IV Training Practice Review Questions • USP/NF 797 requires that air sampling for high risk level areas be performed at least: • Daily • Weekly • Monthly • Annually • weekly • How often must work surfaces in the ISO Class 7 and 8 area buffer/clean rooms be cleaned? • At least daily • Every shift • Every 8 hours • PRN • At least daily • Which of the following pharmacy areas should not contain sinks or floor drains according to USP/NF 797? • Workroom • Anteroom • Clean room • All of the above • Clean room • The Buffer / Clean rooms should provide which of the following environments according to USP/NF 797? • ISO class 6 • ISO class 7 • ISO class 8 • None of the above • ISO Class 7 • Which is NOT a compounding example of a Low-Risk level Sterile Preparation? • A single transfer from a sterile ampule using sterile supplies • Measuring/mixing 2 manufactured products to prepare an admixture • Measuring/mixing 3 manufactured products to prepare a nutritional preparation • Measuring/mixing 4 manufactured products for TPN. • Measuring/mixing 4 products • Which is a compounding example of a HighRisk level Sterile Preparation? • Sterile ingredients are measured/mixed in nonsterile devices before sterilization. • Dissolving nonsterile bulk drug and nutrient powders for solutions to be sterilized. • TPN fluids prepared by automated device requiring multiple injections to a container. • All of the above. • Only A&B • Only A&B • How often must High-Risk level media fill testing be conducted by compounding personnel? • At least monthly • At least annually • At least semiannually • At least weekly • At least semiannually • Which of the following components of a syringe must remain sterile? • Tip • Barrel • Inner core of plunger • All of the above • Only A and C • Only A and C • Which gauge of needle would be used to draw up a thick substance such as Albumin? • 14 gauge • 18 gauge • 21 gauge • 23 gauge • 14 gauge • Which of the following components of the Intravenous Administration Set is used to calculate the rate at which the solution is being infused? • Spike • Drip chamber • Roll clamp • Additive port • Needle adaptor • Drip chamber • The cover protecting the Intravenous Administration Set spike should not be removed outside of the hood prior to inserting it into the IV bag administration set port because it must remain sterile at all times. • True • False • True • When preparing a TPN solution containing both phosphate and calcium type additives, _______ should be added first, then squeeze and agitate the additive port, flush by adding other drugs in between and then add ______ last. • Calcium, phosphate • Phosphate, calcium • Phosphate, calcium • There are various sizes of bacteria, but the average size of bacteria is • 5 micron • 13 micron • 1 micron • 20 micron • None of the above • 1 micron • Which of the following bacteria are so light in weight that they can stay suspended in air and be carried by air currents? • Staphylococcus • Streptococcus • Proteus • All of the above • Only A and B • Only A and B • Alcohols have excellent in vitro germicidal activity against • Gram-positive vegetative bacteria • Gram-negative vegetative bacteria • Multidrug-resistant pathogens • Mycobacterium tuberculosis • All of the above • All of the above • Put the following gowning and gloving garb in the correct order, according to USP NF/797. • Head and/or facial hair covers • Nonshedding gown • Shoe cover • Sterile gloves • Face mask • B,D,A,E,C: shoe covers, head/hair covers, • Face mask, gown, sterile gloves • The USP NF/797 states that when carts are being used they can NOT cross over clean zones unless they are cleaned and sanitized before returning to the clean room. • True • False • True • If the blower on a laminar flow hood or barrier isolator is turned off, then only TWO persons can enter the buffer area for the purposes of turning on the blower and of sanitizing the work surface for a minimum of 30 minutes. • True • False • False • USP NF/797 requires that all surfaces of the direct compounding environment be first cleaned with _____, to remove any water soluble residues, then with ______, and wiped clean with a nonshedding wipe. • Water for irrigation, Sterile 70% Isopropyl Alc. • Sterile water, Purified 70% Isopropyl Alcohol • Purified Water, Sterile 70% Isopropyl Alcohol • Spring Water, 90% Isopropyl Alcohol • Purified Water, Sterile 70% Isopropyl