA definitions · FDA: Drug Supply Chain Security Act (DSCSA) · Report a problem with this question

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 · Report a problem with this question

Correct answer: A

Once a dispenser determines, in coordination with the manufacturer, that a product is illegitimate, it must notify FDA and the immediate trading partners that may have received it no later than 24 hours later. FDA's preferred route is the Form FDA 3911 platform in CDER NextGen. The pharmacy then dispositions the product, keeps a sample if requested, and keeps the records for at least 6 years.

• A Correct: within 24 hours of determining that a product is illegitimate, the dispenser must notify FDA and all immediate trading partners it believes may have received it.
• B DEA theft and loss reporting applies to controlled substances; DSCSA illegitimate-product notices go to FDA.
• C Returning it for credit puts illegitimate product back into the supply chain instead of removing it.
• D The dispenser must disposition the product but retain a sample for testing if the manufacturer or FDA requests it.

Learn this topic: How the DSCSA tracks prescription drugs and what the pharmacy must do 5-minute lesson

Source: FDA: Notify FDA of Illegitimate Products · 21 U.S.C. 360eee-1 (LII): DSCSA pharmaceutical distribution supply chain requirements · Report a problem with this question

Correct answer: A

21 CFR 1314.30(a) requires a written or electronic logbook for pseudoephedrine sales, with one exception: an individual buying a single sales package that contains not more than 60 mg of pseudoephedrine. DEA's training adds that this exemption covers pseudoephedrine only, not ephedrine or phenylpropanolamine. The package must still be kept behind the counter or in a locked cabinet.

• A Correct: the logbook rule does not apply to an individual's purchase of a single sales package containing not more than 60 mg of pseudoephedrine.
• B Liquids are scheduled listed chemical products too; their sales must be logged.
• C 3.6 grams is the daily sales limit; sales below it still need a logbook entry.
• D Every sale needs its own logbook entry with the date and time; an earlier signature does not cover it.

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) · FDA: Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine · Report a problem with this question

Correct answer: B

FDA separates recalls (violations it would take legal action on, classified I, II or III) from market withdrawals (minor or no violations) and stock recoveries (product still under the firm's control). FDA's own example of a market withdrawal is a product removed because of tampering, without evidence of manufacturing or distribution problems.

• A A recall involves a violation FDA would take legal action against; FDA gives tampering without manufacturing problems as an example of a market withdrawal instead.
• B Correct: a market withdrawal is a removal or correction for a minor violation, or no violation, that FDA would not take legal action on.
• C A stock recovery covers product that never left the firm's direct control; this product was already on the market.
• D A safety alert concerns a medical device that may present an unreasonable risk of substantial harm, not a drug removed for tampering.

Learn this topic: How FDA drug recalls work and what the pharmacy does 4-minute lesson

Source: FDA: Recalls Background and Definitions · eCFR 21 CFR Part 7, Subpart C: Recalls (Including Product Corrections) · Report a problem with this question

Correct answer: B

ISMP defines high-alert medications by the harm an error can cause, not by how often errors happen: mistakes with them may or may not be more common, but the consequences are more severe. Examples on ISMP's lists include insulin, opioids, warfarin and oral methotrexate for non-cancer use. Pharmacies protect these drugs with extra safeguards such as auxiliary labels, automated alerts and double checks.

• A ISMP says errors with high-alert drugs may or may not be more common, so error frequency is not the definition.
• B Correct: a high-alert drug carries a heightened risk of significant patient harm when it is used in error.
• C Prior authorization is an insurance billing step and has nothing to do with the high-alert label.
• D Controlled-substance schedules reflect abuse potential; many high-alert drugs, such as insulin and warfarin, are not controlled.

Learn this topic: Which drugs are high-alert, and why are look-alike names dangerous? 5-minute lesson

Source: ECRI/ISMP: High-Alert Medications in Acute Care Settings · 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) · Report a problem with this question

Correct answer: C

ISMP's community/ambulatory high-alert list names methotrexate for non-cancer use as a specific drug, alongside classes such as insulin, opioids, anticoagulants like warfarin, and oral chemotherapy. Once-weekly methotrexate is a classic danger because taking the weekly dose every day by mistake has caused deaths. Amoxicillin, loratadine and omeprazole are not on the list.

• A Amoxicillin is a common antibiotic, but neither it nor its class appears on ISMP's community high-alert list.
• B Loratadine is not on the list; oral antihistamines are not a high-alert category.
• C Correct: ISMP lists methotrexate for non-oncologic use as a specific high-alert medication in community practice.
• D Omeprazole is not on ISMP's community high-alert list.

