ExCPT Dispensing Process Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Medium

   On a traditional written prescription, which section provides directions to the pharmacist regarding compounding or the quantity to dispense?

   1. AA. Inscription
   2. BB. Transcription
   3. CC. Subscription
   4. DD. Superscription
   Show answer to question 1

   Answer: C. Subscription

   The subscription contains specific directions to the compounder or dispenser, primarily indicating the dosage form and number of units to dispense (e.g., Dispense 30 tablets). In contrast, the transcription (or signa) contains directions intended for the patient.

2. Question 2 of 25Hard

   A pharmacist wants to prepare 500 g of a 15% (w/w) zinc oxide ointment by mixing a 5% ointment with a 25% ointment. How many grams of the 25% ointment should be mixed?

   1. AA. 150 g
   2. BB. 200 g
   3. CC. 300 g
   4. DD. 250 g
   Show answer to question 2

   Answer: D. 250 g

   Alligation: Desired = 15%. Lower = 5%, higher = 25%. Difference: 15 - 5 = 10 parts of higher; 25 - 15 = 10 parts of lower. Total parts = 20. Fraction of higher = 10/20 = 1/2. Therefore, 500 g × 1/2 = 250 g of 25% ointment.

   Why the other options are wrong

   • A150 g is 30% of the total, which would give a concentration near 11%.
   • B200 g would correspond to a 40% fraction, not 50%.
   • C300 g would be 60% of the total, which would yield a higher concentration.

3. Question 3 of 25Medium

   An intravenous bag contains 40 mEq of potassium chloride in 1,000 mL of normal saline. The solution is infusing at a rate of 100 mL/hr. How many milliequivalents of potassium chloride is the patient receiving per hour?

   1. AA. 2 mEq/hr
   2. BB. 4 mEq/hr
   3. CC. 10 mEq/hr
   4. DD. 40 mEq/hr
   Show answer to question 3

   Answer: B. 4 mEq/hr

   The concentration of potassium chloride is 40 mEq per 1,000 mL, which simplifies to 0.04 mEq/mL. Multiplying 0.04 mEq/mL by the infusion rate of 100 mL/hr yields 4 mEq/hr. The value of 10 mEq/hr incorrectly divides 1,000 mL by 100 mL/hr instead of multiplying the hourly volume by the solution concentration.

4. Question 4 of 25Medium

   During the receiving process, a pharmacy technician counts the units of a medication and finds 48 bottles, but the invoice states 50 bottles. What should the technician do?

   1. AA. Accept the shipment as 50 bottles and adjust the inventory to match the invoice.
   2. BB. Document the discrepancy on the invoice, adjust the inventory count to 48, and contact the wholesaler for a credit or replacement.
   3. CC. Ignore the discrepancy if it is only two bottles, as it is within an acceptable margin.
   4. DD. Refuse the entire shipment and return it to the wholesaler.
   Show answer to question 4

   Answer: B. Document the discrepancy on the invoice, adjust the inventory count to 48, and contact the wholesaler for a credit or replacement.

   Any discrepancy between received quantity and invoice must be documented and reported to the wholesaler. The inventory should reflect the actual quantity received.

   Why the other options are wrong

   • AAccepting an incorrect quantity without adjustment would lead to inventory inaccuracies and potential billing issues.
   • CAll discrepancies, no matter how small, must be documented to maintain accurate inventory and financial records.
   • DRefusing the entire shipment is excessive; only the discrepancy needs to be addressed.

5. Question 5 of 25Hard

   A prescription for metformin 500 mg tablets reads: take 1 tablet twice daily for 7 days, then take 2 tablets twice daily thereafter, dispense a 30-day supply. How many total tablets should be dispensed?

   1. AA. 90 tablets
   2. BB. 120 tablets
   3. CC. 92 tablets
   4. DD. 106 tablets
   Show answer to question 5

   Answer: D. 106 tablets

   Days 1 to 7: 1 tablet twice daily = 2 × 7 = 14 tablets. Days 8 to 30: 2 tablets twice daily = 4 × 23 = 92 tablets. Total = 14 + 92 = 106 tablets.

