ExCPT Roles and Duties Practice Test

25 practice questions

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1. Question 1 of 25Medium

   A pharmacy dispenses a prescription that generates a total payment of $60.00, consisting of a $50.00 insurer payment and a $10.00 patient copayment. The pharmacy purchased the medication at an actual acquisition cost of $42.00. What is the pharmacy's gross profit on this prescription?

   1. AA. $10.00
   2. BB. $8.00
   3. CC. $18.00
   4. DD. $28.00
   Show answer to question 1

   Answer: C. $18.00

   Gross profit is calculated by subtracting the actual acquisition cost from the total payment received, which includes both the insurer reimbursement and the patient copayment ($60.00 minus $42.00 equals $18.00). The amount $8.00 is incorrect because it omits the patient copayment from the total revenue received by the pharmacy.

2. Question 2 of 25Easy

   What is the primary purpose of establishing a periodic automatic replenishment (PAR) level for a pharmacy item?

   1. AA. To set a predetermined stock threshold that triggers reordering
   2. BB. To establish the maximum retail price charged to out-of-pocket patients
   3. CC. To monitor the clinical effectiveness of fast-moving prescription drugs
   4. DD. To record the definitive expiration date for each specific lot
   Show answer to question 2

   Answer: A. To set a predetermined stock threshold that triggers reordering

   A PAR level is a set baseline inventory quantity that alerts pharmacy staff to reorder an item when stock drops below that threshold, preventing stockouts. Determining expiration dates or establishing retail prices involves manufacturer dating and financial billing systems rather than replenishment levels.

3. Question 3 of 25Medium

   While verifying a delivered order against the wholesaler invoice, a pharmacy technician discovers that a bottle of atorvastatin listed on the invoice is missing from the tote. Which of the following actions should the technician take?

   1. AA. Manually add the missing item to the electronic on-hand inventory count.
   2. BB. Mark the item as received and anticipate its arrival in the subsequent delivery.
   3. CC. Note the discrepancy on the invoice and report the shortage to the wholesaler.
   4. DD. Transfer a bottle from another pharmacy section to balance the delivery manifest.
   Show answer to question 3

   Answer: C. Note the discrepancy on the invoice and report the shortage to the wholesaler.

   When an invoiced item is missing from a physical shipment, the technician must document the discrepancy directly on the invoice and contact the wholesaler promptly to request a credit or replacement. Recording the item as received or adding it to on-hand inventory creates false inventory counts for medication the pharmacy does not possess. Transferring bottles internally fails to address the billing and shipping error with the vendor.

4. Question 4 of 25Medium

   A pharmacy technician is processing a return of expired over-the-counter medications to the wholesaler. What documentation is typically required before the wholesaler will accept the return?

   1. AA. A DEA Form 222
   2. BB. A return authorization number from the wholesaler
   3. CC. A signed patient consent form
   4. DD. A copy of the original prescription
   Show answer to question 4

   Answer: B. A return authorization number from the wholesaler

   Most wholesalers require a return authorization (RA) number before accepting returns of expired or damaged non-controlled products. This number tracks the return and ensures proper credit.

   Why the other options are wrong

   • ADEA Form 222 is only for Schedule II controlled substances, not for OTC returns.
   • CPatient consent is not required for returning expired inventory.
   • DPrescription copies are not needed for OTC product returns.

5. Question 5 of 25Easy

   In an inpatient hospital practice setting, which electronic or paper document is primarily used by nursing staff to document the exact time, dose, and administration of a patient medication?

   1. AA. Material Safety Data Sheet
   2. BB. Medication Administration Record
   3. CC. Certificate of Medical Necessity
   4. DD. Standard Operating Procedure
   Show answer to question 5

   Answer: B. Medication Administration Record

   The Medication Administration Record (MAR or eMAR) is the legal record of drug administration to a patient in an inpatient health system. A Material Safety Data Sheet provides chemical safety information rather than patient-specific administration tracking.

6. Question 6 of 25Easy

   A pharmacy technician in a community pharmacy is asked by a patient about the side effects of a newly prescribed blood pressure medication. According to the pharmacy technician's scope of practice, what is the appropriate response?

