A pharmacy technician receives a prescription for Dilaudid 4 mg tablets DAW. The
pharmacy is out of Dilaudid. The technician fills the prescription with hydromorphone.
The pharmacist performs the final check and tells the technician that hydromorphone
cannot be dispensed because:
A.the pharmacist cannot substitute any medications due to "the patient's right."
B.generic substitution is not authorized by prescriber.
C.the prescription is written as Dilaudid, not hydromorphone.
D.hydromorphone and Dilaudid are two different Schedule controlled substances. -
ANSWERThe key (B) is correct because "DAW" is an abbreviation for "Dispense as
Written," a notation that indicates that the prescriber wants only the medication named
on the prescription to be dispensed. This means that brand name Dilaudid must be
dispensed for this prescription; Dilaudid's generic, hydromorphone, is not authorized by
the prescriber.
A patient diagnosed with type 2 diabetes requests a refill of a prescription for extended-
release glipizide. The patient is approximately 15 days late in refilling the prescription.
The patient, when asked if the medication is being taken as directed, says, "Yes, I
always take it at breakfast, but many days I simply don't have time to eat before I leave
for work." How should the pharmacy technician respond?
A.Tell the patient that the medication is being taken incorrectly and advise that the
medication should be taken every morning
B.Ask the patient to speak with the pharmacist to clarify the prescription directions
C.Ask the patient to call the prescriber immediately to have blood sugar testing ordered
at once
D.Tell the patient that the medication is being taken incorrectly and the prescriber
should be seen at once - ANSWERThe key (B) is correct because the patient appears
,to have been taking the medication incorrectly and needs to be counseled, which can
only be done by a pharmacist.
When withdrawing an injectable drug from a glass ampule to transfer it into a sterile
empty vial, the pharmacy technician should use a:
A.transfer needle.
B.29-gauge needle.
C.needle with filter paper.
D.filter needle. - ANSWERThe key (D) is correct because filter needles must be used to
withdraw solutions from ampules. This is because filter needles are able to keep glass
or paint chips that may have fallen into the solution when the ampule's neck was broken
from being drawn into the syringe. A regular needle may then be used to inject the drug
into a sterile vial.
A pharmacy technician receives a telephone call from a worried patient who heard on
the news that an inhaler is being recalled. The technician should tell the patient to:
A.discard any of this medication on hand and request a refill.
B.continue to use the medication on hand if it seems to be working.
C.contact the prescriber to consider a therapy change.
D.bring the medication to the pharmacy to check the lot number and manufacturer. -
ANSWERThe key (D) is correct because items affected by a recall may be identified
using the product's National Drug Code (NDC) number (which includes manufacturer
information) and lot or batch number. Further action may then be taken if necessary.
Upon receipt of a medication order, two important steps should be taken, which include
reviewing the order for:
A.completeness and prioritizing the order based upon urgency.
B.dangerous abbreviations and placing the order in sequential order.
C.special handling precautions and contacting the onsite OSHA representative.
D.REMS and calling the appropriate insurance number. - ANSWERThe key (A) is
correct because new medication orders must be reviewed for completeness and clarity,
meaning that all required information is present and legible, and prioritized on the basis
of a number of factors, including the time the medication is needed, the seriousness of
the condition being treated, and the urgency of the other orders waiting to be
processed.
,A physician orders phenobarbital elixir 60 mg for a patient. The drug is available in a 20
mg/5 mL concentration. How many teaspoonfuls should be given for each dose?
A.1
B.2
C.3
D.4 - ANSWERThe key (C) is correct and can be calculated as follows.
First, find how many mL of elixir are required for a dose of 60 mg.
20 mg/5 mL = 4 mg/mL
60 mg ÷ 4 mg/mL = 15 mL
Then, convert mL to teaspoonfuls. 1 teaspoonful is equivalent to 5 mL.
15 mL/5 mL per teaspoonful = 3 teaspoonfuls
A prescriber writes a prescription for "XCIX tablets." How many tablets did the
prescriber order?
A.29
B.49
C.79
D.99 - ANSWERThe key (D) is correct because of the rules governing Roman
numerals. "I" equals 1, "X" equals 10, and "C" equals 100. When a lower number
appears in front of a higher number, subtract the lower number from the higher number
(e.g., "XC" is 100 - 10, or 90, and "IX" is 10 - 1, or 9). Then add those numbers together
to equal the total: 90 + 9 = 99.
A pharmacy technician is entering a prescription when a warning message appears that
reads, "Contraindicated in patients with sulfa sensitivity." Which part of the patient
profile should be reviewed?
A.Medical history
B.Medication allergies
C.Medication interaction
D.Medication profile - ANSWERThe key (B) is correct because medication allergies
cause sensitivity or hypersensitivity to medications, so the patient's medication allergies
should be checked for a sulfa allergy.
The primary routing mechanism for a real-time third-party prescription claim is a:
, A.person code.
B.BIN.
C.group number.
D.member number. - ANSWERThe key (B) is correct because the BIN (bank
identification number) establishes the claims processor or pharmacy benefits manager
responsible for adjudicating claims for the patient's plan.
In order to minimize the risk of contamination by pathogens, hospital staff should:
A.make all chemotherapeutic preparations under a horizontal laminar flow hood.
B.follow procedures to ensure that infectious agents are handled and disposed of
properly.
C.dispose of bloodstained dressings in a regular trash can to be emptied daily.
D.place all infected patients into reverse isolation. - ANSWERThe key (B) is correct
because pathogens are microorganisms (such as bacteria, viruses, and fungi) that can
cause disease and must be handled and disposed of safely in order to avoid infection.
Workers' compensation provides coverage for:
A.dependents of active and retired military personnel.
B.surviving spouses of veterans who died from service-related disabilities.
C.most citizens aged 65 and over as well as people with disabilities.
D.people with job-related illnesses or injuries. - ANSWERThe key (D) is correct because
people with job-related illnesses or injuries are covered under workers' compensation
insurance through their employers. Distractor (A) describes TRICARE, distractor (B)
describes CHAMPVA, and distractor (C) describes Medicare.
According to the ISMP, which of the following drug classifications is considered high-
alert in a community pharmacy setting?
A.Antipsychotics
B.Antiretrovirals
C.Antiemetics
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