Pass the PTCB CPhT PTCE Questions and answers with Dumpstech

A vaccine administration error occurs when a vaccine is given in a way that deviates from standard guidelines established by the Centers for Disease Control and Prevention (CDC) and the vaccine manufacturer’s recommendations. Some administration errors must be reported voluntarily to theVaccine Adverse Event Reporting System (VAERS)to help improve vaccine safety and prevent future errors.

(A) Fluzone was administered subcutaneously.✅(Incorrect Route – Error that Should Be Reported)

Fluzone is aninactivated influenza vaccine (IIV)that should be administeredintramuscularly (IM).

Subcutaneous (SQ) administration isnot recommendedand may reduce vaccine efficacy.

According to theCDC and the Immunization Action Coalition (IAC), administering an inactivated influenza vaccine subcutaneously is a vaccine administration error and should be reported.

(B) Boostrix was administered intramuscularly.❌(Correct Route – No Error)

Boostrix is aTdap (Tetanus, Diphtheria, and Acellular Pertussis) vaccineindicated for booster immunization.

It iscorrectly administered intramuscularly (IM)in thedeltoid muscle.

Since the correct administration route was followed, this does not qualify as a vaccine administration error.

(C) Varivax was administered subcutaneously.❌(Correct Route – No Error)

Varivax is alive-attenuated varicella (chickenpox) vaccine.

It iscorrectly administered subcutaneously (SQ), typically in the upper arm or thigh.

Since the correct administration route was followed, this is not a vaccine administration error.

(D) Shingrix was administered intramuscularly.❌(Correct Route – No Error)

Shingrix is arecombinant zoster vaccine (RZV)used for shingles prevention.

It should be administeredintramuscularly (IM).

Since the correct administration route was followed, this is not a vaccine administration error.

TheInstitute for Safe Medication Practices (ISMP)and theCDCrecommend reportingvaccine administration errorsto VAERS, especially if the error could affect the vaccine’s efficacy or patient safety.

Administration of Fluzonevia the incorrect route (subcutaneously instead of intramuscularly)could alter immune response and should be reported.

If a vaccine is given via the incorrect route, the CDC provides guidance on whether the dose needs to be repeated. For inactivated influenza vaccines given subcutaneously, the CDC states that the dose doesnot need to be repeated, but the error should still be documented and reported.

CDC General Best Practices for Immunization:https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html

Vaccine Adverse Event Reporting System (VAERS): https://vaers.hhs.gov/

Immunization Action Coalition (IAC) - Vaccine Administration Guidelines: https://www.immunize.org/technical-support/administering-vaccines/

Institute for Safe Medication Practices (ISMP) - Vaccine Safety Recommendations: https://www.ismp.org/recommendations/immunization-safety

Analysis of Each Answer Choice:Reporting Vaccine Administration Errors:References for Pharmacy Technicians:

Risk Evaluation and Mitigation Strategies (REMS)areFDA-required programsto ensure that thebenefits of certain medications outweigh their risks. REMS programsrestrict prescribing, dispensing, and monitoringdue to the potential for serious side effects or misuse.

Suboxoneis used foropioid dependenceand containsbuprenorphine, apartial opioid agonist, which can causeaddiction, misuse, and respiratory depressionif used improperly.

REMS Requirements for Suboxone:

Prescriber Certification:Only specially certified providers can prescribe Suboxone.

Patient Education:Patients must be informed about the risks of misuse, overdose, and dependence.

Limited Dispensing:Pharmacists must ensure prescriptions meet REMS criteria before dispensing.

A. Xarelto (Rivaroxaban).→ Incorrect. While Xarelto is an anticoagulant, it isnot under REMS.

C. Warfarin.→ Incorrect. Warfarin requires monitoring butdoes not have a REMS program.

D. Haloperidol.→ Incorrect. Haloperidol is an antipsychotic, but itdoes not have a REMS program.

FDA REMS Program List (www.accessdata.fda.gov).

Suboxone REMS Guidelines (www.suboxonerems.com).

PTCB PTCE Exam Content Outline – REMS and Medication Safety.

Mosby’s Pharmacy Technician: Principles and Practice – REMS Regulations.

Why Is Suboxone (Buprenorphine/Naloxone) Under REMS?Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

TheU.S. Food and Drug Administration (FDA)requires aMedication Guide (MedGuide)to be provided when dispensing certain medications that have significant safety concerns.Zyprexa (Olanzapine), anatypical antipsychotic, requires aMedication Guidedue to serious risks such as:

Increased mortality in elderly patients with dementia-related psychosis

Metabolic side effects(e.g., weight gain, hyperglycemia, and dyslipidemia)

Neuroleptic malignant syndrome (NMS)

A. Zafirlukast→ Incorrect; while used forasthma(leukotriene receptor antagonist), it doesnot require a Medication Guide.

B. Zestril (Lisinopril)→ Incorrect; anACE inhibitorfor hypertension, it doesnot require a Medication Guide.

C. Zinc→ Incorrect; adietary supplementthat does not require a Medication Guide.

Other Answer Choices Explained:References:

FDA Medication Guide Requirements for Olanzapine (Zyprexa)

PTCB PTCE Exam Content Outline (Medication Safety & Patient Counseling)

Materials used to clean up chemotherapy (hazardous drug) spills (e.g., pads, wipes, absorbents, PPE used in the cleanup) are managed as hazardous drug waste, due to contamination with active hazardous drug. “Trace” hazardous waste applies to empty containers and PPE with only residual amounts, not spill cleanup materials. These practices are consistent with USP <800>, OSHA/NIOSH guidance, and hazardous waste handling standards.

