TEST BANK for Mosby’s Review for the Pharmacy Technician Certification Examination 3rd Edition by Ja by ACADEMIAMILL

Mosby’s Review for the Pharmacy Technician Certification Examination 3rd Edition Mizner Test Bank Chapter 01: Pharmacology for Technicians Test Bank MULTIPLE CHOICE 1. Which of the following layers of the heart would be found on the outside? a. Myocardium b. Endocardium c. Epicardium d. Atrium ANS: C

The epicardium, with the prefix epi-, would be found on the outermost layer, just as the epidermis is the outermost layer of skin. The myocardium is the middle layer, and the endocardium is the inner layer. The atrium is not a layer of the heart but a chamber. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 12

2. A patient takes pseudoephedrine (Sudafed) for nasal congestion; however, the patient has high

blood pressure. This would be considered a drug– a. food b. disease c. laboratory d. nutrient

interaction.

ANS: B

Pseudoephedrine (Sudafed) cN anUiR ncSrI eaN seGthTeBh. eaCrtOrM ate and would not be recommended for patients with high blood pressure; therefore, this combination would represent a drug–disease interaction. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 17

3. A patient overdoses on an opiate, and naloxone (Narcan) is given as an antidote to combat the

effects of the opiate. Naloxone would then be considered a(n): a. antagonist. b. agonist. c. sympathomimetic. d. anxiolytic. ANS: A

Antagonists can block the effects of another drug. Agonists affect the receptors and activate them. A sympathomimetic mimics the sympathetic nervous system, and anxiolytics stop anxiety symptoms. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 17

4. Augmentin is a combination of amoxicillin and clavulanic acid. Clavulanic acid prevents the

degradation of amoxicillin by -lactamases. Clavulanic acid thus serves to amoxicillin. a. denature

the effects of

b. degrade c. reduce d. potentiate ANS: D

Clavulanic acid increases or potentiates the effect of amoxicillin against bacteria, -lactamases, or enzymes that can degrade amoxicillin. All of the other choices indicate that clavulanate reduces the effectiveness of amoxicillin, which is not correct. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 17

5. When two drugs are combined and said to be “synergistic,” these drugs together would be a. b. c. d.

effective. less more just as None of the above is correct.

ANS: B

When something is synergistic, there is more effectiveness from the combination of the products. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 17

6. In which pregnancy category have animal or human studies shown fetal abnormalities or

toxicity and the risk outweighs the benefits? a. b. c. d.

A B C X

ANS: A

In pregnancy, category X animal or human studies have shown fetal abnormalities or toxicity, and the risk outweighs the benefits. Category A is the safest of the categories. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 17

7. Which of the following is the best definition for a brand name? a. Assigned by the drug manufacturer and is protected through a patent b. Determined by chemical structure of the drug entity c. Assigned to a medication and contains a word stem that has been issued by the

U.S. Adopted Names Council d. Determined by the botanical origin of the drug entity ANS: A

A proprietary, brand, or trade name is assigned by the drug manufacturer and is protected through a patent. The chemical name is determined by chemical structure of the drug entity, and the nonproprietary (generic) name is assigned to a medication and contains a word stem that has been issued by the U.S. Adopted Names Council. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 18

8. Which of the following is the best definition for a generic name? a. Assigned by the drug manufacturer and is protected through a patent b. Determined by chemical structure of the drug entity c. Assigned to a medication and contains a word stem that has been issued by the

U.S. Adopted Names Council d. Determined by the botanical origin of the drug entity ANS: C

DIF: Cognitive Level 1: Knowledge

REF: p. 18

9. Suffixes are often useful in determining the drug class of a medication. Which of the

following suffixes is correctly matched to its drug class? a. -prazole: Proton pump inhibitor for acidic conditions b. -vastatin: H2-blocker for acidic conditions c. -pril: Cholesterol-lowering medication d. -tidine: ACE inhibitor ANS: A

The following drug suffixes are matched to their drug classes: -prazole: Proton pump inhibitor for acidic conditions -vastatin: Cholesterol lowering medication -pril: ACE inhibitor -tidine: H2-blocker for acidN icUcR onSdI itiN onGsTB.COM PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 18

10. Ranitidine (Zantac) and loratadine (Claritin) have very similar suffixes, yet are very different

in their pharmacologic function. What is the difference? a. Both are antihistamines, but one affects acid and the other allergies. b. Loratadine (Claritin) is for acidic conditions, and ranitidine (Zantac) is for allergic conditions. c. Ranitidine (Zantac) is nonsedating, but loratadine (Claritin) is very sedating. d. Both are antihistamines, and there is no difference in their effects. ANS: A

Whereas ranitidine (Zantac) is an H2-blocker that reduces stomach acid, loratadine (Claritin) is an H1-blocker that alleviates allergy symptoms. Loratadine is nonsedating. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 72-73

11. All of the following are ways a patient might distinguish the classes of the medications

nystatin (Mycostatin) and atorvastatin (Lipitor) except which of the following? a. Both have the ending –statin. b. The ending that indicates cholesterol lowering is -vastatin, to which nystatin does not conform. c. Myco- is a prefix that means fungus.

d. Lipi- is one letter short of lipid, and cholesterol is a type of lipid. ANS: A

Although Lipitor is often referred to as a “statin,” both drugs have the same suffix yet are for very different conditions. By using -vastatin as the baseline or the prefixes myco- or lipi-, one can determine the medication’s class. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 18

12. Which of the following drug interactions is correctly matched to its definition? a. Addition: The combined effect of two drugs; it is equal to the sum of the effects of

each drug taken alone b. Antagonism: The joint action of drugs in which their combined effect is more intense or longer in duration than the sum of the effects of two drugs c. Potentiation: One drug works against the action of another drug d. Synergism: One drug increases or prolongs the effect of another drug; the total effect is greater than the sum of the effects of each drug alone ANS: A

The definitions below are correctly matched: Addition: The combined effect of two drugs; it is equal to the sum of the effects of each drug taken alone Antagonism: One drug works against the action of another drug Potentiation: One drug increases or prolongs the effect of another drug; the total effect is greater than the sum of the effects of each drug alone (e.g., Vistaril and Demerol) Synergism: The joint action of drugs in which their combined effect is more intense or longer in duration than the sum of the effects of two drugs PTS: 1

NURSINGTB.COM

DIF: Cognitive Level 1: Knowledge

REF: p. 17

13. Prefixes are often useful in determining the drug class of a medication. Which of the

following prefixes is correctly matched to its drug class? a. sulfa-: Sulfonamide antibiotic b. ceph- or cef-: Estrogen c. estr-: Cephalosporin antibiotic d. profen-: Antiinflammatory ANS: A

The following drug prefixes are matched to their drug classes: sulfa-: Sulfonamide antibiotic ceph- or cef-: Cephalosporin antibiotic estr-: Estrogen Although -profen would be matched correctly to an antiinflammatory, it is a suffix, not a prefix. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 18-19

14. Which of the following mechanisms of action is correctly matched to its antibiotic class? a. Penicillins prevent bacteria from forming a cell wall. b. Sulfonamides inhibit protein synthesis in bacteria by binding ribosomes. c. Cephalosporins interfere with folic acid formation.

d. Tetracyclines prevent bacteria from forming a cell wall. ANS: A

The following mechanisms of action are correctly matched to their antibiotic classes: Penicillins prevent bacteria from forming a cell wall. Sulfonamides interfere with folic acid formation. Cephalosporins prevent bacteria from forming a cell wall. Tetracyclines inhibit protein synthesis in bacteria by binding ribosomes. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 18-20

15. Which of the following mechanisms of action is correctly matched to its antibiotic class? a. Penicillins inhibit protein synthesis in bacteria by binding ribosomes. b. Macrolides inhibit protein synthesis by interacting with ribosomes. c. Cephalosporins interfere with folic acid formation. d. Tetracyclines prevent bacteria from forming a cell wall. ANS: B

The following mechanisms of action are correctly matched to their antibiotic classes: Penicillins prevent bacteria from forming a cell wall. Macrolides inhibit protein synthesis by interacting with ribosomes. Sulfonamides interfere with folic acid formation. Tetracyclines inhibit protein synthesis in bacteria by binding ribosomes. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 19-20

16. Sulfonamides have the ability to block folic acid synthesis in bacteria, but humans also need

folic acid for proper functionN ing.RWhIy dG oes B a. suC lfonMamide harm only the bacteria and not a U S N T O human? a. Bacteria must manufacture their own folic acid; humans can ingest it. b. Bacteria are dependent on folic acid; humans are not. c. Humans are dependent on folic acid; bacteria are not. d. Folic acid is only necessary in pregnant women. ANS: A

Humans can take in folic acid through their diet but bacteria cannot; thus, sulfonamides will hurt bacteria and not a human. Both bacteria and humans need folic acid. All humans need folic acid; pregnant women simply need an increased amount. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 18

17. In looking at erythromycin and azithromycin, two macrolides, what improvement does

azithromycin have in terms of patient compliance? a. It comes in a suspension. b. It has once-daily dosing. c. It comes in a solid dosage form. d. Azithromycin has no advantage over erythromycin. ANS: B

Azithromycin only needs to be taken once a day as opposed to two to four times daily for erythromycin. This improves patient compliance. Both products are available as solid and liquid dosage forms.

PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 20

18. A physician orders a quinolone antibiotic. The generic name of the medication would most

likely end in: a. -floxacin. b. -cillin. c. -mycin. d. -cycline. ANS: A

Ciprofloxacin (Cipro) is a representative of the quinolone class of antibiotics; -cillin, -mycin, and -cycline represent penicillins, macrolides, and tetracyclines, respectively. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 21

19. A patient is being changed from a quinolone antibiotic to a macrolide antibiotic. What will the

suffix of the new medication likely be? a. -floxacin b. -cillin c. -mycin d. -cycline ANS: C

Azithromycin, clarithromycin, and erythromycin all represent macrolide antibiotics. The suffixes -floxacin, -cillin, and -cycline represent quinolones, penicillins, and tetracyclines, respectively.

N R I G B.C M

PTS: 1

U S Level N T1: Knowledge O DIF: Cognitive

REF: p. 20

20. A patient is cautioned that the medication she was prescribed might cause nephrotoxicity,

ototoxicity, tinnitus, and even permanent deafness. What class of antibiotic was this patient likely prescribed? a. Aminoglycoside b. Quinolone c. Penicillin d. Tetracycline ANS: A

Possible adverse effects of the aminoglycosides are nephrotoxicity, ototoxicity, tinnitus, and even permanent deafness. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 22

21. A patient takes an antibiotic medication and exhibits a cross-sensitivity to his previous

penicillin allergy. What nonpenicillin class of antibiotics was the patient likely given? a. Sulfonamide b. Macrolide c. Tetracycline d. Cephalosporin ANS: D

Cephalosporins exhibit cross-sensitivity with penicillin-type antibiotics allergy. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 19

22. A patient is diagnosed with a fungal infection. Which medication could not be prescribed for

this indication? a. Amphotericin b. Nystatin c. Fluconazole d. Levofloxacin ANS: D

Levofloxacin is an antibiotic prescribed for bacterial infections; the other choices are antifungals. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 21 | p. 23

23. A patient is diagnosed with a viral infection. Which medication could not be prescribed for

this indication? a. Tetracycline b. Acyclovir c. Famciclovir d. Oseltamivir ANS: A

Tetracycline is an antibiotic prescribed for bacterial infections; the other choices are antivirals. Antivirals sometimes (but not always) have the root -vir in the name.

N R I G B.C M

PTS: 1

U S Level N T3: Application O DIF: Cognitive

REF: p. 20 | p. 24

24. Which of the following is not a medication used in the treatment of the HIV retrovirus? a. Acyclovir b. Abacavir c. Didanosine d. Tenofovir ANS: A

Acyclovir (Zovirax) would likely be used in zoster infections such as herpes or shingles. The other choices would be used to combat HIV. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 24-25

25. Which of the following is not a class of HIV medication therapy? a. Protease inhibitors b. Fusion inhibitors c. Antiprotozoals d. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) ANS: C

Antiprotozoals would not be effective against HIV infection. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 25-26

26. HIV medications interfere with processes critical to the HIV virus. Which of the following

drug classes would likely interfere with an enzyme? a. Fusion inhibitors b. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) c. Protease inhibitors d. Both b and c ANS: D

Both NNRTIs and protease inhibitors include the root -ase in their names, indicating these medications interfere with an enzyme. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 25-26

27. Often patients confuse the need for a decongestant with an antihistamine for their cold

symptoms. Which of the following represents a decongestant? a. Diphenhydramine b. Pseudoephedrine c. Loratadine d. Azelastine ANS: B

Only pseudoephedrine is a decongestant; the other choices represent antihistamines. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 27-28

28. A patient comes into the pharmacy complaining of congestion and sneezing. Which of the

following combination produN cts R would be appropriate for these symptoms? U SINGTB.COM a. Cetirizine and pseudoephedrine b. Chlorpheniramine and hydrocodone c. Guaifenesin and codeine d. Promethazine and codeine ANS: A

Cetirizine and pseudoephedrine represent an antihistamine and decongestant preparation that would be appropriate for the patient’s symptoms. The other choices all include an antitussive, and the patient did not complain of cough. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 27-28

29. A patient has anxiety. Which medication would likely be prescribed for this condition? a. Alprazolam b. Diphenhydramine c. Codeine d. Levofloxacin ANS: A

Alprazolam (Xanax) is an antianxiety agent. The other choices would be inappropriate. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 29

30. Which of the following medications is not an SSRI antidepressant?

a. b. c. d.

Paroxetine Alprazolam Sertraline Citalopram

ANS: B

Alprazolam is an antianxiety medication; the other three choices (paroxetine, sertraline, and citalopram) represent SSRIs, or selective serotonin reuptake inhibitors. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 29

Chapter 02: Pharmacy Law and Regulations Test Bank MULTIPLE CHOICE 1. Certain practitioners may prescribe medications. Which of the following practitioners would

least likely have the right to write a prescription? a. Doctors of Pharmacy (PharmDs) b. Medical Doctors (MDs) c. Physician Assistants (PAs) d. Nurse Practitioners (NPs) ANS: A

Generally, MDs, PAs, and NPs write prescriptions. Under certain conditions, a PharmD may be able to author prescriptions, but this is the exception, not the rule. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 83

2. Of the following laws and amendments regarding drugs in the United States, which was most

recently passed? a. Pure Food and Drug Act b. Food Drug and Cosmetic Act c. Durham-Humphrey Act d. Kefauver-Harris Amendment ANS: D

The Kefauver-Harris AmendN mU enRt S wI asNpG asT seBd.inC1O9M 62; all of the other listed laws and amendments were passed before then. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 83-84

3. Which of the following describes adulteration? a. “Prepared, packed, or held under unsanitary conditions” b. Labeling that is “false or misleading in any particular way” c. Failure to label “adequate directions for use” d. Failure to carry a label indicating “Warning—May be habit forming” if the product

is habit forming ANS: A

“Prepared, packed, or held under unsanitary conditions” describes adulteration. The other three choices describe misbranding. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 83

4. Which of the following describes misbranding? a. “Prepared, packed, or held under unsanitary conditions” b. Prepared in containers “composed, in whole or in part, of any poisonous or

deleterious substance” c. Failure to label “adequate directions for use” d. Containing unsafe color additives

ANS: C

Failure to label “adequate directions for use” describes misbranding. The other choices would best describe adulteration. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 83

5. You would expect to find all of the following except the on a manufacturer’s drug label. a. physician’s name b. name and place of business of the manufacturer, packer, or distributor c. National Drug Code number d. statement of ingredients ANS: A

On a manufacturer’s drug label you would expect to find the name and place of business of the manufacturer, packer, or distributor; National Drug Code number; and a statement of ingredients. The doctor’s name would be on a prescription label. PTS: 1

DIF: Cognitive Level 3: Application

6. You would expect to find all of the following except the

REF: p. 83

on an over-the-counter package

label. a. patient’s name b. active ingredients c. inactive ingredients d. National Drug Code number ANS: A

A patient’s name might be tyN pedRon I a prG escrB ip. tiC on lM abel that is affixed to an over-the-counter U Son Nthe Tover-the-counter O package, but it would not be found package label. One would find the active and inactive ingredients as well as the National Drug Code number. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 84

7. All of the following describe provisions of the Durham-Humphrey Act except: a. separated drugs into legend and nonlegend. b. regulated the use of patient information. c. prescription medications required the supervision of a physician. d. refills could be phoned in from the physician’s office. ANS: B

The Durham-Humphrey Act of 1951 did not regulate the use of patient information; HIPAA did that. The act did separate drugs into two categories—legend and nonlegend—that require the supervision of a physician and allowed refills to be called in from a physician’s office. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 84

8. The Kefauver-Harris Amendment of 1962 provided for all of the following except: a. requires all medications in the United States to be pure, safe, and effective. b. controlled substances are placed in one of five schedules. c. established procedures for both drug applications and investigational drugs. d. drug manufacturers are required to be responsible for good manufacturing

processes.

