PTCE Practice Exam Questions with Answers Pharmacy Technician Certification (CPhT) Exam Certification

Pantoprazole (Protonix)is aproton pump inhibitor (PPI)that isonly available by prescriptionfor treatingGERD, Zollinger-Ellison syndrome, and peptic ulcers.

Omeprazole (Prilosec), Lansoprazole (Prevacid), and Esomeprazole (Nexium)are availableOTC and by prescriptionin different strengths.

Prescription PPIsare typically higher strength than OTC versions.

????Reference:FDA Drug Approvals for OTC and Prescription PPIs.

The original sig reads:

“i tab PO t.i.d.” which means “take one tablet by mouth three times a day”.

If the label instructs twice daily (b.i.d.) instead of t.i.d., it is a dosage frequency error, leading to under-dosing.

According to Mosby’s Pharmacy Technician: Principles and Practice:

“A transcription error in the frequency of administration can result in subtherapeutic dosing or treatment failure. Accuracy in translating sig codes is essential.”

Other options:

Route (PO) is correct.

Days supply is still 7 days.

Dosage form (tablet) is unchanged.

Comprehensive and Detailed Step-by-Step Explanation:

TheNational Drug Code (NDC)is a10- or 11-digit numberidentifying a drug'smanufacturer, product, and package size.

????NDC Format:

XXXXX?YYYY?ZZ\text{XXXXX} - \text{YYYY} - \text{ZZ}XXXXX?YYYY?ZZ

First 5 digits= Manufacturer

Middle 4 digits= Drug, strength, and formulation

Last 2 digits=Package size

?A. Package size?Correct.Since the first two segments(00781-1506)are identical, the difference is in thelast segment, which representspackage size.?B. Dosage? Incorrect. Thedosage (mg strength) remains the same.?C. Manufacturer? Incorrect. Themanufacturer is the same (first 5 digits are identical).?D. Strength? Incorrect. Thestrength is unchanged.

????Reference:

FDA NDC Directory

PTCB Inventory Management Guidelines

Addyi (flibanserin)is used to treat hypoactive sexual desire disorder (HSDD) in premenopausal women. It is subject to aRisk Evaluation and Mitigation Strategy (REMS) programbecause of its potential to causesevere hypotension (low blood pressure) and syncope (fainting), especially when taken with alcoholor moderate-to-strong CYP3A4 inhibitors.

The REMS program requires healthcare providers and pharmacists to be certified before prescribing or dispensing Addyi. Patients must be counseled on the risks, and alcohol use is strictly contraindicated while taking this medication.

B. is an emergency oral contraceptive? Incorrect. Addyi is not a contraceptive; it treats HSDD.

C. contains an opioid analgesic? Incorrect. Addyi is not an opioid; it affects serotonin and dopamine receptors.

D. is a monoclonal antibody? Incorrect. Addyi is a non-hormonal serotonin receptor agonist/antagonist, not a monoclonal antibody.

Incorrect Answer Choices:Pharmacy Technician References:

PTCB PTCE Exam Content Outline (Medication Safety and REMS Programs)

FDA REMS Database for Addyi (Flibanserin)

Lexicomp Drug Monograph on Addyi

Mosby’s Pharmacy Technician Exam Review

To determine the required volume of U-100 insulin to administer a20-unitdose ofNPH insulin, we use the concentration definition:

U-100 insulinmeans100 units per 1 ml

We need20 units

Using the formula:

Volume (ml)=Dose (units)Concentration (units/ml)\text{Volume (ml)} = \frac{\text{Dose (units)}}{\text{Concentration (units/ml)}}Volume (ml)=Concentration (units/ml)Dose (units)?Volume=20 units100 units/ml=0.2 ml\text{Volume} = \frac{20 \text{ units}}{100 \text{ units/ml}} = 0.2 \text{ ml}Volume=100 units/ml20 units?=0.2 ml

Thus, the correct answer is0.2 ml.

A. 0.02 ml? Incorrect; this would correspond to only 2 units.

B. 1 ml? Incorrect; this would correspond to 100 units, far exceeding the prescribed dose.

D. 2 ml? Incorrect; this would correspond to 200 units, which is incorrect.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations)

USP <797> Pharmaceutical Compounding—Sterile Preparations

American Pharmacists Association (APhA) Pharmacy Technician Certification Review

To determine the correct volume of amoxicillin suspension per dose, use the given concentration and dose.

Prescription dose:150 mg per dose

Suspension concentration:250 mg per 5 mL

Formula to calculate volume needed:Volume (mL)=Prescribed dose (mg)Concentration (mg/mL)\text{Volume (mL)} = \frac{\text{Prescribed dose (mg)}}{\text{Concentration (mg/mL)}}Volume (mL)=Concentration (mg/mL)Prescribed dose (mg)?

Step 1: Identify Given InformationStep 2: Calculate150 mg250 mg/5 mL=150×5250=750250=3 mL\frac{150 \text{ mg}}{250 \text{ mg/5 mL}} = \frac{150 \times 5}{250} = \frac{750}{250} = 3 \text{ mL}250 mg/5 mL150 mg?=250150×5?=250750?=3 mL

Thus, the patient should take3 mL per dose.

B. 4 mL? Incorrect; this would correspond to a different strength.

C. 5 mL? Incorrect; this would deliver250 mg, which is incorrect.

D. 6 mL? Incorrect; this would deliver300 mg, exceeding the prescribed dose.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations – Dosage & Volume Calculations)

USP <795> Guidelines for Nonsterile Compounding & Drug Dilution

Lexicomp Drug Monograph for Amoxicillin Suspension

During pregnancy, medication safety is classified by theFDA Pregnancy Categories(prior to 2015) or thePregnancy and Lactation Labeling Rule (PLLR)(current system).

Acetaminophen (Tylenol) is considered the safest analgesic for pregnant women, especially for treating mild to moderate pain or fever.

It hasno known teratogenic effectswhen used at recommended doses.

A. Isotretinoin??Severe risk in pregnancy (Category X / Contraindicated)

Causes severe birth defects(craniofacial, cardiac, and central nervous system malformations).

Requires enrollment in theiPLEDGE programto prevent pregnancy exposure.

C. Lovastatin??Not safe in pregnancy (Category X / Contraindicated)

Cholesterol-lowering statins are teratogenic, as fetal development requires cholesterol.