Learn this topic: Which drugs are high-alert, and why are look-alike names dangerous? 5-minute lesson

Source: 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) · DailyMed: Methotrexate tablets label · Report a problem with this question

Correct answer: D

For rheumatoid arthritis, the methotrexate label gives a once-weekly dose (starting at 7.5 mg once weekly), and patients who took a weekly dose every day by mistake have died. Daily directions for this use are a red flag that the pharmacist must resolve with the prescriber. A technician never rewrites directions on their own.

• A Ten mg can be a reasonable weekly amount, but taking it every day would give seven times the weekly dose.
• B The intended schedule may well be weekly, but only the pharmacist, after contacting the prescriber, can change the directions.
• C The patient's memory is not a valid order; the prescriber must confirm the intended schedule.
• D Correct: daily methotrexate for rheumatoid arthritis conflicts with the labeled once-weekly dosing, so the pharmacist must intervene.

Learn this topic: Which drugs are high-alert, and why are look-alike names dangerous? 5-minute lesson

Source: DailyMed: Methotrexate tablets label · 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) · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question

Correct answer: A

The bar code on a drug's label encodes its NDC, so scanning the stock bottle checks that the exact product, including salt, release form and strength, matches what was entered. Metoprolol succinate and metoprolol tartrate are a pair on ISMP's List of Confused Drug Names, and because they are different salts, FDA does not rate them as therapeutic equivalents. A mismatch means stop and pick the right product, never override or bypass the scan.

• A Correct: the scan caught a wrong-product error, so the technician returns the bottle and pulls the product on the prescription.
• B The names share 'metoprolol 50 mg,' but tartrate and succinate ER are different products; the scan is catching a real error.
• C Keying in the NDC bypasses the check and lets the wrong bottle go out.
• D The technician should fix a known product error, not pass it along hoping the pharmacist catches it.

Learn this topic: Which habits stop medication errors before they reach the patient? 5-minute lesson

Source: eCFR: 21 CFR 201.25 Bar code label requirements · Federal Register (2004): Bar Code Label Requirement for Human Drug Products and Biological Products · ISMP's List of Confused Drug Names (2015 PDF) · FDA: Orange Book Preface (therapeutic equivalence) · Report a problem with this question

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? · Report a problem with this question

Correct answer: A

Amoxicillin is a penicillin-class antibiotic, and its label lists a serious reaction to amoxicillin or other beta-lactams (penicillins or cephalosporins) as a contraindication. Drug-allergy checks are part of prospective drug utilization review (DUR), and resolving the alert takes the pharmacist's judgment, often with a call to the prescriber. A technician never overrides a serious allergy alert or switches drugs.

• A Correct: a drug-allergy DUR alert, here a likely serious one, must be resolved by the pharmacist.
• B Amoxicillin is a penicillin-class antibiotic, so the alert is real.
• C Even if the patient answers, deciding whether the drug is safe is a pharmacist judgment.
• D Choosing a different drug is therapeutic substitution, which needs the pharmacist and prescriber.

Learn this topic: Which situations must a pharmacy technician hand to the pharmacist? 5-minute lesson

Source: DailyMed: Amoxicillin label · eCFR: 42 CFR 456.705 Prospective drug review · PTCB: 2026 Certified Pharmacy Technician Knowledge Reference (PDF) · Report a problem with this question

Correct answer: C

June 1 through June 19 is 19 nights, so 19 of the 30 tablets are used and 11 should remain, enough for 11 more nights. A refill this early does not fit the directions and can signal overuse, one of the problems prospective DUR screens for as clinical abuse or misuse, and the zolpidem label warns about abuse and dependence. The technician reports the early request to the pharmacist, who decides what to do.

• A 19 is the number of tablets used, not left, and an early refill should not be processed without the pharmacist.
• B The count is right, but a refill 11 days early needs the pharmacist's review.
• C Correct: 30 - 19 = 11 tablets should remain, so the early request goes to the pharmacist.
• D Referral is right, but 30 - 19 = 11 tablets left, not 19.

Learn this topic: Which situations must a pharmacy technician hand to the pharmacist? 5-minute lesson

Source: eCFR: 42 CFR 456.705 Prospective drug review · eCFR: 42 CFR 456.702 Definitions (drug use review) · DailyMed: Zolpidem tartrate tablets label · PTCB: 2026 Certified Pharmacy Technician Knowledge Reference (PDF) · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question

Correct answer: C

The NCC MERP index sorts events by outcome: A is only the capacity for error, B is an error that did not reach the patient, C through I reached the patient with increasing harm. Errors caught at the pharmacist's final check are classic Category B events. Recording them still matters, because they show where the process is weak.

• A Category A is for conditions that could cause an error before any error happens; here the vial was actually filled wrong.
• B Category C requires the error to reach the patient, and this vial never left the pharmacy.
• C Correct: an error happened (wrong strength in the vial) but it was caught before reaching the patient, which is Category B.
• D Category D also requires the error to reach the patient, plus monitoring or intervention to confirm or prevent harm.

