PTCB practice test, PTCB practice questions and PTCB test prep for the current PTCE

B. Lamotrigine

Lamictal is lamotrigine, an anticonvulsant also used in bipolar disorder. Option A is the reason this question exists rather than a trivia question: lamivudine and lamotrigine are a documented look-alike sound-alike pair, they sit next to each other alphabetically on a shelf, and confusing them means an antiretroviral is dispensed to a seizure patient or the reverse. Option C is levetiracetam, brand name Keppra, which is genuinely another anticonvulsant and therefore the trap that feels safest to a candidate who remembers the drug class but not the name. Option D, labetalol, is a beta blocker with alpha activity used for blood pressure and shares nothing but the first three letters. The transferable habit is to confirm brand to generic against the label rather than from memory whenever the first syllable is shared, because that is exactly the situation error reporting shows technicians get wrong.

B. Store the in-use pen at room temperature and discard it at the end of the labeled in-use period

Insulin has two storage rules and candidates lose the mark by learning only one. Unopened pens and vials stay refrigerated between 2 and 8 degrees Celsius until the printed expiration date. Once a pen is in use it comes out to room temperature and is discarded at the end of the in-use period on that product label, which is 28 days for many pens but genuinely varies by product, so the label governs rather than a memorized number. Option A is the most common wrong answer and it is wrong for a practical reason: injecting cold insulin stings and drives poor adherence. Option C is dangerous. Freezing denatures insulin, and a frozen pen is discarded rather than thawed and used, which is also why insulin is never stored against the back wall or in the freezer compartment. Option D ignores the refrigeration requirement for unopened stock entirely.

C. Warfarin and sulfamethoxazole with trimethoprim

This is one of the interactions serious enough to stop a fill rather than generate a note. Sulfamethoxazole inhibits CYP2C9, the enzyme that clears the more potent S-isomer of warfarin, and it displaces warfarin from plasma protein binding at the same time. The two effects stack, the INR can climb steeply within days, and the documented outcome is major bleeding. The other three combinations are unremarkable in normal practice: lisinopril with acetaminophen, metformin with atorvastatin and amoxicillin with loratadine are all commonly dispensed together. What the question is really testing is whether you can tell a clinically significant interaction from a screen alert, because a technician who escalates everything is as unhelpful as one who escalates nothing. Anticoagulants sit near the top of every high-alert list, so any new medication added to warfarin deserves a look.

C. Schedule IV prescriptions may be refilled up to 5 times within 6 months of the date written, so this one has expired

Alprazolam is a Schedule IV controlled substance, and federal law caps Schedule III and Schedule IV prescriptions at five refills within six months of the issue date, whichever limit is reached first. At ten months this prescription is expired regardless of how many refills remain unused, and a new prescription is required. Option A applies the rule for noncontrolled prescriptions and is the answer most candidates pick, which is precisely why the question is worth practicing. Option B misclassifies the drug: alprazolam is Schedule IV, and it is Schedule II drugs that carry no refills at all under federal law. Option D invents a limit that does not exist federally. One real-world caveat worth carrying: individual states may impose shorter windows than the federal rule, and where they do, the stricter of the two applies.

A. 3.6 g per day and 9 g in any 30-day period

The daily limit is 3.6 grams and the 30-day limit is 9 grams of pseudoephedrine base, and the distinction between base weight and product weight is the part candidates miss, because the limit is calculated on the base rather than on the total tablet weight. Options B and D invert or inflate the figures. There is a fourth number worth knowing that none of the options gives: mail-order and mobile retail purchases are capped at 7.5 grams per 30 days rather than 9. Alongside the quantity limits the Act requires that the product is kept behind the counter or in a locked case, that the purchaser shows photo identification, and that a logbook records the name, address, product, quantity, date and time, with the logbook retained for two years. This whole area sits in Federal Requirements, which the January 2026 outline expanded to 18.75% of the exam.

C. Warfarin 5.0 mg

The trailing zero is the problem. If the decimal point is faint, obscured by a fax artifact or missed on a fast read, 5.0 mg becomes 50 mg, a tenfold overdose of an anticoagulant that already sits on every high-alert list. The rule has two halves and candidates routinely learn only one: never write a trailing zero after a whole number, and always write a leading zero before a decimal less than one. Option A demonstrates the second half correctly, since 0.125 mg with its leading zero is exactly right and .125 mg would be the dangerous version. Options B and D are whole numbers with no decimal at all, so neither rule applies. Both halves exist for the same reason, which is that the decimal point is the least reliable mark on a prescription, and the safest expressions are the ones that stay unambiguous even when it disappears.

B. Refer the question to the pharmacist

An over-the-counter recommendation is a therapeutic judgment, and the current content outline names it explicitly as an issue requiring pharmacist intervention alongside drug utilization review, adverse drug events, therapeutic substitution, adherence and allergies. That a product needs no prescription changes nothing about who may recommend it, which is what makes option A the most tempting wrong answer. Option C is the subtle one and the one worth thinking about, because reading a label aloud feels like neutral information rather than advice; in practice it steers the choice while removing the clinical screen, and the patient with heartburn may be describing cardiac pain, may be on an interacting medication, or may have a condition that rules the product out. Option D delays care the pharmacist standing a few feet away is qualified to give. The line is consistent throughout the exam: technicians handle process, pharmacists handle judgment.

B. 25 days

Ophthalmic days supply is calculated at the standard conversion of 20 drops per milliliter, so a 2.5 mL bottle holds about 50 drops. One drop in each eye is 2 drops per dose, given once at bedtime, so the patient uses 2 drops a day and 50 divided by 2 gives 25 days. Option D is the answer you get by forgetting that each eye is dosed and counting a single drop a day. Option A halves the bottle by some route and option C is the number people reach for because a month feels like the natural answer for a maintenance eye drop. Days supply is not a formality: it drives refill-too-soon logic and it is one of the most frequent causes of a rejected claim, so the exam treats it as a core processing skill rather than a calculation exercise. Worth knowing that some payers use 16 drops per mL for suspensions, but 20 per mL is the default the exam expects.

B. 2.8 mL

Work the Sig code before the arithmetic, because that is where this question is won or lost. Two drops, au meaning each ear, twice a day, for seven days. Two drops in each ear is 4 drops per dose, twice daily makes 8 drops a day, and over 7 days that is 56 drops. At 20 drops per mL the patient needs 2.8 mL, which in practice means dispensing the standard 5 mL bottle. Option A is what you get by treating au as one ear, and that single misreading is the most common error on this style of question. The abbreviation to keep straight is that au is each ear and ad and as are the right and left ear individually, with ou, od and os as the eye equivalents. Option D drops the drops-per-mL conversion entirely. These Sig codes sit inside knowledge area 4.1, which carries the calculation asterisk in the current outline.