PTCB Pharmacy Technician (PTCE) — All Questions

Coreg is the brand name for which generic medication?

• a.captopril
• b.clonidine
• c.chlorthalidone
• d.carvedilol✓

Coreg is carvedilol, a beta blocker that also blocks alpha-1 receptors. Captopril is an ACE inhibitor (Capoten), clonidine is a central alpha-2 agonist (Catapres), and chlorthalidone is a thiazide-type diuretic. All four names start with the same letter, which is exactly why the selection has to be made from the label, not from memory of the first syllable.

A prescription is written for Cozaar 50 mg. Which generic name should appear on the dispensing label?

• a.loperamide hydrochloride
• b.lisinopril
• c.lovastatin
• d.losartan potassium✓

Cozaar is losartan potassium, an angiotensin II receptor blocker. Lisinopril is an ACE inhibitor sold as Prinivil and Zestril, lovastatin is a statin (Mevacor), and loperamide is an antidiarrheal (Imodium). None of the other three is marketed as Cozaar.

Esomeprazole is dispensed under which brand name?

• a.Nexium✓
• b.Prevacid
• c.Prilosec
• d.Protonix

Esomeprazole is Nexium. Protonix is pantoprazole, Prevacid is lansoprazole and Prilosec is omeprazole. All four are proton pump inhibitors, so the class is the same and only the individual molecule tells them apart.

Toprol-XL contains which salt of metoprolol?

• a.metoprolol succinate✓
• b.metoprolol tartrate
• c.metoprolol fumarate dihydrate
• d.metoprolol maleate

Toprol-XL is metoprolol succinate, the extended-release salt given once daily. Metoprolol tartrate is the immediate-release salt sold as Lopressor and usually given twice daily; fumarate and maleate salts of metoprolol are not marketed in the United States. Substituting tartrate for succinate changes the release profile, so the salt has to match the prescription.

Rivaroxaban (Xarelto) belongs to which drug class?

• a.vitamin K antagonist
• b.direct factor Xa inhibitor✓
• c.antiplatelet agent
• d.low-molecular-weight heparin

Rivaroxaban is an oral direct factor Xa inhibitor. Warfarin is the vitamin K antagonist, enoxaparin is the low-molecular-weight heparin given by injection, and clopidogrel and aspirin are antiplatelet agents that act on platelets rather than on a clotting factor.

Diflucan is the brand name of which antifungal medication?

• a.nystatin
• b.griseofulvin
• c.fluconazole✓
• d.terbinafine

Diflucan is fluconazole, an oral azole antifungal. Nystatin is dispensed as an oral suspension or topical product and is not sold as Diflucan, griseofulvin is an older antifungal used for hair and nail infections, and terbinafine is Lamisil.

Valtrex is the brand name for which generic drug?

• a.vancomycin
• b.valsartan
• c.valproic acid
• d.valacyclovir✓

Valtrex is valacyclovir, an oral antiviral for herpes simplex and herpes zoster. Valsartan is an angiotensin II receptor blocker (Diovan), valproic acid is an anticonvulsant, and vancomycin is an antibiotic. The first three letters are shared, so the full name on the label has to be read.

Bactrim DS contains which two active ingredients?

• a.amoxicillin and clavulanate potassium
• b.erythromycin and sulfisoxazole
• c.ampicillin and sulbactam
• d.sulfamethoxazole and trimethoprim✓

Bactrim is a fixed combination of sulfamethoxazole and trimethoprim. Amoxicillin with clavulanate is Augmentin, ampicillin with sulbactam is the injectable Unasyn, and erythromycin with sulfisoxazole is a separate pediatric product. Only the sulfamethoxazole/trimethoprim pair is Bactrim.

Augmentin 875/125 tablets contain amoxicillin together with which second ingredient?

• a.clavulanate potassium✓
• b.tazobactam
• c.sulbactam, a beta-lactamase inhibitor
• d.probenecid

Augmentin is amoxicillin with clavulanate potassium, a beta-lactamase inhibitor. Sulbactam is paired with ampicillin and tazobactam with piperacillin, both injectable products, and probenecid is a uricosuric that was once combined with penicillin but is not part of Augmentin.

Macrobid (nitrofurantoin monohydrate/macrocrystals) capsules are dispensed for a urinary tract infection. Which administration instruction belongs on the label?

