Hazardous Drug Pharmacy Technician Exam Prep 2026
Updated Practice Questions, Comprehensive Medication
Safety Review, Detailed Explanations, Verified Answers,
Success Workbook
SECTION 1: SAFE HANDLING OF HAZARDOUS DRUGS (Questions 1-20)
Question 1: Which of the following is the PRIMARY purpose of using a closed-
system drug-transfer device (CSTD) when handling hazardous drugs?
A) To reduce the cost of chemotherapy preparation
B) To prevent microbial contamination of sterile preparations
C) To minimize environmental and occupational exposure to hazardous drugs
D) To increase the speed of drug preparation
Answer: C) To minimize environmental and occupational exposure to
hazardous drugs
Rationale: The primary purpose of a CSTD is to mechanically prevent the
transfer of environmental contaminants into the system and the escape of
hazardous drug vapors or aerosols from the system, thereby protecting
healthcare workers from occupational exposure. While CSTDs may have
secondary benefits, exposure prevention is their main function. Option A is
incorrect because CSTDs actually increase costs. Option B describes sterile
technique, not the specific purpose of CSTDs. Option D is incorrect as CSTDs
can sometimes slow preparation time.
Question 2: A pharmacy technician is preparing a hazardous drug in a
biological safety cabinet (BSC). Which of the following actions would
COMPROMISE the effectiveness of the BSC?
A) Working at least 6 inches inside the cabinet
B) Keeping the blower running continuously
C) Placing all materials inside before beginning preparation
D) Placing the IV bag outside the BSC and connecting it from outside
,Answer: D) Placing the IV bag outside the BSC and connecting it from
outside
Rationale: The IV bag should be placed inside the BSC along with all other
supplies to maintain the sterile and contained environment. Connecting from
outside would compromise the airflow patterns and containment capabilities
of the BSC. Option A is correct practice (work at least 6 inches inside). Option
B is correct (blower should run continuously, ideally 24/7). Option C is
correct practice (pre-stage all materials to minimize arm movements that
disrupt airflow).
Question 3: According to USP Chapter <797>, which of the following is the
MAXIMUM allowable airborne particle concentration for an ISO Class 5
environment?
A) 3,520 particles ≥0.5μm per cubic meter
B) 352,000 particles ≥0.5μm per cubic meter
C) 3,520 particles ≥5.0μm per cubic meter
D) 352 particles ≥0.5μm per cubic meter
Answer: A) 3,520 particles ≥0.5μm per cubic meter
Rationale: USP Chapter <797> specifies that an ISO Class 5 environment
(such as a compounding aseptic isolator or BSC) must maintain airborne
particle counts of no more than 3,520 particles ≥0.5μm per cubic meter.
Option B describes ISO Class 7. Option C has the wrong particle size threshold.
Option D is incorrect as it describes a stricter environment than ISO Class 5.
Question 4: When a hazardous drug spill occurs in a pharmacy, which of the
following is the CORRECT sequence of steps to follow?
A) Contain the spill → Evacuate the area → Notify supervisor → Clean up
B) Evacuate the area → Notify supervisor → Contain the spill → Clean up
C) Clean up → Contain the spill → Evacuate → Notify supervisor
D) Notify supervisor → Evacuate → Clean up → Contain
Answer: B) Evacuate the area → Notify supervisor → Contain the spill →
Clean up
,Rationale: The correct sequence for handling a hazardous drug spill is to first
evacuate the area to protect personnel, then notify the supervisor
immediately, contain the spill to prevent spread, and finally clean up using
appropriate spill kits and PPE. Options A and C are incorrect because cleanup
should never occur before evacuation and notification. Option D has the
sequence reversed and would put personnel at risk.
Question 5: Which type of personal protective equipment (PPE) is REQUIRED
when handling hazardous drugs in a compounding area?
A) Only gloves and a gown
B) Gloves, gown, eye protection, and respiratory protection
C) Gloves, gown, and hair cover
D) Double gloves, chemoprotective gown, and eye protection
Answer: D) Double gloves, chemoprotective gown, and eye protection
Rationale: When compounding hazardous drugs, the minimum PPE
requirement is double gloves (with the outer glove changed every 30 minutes
or when contaminated), a chemotherapy-rated disposable gown, and eye
protection (face shield or goggles). Hair covers, shoe covers, and respiratory
protection may be required in some situations, but the basic standard is
double gloves, gown, and eye protection. Option A is insufficient; Option B
includes respiratory protection which is not always required for routine
compounding; Option C lacks eye protection and double gloves.