   1. AA. Explain that the technician cannot provide drug information and must refer the patient to the pharmacist.
   2. BB. Print the medication guide from the computer and hand it to the patient without comment.
   3. CC. Provide a brief summary of the most common side effects based on package inserts.
   4. DD. Discuss potential interactions with over-the-counter products the patient mentioned.
   Show answer to question 6

   Answer: A. Explain that the technician cannot provide drug information and must refer the patient to the pharmacist.

   Pharmacy technicians are not authorized to provide clinical drug information or counseling; that is the responsibility of the pharmacist. Technicians may handle administrative tasks and prepare medications, but all drug-related questions must be referred to the pharmacist.

   Why the other options are wrong

   • BHanding out a medication guide may be permissible, but the patient asked for side-effect information, which requires pharmacist involvement.
   • CProviding clinical drug information is outside the technician's scope of practice.
   • DDiscussing drug interactions is a clinical task reserved for the pharmacist.

7. Question 7 of 25Easy

   A pharmacy technician is reviewing a patient profile that lists a diagnosis of hepatitis. Which organ is affected by this condition?

   1. AA. Stomach
   2. BB. Heart
   3. CC. Liver
   4. DD. Kidney
   Show answer to question 7

   Answer: C. Liver

   The root hepat/o refers to the liver, and the suffix -itis means inflammation; therefore, hepatitis is inflammation of the liver. The root nephr/o refers to the kidney, while gastr/o refers to the stomach and cardi/o refers to the heart.

8. Question 8 of 25Easy

   During a shift transition in a hospital pharmacy, a technician uses the SBAR communication model to update the incoming technician on an ongoing sterile compounding backlog. What does the letter 'B' represent in this communication framework?

   1. AA. Billing
   2. BB. Benchmark
   3. CC. Barcode
   4. DD. Background
   Show answer to question 8

   Answer: D. Background

   In the SBAR standardized communication framework, S stands for Situation, B stands for Background, A stands for Assessment, and R stands for Recommendation. Using Background allows the speaker to provide context, relevant history, and clinical or operational data leading up to the current situation.

9. Question 9 of 25Medium

   A pharmacy technician is storing a shipment of vaccines that must be kept under refrigeration according to the manufacturer's package insert. Which temperature range is generally appropriate for standard vaccine refrigerator storage?

   1. AA. 60 to 68 degrees Fahrenheit
   2. BB. 20 to 28 degrees Fahrenheit
   3. CC. 36 to 46 degrees Fahrenheit
   4. DD. 50 to 59 degrees Fahrenheit
   Show answer to question 9

   Answer: C. 36 to 46 degrees Fahrenheit

   Refrigerated vaccines are stored between 36 and 46 degrees Fahrenheit (2 to 8 degrees Celsius). Colder temperatures can freeze and destroy the vaccine and warmer temperatures reduce potency, so refrigerator temperatures are monitored and recorded.

   Why the other options are wrong

   • A60 to 68 degrees F is close to room temperature, far too warm for refrigerated vaccines.
   • B20 to 28 degrees F is below freezing and would damage vaccines that must not freeze.
   • D50 to 59 degrees F falls in the cool range, still too warm for refrigerator storage.

10. Question 10 of 25Easy

    A patient who indicates they are hard of hearing approaches the consultation window. How should the pharmacy technician adjust their communication approach?

    1. AA. Shout loudly directly toward the patient to overcome environmental sound barriers
    2. BB. Face the patient directly, speak clearly at a normal pace, and minimize background noise
    3. CC. Direct all statements and questions to the patient's companion rather than the patient
    4. DD. Turn toward the computer monitor while speaking so transaction details can be entered
    Show answer to question 10

    Answer: B. Face the patient directly, speak clearly at a normal pace, and minimize background noise

    Facing the individual directly allows them to use facial cues and lip-reading, while speaking clearly at a moderate volume and reducing background noise maximizes auditory clarity. Shouting distorts speech sounds and facial expressions, making lip-reading more difficult. Looking away or ignoring the patient in favor of a companion diminishes patient autonomy and impedes communication.

11. Question 11 of 25Medium

    A patient completes a medication therapy management session. Which core MTM document serves as a comprehensive tracker of all prescription drugs, over-the-counter products, and dietary supplements taken by the patient?