• a.Take on an empty stomach one hour before meals.
• b.Take with a full glass of water and remain upright for 30 minutes.
• c.Take with food to improve absorption.✓
• d.Take at bedtime only, separated from all other medicines.

The Macrobid labeling directs that the capsules be taken with food, which improves both absorption and gastrointestinal tolerance. The empty-stomach instruction belongs to drugs such as levothyroxine, the upright-for-30-minutes instruction belongs to oral bisphosphonates, and there is no requirement to restrict nitrofurantoin to bedtime or to separate it from all other medicines.

Generic names ending in the stem '-pril', such as enalapril and ramipril, identify which drug class?

• a.angiotensin II receptor blockers such as losartan
• b.beta blockers
• c.calcium channel blockers
• d.angiotensin-converting enzyme inhibitors✓

The '-pril' stem marks angiotensin-converting enzyme (ACE) inhibitors. Angiotensin II receptor blockers carry the '-sartan' stem, calcium channel blockers of the dihydropyridine type end in '-dipine', and beta blockers end in '-olol'.

A prescription arrives for rabeprazole. The '-prazole' stem tells the technician the drug is which type of agent?

• a.a proton pump inhibitor✓
• b.a histamine-2 receptor antagonist
• c.an antacid
• d.a prokinetic agent

The '-prazole' stem identifies proton pump inhibitors such as omeprazole, pantoprazole and rabeprazole. Histamine-2 blockers carry the '-tidine' stem, antacids are salts such as calcium carbonate and have no stem, and metoclopramide is the common prokinetic and shares neither stem.

A generic name ending in '-mab', such as adalimumab, tells the technician the product is what kind of molecule?

• a.a small-molecule enzyme inhibitor
• b.a synthetic corticosteroid
• c.a monoclonal antibody✓
• d.an inhaled bronchodilator

The '-mab' stem is reserved for monoclonal antibodies, which are large protein biologics. Small-molecule enzyme inhibitors carry stems such as '-statin' or '-prazole', corticosteroid generic names usually end in '-sone' or '-onide', and inhaled bronchodilators end in '-terol' or '-tropium'.

Minocycline and doxycycline share the '-cycline' stem. Which antibiotic class does that stem identify?

• a.macrolides
• b.tetracyclines✓
• c.aminoglycosides
• d.cephalosporins

The '-cycline' stem identifies the tetracyclines. Macrolides end in '-thromycin', cephalosporin generic names begin with 'cef-' or 'ceph-', and aminoglycosides end in '-micin' or '-mycin' as in gentamicin and tobramycin.

Sitagliptin (Januvia) is an oral antidiabetic agent of which class?

• a.second-generation sulfonylurea secretagogue
• b.dipeptidyl peptidase-4 inhibitor✓
• c.biguanide
• d.thiazolidinedione

Sitagliptin is a DPP-4 inhibitor; the '-gliptin' stem names the class. Sulfonylureas are glipizide and glyburide, the only biguanide in use is metformin, and pioglitazone is the thiazolidinedione.

Empagliflozin (Jardiance) works by which mechanism?

• a.it reduces hepatic glucose production
• b.it stimulates the pancreatic beta cells to release more insulin
• c.it blocks SGLT2 in the kidney✓
• d.it slows carbohydrate absorption in the gut

Empagliflozin is an SGLT2 inhibitor, so glucose is lost in the urine rather than reabsorbed by the kidney. Stimulating insulin release describes the sulfonylureas, reducing hepatic glucose production describes metformin, and slowing carbohydrate absorption describes acarbose.

Carbidopa/levodopa (Sinemet) is prescribed for which condition?

• a.Alzheimer's disease
• b.multiple sclerosis
• c.benign essential tremor
• d.Parkinson's disease✓

Carbidopa/levodopa replaces dopamine in Parkinson's disease; carbidopa keeps levodopa from being broken down before it reaches the brain. Donepezil and memantine are used in Alzheimer's disease, disease-modifying injectables and infusions are used in multiple sclerosis, and propranolol and primidone are typical for essential tremor.

Donepezil (Aricept) is most commonly prescribed for which condition?

• a.Alzheimer's dementia✓
• b.generalized anxiety disorder
• c.major depressive disorder
• d.attention deficit hyperactivity disorder

Donepezil is a cholinesterase inhibitor used in dementia of the Alzheimer's type. Antidepressants such as sertraline treat major depression, benzodiazepines and SSRIs are used in generalized anxiety, and stimulants such as methylphenidate are used in ADHD.