Question 6: How often should chemotherapy gloves be changed during
continuous compounding?
A) Every 15 minutes
B) Every 30 minutes
C) Every 60 minutes
D) Every 2 hours
Answer: B) Every 30 minutes
Rationale: According to NIOSH and USP guidelines, the outer pair of
chemotherapy gloves should be changed every 30 minutes during continuous
, compounding, or immediately if torn, punctured, or contaminated. The inner
gloves should be changed every 60-90 minutes. Option A is overly frequent
and unnecessary; Option C and D exceed the recommended time frame and
increase the risk of permeation.
Question 7: Which of the following hazardous drugs requires EXTRA
precautions due to its ability to be absorbed through intact skin?
A) Cyclophosphamide
B) Paclitaxel
C) 5-Fluorouracil
D) Methotrexate
Answer: A) Cyclophosphamide
Rationale: Cyclophosphamide is a nitrogen mustard alkylating agent that has
been documented to be absorbed through intact skin. This is why it requires
particular caution during handling. While all hazardous drugs require careful
handling, cyclophosphamide is notably one of the drugs with documented
dermal absorption. Options B, C, and D are also hazardous but have less
documented dermal absorption potential compared to cyclophosphamide.
Question 8: When using a biological safety cabinet (BSC) for hazardous drug
compounding, where should the work be performed?
A) At the very front edge of the cabinet
B) In the middle of the work surface
C) At least 6 inches inside the cabinet from the front grille
D) On the back wall of the cabinet
Answer: C) At least 6 inches inside the cabinet from the front grille
Rationale: Work should be performed at least 6 inches (approximately 15
cm) inside the BSC from the front grille to ensure that the laminar airflow is
properly established and that particulates and aerosols are pulled away from
the worker. Working too close to the front compromises the air curtain and
containment. Option A would allow contaminants to escape; Option B is vague
but may be too close; Option D would disrupt airflow patterns.
Updated Practice Questions, Comprehensive Medication
Safety Review, Detailed Explanations, Verified Answers,
Success Workbook
SECTION 1: SAFE HANDLING OF HAZARDOUS DRUGS (Questions 1-20)
Question 1: Which of the following is the PRIMARY purpose of using a closed-
system drug-transfer device (CSTD) when handling hazardous drugs?
A) To reduce the cost of chemotherapy preparation
B) To prevent microbial contamination of sterile preparations
C) To minimize environmental and occupational exposure to hazardous drugs
D) To increase the speed of drug preparation
Answer: C) To minimize environmental and occupational exposure to
hazardous drugs
Rationale: The primary purpose of a CSTD is to mechanically prevent the
transfer of environmental contaminants into the system and the escape of
hazardous drug vapors or aerosols from the system, thereby protecting
healthcare workers from occupational exposure. While CSTDs may have
secondary benefits, exposure prevention is their main function. Option A is
incorrect because CSTDs actually increase costs. Option B describes sterile
technique, not the specific purpose of CSTDs. Option D is incorrect as CSTDs
can sometimes slow preparation time.
Question 2: A pharmacy technician is preparing a hazardous drug in a
biological safety cabinet (BSC). Which of the following actions would
COMPROMISE the effectiveness of the BSC?
A) Working at least 6 inches inside the cabinet
B) Keeping the blower running continuously
C) Placing all materials inside before beginning preparation
D) Placing the IV bag outside the BSC and connecting it from outside
,Answer: D) Placing the IV bag outside the BSC and connecting it from
outside
Rationale: The IV bag should be placed inside the BSC along with all other
supplies to maintain the sterile and contained environment. Connecting from
outside would compromise the airflow patterns and containment capabilities
of the BSC. Option A is correct practice (work at least 6 inches inside). Option
B is correct (blower should run continuously, ideally 24/7). Option C is
correct practice (pre-stage all materials to minimize arm movements that
disrupt airflow).
Question 3: According to USP Chapter <797>, which of the following is the
MAXIMUM allowable airborne particle concentration for an ISO Class 5
environment?
