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Which of the following antibiotics could cause the discoloration of teeth in young children? A.Cephalexin B.Amoxicillin C.Doxycycline D.Erythromycin ANSWERV Vv C., doxycyeline is a tetracycline antibiotic, and all tetracyclines run the risk of tooth discoloration and cnamel hypoplasia when given to young children. Distractor (A) is a sulfa antibiotic, distractor (B) is a penicillin antibiotic, and distractor (D) is a macrolide antibiotic, none of which are known to cause discoloration of teeth in young children. Which of the following medications are considered a therapeutic substitution? A.Tenormin and atenolol B.Prilosee and paroxetine C.Zocor and pravastatin D.Loxitane and fluoxetine ANSWERV V C. because Zocor (simvastatin) and Pravachol (pravastatin) are both HMG-CoA reductase inhibitors. Distractor (A) is an example of generic substitution, distractor (B) contains drugs for two different indications, and distractor (D) is an example of look-alike/sound-alike drug names. Look-alike/sound-alike precautions should be applied to medications with similar: A.manufacturer labels. B.expiration dates. C.therapeutic indications. D.DRA classifications. ANSWER v A. because similar label formats fall under the "look-alike" portion of look-alike/sound-alike. Distractors (B), (C), and (D) are all irrelevant in terms of look-alike/sound-alike precautions. According to federal law, a complete inventory of the controlled substances on hand ina pharmacy must be made every: A.month. B.6 months. C.year. D.2 years. ANSWERV ¥ D. because Title 21 Code of Federal Regulations (Part 1304) requires pharmacies to take a new inventory of all stocks of controlled substances on hand at least every two years (biennially). Advair Diskus inhalation powder comes in a sealed pouch. Once the pouch is opened, any remainder should be discarded after how many months? Al B2 C.6 D.12 ANSWERV ¥ A. because the manufacturer advises that Advair Diskus should be discarded | month after the foil pouch is opened or when the counter reads zero, whichever comes first. Which of the following medications should be avoided by patients allergic to sulfa drugs? A.Biaxin B.Keflex C.Ceftin D.provide work for students and interns in the pharmacy. ANSWERV V A. because proper rotation of inventory helps reduce the potential for dispensing expired medications. Rotating inventory may be useful for distractors (B), (C), and (D), but those are not the primary purpose. A physician orders phenobarbital elixir 60 mg for a patient. The drug is available in a 20 mg/5 mL concentration. How many tsp should be given for each dose? All B2 C3 D4 ANSWERVYV The key (C) is correct and can be calculated as follows. First, find how many mL of elixir are required for a dose of 60 mg. 20 mg/5 mL = 4 mg/mL 60 mg + 4 mg/mL = 15 mL Then, convert mL to tsp. | tsp is equivalent to 5 mL. 15 mL/5 mL per tsp = 3 tsp In order to ensure that the appropriate product was selected from the shelf, a pharmacy technician should verify the medication's: A.expiration date. B.lot number. C.package size. D.National Drug Code. ANSWER ¥ D. because it is the only option that will remain unchanged as long as the correct medication has been selected. The following order arrives in the pharmacy: Lantus SoloStar #1 box (5 pens each containing 3 mL) Sig: 25 units SQ q.p.m. How long, in days, should this box of prefilled pens last the patient? A28 B.30 C.60 D.90 ANSWERV V The key (C) is correct and can be calculated as follows. First, calculate the total mL supplied by the entire box by multiplying the number of pens by the mL contained in each pen: 5 pens x 3 mL per pen = 15 mL total Next, find the total units contained in each box by multiplying the units per mL by the total mL: 100 units/mL x 15 mL = 1500 units Finally, divide the total units by how many units the patient is directed to use per day to find the days supply: D.OTC advice. ANSWERV ¥ B. because federal laws such as OBRA-90) do not include a requirement for pharmacists to counsel patients on new refills. while it does require pharmacists to counsel on distractors (A), (C), and (D). Which auxiliary label should be affixed to a prescription bottle of metronidazole? A.Chew tablets before swallowing B.May cause drowsiness C.Keep in refrigerator; Do not freeze D.Do not drink alcoholic beverages when taking this medication ANSWERV V The key (D) is correct because metronidazole may enhance the adyerse/toxic effect of alcohol and the combination should be avoided. Distractors (A), (B). and (C) are not relevant to metronidazole. According to federal law, prescriptions for Schedule III controlled substances may: A.be refilled for up to 6 months if indicated. B.not be refilled under any circumstances. C.have p.r.n. refills. D.be refilled for up to 12 months if indicated. ANSWERV V The key (A) is correct because, according to Title 21 Code of Federal Regulations (Part 1306), prescriptions for Schedule III and IV medications may be refilled no more than five times within six months from the date they were issued. For which of the following questions should a pharmacy technician refer the patient to the pharmacist? A."How many refills do I have left on this prescription?" B."What should I do if I forget