CSPT Certification Exam Prep 2026 Updated Practice
Questions Comprehensive Sterile Compounding Review
Detailed Explanations, Verified Answers, Complete
Success Workbook
Question 1
A pharmacy technician is preparing a total parenteral nutrition (TPN)
admixture. Which of the following is a standard component of a TPN
formulation?
A) Dextrose, amino acids, and lipids
B) Normal saline and potassium chloride only
C) Dextrose and lactated Ringer's only
D) Amino acids and sterile water only
Answer: A) Dextrose, amino acids, and lipids
Rationale: Total parenteral nutrition (TPN) formulations typically contain
three macronutrients: dextrose (carbohydrate source), amino acids (protein
source), and lipids (fat source), along with electrolytes, vitamins, and trace
elements. The "3-in-1" or "all-in-one" TPN admixture contains all three
macronutrients in a single bag.
Question 2
Which of the following medications is classified as a narrow therapeutic index
(NTI) drug that requires extra caution during sterile compounding?
A) Amoxicillin
B) Warfarin
C) Ciprofloxacin
D) Metformin
Answer: B) Warfarin
Rationale: Warfarin is a narrow therapeutic index (NTI) medication, meaning
small differences in dose or blood concentration can lead to serious
,therapeutic failures or adverse drug reactions. Other NTI drugs include
digoxin, phenytoin, theophylline, and levothyroxine. Amoxicillin (A),
ciprofloxacin (C), and metformin (D) are not classified as NTI drugs.
Question 3
A patient is prescribed IV vancomycin. What is the primary therapeutic
indication for this medication?
A) Treatment of serious Gram-positive infections, including MRSA
B) Treatment of Gram-negative infections
C) Antifungal therapy
D) Antiviral therapy
Answer: A) Treatment of serious Gram-positive infections, including
MRSA
Rationale: Vancomycin is a glycopeptide antibiotic used to treat serious
Gram-positive infections, including methicillin-resistant Staphylococcus
aureus (MRSA), enterococcal infections, and Clostridioides difficile (oral route).
It is not effective against Gram-negative bacteria (B), fungi (C), or viruses (D).
Question 4
Which component is commonly added to IV solutions to adjust tonicity?
A) Sterile water
B) Sodium chloride or dextrose
C) Preservatives
D) Buffering agents
Answer: B) Sodium chloride or dextrose
Rationale: Sodium chloride and dextrose are the most common components
used to adjust the tonicity of IV solutions. Normal saline (0.9% NaCl) is
isotonic, while D5W (5% dextrose in water) is also isotonic initially. These
agents help match the osmotic pressure of blood and body fluids. Sterile water
(A) is hypotonic and would cause hemolysis if infused alone.
,Question 5
A pharmacy technician is compounding an IV medication that requires
reconstitution. Which of the following is the appropriate diluent for
reconstituting a medication that is supplied as a lyophilized powder?
A) Sterile water for injection or 0.9% sodium chloride as specified by the
manufacturer
B) Any available IV fluid
C) Tap water
D) Bacteriostatic water
Answer: A) Sterile water for injection or 0.9% sodium chloride as
specified by the manufacturer
Rationale: Lyophilized (freeze-dried) powders must be reconstituted with
the specific diluent recommended by the manufacturer, typically sterile water
for injection (SWFI) or 0.9% sodium chloride injection. Using the wrong
diluent (B, C, D) can affect drug stability, solubility, and safety.
Question 6
Which of the following is classified as a high-alert medication that requires
special safeguards during sterile compounding?
A) Amoxicillin
B) Heparin
C) Metformin
D) Lisinopril
Answer: B) Heparin
Rationale: Heparin is a high-alert medication due to the significant risk of
patient harm if used in error (e.g., incorrect concentration, dosing
errors). Other high-alert medications include insulin, opioids, chemotherapy
agents, and potassium chloride. Amoxicillin (A), metformin (C), and lisinopril
(D) are not classified as high-alert medications.
, Question 7
Which chemotherapy agent requires special handling as a hazardous drug
during sterile compounding?
A) Cyclophosphamide
B) Amoxicillin
C) Metformin
D) Omeprazole
Answer: A) Cyclophosphamide
Rationale: Cyclophosphamide is an alkylating agent classified as a hazardous
drug (HD) by NIOSH. It requires special handling, including compounding in a
biological safety cabinet (BSC) or CACI, use of chemotherapy-rated gloves, and
adherence to USP <800> standards. Amoxicillin (B), metformin (C), and
omeprazole (D) are not hazardous drugs.
Question 8
A patient is prescribed IV immunoglobulin (IVIG). What is the primary
therapeutic indication for this medication?
A) Immunodeficiency disorders and autoimmune conditions
B) Hypertension
C) Diabetes mellitus
D) Hyperlipidemia
Answer: A) Immunodeficiency disorders and autoimmune conditions
Rationale: IVIG is used to treat primary immunodeficiency disorders,
secondary immunodeficiencies, and various autoimmune and inflammatory
conditions (e.g., Guillain-Barré syndrome, chronic inflammatory
demyelinating polyneuropathy, immune thrombocytopenic purpura). It is not
indicated for hypertension (B), diabetes (C), or hyperlipidemia (D).
Question 9
Which of the following is a standard electrolyte additive commonly found in
IV solutions?