D. Triazolam??Not safe in pregnancy (Category X / Contraindicated)

A benzodiazepine that can cause birth defects, neonatal withdrawal syndrome, and CNS depression in the fetus.

FDA Pregnancy and Lactation Labeling Rule (PLLR)– Discusses medication risks in pregnancy.

American College of Obstetricians and Gynecologists (ACOG) Guidelines– Listsacetaminophen as the preferred pain reliever during pregnancy.

PTCB PTCE Exam Content Outline– Covers drug safety in special populations, including pregnancy.

Why Not the Other Options?Key References:

According tofederal law,a reverse distributor must issue a DEA Form 222 (or electronic equivalent) when a pharmacy requests the destruction of a Schedule II controlled substance.

Reverse distributorshandle the return and disposal ofexpired, damaged, or unusable controlled substances.

DEA Form 222 (or CSOS, the electronic equivalent) is required for Schedule II drugs.

Hydrocodone with acetaminophen (e.g., Norco, Vicodin)is aSchedule II controlled substance, requiringDEA Form 222for reverse distribution.

A. Acetaminophen with codeine??Schedule III

Does not require DEA Form 222; instead, DEA Form 41 is used for disposal.

C. Promethazine with codeine??Schedule V

Lower abuse potential; does not require DEA Form 222.

D. Pseudoephedrine with ibuprofen??Not a controlled substance

Pseudoephedrine is regulated under the Combat Methamphetamine Epidemic Act (CMEA), not the DEA controlled substance schedules.

DEA Controlled Substances Act (CSA)– Confirms thatSchedule II drugs require DEA Form 222 for reverse distribution.

PTCB PTCE Exam Content Outline– Covers controlled substances and reverse distribution requirements.

DEA Diversion Control Division Guidelines– Listshydrocodone as a Schedule II drug requiring Form 222 for disposal.

Understanding DEA Form 222 and Reverse Distribution:Why is Hydrocodone with Acetaminophen the Correct Answer?Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Acetaminophen (Tylenol)is metabolized by theliver.Excessive doses or concurrentalcohol useincreases the risk ofliver damage (hepatotoxicity).

????Explanation of Answer Choices:?D. Alcoholic beverages?Correct. Alcohol and acetaminophen together can causesevere liver damage.?A. Citrus fruits? Incorrect. Citrus does not interfere withacetaminophen metabolism.?B. Leafy greens? Incorrect. Leafy greens affectwarfarin, notacetaminophen.?C. Dairy products? Incorrect. Dairy does not interact withacetaminophen.

????Reference:

FDA Acetaminophen Warnings

PTCB Medication Safety Guidelines

Beyond-use dates (BUDs) apply specifically to compounded medicationsand indicate thetime frame in which the medication remains stable and safe to use.

BUDs are different from expiration dates, which are determined by manufacturers through long-term stability testing.

USP <795> BUD Guidelines for Nonsterile Compounds:

Non-aqueous formulations(e.g., capsules, powders) ?6 months

Water-containing oral formulations(e.g., suspensions) ?14 days (refrigerated)

Water-containing topical formulations(e.g., creams, lotions) ?30 days

Why Other Options Are Incorrect:

B. Manufactured preparation expiration dates??Expiration dates apply tocommercially manufactured drugs, NOT compounded ones.

C. Shelf-life of manufactured drugs??This is determined by themanufacturer’s expiration date.

D. Time to prepare a compound??BUDsdo not refer to preparation time.

????Reference:USP <795> & USP <797> Guidelines, PTCE Compounding Study Materials.

When abody area is exposed to a hazardous substance, thefirst actionshould be tothoroughly flush the area with watertoimmediately remove the contaminantand reduce absorption into the skin.

Flush the affected area with water for at least 15 minutes.

Remove contaminated clothing.

Seek medical attention if needed.

Report the incident to the pharmacy manager.

A. Notify the pharmacy manager? Incorrect;the immediate priorityis to flush the area.Reporting comes after decontamination.

C. Call environmental services for cleanup? Incorrect; personal exposure should be addressed before worrying about cleanup.

D. Go to the emergency department? Incorrect; first aid (flushing with water) should beperformed immediatelybefore seeking additional care if necessary.

Proper Emergency Response:Other Answer Choices Explained:References:

USP <800> Guidelines for Handling Hazardous Drugs

OSHA (Occupational Safety and Health Administration) Hazardous Substance Exposure Protocols

PTCB PTCE Exam Content Outline (Medication Safety & Hazardous Drug Handling)

USP <800> mandates that personal protective equipment (PPE) be worn when handling hazardous drug spillsto protect againstinhalation, skin absorption, or accidental ingestion.

Full PPE includes gloves, gowns, eye protection, and respiratory protection when necessary.

????Reference:USP <800> Hazardous Drug Handling Guidelines.

Pharmacy technicians in certain states may initiate the transfer of non-controlled prescriptions under pharmacist supervision.

Controlled substance transfers MUST be done by pharmacists.

????Reference:State Board of Pharmacy Regulations.

The abbreviation"PO"means"by mouth" (per os).

The abbreviation"ac"stands for"before meals" (ante cibum).

The phrase"daily for 14 days"indicates that the patient should take the medication once a day for a total of 14 days.

Thus, the correct label instructions should be:"Take one capsule by mouth before a meal once daily for 14 days."

PTCB PTCE Exam Content Outline – Prescription Interpretation– Covers standard medical abbreviations.

ISMP (Institute for Safe Medication Practices) List of Common Pharmacy Abbreviations– Defines "PO" (by mouth) and "ac" (before meals).

USP Medication Labeling Standards– Ensures clear and accurate patient instructions.

Pharmacy Technician References:

Naproxen (Aleve, Naprosyn) is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation.

????Reference:FDA NSAID Safety Guidelines.

PerUSP standards, a drug with an expiration date ofMarch 2025is consideredvalid until the last day of the month, which isMarch 31, 2025. This applies unless otherwise specified by the manufacturer.

If a drug is labeledMM/YYYY, itremains valid until the last day of that month.

If a drug is labeled with aspecific day (MM/DD/YYYY), itexpires at the end of that day.

