Mosby's Sterile Compounding for Pharmacy Technicians 2nd Edition Principles and Practice By Karen Da

Mosby Sterile Compounding for Pharmacy Technicians 2nd Edition Davis Test Bank Chapter 01: Introduction to Sterile Compounding Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Parenteral medications must be free from pyrogens because: a. they are given to patients in an emergency. b. they pass through the digestive system. c. they are given directly into the bloodstream. d. they are given to immune-compromised patients.

ANS: C

Parenteral medications are given often in emergency situations and to those who are immune compromised, but the main reason they must be free from pyrogens is because they are given directly into the bloodstream and bypass all of the body’s natural defense systems.

DIF: Application REF: p. 1 OBJ: 1 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 2. The guidelines for preparing intravenous medications are provided by which of the following? a. CDC b. NCCLVP c. USP d. The Joint Commission ANS: C

The United States PharmacToE poSeTiaB(A UN SK P)SiE s aLnLoEffRic.iaCl O stM andard setting organization made up of volunteer body of experts in the medical field who provide the guidelines for preparing intravenous medications.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment) 3.

OBJ: 4

was a well-known surgeon who wrote about using carbolic acid to kill germs in Antiseptic Principle of the Practices of Surgery. a. Fleming b. Pasteur c. Baxter d. Lister ANS: D

Sir Joseph Lister was a well-known surgeon who, after reading a paper by Louis Pasteur, learned about the germ theory of disease and reasoned that if infections were caused by microbes, the best way of preventing infections would be to kill the microbes before they reached open wounds.

DIF: Recall REF: p. 2 OBJ: 4 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 4. The route of medication that bypasses the digestive system is known as: a. sterile.

b. pyrogenic. c. parenteral. d. aseptic.

ANS: C

The parenteral route is any medication route other than the digestive system.

DIF: Recall REF: p. 1 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 5. The first set of recommendations for pharmacy and other health care professionals was

published by the: a. CDC. b. NCCLVP. c. ASHP. d. USP. ANS: B

The National Coordinating Committee on Large-Volume Parenterals (NCCLVP) published the first set of recommendations for pharmacy and other health care professionals.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

OBJ: 4

6. Infection control, patient rights, and treatment are the main focuses of which organization? a. ASHP b. The Joint Commission c. USP d. CDC ANS: B

The Joint Commission’s main focus is on patient rights, treatments, and infection control.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

OBJ: 4

7. The first line of defense against the spread of microorganisms is handwashing, according to

the: a. b. c. d.

USP. ASHP. CDC. NCCLVP.

ANS: C

According to the CDC, the first line of defense against the spread of microorganisms is good handwashing.

DIF: Comprehension REF: p. 4 TOP: CSPT Exam 1.6 (1.0 Medications and Components)

OBJ: 1

8. Sterile IV products are commonly made in all of the following settings except: a. patient’s home.

b. hospitals. c. outpatient pharmacies. d. clinics.

ANS: A

IV medications needed for home health therapy are made at a facility with appropriate quality standards for making IV products and delivered to the patient’s home. Sterile IV products can be prepared in a patient’s home but only if the quality standards are met to maintain an aseptic environment—not adhering to these guidelines would put the patient at risk.

DIF: Application REF: p. 2 OBJ: 5 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 9. According to the USP Chapter 797, which type of preparation does NOT require aseptic

technique? a. Eye preparations b. Intravenous preparations c. Tissue implants d. Ear preparations ANS: D

Ear preparations do not require aseptic technique during preparation.

DIF: Application REF: p. 3 OBJ: 2 TOP: CSPT Exam 1.4 (1.0 Medications and Components) 10. A condition known to be free from infection, germs, and any form of life is called: a. normal flora. b. asepsis. c. sterile. d. pyrogenic.

ANS: B

Asepsis is a condition free from germs, infection, and any form of life.

DIF: Comprehension REF: p. 4 TOP: CSPT Exam 1.6 (1.0 Medications and Components)

OBJ: 3

11. The practice of medicine advanced quickly in the: a. 1600s. b. 1700s. c. 1800s. d. 1900s.

ANS: C

In the 19th century, researchers began discovering that certain diseases were caused by germs and unknown organisms, resulting in advancements in the practice of medicine.

DIF: Recall

REF: p. 2

OBJ: 4

12. An example of a positive antibiotic is a(n): a. staphylococci.

TOP: N/A

b. diplococci. c. aminoglycosides. d. both staphylococci and aminoglycosides.

ANS: A

Antibiotic drugs are classified as positive, such as staphylococci, or negative, such as diplococci or aminoglycosides.

DIF: Application REF: p. 3 OBJ: 2 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 13. The primary goal for aseptic technique is to: a. keep personnel free from microbes. b. keep products from expiring. c. keep products free from contamination. d. keep patients from returning to the hospital.

ANS: C

Keeping products free from contamination from microbes is the primary goal of aseptic technique.

DIF: Comprehension REF: p. 4 TOP: CSPT Exam 1.6 (1.0 Medications and Components)

OBJ: 3

14. Policies and procedures put into place to prevent the spread of microorganisms that cause

infection is known as: a. normal flora. b. aseptic technique. c. infection control. d. standard precautions.

ANS: C

Policies and procedures organizations put into place to prevent the spread of infection is known as infection control.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

OBJ: 2

15. All of the following are responsibilities of technicians except: a. entering the order. b. calculating volume. c. labeling the final product. d. checking the final product.

ANS: D

Pharmacy technicians are responsible for entering the order, calculating volume, and labeling the final product; however, the pharmacist is responsible for checking the final product before it is sent to the patient.

DIF: Application REF: p. 4 OBJ: 2 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

TRUE/FALSE 1. The USP is a not-for-profit organization that evaluates medical facilities to ensure good public

health.

ANS: F

The USP is not-for-profit organization that sets the standards for OTC and prescription medications. The Joint Commission is a not-for-profit organization that evaluates medical facilities to ensure good public health.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

OBJ: 4

2. Compounding sterile preparations began in the early 1960s.

ANS: F

Compounding sterile preparations has been performed since the beginning of pharmacy.

DIF: Recall

REF: p. 1

OBJ: 4

TOP: N/A

3. Normal bacteria cannot cause harm to an immune-compromised person.

ANS: F

Normal bacteria can cause significant harm, such as infection and even death, to a patient who is immune compromised.

DIF: Comprehension REF: p. 2 TOP: CSPT Exam 1.6 (1.0 M edS icT atB ioA nsNaK ndSC onRe. ntC s)OM TE EoLmLpE

OBJ: 1

4. Chapter 797 is endorsed by ASHP and CDC. ANS: F

Chapter 797 is endorsed by ASHP and The Joint Commission.

DIF: Recall REF: p. 3 OBJ: 4 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment) 5. When preparing any medications that enters the body through parenteral or otic route, aseptic

technique is required.

ANS: F

Aseptic technique is required for any medication that enters the body through parenteral and ophthalmic routes.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 1.6 (1.0 Medications and Components)

OBJ: 1

6. The first enforceable document to outline the practices associated with sterile compounding is

Chapter 797.

ANS: T

USP Chapter 797, which was written in 2004, was the first enforceable document to outline the practices associated with sterile compounding.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

OBJ: 4

7. The basic defense mechanism for our bodies is called normal flora.

ANS: T

Normal flora include the bacteria that reside on the skin’s outer surface but is not disease. It is the basic defense mechanism of the body.

DIF: Recall REF: p. 4 OBJ: 1 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 8. Improper handwashing could possibly result in the death of a patient.

ANS: T

Touch contamination is the most common type of contamination. With improper handwashing, our normal bacteria can contaminate the product we are working on and get into the patient’s bloodstream, causing infection and possibly resulting in death.

DIF: Comprehension REF: p. 4 OBJ: 1 TOP: CSPT Exam 1.6 (1.0 Medications and Components) | CSPT Exam 3.4 (3.0 Sterile Compounding Procedures) 9. Once the pharmacy personnel properly wash their hands, they can immediately begin

compounding sterile prepaT raE tiS onTsB . ANKSELLER.COM ANS: F

Pharmacy personnel must also wear appropriate personal protective equipment or PPE. DIF: Comprehension REF: p. 4 OBJ: 2 TOP: CSPT Exam 1.6 (1.0 Medications and Components) | CSPT Exam 3.4 (3.0 Sterile Compounding Procedures) 10. Technicians must be as accurate and correct as possible when compounding sterile

medications.

ANS: T

Although the pharmacist has the final check on any medication mixed in the clean room, technicians must be as accurate and correct as possible.

DIF: Comprehension REF: p. 4 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

OBJ: 2

11. Establishing beyond use dates for sterile products is an important aspect of a quality standards

for sterile products.

ANS: T

To ensure quality assurance, facilities must provide, at a minimum, quality standards including beyond use dates for sterile products.

DIF: Comprehension REF: p. 3 TOP: CSPT Exam 1.6 (1.0 Medications and Components)

OBJ: 2

12. The ante room can be placed in a regular traffic area as long as the air in continuously filtered.

ANS: F

The space or areas for compounding should be separated from the regular flow of traffic and only authorized personnel are allowed in. These spaces include the ante room and buffer room.

DIF: Comprehension REF: p. 5 TOP: CSPT Exam 2.2 (Facilities and Equipment)

OBJ: 5

13. With proper aseptic technique, IV medications needed for home health therapy can be made at

the patient’s home.

ANS: F

Having proper aseptic technique is not enough make IV medications. IV medications needed for home health therapy are made at a facility with the appropriate quality standards for asepsis and delivered to the patient’s home.

DIF: Application REF: p. 5 OBJ: 5 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 14. Patient education should always be stressed, especially in a home health care setting.

ANS: T

Patients should always be educated on the medications they receive, especially while they are at home.

DIF: Comprehension REF: p. 5 TOP: CSPT Exam 2.8 (Facilities and Equipment)

OBJ: 2

Chapter 02: Medications and Disease Management Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. The process of a drug being altered chemically is: a. distribution. b. absorption. c. elimination. d. metabolism.

ANS: D

Metabolism is the third step in the life of the drug, also known as pharmacokinetics and it is an actual chemical alteration of the original drug.

DIF: Recall REF: p. 9 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 2. Any condition that a drug should not be used is called a(n): a. contraindication. b. indication. c. allergy. d. adverse reaction.

ANS: A

A contraindication is a reason that makes it ill advised to order a specific drug for treatment.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 3. When a drug is administered and the intended effect occurs, what is it called? a. Toxic effect b. Therapeutic effect c. Adverse effect d. Side effect ANS: B

The therapeutic effect of a drug is the intended effect.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 4. Undesirable yet unexpected effects that are not widely known or reported are known as: a. side effects. b. toxic effects. c. adverse effects. d. allergies.

ANS: C

Adverse drug reactions are drug effects that are unexpected and unwanted and are usually reported in only a few patients.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 5. When dosing a drug, sometimes one drug can magnify another the patient is currently taking.

This is said to be caused by what factor? a. Disease b. Age c. Body weight d. Drug interactions ANS: D

Drug interactions occur when one drug prolongs or magnifies the effect of another being given at the same time.

DIF: Comprehension REF: p. 11 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

6. Which of the following is the correct order of the steps involved in pharmacokinetics? a. Absorption, metabolism, distribution, and excretion b. Distribution, absorption, metabolism, and excretion c. Absorption, distribution, metabolism, and excretion d. Distribution, metabolism, absorption, and excretion ANS: C

Pharmacokinetics is the process that drugs go through in the body. It involves four steps, absorption, distribution, metabolism, and excretion.

DIF: Application REF: p. 8 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 7. Which of the following is the second step involved in pharmacokinetics? a. Excretion b. Absorption c. Distribution d. Metabolism ANS: C

Distribution is the second step in the process of pharmacokinetics. This step allows the drug to be distributed throughout the body so they can act on the body.

DIF: Application REF: p. 8 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 8. IV medications have the most rapid onset of action because: a. they are absorbed in the digestive system. b. they are absorbed in the muscle tissue. c. they are absorbed in the bloodstream. d. they are absorbed in the subcutaneous tissue.

ANS: C

IV medications are injected directly into the bloodstream, allowing the medication to act quickly.

DIF: Comprehension REF: p. 9 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

9. Drug effects that are predictable and widely reported and can be found in literature are known

as a(n): a. adverse reaction. b. therapeutic effect. c. side effect. d. intended effect.

ANS: C

Side effects are drug effects that were found during studies of the drug. They are predictable and widely reported and can be found in literature, such as the package insert.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.5 (1.0 Medications and Components) 10. Why are pediatric patients dosed differently than adult patients? a. A pediatric patient has a lower percentage of body water and a higher percentage

of body fat than an adult patient. b. A pediatric patient’s brain has a protective barrier known as the blood–brain

barrier. c. A pediatric patient has a higher percentage of body water and lower percentage of

body fat than an adult patient.

d. A pediatric patient’s plT asEmSaTpB roAteNinKiSs E hiLgL heEr R th.anCO it M is in an adult patient.

ANS: C

There are multiple reasons why pediatric patients are dosed differently from adult patients.

One reason is that children have a higher percentage of body water and a lower percentage of body fat than adults, causing drugs to stay in the body longer, possibly causing toxicity.

DIF: Comprehension REF: p. 9-10 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

11. The NDC number identifies the specific: a. drug, expiration date, and manufacturer. b. drug, package size, and expiration date. c. drug, manufacturer, package size. d. manufacturer, expiration date, and package size.

ANS: C

The purpose of the National Drug Code (NDC) is to identify the specific drug, the manufacturer of the drug, and the package size it is in.

DIF: Comprehension REF: p. 12 TOP: CSPT Exam 1.5 (1.0 Medications and Components)

OBJ: 3

12. The label of every IV drug package must include all of the following except: a. generic name.

b. concentration of the liquid. c. chemical name. d. storage requirements.

ANS: C

Although every drug has an individual chemical name, it does not have to appear on the label of the drug package.

DIF: Application REF: p. 12 OBJ: 3 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 13. Which of the following is not often taken into consideration for parenteral medications? a. Age b. Height c. Weight d. Existing conditions ANS: B

Height is not usually something that needs to be taken into consideration when ordering a medication.

DIF: Application REF: p. 9-11 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 14. The step of pharmacokinetics that could be affected by failed kidneys is: a. distribution. b. excretion. c. metabolism. d. absorption.

ANS: B

Most drugs are excreted through the liver or the kidneys. If a patient has renal failure, then this could cause the drug to stay in the system longer and could become toxic.

DIF: Recall REF: p. 8 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 15. The age variables of a child are between the ages of: a. 2 and 12 years. b. 1 and 12 years. c. 3 and 13 years. d. 2 and 15 years.

ANS: A

Concerning medications, a “child” is anyone between the ages of 2 and 12 years of age.

DIF: Recall REF: p. 10 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 16. The of the drug is the amount of drug given at one time. a. strength b. dose

c. quantity d. volume ANS: B

The dose is the amount of drug given at one time.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 17. The removal of a drug from the body is known as: a. metabolism. b. absorption. c. distribution. d. excretion.

ANS: D

The fourth and final step in pharmacokinetics, in which the body rids itself of the drug, is called excretion.

DIF: Recall REF: p. 9 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 18. The drug effect that occurs when too little of a dose is administered is known as: a. therapeutic effect. b. adverse effect. c. side effect. d. subtherapeutic effect.

ANS: D

Subtherapeutic effect is a drug effect that occurs when a patient is underdosed, which could cause harm to the patient.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 19. Which of the following reference material would be the best choice to look up an

incompatibility between ampicillin IV and heparin? a. USP-NF b. Trissel’s Handbook on Injectable Drugs c. PDR d. Red Book ANS: B

Trissel’s Handbook on Injectable Drugs is one of the preferred references to use in regards to compatibility questions about injectable drugs.

DIF: Application REF: p. 12 OBJ: 3 TOP: CSPT Exam 1.5 (1.0 Medications and Components) 20. The “special” place where drugs go to allow a specific action to take place is/are known as: a. receptor sites. b. blood–brain barrier.

c. digestive system. d. adverse reaction site.

ANS: A

The receptor sites, located on the target cells, are the “special” places where drugs go to allow a specific action to take place.

DIF: Comprehension REF: p. 8 TOP: CSPT Exam 1.1 (1.0 Medications and Components)

OBJ: 2

21. What term is used for an intravenous solution that is free from bacteria and other

microorganisms? a. Clarity b. Sterility c. pH d. Tonicity ANS: B

Sterility is being free from bacteria and other microorganisms.

DIF: Recall REF: p. 13 OBJ: 4 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 22. What term is used to describe a solution containing the concentration of dissolved substances

closest to the red blood cells? a. Hypertonic b. Hypotonic c. Isotonic d. None of the options ANS: C

Any solution containing a concentration of dissolved substances that is the same as the concentration in red blood cells is an isotonic solution.

DIF: Recall REF: p. 13 OBJ: 4 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 23. Both 0.9% sodium chloride and 5% dextrose solutions are said to be: a. isotonic. b. hypotonic. c. hypertonic. d. osmolar.

ANS: A

Examples of an isotonic solution include 5% dextrose and 0.9% sodium chloride.

DIF: Recall REF: p. 13 OBJ: 4 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 24. When red blood cells swell due to the surrounding fluid having a lower concentration of

dissolved substances, it is said to be: a. hypertonic.

b. hypotonic. c. isotonic. d. admixture.

ANS: B

A hypotonic solution is any solution containing a concentration of dissolved substances less than red blood cells, causing the cells to swell as the fluid moves in.

DIF: Recall REF: p. 13 OBJ: 4 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 25. Medications that are added to the final fluid are known as: a. admixtures. b. particulate matter. c. additives. d. isotonic fluids.

ANS: C

Additives are the medications that are added to the final fluid.

DIF: Recall REF: p. 13 OBJ: 4 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 26. What fluid is used primarily as a source of fluid and carbohydrates for nutrition? a. Lactated Ringer b. 0.9% sodium chloride c. 5% dextrose d. 10% dextrose ANS: C

Dextrose 5% is primarily used as a carbohydrate for nutrition and as a source of fluid.

DIF: Application REF: p. 13 OBJ: 4 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 27. An IV admixture is said to have what when the prescribed drugs cannot be combined

satisfactorily? a. Compatibility b. Incompatibility c. Adverse effects d. Side effects ANS: B

An unsatisfactory combination of two particular drugs is known as incompatibility.

DIF: Comprehension REF: p. 16 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 5

28. Drugs may need to be given the time to dilute before added back to back. This is attributable

to what factor? a. Buffer capacity b. Complexation

c. Order of mixing d. IV solution ANS: C

Order of mixing refers to mixing two particular drugs together only after allowing one to completely diluted into the fluid, causing their chance for contact to be much less.

DIF: Application REF: p. 17 OBJ: 6 TOP: CSPT Exam 1.4 (1.0 Medications and Components) 29. Rubber cores from vials are examples of what type of matter? a. Particulate b. Incompatible c. Preservative d. Turbidity ANS: A

Rubber cores found in fluid are also known as particulate matter.

DIF: Application REF: p. 16 OBJ: 5 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 30. This drug should not be refrigerated. a. Ampicillin b. Insulin c. Metronidazole d. Cefazolin ANS: C

Metronidazole (Flagyl) should be kept at room temperature because refrigeration causes participate to form.

DIF: Application REF: p. 16 OBJ: 6 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 31. The process of adding a diluent to a powder form of a medication is called: a. admixture. b. reconstitution. c. precipitation. d. particulate ANS: B

Reconstituting is the process of adding a diluent to a powder form of a medication.

DIF: Comprehension REF: p. 17 TOP: CSPT Exam 1.4 (1.0 Medications and Components) 32. Acidic solutions have a pH: a. around 7. b. between 8 and 14. c. between 0 and 9. d. between 0 and 6.

OBJ: 6

ANS: D

The pH scale ranges from 0 to 14 with 0 to 6 being acidic, 7 being neutral, and 8 to 14 being alkaline.

DIF: Recall REF: p. 17 OBJ: 5 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 33. All of the following are factors to consider about the stability of an IV medication once mixed

except: a. smell. b. time. c. light. d. temperature.

ANS: A

Some medications have a distinctive smell; this is not a cause for concern when you are stability.

DIF: Application REF: p. 12 OBJ: 6 TOP: CSPT Exam 1.4 (1.0 Medications and Components) 34. The ability to combine drugs or substances without interfering with their action is known as: a. stability. b. compatibility. c. osmolarity. d. incompatibility.

ANS: B

Compatibility is the ability to combine drugs without interfering with the action of one another.

DIF: Recall REF: p. 16 OBJ: 6 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 35. Storage information can be found in which reference? a. Trissel’s Handbook on Injectable Drugs b. Package insert c. Electronic databases d. All of the options ANS: D

The technician or pharmacist can find storage information in the package inserts, electronic databases, and Trissel’s Handbook on Injectable Drugs.

DIF: Application REF: p. 12 OBJ: 7 TOP: CSPT Exam 1.5 (1.0 Medications and Components) 36. The technician should always label the final product with: a. storage requirements. b. diluent added. c. patient’s name. d. patient’s diagnosis.

ANS: A

All final IV preparations must have the storage requirement on the label, so it will be stored in the proper place.

DIF: Application REF: p. 12 OBJ: 7 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 37. The technician should avoid: a. osmolarities. b. compatibilities. c. sterility. d. incompatibilities.

ANS: D

Incompatibilities are unwanted or unexpected effects caused by two or more drugs or a drug and the fluid it is added to and should be avoided when possible.

DIF: Comprehension REF: p. 16 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 7

38. Solid material that is separated from a solution often caused from reactions drugs or drugs and

certain fluids is known as: a. particulate. b. precipitation. c. osmosis. d. coring.

ANS: B

Precipitation is the solid material or deposits that are separated from a solution often caused from reaction drugs or drugs and certain fluids.

DIF: Recall REF: p. 17 OBJ: 6 TOP: CSPT Exam 1.7 (1.0 Medications and Components) 39. This IV fluid contains primary electrolytes found in the plasma. a. 5% dextrose b. 0.9% sodium chloride c. Lactated Ringer d. 10% dextrose ANS: C

Lactated Ringer contains primary electrolytes found in the plasma and is used for source of electrolytes or as a fluid replacement.

DIF: Recall REF: p. 16 OBJ: 4 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 40. Movement of a solvent across a cell membrane is known as: a. reconstitution. b. osmosis. c. clarity.

d. coring.

ANS: B

Osmosis is the movement of a solvent (water) across a cell membrane from a lower osmolarity to a higher osmolarity.

DIF: Recall REF: p. 14 OBJ: 4 TOP: CSPT Exam 1.7 (1.0 Medications and Components) TRUE/FALSE 1. The dose of a drug is the amount of drug given and is the same for every patient.

ANS: F

The dose of a drug is the amount of drug given, but it varies with each patient, depending on weight, age, specific condition, and so on.

DIF: Comprehension REF: p. 9 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

2. Absorption is the movement of a drug through the body into tissues and organs.

ANS: F

Absorption is the movement of a drug into the circulatory system.

DIF: Comprehension REF: p. 8 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 1

3. The primary enzyme responsible for metabolism is cytochrome P450.

ANS: T

Cytochrome P450 is the primary enzyme responsible for metabolism.

DIF: Recall REF: p. 9 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 4. Plasma proteins are lower in pediatric patient that in adults, allowing more of the drug to

remain bound in the body.

ANS: F

The plasma protein is lower in the pediatric patient, which allows more of the drug to remain unbound, or “free,” in the body.

DIF: Comprehension REF: p. 10 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

5. The adult brain has a protective barrier called the blood–brain barrier, which protects it from

fat-soluble substances.

ANS: F

The blood–brain barrier protects the brain from water-soluble substances.

DIF: Comprehension REF: p. 10 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

6. The liver and kidneys are not fully developed in pediatric patients. This allows metabolism

and excretion to occur more slowly than it does in adults.

ANS: T

Metabolism and excretion occur more slowly in pediatric patients than they do in adult patients because children’s livers and kidneys are not fully developed.

DIF: Comprehension REF: p. 10 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

7. Common side effects to medications include nausea, dry mouth, and dizziness.

ANS: T

There are many common side effects of medications, including dizziness, nausea, and dry mouth.

DIF: Recall REF: p. 9 OBJ: 2 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 8. Adverse effects can be found in manufacturer’s literature for a medication and are usually

widely reported.

ANS: F

Side effects can be found in manufacturer’s literature for a medication and are usually widely M to a patient, and are not widely reported. Adverse effects aTreEuSnT exBpAecNteKdS ,E caL nLcaEuRse.hCaO rm reported.

DIF: Comprehension REF: p. 9 TOP: CSPT Exam 1.5 (1.0 Medications and Components)

OBJ: 2

9. As aging occurs, elderly patients experience many differences in the pharmacokinetics

process.

ANS: T

The pharmacokinetics process differs in elderly patients throughout the aging process. This is due to the changing of bodily functions.

DIF: Comprehension REF: p. 10 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

10. The amount of drug given is directly related to weight because it determines the concentration

of drug in the body.

ANS: T

The amount of drug required is directly related to weight because it determines the concentration of drug in the body.

