Practice Exam 4
What does the term "gram" measure?
"Gram" is the basic unit of weight in the metric system.
What is the maximum volume a tuberculin syringe can hold?
Tuberculin syringes can hold volumes from 0.01 to 1.0 mL.
Why are medication error rates reported in studies underestimated?
Unfortunately, many medication errors are never detected; therefore, the exact number of medication errors is not known.
What should be done if you have questions about the directions on a prescription? Ask the patient to help you with the directions. ---Ask the pharmacist for assistance. Attempt to interpret the prescription. Call the physician's office immediately.
Whenever in doubt about anything in the pharmacy, ask the pharmacist for assistance.
Which of the following drugs is not a beta-blocker? Coreg Inderal ---Procardia Tenormin
Procardia (nifedipine) is a calcium channel blocker.
How many days would a prescription of 30 tablets last if the directions were "i tab tid ac"?
"i tab tid" means take 1 tablet three times per day. 30 tablets/3 tablets/day = 10 days' supply.
How many days would 40 capsules of a medication last if the directions were "i cap qid ac and hs"? 4 8 ---10 None of the above
"qid" (four times a day) indicates how many times per day a medication would be taken. The term "ac and hs" tells the patient when during the day the medication is to be taken.
Which of the following suffixes indicates a condition of the blood? -----emia -itis -pathy -malacia
-emia indicates a condition of the blood, -itis means inflammation, -pathy means disease, and -malacia means softening.
What standard time would a patient receive a medication if the military time was 1800 hr?
1800 hours is the same as 6 pm. Military time begins at midnight, and each hour of the day corresponds to a specific time. Military time does not reset at noon. Military time does not consider am or pm.
If a patient receives 10 mL of a 20% (w/v) solution of a drug, how much active ingredient will he or she receive? 20 mg 200 mg --2 g 20 g
20% (w/v) means that 20 g is dissolved in 100 mL. The problem can be solved using a proportion: 20 g/100 mL = X g/10 mL, which is 2 g.
A pharmacy offers a 10% discount on prescriptions for all senior citizens. How much would a senior citizen pay for a prescription that has a usual and customary price of $75.00?
A 10% discount means the patient will saver 10% or pay 90% of the prescription price ($75.00 × 0.9 = $67.50).
How is a U-100 insulin syringe calibrated? In 1 unit increments ---In 2 unit increments In 5 unit increments In 10 unit increments
A U-100 syringe will hold 1 mL of insulin. It is calibrated in 2-unit increments. Low-dose syringes are calibrated in 1-unit increments.
What vitamin deficiency may result in beriberi? Vitamin A ---Vitamin B1 Vitamin C Vitamin D
A deficiency in vitamin B1 causes beriberi; deficiencies in vitamin A result in night blindness, dry corneas, and an inability of the epithelial cells to shed; a vitamin C deficiency causes scurvy; and a vitamin D deficiency causes rickets.
In how many minutes should a pharmacy be allowed to deliver a "stat" order?
A pharmacy is to prepare a "stat order" as quickly as possible, within 5 to 15 minutes of receiving the order.
Which of the following would not be found on a pharmacy technician's job description? General responsibilities Job title ---Salary Specific responsibilities, including internal and external contacts
A pharmacy technician's salary does not need to be found on his or her job description.
Which of the following is not an example of a sound-alike, look-alike drug? Accupril-Acphex Actronel-Actos ---Hydrochlorothiazide-Hytrin Clozaril-Colazal
Accupril-Acphex, Actronel-Actos, and Clozaril-Colazal have been identified by the Institute of Safe Medication Practices (ISMP) after being reported to ISMP-MERP as being involved in many medication errors due to their sound-alike or look-alike names.
Which of the following auxiliary labels should be placed on a canister of albuterol spray? For nasal use ---Shake well Store in box Store in refrigerator
Albuterol is an oral inhalation agent that should be shaken before used to relieve bronchospasms.