    1. AA. Personal Medication Record
    2. BB. Medication Action Plan
    3. CC. Drug Utilization Evaluation
    4. DD. Prior Authorization Summary
    Show answer to question 11

    Answer: A. Personal Medication Record

    The Personal Medication Record (PMR) is a comprehensive document provided to the patient that lists all active prescription medications, OTC drugs, herbal products, and supplements. The Medication Action Plan (MAP) is also a core MTM element, but it focuses on patient-centered action steps to resolve specific therapy-related goals rather than serving as the comprehensive product inventory.

12. Question 12 of 25Medium

    A pharmacy receives a recall notice from a manufacturer for a specific lot of atorvastatin 20 mg tablets due to a labeling error. The pharmacy has 150 tablets from that lot in stock and 200 tablets dispensed to patients. What is the pharmacy technician's first step in handling this recall?

    1. AA. Send the 150 tablets back to the wholesaler without documentation.
    2. BB. Contact all patients who received the medication and arrange for return.
    3. CC. Dispose of the 150 tablets in the pharmacy's hazardous waste container.
    4. DD. Immediately quarantine all remaining stock of that lot and notify the pharmacist.
    Show answer to question 12

    Answer: D. Immediately quarantine all remaining stock of that lot and notify the pharmacist.

    The first step in a drug recall is to quarantine the affected inventory to prevent further dispensing. The technician should remove the lot from accessible stock and inform the pharmacist, who will then follow the recall instructions (e.g., return, disposal, patient notification).

    Why the other options are wrong

    • AReturns require proper documentation and authorization; sending without paperwork is not compliant.
    • BPatient notification is important but should be done after the pharmacist reviews the recall instructions and determines the severity.
    • CDisposal should only be done per recall instructions; not all recalls require destruction, and hazardous waste rules may not apply.

13. Question 13 of 25Easy

    During the retail dispensing process, which of the following duties is permissible for a pharmacy technician to complete independently before the final verification?

    1. AA. Selecting and counting the medication into an amber vial
    2. BB. Authorizing a therapeutic substitution for a non-formulary drug
    3. CC. Determining whether an off-label medication use is appropriate
    4. DD. Resolving a severe therapeutic duplication warning
    Show answer to question 13

    Answer: A. Selecting and counting the medication into an amber vial

    Counting tablets, pouring liquids, and labeling dispensing containers are primary technical tasks performed by pharmacy technicians before the pharmacist performs the final check. Resolving drug interactions, authorizing therapeutic substitutions, and assessing therapeutic appropriateness require clinical judgment reserved for pharmacists.

14. Question 14 of 25Medium

    An adolescent patient receives a replacement peak flow meter for home asthma management. When the caregiver asks how often the plastic device should be cleaned, what is the standard recommendation?

    1. AA. Wipe the mouthpiece with isopropyl alcohol and dry it immediately with a paper towel.
    2. BB. Soak the meter in boiling water daily after every scheduled exhalation.
    3. CC. Clean the meter in an automated dishwasher on the sanitize cycle once a month.
    4. DD. Wash the meter weekly in warm, soapy water and allow it to air dry completely.
    Show answer to question 14

    Answer: D. Wash the meter weekly in warm, soapy water and allow it to air dry completely.

    Peak flow meters should typically be washed once a week by soaking in warm, soapy water, rinsing thoroughly with clear water, and air drying completely on a clean surface. Boiling water or high-heat automated dishwashers can warp the plastic body or damage the internal spring mechanism, which permanently alters the meter's calibration.

15. Question 15 of 25Medium

    During a medication intake interview, a patient states, "I am really nervous about taking this new tablet because the last one caused severe nausea." The pharmacy technician responds, "It sounds like you are worried this new medication might upset your stomach like the last one did." Which communication technique is the technician demonstrating?

    1. AA. Directed questioning
    2. BB. Probing
    3. CC. Reflective listening
    4. DD. Passive agreement
    Show answer to question 15

    Answer: C. Reflective listening

    Reflective listening involves restating or paraphrasing the patient's feelings and message in the technician's own words to confirm understanding and show empathy. Probing involves asking follow-up questions to uncover additional facts rather than mirroring the patient's emotional concern.

16. Question 16 of 25Hard

    While conducting a medication history interview, a patient mentions taking an over-the-counter St. John's wort supplement daily alongside their prescribed antidepressant. What is the most appropriate action for the pharmacy technician?