ANS: B

The Comprehensive Drug Abuse and Control Act of 1970 put controlled substances in five categories. The other three choices are part of the Kefauver-Harris Amendment of 1962. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 84

9. Which of the following drugs would be classified as Schedule I under the DEA’s guidelines? a. Oxycodone b. Hydrocodone c. Psilocybin d. Codeine ANS: C

Psilocybin is a hallucinogenic and is classified as Schedule I. The other drugs would fall between Schedules II and V depending on their dosage form. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 84

10. Last night a local pharmacy had their safe broken into, and Schedule II drugs were stolen.

Which form would need to be completed? a. DEA Form 106 b. DEA Form 41 c. DEA Form 222 d. DEA Form 22 ANS: A

In the case of theft, a DEA Form 106 would need to be filled out after the police and local DEA diversion office were nN otU ifiR edS. INGTB.COM PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 87

11. Which DEA form must be completed to verify the destruction of Schedule II narcotics? a. DEA Form 106 b. DEA Form 41 c. DEA Form 222 d. DEA Form 22 ANS: B

In the case of destruction of Schedule II narcotics, a DEA Form 41 would need to be filled out. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 87

12. The proper form used to order Schedule II medications for the pharmacy would be DEA form: a. 106. b. 41. c. 222. d. 22. ANS: C

For regular ordering of Schedule II medications, DEA Form 222 would be used.

PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 85-86

13. The first letter of a prescriber’s DEA number would definitely not be: a. A. b. B. c. Q. d. M. ANS: C

A, B, F, and M would be legitimate starting letters for a physician’s DEA number. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 87

14. How many refills are available on a Schedule II medication? a. 0 b. 1 c. 5 d. PRN ANS: A

A Schedule II medication does not carry refills. A Schedule III-V medication might carry up to five refills, and any medication that is not a scheduled drug can have PRN refills. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 87

15. A patient brings a prescription for hydrocodone/APAP (Vicodin) #60 tablets with five refills.

The patient can only pay for 30 tablets this week. How many refills are available to be filled in the next 6 months after thiN s onR e toIincG ludeBt. heCexM tra 30 tablets that have not been picked up? a. 5 U S N T O b. c. 11 d. PRN ANS: A

The number of refills remaining on the prescription is regardless of the number of tablets picked up at any given time. If the patient requests 30 tablets with each fill, then the patient would only be eligible to fill 180 of the 360 tablets originally prescribed. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 92

16. The Poison Prevention Packaging Act of 1970 requires that most OTC and legend drugs be

packaged in a child-resistant container, which is one that cannot be opened by children younger than 5 years but can be opened by % of adults. a. 100; 90 b. 90; 100 c. 90; 80 d. 80; 90 ANS: D

% of

The Poison Prevention Packaging Act of 1970 was enacted to reduce accidental poisoning in children. The Act requires that most OTC and legend drugs be packaged in child-resistant containers. A child-resistant container is one that cannot be opened by 80% of children younger than 5 years but can be opened by 90% of adults. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 93

17. All of the following describe the Orphan Drug Act except: a. medications that treat a condition for which there are fewer than 200,000 cases

worldwide. b. was passed in 1983. c. provides tax incentives and exclusive licensing of products. d. makes provisions for the use of drugs abandoned by a pharmaceutical company’s

research and development team. ANS: D

The Orphan Drug Act of 1983 established advantages for the manufacture of drugs for treatment of diseases or conditions of which there are fewer than 200,000 cases in the world and provides tax incentives and exclusive licensing of products for manufacturers to develop and market orphan medications. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 95

18. Which of the following is a provision of the Hatch-Waxman Act of 1984 (also known as the

Drug Price Competition and Patent Term Restoration)? a. Prohibits the reimportation of a drug into the United States by anyone except the manufacturer N R I G B.C M b. Forbids the sale or distribuU tionSof sN amT ples to aOnyone other than those licensed to prescribe them c. Encourages the creation of both generic and new medications by streamlining the process for generic drug approval and by extending patent licenses d. Requires the following label to appear on all medications to be administered to animals: “Caution: Federal law restricts this drug to use by or on an order of a licensed veterinarian” ANS: C

The Hatch-Waxman Act of 1984 encouraged the creation of both generic and new medications by streamlining the process for generic drug approval and by extending patent licenses. The other choices are provisions of the Prescription Drug Marketing Act of 1987. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 96

19. All of the following are provisions of OBRA 1987 except: a. resident’s drug regimen must be free of unnecessary medications. b. retrospective drug use review. c. behavioral modification and drug holidays are used to see if the medication may be

discontinued. d. long-term care facilities must have the services of a consultant pharmacist. ANS: B

OBRA ’90 required states to establish drug use review programs consisting of three essential components: (1) prospective drug use review, (2) retrospective drug use review, and (3) educational programs. The other three provisions are part of OBRA ’87. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 96-97

20. “All medical devices are to be tracked and records be maintained for durable medical

equipment” describes a provision of which law or amendment? a. FDA Safe Medical Devices Act of 1990 b. Dietary Supplement Health and Education Act (DSHEA) of 1994 c. Health Insurance Portability and Accountability Act (HIPAA) of 1996 d. Combat Methamphetamine Epidemic Act of 2005 ANS: A

“All medical devices are to be tracked and records be maintained for durable medical equipment” describes a provision of the FDA Safe Medical Devices Act of 1990. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 97

21. “The manufacturers of supplements are allowed to make claims with regard to general health

promotion, but not disease claims” describes a provision of which law or amendment? a. FDA Safe Medical Devices Act of 1990 b. Dietary Supplement Health and Education Act (DSHEA) of 1994 c. Health Insurance Portability and Accountability Act (HIPAA) of 1996 d. Combat Methamphetamine Epidemic Act of 2005 ANS: B

The Dietary Supplement HeaN lth R andI EduGcatB io. nC ActM (DSHEA) of 1994 indicated that herbal U S N T O products are dietary supplements rather than drugs. The manufacturers of supplements are allowed to make claims with regard to general health promotion but not disease claims. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 97

22. “Established conditions on the use and the disclosure of protected health information”

describes a provision of which law or amendment? a. FDA Safe Medical Devices Act of 1990 b. Dietary Supplement Health and Education Act (DSHEA) of 1994 c. Health Insurance Portability and Accountability Act (HIPAA) of 1996 d. Combat Methamphetamine Epidemic Act of 2005 ANS: C

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires that health care providers ensure that patient confidentiality be maintained; established conditions on the use and the disclosure of protected health information (PHI); and requires that patients be notified on how their PHI will be used. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 97

23. “Placed ephedrine, pseudoephedrine, and phenylpropanolamine in the Controlled Substances

Act category ‘scheduled listed chemical products’” describes a provision of which law or amendment? a. FDA Safe Medical Devices Act of 1990

b. Dietary Supplement Health and Education Act (DSHEA) of 1994 c. Health Insurance Portability and Accountability Act (HIPAA) of 1996 d. Combat Methamphetamine Epidemic Act of 2005 ANS: D

The Combat Methamphetamine Epidemic Act of 2005 placed ephedrine, pseudoephedrine, and phenylpropanolamine in the Controlled Substances Act category “scheduled listed chemical products.” Products containing ephedrine, pseudoephedrine, and phenylpropanolamine are subject to sales restrictions, storage requirements, and record-keeping requirements. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 98

24. Certain medications have severe side effects and are only approved for certain populations.

Which of the following describes stipulations for the use of clozapine (Clozaril)? a. Reporting of white blood cell (WBC) values and absolute neutrophil counts (ANCs) b. Indicated for multiple myeloma c. Blood should never be donated d. A woman can be excused from the requirements if she has not had a period 24 months in a row ANS: A

The Clozaril Administration Registry Enrollment (CARE) is a secured Internet application that facilitates the reporting of WBC values and ANCs of patients taking the brand Clozaril (clozapine) to the Clozaril National Registry (CNR). CARE is designed to safeguard patient information, protect patients’ privacy, and assist physicians and pharmacists with effective monitoring functionalities. TN heUoR thSerIcN oG ndT itB io. nsCaO reMspecific to thalidomide use. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 99

25. Certain medications have severe side effects and are only approved for certain populations.

Which of the following describes stipulations for the use of thalidomide? a. CARE is designed to streamline the process. b. The system is used to detect agranulocytosis. c. The ANC is one of the measures that determine if a patient may take the medication or not. d. A woman must have a negative pregnancy test result within the 24 hours before beginning treatment. ANS: D

A woman must have a negative pregnancy result test within the 24 hours before beginning treatment with thalidomide. In addition, she will need to be tested for pregnancy in a laboratory weekly during the first 4 weeks of her treatment and then once every 4 weeks if she has regular menstrual cycles or once every 2 weeks if she has irregular menstrual cycles. The other three choices represent stipulations of using Clozaril. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 99-100

26. All of the following have to do with the use of isotretinoin except: a. prescribed only for severe recalcitrant nodular acne unresponsive to other

therapies. b. it might produce depression and psychosis. c. it might produce suicidal ideation and suicide. d. indicated for multiple myeloma. ANS: D

Isotretinoin (Accutane) is a very powerful medication used to treat acne. Unfortunately, the medication has been found to cause severe birth defects; induce spontaneous abortions; and produce adverse psychiatric effects, including depression, psychosis, suicidal ideation, suicide attempts, and suicide. It is only to be used for severe recalcitrant nodular acne unresponsive to other medications. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 98

27. Certain records must be maintained in the pharmacy. Which of the following would not have

to be maintained in the pharmacy? a. The biennial inventory of narcotics b. Change of pharmacist-in-charge inventory c. Over-the-counter medication orders d. Controlled substance invoices ANS: C

The biennial inventory of narcotics, change of pharmacist-in-charge inventory, and controlled substance invoices must all be maintained in the pharmacy. OTC orders might be completed by the front office and maintained there. PTS: 1

DIF: Cognitive Level 1: Knowledge

NURSINGTB.COM

REF: p. 100

28. Which chapter provides guidance on applying good compounding practices in the preparation

of nonsterile compounded formulations for dispensing or administration to humans or animals? a. USP 795 b. USP 797 c. USP 222 d. USP 41 ANS: A

USP 795 provides guidance on applying good compounding practices in the preparation of nonsterile compounded formulations for dispensing or administration to humans or animals. USP 795 was recently revised, and the chapter now includes new material; this includes categories of compounding (simple, moderate, and complex), new definitions for terms (e.g., beyond-use date, hazardous drug, stability), and criteria for compounding each drug preparation (e.g., suitable compounding environment, use of appropriate equipment). PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 101

29. Which chapter contains many procedural training and quality assurance requirements for

preparing sterile products? a. USP 795 b. USP 797 c. USP 222

d. USP 41 ANS: B

USP 797 is designed to cut down on infections transmitted to patients through pharmaceutical products and to better protect staff working in pharmacies in the course of their exposure to pharmaceuticals. USP 797 contains many procedural training and quality assurance requirements for preparing sterile products. USP 797 affects all health care institutions, pharmacies, physicians’ practices, and other facilities in which compounded sterile preparations are prepared, stored, and dispensed. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 101-102

30. Which of the following publications would least likely have peer-reviewed material in it? a. American Journal of Pharmaceutical Education (AACP) b. Pharmaceutical Research (AAPS) c. American Journal of Health System Pharmacists (AJHP) d. Drug Topics ANS: D

Drug Topics contains many advertisements and information that is more of a casual news report on current topics important to pharmacists and technicians. The AACP, AAPS, and AJHP publications contain peer-reviewed work of a more academic nature. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 106

Chapter 03: Sterile and Non-Sterile Compounding Test Bank MULTIPLE CHOICE 1. If the prefix kilo- means 1000 times the base unit, one would expect a gram, the base unit of

weight, to be what fraction of a kilogram? a. 1000 b. 1/10 c. 1/100 d. 1/1000 ANS: D

One gram is 1/1000th of the kilogram. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 115

2. To determine the number of grams in 3.0 kg, one can multiply 3.0 by 1000 or simply move

the decimal over a. 6; right b. 6; left c. 3; left d. 3; right

places to the

ANS: C

Three kilograms would contain 3000.0 g. The decimal has been moved three places to the right from 3.0 to 3000.0. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 115

3. The ideal body weight for a 5’8” woman is approximately 140 lb. What would this weight be

in metric units? a. 63.6 kg b. 636 kg c. 636 g d. 63.6 g ANS: A

To determine the number of kilograms for any given number of pounds, divide the number of pounds (in this case, 140) by 2.2, the conversion factor, to get 63.6 kg. PTS: 1 4. A child is to take

DIF: Cognitive Level 3: Application

REF: p. 115

teaspoonful of medication every 4 hours for fever. However, the only measuring device the parents have expresses volume in mL, or milliliters. How many milliliters should this patient get every 4 hours? a. 2.5 mL b. 5 mL c. 7.5 mL d. 15 mL

ANS: A

One teaspoonful represents 5 mL; therefore, of 5 would come to 2.5 mL. 15 mL would be one tablespoonful, and of a tablespoonful would come to 7.5 mL; both represent incorrect answers for this question. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 115

5. A 10% solution of medication would represent a volume/volume concentration of: a. 1 mL/100 mL. b. .01 mL/1000 mL. c. 10 mL/100 mL. d. 1 mL/100 g. ANS: C

By definition, a 10% solution would be represented by the number of milliliters equal to the percentage; in this case, it is 10 mL over 100 mL. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 116

6. In setting up an alligation table, the correct positioning of the variables would be which of the

following? a. Place the lowest concentration in the upper left corner, the highest concentration in the lower left corner, and the desired concentration in the middle. b. Place the desired concentration in the upper left corner, the highest concentration in the lower left corner, and the lowest concentration in the middle. c. Place the highest concentration in the upper left corner, the desired concentration in the lower left corner, aN nd tR he loweGst cB oncentration in the middle. U SinIN T .COM d. Place the highest concentration the upper left corner, the lowest concentration in the lower left corner, and the desired concentration in the middle. ANS: D

To properly set up an alligation table, place the highest concentration in the upper left corner, the lowest concentration in the lower left corner, and the desired concentration in the middle. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 117

7. A child comes into the emergency department, and the parent reports the child is 11 months

old. This child would be properly classified as a(n): a. neonate. b. infant. c. child. d. adolescent. ANS: B

An 11-month-old patient would be considered an infant. Neonates range from birth to 1 month of age, and infants range from 1 month to 1 year of age. Early childhood is the period from 1 to 5 years of age, late childhood is from 6 to 12 years of age, and adolescence is from 13 to 17 years of age. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 118

8. A prescriber uses the age in months of a child, divides it by 150, and multiplies that result by

the adult dose. Which rule is the prescriber using? a. Young’s rule b. Fried’s rule c. Clark’s rule d. Newton’s rule ANS: B

Fried’s rule uses the age in months over 150 multiplied by the adult dose. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 118

9. Which of the following rules relies on a child’s weight to determine the proper dosage? a. Fried’s rule b. Young’s rule c. Clark’s rule d. Newton’s rule ANS: C

Clark’s rule takes the child’s weight expressed in pounds over 150 and multiplies that result by the adult dosage. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 118

10. A patient reads that the medication must be stored at room temperature but only has a Celsius

thermometer. What is room temperature in Celsius degrees if the Fahrenheit equivalent is 68 degrees? a. 20 b. 18 c. 24 d. 32 ANS: A