Which of the following is not an example of a hospital outpatient dispensing system? Amerisource MedSelect ----McKesson Loop Distribution Omnicell Medguard Pyxis ADS
Amerisource MedSelect, Omnicell Medguard, and Pyxis ADS are outpatient dispensing systems.
What is the brand name for amlodipine? Cardizem Isoptin --Norvasc Procardia
Amlodipine is the generic name for Norvasc. The other medications are Cardizem (diltiazem), Isoptin (verapamil), and Procardia (nifedipine).
Who may recommend an OTC product to a patient?
An individual who recommends a product to a patient is performing a judgmental duty, which only a pharmacist may do.
What is the generic name for Lipitor?
Atorvastatin is the generic name for Lipitor, which is used in the treatment of hyperlipidemia (high cholesterol).
Which term indicates the measurement of both the drug absorption and total amount of drug that reaches the systemic blood circulation? ---Bioavailability Duration of action Half-life Therapeutic index
Bioavailability is a pharmacokinetic parameter used to determine a safe and effective dosage for a patient. Bioavailability compares the amount of drug administered with how much actually reaches the site. The duration of action calculates the amount of time needed to obtain a therapeutic level before a therapeutic response is experienced. A half-life measures the amount of time necessary for half of the amount of the medication to be eliminated by the body. The therapeutic index illustrates the minimum amount of medication required to obtain a response and the maximum amount of drug safe enough for the patient to take without experiencing toxicities.
Which of the following is not a manner for a new prescription to be presented for filling at a pharmacy? Called by the physician ---Called by the patient Fax Presented by the patient
Both federal and state law do not allow for a patient to call a new prescription into the pharmacy. A patient may refill a prescription by telephone.
A 35-kg child is prescribed amoxicillin with a dosage of 10 mg/kg. The pharmacy has in stock amoxicillin 50 mg/mL. How many milliliters will the child be given in one dose?
Calculate the amount of medication the child will need (35 kg × 10 mg/kg = 350 mg). To calculate the volume required use a proportion: 50 mg/mL = 350 mg/X, where X = 7 mL. The patient will need to be given 7 mL for each dose.
If a pharmacy technician is having problems processing a prescription claim to a third-party drug plan provider, what should he or she do?
Call the help desk whose telephone number is found on the back of the prescription drug card for assistance.
Why must care be followed when refilling an ADS system? To ensure the right drug is being placed in the correct hopper To ensure the hoppers are kept clean to that mistakes are not being made when the medicine is being counted To ensure the NDC number on the hopper matches the NDC number of the medication being placed in the hopper ---All of the above
Care must be taken when refilling ADS machines to reduce the possibility of a medication error.
Which of the following herbal products would be used as a laxative? American ginseng Cascara sagrada Goldenseal Melatonin
Cascara sagrada is used as a laxative, American ginseng is used to provide energy for the body, goldenseal is used for the immune system, and melatonin is used to induce sleep.
What is the first step the pharmacy should do after being notified of a drug recall?
Check the pharmacy shelves first. If there is any of the recalled medication in stock, pull it aside and notify the pharmacist. The recalled medication should be kept separate from the remaining pharmacy inventory so it is not dispensed to a patient.
Which of the following products should not be chewed? Azatadine Azelastine ---Benzonatate Fexofenadine
Chewing benzonatate (Tessalon Perles) would result in excessive salivation.
A 44-lb child is to receive 4 mg of phenytoin per kilogram of body weight daily as an anticonvulsant. How many milliliters of pediatric phenytoin suspension containing 30 mg per 5 mL should the child receive?
Convert pounds to kilograms (44 lb × 1 kg/2.2 lb = 20 kg). Next calculate the amount the patient is to receive each day (4 mg/kg × 20 kg = 80 mg/day). Then calculate the volume to be given to the patient (30 mg/5 mL = 80 mg/X mL, where X = 13.3 mL).
To which medication class does digoxin belong? Beta-blocker Calcium channel blocker Cardiac glycoside Sodium channel blocker
Digoxin (Lanoxin) is a cardiac glycoside.
