PTCB Pharmacy Technician (PTCE) — All Questions

A pharmacy's cost of goods sold for the year was $1,200,000 and its average inventory value was $100,000. What is the inventory turnover rate?

• a.0.08 times a year
• b.12 times a year✓
• c.120 times a year
• d.1 time a year

Inventory turnover is the cost of goods sold divided by the average inventory value: $1,200,000 / $100,000 = 12, so the pharmacy sells and replaces the value of its shelf stock twelve times a year. Checking the same figure another way, $100,000 of stock turned twelve times supplies $1,200,000 of goods. Dividing in the opposite direction, $100,000 / $1,200,000, gives 0.08, using one month's cost of goods, $100,000 / $100,000, gives 1, and shifting the decimal one place gives 120.

What does a perpetual inventory of Schedule II drugs give a pharmacy?

• a.A record the wholesaler keeps for the pharmacy's audits
• b.A monthly reconciliation of purchases against the DEA Form 222 file
• c.A count of the entire controlled stock taken once every two years
• d.A running balance updated with every transaction✓

A perpetual inventory is a live running balance: every receipt adds, every dispensing subtracts, and the recorded quantity of a Schedule II drug can be compared with the shelf at any moment. The biennial count is the closest wrong answer, because federal law does require a complete controlled-substance inventory every two years, but that is a snapshot taken once every two years and it cannot show a loss in the week it happens. Reconciling against the Form 222 file covers only what was ordered, and the wholesaler's records document what was shipped rather than what left the pharmacy.

A stock bottle is labelled EXP 09/2026, with no day shown. What does that date mean for dispensing?

• a.Once the bottle is opened the printed date no longer applies and a six-month limit takes over
• b.The product may be dispensed through the last day of September 2026✓
• c.The product should have been pulled at the end of August 2026
• d.The product may be dispensed only through 1 September 2026

A manufacturer's expiration date printed as a month and a year runs through the last day of that month, so this bottle may be used up to and including 30 September 2026. Reading it as the first of the month is the closest wrong answer, and it errs on the safe side, but it discards a month of usable stock on every bottle in the pharmacy. An unopened manufacturer's container stored as labelled keeps its printed date; the shorter dating that starts when a container is opened belongs to products the pharmacy repackages or compounds.

A pharmacy sends expired Schedule II tablets to a DEA-registered reverse distributor. What documents that transfer of the drugs?

• a.A DEA Form 41 completed by the pharmacy when the courier collects them
• b.A signed inventory sheet kept in the pharmacy for two years
• c.A DEA Form 222 issued to the pharmacy by the reverse distributor✓
• d.The credit memo the reverse distributor returns

A transfer of a Schedule II substance moves on a DEA Form 222, executed by the registrant receiving the drugs, and that applies to expired stock going to a reverse distributor just as it does to a purchase. Form 41 is the closest wrong answer, because it is the controlled-substance disposal record, but it documents the actual destruction and is completed by the registrant who destroys the drugs rather than by the pharmacy handing them over. A credit memo and an internal inventory sheet are business records with no standing under the controlled-substance rules.

A technician repackages tablets from a bulk bottle into unit-dose blisters for a hospital's cabinets. Besides the blister labels, what must the repackaging record capture?

• a.The name of every patient who later receives one of the repackaged doses
• b.The source lot number and expiration date and the run's control number
• c.The drug name, strength and the number of packages produced
• d.The wholesaler's invoice number for the bulk bottle✓

A repackaging record has to make it possible to walk any unit-dose package back to the container it came from, so it captures the manufacturer's lot number and expiration date of the source bottle together with the internal control number placed on the run. Recording drug, strength and count is the closest wrong answer, because those details do belong in the log, but without the source lot number a recall cannot be traced and every package from that run has to be destroyed. Patient names belong to dispensing records, and an invoice number tracks a purchase rather than a package on a cart.

A hospital outpatient pharmacy fills prescriptions from 340B-purchased inventory. What has to be true before a given prescription may be filled from that stock?