Alcohol • In which laminar airflow hood is the HEPA filter located at the back of the hood facing the preparer? • Vertical airflow • Horizontal airflow • Biological safety cabinet • Only A and C • None of the above • Horizontal airflow • In which Class of Biological Safety cabinet is the entire cabinet under negative pressure where operations are performed through attached gloves and the cabinet is entirely enclosed with gas tight construction? • Class I • Class II • Class III • None of the above • Class III • In which type of Biological Safety cabinet is air not re-circulated, total exhaust? • Type A • Type B1 • Type B2 • Type B3 • Type B2 • When working in a horizontal laminar airflow hood, all manipulations should be performed at least ___ inches within the hood to prevent contamination of mixed air from the room. •3 •6 •8 • 10 •6 • When working inside the vertical flow hood, all manipulations should be carried out at least ___ or more inches above the work surface area, because of where the HEPA filter is located. •3 •6 •8 • 10 •3 • When using a contaminant barrier isolator to prepare cytotoxic or hazardous drugs, it should be under ______ pressure. • Positive • Negative • Negative • Which of the following drugs are used to treat cancer by substituting in or blocking the use of essential nutrients and enzymes? • Mitotic Inhibitors • Alkylating Agents • Antimetabolites • None of the above • Antimetabolites • Which of the following drugs are considered the first anticancer drugs and work by binding to human DNA cells to stop their duplicating? • Mitotic Inhibitors • Alkylating Agents • Antimetabolites • None of the above • Alkylating Agents • Although Vinblastine and Vincristine can both be used to treat solid tumors, lymphomas, and Hodgkins disease, only one of these can be used to treat Leukemia. Which is it? • Vinblastine • Vincristine • Oncovin • Both A and C • Both B and C • Both B and C • Which of the following cancer drugs can be used to treat testicular cancer? • Ifosfamide • Etoposide • Dactinomycin • All of the above • All of the above • Which of the following cancer drugs can be used to treat head, neck and lung cancer? • Mitomycin • Methotrexate • Mithracin • All of the above • Only A and B • Only A and B • Match the cancer drugs with the correct cell cycle specific agent they act upon. • Cytarabine • Bleomycin • Floxuridine • Vinblastine • A. G1 Phase, S Phase • B. G2 Phase, M Phase • C. M Phase • D. S Phase • D, B, A, C • Which of the following cytotoxic agents is considered a vascular irritant, not a vesicant? • Mitomycin • Mitoxantrone HCl • Mechlorethamine HCl • All of the above are vascular irritants. • None of the above. • Mitoxantrone HCl • OSHA recommends cleaning ____ time(s) using a detergent solution followed by water when cleaning up a small hazardous drug spill. • One • Two • Three • Four • Three • Which of the following Cytotoxic drugs must be filtered? • Alemtuzumab • Asparaginase • Aldesleukin Interleukin-2 • Dactinomycin • Daunorubian Citrate Liposomal • Alemtuzumab • Which of the following solutions should Filgrastim (Neupogen) be mixed in? • NS • D5W • Sterile Water • All of the above • D5W • Which of the following Cytotoxic agents should be mixed in a glass container? • Docetaxel • Doxorubicin • Dacarbazine • Dexrazoxane • Docetaxel • Which of the following cytotoxic agents should be diluted with NaCl instead of D5W? • Mechlorethamine • Mitomycin • Cladridine • All of the above • Only A and B • All of the above • The USP NF/797 requires daily monitoring and documentation of refrigerators to ensure that the temperature remains between ______ degrees Celsius. • 2 to 8 • 4 to 10 • 6 to 12 • 8 to 14 • 10 to 16 • 2 to 8 • • • • • • The USP defines room temperature as © 8 to 15 15 to 20 20 to 25 25 to 30 30 to 40 • 20 to 25 • The USP 797 requires that any compounded sterile preparation which is exposed to temperatures exceeding 40 degrees Celsius for more than 4 hours should be discarded unless appropriate documentation or direct assay can confirm the preparation is stable. • True • False • True • The USP 797 requires that labeling for IV preparations which are shipped off-site contain which of the following? • Clearly readable beyond use dates • Storage instructions • Instructions for disposal of out-of-date units • All of the above are required. • Only A and B are required. • All of the above