What term describes the process by which drug molecules leave the bloodstream and enter the tissues of the body? Absorption ---Distribution Metabolism Elimination
Distribution is the process by which drug molecules leave the bloodstream and enter the body tissue. Absorption is the process by which a drug enters the bloodstream, metabolism is the process by which drugs are converted to other compounds, and elimination (excretion) is the removal of a drug from the body.
Who licenses pharmacists in each state?
Each state has a board of pharmacy (BOP), which is responsible for determining the licensing requirements of pharmacists in that state. The state BOP can suspend or revoke the license of a pharmacist in that particular state. The BOP is responsible for the practice of pharmacy in a state, which includes pharmacy technicians.
Which of the following is not a cardiovascular medication? Coreg Diovan ---Evista Plavix
Evista is used to treat osteoporosis.
What is the preparation of a specific dosage form for a patient with specific needs called? Aseptic technique Bulk compounding --Extemporaneous compounding Product formulation
Extemporaneous compounding involves compounding a specific product for a particular patient based on a physician's prescription or medication order. Aseptic technique is used in the preparation of intravenous products. Bulk compounding is similar to extemporaneous compounding with the exception that a large quantity is prepared to be used at a future time.
Which of the following medications does not need to be refrigerated? Insulin ---Gabapentin Latanoprost Reconstituted amoxicillin suspension
Gabapentin (Neurontin) needs to be stored at room temperature. Insulin should be refrigerated but not frozen; latanoprost (Xalatan) is an ophthalmic product that needs to be kept refrigerated; and amoxicillin that has been reconstituted with distilled water should be stored in a refrigerator and is stable for 14 days.
What unit of measurement is used to indicate the strength of heparin? --International units mEq mg mL
Heparin is a biological substance that is measured in international units. International units measure the activity of the substance.
Which of the following is not commercially available? Cephalexin tablets ---Heparin tablets Lidocaine injection Nystatin tablets
Heparin is available only as an injectable solution.
What type of ointment base is hydrous lanolin? Absorption base Oleaginous base Oil-water emulsion base ---Water-oil emulsion base
Hydrous lanolin is a water-oil emulsion base. Examples of other bases are as follows: absorption base (Aquaphor), oleaginous base (white petrolatum), and oil-water emulsion base (hydrophilic ointment).
What does hypoglycemia mean? High blood pressure High blood sugar Low blood pressure --Low blood sugar
Hypo means low, gly means sugar, and emia means blood.
Interpret the following signa: IV gtt ad q 6-8 hr prn pain.
IV (Roman numeral for 4) gtt (drops) ad (right ear) q (every) hr (hour) prn (as needed).
Which of the following is a true about CPOE systems?
If a CPOE system is not properly integrated with the pharmacy system, the pharmacy will need to obtain a copy of the printout and enter the information manually, which may result in an error. CPOE systems are paperless systems used in hospitals that are capable of reducing medication errors, but they are unable to eliminate all medication errors.
Which of the following drugs, if expired, can result in a fatality? Amoxicillin Cephalexin Clarithromycin ---Tetracycline
If tetracycline is taken after it has passed its expiration date established by the manufacturer, the patient may die. If the other products are taken after they have expired, the effectiveness will not be guaranteed by the manufacturer, and the patient may experience side effects.
An inspector from the state board of pharmacy appears unannounced at your pharmacy on a Monday morning seeking to examine various pharmacy records. Because of the small confines of the pharmacy, these records are not readily accessible. What do you do?
Inform the inspector they are not readily retrievable but you can have them for the inspector in 72 hours. Pharmacy regulations require that all pharmacy records are easily retrievable and must be provided within 72 hours of the request
Which of the following may be found in a formulary? An approved listing of medications that may be used within an institution or organization Approved pharmacy abbreviations Policies and procedures ---All of the above
Information contained in a formulary may include any of the above plus medical guidelines for prescribing of specific medications, protocols, nutritional products available, and dosing schedules for medications.
Which of the following pieces of information would be found on a prescription drug card? BIN Help desk telephone number Plan code ---All of the above
Information found on a prescription drug card includes the following: BIN, plan code, group code, issuer, ID, subscriber (cardholder) name, primary care provider (optional) copays (may be identified on the card but not required), and help desk telephone number.