• a.The patient must be enrolled in Medicaid on the day of the fill
• b.The prescription must be for a generic product with an AB rating
• c.The patient must be an eligible patient of the covered entity✓
• d.The patient must be uninsured, or below a stated income level

340B pricing follows the patient relationship: the drug has to go to a patient of the covered entity on a prescription arising from care the entity provided, and diverting that inventory to anyone else is exactly what program audits look for. Income or insurance status is the closest wrong answer, because 340B entities do serve low-income populations, but the discount is conditioned on the patient relationship and not on the patient's means. Medicaid enrolment matters only for the separate rule that stops a manufacturer paying a rebate on a drug already sold at the 340B price, and the program covers brand products as well as generics.

A mail-order pharmacy located in one state ships maintenance prescriptions to patients in thirty others. What does shipping into those states require?

• a.A nonresident pharmacy license in each state served✓
• b.Nothing beyond the license held in the pharmacy's home state
• c.Registration with the FDA as an out-of-state dispenser of drugs
• d.A staffed pharmacy location inside every state served

Pharmacy licensure follows the patient, so a mail-order operation needs a nonresident or out-of-state pharmacy license from the board of every state it ships into, on top of the license where it physically sits. Relying on the home-state license is the common misreading, and it is precisely what boards pursue when an unlicensed pharmacy ships across a border. The FDA registers manufacturers, repackagers and outsourcing facilities rather than dispensing pharmacies, and no state makes a physical location a condition of shipping in.

Electronic prescribing takes the prescriber's handwriting out of the process. Which new error should the technician watch for when an e-prescription arrives?

• a.A drug or strength picked from the wrong line of the prescriber's drop-down list✓
• b.The same prescription transmitted twice, so the patient is set up with a duplicate supply
• c.A decimal point misread because the dose was written with a trailing zero
• d.A transcription slip made as the pharmacy re-keys the directions

The characteristic e-prescribing error is a selection error: the prescriber clicks the line above or below the intended product and the pharmacy receives a clean, legible prescription for the wrong drug or the wrong strength, with nothing on its face to signal the mistake. Duplicate transmission is the closest wrong answer, and it does happen, but a duplicate arrives as two identical orders and is caught by the system's duplicate-therapy and refill-too-soon edits. Trailing-zero misreads and re-keying slips belong to handwritten and telephoned orders, which an e-prescription bypasses.

A non-controlled prescription is written for #30 with the note 'refill prn'. In most states, how should the refills be entered?

• a.As refills for two years, the federal limit for non-controlled drugs
• b.As refills sufficient to cover one year from the date written✓
• c.As unlimited refills until the prescriber cancels the prescription
• d.As five refills within six months of the date written

A note to refill as needed is not a license for perpetual refills: in most states a non-controlled prescription may be refilled for one year from the date it was written, so the entry is capped at that horizon, commonly eleven refills on a thirty-day quantity. Unlimited refills is the closest wrong answer, because the prescriber did write prn, but the prescription itself expires under state law whatever the note says. Five refills in six months is the federal limit for Schedules III and IV, and there is no federal two-year refill limit for non-controlled drugs.

Cefdinir 125 mg/5 mL oral suspension is prescribed as 3.75 mL by mouth twice daily for 10 days. What quantity should be dispensed?

• a.112.5 mL
• b.37.5 mL
• c.75 mL✓
• d.7.5 mL

Each day the patient takes 3.75 mL x 2 = 7.5 mL, and over 10 days that is 7.5 mL x 10 = 75 mL. Checking the same figure another way, twice daily for 10 days is 20 doses in all, and 3.75 mL x 20 = 75 mL. Counting one dose a day gives 37.5 mL and counting three a day gives 112.5 mL, while 7.5 mL is a single day's total rather than the quantity for the course.

Warfarin 5 mg tablets are prescribed as: take 1 tablet by mouth on Monday, Wednesday and Friday, and one-half tablet by mouth on each of the other days. Ninety tablets are dispensed. What is the day supply?

• a.90 days
• b.126 days✓
• c.18 days
• d.60 days

One week uses 3 x 1 tablet + 4 x 0.5 tablet = 3 + 2 = 5 tablets, so 90 tablets last 90 / 5 = 18 weeks, and 18 x 7 = 126 days. Checking the same figure another way, 5 tablets per 7 days is 0.714 tablets a day, and 90 / 0.714 = 126 days. Averaging the two dose sizes into 1.5 tablets a day gives 90 / 1.5 = 60 days, counting a whole tablet every day gives 90 days, and 18 is the number of weeks left unconverted.