A. February 28, 2025? Incorrect; the expiration is at the end ofMarch, not February.

B. March 1, 2025? Incorrect; the drug is stillusable until March 31.

D. March 1, 2026? Incorrect; the drugexpires in March 2025, not 2026.

Expiration Date Rules:Other Answer Choices Explained:References:

USP <797> Pharmaceutical Compounding – Expiration and Beyond-Use Dating (BUD) Guidelines

FDA Drug Expiration Date Regulations

PTCB PTCE Exam Content Outline (Pharmaceutical Storage & Stability)

Eliquis (apixaban) is a direct oral anticoagulant (DOAC) that increases the risk of serious bleeding.

High-alert medications have anarrow therapeutic indexand requirespecial monitoring.

????Reference:ISMP High-Alert Medication List, FDA Eliquis Safety Warnings.

Cyanocobalamin (Vitamin B12)is used to treatpernicious anemia, a condition caused byVitamin B12 deficiencydue to the body’s inability to absorb it properly.

Pernicious anemiais an autoimmune disorder where the stomach does not produceintrinsic factor, a protein needed for Vitamin B12 absorption.

Symptoms includefatigue, weakness, neurological issues (numbness, tingling), and megaloblastic anemia.

Cyanocobalamin is given viaIM injection or high-dose oral supplementation.

(A) Pernicious anemia?Correct – Cyanocobalamin is the primary treatment.

(B) Alcohol withdrawal?Incorrect – Thiamine (Vitamin B1) is used for alcohol withdrawal, not cyanocobalamin.

(C) Hypothyroidism?Incorrect – Treated withlevothyroxine (Synthroid), not Vitamin B12.

(D) Narrow-angle glaucoma?Incorrect – Treated withtimolol, acetazolamide, or surgery, not cyanocobalamin.

Cyanocobalamin Prescribing Information (NIH): https://medlineplus.gov/druginfo/meds/a607038.html

PTCB Exam Content Outline – Disease States & Medications

Key Facts About Cyanocobalamin & Pernicious Anemia:Analysis of Answer Choices:References for Pharmacy Technicians:

Comprehensive and Detailed Step-by-Step Explanation:

Root-Cause Analysis (RCA)is asystematic approachused toidentify the underlying causes of medication errors. RCA focuses onsystems and processes, not individual blame.

????Explanation of Answer Choices:?B. Focusing primarily on systems and processes rather than individual performance?Correct.RCA aims toprevent future errors by improving systems.?A. Termination of employment? Incorrect.Blaming individuals does not address system failures.?C. Immediate reporting to the state board? Incorrect.RCA is an internal investigation process.?D. Criminal charges? Incorrect.RCA focuses on improvement, not legal punishment.

????Reference:

ISMP Guidelines on Root-Cause Analysis

PTCB Medication Safety Principles

The prescription forhydroxyzine (25 mg q6h) for hypertensionis likely alook-alike, sound-alike (LASA) medication error, ashydroxyzineis anantihistamineused foranxiety, nausea, and allergiesbutnot for hypertension.

A common LASA confusion is between:

Hydroxyzine (antihistamine, sedative effects, brand names: Vistaril, Atarax)

Hydralazine (antihypertensive, vasodilator, used for hypertension, brand: Apresoline)

Sincehydralazineis used forhypertension, the prescription likely contains anordering errorthat must be clarified with the prescriber.

A. Hydroxyzine requires special handling? Incorrect; hydroxyzine does not require special handling.

B. The prescription exceeds the maximum recommended daily dose? Incorrect; hydroxyzine's max daily dose is400 mg/day, and this prescription does not exceed it.

D. Hydroxyzine is subject to a REMS program? Incorrect; hydroxyzineis not part of a Risk Evaluation and Mitigation Strategy (REMS) program.

Other Answer Choices Explained:References:

FDA & ISMP Look-Alike Sound-Alike (LASA) Drug List

PTCB PTCE Exam Content Outline (Medication Safety & Error Prevention)

Lexicomp Drug Monographs for Hydroxyzine & Hydralazine

Comprehensive and Detailed Step-by-Step Explanation:

To calculate the percentage ofpsylliumin the final preparation:

Formula:

A math equations with numbers and symbols Description automatically generated with medium confidence

Sincepsylliummakes up500 gout of1000 g (1 kg)of the bulk laxative, it accounts for50%of the total formulation.

????Reference:

USP <795>Compounding Standards

PTCE ExamPharmaceutical Calculations

Linagliptin is thegeneric name for Tradjenta, a medication used to treattype 2 diabetes mellitus.

Linagliptin is a DPP-4 inhibitor (Dipeptidyl Peptidase-4 Inhibitor).

Works byincreasing incretin levels, which boost insulin secretion and reduce glucagon levels.

Used tolower blood glucose levelsin patients with type 2 diabetes.

(A) Forteo?Incorrect – Forteo (teriparatide) is for osteoporosis.

(B) Januvia?Incorrect – Januvia (sitagliptin) is another DPP-4 inhibitor but not the same as Tradjenta.

(C) Tradjenta?Correct – The brand name for linagliptin.

(D) Xarelto?Incorrect – Xarelto (rivaroxaban) is an anticoagulant.

Tradjenta Prescribing Information (FDA):https://www.tradjenta.com

American Diabetes Association (ADA) – Pharmacologic Approaches to Diabetes Management:https://diabetesjournals.org

PTCB Exam Content Outline – Brand & Generic Name Drug Recognition

Drug Classification & Mechanism:Analysis of Answer Choices:References for Pharmacy Technicians:

Comprehensive and Detailed Step-by-Step Explanation:

Underfederal law (21 CFR §1306.25),Schedule III-V controlled substances (e.g., Alprazolam)can be transferred ONCEfor refill purposes between licensed pharmacieswith a shared database.Schedule II drugs (e.g., Methylphenidate, Fentanyl, Hydromorphone) CANNOT be transferred.

????Explanation of Answer Choices:?A. Alprazolam (C-IV)?Correct.Schedule III-V drugs can be transferred ONCEfor refill purposes.?B. Methylphenidate (C-II)? Incorrect.Schedule II drugs cannot be transferred.?C. Fentanyl (C-II)? Incorrect.C-II drugs are non-transferablebetween pharmacies.?D. Hydromorphone (C-II)? Incorrect.C-II drugs cannot be transferred.

????Reference:

DEA Controlled Substance Act (CSA)

21 CFR §1306.25 – Prescription Transfers

Carbon dioxide exposure can cause oxidation and degradation of certain medications, reducing theirstability and effectiveness.

????Reference:USP Drug Storage and Stability Guidelines.

USP <800> mandates that hazardous drug exposure requires immediate decontamination.