9C = 5F – 160 where C represents the temperature in Celsius and F represents the Fahrenheit temperature. Only one of the two variables is required for this problem to be solved. In this case, by plugging in 68 degrees on the right-hand side of the equation, when solving for C, we determine it to be 20° Celsius. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 118

11. Which of the following factors would least likely affect a medication that is in an

amber-colored container? a. Humidity b. Light c. Temperature d. Dosage form ANS: B

Amber vials protect the medication from light. The other factors would not necessarily be affected by the color of the container. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 118

12. Which of the following incompatibilities would be most aptly described as therapeutic

incompatibility? a. The presence of light may cause deterioration of the ingredients. b. It occurs because of changes in solubility, which may result in changes in color or the formation of a precipitate. c. A change in the pH of a solution, the use of buffers, and the type of solvent used may create problems. d. The mixing together of two or more ingredients, resulting in a change in the therapeutic response of the drugs. ANS: D

A therapeutic incompatibility is the mixing together of two or more ingredients, resulting in a change in the therapeutic response of the drugs. The other options describe physical and chemical incompatibilities. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 118-119

13. A stored temperature above 40° C would be considered: a. room temperature and safe for most medications. b. excessive heat and potentially damaging to medications. c. cool and appropriate for most medications. d. cold and appropriate for frozen medications. ANS: B

Excessive heat includes temperatures above 40° C (104° F). Be careful when determining the safety of a particular temperature; what may seem like a safe temperature in Fahrenheit degrees may be unsafe in CeN lsiU usRdSeI grN eeG s.TB.COM PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 119-120

14. Advantages of solid dosage forms include all of the following except: a. difficult for patients to swallow, especially large tablets. b. convenient for self-dosing and generally lack smell or taste. c. suited for sustained- or delayed-release medications. d. easy to package, transport, store, and dispense. ANS: A

Solid dosage forms are easy to package, transport, store, and dispense; are convenient for self-dosing; generally lack smell or taste; and are suited for sustained- or delayed-release medications. However, some patients have difficulty with the size of larger pills, and in this case, having a liquid dosage form would be preferred. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 120

15. Finely ground substances that can be administered internally or externally describes a(n): a. suppository. b. plaster. c. powder. d. implant. ANS: C

Powders are finely ground substances that can be administered internally or externally. Their chief disadvantages are their taste and that they are not stable when exposed to the air. Powders may be dispensed in a bulk form, a multidose form, or as a divided dose such as a powder paper. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 120

16. Solid dosage forms to be inserted in body orifices, such as the rectum, vagina, or urethra, are

called: a. effervescent salts. b. pellets. c. suppositories. d. plasters. ANS: C

Suppositories are solid dosage forms to be inserted in body orifices, such as the rectum, vagina, or urethra. They may produce either a local or systemic effect. Their mechanism of action is either through melting or dissolving, and the medication is released over a period of time. The major disadvantages of a suppository are that it may be easily expelled from the body, and the medication’s absorption into the body can be erratic. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 120

17. The pharmacist recommends a dosage form with flavoring that dissolves in the mouth for a

patient with a sore throat. The pharmacist has recommended a(n): a. lozenge. b. implant. c. capsule. d. powder. ANS: A

Lozenges, troches, and pastilles are solid dosage forms with flavoring that dissolve in the mouth. PTS: 1 18.

DIF: Cognitive Level 1: Knowledge

REF: p. 120

Which of the following is a disadvantage of liquid dosage forms? a. Easier to swallow than a solid dosage form for many patients b. Uniformity and flexibility of dosage form in dosing c. Effective more quickly than a solid dosage form because the drug is already dissolved d. May require preservatives to prevent bacteria or mold from developing ANS: D

A liquid dosage form may require preservatives to prevent bacteria or mold from developing. All of the other choices are advantages of liquid dosage forms. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 121

19. A patient empties a package of granules into water, and it bubbles and releases carbon

dioxide. This dosage form is likely a(n): a. capsule.

b. tablet. c. pellet. d. effervescent salt. ANS: D

Effervescent salts are granules or powders; when dissolved in water, they effervesce and release carbon dioxide. Pellets are generally small cylinders that are implanted subcutaneously for continuous absorption. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 120

20. Which of the following could be an advantage of a liquid dosage form? a. Deterioration and loss of potency occur more quickly than in a solid dosage form. b. Certain medications may cause gastrointestinal distress if administered in a solid

dosage form. c. They may require special sweetening or flavoring to be palatable. d. They are bulkier to carry than solid dosage forms. ANS: B

Certain medications may cause gastrointestinal distress if administered in a solid dosage form, and this could be an advantage of the liquid dosage form. All of the other choices are disadvantages to having a liquid dosage form. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 121

21. An alcoholic or hydroalcoholic solution containing volatile aromatic ingredients would

describe a: a. spirit. b. liniment. c. syrup. d. douche. ANS: A

A spirit is an alcoholic or hydroalcoholic solution containing volatile aromatic ingredients. A liniment may be an emulsion or alcoholic or oleaginous solutions that are applied through rubbing. A syrup is likely to contain sucrose, and a douche is an irrigating or bathing solution. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 121

22. A pharmacist compounds a sweetened, flavored product containing water and alcohol. This is

most likely a(n): a. enema. b. douche. c. elixir. d. spirit. ANS: C

An elixir is a clear, sweetened, flavored hydroalcoholic solution, containing water and alcohol, that may or may not be medicated. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 121

23. A dispersion in which one sees solid particles suspended in the liquid that pours freely would

be considered a(n): a. suspension. b. solution. c. gel. d. alligation. ANS: A

A suspension is a two-phase system in which solid particles are dispersed in a liquid vehicle which may be oral, topical, or injectable. The suspended material should not settle rapidly and should pour freely. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 121

24. Which dispersion is properly matched to its definition? a. Emulsion: A liquid for topical application that contains insoluble solids or liquids b. Lotion: A two-phase system containing an extremely fine solid particle; when

mixed, it is difficult to distinguish between the two phases, and it is considered a semisolid form c. Gel: One liquid is dispersed in another liquid; may be water in oil (w/o) or oil in water (o/w) d. Suspension: A two-phase system in which solid particles are dispersed in a liquid vehicle that may be oral, topical, or injectable. The suspended material should not settle rapidly and should pour freely. ANS: D

The following dispersions are correctly matched to their definitions: Emulsion: One liquid is disN peUrR seS dI inNaG noTthBe. r lC iqO uiM d; may be water in oil (w/o) or oil in water (o/w) Lotion: A liquid for topical application that contains insoluble solids or liquids Gel: A two-phase system containing an extremely fine solid particle; when mixed, it is difficult to distinguish between the two phases, and it is considered a semisolid form Suspension: A two-phase system in which solid particles are dispersed in a liquid vehicle that may be oral, topical, or injectable. The suspended material should not settle rapidly and should pour freely. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 121

25. A dosage form that consists of a container with a valve assembly that, when activated, will

emit a dispersion of liquid, solid, or gaseous material is a(n): a. spray. b. pellet. c. effervescent tablet. d. nebule. ANS: A

A spray is a dosage form that consists of a container with a valve assembly that, when activated, will emit a dispersion of liquid, solid, or gaseous material. A nebule does not contain a valve assembly. PTS: 1

DIF: Cognitive Level 2: Comprehension

REF: p. 122 26. Which of the following nonsterile compounding techniques is improperly matched with its

definition? a. Blending: an act of combining two substances b. Comminution: trituration of a powder drug with a solvent in which the drug is insoluble with the solvent c. Geometric dilution: an act of reducing a substance to small, fine particles d. Levigation: a technique used in mixing two ingredients of unequal quantities in which one begins with the smallest quantity and adds an equal quantity of the ingredient having the larger amount; the process continues until all of the ingredients are used ANS: A

The following definitions and compounding techniques are properly matched: Blending: an act of combining two substances Comminution: an act of reducing a substance to small, fine particles Geometric dilution: a technique used in mixing two ingredients of unequal quantities in which one begins with the smallest quantity and adds an equal quantity of the ingredient having the larger amount; the process continues until all of the ingredients are used Levigation: trituration of a powder drug with a solvent in which the drug is insoluble with the solvent PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 122

27. Which of the following compounding techniques is properly matched to its definition? a. Sifting: combining powders in a bag and shaking it NUn:RrSedu INcing GTB.C M b. Pulverization by interventio the sizOe of a particle in a solid with the aid

of an additional material c. Trituration: a technique to either blend or combine powders d. Tumbling: a process of rubbing, grinding, or pulverizing a powder to create fine

particles ANS: B

The following compounding techniques are properly matched to their definitions: Sifting: a technique to either blend or combine powders Pulverization by intervention: reducing the size of a particle in a solid with the aid of an additional material Trituration: a process of rubbing, grinding, or pulverizing a powder to create fine particles Tumbling: combining powders in a bag and shaking it PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 122-123

28. Capsule sizes run opposite of intuition where the biggest number should equal the biggest

capsule. Instead of the largest capsule size being 5, it is: a. 000. b. 00. c. 0. d. 1. ANS: A

One would expect three zeros to indicate the smallest capsule size; however, triple zero indicates the largest. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 125-126

29. Which sterile product contains antimicrobial agents? a. Purified water USP b. Water for injection USP c. Bacteriostatic water for injection USP d. Sterile water for irrigation USP ANS: C

Bacteriostatic water for injection USP is sterile water with antimicrobial agents that can be used for injection. Purified water USP is not intended for parenteral administration; it is used in the reconstitution of oral products. Water for injection USP is not sterile and cannot be used in aseptic compounding of sterile products. Sterile water for irrigation USP has been sterilized but contains no antimicrobial agents. It is used as an irrigating solution. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 131

30. An area in which all preparations for IV admixtures are gathered, including labels and

gowning and drug materials is the: a. buffer area. b. clean area. c. ante area. d. critical site. ANS: C

The ante area is an area in which all preparations for IV admixtures are gathered, including labels and gowning and drug materials. In the buffer area, hoods are kept and IV preparations take place. The clean area is a space where microbial containment is kept at a specific level of safety to ensure a certain level of cleanliness. The critical site is an area exposed to air or touch, such as vial, needle, or ampule. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 127-128

Chapter 04: Medication Safety Test Bank MULTIPLE CHOICE 1. A patient requires that acyclovir (Zovirax) be administered intravenously rather than by

mouth. Which of the patient’s five rights does this example fall under? a. The right dose b. The right dosage form c. The right route d. The right time of administration ANS: C

This example requires the provider to use the right route of administration. The other four rights include the right drug, the right dose, the right dosage form, and the right time of administration. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 149

2. Which of the following describes a dispensing error? a. Incorrect transcription by the pharmacist receiving a call b. Incorrect strength of medication c. Incomplete medication name d. Quantity and refills omitted ANS: A

The incorrect transcription byNtU heRpShI arN mG acTisB t. reC ceO ivM ing a call from a physician is a dispensing error. The other errors—incorrect strength of medication, incomplete medication name, and quantity and refills omitted—represent prescribing errors. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 150

3. Which of the following describes a prescribing error? a. The prescription is interpreted incorrectly. b. The prescription is transcribed incorrectly. c. The pharmacist incorrectly counsels the patient. d. The prescription contains an incomplete medication name. ANS: D

If a physician, nurse practitioner, or other authorized prescriber writes an incomplete medication name, it is considered a prescribing error. The other choices—the prescription is interpreted incorrectly, the prescription is transcribed incorrectly, and the pharmacist incorrectly counsels the patient—are considered dispensing errors. PTS: 1

DIF: Cognitive Level 1: Knowledge

4. All of the following describe an administration error except: a. oral medications given intravenously. b. enteral formulas administered parenterally. c. ear medications being placed in the eye.

REF: p. 150

d. incorrect strength of medication. ANS: D

An incorrect strength of medication is considered a prescriber error. The other choices—oral medications given intravenously, enteral formulas administered parenterally, and ear medications being placed in the eye—are all administration errors. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 150

5. A physician calls in a prescription to the community pharmacy for amoxicillin capsules but

fails to put the number of capsules. This would be considered a(n): a. prescribing error. b. dispensing error. c. administration error. d. situation when no error has occurred. ANS: A

Because the prescriber failed to place the number of capsules on the prescription, it is considered a prescribing error. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 150

6. A prescription calls for a 2-week supply of antibiotic suspension. The pharmacy fills the

prescription with only a 1-week supply. This would be considered a(n): a. prescribing error. b. dispensing error. c. administration error. d. situation when no error hN asUoR ccSuI rreNdG . TB.COM ANS: B

The pharmacy failed to dispense the amount prescribed correctly, making this a dispensing error. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 150

7. A prescriber writes a prescription for gentamicin (Garamycin) eyedrops to be used 2 GTTS

OS BID. The pharmacy prepares a label that reads: “Instill 2 drops into the left eye twice daily.” This would be described as a(n): a. prescribing error. b. dispensing error. c. administration error. d. situation when no error has occurred. ANS: D

The pharmacy has correctly translated the prescription. It is permissible to add a clarifying instruction such as “instill” for a patient based on the pharmacist’s judgment. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 150

8. A nurse prepares and administers a vaccination labeled for IM use. He administers this

injection subcutaneously. This describes a(n): a. prescribing error.

b. dispensing error. c. administration error. d. situation when no error has occurred. ANS: C

A vaccination for IM use should be injected into the muscle. Administering the medication subcutaneously would be an administration error. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 150

9. A psychiatric patient “cheeks” a medication, hiding it in his cheek and then spitting it out

later. What medication error has occurred? a. Improper storage b. Wrong time error c. Compliance error d. Unauthorized drug error ANS: C

A patient who does not adhere to the prescribed drug regimen is causing a compliance error. The other errors would not apply to this scenario. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 150

10. A hospitalized patient asks a certified nursing assistant (CNA) if she can get a couple of

aspirin to help with her headache. The CNA says she has some in her purse and gives them to the patient. What error has occurred? a. Improper storage b. Wrong time error c. Compliance error d. Unauthorized drug error ANS: D

Only prescribers who have privileges in the hospital, such as physician assistants, nurse practitioners, and physicians, may give medication to patients under the hospital’s care. Even though aspirin is an over-the-counter medication, it may interact with the patient’s condition or prescription medications. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 150

11. Which medication error term is correctly matched with its definition? a. Unauthorized drug error: A medication being stored at room temperature when it

should have been refrigerated b. Wrong time error: Medication administered outside the scheduled time frame c. Compliance error: Medication administered to a patient from an unauthorized

prescriber d. Improper storage: Patient does not adhere to prescribed regimen ANS: B

The following terms and definitions are correctly matched: Unauthorized drug error: Medication administered to a patient from an unauthorized prescriber Wrong time error: Medication administered outside the scheduled time frame

Compliance error: Patient does not adhere to prescribed regimen Improper storage: A medication being stored at room temperature when it should have been refrigerated PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 150

12. All of the following are workplace conditions that would make an error more likely except: a. pharmacy staff members multitasking. b. difficult-to-read medication labels. c. multiple checks by multiple pharmacy staff members. d. similar medication labels of the same font size and color. ANS: C

Multiple checks would make an error less likely. All of the other choices would make an error more likely. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 151

13. Which of the following abbreviations would be appropriate and safe for a physician to use? a. SC (subcutaneous) b. SL (sublingual) c. SQ (subcutaneous) d. None of these abbreviations should be used. ANS: D

SC (subcutaneous) or SQ (subcutaneous) may be misinterpreted as SL (sublingual). SC and SQ are interchangeable, but SQ/SC and SL are not, creating a chance for error. In general, these abbreviations should beNaU vR oiS deI d.N GTB.COM PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 153

14. The abbreviations AU and OU should not be used because they can be misinterpreted. What

do AU and OU mean? a. Right ear and right eye b. Left ear and left eye c. Right ear and left eye d. Both ears and both eyes ANS: D

AU and OU stand for both ears and both eyes. They should not be used because they might be easily confused. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 152

15. Although generic drug suffixes and prefixes help identify a medication belonging to a certain

class, they can also be easily confused for one another. Which of the following medications is not an adrenergic antagonist (beta-blocker)? a. Propranolol b. Albuterol c. Metoprolol d. Labetalol