A) 3,520 particles ≥0.5μm per cubic meter
B) 352,000 particles ≥0.5μm per cubic meter
C) 3,520 particles ≥5.0μm per cubic meter
D) 352 particles ≥0.5μm per cubic meter
Answer: A) 3,520 particles ≥0.5μm per cubic meter
Rationale: USP Chapter <797> specifies that an ISO Class 5 environment
(such as a compounding aseptic isolator or BSC) must maintain airborne
particle counts of no more than 3,520 particles ≥0.5μm per cubic meter.
Option B describes ISO Class 7. Option C has the wrong particle size threshold.
Option D is incorrect as it describes a stricter environment than ISO Class 5.
Question 4: When a hazardous drug spill occurs in a pharmacy, which of the
following is the CORRECT sequence of steps to follow?
A) Contain the spill → Evacuate the area → Notify supervisor → Clean up
B) Evacuate the area → Notify supervisor → Contain the spill → Clean up
C) Clean up → Contain the spill → Evacuate → Notify supervisor
D) Notify supervisor → Evacuate → Clean up → Contain
Answer: B) Evacuate the area → Notify supervisor → Contain the spill →
Clean up
,Rationale: The correct sequence for handling a hazardous drug spill is to first
evacuate the area to protect personnel, then notify the supervisor
immediately, contain the spill to prevent spread, and finally clean up using
appropriate spill kits and PPE. Options A and C are incorrect because cleanup
should never occur before evacuation and notification. Option D has the
sequence reversed and would put personnel at risk.
Question 5: Which type of personal protective equipment (PPE) is REQUIRED
when handling hazardous drugs in a compounding area?
A) Only gloves and a gown
B) Gloves, gown, eye protection, and respiratory protection
C) Gloves, gown, and hair cover
D) Double gloves, chemoprotective gown, and eye protection
Answer: D) Double gloves, chemoprotective gown, and eye protection
Rationale: When compounding hazardous drugs, the minimum PPE
requirement is double gloves (with the outer glove changed every 30 minutes
or when contaminated), a chemotherapy-rated disposable gown, and eye
protection (face shield or goggles). Hair covers, shoe covers, and respiratory
protection may be required in some situations, but the basic standard is
double gloves, gown, and eye protection. Option A is insufficient; Option B
includes respiratory protection which is not always required for routine
compounding; Option C lacks eye protection and double gloves.
Question 6: How often should chemotherapy gloves be changed during
continuous compounding?
A) Every 15 minutes
B) Every 30 minutes
C) Every 60 minutes
D) Every 2 hours
Answer: B) Every 30 minutes
Rationale: According to NIOSH and USP guidelines, the outer pair of
chemotherapy gloves should be changed every 30 minutes during continuous
, compounding, or immediately if torn, punctured, or contaminated. The inner
gloves should be changed every 60-90 minutes. Option A is overly frequent
and unnecessary; Option C and D exceed the recommended time frame and
increase the risk of permeation.
Question 7: Which of the following hazardous drugs requires EXTRA
precautions due to its ability to be absorbed through intact skin?
A) Cyclophosphamide
B) Paclitaxel
C) 5-Fluorouracil
D) Methotrexate
Answer: A) Cyclophosphamide
Rationale: Cyclophosphamide is a nitrogen mustard alkylating agent that has
been documented to be absorbed through intact skin. This is why it requires
particular caution during handling. While all hazardous drugs require careful
handling, cyclophosphamide is notably one of the drugs with documented
dermal absorption. Options B, C, and D are also hazardous but have less
documented dermal absorption potential compared to cyclophosphamide.
Question 8: When using a biological safety cabinet (BSC) for hazardous drug
compounding, where should the work be performed?
A) At the very front edge of the cabinet
B) In the middle of the work surface
C) At least 6 inches inside the cabinet from the front grille
D) On the back wall of the cabinet
Answer: C) At least 6 inches inside the cabinet from the front grille
Rationale: Work should be performed at least 6 inches (approximately 15
cm) inside the BSC from the front grille to ensure that the laminar airflow is
properly established and that particulates and aerosols are pulled away from
the worker. Working too close to the front compromises the air curtain and
containment. Option A would allow contaminants to escape; Option B is vague
but may be too close; Option D would disrupt airflow patterns.