Flushing the affected area with large amounts of water for at least 15minutes is the first step.

For eye exposure, an eye wash station must be used immediately.

Why Other Options Are Incorrect:

A. Writing a report first??Incident reports should be done AFTER flushing the area.

B. Ice bag??Ice can worsen chemical burns.

C. Soapy water??Soap may react with chemicals, causing further irritation.

????Reference:USP <800> Hazardous Drug Handling, OSHA Chemical Safety Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

Lorazepam oral concentrate (Ativan)should be storedat controlled room temperature (20-25°C or 68-77°F)and protected fromlight. It should not be refrigerated or frozen.

????Explanation of Answer Choices:?B. Lanoxin oral solution?Correct.LikeLorazepam, Lanoxin (Digoxin)requires room temperature storage.?A. Lamictal chewable tablets? Incorrect.Stored at room temperature, but not a liquid formulation.?C. Lyumjev KwikPen? Incorrect.Insulin pens require refrigeration.?D. Lunesta tablets? Incorrect.A solid dosage form, not comparable to a liquid oral concentrate.

????Reference:

USP <1079>: Storage and Handling of Pharmaceuticals

FDA Storage Recommendations for Lorazepam

Chemotherapy drugs (e.g., methotrexate, cisplatin)arehigh-alertdue to theirtoxicity, risk of overdose, and narrow therapeutic index.

????Reference:ISMP High-Alert Medication List, PTCE Study Materials.

]

A medication'sstabilityrefers tohow well it maintains potency, effectiveness, and safety over time. Several factors candegrade medications, includingoxygen, moisture, temperature, and light.

Oxygen exposurecan causeoxidation, leading to drug degradation and loss of potency.

Many medications, especiallyvitamins (e.g., vitamin C), biologics, and certain antibiotics, are susceptible to oxidative damage.

Medications requiring protection from oxygen are often packaged inair-tight containersorblister packs.

A. Allergies? Incorrect; allergies affect thepatient, not the drug’sstability.

B. Equivalence? Incorrect; equivalence refers tobioavailabilitybetween generic and brand-name drugs, not drug stability.

D. Indications? Incorrect; indications refer toapproved uses of a drug, not factors affecting its stability.

Other Answer Choices Explained:References:

USP <797> and <795> Guidelines on Medication Stability

FDA Drug Stability and Shelf Life Guidelines

PTCB PTCE Exam Content Outline (Medication Storage & Stability)

Comprehensive and Detailed Step-by-Step Explanation:

The FDA requires patient package inserts (PPIs) for certain medications, including oral contraceptives like norethindrone/ethinyl estradiol.

????Explanation of Answer Choices:

?B. Norethindrone/Ethinyl Estradiol ? Correct. Oral contraceptives must include a PPI with risk information.

?A. Sulfamethoxazole/Trimethoprim ? Incorrect. Does not require a package insert.

?C. Triamterene/HCTZ ? Incorrect. A diuretic, no required PPI.

?D. Emtricitabine/Tenofovir Disoproxil ? Incorrect. A PPI is required only for certain formulations.

????Reference:

FDA Patient Information Leaflet Requirements

According to theCDC Hand Hygiene Guidelines,alcohol-based hand sanitizershould be used:

Before and after direct patient contact(if hands are not visibly dirty).

Before and after wearing gloves(if no contamination is visible).

Before handling medication or sterile supplies.

A. Are about to touch a contaminated surface??Incorrect

Hand sanitizer should not be used before touching a contaminated surface.Instead, gloves should be worn, and hand hygiene should be performedaftertouching a contaminated surface.

B. Have just performed an aseptic task??Incorrect

Before aseptic tasks (e.g., preparing IV medications), soap and water or hand sanitizer is used.Afterward, contamination risk determines if sanitization is needed.

C. Are about to remove their gloves??Incorrect

Gloves do not completely prevent contamination; hand hygiene should be performedafterremoving gloves, not before.

CDC Guidelines for Hand Hygiene in Healthcare Settings– Recommends hand sanitizer use after patient contact.

USP <797> Sterile Compounding Guidelines– Reinforces aseptic hand hygiene practices.

PTCB PTCE Exam Content Outline– Covers infection control and proper use of hand hygiene techniques.

Why Not the Other Options?Key References:

Maximum dose: 2 tabs twice daily (4 tabs/day).

20 tabs ÷ 4 per day = 5 days.

????Reference:PTCB Pharmacy Dosage Calculations.

Grapefruit juice inhibits CYP3A4 enzymes, increasingbudesonide levels inthe blood, leading tohigher risk of side effects (immune suppression, adrenal insufficiency).

Budesonide is a corticosteroid used for Crohn’s disease and asthma.

Why Other Options Are Incorrect:

B. Dairy products??No significant interaction.

C. Leafy greens??Affectswarfarin (not budesonide).

D. Aged cheese??Interacts withMAO inhibitors, not budesonide.

????Reference:FDA Drug-Food Interaction Guide, PTCB Medication Safety Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

The abbreviation "PR" stands for "per rectum", which is a route of administration where the medication is inserted into the rectum for absorption.

????Explanation of Answer Choices:

?A. Route of administration ? Correct. "PR" means rectal administration (e.g., suppositories).

?B. Frequency of dosing ? Incorrect. Frequency abbreviations include BID (twice daily), QD (once daily), etc.

?C. Medication strength ? Incorrect. Strength is indicated by mg, mcg, etc.

?D. Dosage form ? Incorrect. Dosage forms include tablets, capsules, solutions, etc.

????Reference:

ISMP List of Common Prescription Abbreviations

PTCB Exam: Medication Order Interpretation

1 pint =473 mL(since 1 pint = 16 fluid ounces, and 1 fluid ounce = 29.5735 mL).A1% suspensionmeans1 g (1000 mg) of rifampin per 100 mLof suspension.

Total dose required:2 tbsp daily =30 mL per day(1 tbsp = 15 mL).

Total volume of the suspension:473 mL

Total rifampin required:(473 mL × 1000 mg) ÷ 100 mL =4730 mg

Each rifampin capsule contains300 mg.So,4730 mg ÷ 300 mg/capsule = 15.77 capsules, which rounds up to16 capsules.

Thus, the correct answer isC. 32 capsules(since the full pint must be compounded).

????Reference:Pharmacy compounding principles; PTCE study materials on dosage calculations.