References (Pharmacy Technician documents / Study Guides):

• USP <800> Hazardous Drugs—Handling in Healthcare Settings: Spill management and waste disposal.

• NIOSH/OSHA guidance on hazardous drug spill response and contaminated materials disposal.

• ASHP Guidelines on Handling Hazardous Drugs: Waste classification and disposal practices.

Pharmacy staff should always visually inspect nonsterile compounds for signs of incompatibility to ensure medication safety and efficacy. The presence ofprecipitationis a key indicator of an incompatibility issue in nonsterile compounded preparations. Precipitation occurs when a solute (drug) comes out of solution, forming visible solid particles. This can result from changes in pH, solvent composition, or chemical interactions between ingredients.

A. Photolysis:

Decomposition of a drug due to light exposure, leading to color changes or potency loss, but it is not a physical incompatibility visible as precipitation.

B. Hydrolysis:

Chemical breakdown of a drug due to water, common in ester and amide-containing drugs, but not a visual incompatibility like precipitation.

D. Oxidation-Reduction:

A chemical reaction that may change drug color or effectiveness but does not typically lead to visible precipitation in nonsterile compounds.

Other Answer Choices Explained:References:

USP <795> Pharmaceutical Compounding—Nonsterile Preparations

PTCB PTCE Exam Content Outline (Medication Safety & Quality Assurance)

Remington: The Science and Practice of Pharmacy

Per the FDA-approved labeling for NuvaRing (etonogestrel/ethinyl estradiol vaginal ring), the product should be stored refrigerated at 2°C to 8°C (36°F to 46°F) prior to dispensing. After dispensing, NuvaRing may be stored at room temperature for a limited period per labeling (commonly referenced in technician materials as up to 4 months), but pharmacy stock should be kept refrigerated before it is dispensed. Freezing is not recommended.

References (Pharmacy Technician documents/Study Guides):

• NuvaRing Prescribing Information: Storage conditions (refrigeration prior to dispensing; room temperature allowance after dispensing).

• PTCB Top 200/Storage Requirements: Hormonal contraceptive ring storage.

• ASHP/Institutional storage guidelines for temperature-sensitive medications.

Apidra (insulin glulisine)is arapid-acting insulinthat must bestored between 36°F and 46°F (2°C to 8°C)in the refrigerator. If frozen,it is no longer usableand shouldnever be thawed or dispensed. The best course of action is toreturn it to the distributorto ensure medication integrity and patient safety.

A. Thawed and stored in a refrigerator→ Incorrect;frozen insulin loses its potencyand shouldnot be used.

B. Sent to the prescriber→ Incorrect; the prescriber does not handle medication storage or replacements.

C. Dispensed to a patient→ Incorrect;frozen insulin is ineffectiveand could harm the patient.

Other Answer Choices Explained:References:

FDA Insulin Storage and Handling Guidelines

USP <797> Sterile Preparations – Storage Conditions

Manufacturer Storage Requirements for Apidra (Sanofi-Aventis)

In prescription terminology,"troche" refers to a dosage form, specifically alozengethat dissolves slowly in the mouth to release medication.

Atroche (or lozenge)is asolid, flavoredmedication thatdissolves in the mouthover time, allowing for gradual drug absorption.

Used for:

Local effects(e.g., sore throat relief with benzocaine troches)

Systemic effects(e.g., hormone replacement therapy troches)

A. Time❌→ Incorrect

"Troche" doesnotindicate when to take the medication.

C. Rate❌→ Incorrect

"Troche" doesnotindicate how fast the drug is absorbed.

D. Route❌→ Incorrect

"Troche"describes the dosage form, whilerouterefers to how a drug is administered (e.g., oral, IV).

USP-NF (United States Pharmacopeia–National Formulary)– Defines dosage forms, including lozenges/troches.

PTCB PTCE Exam Content Outline– Covers pharmaceutical dosage forms and prescription terminology.

ISMP Medication Safety Guidelines– Includes troches in standard medication formulations.

Definition of Troche:Why Not the Other Options?Key References:

NSAIDs (e.g., ibuprofen, naproxen, aspirin) can irritate the gastric mucosa, increase gastric acidity, and worsen GERD symptoms or cause GI adverse effects such as dyspepsia and ulceration. Acetaminophen does not have NSAID gastric effects and is the preferred OTC analgesic/antipyretic for patients with GERD or those at risk for GI complications, when appropriate and within dosing limits.

AMaster Formulation Record (MFR)is adetailed document used in compounding pharmaciesto ensureconsistency, accuracy, and quality controlin preparing compounded medications.

An MFR includes:

Ingredients & amounts required.

Compounding procedures.

Stability and beyond-use dating (BUD).

Storage and labeling instructions.

This ensures that each compounded preparationmeets quality standardsand ismade correctly every time.

B. Prevent drug diversion❌→Incorrect

Drug diversion prevention involves security measures, inventory control, and trackingcontrolled substances, not MFRs.

C. Eliminate patient profiles❌→Incorrect

Patient profiles are essential for tracking medication history; MFRs are unrelated.

D. Guarantee drug availability❌→Incorrect

MFRs do not affect drug supply; they ensure accurate compounding.

USP <795> (Non-Sterile Compounding Guidelines)– RequiresMaster Formulation Records for all compounded preparations.

PTCB PTCE Exam Content Outline– Covers compounding procedures and quality control measures.

Why Not the Other Options?Key References: