Exam Questions Assignment

Which of the following is the national standards of practice which states the rules of sterile compounding?

a. USP 796

b. USP 800

c. Contamination categories

d. USP 797

e. Compounded Sterile Preparations

D

Where should the preparation of all sterile products take place?

a. Compounding aseptic containment isolator (CACI)

b. Laminar airflow work bench (LAWB)

c. Containment ventilated enclosure (CVE)

d. Anteroom

e. Closed-system transfer device (CSTD)

b

What term means “free of pyrogens, physical and chemical contaminants?”

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a. Aseptic

b. Clean

c. Sterile

d. Healthy

e. Febrile

c

Who does USP 797 protect?

a. Practitioners

b. Pharmacists

c. Nurses

d. Patients

e. All the above

d

Which size micron filter removes bacteria and fungi when used for aseptic compounding?

a. 0.66

b. 0.22

c. 0.45

d. 0.5

e. 0.2

b

What is the correct term for the interior dimension of a needle?

a. Hub

b. Shaft

c. Bevel

d. Lumen

e. Gauge

d

How long should you wash your hands for when preparing to compound a sterile product?

a. 5 seconds

b. 10 seconds

c. 30 seconds

d. 60 seconds

e. 120 seconds

c

Jasna is preparing an IV bag for a patient. She will have to transfer Vitamin K, which comes in an ampule, into a 0.9% sodium chloride bag. What type of needle should she use to draw up the medication?

a. 18 gauge needle

b. Vented needle

c. Blunt-tipped needle

d. Filter needle

e. Huber needle

d

What term is defined as the process by which surface bioburden is reduced to a safe level or eliminated?

A. Aseptic technique

B. Disinfection

C. Closed-system transfer device

D. Decontamination

E. Laminar airflow workbench

b

What term is defined as pharmaceutical dosage forms administered by injection?

A. Compounded sterile preparations

B. Nonsterile preparations

C. Parenteral preparations

D. Particulates

E. Admixtures

c

A non-sterile hazardous drug would best be prepared in what type of environment?

a. Containment ventilated enclosure

b. Compounding aseptic isolator

c. Compounding aseptic containment isolator

d. Ante room

e. Containment primary engineering control

a

Peridox is a chemical used to clean the hood. Peridox is what type of agent?

a. Sterilization agent

b. Disinfecting agent

c. Pyrogenic agent

d. Detergent agent

e. Abrasive agent

b

A pharmacy technician is preparing a sterile product in an atmospheric environment that allows a maximum of 100 particles per cubic foot of space. Which of the following most accurately describes this environment?

a. Containment Primary Engineering control (C-PEC)

b. Containment Secondary Engineering control (C-SEC)

c. Compounding Aseptic Containment Isolator

d. ISO Class 5 Environment

e. ISO Class 7 environment

d

A pharmacy intern is compounding a sterile preparation used for chemotherapy in a negative pressure room designed to contain hazardous drug contaminants. Which of the following most accurately describes the room the intern is currently in?

a. Containment Primary Engineering Control (C-PEC)

b. Containment Secondary Engineering Control (C-SEC)

c. Containment Segregated Compounding Area (C-SCA)

d. Compounding Aseptic Containment Isolator (CACI) \\n e. Compounding Aseptic Isolator

b

________ is a process that eliminates viable bioburden via use of sporicidal chemical agents.

A. Purification

B. Sterilization

C. Disinfection

D. Decontamination

E. Depyrogenation

d

________ is a room in which the concentration of airborne particles is controlled, and which is constructed and used in a manner to minimize the introduction, generation, and retention of particles inside the room and in which other relevant parameters like temperature, humidity and pressure are controlled as necessary.

A. Sterile Room

B. Clean Room

C. Anteroom

D. Critical Area

E. Containment Segregated Compounding Area (C-SCA)

b

Which of these is not a critical site (exposed and at risk of direction contact)?

a. Injection port

b. Closed ampule

c. Open ampule

d. Needle hub

e. Vial septa

b

Which of the following does NOT have a requirement for air quality?

a. C-SCA

b. CAI

c. Horizontal flow hood

d. Vertical flow hood

e. None of the above

a

Which is of the following is correct regarding the BUD of a Multiple Dose Container?

A. Up to 6 hours from time of puncture or opening.

B. One hour from time of puncture or opening.

C. Up to 28 days from time of puncture or opening unless otherwise specified by manufacturer.

D. Immediate use is required with no exception for storage.

E. Stored up to 9 days refrigerated or 45 days frozen.

c

What compounding area is recommended for a category 1 product under USP 797?

A. ISO Class 5

B. Cleanroom Suite

C. ISO Class 6

D. ISO Class 7

E. ISO Class 8

a

After sending a newly compounded IV bag to a nurse, they call down to the pharmacy and ask how you calculated the BUD. You respond by saying it is calculated by

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a. Specific tests by the manufacturer

b. Point-in-time potency test

c. The date or time of compounding

d. The expiration dates on the vials used

e. The indication of the medication

c

Your hospital pharmacy has decided to switch over to the newly revised USP 797 compounding standards and beyond-use dates. A nurse has recently compounded an IV bag outside of the pharmacy and asks you to categorize it according to its risk level to determine its BUD. What risk level would you mark this bag based on the new guidelines to determine the BUD?

a. High risk

b. Moderate risk

c. Category 2

d. Category 1

e. Low Risk

d

What items can be reused during the same shift in the sterile room?

a. face mask

b. gown

c. hair cover

d. gloves

e. shoe covers

b

What items should be taken off before crossing the line of demarcation for degarbing?

a. hairnet

b. shoe covers

c. facial hair cover

d. face mask

e. none of the above

d

Which of the following is/are considered best practice in the degarbing process?

a. remove face covering and sterile gloves before leaving the clean room to avoid contamination

b. keep hair and shoe coverings on until you cross the line of demarcation out of the Ante room

c. remove gown as well as hair and shoe coverings and hang in the Ante room for later use during your shift

d. B and C

e. A and B

b

Which of the following is not an essential step of the gowning/garbing process?

a. wash hands properly for at least 30 seconds and pat to dry

b. cover mouth and nose with face covering after tucking away and covering the hair

c. cover hands in sanitizer before putting on the suggested powder-free sterile gloves, making sure to go between fingers and up to the fingertips

d. if the technician wears glasses, they must wear contacts instead while sterile compounding

e. all of the above are essential steps of the gowning/garbing process

d

LD, a hospital pharmacy tech, is preparing a parenteral preparation of streptomycin (highly water soluble) for a patient with infective endocarditis. Which vehicle would be suitable for intramuscular injection of the drug?

a. Soybean oil

b. Propylene glycol

c. Sterile water for injection

d. Sodium chloride injection

e. Lactated Ringer’s injection

c

dietician has placed an order for TPN to be made for a patient. The new pharmacy intern is reviewing the order before preparation and asks you (the pharmacist) what the glycerin is added for. What is the purpose of glycerin in a sterile product?

a. Coloring agent

b. Solubilizer

c. pH buffer

d. Preservative

e. Antioxidant

b

Which vehicle is most common for parenteral preparations?

a. Aqueous isotonic vehicles

b. Waters

c. Water-miscible solvents

d. Nonaqueous vehicles

e. None of the above

b

0\.9% sodium chloride is what type of solute?

a. pH buffer

b. antioxidant

c. tonicity agent

d. solubilizers

e. coloring agents

c

A pre-filled syringe for a flu shot would be considered a ____.

a. Single dose container

b. Multiple dose container

c. Large volume injectable

d. Small volume injectable

e. BOTH A & D

e

Unless otherwise specified by the manufacturer, what would be the BUD for a needle-punctured multi-dose container with preservatives?

a. 24 hours

b. 7 days

c. 14 days

d. 28 days

e. 90 days

d

Which container is more likely to interact with the contents it is holding?

a. Multiple-dose container

b. Plastic container

c. Glass container

d. Single-dose container

e. Prefilled syringes

b

Which container has a beyond use date of 28 days once it is punctured (unless specified by the manufacturer)?

a. Fusion-sealed containers

b. Prefilled syringes

c. Multiple-dose container

d. Polyethylene container

e. Glass container

c

Which of the following are physiologic characteristics of injectable products? \n A. Free from bacteria \n B. pH \n C. hypertonic solution \n D. sterilization by filtration \n E. B and C

e

What is an example of a parenteral formulation?

