Free PTCB Practice Test: 80 Questions

Correct answer: C. 10 mL. 250 mg × (5 mL ÷ 125 mg) = 10 mL. Quick check: the liquid has 25 mg in each mL, so 10 mL holds 250 mg.

Why the other choices don't fit

• A: 2.5 mL holds only 62.5 mg.
• B: 5 mL holds 125 mg, half the dose.
• D: 20 mL holds 500 mg, double the dose.

Takeaway: Dose ÷ concentration, with units on every line.

Source: Worked from the numbers in the question (250 × 5 ÷ 125 = 10)

Correct answer: B. Atorvastatin. Lipitor is the brand name for atorvastatin calcium. Its label calls it an HMG-CoA reductase inhibitor, which is the drug class people shorten to "statin."

Why the other choices don't fit

• A: Simvastatin is also a statin, but it is a different drug with its own brand name.
• C: Amlodipine is a blood pressure medicine, not a statin, and not Lipitor.
• D: Rosuvastatin is another statin. Sharing a class doesn't make it the same drug.

Takeaway: Lipitor = atorvastatin. Same class as other "-statins," but not interchangeable by name.

Source: LIPITOR (atorvastatin calcium) label, DailyMed, Highlights; Section 11 Description; ZOCOR (simvastatin) prescribing information, Organon, Highlights; Section 12.1; Amlodipine besylate tablets label, DailyMed, Indications and Usage; patient information; CRESTOR (rosuvastatin) label, DailyMed, Highlights; Section 12.1

Correct answer: B. They carry a heightened risk of significant patient harm when used in error. ISMP defines high-alert medications as drugs that bear a heightened risk of causing significant patient harm when they are used in error. Mistakes may or may not be more common with them. The point is that the consequences are worse, so extra safeguards are used.

Why the other choices don't fit

• A: How often a drug is prescribed isn't what makes it high-alert.
• C: Some high-alert drugs are controlled substances and many aren't.
• D: Storage temperature has nothing to do with the designation.

Takeaway: High-alert = worse harm when an error happens, not necessarily more errors.

Source: ISMP (ECRI), High-Alert Medications in Community/Ambulatory Care Settings, Definition

Correct answer: C. Refilling a Schedule II prescription is prohibited. 21 CFR 1306.12(a) says the refilling of a prescription for a Schedule II controlled substance is prohibited. The patient needs a new prescription. (Separate rules allow a prescriber to issue multiple Schedule II prescriptions with fill dates, but those are new prescriptions, not refills.)

Why the other choices don't fit

• A: That's the federal refill limit for Schedules III and IV.
• B: A phone call can't create a Schedule II refill.
• D: There's no 30-day refill window for Schedule II.

Takeaway: Schedule II: no refills. Ever.

Source: 21 CFR Part 1306 (Prescriptions), eCFR, § 1306.12(a)

Correct answer: C. Selective serotonin reuptake inhibitor (SSRI). The Zoloft label describes sertraline as a selective serotonin reuptake inhibitor (SSRI). That class name tells you it works on serotonin reuptake, which is also why the label warns about combining it with other serotonergic drugs.

Why the other choices don't fit

• A: Benzodiazepines are a different class (for example, alprazolam). Sertraline isn't one.
• B: MAOIs are a separate antidepressant class. The Zoloft label actually lists MAOIs as a contraindication, so mixing up these two classes is a real safety problem.
• D: Beta-blockers (the "-olol" drugs) treat heart and blood pressure conditions.

Takeaway: Sertraline is an SSRI, and MAOIs are a different class it must not be combined with.

Source: ZOLOFT (sertraline) label, DailyMed, Highlights; Section 4 Contraindications; XANAX (alprazolam) label, DailyMed, Sections 11 and 12.1; LOPRESSOR (metoprolol tartrate) label, DailyMed, Highlights; Section 1

Correct answer: A. Insulin. ISMP's high-alert materials list insulin, opioids, and anticoagulants among the examples of high-alert medications. A dosing error with insulin can quickly cause serious harm, such as severe low blood sugar.

Why the other choices don't fit

• B: Saline nasal spray isn't given as a high-alert example.
• C: A calcium antacid can interact with other drugs, but it isn't a high-alert example.
• D: Artificial tears aren't a high-alert example.

Takeaway: Insulin, opioids, and anticoagulants are classic high-alert examples.

Source: ISMP, Medication Safety Self Assessment for High-Alert Medications, Definition of high-alert medications, examples

Correct answer: B. 90 days. Twice daily means 2 tablets a day. 180 ÷ 2 = 90 days. Check: 90 days × 2 tablets = 180.

Why the other choices don't fit

• A: 60 days would mean 3 tablets a day.
• C: 180 days would mean 1 tablet a day.
• D: 360 days would mean half a tablet a day.

Takeaway: Days supply = quantity ÷ units used per day.

Source: Worked from the numbers in the question (180 ÷ 2 = 90)

Correct answer: A. Angiotensin-converting enzyme (ACE) inhibitor. The lisinopril label identifies it as an angiotensin-converting enzyme (ACE) inhibitor. ARBs (the "-sartan" drugs) act on the same system but at a different step, so the two classes aren't interchangeable labels.

Why the other choices don't fit

• B: Calcium channel blockers (for example, amlodipine) lower blood pressure by a different mechanism.
• C: Thiazide diuretics (for example, hydrochlorothiazide) are sometimes combined with lisinopril in one tablet, but lisinopril itself is not a diuretic.
• D: HMG-CoA reductase inhibitors are statins, used for cholesterol.

Takeaway: Lisinopril is an ACE inhibitor. The "-pril" ending is a useful memory hook; the label is the proof.

Source: Lisinopril tablets label (Camber), DailyMed, Highlights, Indications and Usage; Amlodipine besylate tablets label, DailyMed, Indications and Usage; Clinical Pharmacology; Lisinopril and hydrochlorothiazide tablets label, DailyMed, Description; Clinical Pharmacology; COZAAR (losartan potassium) label, DailyMed, Highlights; Section 12.1; LIPITOR (atorvastatin calcium) label, DailyMed, Highlights

Correct answer: A. 5 refills, and none more than 6 months after the date it was issued. 21 CFR 1306.22(a) says a Schedule III or IV prescription may not be filled or refilled more than 6 months after it was issued, and may not be refilled more than 5 times. Both limits apply, whichever comes first. State law can be stricter.

Why the other choices don't fit

• B: The prescriber can't authorize more than the federal limit.
• C: The federal time limit is 6 months, not 1 year.
• D: Schedule IV prescriptions can be refilled within the limits.

Takeaway: Schedules III and IV: 5 refills or 6 months, whichever comes first.