Duloxetine (Cymbalta)is anSNRI antidepressantoften confused withparoxetine (Paxil), another SSRI antidepressantdue tosimilar names andoverlapping indications.

????Reference:ISMP List of Look-Alike, Sound-Alike (LASA) Medications.

TheInstitute for Safe Medication Practices (ISMP)maintains a list oferror-prone abbreviationsthat shouldnot be usedin medication orders to prevent misinterpretation and medication errors.

Analysis of the Answer Choices:Abbreviation

Meaning

ISMP Recommendation

U

Units

?Do NOT use? Can be mistaken for "0" or "4" (e.g., 10U could be misread as 100).Use"unit"instead.

AD

Right ear

?Do NOT use? Can be confused with "OD" (right eye).Use"right ear"instead.

AU

Both ears

?Do NOT use? Can be confused with "OU" (both eyes).Use"both ears"instead.

gtt

Drop

?Accepted? Common and not considered error-prone.

Since"gtt" for drop is not on ISMP's "Do Not Use" list, it is the correct answer.

ISMP List of Error-Prone Abbreviations– Confirms that "U," "AD," and "AU" should not be used in prescriptions.

Joint Commission "Do Not Use" List– Prohibits "U" and similar abbreviations to prevent dosing errors.

PTCB PTCE Exam Content Outline– Covers error prevention strategies, including abbreviation safety.

Key References:

Lisinopril is anangiotensin-converting enzyme (ACE) inhibitor, commonly used forhypertension (high blood pressure)andheart failure. A well-known side effect of ACE inhibitors is apersistent dry, hacking cough.

The cough is caused bybradykinin accumulation, which occurs due to ACE inhibition.

This coughdoes not respond to cough suppressantsand can be bothersome for patients.

If the cough is severe, thepharmacist may recommend switching to an angiotensin II receptor blocker (ARB) such as losartan, which does not cause this side effect.

B. Purchase fexofenadine for seasonal allergies?? No significant interaction between lisinopril and fexofenadine.

C. Mention that they have lowered their cholesterol?? Cholesterol levels do not affect lisinopril’s mechanism of action.

D. Report that their blood pressure has been normal lately?? This is expected with effective treatment and does not require pharmacist intervention unless the patient wants to discontinue the medication.

PTCB PTCE Exam Content Outline– Covers drug interactions, side effects, and patient counseling.

American Heart Association (AHA) Guidelines– Lists ACE inhibitor side effects, including dry cough.

FDA Lisinopril Medication Guide– Mentions dry cough as a common adverse effect requiring pharmacist consultation.

Why is the Cough Significant?Why Not the Other Options?Key References:

St. John's Wort (Hypericum perforatum)is anherbal supplementcommonly used formild to moderate depression.

Containshypericin and hyperforin, which may increaseserotonin, dopamine, and norepinephrinelevels.

Often used as analternative treatment for depression, but not FDA-approved for this indication.

Hasserious drug interactions, including withantidepressants (SSRIs, SNRIs), warfarin, oral contraceptives, and cyclosporine.

(A) Immune enhancer?Incorrect – Not primarily used to boost the immune system.

(B) Mild antidepressant?Correct – Used for mild depression.

(C) Antioxidant?Incorrect – While it has some antioxidant properties, this is not its primary use.

(D) Antihypertensive?Incorrect – It does not lower blood pressure.

National Center for Complementary and Integrative Health (NCCIH) – St. John’s Wort:https://www.nccih.nih.gov/

MedlinePlus – St. John's Wort Drug Interactions:https://medlineplus.gov

PTCB Exam Content Outline – Herbal Supplements & Drug Interactions

How St. John’s Wort Works:Analysis of Answer Choices:References for Pharmacy Technicians:

Lorazepam oral concentrate is a high-potency liquid formulation often dispensed in 2 mg/mL. Due to its strength and risk of dosing errors, it must be dispensed with a calibrated oral syringe for accurate dosing, especially in pediatric or geriatric patients.

From Pharmacy Technician Certification Exam Review:

“Concentrated oral liquids should always be dispensed with calibrated measuring devices to prevent overdose or underdose.”

Other options:

Enoxaparin – subcutaneous injection

Albuterol/ipratropium – inhalation

Polyethylene glycol 3350 – powder mixed with water (no syringe required)

ISMP MERP (Institute for Safe Medication Practices – Medication Error Reporting Program)allows healthcare professionals toreport medication errorsto improve patient safety.

Common errors reported:

Incorrect medication dispensing

Wrong dosages

Look-alike, sound-alike drug errors

????Reference:ISMP Official Medication Error Guidelines.

TheFDA classifies recalls into three levels, withClass III being the least severe:

Class I Recall?Most severe? Issued when a drugmay cause serious harm or death.

Class II Recall?Moderate severity? The drug may causetemporary or medically reversible adverse effects.

Class III Recall?Least severe? The productis unlikely to cause harm but violates FDA regulations(e.g., labeling errors, minor packaging issues).

A. Is issued when there is a reasonable probability that the product will cause serious adverse health consequences or death.??Incorrect

Describes a Class I recall, not Class III.

B. Is initiated by the FDA if a manufacturer has violated the adulteration provisions of the Food, Drug, and Cosmetic Act (FDCA).??Incorrect

FDA action due to adulteration typically leads to Class I or Class II recalls, depending on severity.

C. Occurs when a product may cause temporary or medically reversible adverse health consequences.??Incorrect

Describes a Class II recall, not Class III.

FDA Drug Recall Guidelines– Defines Class I, II, and III recalls.

PTCB PTCE Exam Content Outline– Covers recall classifications and pharmacy responsibilities.

FDA Enforcement Report– Lists real-world examples of Class III recalls (e.g.,mislabeling, incorrect expiration dates).

Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Stock rotation (First In, First Out - FIFO)ensures thatolder medications are used before newer stock, reducing expired medication dispensing.

????Explanation of Answer Choices:?C. Rotating stock on a regular basis?Correct.FIFO method reduces waste and errors.?A. Verifying each lot number? Incorrect.Lot numbers do not indicate expiration dates.?B. Using the newest medications first? Incorrect.Older stock should be used first.?D. Using the last in, first out method? Incorrect.Opposite of the correct practice.

????Reference:

USP <1079>: Medication Storage and Inventory Control

PTCB Exam: Inventory Management

Comprehensive and Detailed Step-by-Step Explanation:

Levetiracetam (Keppra)is classified as ananticonvulsantused to treatseizures (epilepsy).It works by stabilizing electrical activity in the brain.

