PTCB CPhT Comprehensive Practice Exam
1. A patient who has been taking Warfarin for several months arrives at the pharmacy with a
new prescription for a multi-vitamin containing high levels of Vitamin K. What is the most
likely outcome of this drug-nutrient interaction?
A. The patient’s INR will increase, leading to a higher risk of bleeding.
B. There is no significant interaction between Warfarin and Vitamin K.
C. The Vitamin K will enhance the anticoagulation effect of the Warfarin.
D. The patient’s INR will decrease, leading to an increased risk of blood clots.
Correct Answer: D
Explanation: Warfarin works as a Vitamin K antagonist to prevent blood clotting, so
increasing Vitamin K intake directly counteracts its therapeutic effect. A decrease in INR
(International Normalized Ratio) indicates the blood is clotting too quickly, which raises
the risk of stroke or embolism. Technicians must recognize this interaction because
consistent dietary intake of Vitamin K is crucial for patients on anticoagulation therapy.
2. The pharmacy receives a shipment of controlled substances. For which of the following
medications must the pharmacist or technician ensure a DEA Form 222 was used for the
order and is filed accordingly?
A. Alprazolam
B. Codeine with Acetaminophen
,C. Zolpidem
D. Oxycodone
Correct Answer: D
Explanation: DEA Form 222 is exclusively required for the ordering, distribution, and
transfer of Schedule I and II controlled substances. Oxycodone is a Schedule II medication
due to its high potential for abuse and severe physical or psychological dependence. A
common examination trap is confusing Schedule III-V drugs, like Alprazolam or Zolpidem,
which do not require this specific form for ordering.
3. A prescription is written for ‘HydrOXYzine 25mg’ but the technician accidentally selects
‘HydrALAzine 25mg’ from the shelf. What safety strategy is specifically designed to prevent
this type of error?
A. Barcoding at the point of entry
B. Using the NDC number for verification
C. Double-check by a second technician
D. TALL man lettering
Correct Answer: D
Explanation: TALL man lettering uses uppercase letters to highlight the differing parts of
look-alike/sound-alike (LASA) medication names, such as hydrOXYzine and hydrALAzine.
This strategy draws the pharmacy staff’s attention to the differences in spelling to prevent
selection errors. Relying solely on memory or quick scanning is a common mistake that
,leads to dispensing the wrong medication with potentially dangerous pharmacological
differences.
4. A pharmacist asks you to prepare a 20% dextrose solution using 500 mL of 10% dextrose
and an ample supply of 50% dextrose. How much 50% dextrose will you need?
A. 333.3 mL
B. 250.0 mL
C. 166.7 mL
D. 125.0 mL
Correct Answer: C
Explanation: Using the alligation method, you subtract the target 20% from the higher
50% to get 30 parts of the 10% solution, and subtract the lower 10% from the target 20%
to get 10 parts of the 50% solution. Since 500 mL represents 30 parts, one part equals
16.67 mL (500/30). Multiplying 10 parts by 16.67 mL gives approximately 166.7 mL of the
50% solution required. Beginners often misplace the values in the alligation grid, leading to
an incorrect ratio of the two concentrations.
5. A prescription reads: ‘1 tab po bid ac’. When should the patient take this medication?
A. One tablet by mouth twice a day after meals.
B. One tablet by mouth twice a day before meals.
C. One tablet by mouth twice a day as needed.
, D. One tablet by mouth three times a day before meals.
Correct Answer: B
Explanation: The sig code ‘bid’ stands for ‘bis in die’, which means twice daily, and ‘ac’
stands for ‘ante cibum’, which means before meals. Understanding Latin abbreviations is
essential for accurate prescription processing and patient safety. A common error is
confusing ‘ac’ (before meals) with ‘pc’ (after meals) or ‘hs’ (at bedtime).
6. A patient is prescribed Lisinopril for hypertension but develops a persistent, dry, non-
productive cough. Which class of medications does Lisinopril belong to, and is this cough a
known side effect?
A. ACE Inhibitor; yes, this is a common side effect.
B. Beta-blocker; no, the cough is likely due to an infection.
C. Calcium Channel Blocker; yes, this is a common side effect.
D. ARB; no, this medication should not cause a cough.
Correct Answer: A
Explanation: Lisinopril is an ACE (Angiotensin-Converting Enzyme) inhibitor, which
prevents the breakdown of bradykinin, leading to a persistent dry cough in about 10-20%
of patients. If this occurs, the patient is often switched to an ARB (Angiotensin II Receptor
Blocker), which does not affect bradykinin. It is important for technicians to recognize this
side effect so they can refer the patient to the pharmacist for a consultation about
medication adherence.
