PTCE Medications Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Hard

   A patient taking digoxin for heart failure develops nausea, confusion, and visual halos around lights. A pharmacy technician reviewing the chart notes the patient was recently started on a diuretic. Which electrolyte imbalance caused by diuretic therapy most increases the risk of digoxin toxicity in this patient?

   1. AA. Hypernatremia
   2. BB. Hypokalemia
   3. CC. Hypercalcemia
   4. DD. Hyperkalemia
   Show answer to question 1

   Answer: B. Hypokalemia

   Low potassium increases digoxin binding to the sodium-potassium ATPase pump, so toxicity can occur even at usual digoxin levels. Loop and thiazide diuretics waste potassium, which makes hypokalemia the key risk in this patient.

   Why the other options are wrong

   • AHypernatremia is not a recognized trigger of digoxin toxicity in the way low potassium is.
   • CHigh calcium can also predispose to digoxin toxicity, but potassium loss is the far more common and important diuretic effect.
   • DHyperkalemia reduces digoxin binding to the pump; it appears as a result of acute digoxin poisoning rather than as a diuretic-caused risk factor.

2. Question 2 of 25Hard

   Which of the following drug pairs is a well-known look-alike sound-alike (LASA) combination that can lead to medication errors?

   1. AA. Tylenol (acetaminophen) and Motrin (ibuprofen)
   2. BB. Prilosec (omeprazole) and Prevacid (lansoprazole)
   3. CC. Celebrex (celecoxib) and Celexa (citalopram)
   4. DD. Lipitor (atorvastatin) and Zocor (simvastatin)
   Show answer to question 2

   Answer: C. Celebrex (celecoxib) and Celexa (citalopram)

   Celebrex (celecoxib, an NSAID) and Celexa (citalopram, an SSRI) are classic LASA pairs due to similar spelling and pronunciation. Lipitor and Zocor are both statins but not typically confused by name; Prilosec and Prevacid are both PPIs but have distinct names; Tylenol and Motrin are different generics and brands.

   Why the other options are wrong

   • ATylenol and Motrin are different drugs with distinct brand names; they are not look-alike sound-alike.
   • BPrilosec and Prevacid are both PPIs but their names are sufficiently different; they are not considered high-risk LASA.
   • DLipitor and Zocor are both statins but their names are not easily confused; they are not a classic LASA pair.

3. Question 3 of 25Easy

   Which of the following medications increases insulin secretion from the pancreas in a strictly glucose-dependent manner, thereby reducing the risk of hypoglycemia?

   1. AA. Sitagliptin
   2. BB. Glyburide
   3. CC. Repaglinide
   4. DD. Metformin
   Show answer to question 3

   Answer: A. Sitagliptin

   Sitagliptin is a DPP-4 inhibitor that works by enhancing the action of incretin hormones (GLP-1 and GIP). These hormones stimulate insulin release from the pancreas only when blood glucose levels are elevated, making the effect glucose-dependent and lowering the risk of hypoglycemia. This mechanism distinguishes DPP-4 inhibitors from other classes.

   Why the other options are wrong

   • BGlyburide is a sulfonylurea that stimulates insulin secretion regardless of blood glucose level, leading to a higher risk of hypoglycemia. It is not strictly glucose-dependent.
   • CRepaglinide is a meglitinide that also stimulates insulin secretion, but its action is less glucose-dependent than DPP-4 inhibitors and can still cause hypoglycemia, especially if meals are missed.
   • DMetformin is a biguanide that primarily reduces hepatic glucose production and improves insulin sensitivity; it does not directly increase insulin secretion.

4. Question 4 of 25Medium

   A patient on warfarin therapy requests a refill of their prescription for ibuprofen 800 mg. The pharmacist reviews the profile and identifies a potential adverse drug event. What is the primary risk?

   1. AA. Hepatotoxicity
   2. BB. Nephrotoxicity
   3. CC. Increased risk of bleeding
   4. DD. Decreased warfarin efficacy
   Show answer to question 4

   Answer: C. Increased risk of bleeding

   NSAIDs like ibuprofen inhibit platelet aggregation and can cause gastrointestinal bleeding, significantly increasing the bleeding risk when combined with warfarin.

   Why the other options are wrong

   • AHepatotoxicity is not a common interaction between warfarin and ibuprofen.
   • BNephrotoxicity is a possible adverse effect of NSAIDs but is not the primary concern with warfarin.
   • DNSAIDs do not decrease warfarin's anticoagulant effect; they may actually potentiate it.

