PTCB Patient Safety & Quality Assurance Practice Questions
Patient Safety & Quality Assurance makes up 12 of every 50 questions on a Tigertest PTCB practice test. Here are 10 of the 48 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Weighted to the PTCB PTCE content outline effective January 2026. Federal law only; state rules vary.
1. Which group of medications appears on the ISMP list of high-alert medications?
- A.Proton pump inhibitors and H2 blockers
- B.Opioids, insulin, and chemotherapy agents
- C.Statins, ACE inhibitors, and beta blockers
- D.Antihistamines, decongestants, and cough suppressants
Answer: B. ISMP lists opioids, insulin, and antineoplastic (chemotherapy) agents as high-alert because an error with them can cause serious harm. Statins, ACE inhibitors, and beta blockers are widely used but are not on the high-alert list.
2. Why does ISMP classify concentrated potassium chloride injection as a high-alert medication?
- A.It is a Schedule II controlled substance
- B.It is involved in errors more often than other drugs
- C.It must be stored frozen until it is used
- D.An error with it is likely to cause serious harm
Answer: D. High-alert means an error carries a heightened risk of significant patient harm; concentrated KCl given undiluted or too fast can cause fatal cardiac arrest. It does not mean the drug is involved in errors more often than others, and KCl is not a controlled substance.
3. A technician enters a new prescription for methotrexate 2.5 mg, take 3 tablets by mouth daily, for rheumatoid arthritis. What should happen?
- A.Flag it for the pharmacist, since it is usually weekly
- B.Change the directions to weekly before printing the label
- C.Dispense only a 7-day supply to be cautious
- D.Fill it as written because the directions are clear
Answer: A. Oral methotrexate for rheumatoid arthritis is usually taken once weekly, and accidental daily dosing has caused fatal toxicity, so the pharmacist must contact the prescriber. A technician may not change the directions on their own, even if weekly dosing seems likely.
4. A hospital requires an independent double check before an insulin infusion is dispensed. What makes the second check independent?
- A.A second person watches while the first person prepares it
- B.The prescriber signs the order a second time
- C.Another person verifies it without seeing the first check
- D.The same person repeats the check after a short break
Answer: C. An independent double check means a second qualified person verifies the order, calculation, and product on their own, so they are not influenced by the first person's work. Watching the first person prepare it is not independent, because the observer tends to accept what they see.
5. Why are neuromuscular blocking agents such as vecuronium and succinylcholine treated as high-alert medications?
- A.They are only available as oral tablets
- B.They interact with almost every antibiotic
- C.They paralyze the breathing muscles
- D.They cause strong physical dependence with repeated use
Answer: C. Neuromuscular blockers paralyze skeletal muscles, including those used for breathing, so a patient given one by mistake can stop breathing; ISMP recommends segregated storage and warning labels. They are injectable drugs, and dependence is not the concern.
6. A heparin vial contains 10,000 units/mL and the order is heparin 5,000 units subcutaneously. How many mL should be drawn up?
- A.0.5 mL
- B.2 mL
- C.5 mL
- D.0.05 mL
Answer: A. 5,000 units / 10,000 units per mL = 0.5 mL. Drawing 5 mL would be ten times the dose, the classic heparin error when concentrated vials are confused with 1,000 units/mL vials, which is why heparin is a high-alert medication.
7. Which drug name below is written in the Tall Man lettering recommended by FDA and ISMP?
- A.GLYburide
- B.CLONazepam
- C.PREDnisone
- D.hydrOXYzine
Answer: D. Tall Man lettering capitalizes the letters that differ from a look-alike name, so hydroxyzine is written hydrOXYzine to set it apart from hydrALAZINE. The recommended forms of the others are predniSONE, glyBURIDE, and clonazePAM, because capitalizing the shared start (PRED, GLY, CLON) highlights what is the same, not what is different.
8. What is the purpose of Tall Man lettering such as DOPamine and DOBUTamine on labels and shelf tags?
- A.To mark the product as a controlled substance
- B.To highlight how look-alike names differ
- C.To show which product is the brand name
- D.To show which product needs refrigeration
Answer: B. Tall Man lettering uses capital letters to draw the eye to the part of each name that differs, reducing selection errors between look-alike drugs. It has nothing to do with brand status, DEA schedules, or storage.
9. A pharmacy shelves glipiZIDE and glyBURIDE side by side in alphabetical order. Which change best reduces selection errors?
- A.Stock only the brand-name versions of both drugs
- B.Separate them and add shelf warning labels
- C.Store both drugs together in a single bin
- D.Reorder the shelf by manufacturer name
Answer: B. Physically separating look-alike sound-alike drugs and adding shelf alerts makes it harder to grab the wrong bottle. Storing them in one bin or keeping them adjacent under another ordering scheme leaves the confusion in place.
10. A technician receives a prescription for Celebrex 200 mg daily for a patient whose profile shows depression and no arthritis. What is the concern?
- A.Celebrex and Celexa are therapeutically interchangeable
- B.Celebrex does not come in a 200 mg strength
- C.Celebrex is a Schedule IV controlled substance
- D.Celexa (citalopram) may have been intended
Answer: D. Celebrex (celecoxib, an NSAID) and Celexa (citalopram, an SSRI) are a known look-alike sound-alike pair, and a depression diagnosis suggests Celexa, so the pharmacist should verify with the prescriber. Celebrex does come as 200 mg capsules and is not controlled.
Practice all 48 patient safety & quality assurance questions, and the rest of the 200-question bank, in the free PTCB training sets. Questions you miss come back until you have mastered them.
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