1. A prescriber has ordered 240 g of nystatin, diphenhydramine, and 2.5% hydrocortisone creams in equal parts. How many grams of hydrocortisone cream are needed for the order?
To find the number of grams for each ingredient when ordered in equal parts, divide the total weight ordered by the number of ingredients. Because there are three ingredients, you would divide the total by three: (240 g)/3=80 g. Although the hydrocortisone cream has a percentage strength associated with it, it has no relevance in this example.
2. The organ that performs the most drug metabolism is the
Liver metabolism is responsible for changing most drugs to a less active form that is more easily excreted by the kidneys.
3. A pharmacy technician is preparing a hazardous drug and spills some on the counter. Before cleaning the spill, the technician should consult
The Material Safety Data Sheet (MSDS) for the hazardous drug should specify what action should be taken during an accidental spillage.
4. How often should a patient profile be updated?
The patient profile may change often; thus, any updates to address, medications, physical condition, etc. should be noted each time the patient fills a prescription.
5. Which of the following is an approach for identifying the underlying causes of an incident or problem so that it may be prevented in the future?
Root-cause analysis is a problem-solving technique to determine the fundamental cause of an incident (such as a medication error) for the purpose of implementing policies or procedures to prevent its occurrence in the future.
6. The pharmacy technician receives a prescription for Cardizem that has the "DAW" box checked on the prescription. What does "DAW" indicate?
Dispense as written (DAW) clearly means the prescriber wants the drug dispenses exactly as written, without generic substitution.
7. Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed class of drugs for managing
SSRIs such as fluoxetine (Prozac) have replaced the older tricyclic antidepressants (TCAs) due to their effectiveness and favorable safety profile. Bipolar disorder can be exacerbated by SSRIs, causing mania.
8. A drug is dosed at 2 mg/kg every 8h. The drug is stocked in a concentration of 5 mg/mL. How many milliliters of stock solution are needed for one dose if the patient weighs 125 lb?
Convert the patient's weight in pounds to kilograms by dividing by a factor of 2.2: 125 lb/2.2 = 56.82 kg. Multiply the dose by the weight to get the number of milligrams in each dose: 2 mg * 56.82 kg = 113.6 mg. Set up a proportion using the concentration of the stock vial and the milligrams needed to find the milliliters required for the dose: 5 mg/1 mL = 113.6 mg. Cross-multiply and divide to solve for X: X = 22.7 mL. The "every 8h" is irrelevant in this problem because the problem only asked for a single dose, not the total daily dose.
9. The ISMP is a nonprofit organization and its main focus is
The Institute for Safe Medication Practice (ISMP) publishes electronic medication safety letters for healthcare professionals and consumers. They also offer medication safety guidelines. ISMP also operates two error-reporting programs to help improve vaccine and medication safety.
10. Calcium channel blockers are indicated for all of the following disorders EXCEPT
Calcium channel blockers are not prescribed for thrombosis prevention: anticoagulant or antiplatelet drugs are used for this purpose.
11. A prescription for cyclobenzaprine 10 mg was presented to the pharmacy. The physician wants a quantity of "XC" with a sig reading "i-ii tabs po bid-tid prn". What days' supply should be given for this prescription?
This scenario involves converting Roman numerals to Arabic and calculating days' supply. In Roman numerals, X = 10 and C = 100. When the smaller number (X) is placed before the larger number (C), the smaller number is subtracted from the larger: 100 - 10 = 90 tablets. The physician has also written the variable dose in lowercase Roman numerals: i = 1 and ii = 2. When calculating days' supply using a variable dose or variable frequency, always use the maximum quantities for each with the following formula: quantity prescribed/(maximum dose * maximum frequency), so 90 tabs/(2 * 3) = 15 days. This method ensures that a third-party payer will not reject a claim because it was refilled too soon.
12. The patient is receiving a medical device that requires all potential sources of pathogens to be removed. The removal of all pathogens is called
Killing all pathogens on a device or other object is called sterilization. This term is sometimes used interchangeable with medical asepsis, though there are distinctions between the two terms.
13. In order for two medications to be therapeutically equivalent they must meet all of the following criteria EXCEPT
To be approved as therapeutically equivalent, two medications must have identical active ingredients, must be given at identical doses by the same route, must have the same safety profile, and must produce the same biological actions. They may have different packaging, colors, flavors, preservatives, shapes, expiration dates, and storage conditions.
14. Which of the following is true regarding drug names?
There is only one generic name, which is assigned by the United States Adopted Name Council.
15. The pharmacy technician is filling a prescription for a drug to be administered by the buccal route. The technician knows that this drug should be
Buccal medications are tablets placed between the cheek and gum.