to take a dose of my prescription?" C."How much would my prescription cost without insurance?" D."Can you eall me when my prescription is ready?" ANSWERV ¥ The key (B) is correct because answering the question requires clinical knowledge and professional judgment, therefore falling outside the scope of a pharmacy technician's practice. Distractors (A), (C), and (D) are all acceptable for the technician to answer. The iPLEDGE restricted drug distribution program is associated with: A.clozapine. B isotretinoin. C.thalidomide. D.adalimumab. ANSWERV ¥ The key (B) is correct because patients receiving isotretinoin prescriptions must go through iPLEDGE to receive medication in an effort to prevent pregnancy and birth defects. Distractor (A) requires pharmacies to register and receive blood work prior to dispensing, distractor (C) requires a program called Thalomid REMS, and distractor (D) docs not require a specific monitoring program. Tow often do patients typically receive oral metoprolol succinate when treating hypertension? A.Once a day B.Twice a day C.Three times a day D.Once a week ANSWERV V The key (A) is correct because metoprolol succinate is the extended release formulation of metoprolol and is typically given once a day to treat hypertension. Which of the following routes of administration would be considered parenteral? A.Buccal B.Oral C.Subcutaneous Tlow long, in days, should the supply last if there are 200 metered doses in each inhaler? A225 B.30 €.50 D.100 ANSWERV ¥ The key (C) is correct and can be calculated as follows. ‘The first step is to interpret the prescription directions. The abbreviation "q.i.d." (from the Latin "quater in die") means four times a day. Multiply puffs per dose by doses per day to find how many puffs the patient is instructed to use per day: 2 puffs per dose x 4 doses per day = 8 puffs per day Next, find how many puffs total will be dispensed by multiplying the number of inhalers by the number of puffs per inhaler: 2 inhalers x 200 puffs per inhaler = 400 puffs total Tinally, divide the total number of puffs by the number of puffs per day to find the days supply: 400 puffs total + 8 puffs per day = 50 days supply According to federal law, how long, in years, must a pharmacy maintain records for cach controlled substance purchased, received, distributed, or dispensed? Al B.2 C5 D.10 ANSWERVYV The key (B) is correct because the Drug Enforcement Administration (DEA) requires all controlled substance records to be maintained for at least two years. A patient states that they experienced shortness of breath while taking Keflex. The pharmacy technician should enter an allergy to which class of antibiotics in the patient's profile’? A.Cephalosporins B.Macrolides C.Quinolones D.Sulfonamides ANSWERV ¥ The key (A) is correct because Keflex (cephalexin) belongs to the cephalosporin class of antibiotics. Under standard precautions, it is considered safe for healthcare workers to come in direct contact with patients’: A.dirty hands. B.blood. C.non intact skin. D.body fluids. ANSWERV V The key (A) is correct because standard precautions assume that all blood, body Muids, sceretions, excretions except sweat, non intact skin, and mucous membranes may contain transmissible infectious agents. Standard precautions include recommendations regarding appropriate hand hygiene, appropriate personal protective equipment (PPE), and respiratory hygiene/cough etiquette intended to stop the transmission of pathogens. Which of the following is a recommended strategy for preventing medication errors? A.Using only generic names of medications B.Implementing system wide use of Tall Man lettering Since the patient requires 500 mg per day and the available tablets are 500 mg per tablet, one tablet is required per day and 10 tablets are required for 10 days. A physician orders amoxicillin 50 mg/mL for a child at 1 mL PO q&h for 10 days. What is the total volume that must be dispensed, in mL, if the amoxicillin stock is 125 mg/S mL? A2 B.30 C.60 D.150 ANSWERV V The key (C) is correct and can be calculated as follows. First, find how many mg the child should receive per day according to the instructions. Taking 1 mL of 50 mg/mL amoxicillin q8h means that the child will be taking 50 mg every 8 hours, or three times a day: 50 mg per dose x 3 doses per day = 150 mg per day Since the stock amoxicillin contains 125 mg per 5 mL, this means that the stock contains 25 mg per mL. Divide 150 mg per day by 25 mg/mL to find how many mL are required per day: 150 mg per day + 25 mg/mL = 6 mL per day Finally, multiply the total mL required per day by the total days of therapy to find how many mL are needed to complete the course: 6 mL per day x 10 days of therapy = 60 mL total The pharmacy receives the following prescription: Tamsulosin 0.4 mg caps Sig: 0.4 mg PO daily for 2 weeks then increase to 0.8 mg daily thereafter What quantity of capsules will be needed for the first 30 days? A.30 B44 C46 D.60 ANSWERV ¥ The key (C) is correct and can be calculated as follows. First, find how many capsules the patient will need for the first 2 weeks of therapy by multiplying the number of capsules per day by the number of days: 1 capsule per day x 14 days = 14 capsules Next, find how many capsules the patient will need for the