Source: 21 CFR Part 1306 (Prescriptions), eCFR, § 1306.22(a)

Correct answer: D. Albuterol sulfate; beta2-adrenergic agonist. The Ventolin HFA label names the active ingredient as albuterol sulfate and describes it as a beta2-adrenergic agonist. It relaxes the airway muscles.

Why the other choices don't fit

• A: Budesonide is an inhaled steroid, a different ingredient and class.
• B: Ipratropium is an anticholinergic bronchodilator, not the ingredient in Ventolin HFA.
• C: Montelukast is taken by mouth and is in a different class entirely; its oral forms include tablets and granules.

Takeaway: Ventolin HFA = albuterol sulfate, a beta2-adrenergic agonist.

Source: VENTOLIN HFA (albuterol sulfate) label, DailyMed, Highlights, Indications and Usage; Budesonide inhalation suspension label, DailyMed, Highlights, Indications and Usage; ATROVENT HFA (ipratropium bromide) label, DailyMed, Highlights, Indications and Usage; SINGULAIR (montelukast) label, DailyMed, Highlights; Dosage Forms and Strengths

Correct answer: D. To draw attention to the letters that differ, so look-alike names aren't confused. This is Tall Man lettering. hydrALAZINE and hydrOXYzine are on FDA's list of names with recommended Tall Man letters. Capitalizing the letters that differ helps people notice the difference between look-alike names. It's one safeguard, not a replacement for checking the product against the order.

Why the other choices don't fit

• A: Tall Man lettering has nothing to do with price.
• B: Capitals don't signal a controlled-substance schedule.
• C: Both of these are generic names.

Takeaway: Tall Man letters highlight the differences between look-alike names.

Source: ISMP, FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man Letters (2023), Table 1, FDA list

Correct answer: C. 168 mL. 8 mL × 3 doses a day = 24 mL a day. 24 mL × 7 days = 168 mL. Check: 168 ÷ 7 = 24, and 24 ÷ 3 = 8.

Why the other choices don't fit

• A: 56 mL covers only one dose a day.
• B: 24 mL is one day's worth.
• D: 210 mL is more than the directions call for.

Takeaway: Total = dose × doses per day × days.

Source: Worked from the numbers in the question (8 × 3 × 7 = 168)

Correct answer: B. Levothyroxine sodium. Synthroid is the brand name for levothyroxine sodium, a synthetic form of the thyroid hormone T4.

Why the other choices don't fit

• A: Liothyronine is a different thyroid hormone (T3) with different brands.
• C: Methimazole treats an overactive thyroid, the opposite problem.
• D: Levetiracetam is a seizure medicine. The shared "lev-" start is exactly the kind of look-alike trap to slow down for.

Takeaway: Synthroid = levothyroxine. Watch the look-alike "lev-" names.

Source: SYNTHROID (levothyroxine sodium) prescribing information, AbbVie, Highlights; Indications and Usage; Liothyronine sodium tablets label, DailyMed, Highlights, Indications and Usage; Methimazole tablets label, DailyMed, Indications and Usage; Levetiracetam extended-release tablets label, DailyMed, Section 1

Correct answer: B. One time only. 21 CFR 1306.25(a) allows the transfer of Schedule III, IV, and V prescription information for refill purposes on a one-time basis only. Pharmacies that electronically share a real-time online database may transfer up to the maximum refills allowed. The transfer must be communicated directly between two licensed pharmacists.

Why the other choices don't fit

• A: Unlimited transfers are not allowed for pharmacies without a shared database.
• C: Transfers for refills are permitted, within the one-time rule.
• D: There's no "twice in 30 days" rule.

Takeaway: Schedule III–V refill transfer: one time, pharmacist to pharmacist, unless a shared real-time database is used.

Source: 21 CFR Part 1306 (Prescriptions), eCFR, § 1306.25(a) and (b)(1)

Correct answer: A. predniSONE and prednisoLONE. predniSONE and prednisoLONE are on FDA's Tall Man list because the names look and sound alike but are different drugs. The capitalized letters point to where they differ.

Why the other choices don't fit

• B: That's a brand name and its own generic, the same drug.
• C: That's a generic and its own brand, the same drug.
• D: That's a generic and its own brand, the same drug.

Takeaway: This LASA (look-alike/sound-alike) pair names two different drugs, not a brand and its own generic.

Source: ISMP, FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man Letters (2023), Table 1, FDA list; LIPITOR (atorvastatin calcium) label, DailyMed, Brand and active ingredient; VENTOLIN HFA (albuterol sulfate) label, DailyMed, Brand and active ingredient; ZOLOFT (sertraline) label, DailyMed, Brand and active ingredient

Correct answer: C. 500 mL. Use C1 × V1 = C2 × V2: 10% × 100 mL = 2% × V2, so V2 = 1,000 ÷ 2 = 500 mL. That's the final volume. You'd add 400 mL of diluent to get there, but the question asks for the final volume.

Why the other choices don't fit

• A: 200 mL would give a 5% solution.
• B: 400 mL is the diluent you add, not the final volume. Read what the question asks for.
• D: 1,000 mL would give a 1% solution.

Takeaway: C1V1 = C2V2. Then check whether they asked for final volume or diluent added.

Source: Worked from the numbers in the question (10 × 100 ÷ 2 = 500)

Correct answer: C. Two acetaminophen-containing products. APAP is an abbreviation for acetaminophen. FDA notes that prescription labels don't always spell out "acetaminophen" and that taking a prescription and an OTC product that both contain it isn't advised unless a health care professional says so. The pharmacist needs to review this before the sale.

Why the other choices don't fit

• A: Only the prescription contains an opioid (hydrocodone).
• B: The question gives no antihistamine in the prescription, so there's nothing to duplicate there.
• D: This is the trap FDA warns about. APAP on the label means acetaminophen.

Takeaway: APAP = acetaminophen. Check every product's ingredients, not just the drug names.

Source: FDA, Don't Overuse Acetaminophen, Tips on reading labels and avoiding more than one acetaminophen product

Correct answer: A. It can be transferred for initial dispensing one time, pharmacist to pharmacist, if state law allows. 21 CFR 1306.08(e)–(g) allows an electronic Schedule II–V prescription to be transferred between retail pharmacies for initial dispensing, at the patient's request, on a one-time basis. The transfer must be communicated between two licensed pharmacists, kept in electronic form, and allowed under state law.

Why the other choices don't fit

• B: Federal rules added a one-time transfer for initial dispensing of electronic prescriptions.
• C: The rule requires pharmacist-to-pharmacist communication and says the prescription can't be converted to another form such as a fax.
• D: It's one time only.

Takeaway: Unfilled electronic CII–V: one transfer, pharmacist to pharmacist, if the state allows it.