A. Dry, soluble preparations ready to be combined with a solvent before use

B. Dry, insoluble drug ready to be combined with an insoluble drug before use

C. Liquid concentrates ready for dilution during administration

D. Solutions ready for inhalation

E. None of the Above

a

What is a potential problem with container closures?

a. Coring

b. Interaction with drug formulation

c. Latex

d. Pyrogen contamination

e. All of the above

e

Which of the following is not an appropriate formulation for parental administration?

a. Solution ready for injection

b. Dry, insoluble drug combined with vehicle solution

c. Emulsion ready for injection

d. Non-diluted drug concentrate

e. Suspension ready for injection

d

What is an example of instability?

a. Hydrolysis

b. Oxidation

c. Racemization

d. Polymerization

e. All of the above

e

Which of the following is FALSE?

a. Particulates include undissolved chemicals.

b. Incompatibility is a chemical degradation process.

c. Order of mixing does matter.

d. Sterile water for injection is hypertonic.

e. All are true

d

A patient comes into the clinic complaining of chest pain, difficulty breathing, and excessive sweating. After an X-ray showed fluid buildup in the patients’ lungs, the physician diagnosed the patient with pulmonary edema. He orders a hypertonic solution for treatment, which product would you select?

A. SWFI

B. 0.225% sodium chloride

C. 25% dextrose

D. D5W

E. Lactated Ringers

c

The technician was creating an IV for a patient and noticed that when he combined the two products together, the color started to change. What physical change is occurring?

A. Particulates

B. Impurities

C. Instability

D. Incompatibility

E. Hydrolysis

d

What is a possibility to minimize incompatibilities when preparing a sterile product?

a. Using high risk products promptly after preparation and refrigerating if immediate use is not possible

b. Minimize the number of drugs added to one solution

c. Check the compatibility closely if one of the drugs has an extreme pH

d. All of the Above

d

Which of the following is not a type of compatibility reported?

a. Y-Site

b. Solution

c. X-Site

d. Additive

c

What sources of information are usable to find whether or not two medications interact at the Y-site?

A. tertiary sources

B. primary literature

C. package inserts

D. a, b, c

E. none of the above

d

In what ways are you able to minimize incompatibilities of drugs?

A. use high risk products after preparation

B. maximize the number of drugs added to one solution

C. check compatibility references loosely if one of the drugs has an extreme pH

D. closely check references if drug contains calcium or magnesium

E. a, d

e

As the pharmacist checking compounded sterile preparations today in Jackrabbit hospital, you come across a sterile preparation with a label that includes the patient’s name, identification number, name and amount of drug(s) added and admixture solution, beyond use date, and time and date of scheduled administration. What else should be on the label?

a. Patient home address

b. Prescriber’s name

c. Route of administration

d. Precautions

e. Prescriber’s signature

c

A pharmacy technician at Innovation hospital is labeling a sterile product she just compounded. It reads as follows:

Patient: Jack Rabbit

Room#: 123

Drug: Lantus (insulin glargine) 100 units/mL

Volume: 0.22 mL \\n

BUD: 03/06/XXXX at 1430

Inject SC

Made by: *WT*

Verified by: _____

Due: 03/05/XXXX at 0900

As the pharmacist checking the labeled product, what error do you notice that causes the label to be rejected?

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a. since this product is not being administered immediately, it does not require a label

b. the BUD and due times should not be in military time

c. the compounding technician should have spelled out her name

d. subcutaneously should not be abbreviated as SC

e. the vial’s expiration date should have been included

d

What is the objective of the USP chapter 797?

a. Prevent technician/intern harm

b. Prevent contamination of hazardous drug when handling

c. Prevent patient harm

d. Prevent contamination of nonsterile compounding products

e. All the above

c

Which of the following terms means the date beyond which the preparation should not be used stated by the manufacturer?

a. Shelf life

b. Expiration date

c. Beyond use date

d. Sell by date

e. Use by date

b

What CSP-related problems does the USP

e

Which is true about a Beyond-Use Date?

a. Assigned to commercially available drug products by the manufacturer

b. Date beyond which the preparation should not be used

c. Must be assigned when a product is reconstituted, diluted, or transferred

d. A and B

e. All options

c

What is not true about hospital pharmacy?

a. Pharmacists use labs to find the most appropriate med

b. Pharmacists must directly see the medications that the patient receives.

c. Pharmacists don’t have to deal with insurance.

d. Pharmacists are to verify the provider’s prescription orders

b

What is the definition of variance?

a. an event or circumstance not consistent with standard, routine operations (e.g. medication error)

b. unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof

c. most fundamental reason an event has occurred

d. The severity of harm caused by a specific type of medical error

a

A pharmacy technician is preparing a total parenteral nutrition (TPN) solution using multiple additives in an ISO Class 5 cleanroom that has both a buffer and an ante area. In terms of risk level, how would the final TPN solution be classified?

A. Immediate use

B. Low risk

C. Low risk, ≤ 12-hour BUD

D. Medium risk

E. High risk

d

A hospital pharmacy is aseptically preparing a Category 2 product for a patient that has recently been admitted. The resulting product was made using two non-sterile starting components and will not undergo any sterility testing. Upon completion of the preparation of the product, the product is to be stored at a cold temperature until it can be sent up to the unit. What would be the expected BUD for the product that was prepared in this scenario?

A. 14 days

B. 10 days

C. 4 days

D. 1 day

E. ≤ 12 hours

c

Which of the following is NOT a major component of USP 797? A. Environmental testing

B. Cleaning procedures

C. Facility design

D. Personnel cleansing and garbing

E. All of these are major components of USP 797

e

Which of the following fits the NIOSH definition of a hazardous drug?

i. Reproductive toxicity

ii. Organ toxicity at high doses

iii. Teratogenicity

iv. Genotoxicity

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A. i

B. i, ii

C. i, iii

D. i, iii, iv

E. i, ii, iii, iv

d

Which of the following is NOT a hazardous drug characteristic?

a. Genotoxic

b. Carcinogenic

c. Reproductive toxic

d. Organ toxicity at high doses

e. Organ toxicity at low doses

d

Which act required employers to provide work and a workplace to that is free from recognized, serious hazards?

a. OSH Act

b. Pure Food and Drug Act

c. Omnibus Budget Reconciliation Act (OBRA)

d. HIPAA

e. Drug Quality and Security Act

a

The objective of USP 800 is to protect personnel and the environment when:

a. Handling hazardous drugs

b. Non-sterile compounding

c. Preparing TPNs

d. Sterile compounding

e. While working in a pharmacy

a

Preparation of chemotherapy requires special:

a. Garb

b. Handling of waste

c. Documentation

d. LAWF requirements

e. All of the above

e

What is the objective of USP 800?

A. To protect personnel

B. To protect public health

C. To protect the public health and welfare

D. To protect personnel and the environment

E. All of the above

d

Which of the following is not a part of preparing chemotherapy?

A. Special handling of waste

B. Special documentation

C. Special monitoring of employees

D. Special administration

E. Special garb

d

What is an activity that will not result in exposure to hazardous drugs?

a. Crushing hazardous drug tablets for the preparation of an oral dose formulation

b. Touching contaminated waste created during hazardous drug dispensing process

c. Handling hazardous medications with proper PPE in compliance with NIOSH guidelines

d. Cleaning counting trays utilized for dispensing hazardous drugs

e. Removing PPE after handling hazardous drugs

c

What is not a class of oral hazardous agents categorized by NIOSH?

a. Reproductive health risk for men and women

b. Non-antineoplastic drugs

c. Anti-viral drugs

d. Antineoplastic drugs

e. All of the following are classes of oral hazardous agents categorized by NIOSH

c

What is the objective of USP 800?

a. Protect patients and medications

b. Protect personnel and the environment

c. Protect the compatibility and storage

d. Protect privacy and confidentiality

e. None of the above

b

Chloe is a pharmacy technician who works at Jackrabbit Hospital Inpatient Pharmacy. She is 6 months pregnant and avoids any tasks that expose her to hazardous drugs. Which of the following tasks should Chloe avoid?

