Pharmacist Intervention - Pharmacy Technician Certification Exam Ptce

1. Which situation requires pharmacist review when a refill is requested for a drug that should be time-limited (acute therapy)?

   Questionable refill appropriateness for acute-use medication. Refills for acute-use medications beyond intended duration may indicate misuse, necessitating pharmacist review for appropriateness.

2. Which situation requires pharmacist review when the patient has not achieved therapeutic goals or reports lack of effect?

   Possible therapeutic failure requiring pharmacist assessment. Lack of therapeutic effect suggests possible failure, nonadherence, or need for adjustment, necessitating pharmacist evaluation and intervention.

3. Which situation must be escalated to the pharmacist due to a potential drug–drug interaction found in DUR?

   Any clinically significant DUR drug–drug interaction. Drug utilization review (DUR) identifies clinically significant interactions that necessitate pharmacist evaluation to mitigate risks and ensure patient safety.

4. Identify the situation that requires pharmacist review: patient is pregnant and prescription is for a teratogenic drug.

   Pregnancy with potential teratogen exposure. Teratogenic drugs can harm the fetus, necessitating pharmacist review to evaluate risks, confirm necessity, and discuss alternatives during pregnancy.

5. Which situation requires pharmacist review when a high-alert medication is prescribed (e.g., insulin, anticoagulants)?

   Any high-alert medication order for safety verification. High-alert medications carry significant risks of harm if misused, requiring pharmacist verification to ensure dosing and administration safety.

6. Which situation requires pharmacist review because it suggests an adverse drug event (ADE)?

   New or worsening symptom temporally linked to a drug. Symptoms emerging or worsening after starting a medication suggest an ADE, requiring pharmacist review to assess causality and intervene.

7. Which situation requires pharmacist review when a medication is contraindicated due to a disease state on the profile?

   Drug–disease contraindication (DUR drug–condition). Drug-disease contraindications identified in DUR can exacerbate conditions, necessitating pharmacist review to prevent harm and select alternatives.

8. Which situation requires pharmacist review when the dosage form seems inappropriate (e.g., ER tablet prescribed to be crushed)?

   Inappropriate dosage form or administration instruction. Inappropriate dosage forms or instructions can compromise efficacy or safety, requiring pharmacist review to correct and educate.

9. Identify the situation requiring pharmacist review: prescription is for a pediatric patient without a weight on file.

   Pediatric dosing concern (weight needed for safety). Pediatric dosing often relies on weight for accuracy, necessitating pharmacist review to calculate safe doses without this information.

10. Which situation requires pharmacist review when the prescribed drug appears to duplicate therapy already on the profile?

    Therapeutic duplication (same class or same drug). Duplicating therapy increases risks of adverse effects without added benefit, necessitating pharmacist review to optimize the regimen.

11. What should a technician do if the prescriber DEA/NPI information appears invalid or missing on a prescription?

    Refer to pharmacist to validate prescriber credentials. Invalid or missing prescriber credentials may indicate fraud, necessitating pharmacist validation to comply with legal and safety standards.

12. What should a technician do if a patient reports hives and swelling after taking the prescribed medication?

    Refer to pharmacist for possible allergic reaction. Symptoms like hives and swelling indicate a potential allergic reaction, which requires pharmacist evaluation for appropriate management and alternatives.

13. Which situation requires pharmacist review when a prescription exceeds the maximum recommended dose?

    Dose outside recommended limits (potential overdose). Doses exceeding recommended limits pose overdose risks, requiring pharmacist review to confirm appropriateness or adjust based on patient-specific factors.

14. Which patient factor on a profile requires pharmacist review before dispensing due to dosing safety concerns?

    Renal or hepatic impairment affecting dosing. Renal or hepatic impairments alter drug metabolism and clearance, necessitating pharmacist assessment to adjust dosing for safety and efficacy.

15. What should be done when a controlled substance prescription has an unusual quantity or early refill request?

    Refer to pharmacist for misuse/diversion assessment. Unusual quantities or early refills of controlled substances may indicate misuse or diversion, requiring pharmacist assessment for legitimacy.

16. Which situation requires pharmacist review when the prescription directions are ambiguous or incomplete?

    Unclear sig (missing route, frequency, or dose). Ambiguous or incomplete directions (sig) can lead to medication errors, requiring pharmacist clarification to ensure safe and correct use.

17. Which change always requires pharmacist review: substituting a different drug than prescribed to treat the same condition?

    Therapeutic substitution (different drug) needs pharmacist. Therapeutic substitution involves changing to a different drug, which requires pharmacist oversight to ensure equivalence and patient safety.

18. What should occur when a patient requests advice for selecting an OTC product for a medical condition?

    Refer to pharmacist for OTC recommendation/triage. Technicians cannot provide medical advice on OTC selections, so referrals to pharmacists ensure appropriate triage and recommendations.

19. Identify the situation requiring pharmacist review: prescription is for isotretinoin and required program steps are not confirmed.

    Restricted distribution/Risk program not verified. Restricted drugs like isotretinoin require program verification (e.g., iPLEDGE) for safety, necessitating pharmacist confirmation before dispensing.

20. Which situation requires pharmacist review when a prescription conflicts with a documented allergy on the patient profile?

    Allergy alert: prescribed drug or cross-reactive agent. Prescribing a drug matching or cross-reactive with a documented allergy risks severe reactions, requiring pharmacist review for alternatives.

21. Identify the situation requiring pharmacist review: a medication has a narrow therapeutic index and brand is switched.

    NTI product switch requires pharmacist oversight. Switching narrow therapeutic index (NTI) medications risks subtherapeutic or toxic levels, requiring pharmacist oversight for monitoring.

22. Which substitution generally does not require prescriber contact but still requires pharmacist verification for appropriateness?

    Generic substitution (same active ingredient). Generic substitution maintains the same active ingredient but requires pharmacist verification to confirm bioequivalence and suitability.

23. What should a technician do if a patient reports severe diarrhea after starting an antibiotic?

    Refer to pharmacist for possible ADE (e.g., C. difficile). Severe diarrhea post-antibiotic may indicate an ADE like C. difficile infection, requiring pharmacist assessment for management and reporting.

24. Which situation requires pharmacist review when the patient is taking multiple CNS depressants with an opioid?

    Potential additive sedation/respiratory depression interaction. Combining opioids with CNS depressants heightens risks of sedation and respiratory depression, requiring pharmacist review for monitoring and adjustments.

25. Identify the situation requiring pharmacist review: warfarin patient is newly prescribed trimethoprim-sulfamethoxazole.

    Major interaction increasing bleeding risk (warfarin + TMP-SMX). TMP-SMX potentiates warfarin's anticoagulant effect, increasing bleeding risk and necessitating pharmacist monitoring and dose adjustments.

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