Levetiracetam (Keppra) is classified as which type of medication?

• a.a muscle relaxant
• b.an antipsychotic
• c.an antiepileptic drug✓
• d.a proton pump inhibitor

Levetiracetam is an antiepileptic used to control seizures. Antipsychotics include quetiapine and risperidone, muscle relaxants include cyclobenzaprine and methocarbamol, and proton pump inhibitors end in '-prazole'.

Dilantin is the brand name for which generic drug?

• a.phenytoin✓
• b.diltiazem
• c.digoxin
• d.diphenhydramine

Dilantin is phenytoin, an antiepileptic with a narrow therapeutic index. Diltiazem is a calcium channel blocker sold as Cardizem, digoxin is a cardiac glycoside sold as Lanoxin, and diphenhydramine is the antihistamine in Benadryl.

A patient with COPD is dispensed tiotropium (Spiriva) and asks whether it can be used when she suddenly becomes short of breath. What is correct?

• a.It may be used for sudden shortness of breath as long as the daily dose has not been taken yet.
• b.It works within seconds, so it is the preferred product for an attack.
• c.It should be stopped whenever a rescue inhaler is prescribed.
• d.It is a once-daily maintenance bronchodilator and is not indicated for relief of acute bronchospasm.✓

The tiotropium labeling states plainly that the product is a once-daily maintenance treatment and is not indicated for the relief of acute bronchospasm; a rapid-acting beta-2 agonist such as albuterol is used for an attack. It does not act within seconds, it is not made safe for acute use by skipping the daily dose, and it is continued, not stopped, when a rescue inhaler is added.

Metformin-containing products carry a boxed warning about which risk?

• a.severe neutropenia
• b.lactic acidosis✓
• c.tendon rupture
• d.QT prolongation

The metformin boxed warning is titled 'WARNING: LACTIC ACIDOSIS' and describes postmarketing cases that resulted in death. Severe neutropenia is the boxed warning for clozapine, QT prolongation is a labeled concern for drugs such as amiodarone, and tendon rupture is part of the fluoroquinolone boxed warning.

An epinephrine auto-injector is dispensed to a patient with a severe food allergy. Which storage instruction is correct?

• a.Keep it in the refrigerator between 2 and 8 degrees Celsius with the other injectable products.
• b.Store it in the freezer and thaw before use.
• c.Store at room temperature; do not refrigerate.✓
• d.Keep it in the car's glove box so it is always available.

The auto-injector labeling directs storage at 20 to 25 degrees Celsius in the carrier tube that protects it from light, and states 'Do not refrigerate'. Refrigeration and freezing are both excluded by that instruction, and a glove box exposes the device to extreme heat and cold, which the labeling specifically warns against.

A patient asks how long an insulin glargine (Lantus) vial may be used once it has been opened and kept at room temperature below 30 degrees Celsius. What does the labeling say?

• a.7 days, after which any insulin left in the vial must be returned to the refrigerator
• b.until the expiration date printed on the vial
• c.90 days from the date it was first punctured
• d.28 days, after which the vial is discarded even if insulin remains✓

The Lantus instructions for use state that an in-use vial stored in the refrigerator or at room temperature below 30 degrees Celsius is used for up to 28 days and then thrown away even if insulin is left in it. The printed expiration date governs unopened vials kept refrigerated, not in-use vials, and neither 90 days nor 7 days appears anywhere in that labeling.

Clozapine is dispensed under a shared REMS program. What must be documented before each dispensing?

• a.a current absolute neutrophil count✓
• b.the patient's most recent blood pressure reading
• c.a signed patient-prescriber agreement renewed at every anniversary of therapy
• d.a negative pregnancy test within the last seven days

Clozapine carries a boxed warning for severe neutropenia and its REMS is built around absolute neutrophil count monitoring, so a current ANC must be on file before the prescription is released. Pregnancy testing every seven days belongs to the isotretinoin iPLEDGE program, blood pressure is not a clozapine REMS requirement, and an annually renewed agreement is not what governs each individual fill.

Isotretinoin capsules may only be dispensed by a pharmacy that is enrolled and activated in which program?