A wholesaler delivery includes one bottle that expires in six weeks, of a drug the pharmacy dispenses about twice a year. What should the technician do with it?

• a.Shelve it behind the existing stock, which was received earlier
• b.Shelve it in front of the existing stock so it is used first
• c.Return the short-dated bottle to the wholesaler✓
• d.Move it to the quarantine shelf until the date passes

Wholesalers take short-dated stock back within a stated window, and returning it now recovers the money while that credit is still available; at roughly two dispensings a year this bottle will expire untouched on the shelf. Shelving it in front is the closest wrong answer, because first-expired-first-out is the correct rotation rule, but rotation only helps when the product will actually move before the date, which it will not here. Shelving by receipt date ignores expiration altogether, and holding it in quarantine until it expires turns a returnable bottle into waste.

A plan's contract says it pays the lower of the contracted rate or the pharmacy's usual and customary price. What is the usual and customary price?

• a.The average wholesale price less the plan's contracted discount
• b.The maximum allowable cost the plan sets for a multi-source generic
• c.The price a cash customer pays for that prescription✓
• d.The pharmacy's acquisition cost

The usual and customary price is what the pharmacy would charge a cash-paying customer walking in for that same prescription, and the plan pays that figure whenever it is lower than the contracted rate. Maximum allowable cost is the closest wrong answer, because it also caps what a plan will pay, but it is a ceiling the plan sets for a multi-source generic rather than a price the pharmacy sets. Acquisition cost is what the pharmacy paid for the drug and average wholesale price is a published list figure, and a cash customer is charged neither of them.

A prescription reads: take 1 tablet by mouth every morning and 2 tablets by mouth every evening. Ninety tablets are dispensed. What is the day supply?

• a.45 days
• b.30 days✓
• c.60 days
• d.22 days

The patient takes 1 + 2 = 3 tablets a day, so 90 tablets divided by 3 tablets per day equals 30 days. The 45-day answer counts only two tablets a day, 60 days counts only one and a half, and 22 days would require four tablets a day.

A sig reads: take 2 teaspoonfuls by mouth three times daily for 7 days. Using 5 mL per teaspoonful, what quantity should be dispensed?

• a.70 mL
• b.210 mL✓
• c.105 mL
• d.420 mL

Two teaspoonfuls is 10 mL, three times daily is 30 mL a day, and 30 mL x 7 days = 210 mL. The 70 mL answer uses one dose a day, 105 mL treats the dose as one teaspoonful, and 420 mL doubles the correct number of days.

A technician blends 100 g of a 1% ointment with 300 g of a 5% ointment. What is the percentage strength of the finished 400 g mixture?

• a.6%
• b.3%
• c.2.5%
• d.4%✓

The 100 g of 1% ointment contributes 1 g of drug and the 300 g of 5% contributes 15 g, so the mixture holds 16 g of drug in 400 g, and 16 divided by 400 is 0.04, or 4%. The 3% answer averages the two percentages without weighting them, 2.5% is the simple midpoint of 1 and 5 halved again, and 6% is higher than either starting ointment, which is impossible when the two are blended.

A 1 g vial of powdered antibiotic is to be reconstituted to a final concentration of 100 mg/mL. The powder occupies 0.7 mL. How much diluent should be added?

• a.10 mL
• b.0.7 mL
• c.10.7 mL
• d.9.3 mL✓

A 1 g (1,000 mg) vial at 100 mg/mL needs a final volume of 1,000 divided by 100, which is 10 mL. The powder already occupies 0.7 mL, so 10 - 0.7 = 9.3 mL of diluent is added. Adding 10 mL would give a final volume of 10.7 mL and a weaker solution, 0.7 mL is only the powder volume, and 10.7 mL ignores displacement in the wrong direction.

A bag contains 25,000 units of heparin in 500 mL of diluent and the pump is set at 14 mL/hr. How many units per hour is the patient receiving?

• a.700 units/hr✓
• b.350 units/hr
• c.1,400 units/hr
• d.500 units/hr

The concentration is 25,000 units divided by 500 mL, which is 50 units/mL, and 50 units/mL x 14 mL/hr = 700 units/hr. The 350 answer uses 25 units/mL, 1,400 doubles the rate, and 500 simply repeats the bag volume as if it were a dose.

