Pharmacy Technician Certification Review and Practice Exam (2019)

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PHARMACYTECHNICIANCertificationReviewandPracticeEExamPHARMTECH4th EditionBARBARA E. LACHER, BS,RPhTech, CPhT

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Any correspondence regarding this publication should be sent to the publisher, American Society of Health-SystemPharmacists,4500 East-West Highway, Suite 900, Bethesda, MD 20814, attention: Special Publishing.The information presented herein reflects the opinions of the contributors and advisors. It should not be interpreted as an offi-cial policy of ASHP or as an endorsement of any product.Because of ongoing research and improvements in technology, the information and its applications contained in this text areconstantly evolving and are subject to the professional judgment and interpretation of the practitioner due to theuniqueness ofa clinical situation. The editors and ASHP have made reasonable efforts to ensure the accuracy and appropriateness of the infor-mation presented in this document. However, any user of this information is advised that theeditors and ASHP are not respon-sible for the continued currency of the information, for any errors or omissions, and/orfor any consequences arising from theuse of the information in the document in any and all practice settings. Any readerof this document is cautioned that ASHPmakes no representation, guarantee, or warranty, express or implied, as to theaccuracy and appropriateness of the informationcontained in this document and specifically disclaims any liability to any party for the accuracy and/or completeness of thematerial or for any damages arising out of the use or non-use of any ofthe information contained in this document.Vice President, Publishing:Daniel CobaughEditorial Project Manager, Special Publishing:Ruth BloomProduction Manager:Johnna HersheyCover & Page Design:David WadeLibrary of Congress Cataloging - in - Publication DataNames: Lacher, Barbara E., author. | American Society of Health-SystemPharmacists, issuing body.Title: Pharmacy technician certification review and practice exam / BarbaraE. Lacher.Other titles: Complemented by (work): Manual for pharmacy technicians. Fifthedition.Description: 4th edition. | Bethesda, MD : American Society of Health-SystemPharmacists, [2019] | Complemented by: Manual for pharmacy technicians /[edited by] Bonnie S. Bachenheimer. Fifth edition. 2019. | Includesbibliographical references and index.Identifiers: LCCN 2019007935 | ISBN 9781585284986 (paperback : alk. paper)Subjects: | MESH: Pharmacy | Pharmaceutical Services | Pharmacy Technicians |United States | Programmed InstructionClassification: LCC RS122.95 | NLM QV 18.2 | DDC 615.1/90076--dc23 LC record available at https://lccn.loc.gov/2019007935© 2019, American Society of Health-System Pharmacists, Inc. All rights reserved.No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, includingphotocopying, microfilming, and recording, or by any information storage and retrieval system, without written permissionfrom the American Society of Health-System Pharmacists.ASHP is a service mark of the American Society of Health-System Pharmacists, Inc.; registered in the U.S. Patent and Trade-mark Office.ISBN: 978-1-58528-498-610 9 8 7 6 5 4 3 2 1

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iiiCONTENTSPreface.......................................................................................................................................ivAcknowledgments....................................................................................................................vCHAPTER 1Preparing for the Exam and Taking the Test............................................1CHAPTER 2Pharmacy Calculations Review...................................................................9CHAPTER 3Pharmacology Review............................................................................... 35CHAPTER 4Sterile and Nonsterile Compounding.....................................................75CHAPTER 5Medication Safety...................................................................................... 101CHAPTER 6Pharmacy Law and Quality Assurance..................................................115CHAPTER 7Medication Dosage Forms, Routes of Administration,and Drug Usage...........................................................................................131CHAPTER 8Processing Medication Orders and Prescriptions.............................149CHAPTER 9Pharmacy Inventory Management.........................................................171CHAPTER 10Billing/Reimbursement and Information Systems............................. 185APPENDIX APractice Exam 1 + Answers.....................................................................205APPENDIX BPractice Exam 2 + Answers.....................................................................219INDEX..................................................................................................................................... 231