????Explanation of Answer Choices:?C. Anticonvulsant?Correct. Levetiracetam is indicated forpartial-onset, myoclonic, and tonic-clonic seizures.?A. Antibiotic? Incorrect. Levetiracetam does not treat bacterial infections.?B. Antihyperglycemic? Incorrect. Antihyperglycemics lowerblood sugar(e.g., metformin, glipizide).?D. Antihypertensive? Incorrect. Antihypertensives lowerblood pressure(e.g., amlodipine, lisinopril).

????Reference:

PTCB Exam: Pharmacology for Technicians

FDA Approved Drug Database (Levetiracetam)

DEA requires allcontrolled substance prescriptionsto include thedate of issueas per21 CFR 1306.05(a).

Other required elements:

Patient’s full name and address

Drug name, strength, dosage form, quantity

Directions for use

Prescriber’s name, address,DEA number, and signature

????Reference:DEA Controlled Substance Act;21 CFR 1306.05.

Prochlorperazine (Compazine suppository)requiresrefrigeration(store at2°C to 8°C / 36°F to 46°F) to maintain stability.

Other suppositories are stored atroom temperatureunless specified.

????Reference:Manufacturer Storage Guidelines, USP Storage Standards.

AZ-Pakrefers to theAzithromycin 5-day therapy pack, which is commonly prescribed forbacterial infectionssuch as respiratory infections. The standard dosing regimen follows a"loading dose" strategyto quickly reach effective drug levels in the body:

Day 1:Taketwo tablets (500 mg total).

Days 2-5:Takeone tablet (250 mg) daily.

This regimen helps achieverapid therapeutic concentrationswhile maintaining effectiveness over five days.

A. 1 tablet PO on the current day, then 1 PO daily for 4 days? Incorrect; aloading dose (2 tablets on Day 1)is required for proper drug efficacy.

B. 1 tablet PO on the current day, then 1 PO daily for 5 days? Incorrect; the Z-Pak is a5-day regimen, not 6 days.

D. 3 tablets PO on the current day, then 1 PO every other day for 6 days? Incorrect; this isnot a standard dosing regimenfor azithromycin.

Other Answer Choices Explained:References:

FDA Drug Monograph for Azithromycin (Z-Pak)

Lexicomp Drug Guide – Azithromycin Dosing

PTCB PTCE Exam Content Outline (Pharmacology – Infectious Disease Medications)

To calculate how muchamoxicillin suspensionwill be used in the first5 days, we follow these steps:

Amoxicillin concentration:250 mg per5 mL

Dosage:1 tsp (5 mL) three times daily (tid)

Duration:First5 days

Step 1: Identify Given InformationStep 2: Calculate Total Daily Volume5 mL×3=15 mL per day5 \text{ mL} \times 3 = 15 \text{ mL per day}5 mL×3=15 mL per day

Step 3: Multiply by 5 Days15 mL/day×5 days=75 mL15 \text{ mL/day} \times 5 \text{ days} = 75 \text{ mL}15 mL/day×5 days=75 mL

Thus, the patient will use75 mLof medication in the first5 days.

A. 25 mL? Incorrect; this would be correct if taken onlyonce dailyinstead ofthree times daily.

B. 50 mL? Incorrect; this is the correct amount for3.3 days, not 5 days.

D. 150 mL? Incorrect; this is thefull 10-day course, not just the first 5 days.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations – Dosage & Volume Calculations)

USP <795> Nonsterile Compounding Guidelines

Lexicomp Drug Monograph for Amoxicillin Suspension

Comprehensive and Detailed Step-by-Step Explanation:

Shingrix (Zoster Vaccine Recombinant)must be stored in therefrigerator (2°C to 8°C / 36°F to 46°F)and shouldnever be frozen.

????Explanation of Answer Choices:?C. Shingrix that was stored in a freezer?Correct.Shingrixloses potencywhen frozen.?A. Boostrix (Tdap) stored in a refrigerator? Incorrect.Proper storage condition.?B. Havrix (Hepatitis A vaccine) stored in a refrigerator? Incorrect.Proper storage condition.?D. Varivax (Varicella vaccine) stored in a freezer? Incorrect.Varivax must be stored frozen (-50°C to -15°C).

????Reference:

CDC Vaccine Storage & Handling Guidelines

USP <1079>: Vaccine Storage

Cleaning counting trays removes medication residue to prevent cross-contamination, especially with penicillin or sulfa drugs.

????Reference:ISMP Pharmacy Cleaning and Contamination Prevention Guidelines.

In the providedcompounded prescription, the antifungal agent isnystatin.

Nystatin is a polyene antifungalthat works by binding toergosterolin fungal cell membranes, causing leakage of cellular contents and fungal cell death.

It iscommonly used for fungal infections, particularlycutaneous or mucosal Candida infections(e.g., diaper rash, oral thrush).

A. Cholestyramine.? Incorrect. Cholestyramine is abile acid sequestrantused to lowercholesteroland treatdiarrhea(often in combination with other ingredients for skin irritation or wounds).

B. Hydrocortisone.? Incorrect. Hydrocortisone is acorticosteroidused to reduceinflammation and itching, but it does not kill fungi.

C. Zinc oxide.? Incorrect. Zinc oxide is askin protectantused fordiaper rash and minor burns, but it is not an antifungal.

Lexicomp Drug Database – Nystatin Mechanism of Action.

FDA Drug Label for Nystatin – Antifungal Properties.

PTCB PTCE Exam Content Outline – Compounded Preparations and Active Ingredients.

Mosby’s Pharmacy Technician: Principles and Practice – Dermatologic Compounding.

Why Is Nystatin an Antifungal?Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:Conclusion:Pharmacy technicians must befamiliar with drug classificationsto correctly identify active ingredients incompounded prescriptions.Nystatin is the only antifungal agentin the provided formulation.

Comprehensive and Detailed Step-by-Step Explanation:

Pseudoephedrine(Sudafed) is asympathomimetic decongestantthat causesvasoconstrictionand canincrease blood pressure.

????Explanation of Answer Choices:?B. Hypertension?Correct.Pseudoephedrinecan cause arise in blood pressure, so it should be used cautiously in patients withhypertension.?A. Asthma? Incorrect.Pseudoephedrine does not directly worsen asthma, but it may cause mild bronchodilation.?C. Hypokalemia? Incorrect.Pseudoephedrine does not affect potassium levels.?D. Eczema? Incorrect. Eczema is unrelated topseudoephedrine use.