DIF: Comprehension REF: p. 11 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

11. Fluid that is too acidic or too alkaline can cause pain or discomfort when entering the body.

ANS: T

A patient can feel pain or discomfort when they receive a fluid, that is, too acidic or too alkaline.

DIF: Comprehension REF: p.13 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 4

12. The stability from the manufacturer’s packaging on an IV fluid is not affected when

medications are added.

ANS: F

The stability from the manufacturer’s packaging on an IV fluid is changed after a medication is added.

DIF: Comprehension REF: p. 16 TOP: CSPT Exam 1.4 (1.0 Medications and Components)

OBJ: 6

13. Technicians must always double-check their calculation.

ANS: T

When technicians perform calculations, they must always double-check them to make sure they are preparing the medication correctly.

DIF: Comprehension REF: p. 12 TOP: CSPT Exam 1.4 (1.0 M edS icT atB ioA nsNaK ndSC onRe. ntC s)OM TE EoLmLpE

OBJ: 7

14. The package insert of a medication sometimes states the storage requirements for the

medication.

ANS: F

The package insert always states the storage requirements for the medication.

DIF: Comprehension REF: p. 12 TOP: CSPT Exam 1.5 (1.0 Medications and Components)

OBJ: 7

15. Patient safety depends on the knowledge the technician has about the medication and any

special considerations to go along with it such as storage requirements, mixing, and proper handwashing.

ANS: T

It is very important that technicians be knowledgeable about the medications they are preparing, including any special considerations. The patient’s safety depends on it.

DIF: Comprehension REF: p. 7 OBJ: 7 TOP: CSPT Exam 1.4 (1.0 Medications and Components) | CSPT Exam 1.6 (1.0 Medications and Components) | CSPT Exam 1.7 (1.0 Medications and Components) 16. All drugs are compatible with any IV fluid.

ANS: F

Some drugs are only compatible with certain IV fluids.

DIF: Comprehension REF: p. 17 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 6

17. If the medication and the fluid it is mixed in have conflicting pH values, the drug is not

affected.

ANS: F

If a medication and the fluid it is mixed in have a conflicting pH values, it will cause the drug to degrade or form a precipitate.

DIF: Comprehension REF: p. 17 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 6

18. Some drugs must not be exposed to light and should be protected because the medication will

be degraded or destroyed.

ANS: T

Some medications will be destroyed if exposed to light. The technician must put these medications in a brown bag protect from light as soon as the preparation is complete so the medication will not be degraded or destroyed.

DIF: Comprehension REF: p. 17 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 5

19. Some medications must beTsE toSreTdBinAtNhK eS frE eeLzeLrE . R.COM ANS: T

Some medications must be stored in the freezer until they are to be given. After being removed from the freezer, its lifespan begins to decrease.

DIF: Comprehension REF: p. 16 TOP: CSPT Exam 1.4 (1.0 Medications and Components)

OBJ: 5

20. Color changes or particulate matter do not always form immediately.

ANS: T

Changes to the preparation, such as color changes or particulate matter, do not always occur immediately. It is important for other health care professionals to contact the pharmacy if they notice any of these changes before it is given to the patient.

DIF: Comprehension REF: p. 16 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 5

Chapter 03: Communication Within and Beyond the Pharmacy Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. This facility prepares CSPs for IV therapy each shift for a 24-hour supply. a. Home infusion b. Hospice in-patient c. Inpatient hospital d. Infusion center ANS: C

An inpatient setting is a hospital-based setting in which IV therapy and medication is patient based. Each CSP for an inpatient is prepared daily, typically each shift for a 24-hour supply.

DIF: Recall

REF: p. 21

OBJ: 1

TOP: N/A

2. Caregivers within the home will administer IV therapy to a patient in which of the following

settings? a. Home infusion b. Hospice in-patient c. Inpatient hospital d. Infusion center ANS: A

After a patient is discharged from a facility, IV therapy can be prescribed to be administered in the patient’s home knowTnEaS sT hoBmAeNiK nfS usEioLnL. ER.COM DIF: Application

REF: p. 21

OBJ: 1

TOP: N/A

3. IV therapy medication may require an order to be sent to the local pharmacy where delivery is

required to this facility in short notice due to the varying needs of the patient. a. Home infusion b. Hospice in-patient c. Inpatient hospital d. Infusion center ANS: B

For a hospice in-patient facility, an order may be required to be sent to a local pharmacy where delivery is required. In this environment, it may be short notice and require an emergency type preparation.

DIF: Comprehension TOP: N/A

REF: p. 21

OBJ: 1

4. Which of the following is not helpful when collaborating with other health care professionals? a. Share resources. b. Assume the other person will problem-solve a medication shortage. c. Relay important patient information. d. Assist with prioritizing patient care.

ANS: B

When collaborating and communicating with other health care professionals, it is not good practice to assume. Asking questions, sharing information and resources, assisting when needed, and helping with problem solving will everyone work together well.

DIF: Comprehension TOP: N/A

REF: p. 24

OBJ: 4

5. The best way for a patient to receive quality care is to: a. know inventory processes. b. maintain a trusting relationship with other health care professionals. c. know your responsibilities and the responsibilities of other health care

professionals. d. all of the options.

ANS: D

Knowing the inventory process such as turnarounds, PAR levels, and accessibility to common IV medications assists with cost containment and quicker response times on orders.

Maintaining trusting relationships and knowing who is responsible for each element of the process, is the best way to assure the patient gets quality care.

DIF: Comprehension TOP: N/A

REF: p. 23

OBJ: 4

6. Which of the following would a manager not look for in a health care professional to ensure a

team’s productivity and communication will produce quality patient care? a. Appreciates input from others.

BA b. Struggles with learningTfE roSmTm istNaK keSs.ELLER.COM c. Effectively listens to others. d. Willingly shares skills and knowledge.

ANS: B

If an individual is not willing to learn or has trouble learning from their mistakes, quality patient care will be compromised. It is important to be able to learn from mistakes or have a willingness to learn from mistakes to be a good health care professional.

DIF: Comprehension TOP: N/A 7. Automated compounders can be used to a. manage cost b. save preparation time c. manage waste d. all of the options

REF: p. 24

OBJ: 4

when preparing IV medication therapy.

ANS: D

Managing wastes and awareness of supply are ways to keep costs low and provide timely services. In some settings the use of automated compounders can help manage costs and save preparation time.

DIF: Comprehension TOP: N/A

REF: p. 24

OBJ: 2

8. When communicating with colleagues or patients electronically, it is important to: a. check for spelling and punctuation to avoid miscommunication. b. maintain confidentiality of each patient. c. re-read all communication for clarity and accuracy. d. all of the options.

ANS: D

Today’s approach to patent care is often fast paced and required to be available 24/7. It may include a virtual visit, followed by a emailed prescription Communication through these electronic sources can be tricky and sometimes lead to miscommunication with spelling and incorrect punctuation. Maintaining patient confidentiality is also required and without any non-verbal cues, sometimes an e-mail or text message can come across as something entirely unintended.

DIF: Comprehension TOP: N/A

REF: p. 24

OBJ: 2

9. Which of the following common resources for compounding sterile products is available as a

print and electronic version? a. Handbook of Injectable Drugs b. Drug Facts and Comparisons c. Physician Desk Reference d. Global RPh ANS: A

The Drug Facts and Comparisons, Physician Desk Reference, and Global RPh are only available through electroniT cE veSrT siB onAsN . TKhSe EHLanLdEbR oo.kCoOf M Injectable Drugs is still available from the ASHP as a print or electronic version.

DIF: Application REF: p. 25 OBJ: 2 TOP: CSPT Exam 1.5 (1.0 Medications and Components) 10. You read an order for a CSP that contains a medication you have never heard of before.

Before preparing the CSP, you look up the medication in the Handbook of Injectable Drugs to learn about the medication. By doing this, you are portraying which of the following key elements of quality patient care? a. Assertiveness b. Awareness c. Antagonism d. Active ANS: A

To portray assertiveness, you should ask questions, challenge yourself to learn daily, and stay current in your field.

DIF: Application REF: p. 23 OBJ: 3 TOP: CSPT Exam 1.5 (1.0 Medications and Components) 11. When collaborating with other health care professionals, it is important to be an active listener

to ensure quality patient care. Which of the following is not an example of active listening? a. Repeat back what was said.

b. Ask direct questions. c. Respond to questions before the speaker is finished talking. d. Listen to answers.

ANS: C

It is important to let the speaker finish talking so you can listen and catch all information before making a judgment and responding. Important aspects of active listening include repeating back what was said to not only acknowledge the speaker but also to ensure you understood what said, ask direct questions to gain clarity, and listen to the answers to form better judgments.

DIF: Application

REF: p. 23

OBJ: 3

TOP: N/A

12. Knowing who to contact when a problem arises portrays which of the following key elements

of quality patient care? a. Assertiveness b. Awareness c. Antagonism d. Active ANS: B

Awareness is being aware of your role and other’s roles/responsibilities on the team such as who to contact and how your actions affect the entire process.

DIF: Application

REF: p. 23

OBJ: 3

TOP: N/A

Chapter 04: Infection Control and Waste Management Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. The transmission of diseases or infections follows a path known as the: a. chain of disease. b. six chains of infection. c. transmission of disease process. d. path of infectious diseases.

ANS: B

The transmission of diseases or infections follows a path known as the “six chains of infection.”

DIF: Recall

REF: p. 27

OBJ: 1

TOP: N/A

2. Keeping nails short and removing jewelry before preparing CSPs will break which part of the

chain of infection? a. Portal of exit b. Mode of transmission c. Infectious agent d. Susceptible host ANS: C

An infectious agent is a pathogen- or disease-causing agent. They are commonly found on the TeElrSyT NoKvSinEgLjeLwEeRlr. hands or clothing (even jew ). B RA em yC thO atMmay contain pathogens and keeping nails short (where pathogens can be harbored) along with proper garbing and handwashing will break the chain at this link.

DIF: Application REF: p. 27 OBJ: 1 TOP: CSPT Exam 3.3 (3.0 Sterile Compounding Procedures) 3. Which of the following links in the chain of infection are you enabling if you prepare a CSP

with an open weeping sore? a. Portal of exit b. Susceptible host c. Portal of entry d. Reservoir ANS: D

A reservoir is a source of the infectious agent. By preparing a CSP with an open weeping wound, you are the carrier of bacteria or other pathogens that could be introduced to the patient.

DIF: Application REF: p. 27 OBJ: 1 TOP: CSPT Exam 3.3 (3.0 Sterile Compounding Procedures) 4. If you do not cover the IV port with a sterile seal before transporting the CSP, you will be

potentially aiding a pathogen to be transferred to the patient also known as a. mode of transmission

.

b. infectious agent c. portal of entry d. reservoir ANS: A

The mode of transmission is how the organism (or pathogen) is transferred from one host to the next. This can be the transfer from the preparer to the product and then to the patient.

DIF: Comprehension REF: p. 28 TOP: CSPT Exam 3.3 (3.0 Sterile Compounding Procedures)

OBJ: 1

5. If the preparer of a CSP has not followed proper universal precautions, contamination of the

product will allow a pathogen a direct method of entry into a venerable patient breaking this link in the chain of infection. a. Infectious agent b. Mode of transmission c. Portal of entry d. Susceptible host ANS: D

A susceptible host is a person that is at risk for infection. Since parenteral therapy requires an opening into the skin, the patient is venerable because they have a ready portal of entry directly into the blood stream. If the preparer has not followed proper universal precautions, contamination of the product will allow a pathogen a direct method of entry into a venerable patient.

DIF: Comprehension REF: p. 28 TOP: CSPT Exam 3.3 (3.0 S erS ileTCBoA mN poKuS ndEinLgLPE roR ce.dC urO esM ) TtE

OBJ: 1

6. When preparing CSPs, which of the following must be considered so that the preparer does

not enable infection to spread? a. Airborne particles b. Droplets from coughing, sneezing, or talking c. Contact with contaminated surfaces d. All the options ANS: D

Transmission precautions are important when performing aseptic manipulations. These include the (1) airborne—spread of small particles in the air, (2) droplet—spread by coughing, sneezing, or talking, and (3) contact—spread by skin contact(touch) to the CSP or contact with contaminated surfaces. When preparing CSP’s, all three of these must be considered. If the preparer does not use proper precautions, an infection can be spread.

DIF: Application REF: p. 28 OBJ: 2 TOP: CSPT Exam 3.10 (3.0 Sterile Compounding Procedures) 7. According to the CDC, one of the most important ways to prevent contamination or transfer

of infection is: a. covering tattoos. b. removing cosmetics. c. proper handwashing. d. keep natural nails long.

ANS: C

According to the CDC, one of the most important ways to prevent contamination or transfer of an infection is proper handwashing.

DIF: Recall REF: p. 28 OBJ: 2 TOP: CSPT Exam 3.3 (3.0 Sterile Compounding Procedures) 8. Aseptic handwashing must take place in an a. ISO Class 8; after b. ISO Class 8; before c. ISO Class 7; after d. ISO Class 7; before

environment

garbing.

ANS: B

USP <797> guidelines are to properly handwash using aseptic technique in the ante room (ISO class 8 environment) after garbing. Garb to be worn during handwashing includes shoe covers, head and facial covers, face mask/eye shields.

DIF: Recall REF: p. 28 OBJ: 2 TOP: CSPT Exam 3.4 (3.0 Sterile Compounding Procedures) 9. Which of the following PPE should be donned first when garbing to prepare a CSP? a. Shoe covers b. Face mask c. Head cover d. Face shield ANS: A

PPE should be put on in the following order to help prevent the transfer of organisms or pathogens into the ISO class 7 environment where CSPs are prepared: shoe covers, head and facial hair covers, face masks/eye shields.

DIF: Application REF: p. 29-30 OBJ: 2 TOP: CSPT Exam 3.6 (3.0 Sterile Compounding Procedures) 10. When aseptically handwashing, hands and forearms up to the elbows must be washed for at

least . a. 10 seconds b. 30 seconds c. 60 seconds d. 2 minutes ANS: B

USP <797> guidelines for hand hygiene procedures include washing hands and forearms up to the elbows with unscented soap and water for at least 30 seconds.

DIF: Recall REF: p. 31 OBJ: 2 TOP: CSPT Exam 3.4 (3.0 Sterile Compounding Procedures) 11. Which of the following disposal methods is recommended when discarding nonhazardous IV

medication fluids?

a. b. c. d.

Leave superfluous IV medications in the PEC. Flush IV medication fluid down the toilet.

Place in blue pharmaceutical waste container.

Pour IV medications down the sink.

ANS: C

IV medication fluids should not be flushed down the toilet or poured down the sink since they may get into the water source and contaminate the environment. Instead, they should be discarded in the proper pharmaceutical waste container. Expired, unused, or contaminated nonhazardous medications such as IV bags are discarded in BLUE or BLUE and WHITE pharmaceutical waste containers.

DIF: Application REF: p. 31 OBJ: 3 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 12. Needles and other sharp objects such as broken ampules are disposed of in

bio-medical

plastic containers or bags. a. blue b. black c. yellow d. red ANS: D

Needles and other sharp objects such as broken ampules are disposed of in RED bio-medical plastic containers or bags.

DIF: Recall REF: p. 31 OBJ: 3 TOP: CSPT Exam 4.1 (4.0 H dlT inB g,APN acK kaSgE inL g,LSE toR ra. geC, O anMd Disposal) TaEnS 13. All of the following medications should be disposed of in black pharmaceutical waste

containers except: a. physostigmine. b. fluconazole. c. warfarin. d. nitroglycerin.

ANS: B

Hazardous pharmaceutical waste and medications are to be disposed on in BLACK containers. This also includes the U.S. Environmental Protection Agency (EPA)’s—P Listing of certain medications including the following: arsenic trioxide, nitroglycerin, phentermine, physostigmine, warfarin, and empty containers of P listed medications. Fluconazole is an antifungal medication that can be disposed of in a Blue or Blue and White pharmaceutical container.

DIF: Application REF: p. 31 OBJ: 3 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 14. Which of the following medications should be disposed of in a yellow pharmaceutical

container? a. Paclitaxel b. Arsenic trioxide c. Phentermine

d. Nitroglycerin ANS: A

Paclitaxel is a chemotherapy agent and should be placed in a yellow pharmaceutical container when discarding. Arsenic trioxide, phentermine, and nitroglycerin are on the EPA’s P list to be disposed of in a black pharmaceutical container.

DIF: Application REF: p. 31 OBJ: 3 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 15. In which of the following containers should the tetanus toxoid vaccine be discarded in? a. Black pharmaceutical container b. Purple pharmaceutical container c. Yellow pharmaceutical container d. Red pharmaceutical container ANS: B

Dual waste (hazardous + infectious) goes into proper containers (PURPLE buckets) such as live vaccines: Tetanus Toxoid, and Decavac.

DIF: Application REF: p. 31 OBJ: 3 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 16. Precautions such as handwashing, use of PPE, proper disposal of waste, and respiratory

hygiene is known as: a. transmission. b. universal precautions. c. standard of care. d. parenteral route.

ANS: C

Standard of care are precautions such as handwashing, use of PPE, proper disposal of waste, and respiratory hygiene.

DIF: Recall REF: p. 27 OBJ: 2 TOP: CSPT Exam 3.3 (3.0 Sterile Compounding Procedures) 17.

are methods to prevent contamination or transference of infection such as protective barriers. a. Transmission b. Universal precautions c. Standard of care d. Parenteral route ANS: B

Universal precautions are methods to prevent contamination or transference of infection such as protective barriers.

DIF: Recall REF: p. 28 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 18. PPE used in the preparation of nonhazardous sterile compounding can be discarded in a:

a. b. c. d.

yellow pharmaceutical container. blue and white pharmaceutical container. trash can. red pharmaceutical container.

ANS: C

Supply packaging, gowns, and other PPE used in nonhazardous sterile preparation can be disposed of in the regular trash can.

DIF: Recall REF: p. 31 OBJ: 3 TOP: CSPT Exam 3.6 (3.0 Sterile Compounding Procedures)

Chapter 05: Calculations Used in Intravenous Preparations Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. The space that the powder occupies is known as: a. final volume. b. diluent volume. c. powder strength. d. powder volume.

ANS: D

The powder volume is the space that the powder occupies in the container.

DIF: Application REF: p. 36 OBJ: 2 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 2. How many milligrams are in 8.3 mL of Kefzol 225 mg/mL? a. 27.1 mg b. 216.7 mg c. 368 mg d. 1867.5 mg ANS: D

x = 1867.5 mg DIF: Application REF: p. 34 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 3. How many milligrams are in 1.6 mL of Stadol 2 mg/mL? a. 3.2 mg b. 1.25 mg c. 2.8 mg d. 0.8 mg ANS: A

x = 3.2 mg DIF: Application REF: p. 34 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 4. How many grams of drug are in 600 mL of a 1:350 solution? a. 0.5 g b. 0.6 g

c. 1.7 g d. 2 g ANS: C

x = 1.7 g DIF: Application REF: p. 34 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 5. How many milliliters are needed to prepare 750 mg from a 1:250 solution? a. 187.5 mL b. 333.3 mL c. 1875 mL d. 187,500 mL ANS: A

First convert grams to milligrams: 1 g = 1000 mg; then continue:

x = 187.5 mL . 3S 4TBANKS OE BL J: LE 1 R.COM DIF: Application REF: TpE TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 6. Magnesium chloride comes in 2.2 mEq/mL. The order calls for 15 mL. How many

milliequivalents would that be? a. 12.8 mEq b. 15 mEq c. 30 mEq d. 33 mEq ANS: D

x = 33 mEq DIF: Application REF: p. 33-34 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 7. An electrolyte is available as 15 mM/5 mL. How many milliliters are needed to fill an order

for 21 mM? a. 1575 mM b. 63 mM c. 3 mM

d. 7 mM ANS: D

x = 7 mM DIF: Application REF: p. 33-34 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) | CSPT Exam 1.2 (1.0 Medications and Components) 8. Heparin is available as 10,000 units/mL. How many units are in 2.36 mL? a. 2360 units b. 4237 units c. 20,000 units d. 23,600 units ANS: D

x = 23,600 units DIF: Application REF: p. 35 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) | CSPT Exam 1.2 (1.0 Medications and Components) 9. You need to give 60,000 units. Your solution in stock is 15,000 units/mL. How many

milliliters do you give? a. 0.25 mL b. 0.4 mL c. 4 mL d. 5 mL ANS: C

x = 4 mL DIF: Application REF: p. 35 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 10. U-100 insulin is used for a patient who needs 0.9 mL. How many units will he receive? a. 90 units b. 99 units c. 100 units d. 111 units ANS: A

x = 90 units DIF: Application REF: p. 35 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) | CSPT Exam 1.2 (1.0 Medications and Components) 11. A patient is using Humulin insulin U-100. The patient is to use 35 units three times a day.

How many milliliters will be used each day? a. 0.35 mL b. 1.05 mL c. 35 mL d. 3500 mL ANS: B

First, calculate per dose:

x = 0.35 mL 0.35 mL  3 = 1.05 mL p. 35 OBJ: 1 DIF: Application REF: TESTBANKSELLER.COM TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) | CSPT Exam 1.2 (1.0 Medications and Components) 12. The label of a 10-g vial states that you are to add 187 mL to get a concentration of 500 mg/10

mL. What is the powder volume? a. 13 mL b. 167 mL c. 200 mL d. 187 mL ANS: A

First, convert 10 g to milligrams: 10 g = 10,000 mg Second, calculate final volume in the bottle:

x = 200 mL Third, calculate powder volume, using the following formula: fv – dv = pv 200 mL – 187 mL = 13 mL DIF: Application

REF: p. 36

OBJ: 2

TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 13. The label of a vial states that it contains 1 g in 10 mL. You know that 9.6 mL was added.

What was the powder volume? a. 1 mL b. 0.4 mL c. 10 mL d. 9.6 mL ANS: B

Calculate by using the following formula: fv – dv = pv 10 mL – 9.6 mL = 0.4 mL DIF: Application REF: p. 36 OBJ: 2 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 14. A 1-L bag is running at 130 mL/hr. How many 1-L bags are used for a 24-hour time period? a. Three bags b. Four bags c. Seven bags d. Eight bags ANS: B

First, calculate milliliters in 24 hours:

x = 3120 mL Second, convert milliliters to liters: 3120 mL = 3.120 L. Four bags will be needed for a 24-hour period. Because the total amount needed if slightly more than three bags, you need to round up to make sure the patient has enough.

DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 15. A 1-L bag has 200 mL of medication added to it. The bag is running at 120 mL/hr. How long

will it last? a. 10 hours b. 8 hours c. 9 hours d. 7 hours ANS: A

First, calculate total volume of the bag in milliliters: 1000 mL + 200 mL = 1200 mL Second, calculate the amount of time:

x = 10 hours DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 16. A patient is receiving 750 mg of vancomycin in 500 mL of NS over a period of 7 hours. What

is the flow rate in milliliters per hour? a. 50 mL/hr b. 61 mL/hr c. 80 mL/hr d. 71 mL/hr ANS: D

x = 71 mL/hr DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 17. A patient is receiving 1 g cefazolin in a 100-mL bag of D5W at a rate of 50 mL/hr. How many

milligrams per hour will be administered? a. 1000 mg/hr b. 500 mg/hr c. 100 mg/hr d. 50 mg/hr ANS: B

First, convert g to mg: 1 g = 1000 mg

DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 18. An IV that contains 2 mg in 150 mL is being infused at a rate of 25 mL/hr. How many

micrograms will be administered per hour? a. 0.3 mcg b. 200 mcg c. 33 mcg d. 333 mcg ANS: D

First, convert mg to mcg: 2 mg = 2000 mcg

DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 19. If 1200 mL is to be infused at a rate of 100 mL/hr, how long will it last? a. 10 hours b. 8 hours c. 12 hours d. 11 hours ANS: C

x = 12 hours DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 20. The doctor has ordered 75 mL to be infused in 35 minutes using a 10-drop set. What is the

flow rate in drops per minute? a. 21 gtt/min b. 17 gtt/min c. 25 gtt/min d. 5 gtt/min ANS: A

Use the following formulaT : IE nSthTisBcAaN seK , ySoEuLdL oE noRt.nC eeOdMto convert minutes to hours, so there is no need to divide by 60 min/hr. x gtt/min = (Volume of fluid/delivery time)  (Set drop rate) (75 mL/35 min)(10 gtts/mL) = 21 gtt/min DIF: Application REF: p. 37 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 21. You are to prepare 250mL of 8% dextrose using D5W and D10W. How many milliliters of

D5W will you need? a. 150 mL b. 166.7 mL c. 100 mL d. 416 mL ANS: C

10% 8% 5%

3 2 5

x = 150 mL x = 100 mL x = 250 mL

DIF: Application REF: p. 39 OBJ: 4 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 22. In what proportion should 70% alcohol be mixed with 30% alcohol to make 60% alcohol? a. 7:3

b. 3:1 c. 10:6 d. 1:3 ANS: B

70% 60% 30%

30

Reduce 3

10

Reduce 1

DIF: Application REF: p. 39 OBJ: 4 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 23. You are to prepare 900 mL of 10% dextrose from 50% dextrose and 5% dextrose. How many

milliliters of 50% dextrose will you need? a. 112.5 mL b. 800 mL c. 450 mL d. 100 mL ANS: D

50% 10% 5%

5 40 45

x = 100 mL x = 800 mL x = 900 mL

DIF: Application REF: p. 39 OBJ: 4 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

orK mSD nd.sCteOriM le water for injection. How many 24. You are to prepare 850 mLToEfSDT8W BAfN E1L0W LEaR milliliters of D10W will you need? a. 680 mL b. 425 mL c. 170 mL d. 212.5 mL ANS: A

10% 8% 0%

8 2 10

x = 680 mL x = 170 mL x = 900 mL

DIF: Application REF: p. 39 OBJ: 4 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) TRUE/FALSE 1. Technicians must be extremely cautious when calculating amounts of medications.