Learn this topic: How do pharmacies report errors and adverse events? 5-minute lesson

Source: NCC MERP Index for Categorizing Medication Errors (2022) · NCC MERP: Types of Medication Errors (Medication Error Index) · Report a problem with this question

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) · Report a problem with this question

Correct answer: A

A wrong-patient error happens when a correctly filled prescription, or a dose, goes to someone it was not meant for. Similar names make this more likely, which is why pharmacies confirm a second identifier, such as date of birth, at pickup. NCC MERP lists wrong patient as its own error type.

• A Correct: the right product went to the wrong person, which is a wrong-patient error.
• B The drug in the bag matches Maria's prescription; the problem is who received it.
• C The dose on the label is correct for Maria; it went to the wrong person.
• D The count matches the prescription; the problem is who received it.

Learn this topic: How do you spot the main types of prescription errors? 5-minute lesson

Source: NCC MERP Taxonomy of Medication Errors · Report a problem with this question

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) · Report a problem with this question

Correct answer: B

Convert the ordered dose to volume with the concentration: 400 mg x (5 mL / 400 mg) = 5 mL. The label says 10 mL, which delivers 800 mg, a twofold overdose. Whenever a liquid dose is written in mL, recheck it against the mg ordered and the mg per mL on the bottle.

• A At 400 mg per 5 mL, 400 mg is in 5 mL; 10 mL holds twice that.
• B Correct: 10 mL x (400 mg / 5 mL) = 800 mg per dose, twice the 400 mg ordered.
• C This answer inverts the concentration; 10 mL contains more drug than 5 mL, not less.
• D The amount per dose on the label is wrong, which makes it a dose error.

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) · NCC MERP Taxonomy of Medication Errors · Report a problem with this question

Correct answer: D

Route errors include the right drug given by the wrong route or to the wrong site. An otic suspension is labeled for use in the ears, so directions to put it in the eye are a wrong-route error. Matching the dosage form to the route on the label (otic means ear, ophthalmic means eye) catches this.

• A The number of drops and the frequency match the prescription.
• B The product matches the prescription; the directions send it to the wrong place.
• C Nothing suggests the prescription belongs to someone else.
• D Correct: an otic (ear) product labeled for the eye is a wrong-route error.

Learn this topic: How do you spot the main types of prescription errors? 5-minute lesson

Source: DailyMed: Neomycin and polymyxin B sulfates and hydrocortisone otic suspension (label) · NCC MERP Taxonomy of Medication Errors · Report a problem with this question

Correct answer: B

CDC prefers alcohol-based hand sanitizer for most clinical hand hygiene because it works well and is quick. Soap and water is used when hands are visibly soiled, and during outbreaks of C. difficile or norovirus. Sanitizer should contain at least 60% alcohol and be rubbed in until hands are dry.

• A CDC says alcohol-based hand sanitizer is preferred in most clinical situations unless hands are visibly soiled.
• B Correct: visibly soiled hands call for soap and water.
• C Hand hygiene is needed after glove removal, but sanitizer is acceptable then unless hands are soiled.
• D Hand hygiene is needed at many points during a shift, and the method depends on whether hands are soiled.

Learn this topic: How do pharmacy technicians prevent infection and contamination? 5-minute lesson

Source: CDC: Clinical Safety: Hand Hygiene for Healthcare Workers · Report a problem with this question

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) · Report a problem with this question

Correct answer: A

NIOSH says hazardous drugs should be counted carefully with dedicated equipment, and Army Public Health Center guidance adds that the hazardous-drug tray is labeled, stored apart from general trays and used only for hazardous drugs. That keeps hazardous residue out of other patients' prescriptions. NIOSH also advises against automated counting machines for hazardous drugs unless the specific machine is shown not to release powder.

• A Correct: the hazardous-drug tray is reserved for hazardous drugs, so lisinopril is counted on a general tray.
• B Wiping the tray does not change the rule that a hazardous-drug tray is used only for hazardous drugs.
• C Reusing the tray would expose the lisinopril, and the patient, to hazardous-drug residue.
• D NIOSH says hazardous tablets and capsules should not go into an automated counting machine unless the machine is shown not to release powder, and the lisinopril needs no special handling.

Learn this topic: How do pharmacy technicians prevent infection and contamination? 5-minute lesson

Source: NIOSH: Managing Hazardous Drug Exposures: Information for Healthcare Settings (2023-130) · U.S. Army Public Health Center TIP 55-083-0817: Hazardous Drugs, Engineering Controls, Safe Work Practices and PPE · Report a problem with this question

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 · Report a problem with this question

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) · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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) · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question

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 · Report a problem with this question

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 · Report a problem with this question

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) · Report a problem with this question

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) · Report a problem with this question