Source: 21 CFR Part 1306 (Prescriptions), eCFR, § 1306.08(e), (f)(1), (f)(3), (g)

Correct answer: A. Possible duplicate lisinopril therapy. The new combination tablet already contains lisinopril. If both prescriptions stayed active, the patient could get lisinopril from two products. That's a therapeutic duplication for the pharmacist to resolve with the prescriber. It may be an intended switch, but that's the pharmacist's call.

Why the other choices don't fit

• B: Only the new product contains a thiazide, so there's no second diuretic.
• C: The problem described is possible ingredient duplication, not a refill-limit question.
• D: Combination products can repeat an ingredient in a single-ingredient medicine.

Takeaway: Always read combination products ingredient by ingredient.

Source: Lisinopril and hydrochlorothiazide tablets label, DailyMed, Product name and ingredients; PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 1.2; U.S. Bureau of Labor Statistics, Pharmacy Technicians: Duties, What Pharmacy Technicians Do; Duties

Correct answer: B. 0.25 mg and 5 mg. ISMP says to use a leading zero for doses less than one unit (0.25 mg, never .25 mg) and not to use trailing zeros (5 mg, never 5.0 mg). A missed decimal point can turn .25 into 25, a 100-fold error, or 5.0 into 50, a tenfold error.

Why the other choices don't fit

• A: Both mistakes at once: no leading zero and a trailing zero.
• C: The trailing zero in 5.0 mg can be misread as 50 mg.
• D: The missing leading zero in .25 mg can be misread as 25 mg.

Takeaway: Leading zero yes (0.25). Trailing zero no (5, not 5.0).

Source: ISMP, Guidelines for Safe Electronic Communication of Medication Information (2019), Dose designation guidance (a) and (b); Worked from the numbers in the question (25 ÷ 0.25 = 100; 50 ÷ 5 = 10)

Correct answer: C. 250 mg. 1 g = 1,000 mg. 0.25 g × 1,000 mg/g = 250 mg. Check: 250 mg ÷ 1,000 = 0.25 g.

Why the other choices don't fit

• A: Off by a factor of 100.
• B: Off by a factor of 10.
• D: Off by a factor of 10 in the other direction.

Takeaway: g → mg: multiply by 1,000.

Source: Worked from the numbers in the question (0.25 × 1,000 = 250)

Correct answer: D. Take them at least 4 hours apart. Synthroid labeling says to give it at least 4 hours before or after drugs that interfere with its absorption, and calcium carbonate is one of them. Calcium can bind levothyroxine in the gut so less gets absorbed.

Why the other choices don't fit

• A: Taking them together is exactly what reduces absorption.
• B: The 30-to-60-minute window in the label is about taking Synthroid before breakfast, not about calcium.
• C: OTC products can interact with prescription drugs.

Takeaway: Levothyroxine and calcium carbonate: at least 4 hours apart.

Source: SYNTHROID (levothyroxine sodium) prescribing information, AbbVie, Highlights, Dosage and Administration 2.1; Section 7; SYNTHROID (levothyroxine sodium) prescribing information, AbbVie, Section 7.1, Table 5 (calcium carbonate); PDF page 10; SYNTHROID (levothyroxine sodium) prescribing information, AbbVie, Section 7.1, Table 5; PDF page 10

Correct answer: C. "U" can be mistaken for a zero, causing a tenfold overdose. ISMP says to spell out "units" and never use "U," because it can easily be mistaken for a zero. "10U" misread as "100" is a tenfold insulin overdose.

Why the other choices don't fit

• A: That isn't the reason given.
• B: "U" doesn't mean "use as directed."
• D: The guidance isn't about vaccines.

Takeaway: Write "units." Never "U."

Source: ISMP, Guidelines for Safe Electronic Communication of Medication Information (2019), Dose designation guidance (c)

Correct answer: D. 72 hours. When the pharmacist can't supply the full quantity, the remaining portion may be filled within 72 hours of the first partial fill. If it can't be filled in that window, the pharmacist notifies the prescriber, and no more can be supplied without a new prescription. (For a nonemergency prescription, qualifying partial fills requested by the patient or prescriber follow a separate rule allowing the remainder no later than 30 days after the prescription was written.)

Why the other choices don't fit

• A: 7 days is not the rule for this situation.
• B: The separate 30-day provision concerns qualifying patient- or prescriber-requested partial fills of a nonemergency prescription, not the stock-shortage rule asked here.
• C: 6 months is a Schedule III–IV time limit.

Takeaway: CII shortage partial fill: rest within 72 hours of the first partial fill; after that, notify the prescriber and obtain a new prescription for any further supply.

Source: 21 CFR Part 1306 (Prescriptions), eCFR, § 1306.13(a); § 1306.13(b)(2)

Correct answer: A. It is contraindicated because it can cause a dangerous drop in blood pressure. The Nitrostat label lists use with PDE-5 inhibitors such as sildenafil, tadalafil, and vardenafil as a contraindication. These drugs strengthen the blood-pressure-lowering effect of nitrates, and the result can be an extreme drop.

Why the other choices don't fit

• B: The label doesn't give a spacing interval that makes the combination safe. Don't invent one.
• C: Aspirin isn't part of this interaction.
• D: The interaction comes from the drug, not the brand.

Takeaway: Nitrates + PDE-5 inhibitors (sildenafil, tadalafil, vardenafil) = contraindicated.

Source: NITROSTAT (nitroglycerin sublingual tablets) label, DailyMed, Contraindications; Drug Interactions; Patient Information

Correct answer: A. 100 mg. 22 lb ÷ 2.2 lb/kg = 10 kg. 10 kg × 10 mg/kg = 100 mg.

Why the other choices don't fit

• B: 220 mg uses pounds instead of kilograms.
• C: 484 mg comes from multiplying by 2.2 instead of dividing.
• D: 10 mg forgets to multiply by the weight.

Takeaway: Convert pounds to kilograms first (divide by 2.2).

Source: Worked from the numbers in the question (22 ÷ 2.2 = 10; 10 × 10 = 100)

Correct answer: B. It is contraindicated within 14 days of stopping an MAOI. The Zoloft label lists use with an MAOI, or within 14 days of stopping one, as a contraindication because of the risk of serotonin syndrome. Five days is inside that window, so the pharmacist needs to see this.

Why the other choices don't fit

• A: The label's window is 14 days, not 24 hours.
• C: The contraindication isn't lifted by a lower dose.
• D: The label doesn't limit the rule to long-term MAOI use.

Takeaway: Sertraline after an MAOI: the Zoloft label requires a gap of at least 14 days.