Questions Comprehensive Sterile Compounding Review
Detailed Explanations, Verified Answers, Complete
Success Workbook
Question 1
A pharmacy technician is preparing a total parenteral nutrition (TPN)
admixture. Which of the following is a standard component of a TPN
formulation?
A) Dextrose, amino acids, and lipids
B) Normal saline and potassium chloride only
C) Dextrose and lactated Ringer's only
D) Amino acids and sterile water only
Answer: A) Dextrose, amino acids, and lipids
Rationale: Total parenteral nutrition (TPN) formulations typically contain
three macronutrients: dextrose (carbohydrate source), amino acids (protein
source), and lipids (fat source), along with electrolytes, vitamins, and trace
elements. The "3-in-1" or "all-in-one" TPN admixture contains all three
macronutrients in a single bag.
Question 2
Which of the following medications is classified as a narrow therapeutic index
(NTI) drug that requires extra caution during sterile compounding?
A) Amoxicillin
B) Warfarin
C) Ciprofloxacin
D) Metformin
Answer: B) Warfarin
Rationale: Warfarin is a narrow therapeutic index (NTI) medication, meaning
small differences in dose or blood concentration can lead to serious
,therapeutic failures or adverse drug reactions. Other NTI drugs include
digoxin, phenytoin, theophylline, and levothyroxine. Amoxicillin (A),
ciprofloxacin (C), and metformin (D) are not classified as NTI drugs.
Question 3
A patient is prescribed IV vancomycin. What is the primary therapeutic
indication for this medication?
A) Treatment of serious Gram-positive infections, including MRSA
B) Treatment of Gram-negative infections
C) Antifungal therapy
D) Antiviral therapy
Answer: A) Treatment of serious Gram-positive infections, including
MRSA
Rationale: Vancomycin is a glycopeptide antibiotic used to treat serious
Gram-positive infections, including methicillin-resistant Staphylococcus
aureus (MRSA), enterococcal infections, and Clostridioides difficile (oral route).
It is not effective against Gram-negative bacteria (B), fungi (C), or viruses (D).
Question 4
Which component is commonly added to IV solutions to adjust tonicity?
A) Sterile water
B) Sodium chloride or dextrose
C) Preservatives
D) Buffering agents
Answer: B) Sodium chloride or dextrose
Rationale: Sodium chloride and dextrose are the most common components
used to adjust the tonicity of IV solutions. Normal saline (0.9% NaCl) is
isotonic, while D5W (5% dextrose in water) is also isotonic initially. These
agents help match the osmotic pressure of blood and body fluids. Sterile water
(A) is hypotonic and would cause hemolysis if infused alone.
,Question 5
A pharmacy technician is compounding an IV medication that requires
reconstitution. Which of the following is the appropriate diluent for
reconstituting a medication that is supplied as a lyophilized powder?
A) Sterile water for injection or 0.9% sodium chloride as specified by the
manufacturer
B) Any available IV fluid
C) Tap water
D) Bacteriostatic water
Answer: A) Sterile water for injection or 0.9% sodium chloride as
specified by the manufacturer
Rationale: Lyophilized (freeze-dried) powders must be reconstituted with
the specific diluent recommended by the manufacturer, typically sterile water
for injection (SWFI) or 0.9% sodium chloride injection. Using the wrong
diluent (B, C, D) can affect drug stability, solubility, and safety.
Question 6
Which of the following is classified as a high-alert medication that requires
special safeguards during sterile compounding?
A) Amoxicillin
B) Heparin
C) Metformin
D) Lisinopril
Answer: B) Heparin
Rationale: Heparin is a high-alert medication due to the significant risk of
patient harm if used in error (e.g., incorrect concentration, dosing
errors). Other high-alert medications include insulin, opioids, chemotherapy
agents, and potassium chloride. Amoxicillin (A), metformin (C), and lisinopril
(D) are not classified as high-alert medications.
, Question 7
Which chemotherapy agent requires special handling as a hazardous drug
during sterile compounding?
A) Cyclophosphamide
B) Amoxicillin
C) Metformin
D) Omeprazole
Answer: A) Cyclophosphamide
Rationale: Cyclophosphamide is an alkylating agent classified as a hazardous
drug (HD) by NIOSH. It requires special handling, including compounding in a
biological safety cabinet (BSC) or CACI, use of chemotherapy-rated gloves, and
adherence to USP <800> standards. Amoxicillin (B), metformin (C), and
omeprazole (D) are not hazardous drugs.
Question 8
A patient is prescribed IV immunoglobulin (IVIG). What is the primary
therapeutic indication for this medication?
A) Immunodeficiency disorders and autoimmune conditions
B) Hypertension
C) Diabetes mellitus
D) Hyperlipidemia
Answer: A) Immunodeficiency disorders and autoimmune conditions
Rationale: IVIG is used to treat primary immunodeficiency disorders,
secondary immunodeficiencies, and various autoimmune and inflammatory
conditions (e.g., Guillain-Barré syndrome, chronic inflammatory
demyelinating polyneuropathy, immune thrombocytopenic purpura). It is not
indicated for hypertension (B), diabetes (C), or hyperlipidemia (D).
Question 9
Which of the following is a standard electrolyte additive commonly found in
IV solutions?