    1. AA. Document the supplement on the medication list and alert the pharmacist to a potential interaction
    2. BB. Exclude the supplement from the medication list because it is not a prescription drug
    3. CC. Tell the patient to discard the supplement immediately to prevent drug toxicity
    4. DD. Substitute the herbal supplement with an approved prescription medication in the electronic chart
    Show answer to question 16

    Answer: A. Document the supplement on the medication list and alert the pharmacist to a potential interaction

    Over-the-counter products, dietary supplements, and herbal remedies must be recorded during medication reconciliation because they frequently interact with prescription therapies (such as St. John's wort interacting with serotonergic antidepressants). The technician must document the product and alert the pharmacist for clinical assessment. Technicians must not give direct clinical directives, such as ordering a patient to discard a medication, nor can they initiate therapeutic substitutions.

17. Question 17 of 25Medium

    Which of the following responsibilities in prescription processing requires clinical judgment and therefore cannot be delegated to a pharmacy technician?

    1. AA. Comparing the National Drug Code on the manufacturer bottle to the prescription label
    2. BB. Calculating the days supply of an insulin vial based on prescribed daily units
    3. CC. Determining whether a dose is therapeutically appropriate for a patient with renal impairment
    4. DD. Scanning the barcode on the prescription label to verify bin placement in will-call
    Show answer to question 17

    Answer: C. Determining whether a dose is therapeutically appropriate for a patient with renal impairment

    Assessing the therapeutic appropriateness of a dosage regimen based on organ function involves clinical evaluation and patient-specific risk assessment, which is strictly the duty of a pharmacist. Mathematical calculations, NDC matching, and barcode verification are technical tasks that technicians are trained and authorized to perform. While technicians must be accurate in technical calculations, clinical evaluation of the result remains a pharmacist duty.

18. Question 18 of 25Medium

    A customer asks a pharmacy technician for advice on which over-the-counter pain reliever would be best for their frequent headaches. According to standard technician scope of practice, what is the technician's appropriate response?

    1. AA. Recommend a specific product based on the customer's description of symptoms.
    2. BB. Tell the customer that only the pharmacist can answer questions about OTC medications.
    3. CC. Suggest the customer try a combination product that contains both acetaminophen and ibuprofen.
    4. DD. Provide general information about OTC pain relievers and refer the customer to the pharmacist.
    Show answer to question 18

    Answer: D. Provide general information about OTC pain relievers and refer the customer to the pharmacist.

    Technicians may share factual information about OTC products, such as ingredients and label directions, but they cannot recommend a product for a medical problem. Frequent headaches also call for the pharmacist's assessment, so the technician should refer the customer.

    Why the other options are wrong

    • ARecommending a specific product based on symptoms is a clinical judgment reserved for the pharmacist.
    • BTechnicians can share factual product information, so saying only the pharmacist can answer any OTC question overstates the limit.
    • CSuggesting a specific combination product is still a therapeutic recommendation the technician cannot make.

19. Question 19 of 25Medium

    A pharmacy technician processes a Class I recall notice for an injectable cardiovascular drug. A computer report shows that three patients were dispensed vials from the affected lot last week. What action should the technician take regarding these patients?

    1. AA. Notify the supervising pharmacist immediately so appropriate clinical contact can be initiated.
    2. BB. Call the patients directly to advise them to discontinue therapy and switch to an over-the-counter substitute.
    3. CC. Document the dispensed quantities and take no further steps since the medication left the pharmacy.
    4. DD. Wait for the manufacturer to send direct certified letters to the patients before taking action.
    Show answer to question 19

    Answer: A. Notify the supervising pharmacist immediately so appropriate clinical contact can be initiated.

    Patient outreach and clinical consultation regarding recalled medications, especially critical Class I recalls, must be coordinated by or referred to the pharmacist. Technicians should not independently counsel patients on discontinuing therapies or substituting medications, as clinical judgment is required.

20. Question 20 of 25Hard

    When reviewing the Handbook on Injectable Drugs to assess the physical compatibility of two parenteral solutions mixed in a syringe, which observation reported in the reference indicates incompatibility?