Source: ZOLOFT (sertraline) label, DailyMed, Highlights; Section 4 Contraindications

Correct answer: A. Refer the customer to the pharmacist. PTCB's outline lists OTC recommendations among the issues that require pharmacist intervention. The technician can gather the question and bring in the pharmacist, but choosing a product for a patient with a medical condition is the pharmacist's job. State boards define the legal scope of technician practice.

Why the other choices don't fit

• B: Personal preference isn't a clinical recommendation.
• C: That's a clinical judgment the technician shouldn't make.
• D: Changing a dose is never a technician recommendation.

Takeaway: OTC recommendation = pharmacist.

Source: PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.3; PTCB, Certified Pharmacy Technician (CPhT) page, Intro: state boards define CPhT scope; U.S. Bureau of Labor Statistics, Pharmacy Technicians: Duties, What Pharmacy Technicians Do; Duties

Correct answer: B. 1 mg/mL. 1 g = 1,000 mg, so 1 g in 1,000 mL is 1,000 mg ÷ 1,000 mL = 1 mg/mL.

Why the other choices don't fit

• A: That would be 1:10,000.
• C: That would be 1:100.
• D: That ignores the 1,000 mL.

Takeaway: 1:1,000 w/v = 1 mg/mL.

Source: Worked from the numbers in the question (1,000 mg ÷ 1,000 mL = 1)

Correct answer: C. The name of the prescribing practitioner. The rule requires the label to show the pharmacy name and address, the serial number and date of initial filling, the patient's name, the name of the practitioner who issued the prescription, and directions for use with any cautionary statements.

Why the other choices don't fit

• A: A Social Security number isn't a required label element under this rule.
• B: Wholesale account numbers aren't label elements.
• D: The NDC isn't on the list of required label elements in this rule.

Takeaway: CIII–V label: pharmacy, serial number and date, patient, prescriber, directions and cautions.

Source: 21 CFR Part 1306 (Prescriptions), eCFR, § 1306.24(a)

Correct answer: C. Large quantities of grapefruit juice can increase the risk of muscle problems. The Lipitor label tells patients that the risk of myopathy (muscle damage) and rhabdomyolysis is increased when they consume large quantities of grapefruit juice. This is a drug-food interaction worth passing to the pharmacist for counseling.

Why the other choices don't fit

• A: The label describes a risk, not a benefit.
• B: The label specifically names grapefruit juice.
• D: There's no such instruction in the label.

Takeaway: Lipitor + large amounts of grapefruit juice = higher muscle-injury risk.

Source: LIPITOR (atorvastatin calcium) label, DailyMed, Section 17 Patient Counseling Information

Correct answer: D. Leave the alert for the pharmacist to review before the prescription goes further. DUR is listed in PTCB's outline as an issue requiring pharmacist intervention. Deciding what to do about an interaction alert is a clinical judgment for the pharmacist.

Why the other choices don't fit

• A: Overriding a clinical alert isn't a technician decision.
• B: Changing a patient's profile to silence an alert hides real information.
• C: Counseling about the interaction belongs to the pharmacist.

Takeaway: DUR alerts go to the pharmacist.

Source: PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.3; U.S. Bureau of Labor Statistics, Pharmacy Technicians: Duties, What Pharmacy Technicians Do; Duties

Correct answer: B. Increased risk of kidney problems and reduced blood pressure control. Lisinopril labeling lists NSAIDs as causing an increased risk of renal (kidney) impairment and a loss of antihypertensive effect. Daily use is a question for the pharmacist.

Why the other choices don't fit

• A: The label describes the opposite: less blood pressure effect.
• C: Neither drug is a controlled substance.
• D: The label lists this interaction by name.

Takeaway: ACE inhibitor + NSAID: kidney risk and weaker blood pressure control.

Source: Lisinopril tablets label (Camber), DailyMed, Section 7.3, Non-Steroidal Anti-Inflammatory Agents

Correct answer: D. 45. XL = 50 − 10 = 40, and V = 5. 40 + 5 = 45.

Why the other choices don't fit

• A: That would be LV.
• B: That would be LXV.
• C: That would be XXXV.

Takeaway: A smaller numeral before a larger one is subtracted (XL = 40).

Source: Worked from the numbers in the question (XL (40) + V (5) = 45)

Correct answer: A. Within one business day of discovery. The registrant must notify the local DEA Field Division Office in writing of the theft or significant loss within one business day of discovery. The full DEA Form 106 is a separate, later step.

Why the other choices don't fit

• B: 45 days is the deadline for the complete Form 106, not the first written notice.
• C: Waiting for an inventory would miss the deadline.
• D: The rule is triggered by discovery of the theft, not by whether the drugs are recovered.

Takeaway: Theft/significant loss: written notice to DEA within 1 business day.

Source: 21 CFR 1301.76, eCFR, § 1301.76(b)

Correct answer: D. It is contraindicated when eGFR is below 30 mL/min/1.73 m². The label lists severe renal impairment, eGFR below 30 mL/min/1.73 m², as a contraindication. Metformin is cleared by the kidneys, and buildup raises the risk of lactic acidosis. An eGFR of 25 is below that line, so this goes to the pharmacist.

Why the other choices don't fit

• A: The label says the opposite.
• B: This extended-release label contains the contraindication itself.
• C: Raising the dose would make accumulation worse.

Takeaway: Metformin: contraindicated with eGFR below 30.

Source: Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Section 2.2; Section 4 Contraindications

Correct answer: B. About 20 days, so the pharmacist should review the early request. September 1 to September 11 is 10 days. 30 − 10 = 20 days should remain if the patient took it as directed. A refill this early can point to a dosing change, an adherence problem, or misuse, all of which PTCB lists under issues that need the pharmacist.

Why the other choices don't fit

• A: 10 days is how much time has passed, not how much should be left.
• C: Only a third of the supply should be used by now.
• D: Some of the supply should have been used.

Takeaway: Early refill math: days supplied − days elapsed = days that should remain.

Source: Worked from the numbers in the question (30 − 10 = 20); PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.3; U.S. Bureau of Labor Statistics, Pharmacy Technicians: Duties, What Pharmacy Technicians Do; Duties

Correct answer: A. 25 days. 2 puffs × 4 times a day = 8 puffs a day. 200 ÷ 8 = 25 days.

Why the other choices don't fit

• B: 50 days would mean 4 puffs a day.
• C: 100 days would mean 2 puffs a day.
• D: 12 days at 8 puffs a day would use only 96 puffs, not 200.

Takeaway: Inhaler days supply = actuations ÷ puffs per day.

Source: Worked from the numbers in the question (200 ÷ (2 × 4) = 25)

Correct answer: C. Swallow the tablets whole; never crush, cut, or chew them. This metformin ER label says to swallow the tablets whole and never crush, cut, or chew them. These extended-release tablets are designed to release the drug slowly; changing the tablet can change that release. The caregiver's question should go to the pharmacist.

