PTCB EXAM TEST BANK QUESTIONS AND
ANSWERS LATEST WITH RATIONALE
Section A: Medications (Questions 1–35)
1. A patient presents a prescription for lisinopril. Which therapeutic class does this medication
belong to?
A. Angiotensin II receptor blocker (ARB)
B. Angiotensin-converting enzyme (ACE) inhibitor
C. Beta-blocker
D. Calcium channel blocker
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor used for hypertension and heart failure. ARBs end in
“-sartan” (losartan), beta-blockers in “-olol” (metoprolol), and calcium channel blockers include
amlodipine.
2. Which of the following is the generic name for Lipitor?
A. Simvastatin
B. Atorvastatin
C. Rosuvastatin
D. Pravastatin
Correct Answer: B
Rationale: Atorvastatin is the generic for Lipitor. Simvastatin = Zocor, rosuvastatin = Crestor,
pravastatin = Pravachol.
3. A prescription for metronidazole should include which auxiliary label?
A. May cause drowsiness
B. Do not drink alcoholic beverages
C. Take with food
D. Avoid prolonged sunlight exposure
, Correct Answer: B
Rationale: Metronidazole causes a disulfiram-like reaction with alcohol (severe nausea,
vomiting, flushing). Photosensitivity warnings apply to tetracyclines; drowsiness labels apply to
sedatives.
4. Which medication is a leukotriene receptor antagonist used for asthma prophylaxis?
A. Albuterol
B. Ipratropium
C. Montelukast
D. Prednisone
Correct Answer: C
Rationale: Montelukast (Singulair) is a leukotriene inhibitor for asthma and allergic rhinitis.
Albuterol is a short-acting beta-agonist; ipratropium is an anticholinergic bronchodilator.
5. A patient taking levothyroxine should separate the dose from which of the following?
A. Grapefruit juice
B. Calcium-fortified foods and dairy
C. Leafy green vegetables
D. Vitamin C
Correct Answer: B
Rationale: Calcium binds levothyroxine in the GI tract, reducing absorption by up to 50%.
Separate by at least 4 hours. Grapefruit affects CYP3A4 metabolism, not levothyroxine
absorption.
6. Which of the following is a common side effect of metformin?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset
D. Bradycardia
Correct Answer: C
Rationale: Metformin commonly causes diarrhea, nausea, and abdominal discomfort.
,Unlike sulfonylureas, it does not typically cause hypoglycemia. It is weight-neutral or causes
modest weight loss.
7. What is the DEA schedule for oxycodone/acetaminophen combination products?
A. Schedule II
B. Schedule III
C. Schedule IV
D. Schedule V
Correct Answer: A
Rationale: Oxycodone is a Schedule II opioid. Combination with acetaminophen does not
lower the schedule. Schedule III examples include codeine combinations; Schedule IV includes
benzodiazepines.
8. A patient on warfarin asks about starting St. John’s wort. What is the primary concern?
A. Increased bleeding risk
B. Decreased warfarin effectiveness
C. No interaction exists
D. Increased INR without significance
Correct Answer: B
Rationale: St. John’s wort induces CYP450 enzymes and P-glycoprotein, reducing warfarin
plasma concentrations and anticoagulant effect, risking therapeutic failure.
9. Which medication requires a “Do not crush” warning due to extended-release properties?
A. Metoprolol succinate (Toprol-XL)
B. Metoprolol tartrate (Lopressor)
C. Lisinopril
D. Amlodipine
Correct Answer: A
Rationale: Metoprolol succinate is an extended-release formulation. Crushing destroys the
ER mechanism, causing dose dumping and potential bradycardia/hypotension. Metoprolol
tartrate is immediate-release and may be crushed.
, 10. A patient with severe renal impairment (eGFR <30 mL/min) should avoid which diabetes
medication?
A. Metformin
B. Sitagliptin
C. Insulin glargine
D. Glipizide
Correct Answer: A
Rationale: Metformin is contraindicated in severe renal impairment due to increased risk of
lactic acidosis. The FDA requires renal function assessment before and during therapy.
11. Which class of medications commonly causes a persistent dry cough?
A. ARBs
B. ACE inhibitors
C. Beta-blockers
D. Calcium channel blockers
Correct Answer: B
Rationale: ACE inhibitors inhibit bradykinin breakdown, causing accumulation in the lungs
and a dry cough in up to 20% of patients. ARBs do not cause this effect.
12. What is the antidote for acetaminophen overdose?
A. Naloxone
B. N-acetylcysteine
C. Flumazenil
D. Vitamin K
Correct Answer: B
Rationale: N-acetylcysteine replenishes glutathione, allowing the liver to detoxify NAPQI.
Naloxone = opioid overdose; flumazenil = benzodiazepine overdose; vitamin K = warfarin
reversal.