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ivPREFACEPharmacy Technician Certification Review and Practice Exam, 4th edition, is a self-study guidethat is designed to be a companion book to theManual for Pharmacy Technicians, 5th edition;however, it can be used alone in preparation for national certification exams.The fourth edition is expanded to cover all areas of the current exam offered by the Phar-macy Technician Certification Board (PTCB), and it includes educational standards of the2019 ASHP Accreditation Standard for Pharmacy Technician Programs.New expanded areas include:•New calculations preparation questions•Medication safety•Inventory management•Billing and information systems•Two new practice exams containing over 200 questionsCertification is becoming increasingly important for pharmacy technicians, especially in lightof their roles and responsibilities in the changing practice of pharmacy. As pharmacy rapidlyevolves, qualified and credentialed pharmacy technicians are playing a critical role in phar-maceutical care. Many states as well as many employers are now requiring certification as aminimum requirement. Technicians often deem certification important personally so theycan show employers they have the necessary skills to meet the minimum standard of theprofession. Certification demonstrates the technician’s commitment to the profession.Pharmacy has changed the way pharmaceutical care is practiced and continues to change,adding more responsibility and tasks to what technicians do and are expected to do in thefuture. Pharmacists need time to provide care for patients, which has resulted in an increasein pharmacist technicians’ assigned duties. Roles for technicians now include medicationtherapy management, medication reconciliation, immunizations, informatics, and tech-check-tech to name a few.As with all editions of this review manual, it is not intended to be used as a single source forpreparation for the certification exam. To ensure a successful outcome, technicians shoulduse this in conjunction with other study materials recommended by the testing organizations.All the best for a successful career,Barbara LacherMay 2019

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vvACKNOWLEDGMENTSIwould like to acknowledge ASHP and their continued support of pharmacy techniciansas a profession. ASHP has long supported the education of pharmacy technicians notonly in publishing, but in accreditation of educational programs. ASHP has taken anactive role in helping the profession create a definition of entry level and advanced techni-cians in practice. Under the leadership of ASHP and other organizations, we are hopeful ofone day having pharmacy technicians follow the same professional path as pharmacists asthey enter the profession.

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1CHAPTER1PREPARINGFOR THEEXAM ANDTAKING THETESTLearning OutcomesAfter completing this chapter, you willbe able to■■Discuss basic study and review skillsfor objective tests.■■List basic strategies for takingobjective tests.■■Define common trouble areas intaking objective tests and describehow to manage them.■■Recognize test anxiety and definecommon relaxation techniques.You are not alone if you face upcoming examinationswith dread and anxiety. Most people do. But examsserve a purpose. They are intended to test your knowl-edge,notyourpatienceandendurance. Testsarehelpful to others who are attempting to determine yourunderstanding and knowledge of specific areas. Testsalso help you to understand what areas you are compe-tent in and what areas require focus in terms of yourown learning and development.This chapter reviews preparation tips and test-takingstrategies. It concludes with a section on how to dealwith the anxiety most of us feel prior to an examination.TYPES OF EXAMINATIONSThere are two basic types of examinations. The firstis theobjectiveexamination. Objective examinationsinclude multiple-choice, true/false, and matching ques-tions. Objective examinations are designed to test yourability to recognize, rather than recall, facts and infor-mation. The second type is theessayexamination.Essay examinations are tests for which respondentsgive long, written answers. They provide the opportu-nity for respondents to organize their knowledge, inte-grate materials, and express themselves. The two kindsof tests require different skill sets. Because your examwill be objective multiple choice, this chapter focuseson techniques to help you perform at your best on thistype of examination.

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Pharmacy Technician Certification Review and Practice Exam2MULTIPLE-CHOICE QUESTIONSA multiple-choice question usually begins with anincomplete sentence or question, known as astem.Thestem is followed by a series of choices for completingthe sentence or answering the question, known asresponses.The responses are usually lettereda,b,c, andd.Typically, there are four, sometimes five, responsesto choose from. You complete the sentence or answerthe question by choosing the correct or best response.For example, a typical multiple-choice question willlook like this:(Stem) The capital of Illinois is:(Responses)a.Springfieldb.Chicagoc.Rockfordd.St. LouisGenerally, the directions are to pick the one bestresponse. However, the directions vary, so read thedirections and the stem carefully. You may be instructedto pick the incorrect option or to pick more than oneoption. There are also questions that present the stemas a complete statement. Key words to note in the stemare the subject of the question and any qualifiers oradjectives that further define the best answer.PREPARATION FOROBJECTIVE EXAMSYou may be fresh out of the classroom with recent expe-rience in preparing for and taking objective exams, oryou might not have taken an exam in quite some time.Whatever the case, it’s always useful to review goodstudy skills. This section reviews some basic study andtest preparation techniques.The first step is to go to the Pharmacy TechnicianCertification Board─PTCB.org─and complete all thenecessary steps in registering to take the exam.Next,check all the pre-requisite requirements. Once you haveregistered to take the exam and completed the prepara-tion, make sure you look at theWhat to Bringsection.Double check the date, time, and place of the exam. Markyour calendar and be sure to find the location in advance.You do not want to be late for the exam because you gotlost. Estimate how long it will take you to get to the testcenter. You may even want to do a test drive. Find outwhere parking is available, or make a trial run on publictransportation.Be sure you understand the scope of the exam. Inother words, how long is it and what material will itcover? What materials, if any, can you bring with you?EXAM PREPARATION BASICSTime ManagementEvery busy person needs a schedule. But planningyour study schedule, you first need a thorough under-standing of how you study. Answer these basic ques-tions about yourself:•When is the best time of day for me to study?•How do I best learn?If you are unsure of the answers to these ques-tions, you may want to monitor yourself for a week.Develop a time chart and follow your activities. Arethere any times of the day when you are more produc-tive than others? Think about how you learn, too. Whattasks help you learn? Do you learn best by doing or byreading? Some people find reading aloud to be a helpfulmemorization technique. This kind of self-knowledgewill guide you in developing your study schedule. Eventhough family and work responsibilities may take mostof your time, try to use your most productive time ofthe day for your studies.Work HabitsGet OrganizedDesign a workplace to be productive. Find a place thatallows you to work efficiently with a minimum numberof distractions. Also ensure that you have enoughspace to spread your work out, if required. Organizeyour workspace so that you have quick and easy accessto everything you need.Make a “To Do” ListKeep a running list of all projects and assignments thatare due. This will help ensure that you don’t forget about

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CH 1PREPARING FOR THE EXAM AND TAKING THE TEST3any major obligations. An article on time managementrecommends creating three lists1:1.Daily to-do list—all of the tasks that need tobe completed that day, such as homework duetomorrow.2.Projects to-do list—all of the projects you haveand when they are due. This list should be used tocreate the daily to-do list and should be reviewedseveral times a week.3.Long-term to-do list—the projects that you wouldlike to or need to work on sometime in the future,but for which there are not currently any assigneddeadlines. This list should be reviewed about once aweek to see if you can move any of these projects tothe projects to-do list. Spending as little as 1 hour aweek working on these long-term projects can leadto meaningful progress over time.PrioritizeOften times, you will have many things you are workingon simultaneously. Take time each day to prioritizewhat needs to be done first and work on items in thatorder. It is tempting to start on the easier things or theones you are most interested in first. However, if it isat the expense of missing an important deadline, it willmake your future stressful. Be mindful of deadlines andwork first on things that have the earliest due dates.Eliminate DistractorsCreate an area with few distractions so you can concen-trate. Toward that end, the following is suggested:•Attach a “do not disturb” signif you are workingin a room with a door. This lets others know notto bother you and will help to minimize unwantedinterruptions.•Stay in the zone.When people are talking aroundyou, avoid getting pulled into the discussion, espe-cially if it is not relevant to your work.•Stay focused on the task at hand.•Consider using earplugs or headphonesif you haveto work in shared areas. This helps to minimizethe chance that you will be distracted by a nearbyconversation.Avoid ProcrastinationNearlyeveryonehasprocrastinatedatsomepointin time. However, most will testify that it causedmore harm than good in the long run. Putting off anunpleasant task is human nature, but those who musterthe self-discipline to see the task through will ultimatelybe successful in the end.Allocate More Time than You Think You’ll NeedA general rule of thumb is that any task will almost alwaystake more time to finish than you think it will. Thinkin small increments of time. Do not postpone studyingbecause you do not have all afternoon to devote to yourstudies. Plan and organize small learning tasks thatcan occur in short blocks of time. It is easier to learnwhen you break your studies into smaller increments.For example, each of these is an increment: review yournotes, generate questions from your notes, and make aquestion chart (more on that later) or key word list, anddefine key words. Don’t postpone your studies whileyou wait for that perfect free day. That free day maynot come.Question ChartsOne study technique that has been useful in organizingand learning information is a question chart. Questioncharts help you make connections between informa-tion that is new to you and what you already know—animportant step in the learning process. For example, ifyour topic is medication administration,Table 1-1givesan example of how to set up your chart.Make question charts to cover all the main conceptsin this review guide. Complete the charts as you read,revising and adding questions as you go, and then usethem as study guides.

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Pharmacy Technician Certification Review and Practice Exam4Definition of TermsMake a separate section in your notes for terms andtheir definitions. Define each term by a key word orphrase. Review those terms every day, and add terms toyour list as you read new material. This is an exampleof one of the small learning tasks discussed earlier.Group ReviewSome people find it helpful to meet with other studentsto review notes, ask questions, and compare percep-tions. This may or may not be helpful to you; it alldepends on your personal style. If you study withothers, have an organized agenda so that time is notwasted. Listen and learn from your colleagues, but ifyou are unsure, check your references. Do not takeanother person’s word for something─look it up.Mock ExamsUse your question charts to make up your own exam, orif you are working with a group of colleagues, write ques-tions for each other. This is often a helpful way to preparefor exams. The practice exam included in this book is agood way to test your comprehension of the material.Final ReviewSuppose the test is tomorrow. Spend your final reviewtime reviewing, reciting, and summarizing your notes.When you are reviewing your term list or masteringyour notes, make sure that you review from both direc-tions. Begin first with the most difficult material, orreverse the review process by rearranging your notes,reviewing from back to front, and beginning in themiddle. Don’t get tied to order. If there is anything youare not certain of, now is the time to look it up andlearn it. Recite from your summary sheets.Personal PreparationSince you are mentally prepared, prepare yourself phys-ically for your exam. Go to your exam rested. You willnot do well if you are so sleepy that you cannot concen-trate on the questions. Eat a good breakfast before yourexam. It’s hard for the mind to concentrate if the bodyis demanding attention. Your brain functions betterwith a supply of energy. Also, it is probably not wise tostart a new diet, quit smoking, or begin a new exerciseregimen until after you complete the exam. Focus yourenergies on preparing for and taking the exam, not onredesigning your lifestyle.Prepareemotionallytoo.Rememberthatthepurpose of this exam is not to fail you or humiliate you,but to assist you professionally. So relax, be prepared,and concentrate. With preparation and strategy onyour side, you will perform at your best.OBJECTIVE EXAMSYou’ve been preparing for weeks, and now the big testdate has finally arrived. This section outlines severalsteps and strategies that are useful in successfullycompleting an objective test.Come PreparedThe first step in successfully taking objective tests isto come prepared. Make sure you follow the guidelinesofWhat to Bring.Also, arrive at the test site 30 to 40minutes early.TABLE 1-1. Sample Question ChartMedication AdministrationQuestionsIntravenousOralTopicalWhat are the available dosageforms?Solutions, suspensionsTablets, capsules, solutions,suspensions, powdersOintments, creams, patchesWhat are the advantages of thisroute of administration?Quick onset of actionConvenienceLimited systemic route ofabsorption (ointments andcreams only)What are the disadvantages ofthis route of administration?No drug recall, pain atinjection siteSlower onset of action,taste, palatabilityInconvenience