5. Question 5 of 25Medium

   Which of the following is classified as a parenteral route of administration?

   1. AA. Oral
   2. BB. Intramuscular
   3. CC. Topical
   4. DD. Sublingual
   Show answer to question 5

   Answer: B. Intramuscular

   Parenteral administration refers to any route that bypasses the gastrointestinal tract, typically via injection. Intramuscular (IM) is a common parenteral route.

   Why the other options are wrong

   • AOral is an enteral route, not parenteral.
   • CTopical is applied to the skin or mucous membranes, not parenteral.
   • DSublingual is a transmucosal route, considered enteral or buccal, not parenteral.

6. Question 6 of 25Easy

   Which of the following is a common side effect of atorvastatin (Lipitor)?

   1. AA. Dry cough
   2. BB. Hyperglycemia
   3. CC. Muscle pain
   4. DD. Bradycardia
   Show answer to question 6

   Answer: C. Muscle pain

   Atorvastatin, an HMG-CoA reductase inhibitor, commonly causes myalgia (muscle pain); it can also lead to rhabdomyolysis in severe cases.

   Why the other options are wrong

   • ADry cough is more associated with ACE inhibitors like lisinopril, not statins.
   • BHyperglycemia is not a typical side effect of statins; it may be seen with atypical antipsychotics or corticosteroids.
   • DBradycardia is a side effect of beta-blockers or calcium channel blockers, not atorvastatin.

7. Question 7 of 25Easy

   Which medication belongs to the beta-blocker class of antihypertensive agents?

   1. AA. Valsartan
   2. BB. Benazepril
   3. CC. Amlodipine
   4. DD. Atenolol
   Show answer to question 7

   Answer: D. Atenolol

   Atenolol is a selective beta-1 adrenergic antagonist, recognized by the suffix '-olol' common to beta blockers. Amlodipine is a dihydropyridine calcium channel blocker, benazepril is an ACE inhibitor, and valsartan is an angiotensin II receptor blocker.

8. Question 8 of 25Easy

   Which of the following dosage forms is designed to release medication over an extended period?

   1. AA. Immediate-release capsule
   2. BB. Sublingual tablet
   3. CC. Chewable tablet
   4. DD. Extended-release tablet
   Show answer to question 8

   Answer: D. Extended-release tablet

   Extended-release (ER) tablets are formulated to release the drug slowly over time, reducing dosing frequency. Immediate-release capsules release the drug all at once, chewable tablets are meant to be chewed for rapid effect, and sublingual tablets dissolve under the tongue for fast absorption.

   Why the other options are wrong

   • AImmediate-release capsules release the entire dose at once, not over an extended period.
   • BSublingual tablets are placed under the tongue for rapid absorption into the bloodstream, not for extended release.
   • CChewable tablets are designed to be chewed for quick dissolution and absorption, not extended release.

9. Question 9 of 25Medium

   When educating a caregiver on the administration of naloxone nasal spray (Narcan), which instruction is essential regarding device preparation?

   1. AA. Dilute the nozzle tip with sterile water before spraying
   2. BB. Do not test or prime the device prior to administration
   3. CC. Prime the spray twice into the air before insertion
   4. DD. Shake the device vigorously for ten seconds before use
   Show answer to question 9

   Answer: B. Do not test or prime the device prior to administration

   Naloxone nasal spray is prepackaged as a single-dose emergency device, and attempting to prime or test the spray will inadvertently discharge the entire dose into the air. Multidose maintenance nasal sprays frequently require priming before initial use, which leads to the dangerous misconception that emergency naloxone devices require the same step.

10. Question 10 of 25Medium

    A patient taking lisinopril for hypertension is prescribed spironolactone for heart failure. The pharmacy technician recognizes that this combination requires routine monitoring for which electrolyte imbalance?

    1. AA. Hyperkalemia
    2. BB. Hypokalemia
    3. CC. Hypernatremia
    4. DD. Hypocalcemia
    Show answer to question 10

    Answer: A. Hyperkalemia

    Both angiotensin-converting enzyme inhibitors like lisinopril and potassium-sparing diuretics like spironolactone reduce potassium excretion by the kidneys, resulting in an additive risk of hyperkalemia. Thiazide and loop diuretics typically cause hypokalemia, but potassium-sparing agents retain potassium.