remaining 16 days by multiplying the number of capsules per day by the number of days: 2 capsules per day x 16 days = 32 capsules Tinally, add the two totals to find how many capsules are required for the entire 30 days: 14 capsules + 32 capsules = 46 capsules A pharmacy technician should alert the pharmacist to counscl a patient who has presented prescriptions for both: A. Viagra and pravastatin. Which of the following organizations is tasked with enforcing proper medication disposal practices to ensure that pharmaceutical waste does not contaminate waterways and drinking water? A.FDA B.DEA C.CMS D.EPA ANSWERVYV The key (D) is correct because the Environmental Protection Agency (EPA) and state health departments work together to enforce proper disposal of pharmaceutical waste to keep pharmaceuticals out of waterways and drinking water. Digoxin is unavailable in which dosage form? A.Oral tablet B. Injectable solution C.Oral solution D.Sublingual tablet ANSWERV ¥V The key (D) is correct because digoxin is available in oral solution (0.05 mg/mL), injection solution (0.1 mg/mL and 0.25 mg/mL), and oral tablets (62.5 meg, 125 meg, 187.5 meg and 250 meg) but not sublingual tablets. When determining therapeutic equivalence, the FDA requires which of the following criteria to be identical? A. Inactive ingredients B.Tablet color C.Dosage form D.Manufacturer ANSWERV V The key (C) is correct because dosage forms, active ingredients, and route(s) of administration must be identical in order for the FDA to consider drug products to be therapeutically equivalent. Distractors (A), (B), and (D) may be different. A vial of medication shows the manufacturer's expiration date as November 2026. The last date on which this medication may be used is: A.October 31, 2026. B.November 1, 2026. C.November 30, 2026. D.6 months after the stated date. ANS WERV V The key (C) is correct because when a product's expiration date indicates only a month and year, the product can be used through the last day of the specified month. What is the generic name for Lexapro? A.Escitalopram B.Fluoxetine C. Levothyroxine D.Lithium ANSWERV ¥ The key (A) is correct because escitalopram is the generic name for Lexapro. Distractor (B) is generic for Prozac, distractor (C) is generic for Synthroid, and distractor (D) is generic for Eskalith. Which of the following medications is most likely to lead to impaired-driving incidents? A Penicillin B.Famotidine C.Diphenhydramine D.Hydrochlorothiazide ANSWERV ¥ The key (C) is correct because diphenhydramine may cause central nervous system (CNS) depression, which may impair physical or mental abilities; patients taking diphenhydramine should be cautioned about performing tasks that require mental alertness, like driving. Distractors (A), (B), and (D) are not known to commonly cause CNS depression. B.follow procedures to ensure that infectious agents are handled and disposed of properly. C.dispose of bloodstained dressings in a regular trash can to be emptied daily. D. place all infected patients into reverse isolation. ANSWERV Vv The key (B) is correct because pathogens are microorganisms (such as bacteria, viruses, and fungi) that can cause disease and must be handled and disposed of safely in order to avoid infection. A pharmacy receives the following prescription: Warfarin 2.5 mg tablets Disp: 4 weeks supply Sig: | tab PO on Monday, Wednesday, and Friday, and 0.5 tab on Sunday, Tuesday, Thursday, and Saturday What quantity of tablets will be needed to fill this prescription if the first dose is taken on a Sunday? Al4 B.20 C22 D.28 ANSWERVV The key (B) is correct and can be calculated as follows. First, find how many tablets the patient needs per week: (1 tablet per day x 3 days per week) + (0.5 tablet per day x 4 days per week) = 5 tablets per week Next, multiply the tablets needed per weck by the number of weeks to find the total number of tablets: 5 tablets per week x 4 weeks total = 20 tablets Which vitamin is of special importance during pregnancy in order to prevent birth (neural tube) defects? A.Niacin B. Thiamine C Riboflavin D.Folic acid ANSWERV ¥ The key (D) is correct because national guidelines (from the American College of Obstetricians and Gynecologists, among others) recommend the use of oral folic acid before conception and during early pregnancy to reduce the risk of neural tube defects (NTDs). A pharmacy technician receives a prescription for Dilaudid 4 mg tablets DAW. The pharmacy is out of Dilaudid. The technician fills the prescription with hydromorphone. The pharmacist performs the final check and tells the technician that hydromorphone cannot be dispensed because: A.the pharmacist cannot substitute any medications due to "the patient's right." B.generic substitution is not authorized by prescriber. C.the prescription is written as Dilaudid, not hydromorphone. D.hydromorphone and Dilaudid are two different Schedule controlled substances. ANSWERVV The key (B) is correct because "DAW" is an abbreviation for "Dispense as Written," a notation that indicates that the prescriber wants only the medication named on the prescription to be dispensed. This means that brand name Dilaudid must be dispensed for this prescription; Dilaudid's generic, hydromorphone, is not authorized by the prescriber. 
