About this test
PTCB Practice Test 4 draws from set 4, so it is fresh even if you have worked through the first three. Because Medications is 35% of the exam, seven of these 20 questions come from that domain, and it is usually where recall gaps first become obvious.
If the medication questions here feel shaky, pair this test with the drug class identification quiz, the brand and generic quiz, and the drug-class study guides before continuing the series.
New to the material? Work through our 2026 PTCB study guide first, then reinforce it with PTCB Practice Test 3 and PTCB Practice Test 5.
What's in the question bank
| Topic | Questions in bank |
|---|---|
| Brand Generic | 2 |
| Drug Class | 2 |
| Abbreviations | 2 |
| Indication | 1 |
| Side Effects | 1 |
| Ndc | 1 |
| Expiration | 1 |
| Storage | 1 |
Sample questions with answers
These 8 questions come straight from the 30-question bank the timed test above draws from. Work each one before you open the answer: recalling it cold is what moves it into long-term memory.
1. Lasix is the brand name for which generic medication?
- A.Bumetanide
- B.Torsemide
- C.Furosemide
- D.Spironolactone
Show answer and explanation
Correct answer: C. Furosemide
Lasix is the brand name for furosemide, a loop diuretic used to treat edema and high blood pressure. Bumetanide and torsemide are other loop diuretics, while spironolactone is a potassium-sparing diuretic that works by a different mechanism.
2. A caregiver asks how to get rid of a used fentanyl transdermal patch at home. Per FDA recommendations, what should they do?
- A.Throw the used patch directly into the kitchen trash
- B.Cut the patch into small pieces before discarding
- C.Save used patches and return them only at an annual take-back event
- D.Fold the patch in half with the sticky sides together and flush it down the toilet
Show answer and explanation
Correct answer: D. Fold the patch in half with the sticky sides together and flush it down the toilet
The FDA recommends promptly folding used fentanyl patches in half with the sticky sides together and flushing them down the toilet, because a discarded patch still holds enough drug to kill a child who finds and handles it. Ordinary trash disposal is wrong here since children and pets can retrieve the patch.
3. A prescriber's office faxes a Schedule II narcotic prescription for a patient enrolled in a hospice program, noting the hospice status on the prescription. How may the pharmacy handle this fax under federal law?
- A.It must be treated as invalid because Schedule II prescriptions can never be faxed
- B.It may be used only to prepare the fill, and the original paper prescription must arrive before dispensing
- C.It is valid only if the patient picks up the medication within 72 hours
- D.The fax itself may serve as the original written prescription for dispensing
Show answer and explanation
Correct answer: D. The fax itself may serve as the original written prescription for dispensing
Under 21 CFR 1306.11(g), a Schedule II narcotic prescription for a hospice patient may be transmitted by fax, and the fax serves as the original written prescription when hospice status is noted. The same fax-as-original exception applies to residents of long-term care facilities and to narcotics compounded for parenteral infusion.
4. On the ISMP acute care high-alert list, which insulin product is singled out for special emphasis?
- A.Insulin glargine U-100
- B.Insulin U-500
- C.NPH insulin
- D.Insulin lispro U-100
Show answer and explanation
Correct answer: B. Insulin U-500
All subcutaneous and IV insulin is treated as a high-alert class, but U-500 insulin receives special emphasis on the list. Its five-fold concentration makes dosing mix-ups especially dangerous, and 100 percent of practitioners in ISMP's 2023 survey considered it high-alert. The other insulins are covered by the general class listing.
5. A prescriber writes "brand medically necessary" on a prescription for Synthroid and does not authorize substitution. Which DAW code belongs on the claim?
- A.DAW 1
- B.DAW 0
- C.DAW 2
- D.DAW 5
Show answer and explanation
Correct answer: A. DAW 1
DAW 1 indicates that substitution is not allowed by the prescriber, which is the correct code when the prescriber demands the brand product. DAW 0 means no product selection was indicated, and DAW 2 applies when the patient, not the prescriber, requests the brand.
6. Prednisone is classified as which type of medication?
- A.Nonsteroidal anti-inflammatory drug (NSAID)
- B.Disease-modifying antirheumatic drug (DMARD)
- C.Antihistamine
- D.Corticosteroid
Show answer and explanation
Correct answer: D. Corticosteroid
Prednisone is an oral corticosteroid (glucocorticoid) used to reduce inflammation and suppress the immune response in many conditions. NSAIDs such as ibuprofen also reduce inflammation but through a completely different mechanism and are not steroids.
7. A patient is stopping an MAOI prescribed for depression. Per the fluoxetine labeling, how long must they wait after the last MAOI dose before starting fluoxetine?
- A.At least 14 days
- B.At least 5 weeks
- C.24 hours
- D.No waiting period is needed
Show answer and explanation
Correct answer: A. At least 14 days
Fluoxetine must not be started within 14 days of stopping an MAOI intended to treat psychiatric disorders because of the risk of serotonin syndrome. The 5-week figure applies in the opposite direction: an MAOI must not be started within 5 weeks of stopping fluoxetine, because fluoxetine's active metabolite persists that long.
8. The iPLEDGE REMS program for isotretinoin exists primarily to prevent which outcome?
- A.Hepatotoxicity in elderly patients
- B.Abuse and diversion of isotretinoin
- C.QT prolongation when combined with antibiotics
- D.Fetal exposure resulting in severe birth defects (embryo-fetal toxicity)
Show answer and explanation
Correct answer: D. Fetal exposure resulting in severe birth defects (embryo-fetal toxicity)
The stated goal of the iPLEDGE REMS is to mitigate the risk of embryo-fetal toxicity, because isotretinoin causes life-threatening severe birth defects if taken during pregnancy. The program has restricted isotretinoin distribution since 2005 and was approved as a REMS in 2010.
Ready for the full timed run? Scroll back up and start the Practice Test 4, or browse every free PTCB quiz by exam domain.
Key concepts to know
Medications is where scores move
More than a third of the exam is Medications, so improving brand-generic recall and class identification has the largest payoff. Treat every medication miss here as a high-value fix.
Read the cited explanation on drug questions
Drug questions often hinge on one detail: a salt form, a suffix, a single interaction. The explanations are where those distinctions live, so read them even on questions you answered correctly.
Practice Test 4: FAQ
Why are there so many medication questions?
Medications is the largest PTCE domain at 35% of the exam, so a weighted mini test naturally includes the most questions from it. Test 4 keeps that same proportion.
Where should I study if I miss the drug questions?
Start with the drug class identification and brand and generic quizzes, then read the drug-class study guides. Those target exactly what medication questions test.
Official sources checked
This quiz's content and explanations are built from and cross-checked against primary sources. Verify current exam facts directly with PTCB.