11. Question 11 of 25Hard

    A patient taking warfarin (Coumadin) asks about using a dietary supplement to help with mood. Which supplement is known to significantly reduce the anticoagulant effect of warfarin and should be avoided?

    1. AA. Calcium carbonate
    2. BB. Fish oil
    3. CC. St. John's wort
    4. DD. Glucosamine
    Show answer to question 11

    Answer: C. St. John's wort

    St. John's wort induces CYP450 enzymes, increasing metabolism of warfarin and reducing its anticoagulant effect, potentially leading to clot formation. It is contraindicated with warfarin.

    Why the other options are wrong

    • ACalcium carbonate does not significantly affect warfarin.
    • BFish oil may increase bleeding risk, not decrease effect.
    • DGlucosamine may have mild interaction but not as significant.

12. Question 12 of 25Hard

    A patient scheduled for an elective surgical procedure reports taking several herbal supplements. Which supplement poses a significant bleeding risk and typically must be discontinued prior to surgery?

    1. AA. Ginkgo biloba
    2. BB. Echinacea purpurea
    3. CC. Milk thistle
    4. DD. Black cohosh
    Show answer to question 12

    Answer: A. Ginkgo biloba

    Ginkgo biloba inhibits platelet-activating factor and can significantly increase the risk of perioperative bleeding; it is commonly held 1 to 2 weeks prior to elective surgery. Milk thistle is used primarily for liver health and does not have the prominent antiplatelet properties associated with Ginkgo biloba.

13. Question 13 of 25Medium

    A patient is receiving counseling on the safe use of a transdermal fentanyl patch. Which instruction is essential to prevent accidental overdose?

    1. AA. Vigorously rub the application area with alcohol prior to use.
    2. BB. Avoid applying heating pads directly over the application site.
    3. CC. Change the patch every 24 hours at the same time each day.
    4. DD. Cut the patch in half if a lower prescribed dose is required.
    Show answer to question 13

    Answer: B. Avoid applying heating pads directly over the application site.

    External heat sources such as heating pads, electric blankets, or hot tubs accelerate the release and cutaneous absorption of fentanyl, which can lead to life-threatening overdose. Fentanyl patches are designed to be changed every 72 hours rather than every 24 hours, and cutting them disrupts the drug-delivery matrix or reservoir.

14. Question 14 of 25Medium

    A patient on warfarin is prescribed a course of ciprofloxacin. What is the primary concern with this combination?

    1. AA. Decreased antibiotic efficacy
    2. BB. Risk of serotonin syndrome
    3. CC. Increased warfarin metabolism
    4. DD. Increased risk of bleeding
    Show answer to question 14

    Answer: D. Increased risk of bleeding

    Ciprofloxacin inhibits CYP1A2 and CYP3A4, reducing warfarin metabolism and potentiating its anticoagulant effect, leading to elevated INR and bleeding risk. Ciprofloxacin does not decrease its own efficacy; it increases warfarin levels (not metabolism); serotonin syndrome involves SSRIs/MAOIs, not warfarin.

    Why the other options are wrong

    • ACiprofloxacin efficacy is not reduced by warfarin; the concern is the effect on warfarin.
    • BSerotonin syndrome is associated with serotonergic drugs, not warfarin or ciprofloxacin.
    • CCiprofloxacin inhibits warfarin metabolism, increasing rather than decreasing warfarin effect.

15. Question 15 of 25Easy

    A pharmacy technician is stocking a newly arrived shipment of insulin vials. According to manufacturer guidelines, unopened insulin vials should be stored:

    1. AA. In the freezer until ready for use
    2. BB. In a warm cabinet to prevent crystallization
    3. CC. At room temperature in a drawer
    4. DD. In the refrigerator at 2°C to 8°C
    Show answer to question 15

    Answer: D. In the refrigerator at 2°C to 8°C

    Unopened insulin vials are stored in the refrigerator at 2°C to 8°C (36°F to 46°F) until the labeled expiration date. Refrigeration preserves potency, while freezing or heat can damage the insulin protein.

    Why the other options are wrong

    • AFreezing denatures insulin, and insulin that has been frozen must be discarded, never used.
    • BHeat speeds insulin degradation; insulin should be kept away from warmth, not stored in a warm cabinet.
    • CRoom temperature is acceptable only for an opened or in-use vial for a limited time (often 28 days), not for unopened stock.

