CSPT #3

Viable air samples exceed the action limit in a ISO Class 8 Environment when the microorganism count is at least:

101+ CFU (Colony Forming Units)

The assessment of risk should consider which of the following?

A. the type of hazardous drug. B. the dosage form of hazardous drug. C. the risk of exposure to hazardous drug. D. the packaging of hazardous drug. E. the manipulation of hazardous drug.

Which of the following precautions is/are required while administering or disposing hazardous drugs?

Attach drug administration sets to the IV bag, and prime them before adding the drug to the bag.

Gloves, gowns or other materials that have chemotherapy drugs spilled on them shall be classified under:

Bulk chemotherapy wastes

Ventilated cabinets or BSC (Biological Safety Cabinet) are classified based on requirements of asepsis. Which of the following classes of BSC (Biological Safety Cabinet) can be used when asepsis is NOT required?

Class I BSC

Under the USP General Chapter 800, which of the following agents can be considered in an assessment of risk?

Counting Finasteride tablets.

Which of the following hazardous drugs is also considered as the hazardous waste by EPA?

Cyclophosphamide.

According to USP General Chapter 800, one can perform an assessment of risk for an entire group of hazardous drugs (HDs) (e.g. Methotrexate tablets, Methotrexate capsules, Methotrexate injection, Methotrexate suspension as one group) HDs simultaneously instead of listing each individual hazardous drug (HD).

False.

When measuring a liquid, the general rule is to use the size of graduate no less than 50% of the capacity of a graduate should be measured.

False.

As defined by the U.S. Environmental Protection Agency (EPA), the list of hazardous wastes are:

I. "F-listed" wastes that come from common industrial and manufacturing processes. II. "K-listed" wastes that come from specific industry processes. III. "P- and U-listed wastes" that are discarded and unused chemical products and formulations.

Factors that affect worker exposures to hazardous drugs may include:

I. Amount of drug prepared. II. Use of ventilated cabinets. III. Frequency and duration of drug handling.

The pharmacy engagement in which of the following acts may consider by the FDA the violation of the new drug, adulteration, or misbranding provisions of the Act?

I. Compounding very large quantities of particular drug before receiving valid prescriptions II. Compounding drug products that are commercially available in the marketplace. III. Compounding drugs that were withdrawn or removed from the market for safety reasons.

Which of the following is/are listed under P-listed pharmaceuticals?

I. Epinephrine base II. Nicotine III. Phentermine

Which of the following conditions may increase the risk of expose to hazardous drugs?

I. Expelling air from syringes filled with hazardous drugs. II. Priming the IV set with a drug-containing solution at the patient bedside. III. Administering hazardous drugs by intramuscular, subcutaneous, or intravenous routes

Which of the following statements is/are TRUE ABOUT Risk Assessment in USP General Chapter 800?

I. General Chapter 800 uses a risk-based approach that focuses on certain drugs and dosage forms that may pose a lower risk to health professionals II. Drugs on the NIOSH list that are required to follow all containment strategies and work practices listed in 800 III. The "assessment of risk" in 800 enables certain dosage forms of hazardous drugs that are administered without modification (e.g., tablets, capsules) to be exempted from 800 requirements.

Which of the following information is/are TRUE ABOUT Pressure Differential Monitoring environmental testing?

I. It monitors airflow between the buffer area and ante area. II. The results shall be reviewed and documented on a log at least every work shift

What are alternative containment strategies that may be employed under an assessment of risk?

I. Purchasing hazardous drugs in unit dose. II. Exclude pregnant personnel to handle finasteride tablet III. Use of personal protective equipment (PPE)

Which of the following tests should be included in environmental testing program?

I. Room pressure differentials II. Nonviable Particle Testing Program III. Viable Airborne Particle Testing Program

How should a facility or a pharmacy manage chemotherapy wastes?

I. The facility or pharmacy may donate unused or discontinued chemotherapy drugs as product to pharmacies or medical facilities participating in the cancer drug repository program. II. The facility or pharmacy may return chemotherapy drugs to the manufacturer or a reverse distributor for credit or as a product. III. Chemotherapy drugs are only eligible for reverse distribution if they are not leaking or partially used liquids or pastes and do not display any other characteristics that would likely make them ineligible for return.

Which of the following steps may reduce the accidental exposure to hazardous drugs?

I. Wearing chemotherapy gloves to prevent contamination when transporting the vial or syringe to the work area. II. Storing hazardous drugs separately from the regular drugs. III. Transporting hazardous drugs in closed containers that minimize the risk of breakage.

Which of the following information is/are TRUE ABOUT preparing hazardous drugs?

I. When drug preparation is complete, seal the final product in a plastic bag or other sealable container for transport before taking it out of the ventilated cabinet. II. Seal and wipe all waste containers inside the ventilated cabinet before removing them from the cabinet. III. Remove all outer gloves and sleeve covers and bag them for disposal while you are inside the ventilated cabinet.

The universal waste regulations streamline collection requirements for certain hazardous wastes in which of the following categories?

I. batteries II. pesticides III. thermostats

Environmental sampling shall occur as part a comprehensive quality management program and shall minimally be performed under which of the following conditions?

I. in response to identified problems with end products or staff technique. II. as part of the re-certification of facilities and equipment every 6 months. III. in response to patient-related infections where the CSP is being considered as a potential source of the infection.

Which of the following preparations MUST be sterile when they are administered to patients?

I. irrigations for wounds and body cavities II. aqueous nasal inhalations III. tissue implants

Working with or near hazardous drugs in health care settings may cause:

I. skin rashes II. infertility III. miscarriage

Which of the following can be classified as hazardous waste?

I. waste alcohol II. vaccines preserved with thiomersal III. ethyl ether

A buffer area is an area that provides at least:

ISO Class 7 air quality. (A critical area is an area that provides at least ISO Class 5 air quality. An ante area is an area that provides at least ISO Class 8 air quality.)

Which of the following is/are the most likely routes of exposure to hazardous drugs?

Inhalation AND Skin contact/absorption

One of the primary criteria for including a drug on the P-list as acutely hazardous is an oral lethal dose of:

LD50 or Less.

The process of reducing the particle size of a solid by triturating it in a mortar or on an ointment slab or pad by first wetting it with a small amount of liquid is defined as:

Levigation

Which of the following information is/are TRUE ABOUT PPE while reconstituting, preparing or admixing hazardous drugs?

Make sure that gloves are labeled as [ASTM in press] gloves AND Use double gloving for all activities involving hazardous drugs.

Is the Containment Secondary Engineering Control (C-SEC) required to be externally vented through high efficiency particulate air (HEPA) filtration?

No.

In which of the following instances shall a pharmacy consider an assessment of risk?

Repackaging containers of commercially available Hazardous drug (HD) oral liquids into prescription containers. AND The reconstitution, mixing, and diluting of Group 2 Hazardous drugs (HDs) on the NIOSH list.

Who regulates and lists the hazardous waste pharmaceuticals?

Resource Conservation and Recovery Act (RCRA)

According to General Chapter 800, sterile and nonsterile Hazardous drugs (HDs) can be stored together

True.

Bulk chemotherapy waste should be contained in RCRA containers that are DOT approved to transport this type of hazardous material (often black) and labeled as hazardous pharmaceutical waste with the correct DOT hazard class.

True.

Trace or RCRA-empty chemotherapy can be disposed of in waste containers labeled as "Chemotherapy Waste" or "Incinerate Only".

True.

Which of the following is classified under P-Listed Acute Hazardous Waste?

Warfarin.