ANS: T

Technicians must be extremely cautious when calculating amounts of medications. If there is any question on the calculations performed, the technician should consult a pharmacist or another technician. The patient’s safety depends on the technician’s accuracy.

DIF: Comprehension REF: p. 33 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

OBJ: 1

2. The amount of medication in a particular volume of fluid is called the dose.

ANS: F

The concentration is the amount of medication in a particular volume of a fluid.

DIF: Comprehension REF: p. 33 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

OBJ: 1

3. Subtracting the powder volume from the final volume will give you the diluent volume.

ANS: T

The final volume is diluent volume added to the powder volume.

DIF: Comprehension REF: p. 36 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

OBJ: 2

4. Benzyl alcohol cannot be used as a diluent in the neonatal population because it is toxic.

ANS: T

It has been proven that benzyl alcohol is toxic in neonatal patients; therefore, it should never be used as a diluent in this patient population.

DIF: Comprehension REF: p. 36 TOP: CSPT Exam 1.7 (1.0 Medications and Components)

OBJ: 1

5. Units are measurements for electrolytes.

ANS: F

Units are measurements for vitamins and chemicals, milliequivalents (mEq) and millimolar (mM) are measurements for electrolytes.

DIF: Comprehension REF: p. 33 TOP: CSPT Exam 1.2 (1.0 Medications and Components)

OBJ: 1

6. A label reads “fluconazole 200 mg/100 mL, total volume 100 mL.” The concentration of the

medication in the bag is 2 mg/mL. ANS: T

200 mg/100 mL= 2 mg/mL DIF: Application REF: p. 37 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 7. If an error with an IV medication reaches the patient, it is quick and easy to reverse the

effects.

ANS: F

There is no way to immediately reverse the effects of an IV error because it is injected directly into the bloodstream.

DIF: Comprehension REF: p. 33 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) | CSPT Exam 1.1 (1.0 Medications and Components) 8. If the label reads “Humulin R U100” on a 10-mL vial, this means there are 100 units per 10

mL. ANS: F

U-100 is the measurement for insulin that means 100 units per each milliliter.

DIF: Application REF: p. 35 OBJ: 1 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) | CSPT Exam 1.2 (1.0 Medications and Components) 9. Flow rate is the rate at which the medication is injects into the bag.

ANS: F

The flow rate is the rate at which the medication should be infused over a specific amount of time.

DIF: Comprehension REF: p. 37 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

OBJ: 3

10. If the label on a vial states that 9.7 mL of diluent needs to be added to the powder to make a

final volume of 10 mL, then the powder volume is 0.7 mL. ANS: F

Final volume (fv) minus diluent volume (dv) equals the powder volume (pv); therefore, 10 mL – 9.7 mL = 0.3 mL. DIF: Application REF: p. 36 OBJ: 2 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures)

Chapter 06: Medication Administration Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Medications may be given parenterally when: a. a patient has difficulty swallowing or when a patient is vomiting. b. a medication must be absorbed quickly. c. a patient is unconscious. d. all of the options.

ANS: D

Parenteral medications are given when a patient is unable to take medication by mouth or unable to get the same effect at the rate needed for treatment with other routes of administration.

DIF: Comprehension REF: p. 45 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 1

2. Which of the following is not true of IV therapy? a. IV medications are not absorbed through the GI tract, so it gets to the intended

organ or tissue quicker. b. The IV route of administration makes it possible for patients to receive

medications, such as heparin or insulin. c. IV therapy is inexpensive. d. IV therapy has a rapid onset.

TESTBANKSELLER.COM

ANS: C

IV therapy can be very expensive because it has to be prepared aseptically by trained personnel and often requires home health or hospitalization for administration.

DIF: Application REF: p. 47 OBJ: 1 TOP: CSPT Exam 1.4 (1.0 Medications and Components) | CSPT Exam 1.6 (1.0 Medications and Components) 3. A route of administration that allows injection into an existing IV line is known as a(n): a. intramuscular injection. b. subcutaneous injection. c. intravenous push. d. intrathecal injection.

ANS: C

Intravenous push is a small amount of medication, often injected into an existing IV line.

DIF: Recall REF: p. 45 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 4. The most common method of administrating parenteral medications is: a. through a central line. b. through a peripheral line. c. through an epidural.

d. through an intrathecal line.

ANS: B

The most common method of administration for an IV medication is through a peripheral line.

Peripheral veins are smaller, making it easier to inject the medication.

DIF: Comprehension REF: p. 43 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

5. Which of the following would you find on the “do not use abbreviations” list because there a

chance for error? a. SL b. SC c. IM d. IVPB ANS: B

The abbreviations SC or SQ should not be used for subcutaneous because it can be mistaken for SL, or sublingual, and increase the chance for error.

DIF: Application REF: p. 45 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 6. Which of the following medications must be given parenterally because of destruction by

stomach acids? a. Augmentin b. Vancomycin c. Heparin d. Cefazolin ANS: C

Heparin, along with insulin, is an example of a medication that can only be given intravenously because it is destroyed by stomach acids, making it ineffective to take by any other route.

DIF: Application REF: p. 47 OBJ: 1 TOP: CSPT Exam 1.2 (1.0 Medications and Components) | CSPT Exam 1.3 (1.0 Medications and Components) 7. A common adverse reaction to IV therapy is inflammation of the vein is known as: a. infiltration. b. phlebitis. c. vasculitis. d. hives ANS: B

Phlebitis is inflammation of the vein and is a common adverse reaction to IV therapy.

DIF: Comprehension REF: p. 47 TOP: CSPT Exam 1.1 (1.0 Medications and Components)

OBJ: 3

8. Which of the following is not a routine setting for a patient to receive IV therapy?

a. b. c. d.

Doctor’s office Outpatient clinic Nursing homes Outpatient pharmacy

ANS: D

An outpatient pharmacy is not a routine place for IV therapy. IV therapy can be given in the hospital, in long-term care facilities (such as nursing homes), during emergency transport, in hospice, and in doctor’s offices.

DIF: Application REF: p. 47 OBJ: 4 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 9. Devices and supplies provided for home infusion therapy include all of the following except: a. sharps container. b. IV tubing. c. transfer sets. d. alcohol swabs ANS: C

Transfer sets are used in preparation for IV medications and would not be needed in the administration of the medication at home.

DIF: Application REF: p. 47 OBJ: 4 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 10. What type of infusion is the following order?

Give sodium chloride 0.9%TE 10S0T 0B mALNqK 12SE foL rL 3E daRy. s.COM a. SVP b. IVP c. LVP d. Intermittent infusion ANS: C

An IV medication between 250 and 1000 mL and infused over 2 to 24 hours is a large-volume parenteral (LVP).

DIF: Application REF: p. 46 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 11. Which type of infusion is usually regulated with an infusion pump or electronic device? a. Intermittent infusion b. Large-volume infusion c. Small-volume infusion d. An intravenous push ANS: B

A large-volume infusion is usually regulated with an infusion pump or electronic device because it is to be given over a long period of time.

DIF: Application REF: p. 46 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

12. Which of the following is an example of a medication that is usually too concentrated to be

given through a peripheral line? a. Chemotherapy b. Heparin c. Insulin d. Vancomycin ANS: A

Chemotherapy medications are usually too concentrated to go through a peripheral line; therefore, they are given centrally through an implanted port because there is more blood volume running through the larger veins.

DIF: Application REF: p. 43 OBJ: 1 TOP: CSPT Exam 1.2 (1.0 Medications and Components) | CSPT Exam 1.3 (1.0 Medications and Components) 13. A skin test for tuberculosis is an example of an: a. intramuscular injection. b. intrathecal injection. c. intradermal injection. d. intracardiac injection.

ANS: C

A tuberculosis skin test is an example of an intradermal injection, which is an injection into the dermal layer of the skin. . 4S 4TBANKS OE BL J: LE 1 R.COM DIF: Application REF: TpE TOP: CSPT Exam 1.3 (1.0 Medications and Components) 14. Which of the following is a disadvantage of an intravenous medication? a. IV medications can be given in an emergency. b. IV medications can prevent infection from spreading. c. IV medication can cause infiltration. d. IV medication can be given when an oral route is not advised.

ANS: C

One of the disadvantages of IV therapy is that it can cause infiltration to occur, which is when the fluid goes into the tissue surrounding the vein at the injection site.

DIF: Application REF: p. 47 OBJ: 3 TOP: CSPT Exam 1.1 (1.0 Medications and Components) 15. What route of administration is the fastest option for parenteral medications? a. Intracardiac b. Intravenous c. Intramuscular d. Intrathecal ANS: B

The intravenous route of administration is the fastest option for parenteral medication because it injected directly into the bloodstream.

DIF: Comprehension REF: p. 47 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 3

16. A direct injection is also called a(n): a. LVP. b. IVP. c. SVP. d. IVPB ANS: B

An IV push, also known as a bolus, is a direct injection, usually into an existing IV line over 5 to 15 minutes.

DIF: Recall REF: p. 45 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 17. Intermittent infusions are infused between: a. 5 and 15 minutes. b. 2 and 24 hours. c. 15 and 90 minutes. d. 24 and 48 hours ANS: C

Intermittent infusions are volumes of fluid that range from 25 to 250 mL and are infused from 15 to 90 minutes at specific intervals. . 4S 6TBANKS OE BL J: LE 2 R.COM DIF: Recall REF: TpE TOP: CSPT Exam 1.3 (1.0 Medications and Components) 18. Which type of intravenous infusion if given over 2 to 24 hours? a. LVP b. IVP c. SVP d. IVPB ANS: A

Large-volume parenterals are usually infused over a period of 2 to 24 hours.

DIF: Recall REF: p. 46 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 19. A(n) can be given in an existing IV line or IV access device. a. intramuscular injection b. subcutaneous injection c. IV push d. intracardiac injection ANS: C

An IV push is injected directly into the skin or can be given in an existing IV line or access device.

DIF: Comprehension

REF: p. 46

OBJ: 2

TOP: CSPT Exam 1.3 (1.0 Medications and Components) 20. Which of the following statements is not true about parenteral medications? a. Any medication can be given in the same line as a continuous infusion to decrease

infection by not puncturing the skin multiple times. b. Intravenous injection medications are administered either through a peripheral or a central line. c. IV therapy must be prepared aseptically by trained personnel and often requires home health nurses to administer or hospitalization. d. Infection control begins with good aseptic technique, and it is the first step in quality management.

ANS: A

If there is an incompatibility between the drugs, they cannot be infused through the same line.

Familiarity of the drugs, their preparation, and routes of administration are all factors in preventing medication errors and ensuring the patient is safe.

DIF: Application REF: p. 49 OBJ: 1 TOP: CSPT Exam 1.7 (1.0 Medications and Components) TRUE/FALSE 1. TPN and chemotherapy are usually given through a peripheral line.

ANS: F

TPN and chemotherapy are usually too concentrated to be given via a peripheral line. They are usually given through aTcEeS ntT raBl A linNeK . SELLER.COM DIF: Comprehension REF: p. 43 OBJ: 2 TOP: CSPT Exam 1.2 (1.0 Medications and Components) | CSPT Exam 1.3 (1.0 Medications and Components) 2. IV administration does not pose any more risk of infection than oral medications.

ANS: F

A disadvantage to IV therapy is that poses a greater risk of infection because of puncturing the skin.

DIF: Comprehension REF: p. 47 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 3

3. Intramuscular injections are the most common parenteral route of administration.

ANS: F

Intravenous injections are the most common parenteral route of administration because they have the fastest effect.

DIF: Comprehension REF: p. 43 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 1

4. Intravenous injections have slow-acting effects and they are easy to reverse.

ANS: F

IV medications have a fast-acting effect, and it is impossible to remove the medication immediately from the body because it is injected into the bloodstream.

DIF: Comprehension REF: p. 47 OBJ: 3 TOP: CSPT Exam 1.1 (1.0 Medications and Components) | CSPT Exam 1.3 (1.0 Medications and Components) 5. Pumps used for pain therapy or diabetes management can be implantable.

ANS: T

Pumps that are used for pain therapy or diabetes management can be implantable if it is for long-term therapy.

DIF: Comprehension REF: p. 47 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

6. The rate of infusion is the amount of fluid that should enter the body over a certain period of

time.

ANS: T

The amount of fluid that should enter the body over a certain period of time is known as the rate of infusion.

DIF: Recall REF: p. 46 OBJ: 2 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 7. All intravenous medications are given continuously.

ANS: F

IV medications can be given continuously or intermittently depending on how they are ordered.

DIF: Comprehension REF: p. 46 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 2

8. A spinal tap is an example of an epidural injection.

ANS: F

A spinal tap is an example of an intrathecal injection, which is an injection administered into the spinal canal. Epidural injections are given into the epidural space, such as anesthesia medication during labor.

DIF: Comprehension REF: p. 44 TOP: CSPT Exam 1.3 (1.0 Medications and Components)

OBJ: 1

9. A subcutaneous injection is given just under the skin.

ANS: T

An injection given just under the skin is a subcutaneous injection.

DIF: Recall REF: p. 45 OBJ: 1 TOP: CSPT Exam 1.3 (1.0 Medications and Components) 10. To help prevent medication errors, the technician should include all the supplies needed for

the IV home infusion therapy.

ANS: T

The technician needs to include all the supplies, such as pumps or tubing, needed to administer the medication so that the nurse or caregiver has what they need to administer the medication properly.

DIF: Comprehension REF: p. 47-48 TOP: CSPT Exam 1.4 (1.0 Medications and Components)

OBJ: 4

Chapter 07: United States Pharmacopeia <USP797>: Pharmaceutical Compound-Sterile Preparations Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. USP chapters 1 through 999 are considered requirements and are therefore enforceable by the a. b. c. d.

.

USP FDA ISMP ASHP

ANS: B

Chapter 1 through 999 of the USP chapters are considered requirements and are therefore enforceable by the FDA. DIF: Comprehension TOP: N/A

REF: p. 51

OBJ: 1

2. Which of the following USP chapters identifies responsibilities, training, and testing of

compounding personnel and facilities, as well as labeling, storage, and testing of compounded sterile products? a. <825> b. <800> c. <797> d. <795> ANS: C

USP <797> identifies responsibilities, training, and testing of compounding personnel and facilities, as well as labeling, storage, and testing of compounded products.

DIF: Application

REF: p. 51

OBJ: 1

TOP: N/A

3. All of the following preparations would require sterile compounding except: a. nasal sprays. b. live organ baths. c. aqueous bronchial inhalations. d. ophthalmic drops.

ANS: A

The most common CSPs are injectables but other CSPs include aqueous bronchial inhalations, live organ baths and soaks, ophthalmic medications, and internal body cavity irrigations.

DIF: Application 4.

REF: p. 52

OBJ: 1

TOP: N/A

testing ensures a product meets required quality characteristics. a. Media fill b. Batch c. Stability

d. Release ANS: D

Release testing ensures a product meets required quality characteristics.

DIF: Recall REF: p. 52 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 5. A process simulating compounding processes or products to ensure microbial growth is not

present is known as a. media fill test b. pyrogen-free c. verification d. release testing

_.

ANS: A

Media fill test is a process simulating compounding processes or products to ensure microbial growth is not present.

DIF: Recall REF: p. 64 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 6. A a. b. c. d.

is a substance used to prevent microbial growth. disinfectant sporicidal preservative pyrogenic

ANS: C

A substance used to prevent microbial growth is a preservative.

DIF: Recall REF: p. 51 OBJ: 2 TOP: CSPT Exam 3.7 (3.0 Sterile Compounding Procedures) 7. There are a. two b. three c. four d. five

risk levels when it comes to compounding sterile preparations.

ANS: B

There are three categories of sterile compounds in the current revision of USP <797>, category 1, category 2, and urgent use CSPs. DIF: Recall

REF: p. 52

OBJ: 3

8. A category 1 CSP should be assigned a BUD of: a. 12 hours or less at room temperature. b. 24 hours of less at room temperature. c. 4 days at room temperature. d. 10 days when refrigerated.

ANS: A

TOP: N/A

Category 1 CSP has and assigned BUD with a maximum of 12 hours at room temperature and less than 24 hours if kept in refrigerator.

DIF: Recall REF: p. 52 OBJ: 3 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 9. Which of the following can be compounded in a segregated compounding area (SCA)? a. Category 1 CSP b. Category 2 CSP c. Category 3 CSP d. Low-risk CSP ANS: A

Only Category 1 CSPs can be compounded in a segregated compounding area (SCA). The SCA must be located away from unsealed windows, doors that connect to the outdoors, and traffic flow.

DIF: Application REF: p. 52 OBJ: 3 TOP: CSPT Exam 2.2 (2.0 Facilities and Equipment) 10. When a nonsterile product is used in the preparation of a Category 2 CSP, a. the assigned BUD is 10 days when refrigerated. b. sterility testing must be performed. c. endotoxin testing must be performed. d. the assigned BUD is 4 days at room temperature.

ANS: C

When a nonsterile productTisEuSsT edBiA nN thK eS prEeL paLraEtiRo. nC ofOaMcategory 2 CSP, endotoxin testing must be performed. A BUD of 10 days refrigerated or 4 days at room temperature can be assigned to a category 2 CSP when only sterile products were used in the preparation and no sterility testing was performed. Sterility testing does not have to be performed on a category 2 CSP, but the BUD assigned will vary based on sterility testing.

DIF: Comprehension REF: p. 54, Table 7.2 OBJ: 3 TOP: CSPT Exam 3.20 (3.0 Sterile Compounding Procedures) | CSPT Exam 2.2 (2.0 Facilities and Equipment) 11. Personnel preparing category 1 and category 2 CSPs must follow handwashing and garbing

requirements and be visually inspected at least a. monthly b. quarterly c. every 6 months d. yearly

.

ANS: B

Personnel preparing category 1 and category 2 CSPs must adhere to the requirements for garbing and handwashing. This is a visual check performed at least quarterly.

DIF: Comprehension REF: p. 54, Table 7.2 OBJ: 4 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

12. Personnel preparing category 1 and category 2 CSPs must have a gloved fingertip and thumb

sampling inside the ISO Class 5 PEC performed at least a. monthly b. quarterly c. every 6 months d. yearly

.

ANS: B

Gloved fingertip/thumb sampling inside the ISO Class 5 PEC must be performed quarterly.

DIF: Comprehension REF: p. 54, Table 7.2 OBJ: 4 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 13. Measurements of air quality and presence of microbials in the PEC must be certified by an

approved outside organization at least a. monthly b. quarterly c. every 6 months d. yearly

.

ANS: C

Measurements of air quality and presence of microbials in the PEC (ISO Class 5) within the classified areas must be certified by an approved outside organization at least every 6 months.

DIF: Comprehension REF: p. 54, Table 7.2 OBJ: 4 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 14. Surface sampling of the inT teE rioSrToB fA aP NEKCSiEnLaLSECRA.isCrOeqMuired a. yearly b. every 6 months c. quarterly d. monthly

.

ANS: D

Surface sampling of the interior of a PEC in a SCA is required monthly. It is performed using a contact sampling device or plate with a growth media.

DIF: Recall REF: p. 54, Table 7.2 TOP: CSPT Exam 2.6 (2.0 Facilities and Environment)

OBJ: 4

15. If surface sampling of the PEC in a SCA exceeds recommendations, which of the following

should be done? a. Double-check expiration dates of testing materials. b. Retraining of personnel. c. Verify storage conditions of testing materials. d. All of the options.

ANS: D

If the PEC sample exceeds the recommendations set by USP, corrective action plan must be implemented. This may require additional cleaning, retraining of personnel, or verification of storage or expiration dates of testing materials used.

DIF: Recall REF: p. 53 OBJ: 4 TOP: CSPT Exam 2.7 (2.0 Facilities and Environment) 16. A category 2 CSP should be assigned a BUD of _

when prepared with only sterile

products and sterility testing is not performed. a. 24 hours at refrigerated temperature b. 24 hours at room temperature c. 4 days at room temperature d. 4 days at refrigerated temperature ANS: C

When only sterile products are used in the preparation of a category 2 CSP, a BUD of 10 days refrigerated or 4 days at room temperature can be assigned to a category 2 CSP when no sterility testing was performed. Sterility testing does not have to be performed on a category 2 CSP, but the BUD assigned will vary based on sterility testing.

DIF: Recall REF: p. 64 OBJ: 3 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 17. Which of the following must be compounded in a PEC that is in an ISO class 7 or better

environment? a. Category 1 CSP b. Category 2 CSP c. Category 3 CSP d. Low-risk CSP ANS: B

When preparing category 2TcEoS mTpB ouAnN dsK, S thEe L PL EC ERsu.cCh OasMa LAFW must be located within a restricted buffer area with an ISO Class 7 or better environment. The ISO Class 7 area must contain an ISO Class 5 (PEC) where the CSPs are prepared.

DIF: Application REF: p. 53 OBJ: 3 TOP: CSPT Exam 2.2 (2.0 Facilities and Equipment) 18. When preparing a category 2 CSP, handwashing and garbing must take place in: a. the segregated compounding area. b. an ISO class 7 environment. c. an ISO class 8 environment. d. an ISO class 5 environment.

ANS: C

Personnel preparing category 2 CSPs must also adhere to the requirements for garbing and handwashing, but this process takes place in a designated space known as the ante area or ISO Class 8 area.

DIF: Recall REF: p. 53 OBJ: 4 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 19. Gloved fingertip and thumb sampling must performed with a completion of

testing’s prior to initial compounding. a. five b. four

separate

c. three d. two ANS: C

Gloved fingertip/thumb sampling must also be performed quarterly. This is done with completion of three separate testing’s prior to initial compounding.

DIF: Recall REF: p. 53 OBJ: 4 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 20. Airflow adequacy of the ISO-classified areas is required every a. month b. quarter c. 6 months d. Year

.

ANS: C

Airflow adequacy of the ISO-classified areas is required every 6 months.

DIF: Recall REF: p. 56 OBJ: 4 TOP: CSPT Exam 2.5 (2.0 Facilities and Equipment) 21. A minimum of

total HEPA-filtered ACPH must be supplied to ISO Class 7

environment a. 20 b. 30 c. 40 d. 50 ANS: B

The filtered air from an ISO class 7 environment must measure at an ACPH of not less than 30.

DIF: Recall REF: p. 56 OBJ: 4 TOP: CSPT Exam 2.3 (2.0 Facilities and Equipment) 22. Growth media used for surface sampling must be inverted and placed in an incubator for a. b. c. d.

at 20° to 25° C followed by additional 14 days; 2 to 3 days 3 days; 3 days 7 days; 14 days 7 days; 2 to 3 days

at 30° to 35° C.

ANS: D

Growth media used for surface sampling must be inverted and placed in an incubator for 7 days at 20° to 25° C followed by additional 2 to 3 at 30° to 35° C. DIF: Recall REF: p. 57 OBJ: 4 TOP: CSPT Exam 2.6 (2.0 Facilities and Equipment) 23. An urgent use CSP must be prepared and administered in more than a. 1 hour

.

b. 2 hours c. 4 hours d. 12 hours ANS: A

If the time is not available for preparation in a category 1 or 2 environment, and it is for a single patient, the compound can be prepared using aseptic technique and must be administered immediately completion. The entire amount of time from beginning the compounding procedure cannot exceed 1 hour.

DIF: Recall REF: p. 57 OBJ: 3 TOP: CSPT Exam 1.6 (1.0 Medications and Components) 24. The common type of disinfectant used when cleaning compounding surfaces area is: a. PeridoxRTU. b. hydrogen peroxide. c. 70% isopropyl alcohol. d. sterile water.

ANS: C

USP<797> provides a cleaning and disinfecting schedule. The most common type of disinfectant is 70% (IPA) or isopropyl alcohol.

DIF: Recall REF: p. 57 OBJ: 4 TOP: CSPT Exam 3.7 (3.0 Sterile Compounding Procedures) 25. The temperature of the refrigerator used to store CSP must be checked

to ensure the

stability of the CSP. a. monthly b. weekly c. bi-weekly d. daily ANS: D

The storage area must be checked for proper room temperature once daily. Temperature fluctuations for instance can affect the stability of a compound. This also includes the refrigerator and values should be recorded on a log.

DIF: Recall REF: p. 64 OBJ: 5 TOP: CSPT Exam 2.4 (2.0 Facilities and Equipment) 26. When transporting a CSP, all of the following should be used to protect the quality of the CSP

except: a. tamper-evident seal. b. pneumatic tube. c. light-resistant packaging when required. d. cooler to protect from temperature fluctuations.