16. Question 16 of 25Easy

    Which of the following is the brand name for the generic drug atorvastatin?

    1. AA. Crestor
    2. BB. Zocor
    3. CC. Lipitor
    4. DD. Mevacor
    Show answer to question 16

    Answer: C. Lipitor

    Atorvastatin is marketed under the brand name Lipitor. Crestor is rosuvastatin, Zocor is simvastatin, and Mevacor is lovastatin.

    Why the other options are wrong

    • ACrestor is the brand name for rosuvastatin.
    • BZocor is the brand name for simvastatin.
    • DMevacor is the brand name for lovastatin.

17. Question 17 of 25Hard

    A patient with heart failure on digoxin is prescribed clarithromycin for a respiratory infection. What is the most clinically significant interaction?

    1. AA. No significant interaction
    2. BB. Increased risk of clarithromycin toxicity due to digoxin
    3. CC. Increased risk of digoxin toxicity due to P-glycoprotein inhibition
    4. DD. Decreased digoxin efficacy due to increased metabolism
    Show answer to question 17

    Answer: C. Increased risk of digoxin toxicity due to P-glycoprotein inhibition

    Clarithromycin inhibits P-glycoprotein, the efflux transporter that limits digoxin absorption and helps clear it through the kidneys. Blocking it raises digoxin levels and the risk of toxicity, such as arrhythmias, nausea and vision changes.

    Why the other options are wrong

    • AThis is a well-known and significant interaction; it is not negligible.
    • BDigoxin is not known to alter clarithromycin pharmacokinetics to a clinically relevant degree.
    • DClarithromycin inhibits, not induces, drug transporters and metabolizing enzymes; digoxin levels rise.

18. Question 18 of 25Medium

    Which of the following drug pairs is known to be a look-alike sound-alike (LASA) pair that could cause dispensing errors?

    1. AA. Acetaminophen and ibuprofen
    2. BB. Furosemide and bumetanide
    3. CC. Atorvastatin and rosuvastatin
    4. DD. Hydroxyzine and hydralazine
    Show answer to question 18

    Answer: D. Hydroxyzine and hydralazine

    Hydroxyzine (an antihistamine) and hydralazine (an antihypertensive) have similar spellings and pronunciations, leading to frequent confusion.

    Why the other options are wrong

    • AAcetaminophen and ibuprofen are different classes and not typically confused by name.
    • BFurosemide and bumetanide are both loop diuretics but have different names and are not a high-risk LASA pair.
    • CBoth are statins but their names are distinct enough that they are not a common LASA pair.

19. Question 19 of 25Medium

    A patient receives a new prescription for insulin glargine (Lantus) 100 units/mL. The pharmacy technician should instruct the patient to store unopened vials in the refrigerator. Once opened, how long can the vial be kept at room temperature (below 86°F)?

    1. AA. 7 days
    2. BB. 28 days
    3. CC. 56 days
    4. DD. 14 days
    Show answer to question 19

    Answer: B. 28 days

    Opened Lantus vials are stable at room temperature (below 86°F) for 28 days. After this period, the insulin should be discarded even if some remains.

    Why the other options are wrong

    • A7 days is too short; insulin glargine is stable for longer.
    • C56 days exceeds the recommended stability period and could lead to loss of potency.
    • D14 days is incorrect; the approved in-use stability is 28 days.

20. Question 20 of 25Hard

    Which of the following beta-blockers is most likely to exacerbate asthma due to its non-selective beta blockade?

    1. AA. Propranolol
    2. BB. Bisoprolol
    3. CC. Atenolol
    4. DD. Metoprolol
    Show answer to question 20

    Answer: A. Propranolol

    Propranolol is a non-selective beta-blocker that blocks both beta-1 (cardiac) and beta-2 (bronchial) receptors. Beta-2 blockade can cause bronchospasm, making it dangerous in asthma. Atenolol, metoprolol, and bisoprolol are cardioselective (beta-1 predominant) and are safer, though still used with caution.

    Why the other options are wrong

    • BBisoprolol is cardioselective; it has less effect on beta-2 receptors than propranolol.
    • CAtenolol is a cardioselective beta-1 blocker, less likely to cause bronchospasm than non-selective agents.
    • DMetoprolol is also cardioselective (beta-1), safer in asthma compared to propranolol.