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CH 1PREPARING FOR THE EXAM AND TAKING THE TEST5Computerized TestingComputerized testing poses a unique set of problems.People vary in their comfort level when dealing withcomputer programs. If you are not accustomed toworking on a computer, it would be wise to complete apractice exam in that format prior to the actual test, ifpossible. The Pharmacy Technician Certification Board(PTCB) also offers a free practice exam and sells prac-tice exams on its web page (www.ptcb.org). There arealso a number of free apps for your phone to help youprepare. Other programs with computerized standard-ized tests are available commercially.Computerized tests often employ many of the sametypes of questions and question formats as paper tests,and you should use most of the same strategies (e.g.,reading both the questions and the answers carefully).The PTCB exam allows you to skip items and markitems you want to go back to. It also allows you to goback and change your answer. There is only one correctanswer per question and no penalty for guessing. It isimportant for you to try to pace yourself accordingly.Try to make your best answer in the time available andmove on to the next question. An erasable board willbe provided to serve as your scratch paper. You shouldnot bring any electronic devices into the testing center,including calculators. You are permitted to use theon-screen calculator or handheld devices provided bythe testing center. You will be required to lock all yourpersonal items in a locker during the exam.Test-Taking StrategiesSome basic strategies are helpful to most people takingobjective tests. First, make sure you know how tonavi-gate through the pages of the exam. The PTCB has atutorial for this that can be accessed from their website.You are allowed to mark questions to review later; theexam will prompt you to go back to these questions.The second step is touse your time wisely. Set your-self a schedule. Using your time wisely is dependenton reviewing the test carefully. Be aware of how manyand what types of questions you must answer. Youshould have an idea at what time it will be when youare halfway done with the exam. For example, if youhave 2 hours for a test, you should be at least halfwaythrough it by the end of the first hour. Remember toleave extra time for particularly tough questions andfor review. Work as rapidly as possible with a reason-able assurance of accuracy. The PTCB allows 2 hours tocomplete 90 multiple-choice questions.The third strategy is toread carefully. This includesboth the directions and the questions. Sections of theexam may vary, so take time to read the directions care-fully at the beginning of each new section, and keepthose directions in mind while answering the questions.Making careless mistakes because you misunderstoodthe directions is not an effective test-taking strategy!For example, the directions may read, “select the incor-rect response,” or “mark the two best answers.”Part of reading carefully involves reading the ques-tions as they are, not as you would like them to be. Inother words, don’t look for answers you have memo-rized. Answer the question. Many people find it helpfulto mark the key words in the stem so they do not forgetthem or misinterpret them. Also look for and mark thequestion words. This will help you answer the questionas written. Some common question words arewhat,how,when, anddefine.A fourth strategy is toleave your assumptions athome. You should not anticipate or assume trick ques-tions. For example, you may know the correct answerisd,but you feel you have already answered too manyquestions withd.Take the question at face value andmark the answer you think is correct. Also, do notassume that methods or procedures you use at workare necessarily the correct ones. “Because that’s the waywe do it around here” may not be based on fact or bestpractice.Going through the test at least two or even threetimes is another strategy for successful test taking. Gothrough the test completely the first time and answerall the “easy” questions that you are sure of. While youare doing the first run-through, mark the questions youneed to come back to by marking the square in the topleft of the page that says “review later.” By answeringall the easy questions first, you can be assured that youhave answered the questions you know. This strategyalso builds confidence. In the stem of one question, youmay also find an answer to another question.