????Reference:

Combat Methamphetamine Epidemic Act (CMEA) Regulations

American Heart Association (AHA) Guidelines on Hypertension

Total daily dose = 23 units (AM) + 17 units (PM) = 40 units/day

60 days × 40 units = 2,400 units needed

Each NPH insulin vial contains 1,000 units (10 mL × 100 units/mL)

2,400 units ÷ 1,000 units/vial = 2.4 vials ? round up to 3 vials

From Pharmacy Technician Certification Exam Review:

“When calculating insulin quantities, always round up to ensure the patient has sufficient supply. Insulin is typically dispensed in 10 mL vials containing 100 units/mL.”

Phenytoin (Dilantin)is ananticonvulsantthatstabilizes neuronal membranesbyblocking sodium channels, reducing seizure activity.

Used forepilepsy, tonic-clonic seizures, and status epilepticus.

Why Other Options Are Incorrect:

A. Clonidine??Used forhypertension and ADHD, NOT seizures.

B. Atomoxetine??Used forADHD, NOT seizures.

C. Guanfacine??Used forhypertension and ADHD, NOT seizures.

????Reference:FDA Drug Label for Phenytoin, Epilepsy Foundation Guidelines.

According toUSP <800>andOSHA guidelines, exposure control forhazardous drugs (HDs)must begin as soon as the drugenters the facilityto ensure proper handling, storage, and administration safety. This includes:

Receiving:

Hazardous drugs must beunpacked in a designated areathat isseparate from regular medications.

They shouldnot be opened in sterile or positive-pressure areasto prevent contamination.

Storage:

HDs must be stored in anegative-pressure room with proper ventilation.

They must be placed indesignated binsto reduce exposure risks.

Handling and Compounding:

Usepersonal protective equipment (PPE)such as gloves, gowns, and masks when handling hazardous drugs.

Use abiological safety cabinet (BSC) or compounding aseptic containment isolator (CACI)when preparing hazardous drugs.

A. Is dispensed? Incorrect;control measures must start earlier, before dispensing.

C. Is compounded? Incorrect; safety measures beginbefore compounding, when the drug arrives at the pharmacy.

D. Is placed on the pharmacy shelf? Incorrect;exposure control measuresbegin before storage, duringreceiving and handling.

Other Answer Choices Explained:References:

USP <800> Hazardous Drug Handling Guidelines

OSHA Hazardous Drug Safety Standards

NIOSH (National Institute for Occupational Safety and Health) Hazardous Drug List

PTCB PTCE Exam Content Outline (Medication Safety & Hazardous Drug Handling)

Citalopram (Celexa) is an SSRI (Selective Serotonin Reuptake Inhibitor) used for depression and anxiety.

Other drugs listed are for schizophrenia (clozapine, haloperidol) or anxiety (lorazepam).

????Reference:FDA Approved Antidepressants, PTCE Medication Classification Guide.

According to USP <1079> Good Storage and Distribution Practices, the most accurate source for determining proper storage conditions of a medication is the manufacturer's label or package insert, which contains specific temperature and humidity requirements (e.g., refrigeration, protection from light). This information is required by FDA labeling regulations and is essential for maintaining drug stability and potency.

Additionally, the Mosby’s Pharmacy Technician Review Guide states:

“Storage requirements should always be verified using the product’s official labeling or manufacturer’s monograph, as these contain validated stability data.”

Cytoxan (cyclophosphamide)belongs to thechemotherapy agentdrug classification. It is analkylating agentused to treat various types ofcancer, including:

Leukemia

Lymphoma

Breast cancer

Ovarian cancer

It works byinterfering with DNA replication in rapidly dividing cells, preventing cancer growth.

A. ACE inhibitor??Incorrect

ACE inhibitors (angiotensin-converting enzyme inhibitors)are used forhypertension and heart failure(e.g., lisinopril, enalapril).

C. Antibiotic??Incorrect

Antibioticstreatbacterial infections(e.g., amoxicillin, azithromycin).

D. Narcotic??Incorrect

Narcotics (opioids) are pain relievers(e.g., morphine, oxycodone).Cytoxan is not an opioid.

National Cancer Institute (NCI) Drug Dictionary– ClassifiesCytoxan as an alkylating chemotherapy agent.

PTCB PTCE Exam Content Outline– Covers chemotherapy drugs and their classifications.

FDA Drug Classification Guidelines– Lists Cytoxan as acytotoxic antineoplastic (chemotherapy) drug.

Why Not the Other Options?Key References:

Expired medications should first be reported to the wholesaler or manufacturer for return or replacement.

Reverse distributorshandlecontrolled substance disposalbut are not the first point of contact for expired non-controlled medications.

????Reference:DEA Medication Disposal Regulations, PTCE Inventory Management Guide.

Look-alike/sound-alike (LASA) medications are drugs that areeasily confused due to similar spelling or pronunciation, which increases the risk of medication errors.

Citalopram(Celexa) ?Selective serotonin reuptake inhibitor (SSRI) used for depression

Celecoxib(Celebrex) ?Nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation

Why Are Citalopram and Celecoxib Considered LASA?Both drugs sharesimilar spelling and pronunciation, increasing the chance of errors inprescribing, dispensing, and administration.

Example of potential errors: A patient withdepressionmay mistakenly receiveCelecoxib (NSAID)instead ofCitalopram (antidepressant), leading to untreated depression and unnecessary NSAID use.

A. Lisinopril and Metoprolol??Different drug classes, butnot commonly confused.

Lisinopril(ACE inhibitor for blood pressure)

Metoprolol(Beta-blocker for blood pressure and heart conditions)

C. Acebutolol and Acetazolamide??Although their names look similar, they haveless common confusion in clinical practice.

Acebutolol(Beta-blocker)

Acetazolamide(Diuretic for glaucoma, altitude sickness)

D. Naproxen and Misoprostol??These are oftenprescribed togetherbut arenot confused with each other.

Naproxen(NSAID for pain)

Misoprostol(Used to protect the stomach from NSAID-induced ulcers)

Institute for Safe Medication Practices (ISMP) LASA List– ConfirmsCitalopram and Celecoxibas common look-alike/sound-alike drugs.

PTCB PTCE Exam Content Outline– Covers error prevention strategies, including LASA medications.