Why the other choices don't fit

• A: Mixing into food doesn't change the rule against crushing.
• B: The label says not to cut them either.
• D: Taking the tablet with the evening meal is part of the directions, but chewing is still prohibited.

Takeaway: Extended-release: follow the label. This one says whole, never crushed, cut, or chewed.

Source: Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Highlights and Section 2.1; Section 17

Correct answer: B. A complete DEA Form 106, filed electronically, within 45 days of discovery. The registrant must also file a complete and accurate DEA Form 106 through DEA's secure online system within 45 days after discovering the theft or significant loss.

Why the other choices don't fit

• A: Form 222 is used for ordering Schedule I and II substances, not reporting theft.
• C: A phone call doesn't satisfy the written and Form 106 requirements.
• D: The Form 106 is required.

Takeaway: Theft or significant loss: written notice in 1 business day, then Form 106 within 45 calendar days of discovery.

Source: 21 CFR 1301.76, eCFR, § 1301.76(b); 21 CFR Part 1305, orders for Schedule I and II controlled substances, Sections 1305.03 and 1305.04

Correct answer: C. Get the pharmacist involved right away. An adverse drug event is one of the issues PTCB lists for pharmacist intervention. The amoxicillin label also says patients should promptly report skin rash or other signs of hypersensitivity. The pharmacist handles the counseling and next steps.

Why the other choices don't fit

• A: The technician can't judge whether a reaction is harmless, and the label asks for prompt reporting.
• B: Recommending treatment is a pharmacist or prescriber decision.
• D: Changing the flavor does not assess or address a possible drug reaction.

Takeaway: Possible adverse reaction = pharmacist, now.

Source: PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.3; Amoxicillin for oral suspension label, DailyMed, Patient Counseling Information (skin rash, signs of hypersensitivity); U.S. Bureau of Labor Statistics, Pharmacy Technicians: Duties, What Pharmacy Technicians Do; Duties

Correct answer: A. Dissolved under the tongue (sublingual). Nitrostat is a sublingual tablet; its label also permits dissolving it in the buccal pouch (between the cheek and gum). The label says it should not be chewed, crushed, or swallowed. Absorbing through the tissue under the tongue lets it act quickly.

Why the other choices don't fit

• B: Swallowing is exactly what the label says not to do.
• C: The label says not to chew it.
• D: The label says not to crush it.

Takeaway: Nitrostat: dissolve under the tongue or in the buccal pouch. Do not chew, crush, or swallow the tablet.

Source: NITROSTAT (nitroglycerin sublingual tablets) label, DailyMed, Dosage and Administration

Correct answer: B. 300 mg. 1 g per 100 g means 0.01 g of drug per gram of cream. 30 g × 0.01 = 0.3 g, and 0.3 g × 1,000 = 300 mg.

Why the other choices don't fit

• A: Off by a factor of 10.
• C: That would be a 10% cream.
• D: Off by a factor of 100.

Takeaway: Percent w/w = grams per 100 grams.

Source: Worked from the numbers in the question (30 × 0.01 = 0.3 g = 300 mg)

Correct answer: B. MedWatch (FDA at 1-800-FDA-1088 or www.fda.gov/medwatch). The metformin ER label tells readers to report suspected adverse reactions to the manufacturer or to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. MedWatch is FDA's safety reporting program for medicines and other FDA-regulated products.

Why the other choices don't fit

• A: VAERS is for events after vaccination.
• C: Form 106 reports theft or significant loss of controlled substances.
• D: A prescription drug monitoring program tracks controlled substance dispensing, not adverse reactions.

Takeaway: Drug adverse event → MedWatch. Vaccine adverse event → VAERS.

Source: Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Highlights, adverse reaction reporting line; FDA, MedWatch: The FDA Safety Information and Adverse Event Reporting Program, Program scope and reporting links; CDC, Prescription Drug Monitoring Programs (PDMPs), Key points: PDMP definition; VAERS, Frequently Asked Questions, What is VAERS?; 21 CFR 1301.76, eCFR, Section 1301.76(b)

Correct answer: D. 7.5 mL. Set it up with units: 600 mg × (5 mL ÷ 400 mg) = 7.5 mL. Quick check: 400 mg/5 mL is 80 mg per mL, and 7.5 mL × 80 mg/mL = 600 mg.

Why the other choices don't fit

• A: 5 mL contains only 400 mg.
• B: 6 mL contains 480 mg.
• C: 12 mL contains 960 mg, far more than prescribed.

Takeaway: Dose ÷ concentration. Keep the units on every line.

Source: Worked from the numbers in the question (600 × 5 ÷ 400 = 7.5)

Correct answer: D. 1.2 g. A regulated seller may not sell any purchaser more than 3.6 g of pseudoephedrine base in a single calendar day, no matter how many transactions. 3.6 g − 2.4 g = 1.2 g. Note that the limit is in grams of base, not the salt amount printed on some labels. States can set stricter limits.

Why the other choices don't fit

• A: A new transaction doesn't reset the daily limit.
• B: The federal daily limit is 3.6 g, not 2.4 g.
• C: 7.5 g is a 30-day limit for mobile retail vendors and certain mail-order sales, not the daily limit.

Takeaway: Pseudoephedrine: 3.6 g base per purchaser per calendar day, across all transactions.

Source: 21 CFR 1314.20, eCFR, § 1314.20(a); Worked from the numbers in the question (3.6 − 2.4 = 1.2); 21 CFR Part 1314 (Retail sale of scheduled listed chemical products), eCFR, Sections 1314.10, 1314.20(b), and 1314.100(b)

Correct answer: D. 0.3 mL. 30 units ÷ 100 units/mL = 0.3 mL.

Why the other choices don't fit

• A: 3 mL would be 300 units.
• B: 0.03 mL would be 3 units.
• C: 30 mL confuses units with milliliters.

Takeaway: U-100: units ÷ 100 = mL.

Source: Worked from the numbers in the question (30 ÷ 100 = 0.3); LANTUS (insulin glargine) label, DailyMed, Dosage Forms and Strengths (100 units/mL)

Correct answer: C. 30. 1 capsule × 3 times a day = 3 capsules a day. 3 × 10 days = 30 capsules. Reverse check: 30 ÷ 3 per day = 10 days.

Why the other choices don't fit

• A: 10 would cover only 1 capsule a day.
• B: 20 would cover twice-daily dosing.
• D: 40 would cover four times a day.

Takeaway: Quantity = dose per day × days.

Source: Worked from the numbers in the question (1 × 3 × 10 = 30)

Correct answer: D. Report it to VAERS even if you're not sure the vaccine caused it. VAERS encourages reports of clinically important events after vaccination even when it isn't clear the vaccine caused them, and anyone can report. CDC also notes that a VAERS report doesn't by itself mean the vaccine caused the event.