    1. AA. Absence of visible gas formation
    2. BB. Formation of a hazy precipitate
    3. CC. Retention of the original solution color
    4. DD. Maintenance of a completely clear appearance
    Show answer to question 20

    Answer: B. Formation of a hazy precipitate

    The formation of a precipitate, cloudiness, haziness, or gas evolution indicates physical incompatibility between combined parenteral solutions. Maintaining a clear appearance, retaining uniform color, and showing no gas production are characteristics of physical compatibility. A technician who identifies a documented precipitate in the Handbook on Injectable Drugs must know the combination cannot be prepared or administered together.

21. Question 21 of 25Hard

    In the combined United States Pharmacopeia and National Formulary (USP-NF), which category of substances is primarily detailed within the National Formulary monographs?

    1. AA. Prescription finished dosage forms
    2. BB. Inactive ingredients and excipients
    3. CC. Active pharmaceutical ingredients
    4. DD. Radiolabeled therapeutic drugs
    Show answer to question 21

    Answer: B. Inactive ingredients and excipients

    The National Formulary (NF) section of the compendium provides official standards and monographs for excipients and inactive ingredients used in pharmaceutical formulations. Active pharmaceutical ingredients and finished commercial dosage forms are indexed within the United States Pharmacopeia (USP) portion.

22. Question 22 of 25Hard

    A pharmacy technician is preparing expired, non-controlled legend drugs for shipment to a reverse distributor for manufacturer credit. Which action is necessary during this process?

    1. AA. Obtain written approval from the state board of pharmacy before releasing the shipment
    2. BB. Generate a detailed inventory listing product names, strengths, package sizes, and quantities
    3. CC. Submit a DEA Form 41 to the local field division office prior to shipping the non-controlled items
    4. DD. Empty all capsules and tablets into unmarked clear plastic bags to reduce shipping weight
    Show answer to question 22

    Answer: B. Generate a detailed inventory listing product names, strengths, package sizes, and quantities

    When returning non-controlled prescription drugs through a reverse distributor, the pharmacy must generate an accurate, detailed inventory record containing drug descriptions, strengths, quantities, and lot numbers to ensure proper credit accounting and auditing. DEA Form 41 applies specifically to the destruction of controlled substances, not non-controlled pharmaceuticals. Removing medications from original labeled containers makes verification impossible and prevents manufacturers from issuing credit.

23. Question 23 of 25Hard

    Which group of sections in a standardized 16-section Safety Data Sheet is designated by OSHA as non-mandatory because the content falls under other federal agencies?

    1. AA. Sections 4 through 7
    2. BB. Sections 1 through 3
    3. CC. Sections 8 through 11
    4. DD. Sections 12 through 15
    Show answer to question 23

    Answer: D. Sections 12 through 15

    Sections 12 through 15 cover ecological information, disposal considerations, transport information, and regulatory information, which are regulated by agencies such as the EPA and DOT rather than OSHA. Sections 1 through 11 and Section 16 are strictly mandatory and fall directly under OSHA workplace safety jurisdiction.

24. Question 24 of 25Hard

    Following the disposal of unusable controlled substances through a registered reverse distributor, what is the minimum duration the pharmacy must maintain the transfer and disposal records under federal DEA regulations?

    1. AA. 7 years
    2. BB. 1 year
    3. CC. 2 years
    4. DD. 5 years
    Show answer to question 24

    Answer: C. 2 years

    Federal law mandates that all records pertaining to the inventory, receipt, transfer, and destruction of controlled substances be retained for at least 2 years. While some state rules or hospital policies may require 5 years or longer, 2 years is the federal DEA requirement.

25. Question 25 of 25Hard

    In an institutional hospital setting where the central pharmacy is not open 24 hours, which mechanism provides secure after-hours access to urgent medications?

    1. AA. Granting charge nurses administrative credentials to alter central inventory files
    2. BB. Allowing floor staff to borrow non-emergency stock from neighboring retail stores
    3. CC. Supplying nursing supervisors with master physical keys to the central pharmacy
    4. DD. Maintaining an automated dispensing cabinet with restricted access on the nursing unit
    Show answer to question 25

    Answer: D. Maintaining an automated dispensing cabinet with restricted access on the nursing unit

    Hospitals commonly use locked emergency kits or automated dispensing cabinets stocked with predetermined emergency medications to satisfy after-hours needs without compromising pharmacy security. Giving routine open access or master physical keys to central pharmacy shelves bypasses pharmacist supervision and significantly heightens the risk of diversion and medication errors.

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