Free PTCE Practice Questions (with Answers & Explanations)

Answer: C. ezetimibe

Zetia is ezetimibe, which lowers LDL cholesterol by blocking intestinal cholesterol absorption. Colesevelam (Welchol) is a bile acid sequestrant, fenofibrate is a fibrate, and niacin is a B vitamin once widely used for lipids.

Answer: B. Risk of Reye's syndrome

Aspirin use during viral illnesses in children and teens is linked to Reye's syndrome, a rare but potentially fatal disorder affecting the brain and liver. Gingival hyperplasia (phenytoin), orange urine (rifampin), and Stevens-Johnson syndrome are associated with other drugs, not with this aspirin warning.

Answer: C. spironolactone

Spironolactone is a potassium-sparing aldosterone antagonist, and ACE inhibitors also raise potassium by reducing aldosterone, so the combination can cause dangerous hyperkalemia. Loop and thiazide diuretics such as furosemide, hydrochlorothiazide, and metolazone tend to lower potassium.

Answer: B. ibuprofen

NSAIDs such as ibuprofen reduce renal lithium clearance and can raise levels into the toxic range. Acetaminophen is generally the preferred OTC analgesic for patients on lithium.

Answer: D. carbamazepine

Carbamazepine carries a boxed warning for serious skin reactions (SJS/TEN). The risk is strongly linked to HLA-B*1502, found mainly in people of Asian ancestry, so genetic screening is recommended before starting it in at-risk patients. Levetiracetam, gabapentin, and lithium do not carry this warning.

Answer: A. Schedule I

Schedule I drugs such as heroin and LSD have a high potential for abuse and no currently accepted medical use, so they cannot be prescribed. Schedule II is the tempting choice because those drugs also have a high abuse potential, but they do have accepted medical uses (e.g., oxycodone, fentanyl).

Answer: C. Every 2 years

Federal law requires a biennial (every 2 years) inventory of all controlled substances on hand. Every 3 years is tempting because that is how often the pharmacy's DEA registration is renewed, which is a separate requirement.

Answer: A. DEA Form 41

DEA Form 41 is the registrant record of controlled substances destroyed. Form 106 is the tempting distractor because it also involves drugs leaving inventory, but it is only for theft or significant loss.

Answer: B. 7.5 g

Mail-order and mobile retail vendor sales are limited to 7.5 g of base per customer per 30 days. 9 g is tempting because it is the 30-day limit for purchases made in a retail store.

Answer: B. 72 hours

When the pharmacy cannot supply the full quantity, the remainder may be dispensed within 72 hours; after that the prescriber must be notified and no further quantity may be supplied. 30 days is tempting because it applies to partial fills requested by the patient or prescriber under CARA.

Answer: A. To highlight the differing letters of look-alike drug names so they are less likely to be confused

Tall Man lettering capitalizes the letters that differ between look-alike names so the eye catches the difference during selection and verification. Flagging high-alert drugs is tempting because both are safety labels, but high-alert status is shown with separate alerts and storage, not Tall Man lettering.

Answer: A. Forcing functions and constraints, such as oral syringes that cannot connect to IV lines

ISMP's hierarchy ranks forcing functions and constraints highest because they make the error physically impossible rather than relying on people to remember. Education is tempting because it is widely used, but it depends on human memory and is among the least effective strategies.

Answer: D. 0.5 mg

A leading zero is required before a decimal less than 1 (0.5 mg) so the decimal point isn't missed and read as 5 mg. '0.50 mg' is tempting because it includes the leading zero, but the trailing zero is also prohibited because it can turn 0.5 into 50 if the decimal is missed.

Answer: D. The CDC and the FDA

VAERS is jointly run by the CDC and the FDA. 'FDA and HRSA' is tempting because HRSA runs the Vaccine Injury Compensation Program, but VAERS itself is co-managed by the CDC and FDA.

Answer: A. Diluted in a minibag (not a syringe) and labeled for intravenous use only, fatal if given by other routes

Vincristine is fatal if given intrathecally, and dispensing it in a minibag makes it physically hard to connect to a spinal needle. A syringe is tempting because it is a standard way to give small IV doses, but syringes are what allowed the fatal intrathecal errors.

Answer: C. 150 mL

1 teaspoon (tsp) = 5 mL. TID means three times a day. 5 mL x 3 = 15 mL per day. 15 mL/day x 10 days = 150 mL total.

Answer: D. June 30, 2027 (the last day of the month)

When an expiration date shows only a month and year, the product is good through the last day of that month. June 1, 2027 is tempting because it is the first date in the stated month, but the convention is the end of the month.

Answer: A. Take 1 tablet by mouth every 4 to 6 hours as needed for pain

'i' = one, 'tab' = tablet, 'po' = by mouth, 'q4-6h' = every 4 to 6 hours, 'prn' = as needed. '4 to 6 times a day' is tempting, but 'q4-6h' sets the interval between doses, not the number of doses per day.

Answer: A. The inscription

The inscription is the body of the prescription naming the drug, strength, and ingredients. The subscription is tempting because it follows the inscription, but it gives directions to the pharmacist, such as the quantity to dispense.

Answer: B. The prescription's serial number

Federal law requires the dispenser's name and address, the serial number, the date, the prescriber's name, the patient's name (if stated), and the directions and cautionary statements. The NDC is tempting because it is printed on many labels, but that is a state or business requirement, not part of 503(b)(2).