ANSWERS LATEST WITH RATIONALE
Section A: Medications (Questions 1–35)
1. A patient presents a prescription for lisinopril. Which therapeutic class does this medication
belong to?
A. Angiotensin II receptor blocker (ARB)
B. Angiotensin-converting enzyme (ACE) inhibitor
C. Beta-blocker
D. Calcium channel blocker
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor used for hypertension and heart failure. ARBs end in
“-sartan” (losartan), beta-blockers in “-olol” (metoprolol), and calcium channel blockers include
amlodipine.
2. Which of the following is the generic name for Lipitor?
A. Simvastatin
B. Atorvastatin
C. Rosuvastatin
D. Pravastatin
Correct Answer: B
Rationale: Atorvastatin is the generic for Lipitor. Simvastatin = Zocor, rosuvastatin = Crestor,
pravastatin = Pravachol.
3. A prescription for metronidazole should include which auxiliary label?
A. May cause drowsiness
B. Do not drink alcoholic beverages
C. Take with food
D. Avoid prolonged sunlight exposure
, Correct Answer: B
Rationale: Metronidazole causes a disulfiram-like reaction with alcohol (severe nausea,
vomiting, flushing). Photosensitivity warnings apply to tetracyclines; drowsiness labels apply to
sedatives.
4. Which medication is a leukotriene receptor antagonist used for asthma prophylaxis?
A. Albuterol
B. Ipratropium
C. Montelukast
D. Prednisone
Correct Answer: C
Rationale: Montelukast (Singulair) is a leukotriene inhibitor for asthma and allergic rhinitis.
Albuterol is a short-acting beta-agonist; ipratropium is an anticholinergic bronchodilator.
5. A patient taking levothyroxine should separate the dose from which of the following?
A. Grapefruit juice
B. Calcium-fortified foods and dairy
C. Leafy green vegetables
D. Vitamin C
Correct Answer: B
Rationale: Calcium binds levothyroxine in the GI tract, reducing absorption by up to 50%.
Separate by at least 4 hours. Grapefruit affects CYP3A4 metabolism, not levothyroxine
absorption.
6. Which of the following is a common side effect of metformin?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset
D. Bradycardia
Correct Answer: C
Rationale: Metformin commonly causes diarrhea, nausea, and abdominal discomfort.
,Unlike sulfonylureas, it does not typically cause hypoglycemia. It is weight-neutral or causes
modest weight loss.
7. What is the DEA schedule for oxycodone/acetaminophen combination products?
A. Schedule II
B. Schedule III
C. Schedule IV
D. Schedule V
Correct Answer: A
Rationale: Oxycodone is a Schedule II opioid. Combination with acetaminophen does not
lower the schedule. Schedule III examples include codeine combinations; Schedule IV includes
benzodiazepines.
8. A patient on warfarin asks about starting St. John’s wort. What is the primary concern?
A. Increased bleeding risk
B. Decreased warfarin effectiveness
C. No interaction exists
D. Increased INR without significance
Correct Answer: B
Rationale: St. John’s wort induces CYP450 enzymes and P-glycoprotein, reducing warfarin
plasma concentrations and anticoagulant effect, risking therapeutic failure.
9. Which medication requires a “Do not crush” warning due to extended-release properties?
A. Metoprolol succinate (Toprol-XL)
B. Metoprolol tartrate (Lopressor)
C. Lisinopril
D. Amlodipine
Correct Answer: A
Rationale: Metoprolol succinate is an extended-release formulation. Crushing destroys the
ER mechanism, causing dose dumping and potential bradycardia/hypotension. Metoprolol
tartrate is immediate-release and may be crushed.
, 10. A patient with severe renal impairment (eGFR <30 mL/min) should avoid which diabetes
medication?
A. Metformin
B. Sitagliptin
C. Insulin glargine
D. Glipizide
Correct Answer: A
Rationale: Metformin is contraindicated in severe renal impairment due to increased risk of
lactic acidosis. The FDA requires renal function assessment before and during therapy.
11. Which class of medications commonly causes a persistent dry cough?
A. ARBs
B. ACE inhibitors
C. Beta-blockers
D. Calcium channel blockers
Correct Answer: B
Rationale: ACE inhibitors inhibit bradykinin breakdown, causing accumulation in the lungs
and a dry cough in up to 20% of patients. ARBs do not cause this effect.
12. What is the antidote for acetaminophen overdose?
A. Naloxone
B. N-acetylcysteine
C. Flumazenil
D. Vitamin K
Correct Answer: B
Rationale: N-acetylcysteine replenishes glutathione, allowing the liver to detoxify NAPQI.
Naloxone = opioid overdose; flumazenil = benzodiazepine overdose; vitamin K = warfarin
reversal.