ANS: B

The pneumatic tube system is not recommended to use when transporting CSPs since physical shaking may compromise the quality of the CSP.

DIF: Application REF: p. 64 OBJ: 5 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 27. A visual inspection of the CSP is required and should be checked for which of the following? a. Cloudiness b. Particulate matter c. Leakage d. All of the options ANS: D

A visual inspection of the CSP is performed using a white and black background box and includes checks for cloudiness, particulate matter, leakage, or container compromise.

DIF: Application REF: p. 64 OBJ: 5 TOP: CSPT Exam 3.19 (3.0 Sterile Compounding Procedures) 28. If there is an indication that the CSP has been compromised, a. the CSP should be remade. b. the CSP should isolated and how it occurred should be investigated. c. the CSP should not be administered, it should be discarded, and an investigation

should be performed on how it occurred. d. none of the options.

ANS: C

If there is an indication of compromise to the CSP, the compound should be immediately discarded or isolated and a determination of what and how it occurred should be investigated.

EF p.R 64.COM DIF: Comprehension TESTBANKSRE L:LE TOP: CSPT Exam 3.20 (3.0 Sterile Compounding Procedures)

OBJ: 5

Chapter 08: The Sterile Environment Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. All compounding must take place in an: a. ISO Class 5 environment. b. ISO Class 7 environment. c. ISO Class 8 environment. d. area that contains no more than 10,000 particles of 0.5 microns per cubic meter.

ANS: A

The highest air quality is found in Class 5 which is where all compounding must take place.

The buffer area is known as an ISO Class 7 environment, which means that the air contains no more than 10,000 particles of 0.5 microns per cubic meter or less.

DIF: Comprehension REF: p. 68 TOP: CSPT Exam 2.3 (2.0 Facilities and Equipment)

OBJ: 1 | 2

2. You can clean a laminar flow hood with the following: a. 70% alcohol. b. cleaning solution containing alcohol. c. 10% alcohol. d. benzyl alcohol.

ANS: A

When cleaning a laminar fT loE wShToB odA, N yoKuSsE hoLuLldEuRs. eC anOaMpproved agent, such as 70% alcohol and lint-free wipes.

DIF: Comprehension REF: p. 73 TOP: CSPT Exam 3.8 (3.0 Sterile Compounding Procedures)

OBJ: 4

3. In a laminar flow hood: a. air enters the sides and flows across the HEPA filters. b. air enters the front and is pushed through the HEPA filter. c. air enters the top and is pushed downward. d. air enters from the back and is pushed vertically.

ANS: B

The air in a laminar flow hood enters at the front of the hood, travels through the HEPA filter at the back where the bacteria is removed, and then flows horizontally across the work surface.

DIF: Comprehension REF: p. 70 TOP: CSPT Exam 2.1 (2.0 Facilities and Equipment)

OBJ: 2

4. If a laminar flow hood has been cut off, it should be turned on: a. at least 30 minutes before using it. b. at least 45 minutes before using it. c. at least 1 hour before using it. d. at 15 minutes before using it.

ANS: A

If a laminar flow hood is turned off for any reason, it must be turned on for at least 30 minutes before using it.

DIF: Comprehension REF: p. 71 OBJ: 2 TOP: CSPT Exam 2.5 (2.0 Facilities and Equipment) | CSPT Exam 3.10 (3.0 Sterile Compounding Procedures) 5. The compounding environment must be certified no less than every: a. 2 years. b. year. c. 9 months. d. 6 months ANS: D

The compounding environment itself in the ISO Classes 5, 7, and 8 must be certified no less than every 6 months by an approved organization from the CETA National Board of Testing Registered Cleanroom Certification.

DIF: Recall REF: p. 76 OBJ: 3 TOP: CSPT Exam 2.6 (2.0 Facilities and Equipment) 6. Certification of the compounding environment includes all of the following except: a. total particle counts. b. airflow testing. c. HEPA filter replacement. d. smoke studies.

ANS: C

Certification includes: airflow testing, HEPA filter integrity testing, total particle counts, and smoke studies.

DIF: Application REF: p. 76 OBJ: 3 TOP: CSPT Exam 2.6 (2.0 Facilities and Equipment) 7. Which of the following microbial growth mediums would be used to sample for fungi

bacterial growth in the sterile environment? a. MacConkey agar b. Trypticase soy agar c. Tryptone glucose extract agar d. Bacteriological agar ANS: B

Trypticase soy agar is a general microbiologic growth medium that supports bacterial and fungi growth and is used to perform sampling.

DIF: Application REF: p. 76 OBJ: 4 TOP: CSPT Exam 2.6 (2.0 Facilities and Equipment) 8. Choose the statement below that best describes the airflow pattern through a laminar flow

hood. a. Room air is drawn in through pre filter and then through HEPA filter and over the

work surface area in parallel lines. b. Room air is channeled through the HEPA filter, which removes the bacteria; then

air moves through a prefilter and over the work area. c. Room air is drawn through the prefilter, which removes relatively large

contaminates; then air goes through a HEPA filter, which randomly blows over the work area. d. Airflow pattern is vertical, moving inward and downward.

ANS: A

Room air is drawn in through prefilter from the front and then through a HEPA filter and is then blown over the surface area in parallel lines. A BSC uses inward and downward airflow (vertical) rather than the LAFW’s horizontal.

DIF: Application REF: p. 70 OBJ: 2 TOP: CSPT Exam 3.10 (3.0 Sterile Compounding Procedures) 9. To maintain sterility, all compounding manipulations should be performed: a. 8 inches inside the hood. b. 6 inches inside the hood. c. 10 inches inside the hood. d. 3 inches inside the hood.

ANS: B

All manipulations should be done 6 inches inside the hood to maintain sterility.

DIF: Recall REF: p. 70 OBJ: 2 TOP: CSPT Exam 3.10 (3.0 Sterile Compounding Procedures) 10. The LAFW and BSC are both areas that provide an ISO class

environment for aseptic

preparation. a. 5 b. 7 c. 6 d. 8 ANS: A

The LAFW, BSC, RABS, and isolators are areas that provide an ISO class 5 environment.

DIF: Comprehension REF: p. 70 TOP: CSPT Exam 2.1 (2.0 Facilities and Equipment)

OBJ: 2

11. Certain guidelines must be followed while preparing IVs. These guidelines are mandated by: a. ASHP. b. USP 797. c. NCCLVP. d. CSP. ANS: B

USP 797 mandates the practice standards, certain guidelines that must be followed during the preparation of IV medications, because these medication types are most hazardous to patients when administered into the body cavities.

DIF: Comprehension REF: p. 67-68 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

OBJ: 1

12. Clean room is a term sometimes used for the: a. ante area. b. buffer area. c. direct compounding area. d. IV storage room ANS: B

The clean room, also known as the buffer area, is where the LAFW is located.

DIF: Application REF: p. 70 OBJ: 2 TOP: CSPT Exam 2.1 (Facilities and Equipment) 13. Handwashing, garbing, and labeling take place in the: a. ISO Class 7 environment. b. buffer area. c. restricted access barrier system. d. ante room.

ANS: D

The ante room, also known as the ISO Class 8 environment, is the outermost ring of the three compounding environments where handwashing, garbing, gathering of components needed, order entry, labeling, and other activities take place that may “stir up dust.”

DIF: Application REF: p. 71 OBJ: 2 TOP: CSPT Exam 2.2 (FaciT litE ieS sT anB dA EN quKipSmEeL ntL ) ER.COM 14. Which of the following is the correct process for garbing? a. Shoe covers, face shields or masks, hairnets, and beard covers b. Hair nets and beard covers, face shields or masks, and show covers c. Shoe covers, hairnets and beard covers, and face covers or masks d. Face shields or masks, shoe covers, hair nets, and beard covers ANS: C

The correct process for garbing is starting with the dirtiest, shoe covers, and end with the cleanest, face covers or masks.

DIF: Application REF: p. 71 OBJ: 1 TOP: CSPT Exam 3.6 (3.0 Sterile Compounding Procedures) 15. The buffer room must be kept at

growth of bacteria. a. 32° C, 75% b. 68° F, 60% c. 45° C, 55% d. 78° F; 50% ANS: B

or cooler with humidity less than

to prevent

Temperature and humidity in the ISO Class 7 are also controlled through heating systems, ventilation, and HVAC to prevent growth of bacteria. This area must be maintained at 68° F or cooler with less than 60% humidity.

DIF: Application REF: p. 68 OBJ: 2 TOP: CSPT Exam 2.4 (Facilities and Equipment) 16. First air is: a. the cleanest air. b. the dirtiest air. c. the air the technician first comes into contact with in the IV room. d. the air before going through the HEPA filter.

ANS: A

First air is the air inside the DCA that should never be interrupted. It is the cleanest air.

DIF: Comprehension REF: p. 71 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 1

17. The proper way to clean the work surface is: a. front to back in long strokes. b. back to front in short strokes. c. front to back in short strokes. d. back to front in long strokes.

ANS: D

The proper way to clean the work surface in the LAFW is from the back to the front in long strokes.

DIF: Comprehension REF: p. 73 TOP: CSPT Exam 3.8 (3.0 Sterile Compounding Procedures)

OBJ: 4

18. The hood should be cleaned: a. once per shift. b. no longer than 30 minutes from previous cleaning when compounding. c. every 30 minutes. d. only after there is a spill in the hood.

ANS: B

The PEC (except for the isolator) must be cleaned before each shift, before a batch, no longer than 30 minutes following a previous cleaning when compounding is occurring, and any time there is a suspected contamination such as a spill.

DIF: Application REF: p. 73 OBJ: 4 TOP: CSPT Exam 3.8 (3.0 Sterile Compounding Procedures) 19. a. b. c. d.

is designed to prevent the spread of infectious diseases during aseptic preparations.

PEC PPE DCA CSP

ANS: B

Personal protective equipment (PPE) is designed to prevent the spread of infectious diseases during aseptic preparations and must always be worn in the IV room.

DIF: Comprehension REF: p. 71 TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures)

OBJ: 1

20. The floors and counters in the ante area and buffer area must be cleaned: a. daily. b. weekly. c. monthly d. biweekly.

ANS: A

The floors and counters in the ante area and buffer area must be cleaned at least daily to keep the unnecessary particles to a minimum.

DIF: Recall REF: p. 73 OBJ: 4 TOP: CSPT Exam 3.8 (3.0 Sterile Compounding Procedures) 21. Which of the following is an example of a CAI environment that uses glove ports to

physically separate the outside area from the inside compounding area? a. LAFW b. Isolator c. RABS d. BSC ANS: C

Restricted Access Barrier Systems (RABS) are CACI or CAI environments which provide an ISO Class 5 inside the ISO Class 7 area (buffer), by use of glove ports that physically separate the outside area from the inside compounding area.

DIF: Application REF: p. 71 OBJ: 2 TOP: CSPT Exam 2.1 (2.0 Facilities and Equipment) 22. Which of the following can be placed in an ISO Class 8 environment so long as it maintains

an ISO Class 5 environment? a. LAFW b. Isolator c. RABS d. BSC ANS: B

If an isolator maintains an ISO Class 5 environment, it can be placed in an ISO Class 8 area or ante area. Pressure and decontamination are maintained as part of the system controls in order to continuously meet ISO Class 5 conditions.

DIF: Application REF: p. 71 OBJ: 2 TOP: CSPT Exam 2.1 (2.0 Facilities and Equipment) 23. The walls, storage shelving, and ceilings should be disinfected with a germicidal

detergent-soaked, lint-free wipe and then followed with 70% IPA:

a. b. c. d.

daily. weekly. monthly. biweekly.

ANS: C

Walls, storage shelving, and ceilings should be disinfected monthly. The floors and counters in the ante area and buffer area must be cleaned at least daily to keep the unnecessary particles to a minimum.

DIF: Recall REF: p. 74 OBJ: 4 TOP: CSPT Exam 3.8 (3.0 Sterile Compounding Procedures) 24. All cosmetics and jewelry should be removed: a. before entering the ISO class 8 environment. b. before entering the ISO class 7 environment. c. when hands are being washed. d. in the ante room before washing hands.

ANS: A

Before entering the ante room (ISO class 8 environment), personnel should remove outer garments, all cosmetics, and any visible jewelry or piercings that interfere with garb.

DIF: Comprehension REF: p. 71 TOP: CSPT Exam 3.3 (3.0 Sterile Compounding Procedures)

OBJ: 4

TRUE/FALSE 1. Touch contamination is the most common form of contamination.

ANS: T

The most common form of contamination is touch contamination.

DIF: Recall REF: p. 70 OBJ: 1 TOP: CSPT Exam 3.10 (3.0 Sterile Compounding Procedures) 2. The area where the handwashing and garbing must take place is the buffer area.

ANS: F

The buffer area is where the LAFW is located and the sterile preparations take place. The area where the handwashing and garbing take place is called the ante area.

DIF: Comprehension REF: p. 71 TOP: CSPT Exam 2.2 (Facilities and Equipment)

OBJ: 1

3. The HEPA filter should be cleaned with alcohol on a daily basis.

ANS: F

The HEPA filter should never be touched, cleaned, or sprayed with alcohol.

DIF: Comprehension REF: p. 70 TOP: CSPT Exam 2.3 (Facilities and Equipment)

OBJ: 4

4. Food and drink are allowed in the ante area as long as it is in a closed container.

ANS: F

Food and drink are never allowed in the IV areas. The ante room is where handwashing, garbing, gathering of IV components, order entry, and labeling take place.

DIF: Application REF: p. 68 OBJ: 1 TOP: CSPT Exam 2.8 (2.0 Operational Standards)

Chapter 09: Equipment and Supplies Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Needle size is determined by: a. the size of the barrel. b. the volume of fluid it can draw up in it. c. gauge and length. d. its ability to filter.

ANS: C

The gauge and length of the needle determine the size of the needle.

DIF: Comprehension REF: p. 80 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 2. If you have a 27-gauge needle to use, a. you have a large-bore needle and can draw up the drug easier. b. you have a small-bore needle, and it is harder to draw up the drug. c. you have a small-bore need, and it is easier to draw up the drug. d. you have a large-bore needle, and it is harder to draw up the drug.

ANS: B

The higher the gauge of a needle, the smaller the bore and the harder it is to draw up the drug. . 8S 0TBANKS OE BL J: LE 1 R.COM DIF: Application REF: TpE TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 3. When drawing up a syringe, the fingers should not come in contact with: a. the flat knob at the end of plunger. b. the syringe barrel. c. the shaft of the plunger. d. your fingers can come into contact with any of the above.

ANS: C

Your fingers should not come in contact with the shaft of the plunger; this can contaminate the preparation.

DIF: Comprehension REF: p. 79 | p. 84 TOP: CSPT Exam 3.10 (3.0 Sterile Compounding Procedures) 4. All of the following are examples of a critical site except: a. syringe barrel. b. syringe plunger. c. needle tip. d. top of the vial.

ANS: A

OBJ: 3

Critical sites are areas that should never be touched to avoid cross-contamination during aseptic manipulations. Critical sites include a syringe plunger, a needle tip, and the top of the vial.

DIF: Comprehension REF: p. 79, 81 TOP: CSPT Exam 3.11 (3.0 Sterile Compounding Procedures) 5. A a. b. c. d.

OBJ: 3

should be used on a syringe when drawing from an ampule. filter device second syringe cotton swab none of the options

ANS: A

When withdrawing a medication from an ampule, a filter device, such as a filter needle or filter straw, must be used to filter out the glass particles that may have broken into the ampule with it was opened.

DIF: Comprehension REF: p. 82 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 6. Which of the following syringes should be used to measure 0.72 mL? a. Insulin syringe b. Tuberculin syringe c. 3 mL syringe d. 5 mL syringe ANS: B

When very small doses are required, they are measured in tuberculin (TB) syringes, which are calibrated in hundredths. Insulin syringes are used to measure insulin only.

DIF: Application REF: p. 80 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 7. Alcohol pads used to clean a vial top can be used a maximum of: a. one time. b. two times. c. three times. d. four times.

ANS: A

Alcohol pads should only be used once by swabbing across the surface and allowed to dry completely before proceeding.

DIF: Recall REF: p. 81 OBJ: 3 TOP: CSPT Exam 3.11 (Sterile Compounding Procedures) 8. When preparing a CSP, a multidose vial can be reentered

to draw up a dose and stored . a. two times; in the LAFW b. five times; stored in the refrigerator with a foil seal on the vial top c. ten times; in the LAFW

d. when needed; based on the manufacturer’s recommendation after being opened ANS: D

A multi dose vial (MDV) allows for use of partial contents and reentry into the vial based on the manufacturer’s recommendations for storage once opened.

DIF: Comprehension REF: p. 81 OBJ: 2 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 9. Plastic IV bags used in the preparation of CSPs have two ports, one for adding medication and

the other for . a. needle b. IV tubing c. syringe d. filter needle ANS: B

Solution containers can vary in size and are usually plastic or glass. They have two ports on the end, one for adding medication which is a critical site, with a needle and syringe and another rubber port used to connect IV tubing, such as a secondary set.

DIF: Recall REF: p. 83 OBJ: 2 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 10. Each graduation on a 60 mL syringe indicates a. 0.02 mL b. 0.1 mL c. 1 mL d. 5 mL

.

ANS: C

Each graduation (line) on a 60 mL syringe indicates 1mL or 1cc.

DIF: Recall REF: p. 80 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 11. Which of the following syringes should be used to measure 3.6 mL? a. 5 mL syringe b. 10 mL syringe c. Tuberculin syringe d. Insulin syringe ANS: A

A 5 mL syringe should be used since it is the smallest device available to properly measure this amount. Each graduation on a 5 mL syringe indicates 0.2 mL or 0.2 cc.

DIF: Application REF: p. 80 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 12. A needle would be used mainly for reconstituting a powder form of a medication. a. filter b. vented

c. large gauge d. small gauge ANS: B

Vented needles are used mainly for reconstituting a powder form of a medication to avoid negative pressure.

DIF: Recall REF: p. 81 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 13. Sterile 70% IPA in a bottle can be used to clean all of the following except: a. vial tops. b. outside of IV bag packaging. c. surfaces of LAFW. d. gloved hands.

ANS: A

Sterile 70% IPA in a spray or bottle form and lint-free wipes are used to clean the PEC (LAFW), wipe down items entering the buffer area, and wipe down supplies upon entry into the PEC. Alcohol swabs should be used to wipe the tops of vials and ports of containers during sterile preparation.

DIF: Application REF: p. 81 OBJ: 3 TOP: CSPT Exam 3.11 (Sterile Compounding Procedures) 14. A a. b. c. d.

would generally be used for a CSP of an antibiotic medication. large-volume IV bag 10 mL syringe piggyback IV bag cassette

ANS: C

Bags from 50 to 250 mL are known as piggybacks or small-volume parenterals and are generally used for antibiotics or small amounts of fluid.

DIF: Recall REF: p. 83 OBJ: 2 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 15. Which of the following filter needles can be used when preparing a CSP? a. 0.22 micron filter needle b. 15 micron filter needle c. 20 micron filter needle d. 100 micron filter needle ANS: A

Filter needles used in the preparation of CSPs can range in size from 0.22 to 10 microns, depending on the medication to be filtered.

DIF: Application REF: p. 83 OBJ: 1 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) 16. Which of the following large-volume parenteral IV bags would be used for fluid replacement?

a. b. c. d.

50 mL 100 mL 250 mL 1000 mL

ANS: D

Bags from 500 to 1000 mL are known as large-volume parenterals and can be used for fluid replacement and other types of medication therapy. IV bags smaller than 250mL are known as IVPBs or small-volume parenteral IV bags.

DIF: Application REF: p. 83 OBJ: 2 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 17. This critical site must always be exposed to first air and swabbed with a sterile IPA pad. a. Syringe plunger b. Bag port c. Syringe tip d. Needle hub ANS: B

Critical sites such as syringe plungers and tips, needle hubs, vial stoppers, and bag ports must always be exposed to first air. The surfaces of the vial stopper and bag ports must be swabbed with 70% IPA sterile alcohol pads and allowed to dry, while syringe plungers and tips and needle hubs must never be touched.

DIF: Application REF: p. 84 OBJ: 3 TOP: CSPT Exam 3.11 (3.0 Sterile Compounding Procedures) 18. A a. b. c. d.

can be used to seal a syringe dose. sterile bag foil seal tamper proof cap needle cap

ANS: C

Tamper proof caps are used to seal a syringe dose.

DIF: Recall REF: p. 84 OBJ: 3 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 19. A sterile IV syringe and needle can be used _ when preparing a CSP. a. an unlimited amount of times during 30 minute period b. up to two times c. one time then discarded d. an unlimited amount of times during a 24-hour period ANS: C

Syringes and needles are disposable and should be discarded after one use.

DIF: Comprehension REF: p. 79 OBJ: 4 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal)

20. To prevent the spread of microbial contamination,

sterile compounding supplies are

used when preparing CSPs. a. reusable b. nondurable c. durable d. disposable ANS: D

Disposable supplies are used in the preparation of CSPs to prevent the spread of microbial contaminates.

DIF: Comprehension REF: p. 79 OBJ: 4 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) TRUE/FALSE 1. The needle consists of a barrel and a hub.

ANS: F

The needle consists of a hub and a shaft.

DIF: Comprehension REF: p. 81 TOP: CSPT Exam 3.12 (3.0 Sterile Compounding Procedures)

OBJ: 1

2. After the top of the vial is wiped with an alcohol pad, the technician can immediately proceed

with preparing the IV. ANS: F

The process of the alcohol drying is when the dehydration of the bacteria cells occurs which is necessary to kill it. The technician must wait until the alcohol dries to proceed with preparing the IV. DIF: Comprehension REF: p. 81 TOP: CSPT Exam 3.11 (3.0 Sterile Compounding Procedures)

OBJ: 3

3. The finer the needle, the lower the gauge number.

ANS: F

The finer the needle, the higher the gauge number.

DIF: Comprehension TOP: N/A

REF: p. 80

OBJ: 1

4. A filter needle is used to withdraw medication from an ampule and must be replaced with a

regular needle to inject into the bag.

ANS: T

When withdrawing medication from an ampule, you must use a filter device, such as a filter needle or filter straw to filter any glass that fell into the ampule when it was broken. The filter needle must be replaced with a regular needle before adding medication to the bag.

DIF: Comprehension REF: p. 82-83 TOP: CSPT Exam 3.12 (Sterile Compounding Procedures)

OBJ: 1

5. Tamper-evident seals are used to indicate a medication has been added and ensure that there is

no breach of the sterile container before administration to the patient.

ANS: T

After the technician is finished preparing a sterile preparation, a tamper-evident seal is placed on the port to which the medication was added to indicate there was medication added.

DIF: Comprehension REF: p. 84 OBJ: 3 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal)

Chapter 10: Sterile Practice Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. LAFW and BSC are examples of a(n): a. ISO Class 8 environment. b. ISO Class 5 environment. c. ISO Class 7 environment. d. ISO Class 10 environment.

ANS: B

All aseptic technique is performed in a Class 5 environment. The LAFW and BSC are examples of this environment.

DIF: Application REF: p. 87 OBJ: 1 TOP: CSPT Exam 2.1 (2.0 Facilities and Equipment) 2. Sterile supplies are removed from their outer wrappings: a. 6 inches inside the hood. b. at the edge of the hood. c. in the ante area. d. in the buffer room.

ANS: B

Sterile supplies are removed from their outer wrappings at the edge of the PEC. DIF: Comprehension REF: p. 87 TOP: CSPT Exam 3.10 (Sterile Compounding Procedures) 3. During IV preparation, items are to be kept

OBJ: 2

inches from the back and all sides of the

hood. a. 6 b. 3 c. 2 d. 4 ANS: A

All items used to prepare a sterile solution must be kept 6 inches from the back and all sides of the hood.

DIF: Recall REF: p. 87-88 OBJ: 2 TOP: CSPT Exam 3.10 (Sterile Compounding Procedures) 4. Before withdrawing fluid from a vial using a standard nonvented needle, the following should

be done to preventing creating a vacuum in the vial: a. inject a volume of air equal to the amount of liquid being withdrawn. b. inject a volume of air greater than the amount of liquid being withdrawn. c. inject a volume of air that is half of the amount of liquid withdrawn. d. nothing needs to be done beforehand, the fluid can be withdrawn without adding air.

ANS: A

To prevent creating a vacuum in a vial using a standard nonvented needle, you should inject a volume of air equal to the amount of liquid being withdrawn.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 1

5. All of the following are steps that should be taken in the buffer area except: a. spray hands with disinfect. b. perform calculations. c. don sterile gloves. d. clean the LAFW. ANS: B

Calculations should be performed in the ante area before entering the buffer area.

DIF: Application REF: p. 90 OBJ: 3a TOP: CSPT Exam 2.8 (Facilities and Equipment) 6. When entering a vial with a needle and syringe, the bevel should be facing: a. downward. b. upward. c. vertical to the top of the vial. d. any direction.

ANS: B

The bevel of a needle should face upward before entering the vial to prevent coring.

DIF: Recall REF: p. 89 OBJ: 1 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures) 7. “Staging” the final IV preparation means getting it ready to: a. be delivered. b. be checked. c. be wasted. d. be administered.