Why the other choices don't fit

• A: VAERS doesn't require proof of cause before a report.
• B: Vaccine events go to VAERS.
• C: Patients, caregivers, and healthcare providers can all report.

Takeaway: VAERS: report even if unsure. A report is not proof of cause.

Source: VAERS, Frequently Asked Questions, What should be reported; CDC, About the Vaccine Adverse Event Reporting System (VAERS), At a glance

Correct answer: B. Amoxicillin is contraindicated after a serious hypersensitivity reaction to other beta-lactams such as penicillins. The amoxicillin label lists a history of serious hypersensitivity, such as anaphylaxis, to amoxicillin or other beta-lactam antibacterials (for example, penicillins) as a contraindication. This must go to the pharmacist before anything is filled.

Why the other choices don't fit

• A: Amoxicillin is a penicillin-class drug. The name difference is what makes this error easy.
• C: The contraindication covers the drug, not one dosage form.
• D: The label notes anaphylaxis has occurred with oral penicillins too.

Takeaway: Documented penicillin anaphylaxis + amoxicillin = stop and get the pharmacist.

Source: Amoxicillin label (Sandoz), DailyMed, Section 4 Contraindications; Section 5.1

Correct answer: B. Behind the counter or in a locked cabinet, without direct customer access. Part 1314 requires the regulated seller to place the product so customers don't have direct access to it before the sale is made. The regulation calls this "behind-the-counter" placement and expressly includes a locked cabinet in an area to which customers have direct access. States may add their own rules.

Why the other choices don't fit

• A: An open shelf gives customers direct access.
• C: Refrigeration isn't the requirement.
• D: A sign doesn't prevent direct access.

Takeaway: Pseudoephedrine: behind the counter or in a locked cabinet, with no direct access to the product before sale.

Source: 21 CFR Part 1314 (Retail sale of scheduled listed chemical products), eCFR, 21 CFR 1314.25, including locked-cabinet provision; 1314.10, state-law relationship

Correct answer: C. Never share the pen with another person, even if the needle is changed. The Lantus label says a SoloStar pen must never be shared with another person, even if the needle is changed, because sharing carries a risk of passing blood-borne infections. Each patient needs their own pen and new needles.

Why the other choices don't fit

• A: A new needle doesn't make sharing safe.
• B: Wiping the pen doesn't remove the risk.
• D: Dose has nothing to do with infection risk.

Takeaway: Insulin pens: one person per pen, no exceptions.

Source: LANTUS (insulin glargine) label, DailyMed, Warnings and Precautions; Patient Counseling (never share pens)

Correct answer: A. Look for the system problems behind the errors, such as how the strengths are stored, and fix them. AHRQ PSNet describes root cause analysis as looking for system causes and weaknesses rather than assigning individual blame, and notes these tools are used for near misses as well as adverse events. A repeated near miss is a warning that a process, such as shelf layout or labeling, needs to change.

Why the other choices don't fit

• B: Blame doesn't fix the process that keeps producing the same error.
• C: Near misses are exactly the events that reveal problems before a patient is hurt.
• D: Dropping the drug avoids the question and may harm patients who need it.

Takeaway: Repeated near miss = fix the system, not the scapegoat.

Source: AHRQ PSNet, Root Cause Analysis (primer), Background; AHRQ PSNet, Strategies and Approaches for Investigating Patient Safety Events, Root Cause Analysis

Correct answer: A. Angioedema. Lisinopril labeling describes angioedema: swelling of the face, extremities, lips, tongue, glottis, or larynx, including some fatal reactions, which can happen at any time during treatment with an ACE inhibitor.

Why the other choices don't fit

• B: Gout isn't the swelling reaction the label describes for ACE inhibitors.
• C: Tooth discoloration is not the swelling reaction described here.
• D: Hair loss isn't the warning described here.

Takeaway: ACE inhibitors: angioedema can be life-threatening and can appear at any point in therapy.

Source: Lisinopril tablets label (Camber), DailyMed, Warnings and Precautions, Angioedema

Correct answer: D. A calibrated oral syringe. The amoxicillin label says to use a calibrated oral syringe when dosing a child with the suspension, and to rinse it after each use. A marked oral syringe measures small volumes accurately.

Why the other choices don't fit

• A: Household spoons vary in size.
• B: Needles and injection syringes aren't for oral liquids.
• C: A cup marked only in ounces can't measure small mL doses accurately.

Takeaway: Child's liquid dose: calibrated oral syringe.

Source: Amoxicillin label (Sandoz), DailyMed, Storage and Handling / Patient Counseling

Correct answer: D. Report it promptly. Atorvastatin labeling tells patients to promptly report unexplained muscle pain, tenderness, or weakness, especially with malaise or fever, because statins can cause myopathy and rhabdomyolysis. The technician gets the pharmacist involved.

Why the other choices don't fit

• A: The label asks for prompt reporting, not waiting.
• B: A higher dose can increase the risk.
• C: Patients shouldn't change their own regimen. That's a prescriber decision.

Takeaway: Statin + unexplained muscle pain = report promptly.

Source: LIPITOR (atorvastatin calcium) label, DailyMed, Warnings and Precautions 5.1; Section 17

Correct answer: C. Pouring it down a drain that leads to a public sewage treatment plant. 40 CFR 266.505 prohibits all healthcare facilities and reverse distributors from discharging hazardous waste pharmaceuticals to a sewer system that passes through to a publicly owned treatment works. In plain terms: no sinks, no toilets.

Why the other choices don't fit

• A: Proper hazardous waste management is the lawful route, not the prohibited one.
• B: Reverse distributors are part of the regulated system and have their own duties.
• D: Proper containment for pickup is not what the sewer ban prohibits.

Takeaway: Hazardous waste pharmaceuticals: never sewered at a healthcare facility.

Source: 40 CFR 266.505, eCFR, § 266.505

Correct answer: C. Wrong patient. Everything about the medicine matches. What doesn't match is the patient identity: the name and date of birth belong to a different person. PTCB's outline lists incorrect patient as a type of prescription error.

Why the other choices don't fit

• A: The strength and directions match.
• B: The drug matches.
• D: The quantity matches.

Takeaway: Match the patient's name and date of birth, not just the drug.

Source: Fictional records and policy supplied in the question (Records supplied in the question); PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.5

Correct answer: B. Lactic acidosis. The metformin ER label carries a boxed warning for lactic acidosis, a buildup of lactic acid in the blood that has caused deaths. Risk factors include kidney impairment, age 65 or older, and excessive alcohol intake.