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Pharmacy Technician Certification Review and Practice Exam6On the second run through, answer the questionsthat you are unsure of by considering all the alterna-tives and eliminating the options you know are inap-propriate or incorrect. Relate the remaining options tothe stem and balance them against each other. Use theinformation obtained from other questions to help you.On the third run through, look at the remainingquestions. If it is in your best interest to guess, do so.Always guess if your chances of gaining points aregreater than your chances of losing points. Use thefollowing strategies for intelligent guessing:•The most general option is often the correct onebecause it allows for exceptions. If three of thefour options are specific in nature and one is moregeneral, choose the more general option.•The correct choice is most often a middle value. Ifthe options range in value (e.g., from high to lowor from big to small), then eliminate the extremevalues and choose from the middle values.•The longest option is often the correct one. If threeoptions are much shorter than the fourth, thenchoose the longest answer.•When two options have opposite meanings, thenthe correct answer is usually one of them.•Look for grammatical agreement between the stemand the answers. For example, if the stem uses asingular verb tense, then the answer should also besingular. Eliminate the answers that don’t producegrammatically correct sentences. Most multiple-choice questions are designed as sentence comple-tions.•Do not leave questions blank; they will be markedwrong.TROUBLE AREAS INOBJECTIVE EXAMSA couple of areas are problematic for most people takingobjective exams.The first problem area deals with specificdeterminers. There are positive- and negative-specificdeterminers. Positive-specific determiners includeall,every,everybody,everyone,always,all the time,invari-ably,will certainly,will definitely,will absolutely, andthebest.Negative-specific determiners includenone,not one,nobody,no one,never,at no time,will certainly not,willdefinitely not,will absolutely not,the worst, andimpos-sible.When specific determiners like these are includedin an option, that option isusually incorrect.These wordsmake statements absolute, and there are few absolutes inthe world.However, some specific determiners are associ-ated with correct statements. Look for more generalterms such asoften,perhaps,seldom,generally,may,andusually.Life more often reflects statements that usethese kinds of words, rather than the absolute termspresented in the previous paragraph. When you arereading the question, circle the specific determiner soyou keep careful track of them. Don’t ignore them whenanswering the question.The second problem area deals with negative terms.It is more difficult to interpret statements that containnegatives than it is to interpret statements withoutnegatives. Here’s an example of a double-negative state-ment: “Donald works well with patients. Therefore itis not untrue to say that he may be a good pharmacytechnician.” Cross out thenotand theun-and rereadthe statement. It means the same thing but is easier tounderstand. Negatives include words such asno,not,none, andnever, and prefixes such asil-,un-, andim-.Negative prefixes are particularly difficult because theyare easily overlooked when reading a statement. Under-line negatives in the question so you do not overlookthem when answering the question.Another common trouble area in objective tests is“all or none of the above” questions. One way to confirmthe choice of “all of the above” is to find two correctanswers among the options. For example, if you areconfident that two of the four options are correct, thenchoosing “all of the above” is a pretty safe bet. Similarly,if you find one that is definitely incorrect, the “all of theabove” must be ruled out.The last type of question that is usually problem-atic for test takers is the best choice option. The optionspresented may not contain the correct answer, butpossibilities from which you choose the best option.Another way of thinking of it is to consider the correctoption as the least problematic. Select your answer by aprocess of elimination.

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CH 1PREPARING FOR THE EXAM AND TAKING THE TEST7Mental BlocksYou know you know the material.You’ve been answeringquestions—and all of a sudden, you can’t seem to think.You have a mental block. One useful technique is tothink of the multiple-choice question as a series of trueand false statements. In other words, make statementsor complete sentences out of each option and then askyourself if the statement is true or false. This change inperspective may help you to answer a difficult questionor just refresh your thinking. However, keep your timelimitations in mind and don’t spend too much time onany one question. Skip difficult questions and comeback to them, or take a quick 1-minute mental break torefresh yourself.Final ReviewAlways plan on saving time to review your test beforesubmitting it. Check your math if any of the ques-tions required calculations. Contrary to popular belief,research has shown that test takers generally increasetheir scores when they review their answers and makechanges. Make changes thoughtfully, though. Whenchanging an answer, be sure you have considered thereasons why you answered the questions the way youdid in the first place.Finally, don’t let other test takers distract you;concentrate on what you are doing. Do not be concernedif other people are finishing the exam before you. Theymay be finishing early because they simply are not asprepared as you are and cannot answer all the ques-tions. There is little relationship between the amount oftime spent on a test and the test scores.TEST ANXIETIESAt the beginning of this chapter, we discussed howmany people face taking an exam with dread andanxiety. It has been estimated that half of the nation’sstudents suffer test anxiety, and one-quarter of themare significantly hampered by it.You may feel faintat heart, apprehensive, nervous, nauseated, dizzy, oreven have heart palpitations. Some people describe itas “my mind goes blank.” Some amount of test anxietyis normal, so you just need to learn how to make itwork for you. The first step is to recognize that someanxiety is natural; it serves as a primary motivator inyour performance.There are three components of test anxiety. Thefirst one isfear of failure. Nobody likes to fail, butremember to keep it in perspective. Tests just measureand assess one aspect of your life. Passing or failing atest reflects your performance in one area at one partic-ular time. The second component of test anxiety is thepressure of time. You have a limited amount of time toaccomplish a task and to accomplish it as accurately aspossible. We all feel the pressure of time in many situ-ations aside from testing. The third component is thelogistics of taking the exam. You must read the instruc-tions, follow them, understand the questions, and selectthe correct answer. Generally, the higher the stakes, themore anxiety you may feel, particularly if the competi-tion is intense.If your anxiety is moderate, several relaxation tech-niques are helpful in calming your nerves. Physicalrelaxation is one technique. First, sit comfortably withboth feet on the floor and your hands resting on yourthighs. Release all your body tension, close your eyes,and count backward from 10 to 1. Count only on eachexhalation and breathe very deeply from the abdomen.2Another physical technique is to clench your handstightly for 5 to 10 seconds and then slowly relax yourhands. Repeat this process throughout the muscles inyour entire body. Complete your relaxation exercise bytaking a deep breath and tensing your entire body, thenrelaxing it.Now that your body is relaxed, try to relax yourmind too. One popular technique is imagining yourselfin a peaceful setting. Envision a pleasing situation, suchas lying on a favorite beach, sitting in your backyardwith the sun shining, or taking a walk in a park or alongthe lake. When you are feeling particularly stressed,imagine peaceful images.At all costs, avoid fear-generating thoughts. Do notfocus on the negative consequences; instead, focus onthe positive outcomes of your examination.These are just a few simple techniques that mayhelp you relax so that you can do your best. For some,