At what temperature should insulin be stored? Below 8° C ---Between 8° and 15° C Between 15° and 30° C Above 40° C
Insulin should be stored in a refrigerator. One can convert Celsius to Fahrenheit by using the following formula: 9° C = 5° F - 160. 46.4F - 59F
A physician writes a prescription for a generic medication, but the patient requests the brand name drug. What should the pharmacy technician do? Contact the physician and ask if the brand name drug may be dispensed to the patient. Dispense the brand name drug to the patient. ---Dispense the brand name drug to the patient but have the patient sign the back of the prescription acknowledging he or she requested the brand name drug. Dispense the generic drug to the patient.
It is always best in a pharmacy have the patient sign the back of the prescription when a patient requests the brand name drug to ensure that if the pharmacy is audited by a third-party provider, there is proof the patient requested the brand name drug.
Which of the following generic medications is available as an OTC product to treat seasonal rhinitis? Aluminum hydroxide-magnesium hydroxide Fexofenadine ---Loratadine Meclizine
Loratadine (Claritin) is an OTC drug used to treat a seasonal allergy that may cause a runny nose. Aluminum hydroxide-magnesium hydroxide (Maalox or Mylanta) is an OTC product used to treat peptic ulcer disease. Fexofenadine (Allegra) is a prescription medication used to treat seasonal respiratory allergies. Meclizine is both an OTC (Bonine) and legend medication (Antivert) used to treat vertigo.
What does MDI mean? Medical diagnosis included Medical doctor under investigation ---Metered-dose inhaler Multidose inhaler
MDI is an abbreviation meaning metered-dose inhaler.
What is the largest single medical benefits program in the United States? CHAMPUS Medicaid ---Medicare Workers' compensation
Medicare is the largest single medical benefits program in the United States. Medicare provides services to individuals older than 65 years of age, those who are blind, and those who are disabled from long-term disease. CHAMPUS provides coverage for military retirees and dependents of deceased military personnel. Medicaid is a federal program administered by the states for individuals of lower incomes. Workers' compensation is a federal program for workers who are injured on the job.
Levothyroxine is to hypothyroidism as metformin is to _____________. ACE inhibitor beta-blocker oral hyperglycemic agent --oral hypoglycemic agent
Metformin, an oral hypoglycemic agent, is used in the treatment of diabetes.
Which of the following classes of medications might contribute to PUD? APAP H2 blockers ----NSAIDs Proton pump inhibitors
NSAIDs have a tendency to irritate the walls of the stomach and create an ulcer.
Which of the following is not an effect of narcotics? Analgesia ---CNS stimulation Euphoria Sedation
Narcotics have a tendency to sedate an individual. (Central Nervous Stimulation) CNS stimulation would have the opposite effect.
Why would a pharmacy receive a noncompliance report? The pharmacy failed to maintain adequate controlled substance records and has been cited by the DEA on an audit. The pharmacy failed to properly fill out a Form 222. ----The pharmacy failed to purchase medications from a specific vendor, which had been negotiated by the GPO. The pharmacy purchased more drugs than it is permitted to based on its budget.
Noncompliance reports are a tool used to monitor savings and losses of a pharmacy when a group purchasing organization (GPO) has negotiated specific prices for pharmaceutical products with a specific vendor.
What should be worn when handling a hazardous substance in a pharmacy's order? Name tag PPEs Soft-soled shoes White lab jacket
OSHA requires that an individual wear PPEs (Personal Protective Equipment) when handling hazardous substances at any time.
What is the most common route of administration?
Oral medications are the most commonly used because of the ease of administration.
Which of the following is not a barrier to e-prescribing? ---Clear instructions and lack of personal handwriting make it easier for pharmacy to interpret Must adhere to state and federal standards Must meet all requirements of HIPAA standards Use of proper software by pharmacy to ensure patient privacy
Other benefits of e-prescribing include money and time savings, faster prescription processing, and a reduction in medication errors.