ANS: B

After preparing an IV solution, the technician must stage the final product for the pharmacist to check before it is delivered.

DIF: Comprehension REF: p. 92 TOP: CSPT Exam 3.10 (Sterile Compounding Procedures)

OBJ: 3b

8. All of the following should be done after opening a multidose vial except: a. dating it. b. initialing it. c. storing in the LAFW uncovered for later use. d. sealing it with a foil seal.

ANS: C

A multidose vial should be dated, initialed, and sealed with a foil seal after it has been opened.

DIF: Comprehension REF: p. 98 TOP: CSPT Exam 1.4 (Medications and Components)

OBJ: 3f

9. When discarding disposable items, needles should be put: a. in the trash. b. in the sink. c. back on the shelf for reuse. d. in a sharps container.

ANS: D

Needles must be discarded in a sharps container after use.

DIF: Recall REF: p. 97 OBJ: 3 TOP: CSPT Exam 3.12 (Sterile Compounding Procedures) 10. After disinfecting all critical sites with alcohol, the technician must wait at least: a. 10 seconds. b. 30 seconds. c. 45 seconds. d. 60 seconds.

ANS: B

The critical sites should be wet for at least 10 seconds and allowed to dry so the microorganisms are eliminated.

DIF: Recall REF: p. 89 OBJ: 2 TOP: CSPT Exam 3.11 (Sterile Compounding Procedures)

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11. Syringes with Luer-Lock systems: a. hold the needle on by friction. b. lock the needle into place. c. allow a closed system. d. allow for an open system ANS: B

Syringes with a Luer-Lock system require a slight turn, locking the needle into place.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.10 (Sterile Compounding Procedures)

OBJ: 1

12. It is important not to touch which of the following because there is a higher risk of touch

contamination? a. Syringe barrel b. IV bag c. Syringe plunger d. They are all at a higher risk of touch contamination ANS: C

A syringe plunger should never be touched because of the risk of touch contamination.

DIF: Application REF: p. 88 OBJ: 1 TOP: CSPT Exam 3.11 (Sterile Compounding Procedures)

13. A common problem when using a syringe to withdraw a solution from a vial is: a. that air bubbles may occur. b. that there is a high risk of contamination. c. air can be easily added to the vial. d. not being able to withdraw all the medication from the vial.

ANS: A

A common problem when using a syringe to withdraw a solution from a vial is that air bubbles can form in the barrel.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 3c

14. The accurate way to read the measurement of a syringe is: a. the top of the rubber part of the plunger. b. the top of the point on the plunger. c. the bottom of the rubber part of the plunger. d. from the bottom of the meniscus at the top of the barrel of the syringe.

ANS: A

The accurate way to read the measurement of a syringe is the top of the runner part of the plunger.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 1

15. A vial is a closed system, w nsK: SELLER.COM ThEicShTmBeAaN a. air is not free to go in and out of the container. b. air is free to move in and out of the container. c. a vacuum will not be formed if a nonvented needle is used to withdraw the

medication. d. it can be opened.

ANS: A

A vial is a closed system, meaning air is not free to go in and out of the container.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 1

16. All of the following is required for preparing the admixture for the pharmacist to check

except: a. labeled the CSP. b. vial or stock bottle used next to the CSP. c. syringe with needle used next to the CSP. d. syringe drawn back to the amount added to CSP. ANS: C

When staging an IV preparation to be checked by the pharmacist, the needle must be discarded in the sharps container.

DIF: Application

REF: p. 92

OBJ: 3b

TOP: CSPT Exam 3.10 (Sterile Compounding Procedures) 17. Which of the following is an example of a critical site? a. A vial lid b. Hub of the needle c. Protective covering of a needle d. Outside of admixture bag ANS: B

The hub of the needle is an example of a critical site and should never be touched.

DIF: Application REF: p. 87 OBJ: 1 TOP: CSPT Exam 3.11 (Sterile Compounding Procedures) 18. When withdrawing medication from an ampule, you must tilt the ampule at least: a. 90 degrees. b. 45 degrees. c. 15 degrees. d. 20 degrees.

ANS: D

When withdrawing medication from an ampule, it should be tilted at least 20 degrees to be able to withdraw the needed volume.

DIF: Recall REF: p. 97 OBJ: 3c TOP: CSPT Exam 3.14 (Sterile Compounding Procedures) 19. After the medication is injeTcE teS d TinBtoAtN heKbSaEgLaL ndEtR he.pCoOrtMis sealed, the technician must: a. discard all the items that were used during preparation. b. inspect the bag for particulate matter or any incompatibility. c. deliver the medication to the patient. d. place it aside and continue to the next preparation.

ANS: B

The technician must inspect the bag for any particulate matter or any incompatibility before labeling it and staging for the final check by the pharmacist.

DIF: Comprehension REF: p. 97 TOP: CSPT Exam 1.7 (Medications and Components) 20. All items should be spread out at

OBJ: 3f

inches apart to ensure there is sufficient space to work

without disrupting airflow. a. 3 b. 8 c. 6 d. 2 ANS: C

The items must be placed 6 inches apart to ensure the airflow will not be interrupted.

DIF: Recall REF: p. 87 OBJ: 3b TOP: CSPT Exam 3.10 (Sterile Compounding Procedures)

TRUE/FALSE 1. All medications that need to be reconstituted must be shaken after the diluent is added.

ANS: F

Some medications cannot be shaken because it causes extra foam that could compromise the medication.

DIF: Comprehension REF: p. 94 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 3d

2. If a medication is to be dispensed in a syringe, the needle should be left on the syringe.

ANS: F

If a medication is to be dispensed in a syringe, the needle should be removed and a push-on or twist-on cap should be added for delivery.

DIF: Comprehension REF: p. 92 TOP: CSPT Exam 3.12 (Sterile Compounding Procedures)

OBJ: 3a

3. Good hand placement is important to not obstruct first air.

ANS: T

Good hand placement will ensure the avoidance of contact critical sites, as well as maintaining an open, direct path for first air in the laminar airflow workbench (LAFW).

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REF: p. 87 DIF: Comprehension TOP: CSPT Exam 3.10 (Sterile Compounding Procedures)

OBJ: 2

4. Aseptic technique is used in a class 7 environment, also known as a clean room.

ANS: F

Aseptic technique is performed in a class 5 environment, also known as a clean room.

DIF: Recall REF: p. 87 OBJ: 1 TOP: CSPT Exam 2.2 (Facilities and Equipment) 5. Before performing any aseptic manipulations, you should always perform proper

handwashing and garbing inside the buffer area.

ANS: F

Proper handwashing and garbing are to be done in the ante area before entering the buffer area.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.4 (Sterile Compounding Procedures)

OBJ: 3a

6. Gloves are not necessary as long as you use proper handwashing technique and spray hands

with 70% alcohol.

ANS: F

You must use proper handwashing technique, put 70% alcohol or disinfectant on your hands, and allow your hands to dry. Next, don sterile gloves and then apply alcohol to the gloves before any manipulation in the clean room.

DIF: Comprehension REF: p. 90, 92 TOP: CSPT Exam 3.4 (Sterile Compounding Procedures)

OBJ: 3a

7. “Stabbing” a needle into the rubber closure of a vial may cause coring.

ANS: T

When pushing the needle into the rubber closure of a vial, you must not stab the rubber. Doing so may cause coring, which is a type of particulate matter that causes contamination to the medication.

DIF: Comprehension REF: p. 89 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 1

8. You must remove and discard the needle from the syringe before staging the admixture for the

pharmacist to check.

ANS: T

When staging the admixture for the final check by the pharmacist, the technician must remove and discard the used needle in the sharps container.

DIF: Comprehension REF: p. 92 TOP: CSPT Exam 3.12 (Sterile Compounding Procedures)

OBJ: 3b

9. All supplies must be gathered and decontaminated before entering the buffer area.

ANS: T

To decrease the possibility of contamination, the supplies needed for compounding the sterile preparation must be gathered and decontaminated using 70% isopropyl alcohol before entering the buffer area.

DIF: Comprehension REF: p. 90, 92, 95, 98 OBJ: 3a TOP: CSPT Exam 2.8 (Facilities and Equipment) 10. When reconstituting a medication, the technician should add the correct diluent to the vial

according to the manufacturer’s recommendations.

ANS: T

The technician should consult the vial or the package insert to find out the manufacturer’s recommendation for proper reconstitution.

DIF: Comprehension REF: p. 92 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures)

OBJ: 3d

Chapter 11: Packaging, Labeling, and Documentation of CSPs Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. According to USP <797> guidelines, which of the following is required on a master

formulation record? a. Prescription number b. Name of the preparer c. Name, strength, and dosage form d. QA procedures performed ANS: C

The master formulation record requires the following: name, strength, dosage form, a physical description of the compound, all quantities and ingredients needed, proper container, complete instructions with steps and supplies/equipment needed, BUD and storage requirements, and QA processes for release testing.

DIF: Application REF: p. 101 OBJ: 3 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures) 2. USP <797> requires all of the following to be on a compounding record except: a. physical description of the compound. b. date and time of the preparation. c. assigned BUD for the CSP. d. name, strength, and dosage form.

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ANS: A

The compounding record requires prescription or other assigned identification number given and preparer name, name, strength, and dosage form, MRF reference if used or compounding preparation process details, date and time of preparation with total prepared quantity compounded, name of manufacturer, lot number, and expiration date of each ingredient used and container used, weight or measurement of each ingredient, calculations used to create quantities needed, assigned BUD for CSP, QA procedures performed such as visual inspection, and additional label container if a batch is prepared.

DIF: Application REF: p. 101-102 OBJ: 4 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures) 3. Documentation of CSPs should be performed in the a. ISO class 7 environment b. ISO class 8 environment c. ISO class 5 environment d. ISO class 100 environment

.

ANS: B

Documentation, preparation of records, and gathering of supplies and medications cannot be completed in an ISO class 5 or ISO class 7 environment. These tasks can be completed in an ISO class 8 environment where order entry and labeling take place.

DIF: Comprehension REF: p. 102 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures)

OBJ: 4

4. A review of the steps and process of making a CSP should be done

garbing and

handwashing. a. while b. after c. during d. before ANS: D

The integrity and expiration dates of all ingredients should be checked along with a review of the steps and process (MFR) that will take place prior to performing garbing and handwashing.

DIF: Comprehension REF: p. 103 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures) 5. Visual inspection of the CSP should be performed a. while b. after c. during d. before

OBJ: 3

the final pharmacist check.

ANS: D

Once the sterile compound is prepared, the compounder can perform a visual inspection prior to the final RPh check.

DIF: Recall REF: p. 103 OBJ: 2 TOP: CSPT Exam 3.19 (3.0 Sterile Compounding Procedures) 6. A visual physical inspection for all of the following except for

will determine if a CSP

is defective. a. foreign matter b. cloudiness c. coloration d. particulate matter ANS: C

Physical inspection of the CSP should include visually inspecting for foreign matter, discoloration, cloudiness, or particulate matter. While discoloration can occur, it does not always occur and should not be relied on.

DIF: Comprehension REF: p. 103 TOP: CSPT Exam 3.19 (3.0 Sterile Compounding Procedures) 7. The refrigerator temperature must be verified a. daily b. weekly c. monthly d. bi-annually

OBJ: 2

if used to store refrigerated CSPs.

ANS: A

When the CSP requires refrigeration, the refrigerator used to store the CSP must be verified daily and the temperature logged to ensure BUD limitations are being followed.

DIF: Recall REF: p. 103 OBJ: 2 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 8. All calculations performed for the CSP should be located on the: a. MFR. b. CR. c. SOP. d. MR. ANS: B

Calculations used to create quantities needed for a CSP must be on the compounding record (CR).

DIF: Recall REF: p. 102 OBJ: 4 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures) 9. The master formula record (MFR), compounding record (CR), and testing results must be for

a minimum of a. 6 months b. 1 year c. 2 years d. 3 years

after the BUD of the CSP.

ANS: D

All records related to compounding a particular CSP such as the Master Formulation Record, the Compounding Record, and any testing results must be kept at least 3 years after the BUD of the CSP. If the state laws require longer, that is followed as the strictest always applies.

DIF: Recall REF: p. 105 OBJ: 3 | 4 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures) 10. The compounding record is created by the a. pharmacist b. physician c. compounder d. pharmacy technician

for each CSP prepared.

ANS: C

A compounding record or CR is created by the compounder for each particular CSP prepared.

It could be the pharmacist or pharmacy technician preparing the CSP, but in those instances, they would be the compounder.

DIF: Comprehension REF: p. 101 TOP: CSPT Exam 3.13 (3.0 Sterile Compounding Procedures)

OBJ: 4

11. A should be placed on a CSP to ensure it has not been compromised during transport. a. IV port seal b. sterile cap

c. IV port cover d. tamper proof seal ANS: D

Tamper proof seals can be used to ensure an uncompromised CSP. Port seals or syringe caps can be used, but it can be difficult to determine if it was removed or opened with these devices.

DIF: Comprehension REF: p. 105 OBJ: 2 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 12. When preparing a CSP from a medication in an ampule, it is important to include which of the

following for staging? a. Syringe used with plunger removed b. Filter needle used c. Diluent used for reconstitution d. Alcohol pads used ANS: B

When staging for the pharmacist’s check, syringes used in removal of fluids from vials should be pulled back to the correct amount added and placed with its respective medication vial. If a powder vial was used, the diluent and syringe used should also be placed together. If there was an ampule used; leave the filter straw or needle for review with the syringe used.

DIF: Comprehension REF: p. 103 TOP: CSPT Exam 3.10 (3.0 Sterile Compounding Procedures)

OBJ: 2

13. The label of the CSP mustT coEnStaTinBaAt N aK mSinEim um LL ERal.l oCfOthMe following except: a. BUD. b. route of administration. c. preparer’s initials. d. total volume.

ANS: C

USP <797> guidelines require that the immediate container of the CSP must, at a minimum, display prominently and legibly the following: (1) assigned internal identification number (e.g., barcode, prescription, order, or lot number), (2) active ingredient(s) and their amounts, activities, or concentrations, (3) storage conditions if other than controlled room temperature, (4) BUD, (5) route of administration, (6) total amount or volume if it is not obvious from the container, (7) if it is a single-dose container, a statement stating such when space permits, (8) if it is a multiple-dose container, a statement stating such. The labeling of the CSP must also provide any applicable special handling instructions or warning statements.

DIF: Application REF: USP 797 Guidelines OBJ: 1 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) 14. When labeling a hazardous CSP, all of the following would be required except: a. special handling instructions. b. preparer’s initials. c. active ingredients. d. BUD.

ANS: B

USP <797> guidelines require that the immediate container of the CSP must, at a minimum, display prominently and legibly the following: (1) assigned internal identification number (e.g., barcode, prescription, order, or lot number), (2) active ingredient(s) and their amounts, activities, or concentrations, (3) storage conditions if other than controlled room temperature, (4) BUD, (5) route of administration, (6) total amount or volume if it is not obvious from the container, (7) if it is a single-dose container, a statement stating such when space permits, (8) if it is a multiple-dose container, a statement stating such. The labeling of the CSP must also provide any applicable special handling instructions or warning statements. If the compounded CSP is considered hazardous, USP<800> chapter guidelines must be followed.

DIF: Application REF: USP 797 Guidelines OBJ: 1 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 15. The label of the CSP may also serve as the a. SOP b. MRF c. CR d. MR

for the CSP.

ANS: C

A prescription or medication order or label may serve as the compounding record.

DIF: Application REF: USP 797 Guidelines OBJ: 1 | 4 TOP: CSPT Exam 4.1 (4.0 Handling, Packaging, Storage, and Disposal) | CSPT Exam 3.13 (3.0 Sterile Compounding Procedures)

Chapter 12: Total Parenteral Nutrition Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Approximately a. 20 to 30 mEq b. 30 to 40 mEq c. 10 to 15 mEq d. 25 to 35 mEq

of potassium is needed for each 1000 calories provided parenterally.

ANS: B

For each 1000 calories provided parenterally, approximately 30 to 40 mEq of potassium is needed.

DIF: Recall REF: p. 109 OBJ: 2 TOP: CSPT Exam 1.3 (Medications and Components) 2. Proteins are necessary for all of the following except: a. replacing cells. b. tissue growth. c. tissue repair. d. organ function.

ANS: D

Proteins are body building nutrients that promote the replacement of cells as well as tissue growth and repair.

DIF: Application REF: p. 109 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 3. When administering a TPN, the bag should be discarded how often? a. As ordered by the physician b. Every 24 hours c. Every 12 hours d. After it finishes running ANS: B

After a TPN is hung, it should be infused and discarded after 24 hours because of the increased risk of microbial growth because of the high dextrose content.

DIF: Recall REF: p. 113 OBJ: 2 TOP: CSPT Exam 3.15 (Sterile Compounding Procedures) 4. When using an automated compounder, the amount for each ingredient is measured by: a. mL/mL. b. g/g. c. g/mL. d. weight.

ANS: C

Automated compounding machines are programmed using specific gravity, which is the weight of each substance measured in grams per milliliters as compared with an equal volume of water.

DIF: Comprehension REF: p. 112 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures) 5. a. b. c. d.

OBJ: 3

is often added to adjust the volume of parenteral solutions.

Dextrose Lactated Ringer solution Sterile water Amino acids

ANS: C

Sterile water is used to adjust the volume of the final solution of a TPN. DIF: Recall REF: p. 108 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 6. Up to a a. 5% b. 25% c. 10% d. 70%

concentration of dextrose can be given in a peripheral nutrition solution.

ANS: C

Dextrose 10% is the highest concentration that should be given through a peripheral vein.

DIF: Recall REF: p. 108 OBJ: 2 TOP: CSPT Exam 1.3 (Medications and Components) 7. a. b. c. d.

is an example of a fat source used in parenteral solutions.

Aminosyn Dextrose Liposyn Normal saline

ANS: C

Liposyn is an example of a fat source used in parenteral solutions.

DIF: Recall REF: p. 108 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 8. The base solution can consist of all of the following except: a. dextrose. b. amino acids. c. micronutrients. d. sterile water.

ANS: C

The base solution of a TPN consists of an energy source, a fat, a protein, and usually sterile water to adjust the volume of the final solution. Micronutrients are nutrients added individually after the base is compounded.

DIF: Application REF: p. 110 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 9. Parenteral nutrition may be indicated for the following conditions except: a. massive bowel surgery. b. malnourished patients. c. pancreatitis. d. minor burns.

ANS: D

A TPN is needed for chronic weight loss, conditions requiring the bowels to rest (bowel surgery, pancreatitis, or peritonitis), multiple trauma, coma, critical illness, and severe burns.

DIF: Application REF: p. 107 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 10. When making a three-in-one solution, the following are the components needed: a. Liposyn, dextrose, and amino acids. b. dextrose, sterile water, and micronutrients. c. sterile water, amino acids, and dextrose. d. Liposyn, amino acids, and sterile water.

ANS: A

The three components needTeEdSfoTrBaAthNreKeS -iE n-LoL neEsRo. luC tioOnMare an energy source (dextrose), a protein (amino acid), and a fat (Liposyn).

DIF: Recall REF: p. 112 OBJ: 3 TOP: CSPT Exam 1.1 (Medications and Components) 11. Sources of carbohydrates, protein, and fat are: a. micronutrients. b. additives. c. macronutrients. d. electrolytes.

ANS: C

Macronutrients are the source of carbohydrates, protein, and fat.

DIF: Recall REF: p. 108 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 12. Inflammation of the abdominal cavity is known as: a. gastritis. b. peritonitis. c. pancreatitis. d. parenteralitis.

ANS: B

Peritonitis is inflammation of the abdominal cavity.

DIF: Recall

REF: p. 107

OBJ: 1

TOP: N/A

13. All of the following are goals for parenteral nutrition except: a. to promote wound healing. b. to increase weight loss. c. to prevent malnutrition. d. to replace nutritional deficits.

ANS: B

Increasing weight loss is not a goal for parenteral nutrition. Increasing weight or diminishing the rate of weight loss is a goal of parenteral nutrition.

DIF: Application REF: p. 107 OBJ: 1 TOP: CSPT Exam 1.1 (Medications and Components) 14. Which of the following TPN components are used to provide energy? a. Electrolytes b. Carbohydrates c. Fats d. Proteins ANS: B

The major function of carbohydrates is to provide energy for the patient.

DIF: Application REF: p. 108 OBJ: 2 TOP: CSPT Exam 1.1 (MedTicE atS ioT nsBaA ndNC o ntR s).COM KSmEpLonLeE 15. Which of the following trace elements aid in wound healing? a. Copper b. Selenium c. Zinc d. Nickel ANS: C

Zinc is a trace element, or microelement, that aids in the process of wound healing.

DIF: Application REF: p. 110 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 16. Which of the following are advantages to using a compounding machine, as opposed to the

gravity method, when preparing TPNs? a. There is less touch contamination. b. Compounding machines have better accuracy than the gravity method. c. Compounding machines are faster than the gravity method. d. All of the options.

ANS: D

There are many advantages to using a compounding machine when making TPNs. Some of these advantages are there is less touch contamination, they have better accuracy, and they are faster way to prepare a TPN.

DIF: Application REF: p. 112 OBJ: 3 TOP: CSPT Exam 3.14 (Sterile Compounding Procedures) 17. If a TPN is stopped abruptly, a bag of

should be administered at the same rate that the

TPN was being given. a. D10W b. D5W c. normal saline d. lipids ANS: A

If a TPN is stopped abruptly, a bag of D10W should be hung in its place and administered at the same rate that the TPN was given to decrease the chance of hypoglycemia occurring because of the imbalance of glucose in the body due to the high concentration in the solution.

DIF: Comprehension REF: p. 113 TOP: CSPT Exam 1.1 (Medications and Components)

OBJ: 2

18. 500 mL of 20% Liposyn provides: a. 2000 calories per day. b. 1000 calories per day. c. 500 calories per day. d. 1500 calories per day.

ANS: B

A total of 1000 calories is provided daily from 5000 mL of 20% Liposyn.

DIF: Recall REF: p. 109 OBJ: 2 TOP: CSPT Exam 1.3 (Medications and Components) | CSPT Exam 3.2 (Sterile Compounding Procedures) 19. Which of the following is not an electrolyte? a. Magnesium sulfate b. Potassium chloride c. Insulin d. Calcium gluconate ANS: C

Insulin is an additive that could be added to a TPN to control the glucose level.

DIF: Application REF: p. 109, 110 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) | CSPT Exam 1.2 (Medications and Components) 20. An abnormally high level of glucose in the blood is known as: a. hypoglycemia. b. hyperglycemia. c. hypocalcemia. d. hypokalemia.

ANS: B

Hyperglycemia is a blood disorder that occurs when there is an abnormally high level of glucose in the blood.

DIF: Recall REF: p. 108 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) 21. All parenteral nutrition should be filtered with a: a. filter straw. b. tubing filter. c. 0.2-micron filter. d. filter needle.

ANS: B

All parenteral nutrition should be filtered with a 0.2-micron filter. Most filter needles and filter straws filter 5 microns.

DIF: Recall REF: p. 113 OBJ: 3 TOP: CSPT Exam 4.3 (4.0 Handling, Packaging, Storage, and Disposal) TRUE/FALSE 1. A 25% final concentration of dextrose should be infused via a peripheral line.

ANS: F

The highest concentration of dextrose that should be given in a peripheral vein is 10%, and it should only be given for 7 to 10 days.

TESTBANKSRE L:LE EF p.R 10.8COM DIF: Comprehension TOP: CSPT Exam 1.3 (Medications and Components)

OBJ: 2

2. Parenteral nutrition should be titrated or tapered up gradually to prevent hyperglycemia and

down to prevent hypoglycemia.

ANS: T

Parenteral nutrition should be tapered up to prevent hyperglycemia and down to prevent hypoglycemia because of the high levels of dextrose in the admixture.

DIF: Comprehension REF: p. 108 TOP: CSPT Exam 1.3 (Medications and Components)

OBJ: 2

3. Hypometabolic states are conditions that require additional energy to heal.

ANS: F

Hypermetabolic states are conditions that require additional energy to heal.

DIF: Comprehension TOP: N/A

REF: p. 108

OBJ: 1

4. Patients who have a decrease in renal function may require decreased amounts of potassium.

ANS: T

Potassium is excreted through the kidneys, so patients who have a decrease in their renal function should receive smaller amounts.

DIF: Comprehension REF: p. 110 TOP: CSPT Exam 1.1 (Medications and Components)

OBJ: 1

5. Nutritional requirements for a patient can vary but commonly range from 1200 to 2500

calories per day while on TPN therapy.

ANS: F

The most common range for nutritional requirements for patients receiving TPN therapy varies from 2500 to 3000 calories per day.

DIF: Recall REF: p. 107 OBJ: 1 TOP: CSPT Exam 1.1 (Medications and Components) 6. Potassium chloride and calcium gluconate can precipitate if they are added too closely

together.

ANS: F

Calcium gluconate and potassium phosphate can cause precipitation if added too close together.