are required. • Which of the following IV Admixtures does NOT require filter tubing when dispensing? • Albumin • Amiodarone • Fat Emulsion • Mannitol • Sodium Nitroprusside • Sodium Nitroprusside • Which of the following IV admixtures should NOT be refrigerated when dispensing? • Acyclovir • Dopamine • Metronidazole • All of the above • Only A and C • All of the above • Which of the following IV admixtures should be mixed in glass containers when dispensing? • Hydrochloric Acid • Nitroglycerin • Amiodarone if infusion > 2 hours • All of the above • Only A and B • All of the above • Which of the following injectables MUST be stored in the refrigerator? • Amphoteracin B • Atenolol • Filgrastim • All of the above must be refrigerated. • Only A and C • Only A and C • Which of the following injectables should NOT be stored in the refrigerator? • Vecuronium Bromide • Ganciclovir Powder • Polymixin B Sulfate • All of the above • Only B and C • All of the above • The USP 797 divides contamination into 4 major categories. • True • False • False; just 3 categories • Which of these would work for the sterilization AND depyrogenation process? • Temp 160° Celsius for 120-180 minutes • Temp 170° Celsius for 90-120 minutes • Temp 180° Celsius for 45-60 minutes • Temp 230° Celsius for 60-90 minutes • Temp 230° Celsius for 60-90 minutes • The Texas State Board of Pharmacy does NOT require which of these on the “Master Formulation Worksheet” for batched prepared sterile preparations. • Formula, components, compounding directions • Pharmacist and PT names / signatures • Specific equipment used and a sample label • Evaluation and testing requirements • Sterilization methods and storage req. • Pharmacist and PT names / signatures Which of the following is NOT required on the label of a sterile pharmaceutical product by the Texas State Board of Pharmacy? Patient birth date Patient name Patient location Patient identification Patient birth date • Which of the following is NOT required by the USP 797 on labels and accessory labels for all compounded sterile preparations shipped offsite by a pharmacy? • Clearly readable beyond-use dates • Storage instructions • Instructions for contacting the physician in case of emergency • Instructions for disposal of out-of-date units • Instructions for contacting the physician • Using multiple ampules to be transferred into one final sterile container is an example of: • Immediate Use Risk Level • Low Risk Level • Medium Risk Level • None of the Above • Medium Risk Level • Only a single transfer from a sterile vial utilizing sterile supplies is an example of • Immediate Use Risk Level • Low Risk Level • Medium Risk Level • High Risk Level • None of the Above • Low Risk Level • Emergency Room Treatments, to be used within 1 hour, are an example of • Immediate Use Risk Level • Low Risk Level • Medium Risk Level • High Risk Level • None of the Above • Immediate Use Risk Level • Sterile ingredients measured /mixed with nonsterile devices before sterilization is performed is an example of • Immediate Use Risk Level • Low Risk Level • Medium Risk Level • High Risk Level • None of the above • High Risk Level • How many grams of Mannitol are needed to prepare 500 grams of a 10% (w/w) solution in water? • You need to prepare a 20% viscous Lidocaine solution. How many grams of Lidocaine will need to be dissolved in 500 ml of water to make this solution? • What is the percentage strength of a solution containing Benadryl 50 gm in 473 ml of liquid? • How many grams of Mannitol will you need to prepare 1 liter of a 20% solution? • How many grams of Epinephrine are needed to prepare 500 ml of a 0.01% Epinephrine solution? • In order to prepare 1 liter of 5% Hydrochloric Acid solution, how many ml’s of Hydrochloric Acid are required? • For the last question, how many ml’s of sterile water should be added to the Hydrochloric acid solution to prepare the 1 liter solution? • A 500 ml bag of D5NS infusing at 32 ml/hour will last for how many hours? • For the last question, how many bags will need to be sent in a 24 hour period? • You have Pitocin 40 units in D5W 500 ml to be infused over 4 hours. What is the rate in ml/hr the patient is receiving the Pitocin? • Order: D5LR infusing at 80 ml/hr. How many ml’s will be infused at the end of 24 hours? • What is the rate of infusion of Dopamine 250 mg in D5W 500 ml to be infused over 4 hours?