FDA Medication Error Prevention Guidelines– Recommends usingTall Man Lettering(e.g.,CeleXib vs. CitaloPram) to differentiate LASA drugs.

Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Hazardous drugs (HDs)must be handled withpersonal protective equipment (PPE), including:

Gloves (chemotherapy-rated)

Gown (disposable, impermeable material)

Eye protection (if splashing risk exists)

Respirator (if airborne exposure is possible)

????Explanation of Answer Choices:?B. Wearing personal protective equipment?Correct.USP <800> mandatesPPEfor handling hazardous drugs.?A. In a chemical safety cabinet? Incorrect.Only sterile hazardous drugs require a biological safety cabinet.?C. Using disposable gloves washed between each use? Incorrect.Disposable gloves should be discarded, not washed.?D. In a positive-pressure clean room? Incorrect.Hazardous drugs require negative pressure rooms, not positive pressure.

????Reference:

USP <800>: Hazardous Drug Handling

NIOSH Guidelines on PPE for Hazardous Drugs

Prilosec (Omeprazole) is a delayed-release proton pump inhibitor (PPI)used forGERD, ulcers, and acid reflux. It comes incapsulescontainingenteric-coated granules, designed to protect the medication from stomach acid and ensure proper absorption.

Prilosec capsules contain enteric-coated granulesthat are safe to sprinkle on soft foodswithout chewing.

Applesauce is an ideal optionbecause it doesnot interfere with drug absorption or stability.

B. Chew and swallow the capsules?? Incorrect

Chewing destroys the enteric coating, leading to premature drug release and degradation by stomach acid.

C. Compound the capsules into a topical preparation?? Incorrect

Prilosecis not formulated for topical use. The medication must reach the stomach intact for proper effect.

D. Allow the capsules to dissolve under the tongue?? Incorrect

Sublingual administration is ineffectivebecauseomeprazole is not absorbed through the mucous membranesand needs enteric protection.

FDA Omeprazole Medication Guide– States that the contents can be sprinkled on applesauce.

ISMP Safe Medication Use Guidelines– Emphasizes proper administration of delayed-release capsules.

PTCB PTCE Exam Content Outline– Covers modified-release formulations and proper drug administration techniques.

Why Can the Capsules Be Opened?Why Not the Other Options?Key References:

TheZ-Pak(azithromycin 250 mg) is a5-day antibiotic coursewith aloading doseto reach effective levels quickly.

Day 1: 2 tablets (500 mg total)

Days 2–5: 1 tablet (250 mg) daily

????Reference:FDA Azithromycin Dosing Guidelines, PTCE Exam Study Materials.

Step 1: Convert pounds to kilograms

1 kg = 2.2 lbs

132 lbs ÷ 2.2 = 60 kg

Step 2: Calculate total dose

5 mg/kg × 60 kg = 300 mg

Thus, the correct answer isC. 660 mg.

????Reference:PTCE Calculation Guide, Pediatric Dosage Calculations.

MedWatch is the FDA’s reporting system for adverse drug events, medication errors, and safety concerns.

????Reference:FDA MedWatch Program.

Emulsionsaremixtures of two immiscible liquids (e.g., oil and water) stabilized by an emulsifying agent.

When an emulsion breaks (phase separation occurs), the oil and water separate permanently, rendering the medication unusable.

Why Other Options Are Incorrect:

A. Tinctures??Alcohol-based solutions with dissolved drug, no phase separation occurs.

B. Solutions??Homogeneous mixtures that do NOT separate.

C. Suspensions??May settle over time but can be re-mixed by shaking.

????Reference:USP <795> Compounded Dosage Forms, PTCE Compounding Guidelines.

A vaccine administration error occurs when a vaccine is given in a way that deviates from standard guidelines established by the Centers for Disease Control and Prevention (CDC) and the vaccine manufacturer’s recommendations. Some administration errors must be reported voluntarily to theVaccine Adverse Event Reporting System (VAERS)to help improve vaccine safety and prevent future errors.

(A) Fluzone was administered subcutaneously.?(Incorrect Route – Error that Should Be Reported)

Fluzone is aninactivated influenza vaccine (IIV)that should be administeredintramuscularly (IM).

Subcutaneous (SQ) administration isnot recommendedand may reduce vaccine efficacy.

According to theCDC and the Immunization Action Coalition (IAC), administering an inactivated influenza vaccine subcutaneously is a vaccine administration error and should be reported.

(B) Boostrix was administered intramuscularly.?(Correct Route – No Error)

Boostrix is aTdap (Tetanus, Diphtheria, and Acellular Pertussis) vaccineindicated for booster immunization.

It iscorrectly administered intramuscularly (IM)in thedeltoid muscle.

Since the correct administration route was followed, this does not qualify as a vaccine administration error.

(C) Varivax was administered subcutaneously.?(Correct Route – No Error)

Varivax is alive-attenuated varicella (chickenpox) vaccine.

It iscorrectly administered subcutaneously (SQ), typically in the upper arm or thigh.

Since the correct administration route was followed, this is not a vaccine administration error.

(D) Shingrix was administered intramuscularly.?(Correct Route – No Error)

Shingrix is arecombinant zoster vaccine (RZV)used for shingles prevention.

It should be administeredintramuscularly (IM).

Since the correct administration route was followed, this is not a vaccine administration error.

TheInstitute for Safe Medication Practices (ISMP)and theCDCrecommend reportingvaccine administration errorsto VAERS, especially if the error could affect the vaccine’s efficacy or patient safety.

Administration of Fluzonevia the incorrect route (subcutaneously instead of intramuscularly)could alter immune response and should be reported.

If a vaccine is given via the incorrect route, the CDC provides guidance on whether the dose needs to be repeated. For inactivated influenza vaccines given subcutaneously, the CDC states that the dose doesnot need to be repeated, but the error should still be documented and reported.

CDC General Best Practices for Immunization:https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html

Vaccine Adverse Event Reporting System (VAERS): https://vaers.hhs.gov/

Immunization Action Coalition (IAC) - Vaccine Administration Guidelines: https://www.immunize.org/technical-support/administering-vaccines/

Institute for Safe Medication Practices (ISMP) - Vaccine Safety Recommendations: https://www.ismp.org/recommendations/immunization-safety

Analysis of Each Answer Choice:Reporting Vaccine Administration Errors:References for Pharmacy Technicians: