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Pharmacy Technician Certification Exam (PTCE) practice questions and answers

20 free questions from our 100-question Pharmacy Technician Certification Exam (PTCE) bank, each with the correct answer, explanation, and source note. Official format: 90 items (80 scored + 10 unscored) · 110-minute limit · 1,400 scaled score.

Questions last updated September 19, 2026 · Original questions mapped to the current PTCB PTCE Content Outline; not official or recalled questions.

1. Drug classifications

   1. Metformin is classified as which type of medication?

   1. AA) ACE inhibitor
   2. BB) Biguanide antidiabetic
   3. CC) Beta-blocker
   4. DD) Calcium channel blocker

   Answer: B. Correct — Metformin belongs to the biguanide class of antidiabetic medications. It is first-line therapy for type 2 diabetes mellitus and works primarily by decreasing hepatic glucose production. ACE inhibitors like lisinopril, beta-blockers like metoprolol, and calcium channel blockers like amlodipine are used for hypertension, not as primary antidiabetics.

   Source: PTCE Content Outline — Medications: Drug Classifications

2. Drug interactions

   2. A patient is taking warfarin (Coumadin) and is started on amiodarone (Cordarone). What is the primary concern?

   1. AA) Increased risk of hypoglycemia
   2. BB) Increased risk of bleeding due to elevated INR
   3. CC) Decreased effectiveness of warfarin
   4. DD) Increased risk of renal toxicity

   Answer: B. Correct — Amiodarone is a potent inhibitor of CYP2C9 and CYP3A4, which metabolize warfarin. This interaction can significantly increase warfarin levels and INR, leading to an elevated risk of bleeding. The pharmacist should alert the prescriber, and INR monitoring should be intensified. Hypoglycemia is not directly relevant to this interaction, warfarin efficacy would increase (not decrease), and renal toxicity is not the primary concern here.

   Source: PTCE Content Outline — Medications: Drug Interactions

3. Dosage forms

   3. Which of the following dosage forms is designed to dissolve under the tongue without chewing or swallowing?

   1. AA) Enteric-coated tablet
   2. BB) Sublingual tablet
   3. CC) Extended-release capsule
   4. DD) Chewable tablet

   Answer: B. Correct — Sublingual tablets (such as nitroglycerin) are placed under the tongue where they dissolve rapidly for direct absorption through the oral mucosa into the bloodstream, bypassing first-pass metabolism. Enteric-coated tablets resist stomach acid and dissolve in the intestine. Extended-release capsules release drug slowly over time. Chewable tablets are meant to be chewed before swallowing.

   Source: PTCE Content Outline — Medications: Dosage Forms and Routes

4. Drug classifications

   4. Sertraline (Zoloft) belongs to which therapeutic class of medications?

   1. AA) Benzodiazepine
   2. BB) Selective serotonin reuptake inhibitor (SSRI)
   3. CC) Monoamine oxidase inhibitor (MAOI)
   4. DD) Tricyclic antidepressant (TCA)

   Answer: B. Correct — Sertraline is an SSRI, a first-line treatment for depression, anxiety disorders, and OCD. SSRIs selectively block the reuptake of serotonin in the brain. Benzodiazepines like alprazolam enhance GABA activity. MAOIs like phenelzine inhibit monoamine oxidase. TCAs like amitriptyline block norepinephrine and serotonin reuptake non-selectively and have more anticholinergic side effects than SSRIs.

   Source: PTCE Content Outline — Medications: Drug Classifications

5. Drug administration

   5. A technician notices that a prescription for omeprazole 20 mg reads "take on an empty stomach." Why is this instruction important?

   1. AA) Omeprazole is degraded by stomach acid
   2. BB) Food increases omeprazole absorption
   3. CC) Food significantly delays omeprazole absorption
   4. DD) Taking omeprazole with food causes hypoglycemia

   Answer: C. Correct — Taking omeprazole on an empty stomach (typically 30–60 minutes before a meal) ensures optimal absorption. Food delays gastric emptying and can reduce the rate of absorption of proton pump inhibitors. While omeprazole is acid-labile and given enteric-coated, the timing instruction is about absorption kinetics. Omeprazole does not cause hypoglycemia, and food does not increase its absorption.

   Source: PTCE Content Outline — Medications: Drug Administration

6. Side effects

   6. Which of the following is a common adverse effect of lisinopril (Prinivil/Zestril) that the technician should counsel patients about?

   1. AA) Persistent dry cough
   2. BB) Excessive hair growth
   3. CC) Yellowing of the skin
   4. DD) Muscle spasms

   Answer: A. Correct — A persistent dry, nonproductive cough is a well-known side effect of ACE inhibitors like lisinopril, occurring in up to 10–15% of patients. It is caused by accumulation of bradykinin in the lungs. If intolerable, the prescriber may switch to an ARB (like losartan). Hair growth changes, jaundice, and muscle spasms are not characteristic side effects of ACE inhibitors.

   Source: PTCE Content Outline — Medications: Side Effects

7. Dea schedules

   7. Hydrocodone/acetaminophen (Vicodin) is a combination product classified under which DEA schedule?

   1. AA) Schedule II
   2. BB) Schedule III
   3. CC) Schedule IV
   4. DD) Schedule V

   Answer: A. Correct — Hydrocodone combination products were reclassified from Schedule III to Schedule II effective October 6, 2014. This means no refills are permitted, and a written (not verbal) prescription is required. Schedule III includes products like testosterone and some codeine combinations under 90 mg per dose unit. Schedule IV includes benzodiazepines, and Schedule V includes cough preparations with limited narcotics.

   Source: PTCE Content Outline — Federal Requirements: DEA Schedules

8. Hipaa

   8. Under HIPAA, a pharmacy technician may disclose a patient's prescription information to which of the following WITHOUT patient authorization?

   1. AA) The patient's employer requesting drug information
   2. BB) Law enforcement officials with a valid court order
   3. CC) Another patient asking about their neighbor's prescriptions
   4. DD) A pharmaceutical sales representative

   Answer: B. Correct — HIPAA permits disclosure of protected health information (PHI) without authorization in specific circumstances, including to law enforcement officials with a valid court order, subpoena, or court-ordered warrant. The other scenarios described do not meet HIPAA exceptions. Employers, other patients, and pharmaceutical representatives do not have a legal right to access individual patient prescription records without explicit authorization.

   Source: PTCE Content Outline — Federal Requirements: HIPAA

9. Record keeping

   9. Which federal law requires pharmacies to maintain records of all controlled substances received, dispensed, or disposed for a minimum of two years?

   1. AA) HIPAA Privacy Rule
   2. BB) Drug Supply Chain Security Act (DSCSA)
   3. CC) Controlled Substances Act (CSA)
   4. DD) Fair Packaging and Labeling Act

   Answer: C. Correct — The Controlled Substances Act (CSA), administered by the DEA, requires that records related to controlled substances (receipts, dispensing, and disposal) be maintained for a minimum of two years from the date of the transaction. HIPAA addresses privacy of health information, DSCSA addresses drug supply chain traceability, and the Fair Packaging and Labeling Act regulates product labeling.

   Source: PTCE Content Outline — Federal Requirements: Record Keeping

10. Dea schedules

    10. A pharmacy receives a prescription for diazepam (Valium). This medication is classified in which DEA schedule?

    1. AA) Schedule II
    2. BB) Schedule III
    3. CC) Schedule IV
    4. DD) Schedule V

    Answer: C. Correct — Diazepam is a benzodiazepine classified as a Schedule IV controlled substance under the DEA. Schedule IV drugs have a lower potential for abuse than Schedule III drugs and include medications like alprazolam, lorazepam, and zolpidem. Schedule II includes drugs like oxycodone and amphetamine; Schedule III includes products like buprenorphine and testosterone; Schedule V includes cough preparations with limited codeine.

    Source: PTCE Content Outline — Federal Requirements: DEA Schedules

11. Controlled substances

    11. A patient drops off a prescription for a controlled substance. The prescription has no refill written on it. How many times can this prescription be refilled?

    1. AA) Up to 5 times within 6 months
    2. BB) Up to 3 times within 6 months
    3. CC) No refills are permitted
    4. DD) Unlimited refills for one year

    Answer: C. Correct — Under federal law (21 CFR 1306.12), Schedule II controlled substances cannot be refilled. A new prescription must be issued for each dispensing. Refills are permitted for Schedule III–V substances: up to 5 refills within 6 months from the date issued. The notation of no refills on a Schedule II prescription is standard because refills are legally prohibited regardless of what is written.

    Source: PTCE Content Outline — Federal Requirements: Controlled Substances

12. Drug supply chain

    12. Under the Drug Supply Chain Security Act (DSCSA), which of the following is a pharmacy required to do when receiving a drug shipment?

    1. AA) Perform laboratory testing on every incoming product
    2. BB) Verify the product identifier on each package and case
    3. CC) Reject all shipments from wholesalers not licensed in the pharmacy's state
    4. DD) Store the drug in a quarantined area for 30 days

    Answer: B. Correct — The DSCSA requires trading partners (including pharmacies) to verify product identifiers (including the National Drug Code, serial number, lot number, and expiration date) encoded in a 2D barcode on each package and case when receiving products. This enhances drug traceability and helps prevent counterfeit, stolen, or contaminated drugs from entering the supply chain. The other options describe practices not specifically mandated by DSCSA.

    Source: PTCE Content Outline — Federal Requirements: DSCSA

13. Controlled substances

    13. A pharmacy technician is asked to help with an inventory of controlled substances. Which document must be completed when controlled substances are received from a distributor?

    1. AA) DEA Form 222 or an electronic equivalent
    2. BB) DEA Form 106
    3. CC) A standard purchase order only
    4. DD) DEA Form 41 only

    Answer: A. Correct — DEA Form 222 (or its electronic equivalent CSOS) is used to order Schedule II controlled substances. Schedule III–V controlled substances can be ordered using standard invoice/order forms. DEA Form 106 is used to report theft or significant loss. DEA Form 41 is used for destruction of controlled substances. Standard purchase orders alone are insufficient for Schedule II orders.

    Source: PTCE Content Outline — Federal Requirements: Controlled Substances

14. Allergy alerts

    14. A pharmacist asks a technician to prepare a medication for a patient who is allergic to sulfa drugs. Which of the following medications would require an allergy alert?

    1. AA) Metformin (Glucophage)
    2. BB) Celecoxib (Celebrex)
    3. CC) Lisinopril (Zestril)
    4. DD) Atorvastatin (Lipitor)

    Answer: B. Correct — Celecoxib is a sulfonamide-containing NSAID (COX-2 selective inhibitor). Patients with a documented sulfa allergy may experience cross-reactivity. Metformin, lisinopril, and atorvastatin do not contain sulfonamide moieties. However, the technician should always defer clinical allergy evaluation to the pharmacist, who can assess the nature and severity of the allergy before any dispensing decision.

    Source: PTCE Content Outline — Patient Safety: Allergy Alerts

15. Look alike drugs

    15. The medication name hydralazine is frequently confused with which of the following drugs?

    1. AA) Hydroxyzine
    2. BB) Hydrochlorothiazide
    3. CC) Hydromorphone
    4. DD) Hydroxychloroquine

    Answer: B. Correct — Hydralazine (an antihypertensive vasodilator) and hydrochlorothiazide (a thiazide diuretic) are look-alike/sound-alike (LASA) names that are commonly confused. Both start with 'Hydro-' and are used in cardiovascular therapy. This is a well-documented LASA pair requiring tall-man lettering or auxiliary warnings. Hydroxyzine (antihistamine), hydromorphone (opioid), and hydroxychloroquine (antimalarial) are different drug classes.

    Source: PTCE Content Outline — Patient Safety: Look-Alike/Sound-Alike Drugs

16. High alert meds

    16. Insulin is classified as a high-alert medication. Which of the following is the MOST important reason for this classification?