ANS: B

Albuterol is an adrenergic agonist used for asthma that has a suffix of -terol. The others are adrenergic antagonists (beta-blockers) used for a condition such as hypertension with a suffix of -olol. PTS: 1 REF: p. 154

DIF: Cognitive Level 2: Comprehension

16. All of the following drugs on are on the high-alert medication list except: a. analgesics. b. anesthetics. c. antiarrhythmics. d. antithrombotics. ANS: A

Analgesics such as aspirin and naproxen are not on the list. Anesthetic agents, general, inhaled, and IV (e.g., propofol, ketamine); IV antiarrhythmics (e.g., lidocaine, amiodarone); and antithrombotic agents, including heparin and warfarin, are on the list. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 154

17. All of the following drugs cannot be crushed except: a. regular-release dosage form tablet. b. slow-release dosage form. c. enteric-coated dosage form. d. extended-release dosage form. ANS: A

A regular-release dosage form tablet can be crushed, but slow-release dosage forms, enteric-coated dosage forms, and extended-release dosage forms will not work properly if crushed. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 154-155

18. Certain medications need to be used with caution in elderly adults. The correct rationale is

matched to the medication in each case below except: a. antiparkinson agents cause drowsiness. b. benzodiazepines cause drowsiness. c. androgens cause drowsiness. d. aspirin increases the likelihood of GI bleeds. ANS: C

Androgens cause cardiac complications, not drowsiness. Antiparkinson agents and benzodiazepines cause drowsiness, and aspirin increases the likelihood of GI bleeds. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 156-157

19. First-generation antihistamines can cause significant sedation and should be avoided in older

patients. Which of the following is the second-generation nonsedating antihistamine? a. Loratadine b. Chlorpheniramine c. Hydroxyzine

d. Diphenhydramine ANS: A

Loratadine (Claritin), cetirizine (Zyrtec), and other newer antihistamines do not cause the sedation that first-generation antihistamines such as chlorpheniramine, hydroxyzine, diphenhydramine, and cyproheptadine do. These second-generation antihistamines are the preferred treatment for older patients with allergy symptoms. PTS: 1 REF: p. 156

DIF: Cognitive Level 2: Comprehension

20. Which of the following pieces of information is considered counseling? a. Name of medication b. Dosage form c. Route of administration d. Duration of therapy ANS: D

Providing the duration of therapy is considered counseling, but giving the name of the medication, dosage form, or route of administration is not. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 157

21. All of the following information would be found in a package insert except: a. prescriber name. b. clinical pharmacology. c. contraindications. d. warnings. ANS: A

The prescriber name would be found on the prescription or the prescription label but not in the package insert. The clinical pharmacology, contraindications, and warnings would be found in the package insert. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 158

22. Package inserts are provided to patients taking all of the following types of medication except: a. metered-dose inhalers. b. oral contraceptives. c. blood pressure medication. d. estrogen products. ANS: C

A pharmacy is required to provide patient package inserts to all patients receiving metered-dose inhalers, oral contraceptives, estrogen, progesterone, and Accutane. Package inserts are not required for patients taking blood pressure medications. PTS: 1 REF: p. 158

DIF: Cognitive Level 2: Comprehension

23. Which of the following is not associated with medication error tracking? a. FDA

b. APhA c. ISMP d. FAERS ANS: B

The American Pharmacists Association (APhA) is a membership organization and would not track medication errors. The other three choices—the FDA, ISMP, and FAERS—are involved in medication error tracking. MedWatch of the Food and Drug Administration (FDA) is a voluntary program that allows the reporting adverse health events and medical problems. The Institute of Safe Medication Practices (ISMP) oversees the Medication Error Reporting Program (MERP). The FDA Adverse Event Reporting System (FAERS) (formally known as AERS) is a database that contains information regarding both adverse events and medication error reports submitted to the FDA. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 158

24. What is a disadvantage of electronic prescribing? a. Eliminates illegible prescriptions b. Computer downtime prevents prescription transmission c. Uses clinical decision support to reduce preventable errors d. Improves work efficiency ANS: B

If a computer system is not working, then the electronic prescribing cannot work, but a simple pen and paper would. The other three choices—eliminates illegible prescriptions, uses clinical decision support to reduce preventable errors, and improves work efficiency—are all advantages. PTS: 1

NURSINGTB.COM

DIF: Cognitive Level 3: Application

REF: pp. 158-159

25. What is a disadvantage of automation? a. Automation repair technicians may be outside of the local health facility area b. Reduction in medication errors c. Increased speed in medication processing d. Managing and tracking inventory ANS: A

Automation repair technicians may be outside of the local health facility area, and it may require hours to days to repair a machine. The other choices—reduction in medication errors, increased speed in medication processing, and managing and tracking inventory—are advantages. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 159

26. Technicians may help prevent medication errors by: a. keeping their work areas free of clutter. b. ignoring dosage appropriateness, leaving that to the pharmacist. c. guessing on ambiguous orders. d. guessing on illegible handwriting. ANS: A

Technicians should keep their work areas free of clutter but should mentally check dosage appropriateness, question ambiguous orders, and call for clarification on illegible handwriting. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 159

27. Pharmacists can help avoid medication errors by: a. avoiding using abbreviations that have more than one meaning. b. checking prescriptions in a timely manner. c. documenting OTC and herbal remedy use. d. all of the above. ANS: D

The pharmacist can avoid medication errors by avoiding using abbreviations that have more than one meaning and verifying the meaning of these abbreviations with the prescriber, checking prescriptions in a timely manner so that any special considerations are not forgotten or lost, and encouraging OTC and herbal remedy documentation so that drug interactions might be caught. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 159

28. Medication error prevention best practices in the pharmacy include: a. using electronic prescribing. b. encouraging physicians to use common terminology and abbreviations. c. automating and bar coding all fill procedures. d. all of the above. ANS: D

Using electronic prescribing,NencR ourI aginGg pB hy.siC cianMs to use common terminology and U S N T O abbreviations, and automating and bar coding all fill procedures are all best practices in the pharmacy. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 159-160

29. A medication with which acronym in the name might be safely crushed; the others would

definitely not be crushed? a. OTC b. XR c. ER d. CR ANS: A

An over-the-counter (OTC) medication might be safely crushed depending on the medication; however, XR, ER, and CR indicate long-acting preparations that should not be crushed. PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 154-155

30. Which of the following medications would be appropriately prescribed for someone needing

an antiinflammatory drug? a. Cerebryx b. Celebrex c. Celexa d. Cardizem

ANS: B

Celebrex is an antiinflammatory drug that can be confused with Cerebryx, Celexa, and Cardizem. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 153-154

Chapter 05: Pharmacy Quality Assurance Test Bank MULTIPLE CHOICE 1. The United States Pharmacopeia and National Formulary (USP-NF) contains standards for all

of the following except: a. chemical and biological drug substances. b. compounded preparations. c. energy drinks. d. dietary supplements. ANS: C

The USP-NF contains standards for chemical and biological drug substances, dosage forms, compounded preparations, excipients, medical devices, and dietary supplements. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 164

2. A patient requires a compound made up of two over-the-counter creams to be made by the

pharmacy. The requirements for the compound would be found in: a. USP 795. b. USP 797. c. both USP 795 and 797. d. neither USP 795 nor 797. ANS: A

The United States PharmacopNeU iaReS staIbN lisGhT esBn. onCsO teM rile compounding requirements under USP 795 and establishes sterile compounding requirements under USP 797 to include infection control. Combining two over-the-counter creams would be an example of nonsterile compounding. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 164

3. A patient requires an IV antibiotic to be made by the pharmacy. The requirements for the

compound would be found in: a. USP 795. b. USP 797. c. both USP 795 and 797. d. neither USP 795 nor 797. ANS: B

The United States Pharmacopeia establishes nonsterile compounding requirements under USP 795 and establishes sterile compounding requirements under USP 797 to include infection control. An antibiotic to be infused must be sterile. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 164

4. The Food and Drug Administration (FDA) has the responsibility to oversee the safety of: a. medical devices. b. vaccines.

c. cosmetics. d. all of the above. ANS: D

The FDA oversees that food, drugs, medical devices, vaccines, blood, biologics, veterinary products, cosmetics, radiation-emitting products, and tobacco are safely produced for the public. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 164

5. The FDA has responsibility for all of the following except: a. establishing requirements for labeling of medications, whether they are in a

multidose vial or unit-dose container, an IV admixture, or a compound. b. providing information on recent drug approvals and drug shortages and providing

drug safety information. c. establishing clinical trials, submission of drug applications, and the required

labeling of medications. d. issuing warning letters to the public regarding specific medications and conducting

postmarket surveillance programs for newly approved medications. ANS: A

The United States Pharmacopeia has the responsibility for establishing requirements for labeling of medications, whether they are in a multidose vial or unit-dose container, an IV admixture, or a compound. The FDA is responsible for the other choices, including providing information on recent drug approvals and drug shortages and providing drug safety information; establishing clinical trials, submission of drug applications, and the required labeling of medications; and issuing warning letters to the public regarding specific medications and conducting N poU stR mS arI keNt G suTrvBe. illC anOcM e programs for newly approved medications. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 164

6. Which of the following shows a good understanding of the purpose of accreditation? a. Accreditation is the same as licensure. b. Accreditation is governed by the state boards of pharmacy. c. Accreditation is completed every 6 months. d. Accreditation reflects an institution’s commitment to meeting specific performance

standards ANS: D

Accreditation reflects an institution’s commitment to meeting specific performance standards. Accreditation is not the same as licensure; it is governed by The Joint Commission and is generally completed in multiple year cycles. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 164

7. Which of the following is not an initiative of The Joint Commission? a. Leadership process and accountability b. Safe environment for staff and patients c. Improving quality and safety d. Drug safety and efficacy

ANS: D

The Joint Commission does not focus on drug safety and efficacy but is involved with leadership process and accountability, safe environments for staff and patients, and improving quality and safety. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 165

8. The Institute of Safe Medication Practices (ISMP) has initiatives in five key areas. They are

correctly listed as: a. knowledge, analysis, education, independence, and communication. b. knowledge, analysis, education, cooperation, and communication. c. knowledge, review, education, cooperation, and communication. d. knowledge, analysis, education, cooperation, and privacy. ANS: B

The ISMP’s five key areas include knowledge, analysis, education, cooperation, and communication. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 165

9. The ISMP provides pharmacy resources that include all of the following except: a. black box warnings. b. error-prone abbreviations list. c. list of error-prone health providers. d. ISMP confused drug name list. ANS: C

The ISMP does not provide aNlistRof I erroG r-prB on.eCheaM lth providers but does provide black box U S Nlist, Tand O ISMP confused drug name list. warnings, an error-prone abbreviations the PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 165

10. The ISMP provides pharmacy resources that include all of the following except: a. guidelines for preventing medication errors in geriatric patients. b. “DO NOT CRUSH” list. c. guidelines for preventing medication errors in pediatric patients. d. “tall man” letters. ANS: A

The ISMP does not provide a list of guidelines for the prevention of medication errors in geriatric patients but does provide the “DO NOT CRUSH” list, guidelines for preventing errors in pediatric patients, and “tall man” letters. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 165

11. Types of errors that might be reported to the ISMP’s error reporting programs might include

all of the following except wrong a. patient b. provider c. drug d. route

error.

ANS: B

The ISMP’s reporting program would not expect a report of a wrong provider but would possibly receive wrong patient, wrong drug, and wrong route errors. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 165

12. Which organization has goals of improving medication use and advancing patient care and

advocates for the practice of pharmacy regardless of the setting? a. APhA b. ASHP c. ACPE d. BOP ANS: A

The APhA is the organization whose goal is to improve medication use and advance patient care and advocates for the practice of pharmacy regardless of the setting. The ASHP advocates for the practice of pharmacy to various organizations to include The Joint Commission, federal and state regulatory agencies, and other health care organizations and establishes regulations and standards for pharmacy technician programs to include curriculum and clinical expectations. The ACPE accredits professional degree programs in pharmacy and providers of continuing pharmacy education and assures and advances the quality of continuing pharmacy education. The state BOPs (state boards of pharmacy) ensure that specific standards are met for the licensing of pharmacists, permits are issued for pharmacies, and pharmacy technicians meet specific requirements. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 166

13. Which organization advocateN sU foR rS thI eN prG acT tiB ce.oC fO phM armacy to various organizations to include

The Joint Commission, federal and state regulatory agencies, and other health care organizations and establishes regulations and standards for pharmacy technician programs to include curriculum and clinical expectations? a. APhA b. ASHP c. ACPE d. BOP ANS: B

DIF: Cognitive Level 1: Knowledge

REF: p. 166

14. Which organization accredits professional degree programs in pharmacy and providers of

continuing pharmacy education and assures and advances the quality of continuing pharmacy education? a. APhA b. ASHP c. ACPE d. BOP ANS: C

DIF: Cognitive Level 1: Knowledge

REF: p. 166

15. Which organization ensures that specific standards are met for the licensing of pharmacists,

permits are issued for pharmacies, and pharmacy technicians meet specific requirements? a. APhA b. ASHP c. ACPE d. BOP ANS: D

DIF: Cognitive Level 1: Knowledge

REF: p. 166

16. Contrasting the function of the National Association of Boards of Pharmacy and the state

boards of pharmacy (BOPs), which of the following is correct? a. The National Boards of Pharmacy accredit professional degree programs. b. The state BOPs are responsible for insuring safe working conditions. c. The National Boards of Pharmacy rely on the state BOPs for assistance. d. The state BOPs rely on the National Boards of Pharmacy for assistance. ANS: D

The state BOPs rely on the National Boards of Pharmacy for assistance. OSHA is responsible for insuring safe working conditions, and the ACPE accredits professional degree programs. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 166

17. All of the following describe the requirements to become or maintain status as a pharmacist

except: a. can practice with only a high school diploma or GED. b. must be a high school graduate and have graduated from an accredited school of pharmacy with a BS in pharmacy or a PharmD. c. they may reciprocate their pharmacy license to another state without taking that state’s board of pharmacy examination; however, they may be required to take a pharmacy law examination. d. meet state requirements for licensure, which include externship requirements, passing a pharmacy board examination, and continuing education. ANS: A

A pharmacist must be a high school graduate and have graduated from an accredited school of pharmacy with a BS in pharmacy or a PharmD and meet state requirements for licensure, which include externship requirements, passing a pharmacy board examination, and continuing education. Pharmacists may reciprocate their pharmacy licenses to another state without taking that state’s board of pharmacy examination; however, they may be required to take a pharmacy law examination. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 166-167

18. All of the following describe the requirements to become or maintain status as a pharmacy

NUR SI NG TB.C OM technician except: a. must be a high school graduate or hold a GED. b. required to have a minimum number of externship requirements. c. currently, 43 states require PTCB or NHA certification. d. several, but not all, states require them to become registered or licensed with the state. ANS: B

A pharmacist is required to have a minimum number of externship requirements. A pharmacy technician must be a high school graduate or hold a GED. Currently, 43 states require PTCB or NHA certification, and several, but not all, states require them to become registered or licensed with the state. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 167

19. Which of the following is not correct regarding dress code? a. Fingernails should be kept clean and short. b. Nail polish should be nonacrylic to prevent fungal infections. c. Makeup can be worn in all hospital and community settings. d. Hair should be pulled back. ANS: C

Makeup cannot be worn in some hospital and community settings because of the particulate nature of the product. It is true that fingernails should be kept clean and short, nail polish should be nonacrylic to prevent fungal infections, and hair should be pulled back. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 167

20. Which of the following does not show good hand-washing technique? a. Washing the hands with cold water only b. Washing the hands with hot water and Betadine c. Scrubbing both the top and bottom of the hands d. Scrubbing between the fingers and up to the elbow ANS: A

Proper hand-washing techniques include washing the hands and arms with hot water and Betadine; scrubbing both the top and bottom of the hands; scrubbing between the fingers up to the elbow; and rinsing the arms and hands thoroughly. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 167

21. Hands should be washed: a. after the person uses the restroom. b. only after contact with a patient. c. after donning gloves for work in a laminar flow hood. d. only before contact with a patient. ANS: A