16. Rivastigmine (Exelon) and donepezil (Aricept) are common drugs used for the management of
Rivastigmine (Exelon) and donezepil (Aricept) are used to manage early symptoms of Alzheimer's disease, although they provide only modest improvement in symptoms.
17. An order for 20% dextrose has been received. How many milliliters of 50% dextrose must be compounded with sterile water to make 1 L?
Use an alligation grid (see below) and subtract diagonally to find number of parts of each solution: 20 parts dextrose 50% and 30 parts water. Calculate the sum of both parts: 20 + 30 = 50 parts total. Divide the number of parts of dextrose 50% by the total number of parts, then multiply by the volume you require: 20 / 50 * 1000 mL = 400 mL dextrose 50%. You may use a similar method to solve for the volume of water required, but it is not necessary in this problem.
18. Propranolol (Inderal) is contraindicated in patients with asthma because beta blockers
The lung has beta-2 receptors and blocking them may result in bronchoconstriction, triggering an acute asthma attack.
19. Which of the following is NOT a method used in pharmacy to prevent medication errors?
The lot number will give you no drug information at the time of fill to indicate the product is incorrect. The other three are common methods used to prevent misfills and drug errors.
20. Cytarabine is to be given 100 mg/m2 every 12 hours. If the patient has a BSA of 2.1 m2, how many milligrams will the patient receive each day?
BSA refers to body surface area, which is measured in meters squared. Multiply the milligrams required by the BSA to determine the number of milligrams needed for each dose: 2.1 m2 * 100 mg = 210 mg. This dose is given every 12 hours or twice daily. Multiply the dose by two to find the total daily dosage: 210 mg * 2 = 420 mg daily.
21. The "Do Not Use" List from The Joint Commission requires healthcare organizations to avoid the use of all the following abbreviations EXCEPT
All are easily mistaken for other terms except for PO. The other abbreviations should not be used and the term must be written out.
22. Digoxin is a medication with a narrow (small) therapeutic index. What can you conclude from this information about digoxin?
Therapeutic index (TI) is the ratio of the amount of drug required to produce a therapeutic effect versus the dose that produces toxic effects. Drugs with a narrow (small) TI such as digoxin need to be monitored carefully for safety because there is very little difference between a therapeutic dose and a toxic dose.
23. A patient receiving cyclophosphamide (Cytoxan) and paclitaxel (Taxol) is being treated for
Cytoxan and Taxol are antineoplastic drugs used to treat various types of cancer.
24. A prescription for tobramycin 0.3% ophthalmic solution was presented to the pharmacy. What days' supply should be given for a 5 mL bottle if the directions state: "2 gtt os every 4 h until gone"?
The days' supply for eye/ear drops can be approximated using the conversion factor 20 gtt = 1 mL. Determine the number of drops in the bottle by using a proportion with this conversion factor and the volume of the bottle in milliliters: 20 gtt/1 mL = X/5 mL. Cross-multiply and divide to solve for X: X = 100 gtt. This is the number of drops in the bottle. To determine the number of drops used daily, use the following equation: Number of drops per dose * number of eyes * frequency. 2 gtt * 1 eye * 6 times per day (equivalent to every 4 hours) = 2 * 1 * 6 = 12 drops per day. Divide the total number of drops in the bottle by the number of drops per day to determine the days' supply: 100 gtt/12 = 8 days.
25. Severe postoperative nausea and vomiting would likely be treated with
Severe postoperative nausea, as well as that due to chemotherapy agents, is often treated with 5-HT3 antagonists such as ondansetron (Zofran).
26. How many tablets will be needed to fill an order with the following sig: 2 tabs po qid X 7d?
The sig refers to the directions for use. To determine the number of tablets needed for the supply, use the following formula: Dose * frequency * number of days. The dose is two tablets, the frequency is four times a day, and the number of days is seven. 2 * 4 * 7 = 56 tablets.
27. Which vitamin is often prescribed during pregnancy to help prevent neural tube defects in the fetus?
Adequate amounts of folic acid (vitamin B9) are required for development of the nervous system of the fetus.
28. Which of the following routes of administration will result in the fastest onset of drug action?
The IV route is used to deliver emergency medications because drugs will have the fastest onset of action.
29. Once a new vial of insulin has been opened, any remaining drug left in the vial should be discarded
When administered in multiuse vials, all insulin should be used or discarded within 28 days. This is because each penetration of a needle includes a small risk for contamination of the vial.
30. The pharmacy technician is assisting the pharmacist with the preparation of daunorubicin for dispensing. The technician notices a warning on the packaging that states "DANGER: vesicant". Vesicant means that daunorubicin
Vesicant drugs are those that cause severe blistering if they contact the skin or mucous membranes.