DIF: Recall REF: p. 112 OBJ: 3 TOP: CSPT Exam 3.19 (Sterile Compounding Procedures) 7. Automated compounder machines are kept in the LAFW. ANS: T

Admixtures compounded by an automated compounding machines are sterile preparations; therefore, the machine itself must be kept in the LAFW. DIF: Comprehension REF: p. 112 OBJ: 3 TOP: CSPT Exam 3.10 (Sterile Compounding Procedures) | CSPT Exam 3.14 (Sterile Compounding Procedures) | CSPT Exam 3.15 (Sterile Compounding Procedures) 8. A dextrose solution with the volume of 3000 mL provides 1500 calories.

ANS: F

3000 mL of dextrose provides 1000 calories.

DIF: Recall REF: p. 108 OBJ: 2 TOP: CSPT Exam 3.2 (Sterile Compounding Procedures) 9. Before infusion, a TPN solution should be warmed to room temperature for about 1 hour.

ANS: T

For the comfort of the patient, the TPN should be warmed to room temperature before infusion.

DIF: Recall REF: p. 113 OBJ: 2 TOP: CSPT Exam 1.4 (Medications and Components)

10. The more manipulations that need to be involved in a preparation, the higher the risk of

contamination of the parenteral admixture.

ANS: T

For every stick that occurs while preparing a parenteral admixture, the risk for contamination occurs.

DIF: Comprehension REF: p. 113 TOP: CSPT Exam 3.10 (Sterile Compounding Procedures)

OBJ: 3

Chapter 13: United States Pharmacopeia<800> Hazardous Pharmaceuticals Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. When compounding a nonsterile or sterile preparation, USP chapter

guidelines must be

followed. a. <795> b. <797> c. <800> d. <825> ANS: C

When performing nonsterile or sterile compounding, and the quality standards for handling as well as storage, receipt, compounding, dispensing, administration, and disposal, facilities must follow USP <800> guidelines.

DIF: Recall REF: p. 117 OBJ: 1 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment) 2. Which of the following medications is listed on the NIOSH hazardous drug list? a. Cefuroxime b. Dexmedetomidine c. Fosphenytoin d. Ondansetron ANS: C

Fosphenytoin is included on the NIOSH list of antineoplastic and other hazardous drugs in health care settings list in Group 2: non-antineoplastic drugs that meet one or more of the NIOSH criteria for a hazardous drug, including those with the manufacturer’s safe-handling guidance (MSHG).

DIF: Application REF: p. 117 OBJ: 2 TOP: CSPT Exam 1.2 (1.0 Medications and Components) 3. Of the following, which is not listed on the NIOSH hazardous drug list? a. Levothyroxine sodium b. Phenytoin sodium c. Warfarin sodium d. Valproate sodium ANS: A

Valproate sodium and warfarin sodium are included on the NIOSH list of antineoplastic and other hazardous drugs in health care settings list in Table 3 Group 3: non-antineoplastic drugs that primarily have adverse reproductive effects and phenytoin sodium is in Group 2: non-antineoplastic drugs that meet one or more of the NIOSH criteria for a hazardous drug, including those with the manufacturer’s safe-handling guidance (MSHG). Levothyroxine sodium is not on the list.

DIF: Application REF: p. 117 OBJ: 2 TOP: CSPT Exam 1.2 (1.0 Medications and Components)

4. Which of the following compounds would be required to be prepared in a BSC? a. Insulin IV b. Pantoprazole IV c. Ranitidine IV d. Methotrexate IV ANS: D

Methotrexate is included on the NIOSH list of antineoplastic and other hazardous drugs in health care settings list in Table 1, Group 1: antineoplastic drugs, including those with the manufacturer’s safe-handling guidance (MSHG).

DIF: Application REF: p. 117 OBJ: 2 TOP: CSPT Exam 1.2 (1.0 Medications and Components) 5. Exposure to hazardous drugs can happen in all of the following except: a. administration. b. order entry. c. transport. d. dispensing.

ANS: B

Exposure can occur during inventory process, dispensing, compounding, cleaning/deactivation, administration, spills, transport, waste disposal, packaging, and receipt of the medication. Putting in an order for a hazardous would not expose someone the drug.

DIF: Application REF: p. 117-118 OBJ: 1 TOP: CSPT Exam 4.2 (4.0 H dlT inB g,APN acK kaSgE inL g,LSE toR ra. geC, O anMd Disposal) TaEnS 6. If a shipment of a hazardous drug is received in a broken container: a. the drug should be placed with the rest of the hazardous drug stock. b. the drug should be unpackaged in a positive pressure area to prevent particles

being transferred to the air. c. open the drug in the BSC, wipe it down, place it in a plastic bag, and return it. d. deactivate the drug container with the germicidal agent chlorhexidine and return it.

ANS: C

When a drug container is received, that is, broken or opened, it should be opened in the C-PEC on a plastic backed mat, wiped on the outside, and then placed in an appropriate plastic bag. It should then be either returned or disposed of after deactivating or decontaminating it following the USP <800> guidelines. When opening or unpacking hazardous drug, it should be done in a neutral or negative pressure area to prevent particles from being transferred into the air. Deactivating a hazardous drug should be done with hypochlorite or hydrogen peroxide; chlorhexidine is a germicidal agent which is used for cleaning.

DIF: Comprehension REF: p. 118 OBJ: 1 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 7. The air quality in the ISO 7 environment where the BSC is placed must have at least

and be externally vented. a. 50 ACPH

b. 32 ACPH c. 24 ACPH d. 12 ACPH ANS: D

When preparing a compound with a hazardous drug, it needs to be done in a BSC or CACI that is in an ISO 7 or ISO 8 environment. The air quality in the C-SEC must have at least 12 ACPH where temperature and humidity is also monitored.

DIF: Recall REF: p. 118 OBJ: 1 TOP: CSPT Exam 2.1 (2.0 Facilities and Equipment) 8. To help protect the compounder from exposure to aerosols from the medication being drawn

from hazardous drug vial, a a. plastic backed mat b. 0.2-micron filter c. CSTD d. pair of chemo gloves

should be used.

ANS: C

The most common piece of additional equipment used to protect the compounder from exposure to aerosols from the medication being withdrawn from a vial is a CSTD or closed-system drug transfer device, which allows for a closed filter that captures aerosols that can escape from the vial as well as a needle less puncture system to avoid a stick from a HD contaminated needle.

DIF: Comprehension REF: p. 118 TOP: CSPT Exam 3.17 (3.0TSE teS riT l eB CA om inL gE PrR oc.eC duOreMs) NpKoSunEdL

OBJ: 1

9. All personnel who handle hazardous drugs must be trained based on their job functions and

reassessed every a. 3 months b. 6 months c. 12 months d. 24 months

.

ANS: C

All personnel who handle HDs must be trained based on their job functions and reassessed every year.

DIF: Comprehension REF: p. 119 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 1

10. All of the following must be included when training on how to handle hazardous drug CSPs

except: a. overview of hazardous drugs and their risks. b. proper cleaning of the horizontal flow hood. c. review of facility SOPs. d. proper disposal requirements.

ANS: B

Training for personnel when handling hazardous drugs for a CSP must include: overview of HDs and their risks, proper use of PPE and performance of handwashing, proper use of equipment to include cleaning (deactivation, decontamination), spill management, review of the facilities standard operating procedures, and proper disposal requirements. While proper cleaning of a PEC must be included, an LAFW (horizontal flow hood) is not used when compounding a preparation with a hazardous drug.

DIF: Application REF: p. 119 OBJ: 1 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 11. When compounding a product using a hazardous drug, chemotherapy gloves approved by the a. b. c. d.

must be worn.

ASTM NIOSH USP OSHA

ANS: A

The chemotherapy gloves worn while compounding with a hazardous drug are thicker and must meet the American Society for Testing and Materials (ASTM) requirements.

DIF: Comprehension REF: p. 119 TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures)

OBJ: 1

12. When compounding a CSP with a hazardous drug, gloves must be changed every

and

discarded if pin holes or tears are found. a. 60 minutes b. shift c. 30 minutes d. 24 hours ANS: C

Two pairs of gloves must be worn, the outer gloves must be sterile and changed every 30 minutes.

DIF: Comprehension REF: p. 119 TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures)

OBJ: 1

13. Gowns worn during the compounding of a hazardous drug preparation: a. can also be worn while compounding a nonhazardous drug CSPs. b. must be changed every 4 to 5 hours when compounding with a hazardous drug. c. can be cloth but must be changed every 2 to 4 hours when compounding with a

hazardous drug. d. should be changed after a spill or splash.

ANS: D

Gowns worn while compounding with a hazardous drugs must be able to resist permeability (not cloth) and be changed every 2 to 3 hours. They should not be worn to other areas to help avoid exposure to others or other compounds. They should also be changed immediately after a spill or splash.

DIF: Comprehension

REF: p. 119

OBJ: 1

TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures) 14. Which of the following would be most appropriate to wear for eye protection when

compounding with a hazardous drug? a. Face shield b. Goggles and face shield c. Safety glasses d. Goggles ANS: B

Face shield and goggles must be worn, even when eyeglasses are worn. Safety glasses, even with side shields, do not have enough protection from splashes. Goggles with face shield will provide full range protection against splashes to the face and eyes. Face shields alone do not provide full eye and face protection.

DIF: Comprehension REF: p. 119 TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures)

OBJ: 1

15. To reduce the risk of respiratory exposure, a(n) _

must be worn during deactivation, decontamination, compounding, or unpacking of hazardous drugs. a. surgical mask b. face shield c. ISO 5 fitted mask d. N-95 fitted mask ANS: D

The use of a N-95 fitted mask is required and should be worn during deactivation, decontamination, compounTdE inSgT , oBrAuN npKaS ckEinLgLoEf R H. DC s.OM DIF: Recall REF: p. 119 OBJ: 1 TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures) 16. When de-garbing after compounding with a hazardous drug: a. gloves and sleeves must be discarded in a sealed bag inside the BSC. b. outer gloves and gown must be disposed of in an approved container inside the

C-PEC. c. the gown can be worn again but it must stay in the C-SEC. d. only the outer pair of gloves need to be disposed of in the hazardous containment

device.

ANS: A

Disposing of the worn PPE should be prior to leaving the C-SEC area and into an approved hazardous containment device or a sealable bag. Gloves and sleeves should be discarded in a sealed bag inside the C-PEC. DIF: Comprehension REF: p. 119 TOP: CSPT Exam 3.6 (3.0 Sterile Compounding Procedures) 17. To deactivate a hazardous drug, a. sterile alcohol b. germicidal agent c. sodium hypochlorite

can be used.

OBJ: 1

d. sterile water ANS: C

Sterile alcohol can be used to decontaminate, clean, and disinfect. Sterile water can be used to decontaminate. A germicidal agent is used to clean. Sodium hypochlorite and hydrogen peroxide can be used to deactivate.

DIF: Comprehension REF: p. 120 TOP: CSPT Exam 3.7 (3.0 Sterile Compounding Procedures)

OBJ: 1

18. When decontaminating, all of the following agents can be except: a. chlorhexidine. b. sterile alcohol. c. sodium hypochlorite. d. hydrogen peroxide.

ANS: A

Chlorhexidine is a germicidal agent. Sterile alcohol, sterile water, hydrogen peroxide, and sodium hypochlorite can be used to decontaminate surfaces where HDs are used.

DIF: Application REF: p. 120 OBJ: 1 TOP: CSPT Exam 3.7 (3.0 Sterile Compounding Procedures) 19. Before performing the disinfecting process, the BSC cabinet should be cleaned with: a. sodium hypochlorite. b. sterile alcohol. c. hydrogen peroxide. d. sterile water.

ANS: D

Sodium hypochlorite and hydrogen peroxide can be used to deactivate a HD or decontaminate objects. Sterile water should be used to disinfect surfaces after cleaning with sterile water.

DIF: Application REF: p. 120 OBJ: 1 TOP: CSPT Exam 3.9 (3.0 Sterile Compounding Procedures) 20. Any persons transporting hazardous drugs must be trained in

standards for hazardous

waste operations. a. NIOSH b. OSHA c. USP d. FDA ANS: B

If transporting hazardous drugs, personnel must be trained in OSHA standards for hazardous waste operations.

DIF: Recall REF: p. 121 OBJ: 1 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 21. Hazardous drugs must be transported in: a. an amber bag to protect the drug from light.

b. a lead container to reduce the risk of exposure to those who handle it. c. a bag with a hazardous label on the outside. d. the original container it came into eliminate the risk of accidental exposure.

ANS: C

The final hazardous drug product should be labeled itself and then placed in a hazardous labeled sealed bag in case of a leak or spill.

DIF: Comprehension REF: p. 121 OBJ: 1 TOP: CSPT Exam 4.2 (4.0 Handling, Packaging, Storage, and Disposal) 22. To monitor the health of personnel handling hazardous drugs, all of the following would be

required except: a. hair mineral analysis. b. urine test. c. blood test. d. number of hours spent handling HDs. ANS: A

While a hair mineral analysis can be used to detect toxins personnel may be seen exposed to, it is generally not used to monitor exposure to a hazardous drug. The number of hours a worker has spent handling HDs, urine/blood tests, and exit exams for employees who leave will be used to monitor health.

DIF: Application REF: p. 122 OBJ: 1 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment)

Chapter 14: Hazardous Drug Preparation Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. All of the following are common adverse side effects associated with chemotherapy except: a. insomnia. b. loss of hair. c. mouth sores. d. vomiting.

ANS: A

Common adverse side effects of chemotherapy include loss of hair, mouth sores, severe pain, compromised immune system, and nausea and vomiting, Insomnia is not a common side effect.

DIF: Application REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.1 (Medications and Components) 2. All of the following are commonly used to prepare chemotherapy drugs except: a. chemo gloves. b. spill kit. c. preparation mat. d. red disposal container.

ANS: D

Chemo gloves, gown, and T prEeS paTraBtiA onNK mS atE sL arL eE aR fe.wCsO upMplies that are used to prepare chemotherapy drugs. Other supplies include face masks, eye protectors, and shoe protectors.

Instead of red disposal containers, yellow disposal containers are used to differentiate them to indicate hazardous waste.

DIF: Application REF: p. 128 OBJ: 3 TOP: CSPT Exam 3.5 (3.0 Sterile Compounding Procedures) 3. To contain potential spillage, the final chemo product should be prepared as follows for

delivery to patient area: a. Sealed in a plastic bag with a chemo label. b. Placed in a sealed bag. c. Made in a syringe with protective cap only. d. Have no fluid in the tubing.

ANS: A

The final chemo product should be placed in a zipped-lock bag labeled with a warning that reads “Caution Hazardous Drug: Handle with Gloves. Dispose of Properly” on the product and on the outside of the bag for delivery.

DIF: Comprehension REF: p. 130 OBJ: 3 TOP: CSPT Exam 4.2 (Handling, Packaging, Storage, and Disposal) 4. “Cancer drugs” are also called: a. neoplastic agents.

b. antineoplastic agents. c. antimalignant agents. d. none of the options.

ANS: B

Medications used to treat cancer are known as antineoplastic agents or “cancer drugs.”

DIF: Recall REF: p. 125 OBJ: 1 TOP: CSPT Exam 1.1 (Medications and Components) 5. Which of the following statements are true about chemotherapy agents? a. Chemotherapy agents are different from antineoplastic agents. b. Chemotherapy agents damage healthy cells. c. Chemotherapy agents are only given to elderly patients. d. Chemotherapy agents have very few risks.

ANS: B

Chemotherapy agents are designed to kill cancerous cells, but in the process, they can also cause damage to healthy cells.

DIF: Comprehension REF: p. 125 TOP: CSPT Exam 1.1 (Medications and Components)

OBJ: 1

6. The chemotherapeutic agent that inhibit the growth of cells is a(n): a. antimetabolic. b. antitumor antibiotic. c. immunomodulating agent. d. enzyme inhibitor.

ANS: C

Immunomodulating agents inhibit the growth of the cancerous cells.

DIF: Recall REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components) 7. The chemotherapeutic agent that interferes with DNA or RNA synthesis is a(n): a. antimetabolic. b. antitumor antibiotic. c. immunomodulating agent. d. enzyme inhibitor.

ANS: B

Antitumor antibiotics are antibiotics that interfere with the DNA or RNA synthesis.

DIF: Recall REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components) 8. Testing of specific techniques should be given at least: a. quarterly. b. biannually. c. every 3 months. d. annually.

ANS: D

Training should occur before preparing or handling, and testing of specific techniques should be included at least annually.

DIF: Recall REF: p. 131 OBJ: 2 TOP: CSPT Exam 3.1 (Sterile Compounding Procedures) 9. Sampling of surface areas for facilities that prepare large amount of hazardous drugs should

occur at least every: a. 6 months. b. 12 months. c. 24 months. d. 18 months.

ANS: A

Disinfecting, deactivating, and disinfecting of the environment, including sampling of surface areas, such as the BSC and counter tops for HD environment adheres to the same scheduling s USP<797> guidelines, which is every 6 months.

DIF: Recall REF: p. 131 OBJ: 3 TOP: CSPT Exam 2.5 (Facilities and Equipment) 10. If a spill occurs and there is contact with the eyes, they should be rinsed for: a. 1 to 2 minutes. b. 2 to 3 minutes. c. 3 to 5 minutes. d. 2 to 4 minutes.

ANS: C

If there is eye contact during a spill of hazardous drugs, you should rinse your eyes for 3 to 5 minutes before proceeding.

DIF: Recall REF: p. 131 OBJ: 3 TOP: CSPT Exam 2.8 (Facilities and Equipment) 11. A needleless device that is used to allow the air to escape through the closed system rather

than in the air is referred to as: a. EEC. b. CSP. c. PPE. d. CSTD. ANS: D

A closed system vial-transfer device, CSTD, is a needleless device that allows air to escape through the closed system rather than in the air.

DIF: Comprehension REF: p. 130 TOP: CSPT Exam 3.17 (Sterile Compounding Procedures)

OBJ: 3

12. A closed container that should be used to expel excess drug is called a(n): a. EEC. b. CSP.

c. PPE. d. CSTD. ANS: A

An empty evacuated container (EEC) is a closed container that should be used to expel excess drug.

DIF: Comprehension REF: p. 130 TOP: CSPT Exam 3.17 (Sterile Compounding Procedures)

OBJ: 3

13. When wearing double gloves, the technician should: a. tuck both gloves under the gown sleeve. b. tuck the gown sleeve under both gloves. c. tuck the inner glove under the gown sleeve and the outer glove over. d. replace both gloves immediately if the outer glove is contaminated.

ANS: C

The proper way to double glove is to tuck the inner glove under the gown sleeve and tuck the cuff of the outer glove over the gown sleeve.

DIF: Comprehension REF: p. 131 TOP: CSPT Exam 3.6 (Sterile Compounding Procedures)

OBJ: 3

14. When adding diluent to a vial of hazardous drug, the technician should inject: a. slightly more air into the vial than required to maintain “negative” pressure. b. slightly less air into the vial than required to maintain “negative” pressure. c. slightly more air into the vial than required to maintain “positive” pressure. d. slightly less air into theTvEiaSl T thBaA nN reK quSiE reL dL toEm Ra.inCtaOinM“positive” pressure.

ANS: B

Before withdrawing the medication out of the vial, the technician should inject slightly less air into the vial than the amount required to maintain “negative” pressure.

DIF: Comprehension REF: p. 130 TOP: CSPT Exam 3.17 (Sterile Compounding Procedures)

OBJ: 3

, “Personnel who compound hazardous drugs should be fully trained in the storage, handling, and disposal of these drugs.” a. <797> b. <800> c. <795> d. <825>

15. According to USP

ANS: B

USP <800> states, “Personnel who compound hazardous drugs should be fully trained in the storage, handling, and disposal of these drugs.”

DIF: Recall REF: p. 131 OBJ: 3 TOP: CSPT Exam 3.1 (Sterile Compounding Procedures) 16. The chemotherapeutic agents that attach side chains to the proteins within the cancer cells and

interfere with their functions are called:

a. b. c. d.

alkylating agents. hormone agents. miscellaneous agents. antimetabolic agents.

ANS: A

Alkylating agents attach side chains, or “alkyl groups,” to the proteins within the cancer cell and interfere with their function.

DIF: Comprehension REF: p. 126 TOP: CSPT Exam 1.2 (Medications and Components)

OBJ: 1

17. Mitotic inhibitors interfere with: a. cell metabolism. b. cell function. c. cell growth. d. cell division.

ANS: D

Mitotic inhibitors interfere with cellular division.

DIF: Comprehension REF: p. 126 TOP: CSPT Exam 1.2 (Medications and Components)

OBJ: 1

18. Chemotherapy agents should be prepared in a(n): a. LAFW. b. CACI. c. horizontal flow hood. d. vertical flow hood.

ANS: B

The ISO Class 5 environment required PEC used in preparing HDs requires a C-PEC such as a Class I or II biological safety cabinet (BSC), the CVE containment ventilated enclosure, or a CACI. DIF: Comprehension REF: p. 128 TOP: CSPT Exam 2.1 (Facilities and Equipment)

OBJ: 3

19. The air in a biological safety cabinet is taken in at: a. the bottom, passes through the HEPA filter, and is then blown upward. b. the top, passes through the HEPA filter, and then is blown downward. c. the top, passes through the HEPA filter, and then is blown across the work surface. d. the front, passes through the HEPA filter, and then is blown across the work area.

ANS: B

The BSC is designed so the air is taken at the top, passing through a HEPA filter, then blown downward, not exposing the operator to the air.

DIF: Comprehension REF: p. 128 TOP: CSPT Exam 2.1 (Facilities and Equipment) 20. The BSC should be:

OBJ: 3

a. b. c. d.

turned off when it is not being used. turned on only during business hours. turned on 24 hours a day. used at least once a day.

ANS: C

The biological safety cabinet (BSC) should remain on for 24 hours a day even when it is not being used.

DIF: Recall REF: p. 128 OBJ: 3 TOP: CSPT Exam 2.8 (Facilities and Equipment) 21. All of the following are alkylating chemotherapeutic agents except: a. carboplatin. b. cisplatin. c. cyclosporine. d. cyclophosphamide.

ANS: C

Alkylating agents attach “alkyl groups,” or side chains, to the proteins within the cancer cell and interfere with their function. Drugs include carboplatin, cisplatin, cyclophosphamide, and mechlorethamine. Cyclosporine is an immunosuppressive drug.

DIF: Application REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components) 22. Which of the following is an antitumor antibiotic commonly used for the treatment of cancer? a. Methotrexate b. Doxorubicin c. Fluorouracil d. Gemcitabine ANS: B

Doxorubicin, bleomycin, mitomycin, and dactinomycin are antitumor antibiotics commonly used in the treatment of cancer. Methotrexate, fluorouracil, and gemcitabine are antimetabolites.

DIF: Application REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components) 23. All of the following are enzyme inhibitors commonly used for the treatment of cancer except: a. Aldesleukin b. Irinotecan c. Pegaspargase d. Asparaginase ANS: A

Irinotecan, pegaspargase, and asparaginase are enzyme inhibitors commonly used in the treatment of cancer. Aldesleukin is an immunomodulating agent.

DIF: Application REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components)

24. Which of the following chemotherapeutic agent replaces, competes with, or antagonizes a

metabolic or body function by interfering with a specific phase of cell metabolism? a. Vincristine b. Dactinomycin c. Fulvestrant d. Fluorouracil ANS: D

Antimetabolites replace, compete with, or antagonize a metabolic or body function by interfering with a specific phase of cell metabolism. Methotrexate, fluorouracil, cytarabine, and gemcitabine are antimetabolites.

DIF: Application REF: p. 126 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components) 25. A complete list of hazardous drugs is available through which of the following organizations? a. ISMP b. MEDMARX c. NIOSH d. OSHA ANS: C

A complete list of hazardous drugs can be found on the NIOSH website.

DIF: Application REF: p. 127 OBJ: 1 TOP: CSPT Exam 1.2 (Medications and Components) TRUE/FALSE 1. A conventional laminar flow hood may be used as biological safety cabinet.

ANS: F

A conventional LAFW and the BSC are not the same and cannot be used in each other’s place.

DIF: Comprehension REF: p. 128 TOP: CSPT Exam 2.1 (Facilities and Equipment)

OBJ: 3

2. BSCs should only be cleaned if a spill occurs.

ANS: F

BSCs should be cleaned daily and when a spill occurs.

DIF: Recall REF: p. 131 OBJ: 3 TOP: CSPT Exam 2.5 (Facilities and Equipment) 3. Transporting cytotoxic drugs through a pneumatic system is allowed as long as there is a

“hazardous drug” warning label on the outside of the bag.

ANS: F

A cytotoxic drug should never be sent through a pneumatic system because this is a way of exposure.

DIF: Comprehension REF: p. 130 OBJ: 3 TOP: CSPT Exam 4.2 (Handling, Packaging, Storage, and Disposal) 4. Handling hazardous or cytotoxic agents is the same as any IV admixture.

ANS: F

There are additional precautions to follow that include special procedures, disposal, storage, and delivery to avoid unnecessary exposure.

DIF: Comprehension REF: p. 127 OBJ: 3 TOP: CSPT Exam 4.2 (Handling, Packaging, Storage, and Disposal) 5. The air in a BSC should be 100% vented to the outside air through HEPA filtration.