    1. AA) It is extremely expensive
    2. BB) It carries a significant risk of causing serious harm when used in error
    3. CC) It requires a DEA order form
    4. DD) It must be stored at room temperature

    Answer: B. Correct — The Institute for Safe Medication Practices (ISMP) classifies high-alert medications as those bearing a heightened risk of causing significant patient harm when used in error. Insulin, particularly when given in incorrect doses or to the wrong patient, can cause fatal hypoglycemia or severe hyperglycemia (DKA). Cost, DEA scheduling, and storage requirements do not determine the high-alert classification.

    Source: PTCE Content Outline — Patient Safety: High-Alert Medications

17. Medication storage

    17. A technician notices that a bottle of amoxicillin suspension requires refrigeration after reconstitution. If it has been left at room temperature for 48 hours, what should the technician do?

    1. AA) Return it to the refrigerator and use it until the expiration date
    2. BB) Discard the medication and notify the pharmacist
    3. CC) Shake it vigorously and dispense it to the patient
    4. DD) Place it in the freezer for one hour before dispensing

    Answer: B. Correct — When a reconstituted antibiotic suspension that requires refrigeration has been stored at room temperature beyond the allowable time (typically 24 hours for most formulations), the medication should be discarded due to potential loss of potency and risk of microbial growth. The technician should notify the pharmacist, who will determine the appropriate course of action, which usually includes preparing a new batch for the patient.

    Source: PTCE Content Outline — Patient Safety: Medication Storage

18. Error prevention

    18. What is the primary purpose of tall-man lettering in pharmacy (e.g., hydrOXYzine vs. hydrALAZINE)?

    1. AA) To make the drug name easier to pronounce
    2. BB) To highlight the differences between look-alike drug names and reduce errors
    3. CC) To indicate the drug is a brand name
    4. DD) To show the drug is a controlled substance

    Answer: B. Correct — Tall-man lettering is a naming convention recommended by the FDA and ISMP to differentiate between look-alike drug names (LASA) by emphasizing the dissimilar letters in each name. This visual cue helps reduce medication errors caused by name confusion. It does not indicate pronunciation, brand vs. generic status, or controlled substance scheduling. Examples include hydrOXYzine vs. hydrALAZINE and vinBLAStine vs. vinCRIStine.

    Source: PTCE Content Outline — Patient Safety: Error Prevention

19. Prescription processing

    19. A patient presents a prescription for warfarin 5 mg tablets. The prescription says "take one tablet daily." What is the maximum number of refills this prescription can have?

    1. AA) No refills — warfarin is Schedule II
    2. BB) 5 refills within 6 months
    3. CC) 3 refills within 3 months
    4. DD) 12 refills within 1 year

    Answer: B. Correct — Warfarin (Coumadin) is NOT a controlled substance but a prescription drug. Non-controlled prescriptions may have up to 5 refills within a 6-month period from the date written. Warfarin is commonly prescribed with instructions for dose adjustments based on INR monitoring. The prescription must specify the number of refills authorized, and the pharmacy may not exceed that number without a new prescription from the prescriber.

    Source: PTCE Content Outline — Order Entry: Prescription Processing

20. Insurance billing

    20. When a pharmacy receives a prescription insurance claim rejection stating "Prior Authorization Required," what is the MOST appropriate first step?

    1. AA) Dispense the medication anyway and bill the patient
    2. BB) Contact the prescriber's office to initiate the prior authorization process
    3. CC) Change the prescription to a different medication without the prescriber's consent
    4. DD) Ask the patient to pay the full cash price

    Answer: B. Correct — When a prior authorization (PA) is required, the pharmacy should contact the prescriber's office to inform them that the insurance plan requires authorization before coverage. The prescriber then contacts the insurance company to justify the medical necessity. The pharmacy should not change the prescription without prescriber authorization, nor should they routinely ask patients to pay cash without exploring the PA option first.

    Source: PTCE Content Outline — Order Entry: Insurance and Billing