A continuous infusion runs at 125 mL/hr for a full 24 hours and is supplied in 1,000 mL bags. How many bags are needed for the day?

• a.2 bags
• b.2.5 bags
• c.4 bags
• d.3 bags✓

125 mL/hr x 24 hr = 3,000 mL, which is exactly three 1,000 mL bags. Two bags would run out after 16 hours, a half bag cannot be hung as a separate unit, and four bags would supply 4,000 mL, a full litre more than the order calls for.

A compounding record calls for capsules containing 250 mg of active drug each. How many capsules can be filled from 15 g of the drug?

• a.15 capsules
• b.60 capsules✓
• c.150 capsules
• d.40 capsules

15 g is 15,000 mg, and 15,000 divided by 250 mg per capsule equals 60 capsules. The 15 answer confuses grams with capsules, 40 would apply to a 375 mg capsule, and 150 would apply to a 100 mg capsule.

A prescriber orders 62.5 mg once daily for 30 days. The pharmacy stocks 25 mg scored tablets. What quantity should be dispensed?

• a.90 tablets
• b.60 tablets
• c.75 tablets✓
• d.30 tablets

62.5 mg divided by 25 mg per tablet is 2.5 tablets per dose, and 2.5 x 30 days = 75 tablets. The 60-tablet answer assumes two tablets a day, 90 assumes three, and 30 assumes one.

A pharmacy buys a product for $60.00 and sells it for $80.00. What is the gross margin expressed as a percentage of the selling price?

• a.25%✓
• b.33.3%
• c.20%
• d.80%

Gross profit is $80.00 - $60.00 = $20.00, and as a share of the selling price that is 20 divided by 80, or 25%. The 20% answer confuses the dollar profit with a percentage, 33.3% is the markup on cost rather than the margin on price, and 80% simply repeats the selling price.

A prescription costs the pharmacy $14.60 to acquire and $3.20 to dispense. The plan reimburses $21.40 in total. What is the net profit on this prescription?

• a.$3.60✓
• b.$6.80
• c.$17.80
• d.$10.00

Total cost is $14.60 + $3.20 = $17.80, and $21.40 - $17.80 = $3.60 net profit. The $6.80 answer is the gross profit before the dispensing cost is subtracted, $17.80 is the total cost itself, and $10.00 corresponds to no step in the calculation.

A fast-moving product has a par level of 6 bottles. The shelf holds 2 bottles and 1 more is already on order from the wholesaler. How many bottles should be added to today's order?

• a.6 bottles
• b.5 bottles
• c.3 bottles✓
• d.2 bottles

The par level counts everything the pharmacy will have on hand, so 6 - 2 on the shelf - 1 already on order = 3 bottles. Ordering 6 ignores both the stock and the pending order, 5 counts the shelf stock but forgets the order in transit, and 2 would leave the pharmacy one bottle short of par.

A prescription calls for 8 fluid ounces of a suspension. Using 30 mL per fluid ounce, how many millilitres should be dispensed?

• a.240 mL (8 x 30 mL)✓
• b.120 mL
• c.180 mL
• d.480 mL

8 fluid ounces x 30 mL per ounce = 240 mL. The 120 mL answer uses 15 mL per ounce, 180 mL would be 6 ounces, and 480 mL doubles the requested volume.

How many milligrams of drug are contained in 2 mL of a 1:200 solution?

• a.2 mg
• b.5 mg
• c.20 mg
• d.10 mg✓

A 1:200 solution holds 1 g in 200 mL, which is 1,000 mg in 200 mL, or 5 mg/mL; 2 mL therefore contains 10 mg. The 2 mg answer repeats the volume, 5 mg is the amount in a single millilitre, and 20 mg would require a 1:100 solution.

A cash-paying customer presents a discount card that takes 35% off the pharmacy's usual price of $84.00. What does the customer pay?

• a.$29.40
• b.$60.90
• c.$49.00
• d.$54.60✓

The discount is $84.00 x 0.35 = $29.40, so the customer pays $84.00 - $29.40 = $54.60. The $29.40 answer is the discount itself rather than the price paid, $49.00 would be a 41.7% discount, and $60.90 corresponds to a 27.5% discount.

An order is entered from the sig 'i supp PR qhs prn constipation'. Which label directions are correct?

