Free NHA ExCPT practice questions with answers

Twenty-five original, source-verified NHA ExCPT questions with full answers and rationale below, free to read, no account required. A new set every day.

1. Question 1

   A recalled cough syrup is found to have a slightly inaccurate concentration that could cause a temporary, reversible health problem in some patients but is unlikely to cause serious harm. Which FDA recall class best matches this?

   • Class A
   • Class I
   • Class IICorrect
   • Class III

   Why: Class II recalls are defined by the potential for a temporary health problem or only a slight chance of serious harm, which matches a reversible, non-life-threatening reaction. Class I is reserved for defects that could cause serious harm or death, a higher severity than described here. Class III covers only minor defects that would not be expected to harm a patient at all, a lower severity than described here. There is no 'Class A' designation in the FDA's recall system, making it an easy option to rule out. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 2, PDF p. 4.

2. Question 2

   Under a capitation payment arrangement, how does an HMO pay a physician?

   • Nothing, since HMO physicians work as unpaid volunteers
   • A fixed amount paid per enrolled patient, not per serviceCorrect
   • A percentage of the patient's total annual income
   • A separate fee billed for every single office visit

   Why: Capitation pays a physician a set amount for each patient enrolled under them, regardless of how many services that patient actually uses, rather than billing service by service. It is not a fee-for-service model, an unpaid arrangement, or a percentage tied to the patient's income. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 13, PDF p. 4.

3. Question 3

   Commercially available small-volume piggyback IV containers are generally supplied in what size range?

   • 1 mL to 5 mL
   • 1 L to 10 L
   • 50 mL to 250 mLCorrect
   • 500 mL to 5 L

   Why: Piggyback containers used for secondary IV medications are typically sized from about 50 mL to 250 mL, well below the multi-liter bags used for larger infusions. A 1- to 5-mL range is closer to a syringe volume, and the liter-scale ranges describe large-volume bags instead. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 12, PDF p. 6.

4. Question 4

   A Class A (Class III) prescription balance used in compounding is generally considered accurate down to a minimum quantity of about how much?

   • 1 mg
   • 5 g
   • 120 mgCorrect
   • 500 mg

   Why: A Class A, or Class III, prescription balance is rated for a minimum weighable quantity of roughly 120 mg; weighing less than that on this balance risks an unacceptable error. A quantity as small as 1 mg is below what this balance can reliably weigh, while 500 mg and 5 g are well above its stated minimum. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 11, PDF p. 9.

5. Question 5

   When determining whether a medication will cross the blood-brain barrier to reach the central nervous system, which drug property most favors penetration?

   • High water solubility
   • High ionization at blood pH
   • Large molecular size
   • High lipid (fat) solubilityCorrect

   Why: Drugs that are more fat-soluble cross the blood-brain barrier more easily because the barrier limits passage to small, lipid-soluble molecules. Highly water-soluble, large, or highly ionized molecules are instead the types of substances the blood-brain barrier tends to keep out. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 17, PDF p. 4.

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7. Question 6

   A technician wants to strengthen her word choice and overall communication ability over time. Which combination of habits is recommended for improving verbal communication skills?

   • Limiting all communication training to on-the-job trial and error
   • Relying only on nonverbal cues instead of building vocabulary
   • Avoiding outside reading so she only learns pharmacy-specific terms
   • Reading regularly to build vocabulary and taking a communication courseCorrect

   Why: Improving verbal communication skills is described as including reading to build vocabulary and taking a course in communication. Avoiding outside reading altogether runs counter to that recommendation rather than supporting it. Relying only on nonverbal cues addresses a different communication channel and does not build verbal skill specifically. Limiting training to unstructured, on-the-job trial and error is not the described approach, which instead points to reading and formal coursework. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 4, PDF p. 4.

8. Question 7

   Which 1996 federal law's portability provisions protect workers' ability to keep health coverage when they change jobs?