Why the other choices don't fit

• A: The label mentions postmarketing liver injury, but the boxed warning is lactic acidosis.
• C: Zoloft has a boxed warning about suicidal thoughts and behaviors; that is not the boxed warning on metformin.
• D: That is not metformin's boxed warning.

Takeaway: Metformin's boxed warning: lactic acidosis.

Source: Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Boxed Warning; ZOLOFT (sertraline) label, DailyMed, Boxed Warning

Correct answer: D. The segments identify the labeler, the product, and the package; FDA's final rule moves NDCs to a 12-digit format effective March 7, 2033. An NDC has three segments: labeler code, product code, and package code. This 10-digit example uses the 5-3-2 configuration; the FDA describes 4-4-2, 5-3-2, and 5-4-1 configurations for the 10-digit format. FDA's March 5, 2026 final rule changes FDA-assigned NDCs to a uniform 12-digit 6-4-2 format, effective March 7, 2033.

Why the other choices don't fit

• A: The NDC identifies the product and package, not a patient.
• B: The lot number is a separate code. It isn't part of the NDC.
• C: The 12-digit format isn't effective until March 7, 2033.

Takeaway: NDC = labeler-product-package. 12 digits starts in 2033, not now.

Source: FDA final rule, Revising the National Drug Code Format (Federal Register, March 5, 2026), Summary and effective date; Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Section 16.1 (example NDC 50742-633-60, 60-tablet bottle); FDA, National Drug Code Format, Three-segment 10-digit formats; future 12-digit format

Correct answer: A. Three times the dose; incorrect dose. 15 mL ÷ 5 mL = 3, so each dose would be three times what was prescribed. That's an incorrect-dose error, one of the error types in PTCB's outline.

Why the other choices don't fit

• B: The route (by mouth) matches, and the multiplier is 3, not 2.
• C: The volumes are different.
• D: The multiplier is 3, and the patient isn't in question.

Takeaway: Compare label to prescription line by line, and do the math.

Source: Worked from the numbers in the question (15 ÷ 5 = 3); PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.5

Correct answer: C. Treatment or prevention of bronchospasm. The Ventolin HFA label lists treatment or prevention of bronchospasm in patients 4 years and older with reversible obstructive airway disease, and prevention of exercise-induced bronchospasm.

Why the other choices don't fit

• A: That describes statins.
• B: Ventolin HFA is an oral inhaler, not an eye product.
• D: That describes diabetes drugs such as metformin.

Takeaway: Albuterol inhaler: bronchospasm.

Source: VENTOLIN HFA (albuterol sulfate) label, DailyMed, Section 1 Indications and Usage

Correct answer: A. Class I. FDA defines Class I as a situation with a reasonable probability that use of, or exposure to, a violative product will cause serious adverse health consequences or death. It's the most serious class.

Why the other choices don't fit

• B: Class II covers temporary or medically reversible effects, or cases where serious harm is remote.
• C: Class III covers products not likely to cause adverse health consequences.
• D: A market withdrawal is not a recall class.

Takeaway: Class I is the most serious recall; Class III is the least.

Source: FDA, Recalls Background and Definitions, Recall Classifications

Correct answer: B. Record 2. Only Record 2 matches both the product code and the lot number in the notice. A recall defines its own scope, so both fields must match. (These codes are made up for practice. They aren't real NDCs or a real recall.)

Why the other choices don't fit

• A: Right product, wrong lot.
• C: Right lot number, wrong product.
• D: Neither field matches.

Takeaway: Match every field the recall names: product and lot.

Source: Fictional records and policy supplied in the question (Fictional records in the question); FDA, Recalls Background and Definitions, Recall background

Correct answer: A. Type 2 diabetes mellitus in adults, with diet and exercise. The label indicates metformin ER as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Why the other choices don't fit

• B: The indication is type 2, not type 1.
• C: Metformin isn't a blood pressure drug.
• D: Hypothyroidism is treated with levothyroxine.

Takeaway: Metformin: type 2 diabetes, with diet and exercise.

Source: Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Section 1 Indications and Usage; SYNTHROID (levothyroxine sodium) prescribing information, AbbVie, Section 1, Indications and Usage

Correct answer: B. Incorrect quantity; 60 extra days. The drug and directions are right, but 90 tablets were dispensed instead of 30. 90 − 30 = 60 extra tablets, which is 60 extra days at 1 tablet a day. That's an incorrect-quantity error.

Why the other choices don't fit

• A: The drug is correct, and the extra supply is 60 days, not 30.
• C: Nothing about the route changed.
• D: Quantity must match what was prescribed and authorized.

Takeaway: Quantity errors can hide in a correct-looking label.

Source: Worked from the numbers in the question (90 − 30 = 60); PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.5

Correct answer: D. Quarantine it away from sellable stock and promptly investigate. Under 21 U.S.C. 360eee-1(d)(4)(A), when a dispenser determines a product is suspect, it must quarantine the product from product intended for distribution until it's cleared or dispositioned, and promptly investigate with trading partners as needed to decide whether it's illegitimate.

Why the other choices don't fit

• A: Appearance can't clear a suspect product.
• B: Destroying it skips the required investigation and evidence.
• C: Putting it back in stock is exactly what quarantine prevents.

Takeaway: Suspect product: quarantine and investigate.

Source: 21 U.S.C. 360eee-1 (DSCSA dispenser requirements), U.S. Code, 21 U.S.C. 360eee-1(d)(4)(A); 21 U.S.C. 360eee (DSCSA definitions), govinfo, 21 U.S.C. 360eee(15), definition of quarantine

Correct answer: B. Hypothyroidism (underactive thyroid). Synthroid is labeled as replacement therapy for hypothyroidism, when the thyroid gland doesn't make enough thyroid hormone. It supplies a synthetic version of that hormone.

Why the other choices don't fit

• A: An overactive thyroid needs the opposite kind of treatment.
• C: Levothyroxine isn't an allergy medicine.
• D: That's metformin's indication.

Takeaway: Levothyroxine replaces thyroid hormone: hypothyroidism.

Source: SYNTHROID (levothyroxine sodium) prescribing information, AbbVie, Section 1, Indications and Usage; Metformin hydrochloride extended-release tablets label (Ingenus, rev. 4/2026), DailyMed, Section 1, Indications and Usage

Correct answer: A. Bottle 2. Bottles 1, 3, and 4 all expired before September 2026. Only Bottle 2 (November 2027) is still in date.

Why the other choices don't fit

• B: March 2026 has already passed.
• C: January 2026 has already passed.
• D: June 2025 expired more than a year ago.

Takeaway: Check the expiration on every stock bottle before filling.