• a.the iPLEDGE REMS✓
• b.the Opioid Analgesic REMS
• c.the Clozapine REMS
• d.the Vaccines For Children program

Because of the risk of severe birth defects, isotretinoin is marketed only under the iPLEDGE restricted distribution program, and the labeling states that the capsules must be dispensed by a pharmacy enrolled and activated with iPLEDGE. The Clozapine REMS covers neutropenia monitoring, the Opioid Analgesic REMS is an education-based program with no pharmacy activation requirement of this kind, and Vaccines For Children is a federal vaccine supply program rather than a REMS.

Which patient direction belongs on a prescription for a rectal suppository?

• a.Dissolve one suppository in warm water and drink the solution.
• b.Unwrap and insert one suppository into the rectum.✓
• c.Swallow one suppository whole with a full glass of water.
• d.Place one suppository under the tongue and allow it to dissolve.

A suppository is unwrapped and inserted into the rectum, where the base melts at body temperature and releases the drug. Dissolving it in water, swallowing it or placing it under the tongue would all deliver the product by the wrong route and would not give the intended dose.

A spacer (valved holding chamber) is dispensed with a metered-dose inhaler. What does the spacer do?

• a.It increases the dose delivered by each actuation.
• b.It converts the inhaler into a dry powder device.
• c.It holds the released plume so more drug reaches the lungs and less lands in the mouth.✓
• d.It replaces the need to shake the canister before use.

A spacer holds the aerosol plume for a moment so the patient does not have to coordinate pressing and inhaling perfectly; more of the dose reaches the lower airway and less is deposited in the mouth and throat. It does not change the metered dose itself, it does not turn a pressurised inhaler into a dry powder inhaler, and the canister still has to be shaken when the labeling says so.

Which of these dosage forms must be sterile?

• a.an oral suspension
• b.a topical cream
• c.a compressed oral tablet
• d.an ophthalmic solution instilled into the eye✓

Products instilled into the eye must be sterile, because the eye has no barrier comparable to the skin or the gut and a contaminated drop can cause a sight-threatening infection. Oral suspensions, topical creams and compressed tablets are made to microbial limits but are not required to be sterile.

A stock bottle is labelled 'Protect from light.' Which dispensing practice satisfies that instruction?

• a.Store the bottle in the refrigerator.
• b.Transfer the tablets to a clear vial so the patient can see them.
• c.Dispense in a light-resistant container and leave the protective carton in place until use.✓
• d.Double-bag the prescription at the register.

A light-protection statement is met by keeping the product in a light-resistant container and leaving the manufacturer's carton, foil or amber packaging intact until the dose is taken. Refrigeration addresses temperature rather than light, a clear vial defeats the requirement entirely, and an outer bag at the register offers no lasting protection once the bag is opened at home.

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.

An order is written for insulin '10 IU subcutaneously'. ISMP places 'IU' on its list of error-prone abbreviations. What is the reported misinterpretation, and what should be written instead?

• a.Mistaken as IV or 10; use 'unit(s)'.✓
• b.It is mistaken for 'immediate use'; write 'now'.
• c.It is mistaken for milligrams; write 'mg'.
• d.It is mistaken for 'International Units per hour'; write out 'units per hour'.

The ISMP list records that IU, intended as international unit(s), is mistaken as IV (intravenous) or as the number 10, and directs that unit(s) be written instead. The list does not describe IU being read as units per hour, as 'immediate use', or as milligrams; those are not the documented confusions.

Why does ISMP ask that volumes be written in mL rather than cc?

• a.'cc' can only be used for solids.
• b.'cc' is an apothecary unit while mL belongs to the metric system.
• c.'cc' has been mistaken for 'u' (units).✓
• d.'cc' always means cubic centimetres per hour.

The ISMP list gives the intended meaning of cc as cubic centimetres and the misinterpretation as 'u (units)', with the best practice being to use mL. Both cc and mL are metric and describe the same volume, cc is not restricted to solids, and it carries no per-hour meaning.

A handwritten order reads '125 µg daily'. According to the ISMP list, what is the hazard and the correction?

• a.µg is mistaken for nanogram; write 'ng'.
• b.µg is mistaken for a fraction of a tablet; write 'half tablet'.
• c.µg is mistaken for mEq; write 'milliequivalents'.
• d.µg is mistaken for mg; write 'mcg'.✓

ISMP lists the symbol µg with the intended meaning microgram, the misinterpretation 'mistaken as mg', and the best practice 'use mcg'. Reading microgram as milligram multiplies the dose a thousandfold. Nanogram, milliequivalent and tablet fractions are separate entries on the list with their own, different corrections.

A prescription is written 'give 1 mL SQ daily'. What does the ISMP list say about SC, SQ and sub q?

• a.They are acceptable in handwriting but not in electronic systems.
• b.They are acceptable only for insulin products.
• c.SC has been mistaken for SL (sublingual) and SQ for '5 every'; write SUBQ instead.✓
• d.They are acceptable when the route is repeated twice on the label.

ISMP records that SC and sc are mistaken as SL or sl (sublingual), that SQ is mistaken as '5 every', and that the q in sub q has been mistaken as 'every'; the best practice is SUBQ in all uppercase or the words subcutaneous(ly). The list makes no exception for handwriting, for insulin, or for repeating the route on the label.

An order for a weekly medication is written 'TIW'. Why does ISMP ask that this be spelled out?

• a.TIW has been mistaken for three times a day; write '3 times weekly'.✓
• b.TIW has been mistaken for 'take in water'; write 'with water'.
• c.TIW has been mistaken for 'twice in a while'; write 'as needed'.
• d.TIW is acceptable in every practice setting except long-term care facilities.

The ISMP entry gives TIW the intended meaning '3 times a week', the misinterpretation 'mistaken as 3 times a day or twice in a week', and the best practice 'use 3 times weekly'. Reading it as three times a day more than doubles the weekly dose. The other readings are invented, and the list does not exempt any practice setting.

Why does ISMP warn against writing 'D/C' on a medication list?

• a.It is mistaken for 'daily and continuous'.
• b.Discharge misread as discontinue.✓
• c.It is mistaken for 'do not crush'.
• d.It is mistaken for an abbreviation of a drug name such as a dextrose fluid.

The ISMP entry for D/C gives the intended meanings 'discharge or discontinue' and records premature discontinuation of medications when D/C meant discharge; the best practice is to write discharge and discontinue or stop. The list does not report D/C being read as 'daily and continuous', as a drug name, or as 'do not crush'.

An order is printed as 'propranolol20 mg'. Which ISMP recommendation addresses this?

• a.Always print drug names in uppercase.
• b.Print the dose in a colour different from the drug name on every printed label.
• c.Write the dose before the drug name.
• d.Place adequate space between the drug name, the dose and the unit.✓

ISMP lists 'drug name and dose run together' with the example propranolol20 mg being mistaken as propranolol 120 mg, and the best practice is to leave adequate space between name, dose and unit. All-uppercase printing, reversing the order and colour coding are not the recommendation for this hazard.

A label is generated for a product dosed in large numbers of units and prints '100000 units'. What does ISMP recommend?

• a.Round the figure to the nearest thousand units.
• b.Express the dose in milligrams instead.
• c.Use commas for dosing units at or above 1,000, as ISMP recommends.✓
• d.Print the number twice on the same line.

ISMP lists 'large doses without properly placed commas' and records 100000 being mistaken as 10,000 or 1,000,000; the correction is to use commas at or above 1,000. Rounding changes the dose, converting units to milligrams is not possible for products measured in units, and repeating the number does not stop it from being misread.

A prescription is written 'take 1/2 tablet daily'. What does the ISMP list recommend for this dose designation?

• a.Write '0.50 tablet' so the decimal place is explicit.
• b.Use the Roman numeral 'ss' for one half.
• c.Use text such as 'half tablet' and avoid fractions or decimals entirely.✓
• d.Leave it as written, because tablet fractions are exempt from the list.

ISMP lists '1/2 tablet' with the misinterpretation '1 or 2 tablets' and the best practice of using text such as half tablet while avoiding fractions and decimals. Roman numerals are a separate error-prone entry, a trailing zero after a decimal point is on The Joint Commission's Do Not Use list, and no exemption exists for tablet fractions.

A technician pulls a bottle for a prescription written for metformin and notices the label reads metronidazole. Which safety resource names this pair?

• a.the FDA Orange Book
• b.the NIOSH list of hazardous drugs in healthcare settings
• c.the USP Dictionary of drug names
• d.the ISMP List of Confused Drug Names✓

metFORMIN and metroNIDAZOLE appear as a confused-name pair on the ISMP List of Confused Drug Names, which is why both are written with tall man letters. The Orange Book lists therapeutic equivalence ratings, the NIOSH list identifies hazardous drugs requiring special handling, and the USP Dictionary is a naming reference rather than a safety list of confusable pairs.