ANS: T

According to USP 797 requirements, the air in a BSC must be 100% vented to the outside air through HEPA filtration.

DIF: Comprehension REF: p. 128 TOP: CSPT Exam 2.1 (Facilities and Equipment)

OBJ: 3

6. Tubing should be primed before adding cytotoxic agents to avoid unnecessary exposure for

everyone involved.

ANS: T

To avoid leakage or any other unnecessary exposure to everyone involved with a cytotoxic agent, tubing should be primed before the agent is added to the bag.

DIF: Comprehension REF: p. 130 OBJ: 3 TOP: CSPT Exam 4.2 (Handling, Packaging, Storage, and Disposal) 7. Epoetin alfa is administered when an extreme loss of white blood cells occurs as a result of

the use of chemotherapy agents.

ANS: F

Chronic anemia is an extreme loss of red blood cells.

DIF: Comprehension REF: p. 126 TOP: CSPT Exam 1.1 (Medications and Components)

OBJ: 1

8. Chemotherapy agents are used to either destroy cancer cells or control their growth with

minimal effect to normal cells.

ANS: T

The use of chemotherapy agents is to either control the growth of or destroy the cancer cells altogether, with minimal effect to normal cells.

DIF: Comprehension REF: p. 125 TOP: CSPT Exam 1.1 (Medications and Components)

OBJ: 1

9. Cytotoxic agents are antineoplastic agents.

ANS: T

Antineoplastic agents are cytotoxic agents, hazardous drugs.

DIF: Comprehension REF: p. 125, 127 TOP: CSPT Exam 1.1 (Medications and Components)

OBJ: 1

10. All personnel that handle hazardous drugs must be aware of the risks and adhere to strict

guidelines during exposure.

ANS: T

There are strict guidelines to follow and risks that all personnel handling hazardous drugs must be aware of to prevent exposure.

DIF: Comprehension REF: p. 125 TOP: CSPT Exam 3.1 (Sterile Compounding Procedures)

OBJ: 3

Chapter 15: United States Pharmacopeia<825> Radiopharmaceuticals—Preparation, Compounding, Dispensing, and Repackaging Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Which of the following USP chapters identifies environment controls, training, techniques,

and documentation for preparing radiopharmaceuticals aseptically? a. <825> b. <800> c. <797> d. <795> ANS: A

USP <825> identifies environment controls, training, techniques, and documentation for preparing radiopharmaceuticals aseptically.

DIF: Application

REF: p. 133

OBJ: 1

TOP: N/A

2. Which of the following organizations regulates the safe preparation, dispensing, and delivery

of human and animal radioactive medications? a. CDC b. OSHA c. NRC d. NIOSH ANS: C

The Nuclear Regulatory Commission (NRC) as well as the FDA regulates the safe preparation, dispensing, and delivery of human and animal radioactive medications.

DIF: Application

REF: p. 133

OBJ: 1

TOP: N/A

3. Radiopharmaceuticals should be compounded in which of the following environments? a. ISO class 3 b. ISO class 5 c. ISO class 7 d. ISO class 8 ANS: B

The goal is to handle radiopharmaceutical medications and perform compounding as quickly as possible and limit the time and hand movements in and out of the ISO Class 5 environment (PEC).

DIF: Application

REF: p. 133-134

OBJ: 1

TOP: N/A

4. The designated area that contains the PEC where pharmaceutical compounding takes place is

known as: a. SCA. b. ISO class 8 environment. c. LAFW.

d. SRPA. ANS: D

The segregated radiopharmaceutical processing area (SRPA) is the designated area that contains the PEC where pharmaceutical compounding takes place.

DIF: Comprehension TOP: N/A

REF: p. 134

OBJ: 1

5. A device made of lead that is used to shield or contain radioactive materials is a a. hot lab b. hot cell c. kit d. radio assay

.

ANS: B

A device made of lead that is used to shield or contain radioactive materials is a hot cell.

DIF: Comprehension TOP: N/A 6. A a. b. c. d.

REF: p. 134-135

OBJ: 3

is a nonclassified radiopharmaceutical processing area without a PEC. hot lab hot cell kit radio assay

ANS: A

A hot lab is a nonclassifiedTrE adSiT opBhA arN mKaS ceEuL ticLaE l pRr. ocCeO ssM ing area without a PEC. DIF: Comprehension TOP: N/A 7. A a. b. c. d.

REF: p. 133

OBJ: 1

is a measurement of radioactivity present in a container. hot lab hot cell radio assay kit

ANS: C

A radio assay is a measurement of radioactivity present in a container.

DIF: Comprehension TOP: N/A

REF: p. 133

OBJ: 1

8. To help protect the compounder from the radiation from radiopharmaceutical exposure, vials

and syringe shields made of a. technetium b. tungsten c. thallium d. cadmium ANS: B

should be used.

Shielding refers to special equipment such as vial and syringe shields made of lead or tungsten that are used to protect the radiopharmaceutical exposure to the compounder.

DIF: Recall

REF: p. 134

OBJ: 3 | 2

TOP: N/A

9. Radioisotopes used for diagnostic procedures include which of the following? a. Rocuronium b. Atracurium c. Gallium d. Vecuronium ANS: C

Rocuronium, Atracurium, and Vecuronium are used during surgery to relax the muscles and are listed on ISMP high-alert medication list. Gallium, technetium Tc99m Lidofenin, or technetium Tc99m Mebrofenin are common examples of radioisotopes used for diagnostic procedures.

DIF: Application REF: p. 134 OBJ: 3 TOP: CSPT Exam 1.2 (Medications and Components) 10. Personnel handling radiopharmaceuticals must wear a

to measure long-term radiation

exposure. a. barometer b. spirometer c. Geiger counter d. dosimeter ANS: D

Personnel handling radiopharmaceuticals must wear a dosimeter to measure long-term radiation exposure.

DIF: Recall

REF: p. 134

OBJ: 2

TOP: N/A

11. A device used to measure long-term radiation exposure must be in all of the following area

except: a. on one of the compounder’s shoes underneath the shoe cover. b. on the ring finger of the compounder underneath the glove. c. inside the PEC. d. underneath the gown of the compounder.

ANS: A

Personnel handling radiopharmaceuticals must wear a dosimeter to measure long-term radiation exposure. This is usually on the ring finger and worn under the gloves. A body dosimeter is also used and worn under the gown. Additional measuring devices may be placed inside the ISO Class 5 PEC as well.

DIF: Application

REF: p. 134

OBJ: 3

TOP: N/A

12. Personnel preparing radiopharmaceuticals must follow aseptic handwashing and garbing

requirements and be visually inspected at least a. monthly b. quarterly

.

c. every 6 months d. yearly ANS: D

In addition to following the USP <797> guidelines for aseptic compounding, the personnel who work with radioactive material must have additional training and knowledge of exposure risks to this special group of drugs. Competencies to include aseptic technique, garbing, PEC cleaning, media fill testing, and gloved fingertip sampling must be done every 12 months.

DIF: Recall REF: p. 134 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 13. Personnel preparing radiopharmaceuticals must have a gloved fingertip and thumb sampling

inside the ISO Class 5 PEC performed at least a. monthly b. quarterly c. every 6 months d. yearly

.

ANS: D

In addition to following the USP <797> guidelines for aseptic compounding, the personnel who work with radioactive material must have additional training and knowledge of exposure risks to this special group of drugs. Competencies to include aseptic technique, garbing, PEC cleaning, media fill testing, and gloved fingertip sampling must be done every 12 months.

DIF: Recall REF: p. 134 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 14. Surface sampling of the interior of a PEC that is used to prepare radiopharmaceuticals is

required . a. yearly b. every 6 months c. quarterly d. monthly ANS: D

Surface sampling of the interior of a PEC in a SCA should follow the USP<797> guidelines which is required monthly. It is performed using a contact sampling device or plate with a growth media.

DIF: Recall REF: p. 134 OBJ: 1 TOP: CSPT Exam 2.6 (2.0 Facilities and Environment) 15. Personnel preparing radiopharmaceuticals must have a media fill test inside the ISO Class 5

PEC performed at least a. monthly b. quarterly c. every 6 months d. yearly ANS: D

.

In addition to following the USP <797> guidelines for aseptic compounding, the personnel who work with radioactive material must have additional training and knowledge of exposure risks to this special group of drugs. Competencies to include aseptic technique, garbing, PEC cleaning, media fill testing, and gloved fingertip sampling must be done every 12 months.

DIF: Recall REF: p. 134 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 16. When compounding sterile radiopharmaceuticals, aseptic handwashing must be performed in

the: a. b. c. d.

SRPA. ISO Class 8 environment.

ISO Class 7 environment.

ISO Class 5 environment.

ANS: B

Before entering the SRPA, also considered the buffer room, personnel must perform handwashing (hands and arms up to elbows) and remove all outer clothing and jewelry.

DIF: Comprehension REF: p. 134 TOP: CSPT Exam 3.4 (3.0 Sterile Compounding Procedures)

OBJ: 1

17. When compounding sterile radiopharmaceuticals, PPE should be on the: a. SRPA. b. ISO Class 8 environment. c. ISO Class 3 environment. d. ISO Class 5 environment.

ANS: A

Shoe covers, head/hair covers, and face mask should be put on the segregated radiopharmaceutical processing area (SRPA).

DIF: Comprehension REF: p. 134 TOP: CSPT Exam 3.6 (3.0 Sterile Compounding Procedures) 18. A a. b. c. d.

OBJ: 2

may be used to provide a physically segregated ISO Class 5 processing area. hot lab hot cell kit radio assay

ANS: B

A hot cell may be used to provide a physically segregated ISO Class 5 processing area. This is a device that allows the operator to work remotely and outside of the PEC which limits exposure distance.

DIF: Comprehension TOP: N/A

REF: p. 134

OBJ: 3

19. The temperature and humidity of the classified areas where preparation of

radiopharmaceuticals takes place must be monitored a. monthly

.

b. weekly c. bi-weekly d. daily ANS: D

Surface sampling, media fill testing of personnel, and daily monitoring of temperature and humidity are required.

DIF: Recall

REF: p. 135

OBJ: 1

TOP: N/A

20. Cleaning and disinfecting the PEC where radiopharmaceuticals are prepared should be

performed: a. daily. b. bi-weekly. c. weekly. d. monthly.

ANS: A

Cleaning and disinfecting are performed daily of the PEC and torso shield, surfaces such as sink, hot-cells interior if used, and PEC and equipment within the PEC. DIF: Recall

REF: p. 135

OBJ: 2

TOP: N/A

21. The walls, ceiling, and storage shelving where radiopharmaceuticals are prepared or stored

should be cleaned and disinfected: a. daily. b. weekly. c. monthly. d. yearly.

ANS: C

Walls, ceiling, and storage shelving should be cleaned and disinfected monthly with a sporicidal agent.

DIF: Recall

REF: p. 135

OBJ: 1

TOP: N/A

22. Which of the following should be considered when assigning a BUD for a

radiopharmaceutical? a. Radiochemical stability b. Radio nucleic purity c. Age of generator d. All of the options ANS: D

When assigning a BUD for a radiopharmaceutical, the time starts when the first puncture into the vial septum begins the clock. Several other considerations must be included such as: (1) radiochemical stability, which may be affected by packaging type, stabilizing agents used, or storage temperature, (2) radio nuclidic purity because radioactive materials decays over time and must be considered in assigning a BUD, (3) age of generator or a that chemical changes to the atoms and nuclides of the material which naturally occurs, and (4) specific activity and number of particles.

DIF: Application

REF: p. 135

OBJ: 2

TOP: N/A

23. Which of the following is not required on the inner label of a radiopharmaceutical? a. Standard radioactive symbol b. BUD c. Radioactivity d. Radionuclide and chemical name ANS: B

Both the inner label and outer label or a radiopharmaceutical require the standard radioactive symbol, the words “caution-Radioactive Material,” radionuclide and chemical name, and radioactivity (units at time of calibration). Additionally, the outer label of the radiopharmaceutical must also include the volume dispensed, number of dosages, and BUD. DIF: Application

REF: p. 135

OBJ: 2

TOP: N/A

24. Which of the following is required on both the inner label and outer label for a

radiopharmaceutical? a. Radionuclide and chemical name b. Standard radioactive symbol c. BUD d. Radioactivity ANS: C

Both the inner label and outer label or a radiopharmaceutical require the standard radioactive symbol, the words “caution-Radioactive Material,” radionuclide and chemical name, and radioactivity (units at time of calibration). Additionally, the outer label of the ER radiopharmaceutical must T alE soSiT ncBluAdNeKthSeEvL olL um e. diC spOeM nsed, number of dosages, and BUD. DIF: Application

REF: p. 135

OBJ: 2

TOP: N/A

25. When transporting a radiopharmaceutical, it must be placed in a

lined delivery

container. a. technetium b. thallium c. tungsten d. lead ANS: D

Special leaded containers are used to deliver the radiopharmaceutical doses.

DIF: Recall

REF: p. 135

OBJ: 2

TOP: N/A

Chapter 16: Quality Management, Safety, and Patient Compliance Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Along with a quality assurance program,

should be in place to ensure that personnel are

trained. a. CSPs b. SOPs c. USPs d. ISOs ANS: B

Standard operating procedures (SOPs), as well as a quality assurance program, should be in place to ensure that personnel involved in the preparation of compounded sterile preparations are trained and the environment and processes meet established criteria for accuracy.

DIF: Recall REF: p. 137 OBJ: 1 TOP: CSPT Exam 2.8 (2.0 Facilities and Equipment) 2. The most common error that can occur while compounding sterile preparations is: a. microbacterial. b. nonsterility. c. both microbacterial and nonsterility. d. none of the options.

ANS: C

The most common error that occurs while compounding sterile preparations is microbacterial contamination, or nonsterility.

DIF: Recall REF: p. 137 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 3. All of the following are examples of how contamination may occur, except: a. improper handwashing. b. interruption of first airflow. c. selecting the incorrect medication. d. beginning manipulations before allowing the LAFW to be on for 30 minutes.

ANS: C

Selecting incorrect medications does lead to errors. However, it does not cause contamination.

DIF: Application REF: p. 137 OBJ: 2 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 4. Sterile preparations usually occur in an ISO class a. 7 b. 5 c. 8 d. 6

area.

ANS: B

Sterile preparations must be done in an ISO class 5, or class 100, environment.

DIF: Recall REF: p. 138 OBJ: 1 TOP: CSPT Exam 2.1 (Facilities and Equipment) 5. One way to prevent medication errors is to: a. follow exactly what the label says, even if there is a question. b. double-check the calculations. c. prepare the medication the way you feel comfortable doing so. d. prepare the medication how you interpret it.

ANS: B

The technician should always double-check calculations. If you have a question, do not hesitate asking; doing so will decrease the chance for error.

DIF: Application REF: p. 139 OBJ: 2 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 6. Which of the following pharmacy references can be viewed online for high-risk drug info? a. Mosby’s Drug Guide for Nursing Students b. Drug Facts and Comparisons c. Trissel’s Handbook on Injectable Drugs d. Institute for Safe Medical Practices ANS: D

The Institute for Safe Medical Practices (ISMP) is a pharmacy reference for high-risk drug information and sound-alikTeE , lS ooTkB-aAliN keKdSrE ugLsL . ER.COM DIF: Application REF: p. 139 OBJ: 2 TOP: CSPT Exam 1.5 (Medications and Components) 7. The guaranteed rights a patient has when it comes to medication include all of the following,

except: a. right amount of water. b. right route. c. right strength. d. right time.

ANS: A

The five rights the patient has when it comes to medication are right patient, right medication, right strength, right route, and right time.

DIF: Application REF: p. 140 OBJ: 2 TOP: CSPT Exam 1.1 (Medications and Components) | CSPT Exam 1.4 (Medications and Components) 8. Refresher training for every sterile compounder over core competencies must take place

every: a. 3 months. b. 6 months. c. 12 months.

d. 24 months.

ANS: C

Every compounder must under refresher training annual in the core competencies such as visual observations, sampling, media fill, cleaning and disinfecting, and after any pause of 3 months or more in compounding.

DIF: Recall REF: p. 139 OBJ: 1 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 9. If a sterile compounder has not compounded after

, core competencies for sterile

compounding must undergo refresher training. a. 1 month b. 3 months c. 6 months d. 12 months ANS: B

Every compounder must under refresher training annual in the core competencies such as visual observations, sampling, media fill, cleaning and disinfecting, and after any pause of 3 months or more in compounding.

DIF: Recall REF: p. 139 OBJ: 1 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 10. Sterile compounders who fail any written tests, observations, or sampling and media fill must

undergo repeat training and requalification’s and must pass a series of before resuming compoundTiE ngS. TBANKSELLER.COM a. 5 b. 4 c. 3 d. 2

successive tests

ANS: C

Person who fails any written tests, observations, or sampling and media fill must undergo repeat training and requalification’s before compounding again. Once retrained, personnel must pass a series of three successive tests before resuming compounding.

DIF: Recall REF: p. 139 OBJ: 1 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 11. Organizations that offer continuing education for technicians are all of the following except: a. ASHP. b. All BOPs. c. PTCB. d. Power-Pak C.E. ANS: B

Although some boards of pharmacy offer continuing education for technicians, not all of them do.

DIF: Application

REF: p. 142

OBJ: 1

TOP: N/A

12. Who is responsible for ensuring the integrity of the final preparation? a. The technician who prepared it b. The pharmacist checking it c. The nurse administering the medication d. Each and every person handling the preparation ANS: D

Each and every person is responsible for ensuring the integrity of the final preparation.

DIF: Comprehension REF: p. 142 TOP: CSPT Exam 1.3 (Medications and Components)

OBJ: 3

13. The beyond use date begins: a. at the time of administration to the patient. b. at the start of the preparation. c. as soon as the preparation is checked. d. once the preparation is delivered to the nurse.

ANS: B

As soon as the preparation is mixed, it should be given a beyond use date.

DIF: Comprehension REF: p. 138 TOP: CSPT Exam 1.6 (Medications and Components)

OBJ: 4

14. A set of procedures, including environmental controls, personnel training, and validation of

technique, is known as: a. CSPs. b. BOPs. c. BUDs. d. SOPs. ANS: D

SOPs, standard operating procedures, are a set of procedures put in place to ensure sterility of all CSPs. DIF: Recall REF: p. 137 OBJ: 3 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 15. The greatest threat of risk to the patient is: a. adding the wrong strength of a medication. b. the incorrect fluid volume used in preparation. c. physical contact with the critical areas. d. the incorrect volume of medication added.

ANS: C

Adding the incorrect strength, injecting the incorrect volume of medication, or using the incorrect fluid in the preparation all can cause risk to the patient. However, the greatest risk is physical contact with the critical areas in the process of preparation.

DIF: Comprehension REF: p. 138 TOP: CSPT Exam 3.11 (Sterile Compounding Procedures)

OBJ: 4

16. According to the

, all personnel who prepare CSPs are responsible for understanding the practices and precautions, for exercising the proper procedures, and for the quality of the final product to prevent harm. a. ASHP b. FDA c. USP 797 d. SOP ANS: C

The USP 797 states “All personnel who prepare CSPs are responsible for understanding these fundamentals practices and precautions, for developing and implementing appropriate procedures, and for continually evaluating these procedures and the quality of final CSPs to prevent harm.”

DIF: Comprehension REF: p. 142 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 1

17. A testing of aseptic technique and processes used in preparing CSPs to ensure sterility is

known as: a. process validation. b. a media fill test. c. a standard operating procedure. d. none of the options.

ANS: A

A process validation is a systematic testing of aseptic technique and processes used in preparing CSPs to ensure sTteEriS liT tyB . ANKSELLER.COM DIF: Recall REF: p. 140 OBJ: 3 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 18. Serious or unexpected adverse events that are caused by a CSP must be reported promptly to: a. MedWatch. b. ISMP. c. DEA. d. USP. ANS: A

Reporting of adverse events of CSP must be reviewed promptly and if serious or unexpected adverse events are evident, they must be reported to FDA through MedWatch.

DIF: Recall REF: p. 142 OBJ: 4 TOP: CSPT Exam 1.1 (Medications and Components) 19. The specific standards regarding the environmental conditions to ensure sterility are set by: a. USP. b. SOP. c. ASHP. d. CSP. ANS: A

The United States Pharmacopeia (USP) sets specific standards regarding the environmental conditions to ensure sterility.

DIF: Recall REF: p. 137 OBJ: 1 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 20. All of the following can be used as a reference to drug for compatibility, dilution, or

preparation and storage information except: a. 2018 Intravenous Medication. b. Mosby’s Drug Guide for Nursing Students. c. Drug Facts and Comparisons. d. Trissel’s Handbook on Injectable Drugs.

ANS: B

Trissel’s Handbook on Injectable Drugs, 2018 Intravenous Medication, and Drug Facts and Comparisons for compatibility, dilution, and preparation or storage information. Mosby’s Drug Guide for Nursing Students can be used to reconfirm confusing or specialty orders.

DIF: Application REF: p. 139-140 OBJ: 2 TOP: CSPT Exam 1.5 (Medications and Components) 21. The actual sampling, testing, and documentation of quality assurance results or evidence to

ensure a quality product is: a. standard operating procedures. b. release testing. c. media fill test. d. quality control.

ANS: D

Quality control is the actual sampling, testing, and documentation of quality assurance results or evidence to ensure a quality product.

DIF: Recall REF: p. 137 OBJ: 3 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) 22. A system of procedures, activities, and management to ensure a set of predetermined

standards are met is: a. quality assurance. b. standard operating procedures. c. media fill test. d. quality control.

ANS: A

Quality assurance is a system of procedures, activities, and management to ensure a set of predetermined standards are met.

DIF: Recall REF: p. 140 OBJ: 3 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) TRUE/FALSE

1. Patient safety should always be the most important aspect of any health care worker’s job.

ANS: T

The most important part of any health care worker’s job is guaranteeing the patient’s safety.

DIF: Comprehension REF: p. 140 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 4

2. There is no reason to question an order as long as it has gone through a pharmacist.

ANS: F

Successful QA programs and medication error prevention is a team effort. Each and every person, especially those who are compounding, is responsible for ensuring the integrity of the final preparation. If the technician has any questions regarding an order, he or she should ask the pharmacist to explain. There is a possibility the pharmacist made a mistake and the technician had prevented a medication error.

DIF: Comprehension REF: p. 142 OBJ: 3 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures) | CSPT Exam 3.20 (3.0 Sterile Compounding Procedures) 3. Incorrect doses or strengths are not considered errors as long as it does not reach the patient.

ANS: F

An error is an error. It does not have to make it to the patient.

DIF: Comprehension REF: p. 142 OBJ: 4 TOP: CSPT Exam 1.3 (MedTicE atS ioT nsBaA nN dC ntR s).| C KoSmEpLonLeE CSOPMT Exam 3.21 (3.0 Sterile Compounding Procedures) 4. Physicians, nurses, and pharmacists are the only individuals who should be involved with QA

programs.

ANS: F

Anyone who is involved in the delivery of medication should be included in the quality assurance process, including physicians, nurses, pharmacists, technicians, and any other supportive roles.

DIF: Comprehension REF: p. 140 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 3

5. The purpose of a QA program is to identify and analyze problems. It is management’s

responsibility to come up with solutions.

ANS: F

A QA program consists of a way to monitor, evaluate, correct, and then improve all of the aspects of compounding sterile preparations.

DIF: Comprehension REF: p. 141 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 3

6. Pharmacy technicians should always strive to gain knowledge of the field.

ANS: T

To always guarantee patient safety, pharmacy technicians should always strive to gain knowledge of the field because it is always changing.

DIF: Comprehension REF: p. 140 TOP: CSPT Exam 3.1 (3.0 Sterile Compounding Procedures)

OBJ: 2

7. The quality of a product is determined at the time it is compounded by the person who is

compounding it.

ANS: T

The person compounding the product is the person who determines the quality of the product.

DIF: Comprehension REF: p. 142 TOP: CSPT Exam 1.6 (Medications and Components)

OBJ: 4

8. Handwriting that is difficult to read can result in a medication error.

ANS: T

There are many ways errors can occur in the pharmacy, including poor handwriting. Other causes of medication errors include confusion about drug names, lack of training and knowledge of sterile techniques and best practices.

DIF: Comprehension REF: p. 139 TOP: CSPT Exam 3.20 (3.0 Sterile Compounding Procedures)

OBJ: 2

Chapter 17: Third-Party Billing, Reimbursement, and Inventory Management Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. When billing Medicare for an intravenous compound, a. CPT b. AMA c. HCPCS d. DUR

codes should be used.

ANS: C

The American Medical Association (AMA) provides CPT and HCPCS code used for billing intravenous compounds and supplies or equipment used in their administration. When billing Medicare, HCPCS codes are used.

DIF: Recall

REF: p. 149

OBJ: 1

TOP: N/A

2. Infusions billed to a third-party are based on all of the following categories except: a. IV infusion b. IV push c. Epidural infusion d. IM injection ANS: C

Infusions are based on three categories: IV infusion, IV push (IVP), and IM injection.

DIF: Application

REF: p. 149

OBJ: 1

TOP: N/A

3. If the time it takes for the infusion to be administered is 15 minutes or less, it can be billed for

an: a. b. c. d.

IVP. IV infusion.