   • Omnibus Budget Reconciliation Act (OBRA)
   • Drug Quality and Security Act (DQSA)
   • Patient Protection and Affordable Care Act (ACA)
   • Health Insurance Portability and Accountability Act (HIPAA)Correct

   Why: HIPAA's portability provisions were written to protect workers' health coverage when they move to a new job, which is the portability half of the law's name. The Affordable Care Act reformed insurance markets and expanded coverage but was passed in 2010 for a broader purpose. The Drug Quality and Security Act addresses compounding oversight and drug-supply tracking, not insurance continuity. OBRA '90 mandated prospective DUR and the offer to counsel Medicaid patients; it does not address insurance portability. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 2, PDF p. 2.

9. Question 8

   A pharmacy technician is checking an infusion of heparin: a bag containing 20000 units in 500 mL is infusing at 30 mL per hour. How many units per hour is the patient receiving?

   • 0.75 units/hr
   • 120 units/hr
   • 667 units/hr
   • 1200 units/hrCorrect

   Why: The bag's concentration (20000 units / 500 mL = 40 units/mL) multiplied by the 30 mL/hr rate gives 1200 units/hr. 0.75 units/hr comes from inverting the concentration, dividing the mL by the units. 667 units/hr comes from dividing the bag's total units by the hourly rate instead of multiplying the concentration by the rate. 120 units/hr misplaces the decimal point, giving one-tenth of the correct dose. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 6, PDF p. 8.

10. Question 9

    The FDA and DEA determine which drugs are legal to manufacture and how controlled substances must be handled, but neither agency decides who is allowed to write a prescription. Which entity actually licenses prescribers?

    • The National Association of Boards of Pharmacy (NABP)
    • The Food and Drug Administration (FDA)
    • Individual state licensing boardsCorrect
    • The Drug Enforcement Administration (DEA)

    Why: Prescribing authority is granted by each state's own licensing board, not by a federal agency. The DEA registers prescribers who want to handle controlled substances but does not decide who can practice medicine or prescribe in the first place. The FDA regulates drug products themselves, not the licensing of individual practitioners. The NABP supports state pharmacy boards and accredits pharmacy websites but does not license prescribers either. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 2, PDF p. 9.

11. Question 10

    A company wants to manufacture and distribute a controlled substance. Which DEA registration form must it hold?

    • Form 224
    • Form 41
    • Form 225Correct
    • Form 363

    Why: Form 225 is the DEA registration required for a business to manufacture or distribute controlled substances. Form 224 instead applies to a pharmacy dispensing controlled substances to patients, a retail function rather than manufacturing or distribution. Form 363 registers a narcotic treatment program or a narcotics compounder, an unrelated activity. Form 41 records the destruction of controlled substances; it is not a registration. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 2, PDF p. 6.

12. Question 11

    In addition to on-the-job training, what do some states require of pharmacy technicians before they can practice?

    • Board certification as a registered nurse
    • Additional formal educationCorrect
    • A federal firearms permit
    • A separate license to practice medicine

    Why: Requirements for pharmacy technicians vary by state, and some states require both on-the-job training and additional formal education before a technician may practice. A medical license, a firearms permit, and nursing board certification are unrelated credentials that have nothing to do with pharmacy technician practice requirements. This variation is one reason technicians should confirm the specific rules of the state where they work. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 1, PDF p. 6.

13. Question 12

    CHAMPVA is best described as a program that does what?

    • Covers only active-duty service members, never their dependents
    • Shares service costs for eligible VA dependentsCorrect
    • Provides free, unlimited coverage with no eligibility requirements
    • Replaces TRICARE entirely for all military families

    Why: CHAMPVA shares the cost of covered services, including certain medications, for eligible dependents when requirements are met, operating through the Department of Veterans Affairs. It is not free and unrestricted, it is aimed at dependents rather than active-duty members, and it does not replace TRICARE for every military family. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 13, PDF p. 6.

14. Question 13

    Which medication class is typically used to treat an acute multiple sclerosis relapse (flare-up)?

    • Insulin therapy
    • Opioid analgesics
    • CorticosteroidsCorrect
    • Thyroid hormone replacement

    Why: Corticosteroids are the usual treatment for an acute multiple sclerosis relapse because they calm the flare and shorten it, although they do not change the long-term course of the disease. Opioid analgesics may ease pain but do not treat the relapse itself. Insulin therapy manages blood glucose and thyroid hormone replacement treats hypothyroidism, neither of which addresses an MS flare-up. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 17, PDF p. 12.