Source: Fictional records and policy supplied in the question (Compare the four supplied expiration months with September 24, 2026.); FDA, Don’t Be Tempted to Use Expired Medicines, Expired medicines can be risky

Correct answer: D. Wrong drug. The patient received a different drug than prescribed. This look-alike pair is on FDA's Tall Man list because the names are easy to confuse.

Why the other choices don't fit

• A: Nothing in the question says the count was wrong.
• B: Both are oral tablets.
• C: The patient isn't in question.

Takeaway: LASA mix-ups become wrong-drug errors.

Source: PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 3.5; ISMP, FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man Letters (2023), Table 1

Correct answer: D. After 14 days. The amoxicillin label says any unused portion of the reconstituted suspension must be discarded after 14 days, and that refrigeration is preferable but not required.

Why the other choices don't fit

• A: 7 days is not this label's limit.
• B: A prescribed course length is not the product's stability limit; this label says 14 days.
• C: 30 days goes well past the labeled limit.

Takeaway: This Sandoz reconstituted amoxicillin suspension: discard after 14 days. Refrigeration preferred, not required.

Source: Amoxicillin label (Sandoz), DailyMed, Storage and Handling; Patient Counseling

Correct answer: B. FDA and appropriate immediate trading partners, within 24 hours. FDA explains that dispensers and other trading partners must notify FDA and all appropriate immediate trading partners within 24 hours after determining a product is illegitimate. FDA takes these notices through Form FDA 3911 or its online 3911 platform.

Why the other choices don't fit

• A: The patient isn't the required notification target, and 30 days is far too slow.
• C: The federal DSCSA notice goes to FDA and trading partners. A state may have its own rules too.
• D: Destroying the product doesn't remove the duty to notify.

Takeaway: Illegitimate product: notify FDA and immediate trading partners within 24 hours.

Source: FDA, Notify FDA of Illegitimate Products, Notify FDA Within 24 Hours

Correct answer: A. Up to 28 days. Lantus instructions say to use the pen for up to 28 days after its first use and to throw it away after 28 days even if insulin is left. In-use pens are kept at room temperature below 86°F (30°C) and not put back in the refrigerator.

Why the other choices don't fit

• B: 7 days is far shorter than the labeled in-use period.
• C: 90 days is far longer than the labeled in-use period.
• D: The printed expiration date does not extend the 28-day in-use period. Any earlier expiration still applies.

Takeaway: Opened Lantus pen: 28 days, then discard even if insulin remains.

Source: LANTUS (insulin glargine) label, DailyMed, Section 16 Storage; Instructions for Use

Correct answer: A. Move it to the labeled non-dispensable returns bin. Expired medicine is non-dispensable, and this policy spells out the process: pull it from dispensable stock and put it in the designated returns bin for processing (for example, credit return or reverse distribution). Keeping expired stock separate prevents it from being dispensed by mistake.

Why the other choices don't fit

• B: It stays in dispensable inventory, where it could be dispensed.
• C: Expired stock must not be dispensed.
• D: The policy names a process, and disposal rules can depend on the product.

Takeaway: Expired = out of dispensable stock, into the designated returns process.

Source: Fictional records and policy supplied in the question (Policy supplied in the question); PTCB, PTCE Content Outline (effective January 6, 2026), Knowledge area 4.4; FDA, Don’t Be Tempted to Use Expired Medicines, Expired medicines can be risky

Correct answer: D. Wash with soap and water. CDC says to wash with soap and water when hands are visibly soiled. Alcohol-based hand sanitizer is preferred in most other clinical situations when hands are not visibly soiled.

Why the other choices don't fit

• A: Sanitizer is preferred only when hands are not visibly soiled.
• B: Gloves don't clean hands.
• C: Wiping doesn't clean hands.

Takeaway: Visibly soiled = soap and water.

Source: CDC, Clinical Safety: Hand Hygiene for Healthcare Workers, When to wash with soap and water

Correct answer: C. In a refrigerator at 36°F to 46°F (2°C to 8°C), not frozen. The Lantus label says to store unused Lantus in a refrigerator between 36°F and 46°F (2°C and 8°C), not to freeze it, and to discard it if it has been frozen. It should also be protected from direct heat and light.

Why the other choices don't fit

• A: Freezing ruins the product; frozen Lantus is discarded.
• B: Unused Lantus may be kept at room temperature for up to 28 days, but not until a printed expiration date beyond that period.
• D: Heat damages insulin.

Takeaway: Unused Lantus kept until its printed expiration date: refrigerate at 36–46°F (2–8°C). Never freeze.

Source: LANTUS (insulin glargine) label, DailyMed, Section 16 How Supplied/Storage

Correct answer: C. Standardized numerical identifier, lot number, and expiration date. 21 U.S.C. 360eee defines the product identifier as a standardized graphic, in human-readable and machine-readable form, that includes the standardized numerical identifier, lot number, and expiration date of the product. These make package-level tracing possible.

Why the other choices don't fit

• A: Those are prescription label elements, not the package identifier.
• B: Those are business records.
• D: Those identify the pharmacy, not the product package.

Takeaway: DSCSA product identifier: standardized numerical identifier + lot + expiration.

Source: 21 U.S.C. 360eee (DSCSA definitions), govinfo, 21 U.S.C. 360eee(14), product identifier

Correct answer: B. Sending product back to the authorized trading partner it was bought from, or to a returns processor or reverse logistics provider. The DSCSA defines a return as providing product to the authorized immediate trading partner from which it was purchased or received, or to a returns processor or reverse logistics provider for handling.

Why the other choices don't fit

• A: Dispensing isn't a return.
• C: Moving stock inside the pharmacy isn't a return.
• D: A prescription transfer moves prescription information, not product.

Takeaway: DSCSA return = product back to the seller or to a returns processor.

Source: 21 U.S.C. 360eee (DSCSA definitions), govinfo, 21 U.S.C. 360eee(17), definition of return

Correct answer: A. Clean hands immediately after removing the gloves. CDC lists "immediately after glove removal" as a time to perform hand hygiene.

Why the other choices don't fit

• B: Gloves don't replace hand hygiene.
• C: More gloves don't substitute for cleaning hands.
• D: CDC says immediately, not later.

Takeaway: Gloves off → clean hands.

Source: CDC, Clinical Safety: Hand Hygiene for Healthcare Workers, When to perform hand hygiene

Correct answer: B. Keep them in the original glass container, tightly capped. Nitrostat labeling says to keep the tablets in the original glass container, tightly capped. This helps protect the tablets' potency.

Why the other choices don't fit

• A: The label names a specific container.
• C: The label's direction is about the original glass container, not refrigeration.
• D: Loose tablets are out of the protective container.

Takeaway: Nitrostat tablets: original glass bottle, cap on tight.

Source: NITROSTAT (nitroglycerin sublingual tablets) label, DailyMed, How Supplied; Patient Information