• a.Insert one suppository rectally at bedtime as needed.✓
• b.Insert one suppository vaginally every hour as needed for constipation.
• c.Insert one suppository rectally every morning as needed for constipation.
• d.Take one tablet by mouth at bedtime as needed for constipation.

PR is per rectum, qhs is at bedtime and prn is as needed, so one suppository is inserted rectally at bedtime as needed. An oral tablet is the wrong route and form, PV would be the vaginal route, and qhs means at bedtime rather than every hour or every morning.

An eye drop is entered from the sig 'i gtt OD bid'. What should the label tell the patient to do?

• a.Instill 1 drop into the right eye twice daily.✓
• b.Instill 1 drop into the left eye twice daily.
• c.Instill 1 drop into each eye once daily.
• d.Instill 1 drop into the right ear twice daily.

OD is oculus dexter, the right eye, gtt is a drop and bid is twice daily. OS would be the left eye, OU would be each eye, and AD would be the right ear. ISMP asks that these abbreviations be spelled out precisely because OD and AD have been read for one another.

Nitroglycerin is entered from the sig 'i tab SL q5min prn chest pain, max 3 doses'. Which label directions are correct?

• a.Swallow one tablet every 5 minutes as needed for chest pain, up to 3 tablets.
• b.Place one tablet under the tongue every 5 minutes as needed for chest pain, no more than 3 doses.✓
• c.Place one tablet under the tongue every 5 hours as needed for chest pain, up to 3 tablets.
• d.Chew one tablet every 5 minutes as needed for chest pain, with no maximum.

SL is sublingual, so the tablet is placed under the tongue, q5min is every five minutes, and the maximum of three doses has to be carried onto the label. Swallowing or chewing changes the route, every 5 hours misreads the frequency, and dropping the maximum removes the limit that keeps the patient from taking more than the prescriber allowed.

A claim is rejected with the message 'M/I cardholder ID'. What does that reject mean and how is it resolved?

• a.The member ID is missing or invalid; re-enter it.✓
• b.The drug is not covered; request a formulary alternative.
• c.The prescriber is not enrolled; obtain a new prescription.
• d.The quantity exceeds the plan's limit; reduce the day supply and re-submit.

M/I stands for missing or invalid, so the cardholder ID transmitted does not match the plan's records and the number is checked against the card and re-entered. A non-covered drug, an unenrolled prescriber and a quantity limit each produce their own distinct reject messages.

A patient has coverage under two prescription plans. How should the claim be processed?

• a.Split the quantity and bill half to each plan.
• b.Bill primary first, then the secondary plan.✓
• c.Bill both plans for the full amount at the same time.
• d.Bill whichever plan leaves the lower copay and ignore the other one entirely.

Coordination of benefits means the primary plan adjudicates first and the balance it leaves is then submitted to the secondary plan. Splitting the quantity misrepresents what was dispensed, choosing by copay ignores the order of liability the plans have agreed, and billing both in full at once would claim the same cost twice.

An electronic prescription arrives with a quantity of 30 tablets but directions that read 'take 1 tablet by mouth daily for 90 days'. What should the technician do?

• a.Dispense 30 tablets and enter a 90-day supply on the claim.
• b.Hold it for the pharmacist to resolve with the prescriber.✓
• c.Dispense 90 tablets, because the written directions state the longer treatment period.
• d.Enter whichever figure the insurance plan will pay for.

The quantity and the days supply contradict each other, so the prescription is not filled until the prescriber clarifies which is intended; the pharmacist makes that contact. Entering a 90-day supply for 30 tablets falsifies the claim, dispensing 90 tablets exceeds the written quantity, and choosing by what the plan will pay lets the claim rather than the prescriber decide the therapy.

A patient brings in a prescription for a product the pharmacy does not keep in stock. What is the appropriate handling?

• a.Tell the patient when the product can be ordered in, and offer to transfer the prescription.✓
• b.Return the prescription and tell the patient to look elsewhere.
• c.Substitute a similar product from another class and tell the patient afterwards.
• d.Dispense a partial quantity of a different strength to cover the gap.

The patient needs a realistic answer about timing and a choice, so the technician gives the expected arrival and offers a transfer if waiting is not workable. Substituting across drug classes is a prescribing decision no one in the pharmacy may make unilaterally, simply returning the prescription abandons the patient, and dispensing a different strength changes the dose without authorisation.