Patient Safety and Quality Assurance is 23.75% of the scored PTCE (the PTCB exam). Answer 10 exam style questions on drug utilization review and allergy checks and see exactly which concepts would cost you points on test day.
Start the 10 questions →While picking up lisinopril, a patient asks the technician, "Is it OK to take ibuprofen with this?" What should the technician do?
These questions cover technician vs pharmacist role, drug utilization review and allergy checks. Each one shows the correct answer and why every other option is wrong, so a miss tells you exactly what to review before the PTCE.
Prefer to read first? Every question from the practice set above, with the correct answer and why each wrong option is wrong.
Answer: A. Questions about drug interactions require clinical judgment and are answered by the pharmacist. NSAIDs such as ibuprofen can reduce the effect of ACE inhibitors and affect kidney function, so the pharmacist needs to assess the patient.
Why not B: This is false and gives clinical advice a technician may not give.
Why not C: Interpreting drug information for a patient is counseling, which belongs to the pharmacist.
Why not D: The pharmacist is available now. Delaying the answer leaves the patient at risk in the meantime.
Exam tactic: Any "Is it safe...?" or "Should I...?" question goes to the pharmacist.
Answer: B. An early fill alert may signal overuse, misuse, or a dose change. With an opioid, the pharmacist must evaluate the situation before anything is filled. (Schedule II drugs such as hydrocodone combinations cannot be refilled, which is why a new prescription was needed.)
Why not A: The patient's explanation needs pharmacist evaluation. A technician cannot decide this.
Why not C: Partial fills to bypass an alert are not a technician decision and do not address the concern.
Why not D: The issue is clinical and legal, not only an insurance date.
Exam tactic: Early fill alert on an opioid = pharmacist, every time.
Answer: B. Recording the drug and the exact reaction lets the pharmacist tell an intolerance (such as nausea) from a true allergy (such as hives or swelling). The technician does not decide which it is.
Why not A: Deciding what counts as an allergy is clinical judgment, and unrecorded reactions are lost.
Why not C: This overstates the reaction and may block appropriate therapy.
Why not D: Without the reaction, the pharmacist cannot judge how serious it is.
Exam tactic: Record exactly what the patient reports. Let the pharmacist classify it.
Answer: C. Different ink or altered numbers are signs of a possibly altered prescription. The pharmacist verifies it with the prescriber. The technician should not confront the patient.
Why not A: Guessing the original quantity is not a technician decision. The prescription must be verified.
Why not B: Confrontation can be unsafe and is not the technician's role. The pharmacist handles it.
Why not D: Filling an apparently altered controlled substance prescription without verification is a serious error.
Exam tactic: Signs of alteration = quiet alert to the pharmacist.
Answer: D. Sertraline and escitalopram are both SSRIs. Two drugs from the same class for the same purpose trigger a therapeutic duplication alert, which the pharmacist must review.
Why not A: Nothing indicates an allergy to either drug.
Why not B: Escitalopram is a new prescription, not a refill of sertraline.
Why not C: There is no disease state here that conflicts with escitalopram. The problem is two SSRIs.
Exam tactic: Two drugs, same class, same purpose = therapeutic duplication.
Answer: B. NKDA means no known drug allergies, but allergy status can change. Allergy information should be confirmed and updated, especially with new prescriptions.
Why not A: Allergies can develop at any time, so the profile must be kept current.
Why not C: Entering an allergy the patient does not have creates false data.
Why not D: The patient is present and is the most direct source to confirm current allergy status.
Exam tactic: NKDA = no known drug allergies. Confirm it is still true.
Answer: A. A possible adverse drug reaction requires the pharmacist's assessment. The pharmacist decides on next steps, such as contacting the prescriber or advising urgent care if severe symptoms are present.
Why not B: Advising a patient to stop a medication is clinical advice.
Why not C: Recommending a treatment is clinical judgment reserved for the pharmacist.
Why not D: Delaying assessment of a possible allergic reaction is unsafe.
Exam tactic: Possible adverse reaction = pharmacist now.
Answer: D. Propranolol is a nonselective beta blocker that can cause bronchospasm in patients with asthma. A drug that may worsen an existing condition triggers a drug-disease alert.
Why not A: The concern is the patient's asthma, a condition, not another medication.
Why not B: Nothing in the profile shows another beta blocker.
Why not C: Asthma is a disease, not a documented drug allergy.
Exam tactic: Drug + patient's condition = drug-disease alert.
Answer: C. Penicillins and cephalosporins are both beta-lactam antibiotics, and some patients with a penicillin allergy react to cephalosporins. The pharmacist reviews the type of reaction and decides with the prescriber.
Why not A: Cephalexin is a first-generation cephalosporin, not a penicillin.
Why not B: Cephalexin is not a sulfonamide. The concern is beta-lactam cross-sensitivity.
Why not D: The alert is an allergy alert, not a drug-drug interaction.
Exam tactic: Penicillin allergy + cephalosporin = cross-sensitivity alert for the pharmacist.
Answer: A. Recommending an OTC product requires assessing the patient's conditions and other medications, which is clinical judgment reserved for the pharmacist. For example, some decongestants are a concern in hypertension.
Why not B: Entering demographic and insurance data is a routine technician task.
Why not C: Counting and labeling are standard technician tasks, followed by pharmacist verification.
Why not D: Retrieving products for filling is a routine technician task.
Exam tactic: Choosing or recommending therapy = pharmacist. Data, counting, labeling = technician.
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