   Why the other options are wrong

   • A90 tablets equals 3 a day for 30 days, which matches neither phase of the regimen.
   • B120 tablets applies the higher dose to all 30 days, ignoring the first week.
   • C92 tablets counts only the second phase and leaves out the first week's 14 tablets.

6. Question 6 of 25Medium

   A patient has a Medicare Part D plan with a $500 deductible that has not been met. The patient presents a prescription for a brand-name drug with a negotiated price of $120. What is the patient's out-of-pocket cost for this prescription?

   1. AA. $0
   2. BB. $30
   3. CC. $500
   4. DD. $120
   Show answer to question 6

   Answer: D. $120

   Before the deductible is met, the patient pays 100% of the drug cost up to the deductible amount. Since $120 is less than the $500 deductible, the patient pays the full $120.

   Why the other options are wrong

   • AThe patient must pay until the deductible is satisfied; $0 is incorrect.
   • B$30 might be a copay after deductible, but deductible applies first.
   • C$500 is the full deductible, but the drug cost is only $120.

7. Question 7 of 25Easy

   Which of the following documents serves as the standard "recipe" and operational template for preparing a compounded medication, independent of any specific patient order?

   1. AA. Safety data sheet
   2. BB. Master formulation record
   3. CC. Compounding record
   4. DD. Certificate of analysis
   Show answer to question 7

   Answer: B. Master formulation record

   The master formulation record provides the standard recipe, step-by-step instructions, and ingredient requirements needed to compound a preparation. The compounding record logs the specific details of a single preparation event, such as actual quantities weighed and lot numbers used.

8. Question 8 of 25Easy

   How many micrograms are contained in a 0.25 mg tablet of levothyroxine?

   1. AA. 25,000 mcg
   2. BB. 2,500 mcg
   3. CC. 25 mcg
   4. DD. 250 mcg
   Show answer to question 8

   Answer: D. 250 mcg

   To convert milligrams to micrograms, multiply by 1,000 because 1 mg equals 1,000 mcg. Multiplying 0.25 mg by 1,000 yields 250 mcg. The value 25 mcg results from an erroneous conversion factor of 100 rather than 1,000.

9. Question 9 of 25Easy

   A prescription reads: 'i gtt ou q4h prn itching.' What does the sig code 'ou' mean?

   1. AA. Each eye
   2. BB. Right eye
   3. CC. Left ear
   4. DD. Both ears
   Show answer to question 9

   Answer: A. Each eye

   'ou' is the abbreviation for 'oculus uterque,' meaning each eye. It is used in ophthalmic prescriptions to indicate that the medication should be applied to both eyes.

   Why the other options are wrong

   • B'Right eye' is abbreviated as 'od' (oculus dexter), not 'ou'.
   • C'Left ear' is abbreviated as 'as' (auris sinistra), not 'ou'.
   • D'Both ears' is abbreviated as 'au' (auris utraque), not 'ou'.

10. Question 10 of 25Medium

    A patient taking warfarin asks a pharmacy technician to locate an over-the-counter pain reliever for a mild headache. What is the correct response by the technician?

    1. AA. Bring the patient to the pharmacist to discuss potential drug interactions with pain relievers.
    2. BB. Direct the patient to the acetaminophen section and state it is completely safe with warfarin.
    3. CC. Hand the patient enteric-coated aspirin to minimize the risk of drug-induced stomach upset.
    4. DD. Locate an over-the-counter ibuprofen product and advise taking it with food or milk.
    Show answer to question 10

    Answer: A. Bring the patient to the pharmacist to discuss potential drug interactions with pain relievers.

    Warfarin has significant and potentially dangerous interactions with multiple nonprescription analgesics, including NSAIDs, aspirin, and high-dose acetaminophen. Directing the patient to the pharmacist ensures proper clinical screening for drug interactions and safe dosing guidance. Handing the patient an NSAID or aspirin is hazardous due to the heightened risk of serious gastrointestinal bleeding.

11. Question 11 of 25Easy

    When receiving a shipment of medications, the pharmacy technician verifies the NDC on each bottle. What does the acronym NDC stand for?

    1. AA. National Distribution Code
    2. BB. National Dispensing Code
    3. CC. New Drug Classification
    4. DD. National Drug Code
    Show answer to question 11

    Answer: D. National Drug Code

    NDC stands for National Drug Code, a unique 10- or 11-digit identifier assigned to each drug product in the United States. It is used for ordering, billing, and inventory tracking.

    Why the other options are wrong

    • ANational Distribution Code is incorrect; distribution is not part of the NDC acronym.
    • BNational Dispensing Code is not a standard term; dispensing is not part of the NDC definition.
    • CNew Drug Classification is unrelated; NDC identifies specific products, not classifications.

12. Question 12 of 25Medium

    A pharmacist needs to prepare 200 g of a 5% ointment using a 2% and a 10% ointment. How many grams of the 10% ointment are needed?

    1. AA. 125 g
    2. BB. 50 g
    3. CC. 75 g
    4. DD. 25 g
    Show answer to question 12

    Answer: C. 75 g

    Use alligation. The 10% ointment gets 5 - 2 = 3 parts and the 2% ointment gets 10 - 5 = 5 parts, for 8 parts total. Each part is 200 g ÷ 8 = 25 g, so the 10% ointment needed is 3 × 25 g = 75 g.

    Why the other options are wrong

    • A125 g is the amount of the 2% ointment (5 parts), not the 10% ointment.
    • B50 g covers only 2 parts; mixed with 150 g of the 2% ointment it makes about a 4% product.
    • D25 g is a single part; mixed with 175 g of the 2% ointment it makes only a 3% product.

13. Question 13 of 25Medium

    A prescription reads 'Take 1 tab po qid'. What does the abbreviation 'qid' mean?

    1. AA. Twice daily
    2. BB. Every day
    3. CC. Four times daily
    4. DD. Three times daily
    Show answer to question 13

    Answer: C. Four times daily

    The abbreviation qid comes from the Latin quater in die, meaning four times a day, so the patient takes 1 tablet four times daily.

    Why the other options are wrong

    • ATwice daily is abbreviated bid (bis in die).
    • BEvery day should be written out as daily; the old abbreviation qd is on error-prone abbreviation lists.
    • DThree times daily is abbreviated tid (ter in die).

14. Question 14 of 25Medium

    A child weighing 44 lb is prescribed amoxicillin 20 mg/kg/day divided into two doses. The suspension is 250 mg/5 mL. How many mL should be given per dose?

    1. AA. 2 mL
    2. BB. 4 mL
    3. CC. 8 mL
    4. DD. 5 mL
    Show answer to question 14

    Answer: B. 4 mL

    Convert the weight: 44 lb ÷ 2.2 = 20 kg. Daily dose = 20 mg/kg × 20 kg = 400 mg, divided into 2 doses = 200 mg per dose. The suspension contains 50 mg/mL (250 mg/5 mL), so 200 mg ÷ 50 mg/mL = 4 mL.

    Why the other options are wrong

    • A2 mL delivers only 100 mg, as if the daily dose were split into four doses instead of two.
    • C8 mL delivers 400 mg, the entire daily dose given at one time.
    • D5 mL delivers 250 mg, simply one 5 mL measure of the stock strength rather than the calculated 200 mg.

15. Question 15 of 25Hard

    A child weighs 44 lb. The physician orders amoxicillin 50 mg/kg/day divided every 12 hours. The pharmacy has amoxicillin 250 mg/5 mL suspension. How many mL should be administered per dose? (Round to the nearest 0.1 mL)

    1. AA. 2.5
    2. BB. 7.5
    3. CC. 5.0
    4. DD. 10.0
    Show answer to question 15

    Answer: D. 10.0

    Convert weight: 44 lb ÷ 2.2 = 20 kg. Daily dose: 50 mg/kg × 20 kg = 1000 mg/day. Divided q12h: 1000 mg ÷ 2 = 500 mg per dose. Concentration: 250 mg/5 mL = 50 mg/mL. Volume per dose: 500 mg ÷ 50 mg/mL = 10.0 mL.

    Why the other options are wrong

    • A2.5 mL would provide 125 mg, which is a quarter of the required per dose.
    • B7.5 mL would provide 375 mg, which is not a standard division of the daily dose.
    • C5.0 mL would provide 250 mg, which is half the required per dose (if daily dose miscalculated as 500 mg).