Hands should be washed after the person uses the restroom, before and after contact with a patient, and before donning gN loUvR esSfoIrNwG oT rkB in. gC inOaMlaminar flow hood. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 167

22. Personal protective equipment (PPE) include(s): a. latex gloves. b. goggles. c. gowns. d. all of the above. ANS: D

PPE is used to place a barrier between the employee and specific substances. PPE includes latex gloves, masks, goggles, face shields, gowns, laboratory coats, shoe coverings, and head coverings. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 168

23. Which of the following is a level 1 product? a. Single patient admixture b. Batch-reconstituted antibiotics without preservatives c. Batch-prefilled syringes without preservatives d. TPN solutions mixed with automatic compounding devices ANS: A

A level 1 product includes single patient admixtures, sterile ophthalmic preparations, and syringes without preservatives. Batch-reconstituted antibiotics without preservatives, batch-prefilled syringes without preservatives, and TPN solutions mixed with automatic compounding devices are all level 2 products. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 168

24. Which of the following is a level 2 product? a. Single patient admixtures b. Sterile ophthalmic preparations c. Syringes without preservatives d. Batch-reconstituted antibiotics without preservatives ANS: D

Batch-reconstituted antibiotics without preservatives, batch-prefilled syringes without preservatives, and TPN solutions mixed with automatic compounding devices are all level 2 products. The other choices—single patient admixtures, sterile ophthalmic preparations, and syringes without preservatives—are level 1 products. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 168

25. Which of the following are level 3 products? a. Single patient admixtures b. Sterile ophthalmic preparations c. Autoclaved IV solutions d. Syringes without preservatives ANS: C

Level 3 products include autoclaved IV solutions, TPN solutions made from dry amino acids or sterilized by final filtration, and morphine injections made from powders or tablets. The other choices—single patient admixtures, sterile ophthalmic preparations, and syringes without preservatives—are level 1 products. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 168

26. All of the following describe a “code blue” except a: a. patient’s heart has stopped beating. b. patient has stopped breathing. c. PRN order for a medication. d. crash cart contains the necessary medications. ANS: C

A STAT (immediate) dose might be requested in a “code blue,” but a PRN order (as needed) would be for after the “code blue” has been completed. A “code blue” in a hospital signifies that a patient is in a life-threatening situation such as the stopping of a patient’s heart or a cessation of breathing. Crash carts are located on the floors of a hospital, are stocked with the necessary medications and equipment for a code blue situation, and are used to stabilize a patient. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 169

27. Amoxicillin (Amoxil), furosemide (Lasix), and atorvastatin (Lipitor) are all administered to a

patient. That these medications were provided should be recorded in the: a. medication delivery record. b. medication administration record (MAR). c. patient profile. d. physician order sheet (POS). ANS: B

The MAR is where a health care provider documents medication administered to a patient. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 171

28. A pharmacy technician determines that the date of birth is incorrect in the pharmacy’s records.

Where would the technician revise the date of birth? a. Patient profile b. Medication management sheet c. SOAP note d. Nursing note ANS: A

The patient profile is a hard copy or a computerized list of a patient’s prescriptions (medications) and other information such as his or her name, Social Security number, birth date, gender, and billing information. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 171

29. A doctor has determined the best pharmacologic course of therapy for a patient entering the

hospital. What document woN uld R tainG Ucon SI N thes TBe.inCstru OMctions? a. Physician order sheet (POS) b. Medication delivery record c. Patient profile d. Discharge orders ANS: A

The POS lists all of the physician’s orders for a patient, including both drug and nondrug orders. Discharge orders would contain pharmacologic therapy for a patient leaving the hospital. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 171

30. Channel richness is the capacity of a channel to convey information effectively. Which of the

following is the least effective means to post an employment vacancy notice? a. Face to face b. Posted notice c. Telephone d. E-mail ANS: B

Channel richness is the capacity of a channel to convey information effectively. The following outlines the communication forms from least to most effective: posted notice, e-mail, telephone, and face to face.

PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 173

Chapter 06: Medication Order Entry and Fill Process Test Bank MULTIPLE CHOICE 1. A patient who has difficulty urinating and is likely to get bladder infections most likely has

which condition? a. BPH b. COPD c. CHF d. GERD ANS: A

BPH is benign prostatic hypertrophy, an enlargement of the prostate gland. COPD is chronic obstructive pulmonary disease, a disease of the lungs. CHF is congestive heart failure, a disease of the heart. GERD is gastroesophageal reflux disease, a condition of hypersecretion of acid in the stomach that spills into the unprotected esophagus. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 179

2. A patient who experiences shortness of breath upon walking and has a disease of the heart

muscle most likely has which condition? a. BPH b. COPD c. CHF d. GERD ANS: C

DIF: Cognitive Level 3: Application

REF: p. 179

3. A patient who has difficulty breathing because of damage that previous years of smoking

caused to his lungs most likely has which condition? a. BPH b. COPD c. CHF d. GERD ANS: B

DIF: Cognitive Level 3: Application

REF: p. 179

4. A patient who complains of burning in his throat and an acidic taste in his mouth, especially

when he eats, most likely has which condition? a. BPH b. COPD c. CHF d. GERD ANS: D

DIF: Cognitive Level 3: Application

REF: p. 179

5. A patient needs ear drops to be administered twice daily. Which of the following Latin

abbreviations would be used in the sig? a. AU and tid b. AU and bid c. OU and tid d. OU and bid ANS: B

AU stands for auris utraque, or both ears, and bid stands for bis in die, or twice a day. OU stands for oculus utraque, or both eyes, and tid stands for ter in die, or three times daily. PTS: 1

DIF: Cognitive Level 3: Application

NURSINGTB.COM

REF: p. 179

6. A patient needs a medication for heartburn that is to be taken four times a day before meals.

Which of the following Latin abbreviations would be used in the sig? a. qid and ac b. qd and ac c. qid and pc d. qd and pc ANS: A

The abbreviation qid stands for four times a day (quater in die), and qd (quaque die) stands for every day. The abbreviation ac means before meals (ante cibum), and pc means after meals (post cibum). Therefore, qid and ac are correct. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 179

7. The correct Latin abbreviation for “at bedtime” is: a. PM. b. AM. c. hs. d. prn. ANS: C

The most appropriate answer is hs, or at the hour of sleep (hora somni). The other abbreviations stand for morning (AM), evening (PM), and as needed (prn).

PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 179

8. If a patient’s pulse rate is below 60 beats/min, the patient is deemed to be bradycardic. One

would expect that the condition is one when the heart is: a. beating faster than the normal range. b. beating at a normal pace. c. beating slower than the normal range. d. not beating at all. ANS: C

The root card- indicates that the heart is involved in the word, and brady- indicates slower than. Tachycardia is a condition when a heart beats faster than the normal range (greater than 100 beats/min). PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 179

9. Regarding the pharmacy’s policies and procedures manual, which term is correctly matched

with its definition? a. Mission statement: States the purpose and goals of an organization b. Policy: A notation that can relate to another document c. Procedure: A definite course or method of action; a plan establishing goals and objectives. d. Reference: Process of accomplishing a task to ensure efficiency and consistency; a step-by-step method to accomplish a policy ANS: A

Correctly matched policy and procedure manual terms include: Mission statement: States tN heUpR urp ose oaC lsOoM f an organization SI NGand TBg. Policy: A definite course or method of action; a plan establishing goals and objectives Procedure: Process of accomplishing a task to ensure efficiency and consistency; a step-by-step method to accomplish a policy Reference: A notation that can relate to another document PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 178

10. Which of the following is a way a prescription may be received by the pharmacy? a. Walk in b. Call in c. E-prescription d. All of the above ANS: D

Three methods of receipt include walk in, call in, and e-prescription. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 179-180

11. All of the following are important pieces of information to put in the patient’s health history

the first time the patient visits the pharmacy except: a. medication history to include current prescription medications, OTC medications, vitamins, and herbal supplements. b. drug and food allergies.

c. name, age, sex, race, occupation, address, and weight. d. patient’s credit score. ANS: D

Although a method of payment may be stored in the computer, the patient’s credit score would not. All of the other choices include important information to put in a patient’s health history; these are the patient’s name, age, sex, race, occupation, address, and weight; medical history to include surgeries; medication history to include current prescription medications, OTC medications, vitamins, and herbal supplements; and drug and food allergies. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 180

12. A provider may put an NPI number with or without a DEA number on the prescription. In

which of the following scenarios would it be necessary to have both numbers? a. The patient is prescribed an over-the-counter medication to be run through her insurance. b. The patient is prescribed a controlled substance such as an opioid for severe pain. c. The patient is prescribed a blood pressure pill. d. The patient is prescribed an asthma medication. ANS: B

A National Provider Identifier (NPI) number identifies the physician as a health professional and should be on all prescriptions; however, a Drug Enforcement Agency (DEA) number is required on controlled substances such as opioids. It would not be necessary for substances that are not controlled such as OTCs, blood pressure, and asthma medications. PTS: 1

DIF: Cognitive Level 3: Application

NURSINGTB.COM

REF: p. 181

13. When verifying the correct medication has been dispensed, which part of the NDC number is

matched to the stock bottle? a. The last four numbers, indicating the package size b. The middle four numbers, indicating the drug c. The first five numbers, indicating the manufacturer d. All 11 numbers must always be the same for every fill of the medication. ANS: B

The middle four numbers, which indicate the drug, should be matched to the prescription. Often a prescription can be filled with different generic forms of the same medication, so the manufacturer’s five-digit code will not always be the same. The package size might be of 100 or 500 or 1000 pills, but the medication may still be identical. All 11 numbers do not always have to be the same for these reasons. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 182

14. Certain classes of medications require special handling. All of the following are correctly

matched to the special requirements except the: a. counting tray should be wiped down using isopropyl alcohol when a sulfa drug is dispensed. b. counting tray should be wiped down using isopropyl alcohol when a penicillin drug is dispensed. c. counting tray should be wiped down using isopropyl alcohol when blood pressure

medications are dispensed. d. technician should wear gloves when chemotherapeutic or hazardous agents are

dispensed. ANS: C

A counting tray does not need to be wiped down after each blood pressure prescription is filled, but it should be wiped down with isopropyl alcohol when any penicillin or a sulfa drug is dispensed, and when dispensing oral chemotherapeutic or hazardous agents the pharmacy technician should wear gloves to prevent the skin from coming in contact with the medication. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 180

15. Which of the following steps is not part of the filling process? a. The pharmacist consults with the patient regarding the proper use of the

medication. b. The pharmacist checks the completed prescription and bags the prescription. c. The completed prescription is placed in the appropriate bin. d. The bulk medication bottle is returned to the shelf. ANS: A

When a pharmacist consults with the patient, it is part of the patient consultation process. The other choices—when the pharmacist checks the completed prescription and bags the prescription, the completed prescription is placed in the appropriate bin, and the bulk medication bottle is returned to the shelf—are part of the filling process. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 180-181

16. Which of the following acronNymR foI r typ of.pC resc Us S NGesTB OMription orders is not properly matched? a. PRN: A medication order that should be filled within 15 minutes of receiving it in

a hospital b. STAT: A medication order that should be filled within 15 minutes of receiving it

in a hospital c. ASAP: A medication order that does not have the priority of a STAT order but

needs to be processed as soon as possible d. PRN: An order that may be filled or administered when a patient requests it but

may have limitations associated with it ANS: A

The following acronyms are correctly matched: STAT: A medication order that should be filled within 15 minutes of receiving it in a hospital ASAP: A medication order that does not have the priority of a STAT order but needs to be processed as soon as possible PRN: An order that may be filled or administered when a patient requests it but may have limitations associated with it PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 181

17. Which of the following pieces of information, required to properly process a prescription, is

not correctly matched to the right term? a. Drug allergies: Any medication allergies the patient is known to possess

b. Disease states or health conditions: Specific medications can have an adverse

effect on a disease state or condition; drug–disease interactions c. Medications patient is taking: Prescription, OTC, or complementary and

alternative medication; this information is used to prevent drug–drug interactions. d. Patient demographic information: Any medication allergies the patient is known to possess ANS: D

The following terms and definitions are correctly matched: Drug allergies: Any medication allergies the patient is known to possess Disease states or health conditions: Specific medications can have an adverse effect on a disease state or condition; drug–disease interactions Medications patient is taking: Prescription, OTC, or complementary and alternative medication; this information is used to prevent drug–drug interactions Patient demographic information: Name, sex, address, and age of patient; obtaining the telephone (home, mobile, and work) number of the patient is highly recommended PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 181

18. When a patient calls in a refill, which unique piece of information should be asked for first to

prevent an error in filling? a. Patient’s name b. Patient’s home telephone number c. Patient’s medication name d. Prescription number ANS: D

A prescription number is a unNiqUuR eS nuImNbG erT , bBu. tC mO orM e than one patient may have the same name, telephone number, and medication name. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 181

19. If the prescription does not have any refills remaining, the pharmacy technician will least

likely contact the prescriber by: a. telephoning the physician’s office. b. faxing the physician’s office. c. walking to the physician’s office in person. d. electronically requesting a prescription from the physician’s office. ANS: C

If the prescription does not have any refills remaining, the pharmacy technician may contact the prescriber by telephone or fax or electronically. It is unlikely the pharmacy technician will leave the pharmacy to go to the physician’s office for the request, although the patient may have to. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 182

20. The patient’s relationship to the cardholder will need to be entered; many plans use all of the

following relationship holder codes except: a. 00: cardholder. b. 01: cardholder.

c. 02: spouse. d. 03: dependent. ANS: A

The patient’s relationship to the cardholder will need to be entered; many plans use the following relationship holder codes: 01, cardholder; 02, spouse; and 03, dependent. 00 is not used. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 182

21. Which of the following DAW codes is not properly matched to its definition? a. 1 = Substitution not allowed by provider b. 2 = Substitution allowed – pharmacist selected product dispensed c. 2 = Substitution allowed – patient requested product dispensed d. 0 = No product selection indicated ANS: B

The following DAW codes are correctly matched: 0 = No product selection indicated 1 = Substitution not allowed by provider 2 = Substitution allowed – patient requested product dispensed 3 = Substitution allowed – pharmacist selected product dispensed PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 182

22. Sterile product prescription labeling sometimes differs from the labeling on an oral

medication. Which of the following represents information that might be on a sterile IV product that is not on an oralN medRicaI U S tion NGlab TBel.? COM a. Patient name b. Infusion rate c. Date of filling d. Directions for use ANS: B

A prescription must be a liquid to have an infusion rate. Both oral and sterile products will likely have the patient name, date of filling, and directions for use on the label. PTS: 1 REF: p. 182

DIF: Cognitive Level 2: Comprehension

23. When repackaging a medication, what number changes from the original stock bottle to the

new repackaged label? a. Dosage b. Strength c. Lot number d. Expiration date becomes a beyond-use date. ANS: D

An expiration date from the original stock bottle, which may be longer, is changed to a beyond-use date, which is generally shorter. The dosage, strength, and lot number remain the same.

PTS: 1

DIF: Cognitive Level 3: Application

REF: pp. 182-183

24. Labels that help identify any special instructions the patient needs are known as all of the

following except a. prescription b. ancillary c. auxiliary d. warning

labels.

ANS: A

The prescription label is the main label that includes information such as drug name, instructions for use, patient’s name, and so on. Ancillary, auxiliary, and warning labels are all additional labels that are attached to the bottle. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 183

25. Which of the following directions would least likely be on an ancillary or auxiliary label? a. May cause drowsiness. b. Take with food or milk. c. Take 1 capsule three times daily. d. Shake well. ANS: C

Directions for use are written on the main prescription label. Warnings or special directions such as “may cause drowsiness,” “take with food or milk,” and “shake well” might be included on ancillary labels. PTS: 1

DIF:

CoNgniR tiveI LevG el 3:BA.pC plicaMtion

U S N T

REF: p. 183

26. The following ancillary labels are best matched to their dosage forms except: a. Otic preparation: FOR THE EAR. b. Ophthalmic preparation: FOR THE EYE. c. Suspension: SHAKE WELL. d. Ointments, creams, and lotions: FOR THE EAR. ANS: D

The following ancillary labels are correctly matched to their dosage forms: Otic preparations: FOR THE EAR Ophthalmic preparations: FOR THE EYE Suspension: SHAKE WELL Ointments, creams, and lotions: FOR EXTERNAL USE ONLY PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 183

27. All of the following unit-dose containers are correctly matched except: a. amber blister packs: liquids. b. applicators: suppositories, creams, and ointments. c. oral syringes: liquids. d. plastic cups: liquids and suspensions. ANS: A

Amber blister packs are used for unit-dose tablets and capsules, not liquids. The other choices are correctly matched. PTS: 1 28.