How often do pharmacies back up their data?
Pharmacies back up their data daily.
Which of the following drugs needs to be placed in a child-resistant container? Inhalation products Mebendazole tablets ---Ranitidine Sublingual nitroglycerin tablets
Ranitidine (Zantac) is not among the drugs to be excluded from using child-resistant containers under the Poison Control Act of 1970.
Which of the following might increase the possibility of a medication error?
Receiving a telephoned prescription from a nurse in a physician's office who received the verbal prescription from the physician. Oral prescription orders may be misinterpreted by an individual because of sound-alike, look-alike medication names.
What is the markup rate for a prescription that costs $35.00 and retails for $50.00?
Selling price - Cost = Markup ($50.00 - $35.00 = $15.00). Markup/Cost × 100% Markup rate ($15.00/$35.00) 100% = 43%.
Convert 10 degrees Celsius to Fahrenheit
Solving the problem using the formula 5F = 9C + 160
Which of the following medications is not used to treat acne? Azelex Benzamycin Differin ---Spectazole
Spectazole is used to treat topical fungal infections.
Which of the following is an advantage of a computer dispensing system?
Speed, accuracy, and inventory management are the three primary advantages of computer dispensing systems.
What is the angle of insertion for a subcutaneous injection? 10 to 15 degrees --45 degrees 75 degrees 90 degrees
Subcutaneous injections should have angle of insertion of 45 degrees. Intradermal injections should have a 10- to 15-degree angle, and intramuscular should go in at 90 degrees.
What is the maximum number of refills allowed for a Schedule III drug?
The maximum number of refills allowed for a Schedule III medication if approved by the prescriber is five refills within 6 months of the date the prescription was written.
What type of medication has a suffix of -olol? Antiviral ---Beta-blocker Calcium channel blocker Corticosteroid
The -olol suffix indicates a medication is a beta-blocker; antiviral agents are identified by a suffix of -vir or -ir; calcium channel blockers may have a suffix of -dipine; and corticosteroids may have a suffix of -olone.
How old must a person be to purchase an exempt narcotic?
The Controlled Substances Act of 1970 allows for an individual age 18 years or older to purchase a 4-oz bottle of an exempt narcotic every 48 hr.
Which organization is responsible for drug recalls?
The FDA is responsible for ensuring that all medications are pure, safe, and effective. If a product is adulterated or misbranded, the FDA may issue a product recall if the manufacturer does not voluntarily issue one.
Which organization issued the "do not use" list? FDA ISMP ---TJC Vermont Oxford Network
The Joint Commission (TJC) issued the "do not use" list.
Which organization developed the rejection codes for third-party prescriptions?
The National Council for Prescription Drug Programs (NCPDP) established the rejection codes that are used when a prescription drug claim is rejected by a third-party drug provider.
Which reference book is a compilation of package inserts? Drug Topics Red Book Facts and Comparison ---Physicians' Desk Reference USP-DI
The Physicians' Desk Reference contains information from the package inserts of more than 4000 prescription drugs.
A patient presents a prescription and asks that the medication be dispensed in an E-Z open container. What should be done?
The Poison Prevention Act of 1970 allows for a patient to request a prescription in an E-Z open container. Having the patient sign the back of the original prescription demonstrates that the patient has requested the E-Z open container and helps reduce the pharmacy's liability if an accidental poisoning occurs.
---Which of the following would not be found on a CSAR? Amount of medication administered Amount of medication wasted Date and time of the administration of a drug Expiration date of the drug administered
The amount of medication administered, amount of medication wasted, and date and time of the administration of a drug are required on a Controlled Substance Administration Record (CSAR), which is used to document controlled substance usage in a hospital or long-term care institution.
Which organization oversees the practice of pharmacy in a particular state? BOP FDA NABP USP
The board of pharmacy (BOP) is responsible for the practice of pharmacy within a state; the FDA is responsible to ensure that all medications are pure, safe, and effective; the National Association of Boards of Pharmacy (NABP) evaluates national trends and their impact on the practice of pharmacy and pharmacy law.