15. Question 14

    What distinguishes the daily work of a nuclear pharmacy technician from that of a typical community pharmacy technician?

    • Focusing entirely on billing insurance carriers for retail prescriptions
    • Working exclusively with over-the-counter herbal supplements and vitamins
    • Managing a drive-thru pickup window for walk-up customers
    • Preparing orders for radioactive products while following specific safety precautionsCorrect

    Why: A nuclear pharmacy technician enters and prepares orders for radioactive products, taking specific safety precautions and keeping risks such as radiation exposure in mind. Working only with herbal supplements, focusing solely on insurance billing, or managing a drive-thru window all describe unrelated or much narrower community pharmacy functions. The radiation-safety focus is what most sharply distinguishes this specialized role from typical dispensing work. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 10, PDF p. 6.

16. Question 15

    A pharmacy technician wants an electronic reference that is continuously updated and includes safety data sheets. Which reference has these features?

    • The Purple Book
    • Clinical PharmacologyCorrect
    • Geriatric Dosage Handbook
    • Remington's Pharmaceutical Sciences

    Why: Clinical Pharmacology is continuously updated and contains safety data sheets, making it useful for current, detailed drug information. The Purple Book compiles biological and biosimilar products rather than functioning as a continuously updated compendium with safety data sheets. Remington's is a broad print reference on the history and practice of pharmacy, not a continuously updated electronic tool. The Geriatric Dosage Handbook narrows in on dosing for older adults rather than offering general safety data sheets. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 7, PDF p. 6.

17. Question 16

    A hospital operates a pharmacy that fills prescriptions for patients who are being sent home, functioning much like a retail pharmacy would. What is this pharmacy called?

    • A satellite pharmacy
    • A discharge pharmacyCorrect
    • An investigational pharmacy
    • A central inpatient pharmacy

    Why: A discharge pharmacy performs the same kind of prescription-filling service a retail community pharmacy would, but for patients leaving the hospital. A satellite pharmacy supplies a specific clinic or specialty unit rather than functioning like a community pharmacy for discharged patients. A central inpatient pharmacy serves patients still admitted to the hospital, and an investigational pharmacy handles clinical-trial drugs, neither of which matches this community-pharmacy-like role. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 9, PDF p. 3.

18. Question 17

    A physician's order specifies that a medication is to be given 'parenterally.' Which route listed below fits under this category?

    • Topical cream
    • Intramuscular injectionCorrect
    • Sublingual tablet
    • Rectal suppository

    Why: Parenteral administration bypasses the digestive tract by injection, and intramuscular delivery is one of the parenteral routes along with intravenous and subcutaneous injection. A sublingual tablet is absorbed through tissue under the tongue, an oral-cavity route rather than an injection. A rectal suppository belongs to a separate route category from parenteral delivery. A topical cream is applied to the skin surface and is classified as a topical route, not an injection. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 5, PDF p. 5.

19. Question 18

    A pharmacy schedules regular cleaning and inspection of its laminar airflow hoods as part of its quality-assurance program. What is the primary purpose of this periodic cleaning?

    • To prevent microorganism growth inside the hoodCorrect
    • To meet a building's fire-alarm inspection schedule
    • To recalibrate the hood's airflow speed permanently
    • To update the hood's electrical wiring

    Why: Periodic inspection and cleaning of laminar airflow hoods is specifically aimed at preventing microorganisms from growing inside the hood. This cleaning does not permanently change the hood's airflow speed, which is a separate certification process. It is also unrelated to a building's fire-alarm inspection or to electrical wiring updates. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 14, PDF p. 9.

20. Question 19

    A pharmacy wants to consult an organization focused specifically on identifying causes of medication errors and promoting safer medication practices. Which of the following organizations fits this description?

    • ISMPCorrect
    • ASHP
    • NABP
    • PTCB

    Why: ISMP is identified as one of the organizations that tracks and reports medication errors. NABP is the association representing state boards of pharmacy (it runs programs such as licensure transfer and accreditation), not an organization focused on medication-error prevention. ASHP and PTCB serve professional-association and certification roles rather than functioning as a medication-error tracking organization. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 14, PDF p. 7.

21. Question 20

    A prescription calls for 0.5 g of amoxicillin. Using the metric weight scale, how many mg is this?