21. Question 21 of 25Medium

    Which of the following pairs of drug names are most likely to be confused due to sound-alike similarity?

    1. AA. Celebrex and Celexa
    2. BB. Lipitor and Lescol
    3. CC. Zoloft and Prozac
    4. DD. Tylenol and Motrin
    Show answer to question 21

    Answer: A. Celebrex and Celexa

    Celebrex (celecoxib, NSAID) and Celexa (citalopram, SSRI) are frequently confused because they sound very similar when spoken. Tylenol (acetaminophen) and Motrin (ibuprofen) are different classes and less likely confused. Lipitor (atorvastatin) and Lescol (fluvastatin) are both statins but names are distinct. Zoloft (sertraline) and Prozac (fluoxetine) are both SSRIs but names are not as similar.

    Why the other options are wrong

    • BLipitor and Lescol are both statins but have different prefixes and are less likely to be confused.
    • CZoloft and Prozac are both SSRIs but their names are not as phonetically similar as Celebrex and Celexa.
    • DTylenol and Motrin have different generic names and are not typically confused as sound-alikes.

22. Question 22 of 25Hard

    A patient scheduled for an MRI procedure asks the pharmacy technician if they need to remove their transdermal patch prior to the scan. Which component found in certain transdermal patches poses a safety hazard during an MRI?

    1. AA. Pressurized liquid reservoirs that can vaporize and rupture
    2. BB. Metallic backing containing aluminum that can cause skin burns
    3. CC. Polyethylene backing films that generate electrostatic discharges
    4. DD. Synthetic silicone adhesives that distort magnetic imaging fields
    Show answer to question 22

    Answer: B. Metallic backing containing aluminum that can cause skin burns

    Some transdermal systems incorporate aluminum or other conductive metals into their backing layer, which can overheat in the radiofrequency fields of an MRI and cause significant skin burns. Standard polymer backings and silicone adhesives do not conduct electricity or cause thermal injury.

23. Question 23 of 25Medium

    A patient with uncontrolled hypertension is looking for relief from nasal congestion. Which over-the-counter ingredient should this patient avoid?

    1. AA. Guaifenesin
    2. BB. Cromolyn sodium
    3. CC. Pseudoephedrine
    4. DD. Dextromethorphan
    Show answer to question 23

    Answer: C. Pseudoephedrine

    Pseudoephedrine is a sympathomimetic decongestant that stimulates alpha-adrenergic receptors to induce vasoconstriction, which can elevate blood pressure and heart rate. Expectorants such as guaifenesin, cough suppressants such as dextromethorphan, and mast cell stabilizers like cromolyn sodium do not cause systemic vasoconstriction.

24. Question 24 of 25Easy

    Which of the following best describes the drug class of lisinopril?

    1. AA. Angiotensin-converting enzyme (ACE) inhibitor
    2. BB. Calcium channel blocker
    3. CC. Beta-blocker
    4. DD. Angiotensin II receptor blocker (ARB)
    Show answer to question 24

    Answer: A. Angiotensin-converting enzyme (ACE) inhibitor

    Lisinopril is an ACE inhibitor, ending in '-pril'. ARBs end in '-sartan', beta-blockers end in '-olol', and calcium channel blockers like amlodipine end in '-dipine'.

    Why the other options are wrong

    • BCalcium channel blockers often end in '-dipine' (e.g., nifedipine), not '-pril'.
    • CBeta-blockers end in '-olol' (e.g., metoprolol), not '-pril'.
    • DARBs end in '-sartan' (e.g., losartan), not '-pril'.

25. Question 25 of 25Medium

    A patient has difficulty swallowing tablets and asks about a medication that is designed to release in the intestine rather than the stomach. Which dosage form is specifically formulated for this purpose?

    1. AA. Sublingual tablet
    2. BB. Chewable tablet
    3. CC. Effervescent tablet
    4. DD. Enteric-coated tablet
    Show answer to question 25

    Answer: D. Enteric-coated tablet

    Enteric-coated tablets have a special coating that resists stomach acid and dissolves in the alkaline environment of the small intestine, protecting the drug from gastric degradation or preventing gastric irritation.

    Why the other options are wrong

    • ASublingual tablets dissolve under the tongue for rapid absorption.
    • BChewable tablets are meant to be chewed before swallowing.
    • CEffervescent tablets dissolve in water to produce a solution.

Email me my score report

The full PTCE bank has 1,154 Medications questions. See plans