To what does an NDC number on a prescription bottle refer? Drug product Drug manufacturer Quantity package ---All of the above
The first five digits of an NDC number refer to the drug manufacturer, the next four digits identify the drug product, and the final two digits identify the packaging of the product.
If a patient is hypokalemic, the patient has low sodium. high sodium. ---low potassium. high potassium.
The hypo- prefix means low, and the root word kalemia means potassium.
What is the inscription on a prescription? Directions for the patient Dispensing directions to the pharmacist --Medication prescribed Rx symbol
The inscription is the medication being prescribed to a patient, the signa is the directions to the patient, the subscription is directions to the pharmacist, and the Rx symbol means "take this drug."
How many days will 40 tablets last if the patient is taking the medication "ii bid"? 1 day 5 days ---10 days 20 days
The patient is taking two tablets twice per day for a total of 4 tablets per day. 40 tablets divided by 4 tablets per day will last 10 days.
Which of the following is not required information on a medication order filled in a hospital? Medication name, strength, dosage form, route, and directions ---Patient's home address Patient's hospital room number and identification number Patient's name, height, and weight
The patient's home address is not required on a medication order; it is required on a prescription order.
Who decides when an institution's formulary is to be updated? Centers for Medicare and Medicaid Services Hospital board of directors ---Pharmacy and therapeutics committee The Joint Commission
The pharmacy and therapeutics committee, consisting of physicians, pharmacists, nurses, and hospital administration, will make a decision on the frequency of updating the institution's formulary.
Who assigns a beyond-use date for a medication? Drug manufacturer FDA ---Pharmacy USP
The pharmacy assigns a beyond-use date whenever a compound is prepared or repackaged. The USP provides the guidelines for beyond-use dating.
Which of the following solutions is the most diluted? 25% 20% 2.5% ---0.25%
The smaller the number, the weaker or more dilute the substance.
What is the subscription on a prescription? Directions for the patient ---Dispensing directions for the pharmacist Medication prescribed Rx symbol
The subscription provides dispensing directions to the pharmacist. The signa are directions to the patient, the inscription is the medication prescribed, and Rx means "take this drug."
Which dosage form may either be oil-in-water or water-in-oil? Capsule ---Emulsion Suspension Suppository
There are two types of emulsions, oil-in-water and water-in-oil. Emulsions are dispersions, in which one liquid is dispersed in another immiscible liquid.
From two stock solutions, 18% and 42%, you are to prepare 1.5 L of a 34% solution. How many milligrams of each of the stock solutions do you need?
This is an alligation problem in which 42% is the higher concentration and 18% is the lower concentration. Subtracting the desired concentration of 34% from 42% yields 8 parts of the 18% concentration. Subtracting 18% from 34% yields 16 parts of the 42% concentration. Using proportions, one can calculate the required quantities of each concentration. 42%: (16 parts/24 parts) × 1500 mL = 1000 mL of the 42%; (8 parts/24 parts) × 1500 mL = 500 mL of the 18%.
How much of a 10% and 60% dextrose solution should be mixed to prepare 1 L of a 40% dextrose solution?
This is an alligation problem requiring an individual to make a 40% dextrose solution from both 60% and 10% dextrose solutions. Place the 60% in the upper left-hand corner, the 40% in the middle, and the 10% in the lower left-hand corner. 60% - 40% = 20 parts of the 10% solution. 40% - 10% = 30 parts of the 60% solution. The total number of parts is equal to 50 parts. To calculate the required quantities of each solution, use a proportion. 30 parts of 60% solution/50 parts of 40% solution = X mL of 60% solution/1000 mL of 40% solution, where X = 600 mL of the 60% solution. 20 parts of 10% solution/50 parts of 40% solution = X mL of 10% solution/1000 mL of 40% solution, where X = 400 mL of the 10% solution.
Which of the following interpretations of the signa "i cap qid ac and hs" is correct?
i (1) cap (capsule) qid (four times per day) ac (before meals) and hs (bedtime).