a. Compounding powders into customized dosage capsules

b. Cleaning drug preparation areas

c. Crushing tablets to formulate oral liquid doses

d. Removing PPE after handling drugs and waste

e. All of the above

e

Which of the following are typically found in a parenteral nutrition formula?

a. Protein

b. Electrolytes

c. Sterile water for injection

d. Vitamins

e. All of the above.

e

Which of the following does NOT impact the formation of calcium phosphate in TPN preparations?

a. Temperature

b. Mixing order

c. Lipid concentration

d. pH of formulation

e. concentration of calcium and phosphate

c

AP is a lead pharmacy technician at a community pharmacy. She is going over procedures for safe handling of oral chemotherapy drugs with new technicians. She demonstrates all of the following techniques in her presentation. What is NOT considered safe handling of oral chemotherapy drugs?

a. Preparing oral agents in pharmacy or designated hazardous drug area

b. Wearing single pair of gloves when preparing oral agents

c. Washing hands before putting on gloves and after they are removed

d. Using separate counting tray and clean it after use while wearing PPE

e. Disposing empty containers and unused medications in chemotherapy disposal container

b

Patient MB is a 24 year old male on total parenteral nutrition due to severe malnutrition. A central line is placed. What is a reasonable infusion rate of TPN?

a. 20 mL/hr

b. 150 mL/hr

c. 45 mL/hr

d. 135 mL/hr

e. 30 mL/hr

c

Which of these is NOT an advantage of injectable (parenteral) medications?

a. Quicker onset of action

b. More cost effective

c. Localized action

d. More bioavailable

e. Bypasses 1st pass metabolism

b

Disadvantages of injectable (parenteral) medication include...

a. Risk of infection

b. More painful

c. Shorter beyond use date (BUD)

d. More patient monitoring

e. All of the above

e

Which is not an advantage of parenteral medication administration in an inpatient setting?

a. Alternative for patients unable to take medications orally

b. Drug levels easier to achieve in narrow therapeutic index drugs

c. Greater bioavailability resulting in less frequent dosing

d. More easily reversed if dose administered is too high

e. Quicker onset of action producing faster relief

d

Which medication must be prepared and administered in a sterile manner?

a. D5W IV infusion

b. Epidural morphine

c. Intrathecal baclofen

d. Ophthalmic erythromycin ointment

e. All of the above

e

What are the sites for injection for intradermal preparations?

A. Deltoid and gluteus maximus

B. Inner forearm and upper back

C. Deltoid and upper back

D. Back of upper arm and abdomen

E. Inner forearm and back of upper arm

b

How much volume is a subcutaneous injection typically limited to?

A. 0.1 mL

B. 0.3 mL

C. 0.5 mL

D. 1 mL

E. 2 mL

d

A patient comes in and needs to be given a medication subcutaneously. What is the max volume of medication you can give them subcutaneously?

a. 0.25mL

b. 0.5mL

c. 0.75mL

d. 1 mL

e. 2 mL

d

Which of these injection sites may be used when giving an intradermal injection?

a. Abdomen

b. Inner forearm

c. Upper back

d. Upper arm

e. B and C

e

Which of the following is true about intramuscular sterile product administration?

a. It is faster than SQ route due to muscle tissue vascularity

b. It is slower than SQ route due to muscle tissue vascularity

c. It is more rapid than IV route of administration

d. It is generally of a shorter duration of action than the other types of administration

e. None of the above

a

Where is an epidural typically administered?

a. Injected into the deltoid

b. Injected into the vastus lateralis

c. Injected into the space between the wall of the spinal cord and the covering of the spinal cord

d. Injected into the sublingual vasculature

e. Both b and c

c

David, an adult male, is brought to the ER for treatment. A nurse places an IV in the patient to administer medications through. What is the normal maximum volume of fluid that may be administered through this IV per day?

a. 2 Liters

b. 4 Liters

c. 6 Liters

d. 3 Liters

e. 1 Liter

b

Emily is a patient at the hospital who suffers from type 2 diabetes. Due to this, every night the nurse administers a subcutaneous injection of insulin. What is the maximum volume of medication that can be delivered through the subcutaneous route of administration?

