PTCB Pharmacy Technician (PTCE) — All Questions

A patient taking lisinopril calls to report sudden swelling of the lips and tongue. What should the technician do?

• a.Suggest an over-the-counter antihistamine and a follow-up call tomorrow.
• b.Refer the call to the pharmacist immediately; this may be angioedema.✓
• c.Tell the patient this is the expected dry cough and will settle on its own.
• d.Advise the patient to double the next dose to get past the reaction.

Angioedema is a recognised and potentially airway-threatening reaction to ACE inhibitors, and lisinopril labeling contraindicates further use in a patient with a history of it, so the call goes to the pharmacist at once. Offering an antihistamine delays urgent care, the dry cough is a different and far milder ACE inhibitor effect, and no technician may tell a patient to change a dose.

Which laboratory test is used to monitor a patient stabilised on warfarin?

• a.haemoglobin A1C
• b.serum creatinine
• c.INR (international normalised ratio)✓
• d.serum potassium

Warfarin therapy is followed by the INR, a standardised expression of prothrombin time. Serum creatinine tracks kidney function, haemoglobin A1C reflects average blood glucose over about three months, and potassium is watched with diuretics and ACE inhibitors, not with warfarin dosing.

A diabetic patient asks which test shows how her blood sugar has run over the past few months. Which test is she describing?

• a.a fasting blood glucose drawn in the morning
• b.haemoglobin A1C✓
• c.a fingerstick glucose reading taken at home
• d.a lipid panel

Haemoglobin A1C reflects average blood glucose over roughly the preceding three months, which is why it is checked a few times a year rather than daily. A fasting glucose and a fingerstick each capture a single moment, and a lipid panel measures cholesterol and triglycerides rather than glucose.

A patient's profile shows furosemide 40 mg daily and potassium chloride 20 mEq daily. Why are the two commonly prescribed together?

• a.Potassium makes furosemide work faster.
• b.Potassium prevents the dry cough furosemide can cause.
• c.The two drugs are chemically incompatible and simply cancel each other out.
• d.Furosemide increases potassium loss.✓

Loop diuretics increase urinary excretion of potassium, so a potassium supplement is often added to replace what is lost. Potassium does not speed the diuretic up, the dry cough is an ACE inhibitor effect rather than a furosemide effect, and the pair is a deliberate combination rather than an incompatibility.

A customer has heartburn right now and wants the fastest over-the-counter relief. Which product acts the most quickly?

• a.an antacid such as calcium carbonate, which neutralises acid already in the stomach✓
• b.omeprazole delayed-release tablets, whose own labeling says it may take 1 to 4 days for full effect
• c.a bulk-forming laxative
• d.an oral rehydration solution

An antacid neutralises stomach acid on contact and relieves symptoms within minutes. The over-the-counter omeprazole Drug Facts label states it is 'not intended for immediate relief of heartburn' and 'may take 1 to 4 days for full effect', a bulk-forming laxative treats constipation, and an oral rehydration solution replaces fluid and electrolytes.

A sig reads: take one tablespoonful by mouth twice daily for 10 days. Using 15 mL per tablespoonful, what quantity should be dispensed?

• a.150 mL
• b.300 mL✓
• c.200 mL
• d.450 mL

One tablespoonful is 15 mL, so each day the patient takes 15 mL x 2 = 30 mL, and 30 mL x 10 days = 300 mL. The 150 mL answer counts only one dose a day, 200 mL would come from treating the tablespoonful as 10 mL, and 450 mL would be three doses a day.

How many grams of hydrocortisone are contained in 60 g of a 2.5% (w/w) hydrocortisone cream?

• a.0.15 g
• b.0.25 g
• c.1.5 g✓
• d.15 g

A 2.5% w/w cream contains 2.5 g of drug in every 100 g of cream, so 60 g x 0.025 = 1.5 g. The 0.15 g answer is off by a factor of ten, 0.25 g ignores the 60 g weight altogether, and 15 g would require a 25% cream.

A solution is labelled 0.02% (w/v). Expressed as a ratio strength, what is that concentration?

• a.1:200
• b.1:5,000✓
• c.1:500
• d.1:2,000

A 0.02% w/v solution holds 0.02 g in 100 mL. Scaling to 1 g gives 100 mL x (1 / 0.02) = 5,000 mL, so the ratio strength is 1:5,000. A 1:200 ratio is 0.5%, 1:2,000 is 0.05%, and 1:500 is 0.2%.

Glycerin has a specific gravity of 1.25. What is the weight of 60 mL of glycerin?

• a.48 g
• b.75 g✓
• c.60 g
• d.125 g

Specific gravity 1.25 means each millilitre weighs 1.25 g, so 60 mL x 1.25 g/mL = 75 g. The 48 g answer divides instead of multiplying, 60 g assumes the liquid weighs the same as water, and 125 g simply repeats the specific gravity figure.

A pharmacy refrigerator thermometer reads 41 degrees Fahrenheit. What is that temperature in degrees Celsius?

• a.3 degrees Celsius
• b.10 degrees Celsius
• c.9 degrees Celsius
• d.5 degrees Celsius✓

Celsius equals (Fahrenheit minus 32) multiplied by 5/9, so (41 - 32) x 5/9 = 9 x 5/9 = 5 degrees Celsius. The other three answers come from subtracting before the wrong multiplier, from forgetting to subtract 32, or from halving the difference instead of taking five ninths.