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Pharmacy Technician Certification Review and Practice Exam8however, test anxiety is so severe that it prevents themfrom performing at their best. If you experience severeanxiety, you may benefit from personal counseling.CONCLUSIONNow that the exam is over, you deserve a reward. Bekind to yourself. However, do spend a few minutes toreview what worked for you and what didn’t. Thinkabout your preparation. Did you allow yourself enoughtime? Did you understand what was important to studyand learn and what were minor details? How about thetest itself? Did you glance over the test, run through itseveral times, and save time for review and checkingyour answers? One of the most important lessons inlife is to learn from your experiences, so evaluate yourperformance and learn how you can make it better. Youmay register and take this examination again if youneed to. Most likely, there will be other exams in yourlife.This chapter presented an overview of objectivetests, basic study skills, and test-taking strategies. Italso presented some simple techniques for relaxationto refresh you. But remember, no matter how effectivethe strategies, there is no substitute for thorough prep-aration. Begin your preparation early, be organized, usesmall increments of time, break your studying downinto small tasks, and relax.References1.Schommer JC. Time management techniques for phar-macists. Available at:www.InetCE.com. AccessedNovember 1, 2018.2.Hill KT. Interfering effects of test anxiety on test per-formance: a growing educational problem and solutionsto it.Ill Sch Res Dev. 1983;20:8–19.

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9CHAPTER2PHARMACYCALCULATIONSREVIEWLearning OutcomesAfter completing this chapter, you willbe able to■■Explain why it is important to followa standardized approach when usingmath in pharmacy.■■Convert between fractions, decimals,and percentages.■■Convert between different systems ofmeasurement.■■Perform and check key pharmacycalculations, including the calcula-tions needed to interpret prescrip-tions and those involving patient-specific information.Thischapterreviewsthefundamentalsofcalcula-tions and how those calculations are applied in phar-macy. For additional review and practice problems, seeChapter 12, Pharmacy Calculations, inManual for Phar-macy Technicians,5th Edition.KINDS OF NUMBERSArabicnumbersisthesystemofnotationthatispreferred in pharmacy practice. This is the system weare most familiar with, consisting of the numbers 0, 1,2, 3, 4, 5, 6, 7, 8, and 9. From these numbers, fractionsand decimal numbers are written.Romannumerals consist of a numbering systemusing letters to represent numbers. Roman numeralsare used to designate numbers and are often used inprescription writing to designate quantities to be dis-pensed or the number of a unit of medication thepatient is to take. Roman numerals are used in prescrip-tion writing because they are more difficult to alter inthe case of controlled substances. The following rulesapply to the Roman numbering system:•When a Roman numeral of equal or lesser value isplaced after one of equal or greater value, the valueof the numerals is added.•A numeral cannot be repeated more than threetimes.

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