16. Question 16 of 25Easy

    A patient is prescribed 0.25 g of a medication. The pharmacy stocks 250 mg tablets. How many tablets should be dispensed?

    1. AA. 0.5
    2. BB. 2
    3. CC. 1
    4. DD. 4
    Show answer to question 16

    Answer: C. 1

    Convert grams to milligrams first: 0.25 g × 1,000 = 250 mg. Each tablet contains 250 mg, so 250 mg ÷ 250 mg per tablet = 1 tablet.

    Why the other options are wrong

    • AHalf a tablet supplies only 125 mg, half the prescribed dose, which points to a conversion error.
    • BTwo tablets supply 500 mg, double the prescribed 250 mg.
    • DFour tablets supply 1,000 mg; this comes from dividing 1 by 0.25 instead of converting grams to milligrams.

17. Question 17 of 25Medium

    A prescription is written for a medication to be taken as 1 tablet twice daily. The pharmacist dispenses 90 tablets. What is the days supply?

    1. AA. 90 days
    2. BB. 45 days
    3. CC. 60 days
    4. DD. 30 days
    Show answer to question 17

    Answer: B. 45 days

    The patient takes 2 tablets per day (1 tablet twice daily). Days supply = total tablets ÷ tablets per day = 90 ÷ 2 = 45 days. This calculation ensures the patient has enough medication for the prescribed duration.

    Why the other options are wrong

    • A90 days would be the days supply if the patient took only 1 tablet per day.
    • C60 days would result if the patient took only 1.5 tablets per day (incorrect dosing).
    • D30 days would be correct if the patient took 3 tablets per day.

18. Question 18 of 25Easy

    A patient is dispensed a medication that commonly causes drowsiness. Which auxiliary label should be affixed to the prescription vial?

    1. AA. Take with food
    2. BB. Shake well before use
    3. CC. May cause drowsiness
    4. DD. Do not take with dairy products
    Show answer to question 18

    Answer: C. May cause drowsiness

    Medications that cause drowsiness, such as antihistamines or sedatives, require an auxiliary label warning the patient about drowsiness to prevent activities like driving.

    Why the other options are wrong

    • ATake with food is used for medications that may cause gastrointestinal upset, not for drowsiness.
    • BShake well before use is used for suspensions or liquids that settle, not for drowsiness warnings.
    • DDo not take with dairy products is used for certain antibiotics or thyroid medications, not for drowsiness.

19. Question 19 of 25Medium

    An order reads: 'Infuse 500 mL of Normal Saline over 4 hours.' What is the infusion rate in mL/hr?

    1. AA. 125
    2. BB. 100
    3. CC. 200
    4. DD. 150
    Show answer to question 19

    Answer: A. 125

    Infusion rate (mL/hr) = total volume (mL) ÷ time (hr). 500 mL ÷ 4 hr = 125 mL/hr.

    Why the other options are wrong

    • B100 mL/hr would be correct for 500 mL over 5 hours.
    • C200 mL/hr would be correct for 500 mL over 2.5 hours.
    • D150 mL/hr would be correct for 500 mL over 3.33 hours, not 4.

20. Question 20 of 25Medium

    During data entry, a pharmacy technician enters the patient's date of birth as 03/14/1985, but the prescription hard copy shows 03/14/1984. What type of error has occurred?

    1. AA. Wrong patient name
    2. BB. Wrong date of birth
    3. CC. Wrong prescriber
    4. DD. Wrong medication
    Show answer to question 20

    Answer: B. Wrong date of birth

    The discrepancy between the entered DOB and the hard copy DOB is a data entry error specifically involving the patient's date of birth. This must be corrected to ensure accurate patient identification.

    Why the other options are wrong

    • AThe patient name is not mentioned as incorrect; only the date of birth differs.
    • CThere is no mention of the prescriber information being incorrect.
    • DThere is no indication that the medication entered is wrong; the error is in patient data.

21. Question 21 of 25Easy

    A prescription calls for 240 mL of a 2% (w/v) chlorhexidine gluconate topical solution. How many grams of chlorhexidine gluconate are required to prepare this prescription?