IM injection. epidural infusion.

ANS: A

If the time it takes for the medication to be infused is less than 15 minutes, it is considered an IV push and must be billed as such. If the time goes 16 minutes or over, it can be billed for an hour of infusion.

DIF: Recall

REF: p. 149

OBJ: 1

TOP: N/A

4. When a medication is being administered, the time of service which can be billed to a

third-party includes: a. the time it takes to prepare the infusion and the time it takes to administer the infusion. b. the time the patient is in the prescriber’s office, the time it takes to prepare the infusion, and the time it takes to administer the infusion. c. the time it takes to prepare the infusion, the time it takes to administer the infusion,

and the time it takes to consult with the patient about the infusion. d. the time it takes to administer the infusion.

ANS: D

When a medication is being administered, the time of service which can be billed to a third-party includes the time it takes to administer the infusion. This does not include the time the patient is in the physician’s office, the time it takes to prepare the infusion, or the consultation.

DIF: Comprehension TOP: N/A

REF: p. 149

OBJ: 1

5. The IV line should be flushed with which of the following? a. Heparin b. Enoxaparin c. Warfarin d. Sterile water ANS: A

Heparin and saline vials can be used to flush an IV line between administrations and can be included in the billing of the IV infusion.

DIF: Application REF: p. 150 OBJ: 2 TOP: CSPT Exam 1.2 (1.0 Medications and Components) 6. Supplies sent home for the patient to use with their IV therapy would include all of the

following except: a. IV start kits. b. medication vials. c. syringes and needles. d. batteries.

ANS: B

Patients do not receive the vials of medications that is injected into the bag for home IV therapy.

DIF: Application

REF: p. 150

OBJ: 2

TOP: N/A

7. You are to prepare the following vancomycin IVs: 750 mg  2, 1250 mg  2, and 1500 mg.

Your pharmacy has in stock 500 mg ($40.23 each), 1-g ($54.02 each), and 5-g ($137.77 each) vials, all have a 50 mg/1 mL concentration. Which of the following combinations should you use, so that there is little to no waste but maintain good inventory practices? a. 11 vials of the 500 mg vial b. 2 vials of the 5-g vial c. 5 vials of the 1-g vial and 1 vial of the 500 mg vial d. 1 vial of the 500 mg and 1 vial of the 5-g vial ANS: D

Based on cost alone 1 vial of the 500 mg and 1 vial of the 5-g vial would be the best choice since it would cost $178 for the medication. Using 2 vials of the 5-g vial (275.54) could be an option since the remaining medication in the second vancomycin vial would have a BUD of 4 days when stored at controlled room temperature or 10 days refrigerated and could be used at a later time to prepare another CSP. DIF: Application REF: p. 150 OBJ: 3 TOP: CSPT Exam 3.2 (3.0 Sterile Compounding Procedures) 8. When preparing a CSP, the pharmacy technician must consider all of the following inventory

management aspects except: a. cost of the medication vial. b. time to prepare the CSP. c. volume in the medication vial. d. beyond use date.

ANS: C

While volume in the medication vial is important, so the technician knows how much to use, choosing the most appropriate medication vial is based on cost, time to prepare, and beyond use date.

DIF: Application 9. A a. b. c. d.

REF: p. 150

OBJ: 3

TOP: N/A

is a document used to order and track inventory.

GPO MDV EHR PO

ANS: D

A purchase order (PO) is used to document and track inventory items.

DIF: Recall

REF: p. 152

OBJ: 4

TOP: N/A

10. A just-in-time approach to ordering inventory allows for: a. organizations to negotiate contracts with drug manufacturers on the members

benefit. b. a minimum inventory amount to be ordered which reduces the amount of money

tied up in medications. c. a quick visual of how much inventory is in stock. d. medications to be available when needed to prepare a compound.

ANS: B

A just-in-time approach to inventory allows for minimum inventory amount to be ordered which reduces the amount of the business’s capital tied up in medications. A GPO is an inventory approach an organization can utilize to negotiate contracts with drug manufacturers on the members benefit.

DIF: Comprehension TOP: N/A

REF: p. 152

OBJ: 4

11. Which of the following is not a benefit of being a part of a group purchasing organization?

a. b. c. d.

The pharmacy can communicate directly with the manufacturer about shortages.

Limitations on a drug’s availability are reduced.

Helps keeps pricing for the pharmacies in the GPO lower.

Supply shortages can be easily communicated with those in the GPO and distributed evenly.

ANS: B

If a drug has a limited availability, being a GPO would not reduce that or help them get the medication any quicker or easier.

DIF: Application

REF: p. 152

OBJ: 3

TOP: N/A

12. If a shortage of a medication is anticipated, the pharmacy technician should do all of the

following except: a. order above the PAR level. b. stay up to date with manufacturer alerts. c. communicate with the pharmacist for possible alternatives. d. buy all remaining stock from the wholesaler.

ANS: D

Buying all remaining stock from the wholesaler would not be best practice since an increased amount of capital would be tied up and it would limit the availability to other pharmacies and patients.

DIF: Application

REF: p. 152

OBJ: 4

TOP: N/A

13. Which of the following is not a primary focus of the pharmacy and therapeutics committee? a. Report only good practT icEesSfToB rm edKicSaE tioLnLiE nvRe. ntC orOyMpractices.

AN b. Maintain medication list. c. Develop a policy for adding or removing a medication from the list. d. Maintain drug dosing, effectiveness, and availability information.

ANS: A

The primary focus of the P&T committee is divided into three parts: maintain medication list, develop a policy for adding or removing a medication from the list, and maintain drug dosing, effectiveness, and availability information. The P&T committee also provides useful background medication inventory practices, good and bad, which are used for quality control and the group’s development of best practices.

DIF: Application

REF: p. 153

OBJ: 4

TOP: N/A

14. Which of the following organizations provides guidance for drug use evaluation, the same

drug utilization review mandated by OBRA ‘90? a. FDA b. JHO c. ASHP d. USP ANS: B

The Joint Commission (JHO) and the National Committee for Quality Assurance (NCQA) provides guidance for performing an evaluation of drug use.

DIF: Application

REF: p. 153

OBJ: 4

TOP: N/A

15. The DUE process is designed to improve drug use within an organization by doing all of the

following except: a. develop criteria for a drug to be used. b. collect and organize data. c. identify all high cost drugs and keep them off the formulary. d. communicate findings and improvements to the appropriate responsible parties.

ANS: C

The DUE process is designed to identify specific drugs that should be monitored and evaluated, including identifying high risk, high usage, and high cost drugs. It is not designed to keep them off the formulary when they have a higher risk, higher use, or higher cost.

DIF: Application

REF: p. 153

OBJ: 4

TOP: N/A

16. To help reduce medication selection errors: a. do not order medications that are known to cause errors. b. keep all stock in alphabetical order. c. specially mark all high-alert drugs on the pharmacy shelves. d. do not report the error.

ANS: C

Medication selection errors are the easiest to do. Using tall man lettering, marking high-alert drugs with a special sticker, or placing medications known to cause selections in a specific area can be done to help reduce medication selection errors.

DIF: Comprehension TOP: N/A

p.R 15.4COM TESTBANKSREFL:LE

OBJ: 3

17. Which of the following medications used in the preparation of a CSP is not on the ISMP

high-alert medication list? a. Famotidine injection b. Propranolol injection c. Warfarin sodium injection d. Magnesium sulfate injection ANS: A

ISMP includes adrenergic antagonists (propranolol), anticoagulants (warfarin), and magnesium sulfate injection on the list.

DIF: Application REF: p. 154 OBJ: 3 TOP: CSPT Exam 1.2 (1.0 Medications and Components) 18. The ISMP provides a universal industry standard to identify confusing drugs using this

method: a. look-alike, sound-alike drug list. b. high-alert medication list. c. confused drug names drug list. d. tall man lettering.

ANS: D

ISMP provides a universal industry standard tall man lettering font to distinguish between look-alike, sound-alike drugs, and confusing drug names to help reduce medication errors.

DIF: Comprehension TOP: N/A

REF: p. 154-155

OBJ: 3

19. Which of the following medications should be labeled as a high-alert medication? a. Diphenhydramine HCl injection b. Doxycycline hyclate injection c. Doxorubicin HCl injection d. Dexamethasone sodium phosphate injection ANS: C

Doxorubicin is used as a chemotherapy agent and is on the NIOSH hazardous drug list and on the ISMP high-alert medication list.

DIF: Application REF: p. 155 OBJ: 3 TOP: CSPT Exam 1.2 (1.0 Medications and Components) 20. Evaluation and monitoring the inventory process and inventory management should be done: a. daily. b. weekly. c. monthly. d. annually.

ANS: A

Evaluating and monitoring the inventory process should be done continuously, which means it needs to be done on a dailyTbEaS siT s.BANKSELLER.COM DIF: Comprehension TOP: N/A

REF: p. 152

OBJ: 3 | 4

Chapter 18: Operations and Emergency Preparedness Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Which of the following broad-spectrum antibiotics with a low risk of an allergy reaction be

commonly used during a disaster? a. Penicillin b. Clindamycin c. Levofloxacin d. Metronidazole ANS: C

Penicillin, Clindamycin, Metronidazole, and Vancomycin can commonly cause an allergic reaction. Levofloxacin, Doxycycline, and Ciprofloxacin are broad-spectrum antibiotics with a low risk of an allergy reaction.

DIF: Application REF: p. 160, Table 18.1 TOP: CSPT Exam 1.2 (Medications and Components)

OBJ: 3

2. All of the following IV fluids would be a commonly stocked piled for use during a disaster

except: a. NS. b. D10W. c. D5W. d. LR. ANS: B

IV fluids that would be commonly stockpiled and used during a disaster include NS, D5W, and LR. DIF: Application REF: p. 160, Table 18.1 TOP: CSPT Exam 1.2 (Medications and Components)

OBJ: 3

3. Which of following is an antiemetic that would be commonly stockpiled and used during a

disaster? a. Ondansetron b. Haloperidol c. Lorazepam d. Diphenhydramine ANS: A

Ondansetron is an antiemetic that would be commonly stockpiled and used during a disaster.

Haloperidol is an antipsychotic, lorazepam is an anxiolytic, and diphenhydramine is an antihistamine.

DIF: Application REF: p. 160, Table 18.1 TOP: CSPT Exam 1.2 (Medications and Components)

OBJ: 3

4. Of the following vaccines, which would be needed in the event of a wildfire? a. Yellow fever

b. Influenza c. Hepatitis B d. Tetanus ANS: D

The type of medications most closely associated for wildfire injuries would include breathing treatment solutions, wound care (washes or baths), IV antibiotics, large-volume bags for hydration, immunizations such as tetanus, and IV or IM pain medications.

DIF: Application TOP: N/A

REF: p. 160, Table 18.1

OBJ: 3

5. To help treat injuries for a radiological or chemical exposure, which of the following dose

forms would be most appropriate? a. PO b. IV c. SC d. IM ANS: B

With a critical event like radiological or chemical exposure, often IV therapy is the quickest way to react as fast as possible.

DIF: Application TOP: N/A

REF: p. 160, Table 18.1

OBJ: 3

6. The analgesic

is commonly stockpiled in parenteral form to help treat pain during an emergency or disaster. a. acetaminophen b. ibuprofen c. morphine d. oxycodone ANS: C

Hydrocodone/acetaminophen, oxycodone, acetaminophen, and ibuprofen are commonly used medications during disasters but in PO form. Morphine and fentanyl are commonly used during disasters in parenteral form.

DIF: Comprehension OBJ: 3 TOP: N/A

REF: p. 160, Table 18.1

7. Which of the following would be commonly used during a disaster or emergency to help treat

burns? a. Bacitracin b. Diphenhydramine c. Hydrocortisone d. Erythromycin ANS: A

Silver sulfadiazine and bacitracin would be commonly used during a disaster or emergency to help treat burns.

DIF: Comprehension OBJ: 3 TOP: N/A

REF: p. 160, Table 18.1

8. This team sets up temporary treatment medical site to treat burns and mental health

emergencies. a. DMORT b. NVRT c. DMAT d. IMSRT ANS: C

The Disaster Medical Assistance Team (DMAT) sets up temporary treatment medical site to treat burns and mental health emergencies.

DIF: Comprehension TOP: N/A

REF: p.159

OBJ: 2

9. This team is responsible for treatment and care of working victim animals in affected disaster

area. a. DMORT b. NVRT c. DMAT d. IMSRT ANS: B

The National Veterinary Response Team (NVRT) is responsible for treatment and care of working victim animals in affected disaster area.

DIF: Comprehension TOP: N/A

REF: p.159

OBJ: 2

10. This team is responsible for the identification of victims and to support family members in the

grieving process in a disaster or emergency event. a. DMORT b. NVRT c. DMAT d. IMSRT ANS: A

The Disaster Mortuary Operations Response Team (DMORT) is made up of mortuary directors, pathologists, dental assistants, medical examiners, medical record technicians, and mental health staff, which are responsible for the identification of victims and to support family members in the grieving process in a disaster or emergency event.

DIF: Comprehension TOP: N/A

REF: p.159

OBJ: 2

11. This team performs as an operating room in the field and manages major traumas. a. DMORT b. NVRT c. DMAT d. IMSRT

ANS: D

The International Medical Surgical Response Team (IMSRT) performs as an operating room in the field and manages major traumas.

DIF: Comprehension TOP: N/A

REF: p.159

OBJ: 2

12. Which of the following should always be on hand in the event of a disaster to help store and

transport CSPs? a. Cooler b. Ice packs c. Back-up generator d. All of the options ANS: D

It is a good idea to have ice packs, coolers, and if possible, a back-up generator to maintain a cool place to store and transport CSPs. DIF: Application

REF: p.159

OBJ: 4

TOP: N/A

13. Which of the following allows for pre-planning to make batches of extra medications in the

event of the loss of electricity or supplies? a. Wildfire b. Tornado c. Hurricane d. Radiological or chemical exposure ANS: C

Hurricanes give a window of time for pre-planning such as preparation of batches or extra medications in preparation for loss of electricity or supplies. This will require additional stocking and ordering ahead of medications and supplies as well as alternative and additional storage efforts.

DIF: Application

REF: p.159

OBJ: 1

TOP: N/A

14. The

includes disaster planning and drills in their accreditation requirements for hospital systems and other related facilities. a. TJC b. CDC c. OSHA d. NDMS ANS: A

The Joint Commission (TJC) includes disaster planning and drills in their accreditation requirements for hospital systems and other related facilities.

DIF: Recall

REF: p.159

OBJ: 2

15. The Strategic National Stockpile is operated by the

TOP: N/A

and includes a collection of chemical antidotes, immunizations, antitoxins, antiviral drugs, personal protective equipment, medical/surgical items, and ventilators.

a. b. c. d.

TJC CDC OSHA NDMS

ANS: B

The Strategic National Stockpile is operated by the CDC and includes a collection of chemical antidotes, immunizations, antitoxins, antiviral drugs, personal protective equipment, medical/surgical items, and ventilators.

DIF: Recall

REF: p. 160

OBJ: 2

TOP: N/A

16. Large amounts of medical supplies and medications that would be needed during an

emergency or disaster that can be delivered within 12 hours of a federal decision about the event are known as: a. rescue packs. b. disaster packs. c. push packs. d. med rescue packs.

ANS: C

The CDC keeps large amounts of medical supplies and medications that would be needed during an emergency or disaster that can be delivered within 12 hours of a federal decision about the event are known as push packs.

DIF: Comprehension TOP: N/A

REF: p. 160

OBJ: 3

17. When planning for an emergency or disaster, the rule is to stockpile medications and supplies

for: a. b. c. d.

24 hours.

24 to 48 hours.

48 to 72 hours.

72 to 96 hours.

ANS: D

The rule is usually to stockpile at least 72 to 96 hours of medications and supplies.

DIF: Recall

REF: p. 160

OBJ: 3

TOP: N/A

18. Which of the following organizations would determine if a respirator may be required when

preparing CSPs in a POD in a disaster area? a. TJC b. OSHA c. CDC d. NDMS ANS: B

Using personal protective equipment such as masks, gloves, gowns, shoe, and hair covers may be required to work in the PODs or deliver medications to community areas. In disasters that include air contaminates, which is determined by OSHA, respirators may be required.

DIF: Application

REF: p. 161-162

OBJ: 4

TOP: N/A

19. Which of following should not be compromised in the event you need to make a CSP in less

than ideal conditions? a. Handwashing b. Aseptic technique c. Record keeping d. All of the options ANS: D

Handwashing is still critical and good aseptic technique is everything. Preparing IV medications in a less than perfect environment may be the only option during the event, so preparation and planning is key. Thinking through the challenges such as a setting up an alternate compounding environment with or without electricity. This will have to include some type of PEC, stockpiling and safe storage of supplies, and record keeping as part of the compounding technician’s role.

DIF: Application

REF: p. 159

OBJ: 4

TOP: N/A

20. The “Model Emergency Disaster Preparedness and Response Plan” is provided to state boards

of pharmacy by the a. FDA b. NABP c. CDC d. NDMS

_ to assist each state in planning for disasters.

ANS: B

The NABP’s “Model EmeT rgE enScT y BDAisN asKteSrEPL reL paErR ed.nC esOs M and Response Plan” is provided to state boards of pharmacy to assist them in planning for disasters in each of their states.

DIF: Recall

REF: p. 161

OBJ: 2

TOP: N/A

Chapter 19: Looking Forward Davis: Mosby’s Sterile Compounding for Pharmacy Technicians, 2nd Edition MULTIPLE CHOICE 1. Which of the following organizations provides accreditation for continuing education credit

for pharmacy technicians for advanced training in sterile compounding? a. Accreditation Council for Pharmacy Education (ACPE) b. Pharmacy Technician Certification Board (PTCB) c. National Pharmacy Technician Association (NPTA) d. Professional Compounding Centers of America (PCCA) ANS: A

Several organizations and educational institutions offer specialized or advanced training in sterile compounding and provide the pharmacy technician with continuing education credit through Accreditation Council for Pharmacy Education (ACPE), which is recognized by state Boards of Pharmacy and meet requirements for maintaining (CPhT) certification through PTCB. DIF: Application

REF: p. 165

OBJ: 1

TOP: N/A

2. Skill-based certification training with hands on sessions are offered by the all the following

organizations except: a. Society for the Education for Pharmacy Technicians (SEPhT). b. Critical Point. c. PharmacyTech CE. d. National Pharmacy Technician Association (NPTA).

ANS: C

SEPhT, Critical Point, and NPTA have skill-based ACPE-accredited certification with at home and hands on training. PharmacyTech CE, PowerPak CE, and Pharmacy Tech Topics offer continuing education courses for sterile compounding.

DIF: Application

REF: p. 165-166

OBJ: 1

TOP: N/A

3. The

has two meetings per year with CE sessions to help the pharmacy technician stay up to date with pharmacy practice and regulations. a. National Pharmacy Technician Association (NPTA) b. American Society of Health-System Pharmacists (ASHP) c. Society for the Education for Pharmacy Technicians (SEPhT) d. Pharmacy Tech Topics ANS: B

ASHP has two meetings each year with CE sessions to cover a variety of pharmacy topics.

DIF: Comprehension TOP: N/A

REF: p. 166

OBJ: 1

4. The specialty certification for pharmacy technicians for sterile processing is available through: a. National Pharmacy Technician Association (NPTA).

b. American Society of Health-System Pharmacists (ASHP). c. Society for the Education for Pharmacy Technicians (SEPhT). d. Pharmacy Technician Certification Board (PTCB).

ANS: D

The Pharmacy Technician Certification Board (PTCB) provides the specialty certification for a CSPT or Certified Sterile Processing technician.

DIF: Comprehension TOP: N/A

REF: p. 166

OBJ: 1

5. If a pharmacy technician has not completed an accredited pharmacy technician program, to be

able to test for the sterile compounding specialty certification they must have at least of work experience as a sterile compounding technician. a. 3 years b. 2 years c. 1 year d. 6 months ANS: A

The candidate who wishes to test, must be a CPhT in good standing to start, have completed a PTCB recognized sterile compounding education course, an ASHP-accredited program and have 1 year of work experience in sterile compounding. Another option is to have completed 3 years of work experience in sterile compounding.

DIF: Comprehension TOP: N/A

REF: p. 166

6. The sterile processing specialty certification has _

OBJ: 2

main domain(s) that are covered on the

test. a. one b. two c. three d. four ANS: D

The sterile processing specialty certification has four main domains including: Medication and Components; Facilities and Equipment; Sterile Compounding Procedures; and Handling, Packaging, Storage, and Disposal.

DIF: Recall

REF: p. 166-167

OBJ: 2

TOP: N/A

7. The medications and components domain of the sterile compounding specialty certification

covers all of the following topics except: a. Safety Data Sheets. b. stability of compounded sterile preparations. c. disposal of medications. d. indications of medications used in sterile compounds.

ANS: C

The medications and components domain of the sterile compounding specialty certification will cover topics such as drugs, (brand and generic), dosages, characteristics, stability, storage, and safety information found in the Safety Data Sheets or SDS. The handling, packaging, storage, and disposal domain will cover supplies used, disposal of sharps and other supplies (including medications) and handling of completed CSPs. DIF: Application

REF: p. 167

OBJ: 2

TOP: N/A

8. This domain of the sterile compounding specialty certification covers equipment such as

PECs, environmental monitoring, and operational standards per USP<797> guidelines. a. Medication and Components b. Facilities and Equipment c. Sterile Compounding Procedures d. Handling, Packaging, Storage, and Disposal ANS: B

The Facilities and Equipment domain covers equipment such as PECs, environmental monitoring, and operational standards per USP<797> guidelines.

DIF: Comprehension TOP: N/A

REF: p. 167

OBJ: 2

9. Which of the following domains of the sterile compounding specialty certification is over half

of the test’s content and relates to the aseptic technique procedures? a. Medication and Components b. Facilities and Equipment c. Sterile Compounding Procedures ErS d. Handling, Packaging, STto agTeB , aAnN dK DSisE poLsL alER.COM ANS: C

The Sterile Compounding Procedures domain is over half of the test’s content and relates to the actual aseptic technique procedures, calculations, procedures for cleaning and decontamination, handwashing, and garbing and gowning.

DIF: Comprehension TOP: N/A

REF: p. 167

OBJ: 2

10. Which of the following laws has allowed pharmacists to become more involved in direct

patient care allowing the pharmacy technician to take on more responsibilities? a. Affordable Care Act b. FDA Modernization Act c. Food, Drug, and Cosmetic Act d. FDA Safety and Innovation Act ANS: A

Because of the Affordable Care Act (ACA), Medicare must provide coverage for wellness and preventive services through a physician or another licensed health care professional who is acting under the physician’s direction, the latter of which has opened the door for pharmacists in many states to become much more involved in direct patient care along with providing medications. As the role of the pharmacist expands, so does the role of the pharmacy technician.

DIF: Recall

REF: p. 167

OBJ: 3

TOP: N/A

11. The approach of treating the patient as a whole, treating the patient’s overall wellbeing and

disease management is known as: a. Patient Protection and Affordable Care. b. patient-centered care. c. point of care. d. pharmacy patient care process.

ANS: B

The term patient-centered care refers to an approach of treating the patient as a whole entity.

More emphasis is on the patient’s overall wellbeing and disease management.

DIF: Recall

REF: p. 167

OBJ: 4

TOP: N/A

12. To help offer patient-centered care, the pharmacy technician may have all of the following

responsibilities except: a. bill third-party providers for an immunization. b. educate patients on how to properly dispose of sharps. c. coordinate wellness clinic in the pharmacy. d. administer a vaccination.

ANS: D

Currently, only a pharmacist may administer a vaccination. The pharmacy technician will be able to help educate patients, coordinate wellness clinics, document and process third-party claims.

DIF: Application

REF: TpE . 1S 6T 7 BANKS OE BL J: LE 4 R.COM

TOP: N/A

13. Trained pharmacy technicians can expand their role helping the pharmacist with which of the

following? a. Immunization administration b. Medication compliance support c. Dosing recommendations d. A1c testing ANS: B

The pharmacist will administer immunizations, adjust or make dosing recommendations, and perform A1c testing. The pharmacy technician can help support medication compliance by listening to the patient and relaying information to the pharmacist.

DIF: Application

REF: p. 167

OBJ: 4

TOP: N/A

14. All of the following POCT for a chronic disease may be performed in a pharmacy except: a. fecal occult blood. b. hepatitis C. c. rheumatoid arthritis. d. HIV. ANS: C

POCT for chronic diseases that can be performed in a pharmacy include HIV, cholesterol, hepatitis C, and fecal occult blood.

DIF: Application

REF: p. 168

OBJ: 4

TOP: N/A

15. Monitoring a patient’s

at the pharmacy allows the pharmacist to work closely with the physician and the patient’s for anticoagulation medication dosage. a. INR b. A1c c. HIV d. hepatitis C ANS: A

Patients taking anticoagulants such as warfarin are required to monitor their blood clotting times with either an INR or PT screening. Monitoring it at the pharmacy allows the pharmacist to work closely with the physician and patient for adjustments and combining the testing and prescription in one location.

DIF: Comprehension TOP: N/A

REF: p. 168

OBJ: 4