1. A patient who has been taking Warfarin for several months arrives at the pharmacy with a
new prescription for a multi-vitamin containing high levels of Vitamin K. What is the most
likely outcome of this drug-nutrient interaction?
A. The patient’s INR will increase, leading to a higher risk of bleeding.
B. There is no significant interaction between Warfarin and Vitamin K.
C. The Vitamin K will enhance the anticoagulation effect of the Warfarin.
D. The patient’s INR will decrease, leading to an increased risk of blood clots.
Correct Answer: D
Explanation: Warfarin works as a Vitamin K antagonist to prevent blood clotting, so
increasing Vitamin K intake directly counteracts its therapeutic effect. A decrease in INR
(International Normalized Ratio) indicates the blood is clotting too quickly, which raises
the risk of stroke or embolism. Technicians must recognize this interaction because
consistent dietary intake of Vitamin K is crucial for patients on anticoagulation therapy.
2. The pharmacy receives a shipment of controlled substances. For which of the following
medications must the pharmacist or technician ensure a DEA Form 222 was used for the
order and is filed accordingly?
A. Alprazolam
B. Codeine with Acetaminophen
,C. Zolpidem
D. Oxycodone
Correct Answer: D
Explanation: DEA Form 222 is exclusively required for the ordering, distribution, and
transfer of Schedule I and II controlled substances. Oxycodone is a Schedule II medication
due to its high potential for abuse and severe physical or psychological dependence. A
common examination trap is confusing Schedule III-V drugs, like Alprazolam or Zolpidem,
which do not require this specific form for ordering.
3. A prescription is written for ‘HydrOXYzine 25mg’ but the technician accidentally selects
‘HydrALAzine 25mg’ from the shelf. What safety strategy is specifically designed to prevent
this type of error?
A. Barcoding at the point of entry
B. Using the NDC number for verification
C. Double-check by a second technician
D. TALL man lettering
Correct Answer: D
Explanation: TALL man lettering uses uppercase letters to highlight the differing parts of
look-alike/sound-alike (LASA) medication names, such as hydrOXYzine and hydrALAzine.
This strategy draws the pharmacy staff’s attention to the differences in spelling to prevent
selection errors. Relying solely on memory or quick scanning is a common mistake that
,leads to dispensing the wrong medication with potentially dangerous pharmacological
differences.
4. A pharmacist asks you to prepare a 20% dextrose solution using 500 mL of 10% dextrose
and an ample supply of 50% dextrose. How much 50% dextrose will you need?
A. 333.3 mL
B. 250.0 mL
C. 166.7 mL
D. 125.0 mL
Correct Answer: C
Explanation: Using the alligation method, you subtract the target 20% from the higher
50% to get 30 parts of the 10% solution, and subtract the lower 10% from the target 20%
to get 10 parts of the 50% solution. Since 500 mL represents 30 parts, one part equals
16.67 mL (500/30). Multiplying 10 parts by 16.67 mL gives approximately 166.7 mL of the
50% solution required. Beginners often misplace the values in the alligation grid, leading to
an incorrect ratio of the two concentrations.
5. A prescription reads: ‘1 tab po bid ac’. When should the patient take this medication?
A. One tablet by mouth twice a day after meals.
B. One tablet by mouth twice a day before meals.
C. One tablet by mouth twice a day as needed.
, D. One tablet by mouth three times a day before meals.
Correct Answer: B
Explanation: The sig code ‘bid’ stands for ‘bis in die’, which means twice daily, and ‘ac’
stands for ‘ante cibum’, which means before meals. Understanding Latin abbreviations is
essential for accurate prescription processing and patient safety. A common error is
confusing ‘ac’ (before meals) with ‘pc’ (after meals) or ‘hs’ (at bedtime).
6. A patient is prescribed Lisinopril for hypertension but develops a persistent, dry, non-
productive cough. Which class of medications does Lisinopril belong to, and is this cough a
known side effect?
A. ACE Inhibitor; yes, this is a common side effect.
B. Beta-blocker; no, the cough is likely due to an infection.
C. Calcium Channel Blocker; yes, this is a common side effect.
D. ARB; no, this medication should not cause a cough.
Correct Answer: A
Explanation: Lisinopril is an ACE (Angiotensin-Converting Enzyme) inhibitor, which
prevents the breakdown of bradykinin, leading to a persistent dry cough in about 10-20%
of patients. If this occurs, the patient is often switched to an ARB (Angiotensin II Receptor
Blocker), which does not affect bradykinin. It is important for technicians to recognize this
side effect so they can refer the patient to the pharmacist for a consultation about
medication adherence.