DIF: Cognitive Level 1: Knowledge

REF: p. 183

Which of the following unit dose system is incorrectly matched with its definition? a. Unit-dose system: Synonymous with punch cards, bingo cards, or blister cards b. Unit-dose system: A system that provides a medication in its final “unit of use” c. Modified unit-dose system: A drug distribution system that combines unit-dose medications, which are blister-packaged onto a multiple-dose card instead of being placed in a box d. Blended unit-dose system: Combines a unit-dose system with a non–unit-dose system ANS: A

A unit-dose system is not synonymous with punch cards, bingo cards, or blister cards, which are part of the modified unit-dose system. A unit-dose system is a system that provides a medication in its final “unit of use.” A modified unit-dose system is a drug distribution system that combines unit-dose medications, which are blister packaged onto a multiple-dose card instead of being placed in a box. A blended unit-dose system combines a unit-dose system with a non–unit-dose system. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 184

29. Which of the following containers is incorrectly matched to its definition? a. Light-resistant container: protects the contents from the effects of light due to the

contents of the container R I G B.C M N b. Tamper-evident packagingU : imS pervNiouT s to air O or gas c. Well-closed container: protects the contents from other solids and from loss of the article under normal conditions d. Tight container: protects the contents from contamination by liquids, solids, or vapors ANS: B

A light-resistant container protects the contents from the effects of light due to the contents of the container. A tamper-evident package is a container or individual carton of a sterile article that is intended for ophthalmic or otic use that is sealed so that the contents cannot be used without obvious destruction of the seal. A hermetic container is impervious to air and gas. A well-closed container protects the contents from other solids and from loss of the article under normal conditions. A tight container protects the contents from contamination by liquids, solids, and vapors. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 184-185

30. The following containers are correctly matched to their definitions except: a. single-unit container: designed to hold a quantity of drug product intended for

administration as a single dose. b. multiple-unit container: permits withdrawal of successive portions of the contents

without changing the strength, quality, or purity of the remaining portion. c. hermetic container: impervious to air or gas. d. tamper-evident packaging: protects the contents from the effects of light due to the

contents of the container. ANS: D

Tamper-evident packaging is incorrectly matched to the light-resistant container definition. A single-unit container is designed to hold a quantity of drug product intended for administration as a single dose. A multiple-unit container permits withdrawal of successive portions of the contents without changing the strength, quality, or purity of the remaining portion. A hermetic container is impervious to air and gas. Tamper-evident packaging is a container or individual carton of a sterile article intended for ophthalmic or otic use that is sealed so that the contents cannot be used without obvious destruction of the seal. A light-resistant container protects the contents from the effects of light due to the contents of the container. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 184-185

Chapter 07: Pharmacy Inventory Management Test Bank MULTIPLE CHOICE 1. Which of the following most completely describes pharmacy inventory management? a. Only the process of disposing of drugs b. Only the process of storing drugs c. Only the process of purchasing drugs d. The purchase, storage, distribution, and disposal of drug products ANS: D

Pharmacy inventory management focuses on the procurement, drug storage and inventory control, repackaging and label considerations, distribution systems, and recapture and disposal of used and unused pharmaceutical products. It is not simply the disposing or storing or purchasing of drug products. PTS: 1 REF: p. 190

DIF: Cognitive Level 2: Comprehension

2. Good inventory management provides numerous benefits to the pharmacy in the form of

reductions. Which of the following is not one of those benefits? a. Reduces costs associated with placing orders to the wholesaler b. Reduces profits the pharmacy can earn c. Reduces unexpected stock-outs and temporary shortages, which may affect patient care d. Reduces carrying cost (financial investment) in drug products ANS: B

Good inventory management generally increases profits and reduces unexpected stock-outs and temporary shortages, which may affect patient care, carrying cost (financial investment) in drug products, and costs associated with placing orders to the wholesaler. PTS: 1 REF: p. 190

DIF: Cognitive Level 2: Comprehension

3. Good inventory management minimizes all of the following except: a. time spent on purchasing functions. b. capital charge on average inventory. c. shrinkage, breakage, and obsolescence of inventory. d. patient satisfaction. ANS: D

Good inventory management maximizes patient satisfaction with in-stock status and lower prices from good cost controls. Good inventory management also minimizes time spent on purchasing functions; minimizes capital charge on average inventory; and minimizes shrinkage, breakage, and obsolescence of inventory. PTS: 1 REF: p. 190

DIF: Cognitive Level 2: Comprehension

4. Which inventory process or tool is correctly matched with its definition? a. Just-in-time ordering: A strategy of ordering a product just before it is used b. Minimum and maximum: A method to identify and define inventory items based

on their usage c. PAR (periodic automatic replacement) value: A predetermined number that states the minimum and maximum amount of medication to be kept on a shelf d. ABC analysis: The amount of drug that is automatically reordered ANS: A

The inventory processes and tools below are correctly matched: Just-in-time ordering: A strategy of ordering a product just before it is used Minimum and maximum: A predetermined number that states the minimum and maximum amount of medication to be kept on a shelf PAR (periodic automatic replacement) value: The amount of drug that is automatically reordered ABC analysis: A method to identify and define inventory items based on their usage PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 190

5. The advantage of the 80/20 report is that it allows for a pharmacy to focus on the

of the

inventory rather than the entire inventory. a. most expensive 20% b. least expensive 20% c. most expensive 80% d. least expensive 80% ANS: A

CsOfM The advantage of the 80/20 rN epU oR rt S isI thNaG t iT t aB ll. ow or a pharmacy to focus on the most expensive 20% of the inventory rather than the entire inventory, saving time and money for the establishment. PTS: 1 REF: p. 190

DIF: Cognitive Level 2: Comprehension

6. The inventory that would be completed when the pharmacist in charge retires and a new

pharmacist replaces her would be a(n) a. perpetual b. biennial c. initial d. estimated

inventory.

ANS: C

An initial inventory is an accurate inventory of all controlled substances taken before opening a new pharmacy or when a change in the pharmacist in charge occurs. PTS: 1

DIF: Cognitive Level 1: Knowledge

7. A biennial inventory is one that is completed: a. every 2 years. b. every 2 months. c. twice in 1 year.

REF: p. 191

d. for noncontrolled substances. ANS: A

A biennial inventory is required by the Drug Enforcement Administration of all controlled substances every 2 years. An accurate count of all Schedule II medications must be performed, but Schedules III, IV, V, and “exempt narcotics” may be estimated. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

8. To maintain exact counts at any given moment, it is necessary to maintain a(n)

inventory. a. formal b. annual c. biennial d. perpetual ANS: D

A perpetual inventory reflects exactly what is on hand at a particular time. Often perpetual inventories are maintained on Schedule II medications and any other medication the pharmacy may wish to keep track of. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

9. Over the course of the year, the medication counts become less and less accurate for multiple

reasons, including loss, breakage, and spoilage. To reconcile the actual amount of medication a pharmacy holds, a(n) _ inventory is conducted once a year. a. physical b. estimated c. general d. quarterly ANS: A

A physical inventory is conducted on a yearly basis to determine exactly what is on hand at a particular moment in time and the value of the inventory based on the current cost of that item at that time. A quarterly inventory would be conducted every 3 months. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

10. National Drug Code (NDC) numbers have 11 digits. In the NDC number 00007-1234-56: a. the 1234 represents the medication. b. the 56 represents the quantity or package size. c. the 00007 represents the drug manufacturer. d. all of the above statements are correct. ANS: D

NDC numbers have 11 digits. In the number 00007-1234-56, the 00007 represents the drug manufacturer. The 1234 represents the medication. And, 56 represents the package size. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 191

11. A patient’s prescription requires 30 capsules to be dispensed. Which NDC number would be

appropriate to fill this prescription?

a. 00001-0030-17 b. 00030-0013-12 c. 00343-0712-30 d. It cannot be determined from the information given. ANS: D

In an NDC number, the first digits represent the drug manufacturer, the second four represent the medication, and the last two represent package size. The 30, however, does not necessarily mean there will be 30 tablets or capsules, only that it is a unique number; sometimes the last number does match but not always. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 191

12. When a pharmacist verifies a prescription, often he or she will circle one set of numbers in the

NDC number. Which of the following would the pharmacist circle to ensure the proper medication is being dispensed if the NDC number is 00414-8719-26? a. 00414 b. 8719 c. 26 d. 00414-8719-26 ANS: B

In an NDC number, the second four digits represent the drug. The pharmacist would circle just this number to make sure it matches. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 191

13. The phrase that is nearest in m nu. mC ber Nea URning SItoNGlotTB OMis the: a. NDC number. b. PIN. c. batch number. d. expiration date. ANS: C

The phrase that is nearest in meaning to lot number is the batch number. A lot, or batch of medication, is numbered just in case something is found to be wrong with that particular mixture. An NDC number indicates the manufacturer, drug, and package size. The PIN and expiration date are not correct. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

14. If a bottle of insulin has an expiration date of 1/2016, what date is the last date that bottle

should be used? a. 1/31/2016, the last day of the month b. 1/1/2016, the first day of the month c. 2/7/2016; an expiration date is really a sell-by date, and it can be used for 7 days after purchase d. 2/14/2016; an expiration date is really a sell-by date, and it can be used for 14 days after purchase ANS: A

If a bottle of insulin has an expiration date of 1/2016, the last date that bottle should be used is 1/31/2016, the last day of the month. The other choices are incorrect. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 191

15. Which of the following statements is correct regarding beyond-use-dates? a. There are two possible methods, the 3-month and 9-month methods. b. Sterile compounds follow the 6-month, 1-year method. c. Sterile compounds follow the 3-month, 1-year-method. d. A beyond-use date is assigned by the pharmacy when repacking or compounding a

medication. ANS: D

A beyond-use date is assigned by the pharmacy when repacking or compounding a medication. There are two possible methods, the 6-month and 1-year methods. The 6-month method is either 6 months or of the manufacturer’s expiration date. The 1-year method is a maximum of 1 year as long as it does not exceed the expiration date of the manufacturer. Beyond-use dates for sterile compounded medications do not follow this method because of USP 797 requirements. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

16. Which definition is correct regarding formularies? a. Formulary: a list of drugs approved for use in an institution such as a hospital or

whose cost will be reimbursed by a third-party carrier to a pharmacy b. Closed formulary: a hybrid of both open and closed formularies c. Open formulary: limited number of products of each drug classification covered N R I utic GTalB.C M d. Restricted formulary: all phUarmSaceN prodO ucts are carried ANS: A

A formulary is a list of drugs approved for use in an institution such as a hospital or whose cost will be reimbursed by a third-party carrier to a pharmacy. Formularies are established by the pharmacy and therapeutics committee of a hospital or managed care organization. The following terms and definitions are correctly matched: Open formulary: all pharmaceutical products carried Closed formulary: limited number of products of each drug classification covered Restricted formulary: a hybrid of both open and closed formularies PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

17. Which of the following is incorrect regarding formularies? a. A formulary is not established by the pharmacy and therapeutics committee but by

the pharmacy manager. b. An open formulary carries all of the pharmaceutical products available. c. A closed formulary carries a limited number of products of each drug

classification. d. A restricted formulary is a hybrid of both open and closed formularies. ANS: A

A formulary is a list of drugs that are approved for use in an institution such as a hospital or whose cost will be reimbursed by a third-party carrier to a pharmacy. Formularies are established by the pharmacy and therapeutics committee of a hospital or managed care organization. The following terms and definitions are correctly matched: Open formulary: all pharmaceutical products carried Closed formulary: limited number of products of each drug classification covered Restricted formulary: a hybrid of both open and closed formularies PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 191

18. Procurement can include all of the following except: a. drug selection and source selection. b. returns and refunds c. cost analysis and group purchasing. d. purchasing procedures and receiving control. ANS: B

Procurement includes drug selection, source selection, cost analysis, group purchasing, prime vendor relationships, purchasing procedures, record keeping, and receiving control. Procurement does not include returns. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 191-192

19. Which of the following procurement terms is not correctly matched to its definition? a. Source selection is deciding whether a generic or brand-name drug is to be

purchased. b. Cost–benefit analysis includes shipments, invoices, and purchase orders that must

be reconciled by item. NURSINGTB.C OM c. Group purchasing organizations allow hospitals to purchase medications at a lower cost based on volume. d. A primary or prime vendor is one source, a wholesaler, from which as many products as possible are purchased. ANS: B

Source selection is deciding whether a generic or brand-name drug is to be purchased. Cost– benefit analysis examines the perceived benefit versus the cost of the medication. Receiving procedures include shipments, invoices, and purchase orders that must be reconciled by item. Group purchasing organizations allow hospitals to purchase medications at a lower cost based on volume. A primary or prime vendor is one source, a wholesaler, fromwhich as many products as possible are purchased. PTS: 1

DIF: Cognitive Level 1: Knowledge

20. Which of the following can be found on a purchase order? a. Name and address of the institution b. Shipping address c. Vendor’s name and address d. All of the above ANS: D

REF: pp. 191-192

Information found on a purchase order can include the following: name and address of the institution, shipping address, date the order was placed, vendor’s name and address, and purchase order number (a tracking number used to identify a purchase order). PTS: 1

DIF: Cognitive Level 1: Knowledge

21. During receiving, a technician should match the a. drug b. strength c. package size d. All of the above are correct.

REF: p. 192

to the packing slip or invoice.

ANS: D

During receiving, a technician should match the drug, dosage form, strength, package size, number of units, and expiration date to the packing slip or invoice. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 192

22. Which of the following unit-dose system is correctly matched with its definition? a. Unit-dose system: a system that provides a medication in its final “unit of use” b. Unit-dose system: synonymous with punch cards, bingo cards, or blister cards c. Modified unit-dose system: combines a unit-dose system with a non–unit-dose

system d. Blended unit-dose system: synonymous with punch cards, bingo cards, or blister

cards ANS: A

The following unit-dose systN ems rect ly.mCatc hed with their definitions: Rare Icor G B M U S N T O Unit-dose system: a system that provides a medication in its final “unit of use.” Unit-dose packaging machines may be manual, semiautomatic, or automatic. Modified unit-dose system: a drug distribution system that combines unit-dose medications, which are blister-packaged onto a multiple-dose card instead of being placed in a box; synonymous with punch cards, bingo cards, or blister cards. A blended unit-dose system combines a unit-dose system with a non–unit-dose system and may be a multiple-medication package or a modular cassette. A multiple-medication package has all the medication, which is administered at the same time. A modular cassette is a combination cassette or drawer exchange system. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 193

23. Which of the following is correctly matched to its description of environmental conditions? a. Room temperature: Not to exceed 8° C (46° F) b. Excessive heat: Any temperature between 15° and 30° C (59° and 86° F) c. Freezer: Temperature is maintained thermostatically between –2-25° and –2-10° C

(–2-13° and 14° F) d. Cold: Any temperature above 40° C (104° F) ANS: C

The following are correct descriptions of environmental conditions required in a pharmacy: Freezer: Temperature is maintained thermostatically between –2-25° and –2-10° C (–2-13° and 14° F)

Cold: Not to exceed 8° C (46° F) Cool: Any temperature between 8° and 15° C (46° and 59° F) Room temperature: Any temperature between 15° and 30° C (59° and 86° F) Warm: Any temperature between 30° and 40° C (86° and 104° F) Excessive heat: Any temperature above 40° C (104° F) Dry temperature: Conditions do not exceed 40% humidity at a controlled room temperature PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 193

24. Which of the following drug recall descriptions is correct? a. Class I: Reasonable probability that use of the product will cause or lead to serious

adverse health events or death b. Class II: Use of product will probably not cause an adverse health event c. Class III: Probability exists that use of the product will cause adverse health events

that are temporary or medically reversible d. Class IV: Use of product will not cause an adverse health event ANS: A

The following are correct descriptions of drug recalls: Class I: Reasonable probability that use of the product will cause or lead to serious adverse health events or death Class II: Probability exists that use of the product will cause adverse health events that are temporary or medically reversible Class III: Use of product will probably not cause an adverse health event Class IV: Does not exist PTS: 1

DIF:

Cognitive Level 1: Knowledge

N R I G B.C M U S N T O

REF: p. 193

25. A class III recall is issued for a medication. Which of the following scenarios would most

likely match the recall severity? a. A drug is found to significantly increase death because of cardiac complications. b. A medication causes a rash that sometimes leads to anaphylaxis. c. A drug is discovered to cause severe vomiting in 10% of patients. d. A batch of tablets is of a lighter green than usual but of the same composition. ANS: D

A class III recall is for medications that will probably not cause a severe event. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 193

26. A batch of antiarrhythmic medication is found to have no active ingredient. Which of the

following would probably occur? a. Class I recall b. Class II recall c. Class III recall d. Class IV recall ANS: A

Because of the danger of giving a medication that has no active ingredient that is necessary for someone to prevent arrhythmia, and possibly death, it is most likely there would be a class I recall.

PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 193

27. A clinical trial is being conducted on a new chemical. Which of the following phases would

be associated with healthy persons and not patients with the disease? a. Phase I: Determines the appropriate dose range with regard to safety and toxicity b. Phase II: Preliminary evaluation of safety and efficacy; may focus on dose-response and dosing schedule c. Phase III: Comparison between new treatment and standard therapy or placebo d. Phase IV: Postmarketing evaluation ANS: A

The following are correct descriptions of clinical trial phases: Phase I: Determines the appropriate dose range with regard to safety and toxicity. It is conducted with a small number (20 to 80) of healthy individuals and is 9 to 18 months in length. Phase II: Performed in 100 to 300 patients who have the disease or condition to be treated. Often involves hospitalized patients for close monitoring and is the preliminary evaluation of safety and efficacy and may focus on dose-response and dosing schedule. Phase III: Conducted in larger (several hundred to several thousand) patients in groups for which the medication is ultimately intended. It is a comparison between a new treatment and the standard therapy or a placebo, and the medication is used in the manner in which it will be used after approval. It may take 2 to 5 years to complete. Phase IV: Postmarketing evaluation PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 195

28. A clinical trial is being conduNcU teR dS onIaNnG ew TBch.eC mO icM al. Which of the following phases would

be associated with just a few patients (<300) with the disease? a. Phase I: Determines the appropriate dose range with regard to safety and toxicity b. Phase II: Preliminary evaluation of safety and efficacy; may focus on dose-response and dosing schedule c. Phase III: Comparison between new treatment and standard therapy or placebo d. Phase IV: Postmarketing evaluation ANS: B

DIF: Cognitive Level 3: Application

REF: p. 195

29. A clinical trial is being conducted on a new chemical, which has been shown to be safe in

healthy individuals and approximately 300 patients who have been tested. What phase is the next to be performed? a. Phase I: Determines the appropriate dose range with regard to safety and toxicity b. Phase II: Preliminary evaluation of safety and efficacy; may focus on dose-response and dosing schedule c. Phase III: Comparison between new treatment and standard therapy or placebo d. Phase IV: Postmarketing evaluation ANS: C

DIF: Cognitive Level 3: Application

REF: p. 195

30. A drug has been approved through clinical trials and is being sold to the public. Which phase

is the only one that monitors N patient approval? RSIdata Gafter B.C M N T a. Phase I: Determines the apU propriate dose rangO e with regard to safety and toxicity b. Phase II: Preliminary evaluation of safety and efficacy; may focus on dose-response and dosing schedule c. Phase III: Comparison between new treatment and standard therapy or placebo d. Phase IV: Postmarketing evaluation ANS: D

DIF: Cognitive Level 3: Application

REF: p. 195

Chapter 08: Pharmacy Billing and Reimbursement Test Bank MULTIPLE CHOICE 1. In a managed care organization, what is being managed? a. The health care organization manages each patient’s care for a predetermined

amount of money. b. The patient manages his or her own care. c. The patient decides how to spend an allotted number of health care dollars. d. The managed care organization is just a physician’s group. ANS: A

The health care organization manages each patient’s care for a predetermined amount of money. The organization manages the patient’s care, decides how the health care dollars will be spent, and is much larger than just a small physician’s group (includes many types of health practitioners). PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 201

2. A pharmacy benefit: a. is a charitable event held by a pharmacy. b. focuses on medical services provided. c. is a provision of prescription drugs and sometimes other items that a pharmacy will

provide.

d. is the health care plan that is under the pharmacy benefit. ANS: C

N R I G B.C M U S N T O

A pharmacy benefit is a provision of prescription drugs and sometimes other items that a pharmacy will provide. It is not a charitable event held by a pharmacy; focuses on pharmacy services, not medical services; and falls under the health care plan. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 202

3. Comparing the fee-for-service and capitation models, which statement below is correct? a. Capitation is paying a fixed, prepaid fee per person to provide health services and

is paid before the services are provided. b. Capitation is paying a fixed, prepaid fee per person to provide health services and is paid after the services are provided. c. Fee for service is a set fee paid for each type of service and is paid before the service is performed. d. Fee for service is a variable fee paid for each type of service and is paid before the service is performed. ANS: A

Capitation is paying a fixed, prepaid fee per person to provide health services and is paid before the services are provided. Fee for service is a set fee paid for each type of service and is paid when the service is performed. PTS: 1

DIF: Cognitive Level 2: Comprehension

REF: p. 202 4. Which of the following is a characteristic of a health maintenance organization (HMO)? a. The percentage paid by the insurance is lower if services are provided by an

out-of-network provider. b. There is little flexibility in the selection of providers. c. The program has a nonexclusive contract with network of providers. d. Often members have a yearly deductible to meet before insurance coverage begins. ANS: B

Little flexibility in the selection of providers is a characteristic of an HMO. The other choices are characteristics of PPOs. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 202

5. Which of the following is a characteristic of a preferred provider organization (PPO)? a. The primary care physician (PCP) directs all medical care for the member. b. It provides health care services to members at a discounted fee for service. c. There is usually no deductible. d. It has low premiums. ANS: B

A PPO provides health care services to members at a discounted fee for service. The other choices are characteristics of HMOs. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 202

6. A patient has a very limited bNudgRet aI nd G doesBn.oC t haM ve a physician preference. Which type of

U Sappropriate? N T managed care plan would be most a. Preferred provider organization (PPO) b. Health maintenance organization (HMO) c. Point-of-service plan d. Primary care physician

ANS: B

An HMO has the least flexibility but is the most cost effective. A PPO and POS plan are more expensive, and a primary care physician is not a managed care plan. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 202

7. All of the following describe a point of service (POS) plan except: a. lower premiums. b. the member may choose either an HMO or a PPO for services. c. the primary care physician directs the medical care. d. the member may see out-of-network providers at a higher cost. ANS: A

Generally POS plans carry higher premiums, members may choose either an HMO or a PPO for services, the primary care physician directs the medical care, and members may see out-of-network providers at a higher cost. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 202

8. All of the following is true about health savings accounts (HSAs) except: a. HSAs are financial accounts established by an individual or family to pay for

qualified medical expenses. b. HSAs combine the benefits of both traditional and Roth 401(k)s and IRAs for

medical expenses. c. taxpayers receive a 100% income tax deduction on annual contributions. d. there are no limits to the amount that can be contributed to an HSA. ANS: D

There are limits to the amount that can be contributed to an HSA. An HSA is a financial account established by an individual or family to pay for qualified medical expenses. HSAs combine the benefits of both traditional and Roth 401(k)s and IRAs for medical expenses, and taxpayers receive a 100% income tax deduction on annual contributions. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 202

9. A coupon program can often save patients money on certain medications. Which of the

following is not a characteristic of this type of program? a. Some drug manufacturers provide coupons for specific drug products to physicians. b. The pharmacy bills the drug manufacturer electronically for the value of the coupon. c. The value of the coupon is deducted from what the patient is responsible for paying. d. Coupons can be exchanged for cash if unused. ANS: D

A coupon program can often save patients money on certain medications; however, coupons cannot be exchanged for cash if unused. It is true that some drug manufacturers provide coupons for specific drug products to physicians, the pharmacy bills the drug manufacturer electronically for the value of the coupon, and the value of the coupon is deducted from what the patient is responsible for paying. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 202-203

10. What form of pharmacy payment is not consistent with self-pay? a. Cash b. Check c. Insurance card d. Credit card ANS: C

Self-pay indicates that the patient is using his or her own money. Using an insurance card would indicate that a third party is paying for the medication. However, cash, checks, and credit cards are all methods a person could use to pay for his or her own medication. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 203

11. Which Medicare part covers inpatient hospital care, skilled nursing facilities, hospice, and

home health care?

a. b. c. d.

A B C D

ANS: A

Medicare Part A covers inpatient hospital care, skilled nursing facilities, hospice, and home health care. There is no cost if the patient worked for 10 years in Medicare-covered employment. Medicare Part B provides for physician services, outpatient care, and some physical and occupational therapy; Medicare Part B requires an extra monthly payment. Medicare Advantage (Part C) allows participants in Medicare Parts A and B to obtain coverage through an HMO or PPO that provides additional services at a higher cost. Medicare Part D provides for prescription medications, biological drugs, insulin, vaccines, and select medical supplies. All medications are not covered under Medicare Part D. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 203

12. Which Medicare part provides for physician services, outpatient care, and some physical and

occupational therapy? a. b. c. d.

A B C D

ANS: B

Medicare Part A covers inpatient hospital care, skilled nursing facilities, hospice, and home health care. There is no cost if the patient worked for 10 years in Medicare-covered employment. Medicare Part B provides for physician services, outpatient care, and some N R I dic GT B.C M physical and occupational theraUpy;SMeN are PartOB requires an extra monthly payment. Medicare Advantage (Part C) allows participants in Medicare Parts A and B to obtain coverage through an HMO or PPO that provides additional services at a higher cost. Medicare Part D provides for prescription medications, biological drugs, insulin, vaccines, and select medical supplies. All medications are not covered under Medicare Part D. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 203

13. Which Medicare part allows participants in Medicare Parts A and B to obtain coverage

through an HMO or PPO that provides additional services at a higher cost? a. b. c. d.

A B C D

ANS: C

PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 203

14. Which Medicare part provides for prescription medications, biological, insulin, vaccines, and

select medical supplies? a. b. c. d.

A B C D

ANS: D

DIF: Cognitive Level 1: Knowledge

REF: p. 203

15. Medicaid differs from Medicare in that: a. it can cover physician visits. b. it can cover emergency care. c. it can cover prescription drugs. d. each state determines its own eligibility rules, services provided, and copays. ANS: D

With Medicaid, each state determines its own eligibility rules, services provided, and copays, unlike with Medicare. All of the other choices are similarities between Medicaid and Medicare. PTS: 1 REF: p. 203

DIF: Cognitive Level 2: Comprehension

16. All of the following are characteristics of an in-house pharmacy provider network except: a. pharmacy owned by a health maintenance organization (HMO). b. normally located in the HMO facility. c. consists of multiple chains and independent pharmacies. d. provides pharmacy services only for members of the network. ANS: C

An in-house pharmacy provider network is generally just one pharmacy owned by an HMO, is usually located in the HMO facility, and provides pharmacy services only for members of the network. PTS: 1 REF: p. 203

DIF: Cognitive Level 2: Comprehension

17. Which of the following acronyms and terms are correctly matched? a. AAC: actual average cost

b. MAC: minimum allowable cost c. HMO: health management office d. AWP: average wholesale price ANS: D

AAC stands for actual acquisition cost or the actual cost the pharmacy paid for the medication. MAC is the maximum allowable cost; it is used in calculating the reimbursement formula for generic medications. An HMO is a health maintenance organization. AWP is the average wholesale price or the average price at which wholesalers sell a medication. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 202-203

18. Comparing an open with a closed formulary, which of the following is correct? a. A closed formulary includes few to no medications in each therapeutic

classification. b. An open formulary includes few to no medications in each therapeutic

classification. c. A closed formulary includes many medications in each therapeutic classification. d. An open formulary gives a physician many fewer prescribing choices. ANS: A

Whereas a closed formulary includes few to no medications in each therapeutic classification, an open formulary provides several medications in each class, giving a prescriber many more prescribing options. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 204

19. A “prior authorization” literaN llyUm Rea SIns:NGTB.COM a. before the insurance pays for the medication, authorization must be obtained. b. a prior prescription has been authorized by the physician. c. a prior prescription has been dispensed by the pharmacy. d. an authorization is a priority. ANS: A

A prior authorization literally means that to obtain authorization to use select formulary drugs, before paying for it, an insurance company requires the physician to request and document the reason why the medication is needed. Then the insurance company makes a decision denying or approving the request. PTS: 1 REF: p. 204

DIF: Cognitive Level 2: Comprehension

20. Which of the following is true about online adjudication? a. It is the process by which the pharmacy sends a prescription claim by mail to a

third-party provider. b. It is the process by which the pharmacy sends a prescription claim electronically to

a third-party provider. c. It takes many minutes to hours to receive a response. d. It does not allow the pharmacy to verify a patient’s eligibility. ANS: B

Online adjudication is the process by which the pharmacy sends a prescription claim electronically to a third-party provider. The response is usually immediate, and it does allow the pharmacy to verify the patient’s eligibility. PTS: 1 REF: p. 204

DIF: Cognitive Level 2: Comprehension

21. All of the following are correct regarding prescription drug cards except: a. generally, there is a help desk telephone number on the back of the card. b. a copay is required by law to be written on the card. c. an identification number can be numeric or alphanumeric. d. a BIN (bank identification number) is a six-digit number used to identify the

company that will reimburse the pharmacy for the prescription. ANS: B

The law does not require that a copay be written on the card, and there may be no written copay on the card at all, as copays often change. The other choices are correct regarding prescription drug cards. PTS: 1 REF: p. 204

DIF: Cognitive Level 2: Comprehension

22. Which DAW code is matched correctly with its number? a. 0 = No product selection indicated b. 1 = Substitution allowed by provider c. 2 = Substitution allowed – pharmacist requested product dispensed d. 3 = Substitution allowed – patient selected product dispensed ANS: A

The correct dispense as written (DAW) codes are properly matched to their definitions below: 0 = No product selection indicated 1 = Substitution not allowed by provider 2 = Substitution allowed – patient requested product dispensed 3 = Substitution allowed – pharmacist selected product dispensed PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 204

23. All of the following are cause for prior authorization except: a. medicines with age limits such as tretinoin (Retin-A). b. drugs used for cosmetic purposes such as finasteride (Propecia). c. an inexpensive formulary medication given at normal doses. d. medications prescribed for non–life-threatening medical conditions such as

sildenafil (Viagra). ANS: C

Prior authorization from the insurance company would not be required for an inexpensive formulary medication given at normal doses. However, medicines with age limits such as Retin-A, drugs used for cosmetic purposes such as Propecia, and medications prescribed for non–life-threatening medical conditions such as Viagra could require prior authorization. PTS: 1 REF: pp. 204-205

DIF: Cognitive Level 2: Comprehension

24. Which of the following choices regarding plan limitations is correct? a. Usually a 30 days’ supply at a retail pharmacy, 90 days’ supply at mail order b. Usually a 90 days’ supply at a retail pharmacy, 1 year supply at mail order c. Used to maximize costs to the insurer d. Used to dictate minimum quantities to be dispensed at one time ANS: A

Plan limitations usually include a 30 days’ supply at a retail pharmacy or 90 days’ supply at mail order. These limitations are used to minimize costs to the insurer and to dictate maximum supply to be dispensed at one time. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 205

25. Reviewing the cognitive services that the pharmacist provides (i.e., prescriptive authority and

patient assessment and treatment), which of the following is the best definition for cognitive services? a. The cost of medication plus a dispensing fee b. Per prescription reimbursement c. Services that require the expertise of the pharmacist d. The counting and filling of the medication ANS: C

Cognitive services require cognition, or the use of an expert body of knowledge. The other services are those that do not require an expert body of knowledge but are involved in the prescription filling process. PTS: 1

