TheoryFree Pharmacy Technician Practice Test
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Pharmacy Technician Questions
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Q1A patient with type 2 diabetes is started on metformin. Which mechanism best explains why metformin is preferred as first-line therapy over sulfonylureas for most patients?
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✓ Correct answer: Metformin decreases hepatic glucose production and does not cause hypoglycemia or weight gain
Metformin (Glucophage) works primarily by suppressing hepatic gluconeogenesis; it does not stimulate insulin secretion, so it carries minimal hypoglycemia risk and is weight-neutral, making it first-line per ADA guidelines.
Q2A prescriber orders warfarin for a patient who is also taking fluconazole for a vaginal yeast infection. What is the expected clinical outcome and the mechanism responsible?
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✓ Correct answer: Increased anticoagulant effect; fluconazole inhibits CYP2C9, decreasing warfarin metabolism
Fluconazole is a potent CYP2C9 inhibitor; since S-warfarin (the more active enantiomer) is primarily metabolized by CYP2C9, co-administration raises warfarin plasma levels and significantly increases bleeding risk.
Q3Which of the following brand/generic pairs is correctly matched?
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✓ Correct answer: Lipitor — atorvastatin
Lipitor is the brand name for atorvastatin, a HMG-CoA reductase inhibitor (statin); Norvasc is amlodipine, Synthroid is levothyroxine, and Zestril is lisinopril.
Q4A patient receiving chemotherapy develops severe nausea. The oncologist prescribes ondansetron. To which pharmacological class does ondansetron belong?
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✓ Correct answer: Serotonin 5-HT3 receptor antagonist
Ondansetron (Zofran) is a selective 5-HT3 receptor antagonist that blocks serotonin at vagal afferents in the gut and at the chemoreceptor trigger zone, making it highly effective for chemotherapy-induced nausea and vomiting.
Q5A pharmacy receives a prescription for lithium carbonate 300 mg three times daily. Which parameter is most critical for a technician to flag for pharmacist counseling regarding patient monitoring?
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✓ Correct answer: Serum lithium levels, renal function, and thyroid function tests due to a narrow therapeutic index
Lithium has a narrow therapeutic index (target serum level 0.6–1.2 mEq/L for maintenance), and toxicity correlates closely with renal clearance and sodium balance; routine serum level, BMP, and thyroid monitoring are mandatory.
Q6Which of the following statements correctly describes the dosage form known as a transdermal patch?
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✓ Correct answer: A reservoir or matrix system applied to the skin that delivers drug systemically through the dermal layers
Transdermal patches (e.g., fentanyl, nicotine, nitroglycerin) use reservoir or matrix technology to provide controlled systemic drug delivery through the skin, bypassing first-pass hepatic metabolism.
Q7Amiodarone is prescribed for a patient who is also on simvastatin 40 mg daily. What is the most significant concern with this combination?
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✓ Correct answer: Risk of serious myopathy or rhabdomyolysis because amiodarone inhibits CYP3A4, raising simvastatin levels
Amiodarone inhibits CYP3A4, the primary enzyme metabolizing simvastatin; elevated simvastatin concentrations dramatically increase the risk of skeletal muscle toxicity including rhabdomyolysis, and the FDA limits simvastatin doses when used with amiodarone.
Q8A patient asks a pharmacy technician about the generic name for Proventil HFA. Which answer is correct?
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✓ Correct answer: Albuterol
Proventil HFA and Ventolin HFA are brand names for albuterol, a short-acting beta-2 agonist (SABA) used for acute bronchospasm relief in asthma and COPD.
Q9A 68-year-old patient with a sulfa allergy is prescribed furosemide. Which counseling point is most pharmacologically relevant to this allergy history?
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✓ Correct answer: Furosemide is a sulfonamide-based loop diuretic, so cross-reactivity with sulfa antibiotics is theoretically possible and should be discussed with the prescriber
Furosemide contains a sulfonamide group; while the clinical significance of cross-reactivity is debated, the prescriber should be aware of the sulfa allergy so an informed benefit-risk decision can be made before dispensing.
Q10A patient taking phenytoin for seizures is newly prescribed enteral tube feeds. Which pharmacokinetic interaction is the technician most likely to hear the pharmacist discussing?
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✓ Correct answer: Enteral feeds significantly decrease phenytoin absorption, requiring the feeds to be held around dose times and serum levels to be monitored
Continuous enteral nutrition reduces phenytoin oral bioavailability substantially (mechanism not fully elucidated, possibly protein binding or adsorption to the feeding tube); standard practice is to hold feeds 1–2 hours before and after phenytoin doses and monitor drug levels closely.
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