a. 0.5ml

b. 2ml

c. 3ml

d. 1ml

e. 0.75ml

d

Which of the following is not an appropriate site of administration for an intramuscular injection?

a. Deltoid

b. Gluteus maximus

c. Vastus lateralis

d. Rectus femoris

e. Abdominal muscle

e

Which of the following is not an appropriate indication for the use of an epidural?

a. Childbirth

b. Electrolyte replacement

c. Sever post-op pain

d. Chronic pain

e. Cancer pain

b

What type of administration involves the medication going into the subarachnoid space via an

implantable pump?

a. Intraosseous

b. Intra-arterial

c. Intrathecal

d. Intermittent

c

What are the advantages of continuous IV infusion?

a. Simultaneous delivery of fluids and drugs

b. Continuous, constant serum drug levels

c. Drugs are less irritating in more dilute solution

d. All of the above

d

Which type of administration route involves administration into the subarachnoid space where patients cannot lay on their back for several hours following insertion?

a. Continuous IV injection

b. Direct IV infusion

c. Epidural injection

d. Intrathecal injection

e. Intermittent infusion

d

Which of the following is an advantage of direct IV injection (IV push or bolus)?

a. Drugs are less irritating during this administration due to being in more dilute solutions

b. Allows simultaneous delivery of drugs or fluids

c. Allows less fluid administration for fluid restricted patients

d. Less risk of toxicity when administered over a short period of time

e. Allows continuous and constant drug levels

c

Regarding Intrathecal administration, medications:

a. are administered into the epidural space

b. are administered into the eye

c. are administered into the subarachnoid space

d. are administered into the bone

e. are administered into a central vein

c

This type of intravenous administration administers small amounts of volume over a relatively short period of time (minutes)

a. Direct IV Injection

b. Intramuscular Injection

c. Continuous IV Infusion

d. Intermittent Infusion

e. Subcutaneous injectio

a

LZ is admitted to the hospital with a bacterial meningitis. In addition to bacterial meningitis, he is dehydrated. The doctor wants to start LZ on gentamycin 3 mg/kg/day IV every 8 hours for 10 days for the bacterial meningitis and 0.9% sodium chloride to replenish fluids. What is the best choice of IV administration in this case?

a. IV bolus

b. Continuous IV infusion

c. Intermittent infusion d. Piggyback method

d

Which of the following is an advantage to intermittent infusion?

a. High fluid volume

b. More constant blood levels than with continuous infusion

c. Many drugs are more stable at concentrations used for intermittent dosing than at bolus concentrations.

d. Immediate injection in emergencies

c

Which of the following is a disadvantage of continuous IV infusions?

a. Drugs are less irritating in more dilute solution

b. Higher risk of toxicity when administered over shorter time

c. Simultaneous delivery of fluids and drugs

d. Compatibility issues when other meds are needed

d

What is an advantage of intermittent infusion?

a. Less monitoring necessary

b. Large fluid volume

c. Simultaneous delivery of fluids and drugs

d. Higher risk of toxicity

a

What time period is a peripherally inserted central catheter (PICC) line designed for?

a. 24 hours

b. 48-96 hours

c. No longer than 2 weeks

d. Several weeks to months

e. Up to 12 months

d

A patient needs continuous infusion of doxorubicin for adult T-cell leukemia/lymphoma. The pharmacist is concerned about the irritating effects of doxorubicin and the patient is expected to receive long-term IV therapy. What would be the most appropriate form of administration?

a. Peripheral vein injection

b. Central vein injection

c. Oral solution

d. Peripheral catheter

e. Subcutaneous injection

b

JT received a central vein injection 03/03/2023. Which of the following would suggest that this was the appropriate route of administration for this patient? Select ALL that apply.

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I. The patient received a chemotherapy agent.

II.The patient received Isotonic fluids.

III. The patient requires long-term IV therapy.

IV. A peripheral line could not be maintained.

V. The patient requires short-term therapy.

no answer

A nurse gained central venous access through a peripheral vein for IV access over the next 12 weeks. What type of catheter did the nurse likely place?

I. Midline Catheter \\n II.Peripherally Inserted Central Catheter (PICC)

III.Percutaneous Central Venous Catheter

IV.Hickman Central Venous Catheter

V. Implanted Port

no answer