DIF:

CoNgniR tiveI LevG el 3:BA.pC plicaMtion

U S N T

REF: p. 205

26. Using what you have learned regarding copayments, which of the following describes a fixed

copayment? a. A patient pays $10 for each prescription filled. b. A patient pays 10% for each prescription filled. c. A patient pays $10 for generic medications and $30 for brand medications. d. A patient pays out of pocket. ANS: A

A fixed copayment is one in which the copayment remains constant such as when a patient pays $10 for each prescription filled. A percentage copayment is when a patient pays a percentage of the cost of the medication such as paying 10% for each prescription filled. A variable copayment is when a patient pays on a tiered system such as paying $10 for generic medications and $30 for brand medications. A patient paying out of pocket is not paying a copayment. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 206

27. Using what you have learned regarding copayments, which of the following describes a

percentage copayment? a. A patient pays $10 for each prescription filled. b. A patient pays 10% for each prescription filled. c. A patient pays $10 for generic medications and $30 for brand medications.

d. A patient pays out of pocket. ANS: B

A percentage copayment is when a patient pays a percentage of the cost of the medication such as paying 10% for each prescription filled. A fixed copayment is one in which the copayment remains constant such as paying $10 for each prescription filled. A variable copayment is when a patient pays on a tiered system such paying $10 for generic medications and $30 for brand medications. A patient paying out of pocket is not paying a copayment. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 206

28. Using what you have learned regarding copayments, which of the following describes a

variable copayment? a. A patient pays $10 for each prescription filled. b. A patient pays 10% for each prescription filled. c. A patient pays $10 for generic medications and $30 for brand medications. d. A patient pays out of pocket. ANS: C

A variable copayment is when a patient pays on a tiered system such as paying $10 for generic medications and $30 dollars for brand medications. A fixed copayment is one in which the copayment remains constant such as paying $10 for each prescription filled. A percentage copayment is when a patient pays a percentage of the cost of the medication such as paying 10% for each prescription filled. A patient paying out of pocket is not paying a copayment. PTS: 1

DIF: Cognitive Level 3: Application

REF: p. 206

NURSINGTB.COM 29. Gross profit is defined as selling price less the purchase price. What other term has the same calculation? a. Net profit b. Overhead c. Inventory turnover rate d. Markup ANS: D

The markup is also the selling price less the purchase price. Net profit is the overall costs less the purchase price, the overhead is the sum of all of the expenses, and the inventory turnover rate is the annual dollar purchases divided by the average inventory value. PTS: 1 REF: p. 206

DIF: Cognitive Level 2: Comprehension

30. Methods of cost containment include all of the following except: a. tiered copayments. b. prior authorization. c. mandatory generic substitution. d. postal mail claim submissions. ANS: D

Electronic, not postal, mail claim submission is a method of cost containment. Other methods include tiered copayments, prior authorization, and mandatory generic substitution.

PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 206

Chapter 09: Information System Usage and Application Test Bank MULTIPLE CHOICE 1. Which of the following describes a mainframe computer? a. Large, expensive, and powerful computer used to process large quantities of data b. Smaller scaled mainframe used by several people in a local area network (LAN) c. Stand-alone system that runs software and manages data from a larger source d. A system that governs the basic operation of the hardware ANS: A

A mainframe is a large, expensive, and powerful computer used to process large quantities of data. A minicomputer is a smaller scaled mainframe used by several people in a LAN. A microcomputer is a stand-alone system that runs software and manages data from a larger source. An operating system is a system that governs the basic operation of the hardware. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

2. Which of the following describes a minicomputer? a. Large, expensive, and powerful computer used to process large quantities of data b. Smaller scaled mainframe used by several people in a local area network (LAN) c. Stand-alone system that runs software and manages data from a larger source d. A system that governs the basic operation of the hardware ANS: B

IaNinGfT A minicomputer is a smaller N scU alR edSm raB m. eC usO edMby several people in a LAN. A mainframe is a large, expensive, and powerful computer used to process large quantities of data. A microcomputer is a stand-alone system that runs software and manages data from a larger source. An operating system is a system that governs the basic operation of the hardware. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

3. Which of the following describes a microcomputer (personal computer)? a. Large, expensive, and powerful computer used to process large quantities of data b. Smaller scaled mainframe used by several people in a local area network (LAN) c. Stand-alone system that runs software and manages data from a larger source d. A system that governs the basic operation of the hardware ANS: C

A microcomputer is a stand-alone system that runs software and manages data from a larger source. A mainframe is a large, expensive, and powerful computer used to process large quantities of data. A minicomputer is a smaller scaled mainframe used by several people in a LAN. An operating system is a system that governs the basic operation of the hardware. PTS: 1

DIF: Cognitive Level 1: Knowledge

4. An input device includes a: a. keyboard.

REF: p. 210

b. monitor. c. speaker. d. printer. ANS: A

A keyboard, mouse, trackball, microphone, touch screen, and light pen are all input devices, transmitting information “into” the computer. A monitor, speaker, and printer all represent output devices, transmitting information “out” of the computer visually, audibly, and in a written format, respectively. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

5. An output device includes a: a. monitor. b. keyboard. c. mouse. d. touch screen. ANS: A

A monitor, speaker, and printer all represent output devices, transmitting information “out” of the computer visually, audibly, and in a written format, respectively. A keyboard, mouse, trackball, microphone, touch screen, and light pen are all input devices, transmitting information “into” the computer. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

6. The two major kinds of software include: a. operating systems and haN rdw URare. SINGTB.COM b. operating systems and software applications. c. monitor and printer. d. keyboard and mouse. ANS: B

An operating system is a type of software that governs basic operation of hardware; a software application is one that supports pharmacy tasks. Hardware uses software but is not synonymous with software. Monitors and printers are output devices. Keyboards and mice are input devices. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

7. A benefit of health information technology includes: a. confusing computer screens. b. improvement in the reimbursement processes. c. systems have to be updated frequently. d. alert fatigue. ANS: B

Improvement in the reimbursement process, as well as improved patient care, increased efficiency, and improved communication, are all benefits of health information technology. Risks of health information technology include confusing computer screens, the need to frequently update systems, and alert fatigue (when excessive drug alerts occur).

PTS: 1 8.

DIF: Cognitive Level 1: Knowledge

REF: p. 210

A risk of health information technology includes: a. improvement in the reimbursement processes. b. improved patient care. c. increased efficiency. d. alert fatigue. ANS: D

Risks of health information technology include confusing computer screens, the need to frequently update systems, and alert fatigue (when excessive drug alerts occur). Improvement in the reimbursement process, as well as improved patient care, increased efficiency, and improved communication, are all benefits of health information technology. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

9. The Joint Commission’s (TJC’s) recommendations to prevent harm when implementing

health information technology include: a. resolution of workflow issues after implementation. b. providing training after implementation. c. after taking the technology live, ensuring approval by the P&T committee. d. examination of workflow processes. ANS: D

Examination of workflow processes is one of TJC’s recommendations. Resolution of workflow issues, training, and P&T approval should all happen before implementation. PTS: 1

DIF:

CoNgniR tiveI LevG el 1:BK.nC owleMdge

U S N T

REF: p. 210

10. The Joint Commission’s (TJC’s) recommendations to prevent harm when implementing

health information technology do not include: a. only examining workflow processes for risk, not inefficiencies. b. resolution of workflow issues before implementation. c. providing training before implementation. d. before taking the technology live, ensuring approval by the P&T committee. ANS: A

Examination of workflow processes for risk and inefficiency is one of TJC’s recommendations. Resolution of workflow issues, training, and P&T approval should all happen before implementation, so these are correct. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 210

11. Pharmacy organizations included in the Pharmacist Services Advisory Coalition (PSTAC)

include all of the following except: a. Accreditation Council for Pharmacy Education. b. American Pharmacists Association. c. American Society of Health System Pharmacists. d. National Association of Chain Drug Stores. ANS: A

The American Pharmacists Association, American Society of Health System Pharmacists, and National Association of Chain Drug Stores are all part of PSTAC; the Accreditation Council for Pharmacy Education is not. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 211

12. Comparing pharmacy informatics to e-prescribing, e-prescribing is: a. used for prescription billing. b. done with written prescriptions. c. part of pharmacy informatics. d. not part of pharmacy informatics. ANS: C

E-prescribing is a subset of pharmacy informatics. Pharmacy informatics can include billing, but e-prescribing does not. The prescriptions are electronically transferred, not written. PTS: 1 REF: p. 211

DIF: Cognitive Level 2: Comprehension

13. Contrasting e-prescribing to written prescriptions, written prescriptions: a. reduce medication errors. b. do not incur a fee. c. cannot be lost. d. are easy to change. ANS: B

Written prescriptions do not incur a fee, but e-prescribing can. Written prescriptions have more medication errors, can bNe loRst, I andGareBn. otCas eMasy to change as electronic prescriptions.

U S N T

PTS: 1 REF: p. 211

DIF: Cognitive Level 2: Comprehension

14. Disadvantages of e-prescribing include: a. increased efficiency. b. a transaction fee to the pharmacy. c. reduced medication errors. d. reduced phone calls between the physician’s office and the pharmacy. ANS: B

A disadvantage of e-prescribing is that a transaction fee is incurred; increased efficiency, reduction of medication errors, and reduced phone calls between the physician’s office and the pharmacy are all advantages of e-prescribing. PTS: 1

DIF: Cognitive Level 1: Knowledge

15. The electronic health record (EHR) will: a. automate and streamline the clinician’s workflow. b. be recorded on paper forms. c. not include patient demographics. d. not include past medical history. ANS: A

REF: p. 211

The EHR automates and streamlines the clinician’s workflow. It is recorded electronically and includes such items as the patient’s demographic information, past medical history, immunizations, and laboratory data. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: pp. 211-212

16. The electronic personal health record (ePHR) can be generated by: a. physicians. b. patients. c. pharmacies. d. all of the above. ANS: D

The ePHR can be generated by physicians, patients, pharmacies, and hospitals. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 212

17. Comparing computerized physician order entry (CPOE) with e-prescribing, one finds that

CPOE: a. and e-prescribing can both be used to transfer information. b. cannot provide real-time data. c. cannot provide duplicate therapy warnings. d. cannot provide drug interaction warnings. ANS: A

Both CPOE and e-prescribing can be used to transfer information. CPOE can provide real-time data, duplicate therapy warnings, and drug interaction warnings.

N R I G B.C M

PTS: 1 REF: p. 212

U S Level N T2: Comprehension O DIF: Cognitive

18. Biometrics technologies include using retina or voice pattern recognition. The word biometric

likely comes from the: a. word biology and the unit of length, meter. b. prefix bio-, meaning life, and metric, meaning something is measured. c. prefix bi-, meaning two; the connecting vowel o; and metric, meaning length. d. word biome, meaning a biologic community, and the suffix -trics. ANS: B

Biometrics comes from bio-, meaning life, and metric, meaning something that is being measured. The other choices are either all wrong or partly wrong. PTS: 1 REF: p. 212

DIF: Cognitive Level 2: Comprehension

19. By recognizing eye retinas, voice patterns, and facial patterns, biometrics will: a. increase the level of security. b. decrease the level of security. c. not affect the level of security. d. be easy to trick or get past. ANS: A

Biometrics relies on complex, cutting-edge technologies that increase the level of security for protected health information. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 212

20. Which would most likely be a point of care? a. Patient’s workplace b. Patient’s vacation home c. Patient’s car d. Pharmacy ANS: D

A pharmacy would be the most likely point of care; however, if something happened, such as a heart attack, anyplace where health providers meet a patient would be a point of care. PTS: 1 REF: p. 212

DIF: Cognitive Level 2: Comprehension

21. All of the following are mobile systems used to provide a point of care where the patient is

found except: a. personal digital assistants (PDAs). b. tablet computers. c. desktop computers. d. computers on wheels (COWs). ANS: C

A desktop computer is a stationary device used at the point of care. All of the other devices are mobile. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 212

22. Which statement is true when comparing the Health Insurance Portability and Accountability

Act (HIPAA) with protected health information (PHI)? a. PHI requires that HIPAA remain confidential. b. HIPAA requires that PHI remain confidential. c. Prescriber order entry does not complement HIPAA. d. HIPAA provides barriers to patient access of their health records. ANS: B

HIPAA requires that health practitioners keep PHI confidential and secure. Prescriber order entry complements HIPAA, and HIPAA allows patients better access to their health records. PTS: 1 REF: p. 212

DIF: Cognitive Level 2: Comprehension

23. Documentation principles include several factors that improve the quality of the medical

record. Why is timeliness a critical component? a. Over time, practitioners may forget details of a health care event. b. It is not important because there is no limit to the number of days that may lapse between care and billing. c. It is not important because documentation can be done later when it might be more convenient.

d. Timeliness is not a documentation principle. ANS: A

Timeliness is a critical principle of documentation because important details might be lost or the order in which events occurred might become muddled. There are limits to the number of days between care and billing. Convenience is not the priority. Timeliness is a documentation principle. PTS: 1 REF: p. 213

DIF: Cognitive Level 2: Comprehension

24. The following documentation principles are correctly matched to a summary definition

except: a. completeness: minimum requirements for information. b. retrievability: format standardization for searches. c. interoperability: user allowance to examine basic information events. d. confidentiality: secrecy of the patient record to only those practitioners who need access. ANS: C

Interoperability enables practitioners to capture, share, and report information from their systems. A user allowance to examine basic information events is the definition of auditability. The other choices are correctly matched. PTS: 1 REF: pp. 212-213

DIF: Cognitive Level 2: Comprehension

25. An example of patient demogNrapR hic I infoG rmaBti. onCincMludes: U S N T O a. patient age. b. patient room number. c. patient’s medication names. d. prescription number. ANS: A

Patient age, address, phone, and gender are examples of demographic information. The other choices refer to necessary information for proper prescription processing and delivery. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 213

26. All of the following are steps in the prescription processing process except: a. verification. b. label generation. c. price inquiry. d. patient allergy profile. ANS: D

The patient allergy profile is part of the patient information; the other three choices represent steps in the prescription processing process. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 213

27. Which statement is true when contrasting the use of financial reports to distribution reports?

a. Financial reports include productivity data; distribution reports show drug usage. b. Financial reports include billing information; distribution reports include

productivity data. c. Financial reports include pharmacist intervention information; distribution reports

show drug usage. d. Financial reports include billing information; distribution reports show drug usage. ANS: D

Financial reports include billing information; distribution reports show drug usage. Financial reports do not include productivity data or pharmacist intervention information. Distribution reports do not include productivity data. PTS: 1 REF: p. 213 28.

DIF: Cognitive Level 2: Comprehension

A drug–drug interaction is correctly defined as when: a. medications may cause problems if taken together. b. drugs may cause problems with the patient’s medical condition. c. drugs may cause problems if taken with specific foods. d. a drug is identified as a drug allergy on the patient record. ANS: A

A drug–drug interaction is when medications may cause problems if taken together. A drug– disease interaction is when drugs may cause problems with the patient’s medical condition. A drug–food interaction is when drugs may cause problems if taken with specific foods. A drug–allergy interaction is identified when a patient is prescribed a drug that matchesa drug allergy in the patient record. PTS: 1

NURSINGTB.COM

DIF: Cognitive Level 1: Knowledge

REF: p. 213

29. PAR levels are critical in maintaining inventory because they: a. provide electronic information regarding costs of goods. b. affect the price of individual medications. c. identify the time to purchase more inventory. d. make inventory decisions in committee. ANS: C

PAR levels are simply a number of items that the pharmacy wishes to maintain in stock. A PAR level of three would indicate that more items should be ordered if the level falls to 2, 1, or 0. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 214

30. A disadvantage of pharmacy automation includes: a. improved efficiency and accuracy in filling prescriptions. b. ability to count and prefill containers of medication. c. the need for a minimum number of prescriptions for cost effectiveness. d. allowing time for pharmacists to provide clinical services. ANS: C

A disadvantage of pharmacy automation includes the need for a minimum number of prescriptions for cost effectiveness. The other choices are all advantages of pharmacy automation. PTS: 1

DIF: Cognitive Level 1: Knowledge

REF: p. 214