    1. AA. 0.48 g
    2. BB. 2.4 g
    3. CC. 4.8 g
    4. DD. 12 g
    Show answer to question 21

    Answer: C. 4.8 g

    A 2% (w/v) solution contains 2 grams of solute per 100 milliliters of solution. Multiplying 2 grams per 100 milliliters by 240 milliliters gives 4.8 grams. The choice 2.4 grams is incorrect because it represents dividing the total volume by 100 without multiplying by the 2% concentration factor.

22. Question 22 of 25Hard

    A patient picks up a new prescription for warfarin, an anticoagulant with a narrow therapeutic index. The patient asks the pharmacy technician, 'How should I take this medication and what side effects should I watch for?' What is the technician's appropriate response?

    1. AA. Refer the patient to the pharmacist for counseling because the question involves drug therapy and clinical advice
    2. BB. Provide a brief explanation of dosing and common side effects based on the technician's knowledge
    3. CC. Tell the patient to call their prescriber for instructions
    4. DD. Hand the patient a printed medication guide and tell them to read it carefully
    Show answer to question 22

    Answer: A. Refer the patient to the pharmacist for counseling because the question involves drug therapy and clinical advice

    Pharmacy technicians are not licensed to provide drug counseling or clinical advice. Questions about how to take a medication, side effects, or interactions must be referred to the pharmacist. The pharmacist can provide appropriate counseling and answer patient-specific questions.

    Why the other options are wrong

    • BTechnicians should not provide clinical information; doing so exceeds their scope of practice.
    • CWhile the prescriber can provide information, the pharmacist is available and expected to counsel on new prescriptions.
    • DA printed guide is helpful but does not substitute for pharmacist counseling, especially for high-risk drugs like warfarin.

23. Question 23 of 25Hard

    A patient with a BSA of 1.6 m² is prescribed a chemotherapy drug at a dose of 100 mg/m². The drug is available as a 50 mg/mL injection. How many mL should be added to the IV bag?

    1. AA. 3.0 mL
    2. BB. 2.6 mL
    3. CC. 3.2 mL
    4. DD. 4.0 mL
    Show answer to question 23

    Answer: C. 3.2 mL

    Total dose = 100 mg/m² × 1.6 m² = 160 mg. Concentration = 50 mg/mL, so volume = 160 mg / 50 mg/mL = 3.2 mL.

    Why the other options are wrong

    • AThis would result from using 150 mg total dose, which is incorrect.
    • BThis would be the volume if the dose were 130 mg (e.g., 81.25 mg/m²), not 160 mg.
    • DThis would be the volume if the dose were 200 mg (125 mg/m²), not 160 mg.

24. Question 24 of 25Hard

    The average wholesale price (AWP) of a drug is $120.00. The pharmacy purchases it at AWP minus 15%. The pharmacy applies a 20% markup on the cost to determine the selling price. What is the selling price?

    1. AA. $122.40
    2. BB. $120.00
    3. CC. $126.00
    4. DD. $124.80
    Show answer to question 24

    Answer: A. $122.40

    First calculate cost: AWP - 15% = $120.00 × 0.85 = $102.00. Then apply 20% markup on cost: $102.00 × 1.20 = $122.40. Markup is based on cost, not AWP. This is a common business calculation in pharmacy pricing.

    Why the other options are wrong

    • B$120.00 is the AWP, not the selling price after discount and markup.
    • C$126.00 does not follow from these steps; the cost is $102.00, and a 20% markup on it gives $122.40.
    • D$124.80 equals $104.00 × 1.20, so it starts from the wrong cost; 15% off $120.00 is $102.00.

25. Question 25 of 25Hard

    A community pharmacy sells a blood pressure monitor for $60.00. The acquisition cost from the distributor was $42.00. What is the gross margin percentage for this sale?

    1. AA. 30%
    2. BB. 25%
    3. CC. 43%
    4. DD. 70%
    Show answer to question 25

    Answer: A. 30%

    The gross profit is $18.00 ($60.00 - $42.00). Gross margin percentage is calculated by dividing gross profit by the selling price and multiplying by 100 ($18.00 / $60.00 x 100 = 30%). The value of 43% represents the markup percentage based on cost ($18.00 / $42.00), which is often confused with gross margin.

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