    • 0.0005 mg
    • 50 mg
    • 500 mgCorrect
    • 5000 mg

    Why: Each step on the metric weight scale is a factor of 1000, and converting g to the smaller unit mg means multiplying by 1000, giving 500 mg. 50 mg comes from multiplying by 100 instead of 1000. 5000 mg comes from multiplying by 10,000, moving the decimal one place too far. 0.0005 mg comes from dividing by 1000 instead of multiplying, converting in the wrong direction. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 6, PDF p. 4.

22. Question 21

    An applicant for the PTCE has a prior board-of-pharmacy disciplinary action on record. What does PTCE eligibility require her to do about it?

    • Fully disclose the criminal or board-of-pharmacy action as part of the applicationCorrect
    • Nothing, since only criminal convictions must be disclosed, not board actions
    • Wait ten years before she is eligible to apply at all
    • Have a pharmacist co-sign the application to bypass disclosure

    Why: PTCE eligibility specifically requires full disclosure of all criminal actions and board-of-pharmacy registration or licensing actions, so the applicant must report the disciplinary action rather than omit it. Limiting disclosure to criminal convictions only misstates the requirement, since board actions are named separately and must also be disclosed. There is no described waiting period tied to a prior board action, and no provision allows a pharmacist's co-signature to substitute for the applicant's own disclosure. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 3, PDF p. 5.

23. Question 22

    After a drug is absorbed into the bloodstream, which statement about its distribution throughout the body is accurate?

    • Distribution occurs only after the drug has already been fully eliminated from the body
    • Distribution is always exactly identical in every organ, tissue, and fluid compartment
    • Distribution is uneven throughout the body, and most drugs bind to blood proteins to some degreeCorrect
    • Distribution happens exclusively through the lymphatic system and never involves the bloodstream

    Why: Once absorbed, a drug travels through the bloodstream to tissues and organs, but it does not spread evenly, and most drugs bind to blood proteins to a certain extent, affecting how much free drug is available to act. Claiming distribution is identical everywhere ignores how tissue perfusion and protein binding vary by drug and organ. Elimination is the final phase of a drug's time in the body and happens after, not before, distribution. The bloodstream, not the lymphatic system alone, is the primary route by which an absorbed drug reaches tissues. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 5, PDF p. 6.

24. Question 23

    Biological response modifiers (BRMs) used to treat autoimmune disorders such as rheumatoid arthritis work by which mechanism?

    • Replacing the single deficient hormone directly and permanently
    • Increasing overall antibody production against the body's own cells
    • Broadly suppressing all bone marrow cell production entirely
    • Targeting specific cells to turn off the inflammatory processCorrect

    Why: Biological response modifiers are targeted therapies that work by turning off certain cells to diminish the inflammatory process in autoimmune disease. Broadly suppressing all bone marrow production, replacing a deficient hormone, and increasing antibody production do not describe the targeted mechanism of BRMs. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 25, PDF p. 3.

25. Question 24

    A patient weighs 198 lb. What is the patient's weight in kilograms?

    • 90 kgCorrect
    • 99 kg
    • 198 kg
    • 435.6 kg

    Why: Converting pounds to kilograms divides the weight in pounds by 2.2, giving 90 kg. 435.6 kg comes from multiplying by 2.2 instead of dividing by it. 99 kg comes from dividing by 2 instead of 2.2, a rounding shortcut that is not accurate enough for dosing. 198 kg simply carries the pound value over as if it were already in kilograms. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 6, PDF p. 6.

26. Question 25

    A pharmacy stores hydromorphone and morphine on separate shelves with bright warning labels reading 'high alert' posted above each. What quality-assurance goal does this arrangement support?

    • Speeding up the pharmacy's checkout line
    • Reducing look-alike, sound-alike medication errorsCorrect
    • Meeting a state tax reporting requirement
    • Reducing the pharmacy's utility costs

    Why: Separating storage and posting warning signs for look-alike, sound-alike or special medications is listed as a quality-assurance practice meant to prevent mix-ups. This arrangement has no effect on the pharmacy's utility bills. It is also unrelated to tax reporting or to how quickly customers move through checkout. Primary reference: Mosby's Pharmacy Technician, 6th Edition, Chapter 14, PDF p. 9.