Rxprep- All compounding chapters Questions
with complete solutions
Nurse is adminstering IV Bulsufan to a patient. What PPE should she wear? - answer-
bulsufan is for chronic myeloid leukemia.
High RISK PPE needed during adminstration
1) 2 pairs of chemo gloves
2) chem gown
oncology nurse dropped a vial of reconstituted carmustine solution==> 2 foot spill.What
product can be used to decontaminate the area
1) 70%
2) sodium hypochloride
3) sodium thiosulfate
4) phenolics
5) quaternary ammonium compounds - answer- sodium hypoclorite( bleach)
common agent to decontaminate and deactivate surfaces that have been exposed to
hazardous drugs
order of sanitization
1) deactivate 2) decontaminate
- same product= 2% bleach( sodium hypochlorite or peroxide by reducing HD toxicity
first then removing HD residue
3) clean
-use a germicidal detergent such as Quat ammonium , phenolics
-this removes direct and microbial contamination
4) disinfect
- inhibits and destroys microorganism - required step in sterile compounding
closed system transfer device( phaseal and equashield) should be used when
compounding HD drugs, if dosage form allows. Which activities can't utilized this?
1) injecting solution into an IV bag
2) opening glass ampule and withdrawing solution from ampule
3) transferring solution from syringe to syringe
4) reconstitute a drug powder in vial
,5) withdrawing solution from vial - answer- 2) opening glass ampule and withdrawing
solution from ampule
- because you have to break the neck of the ampule and withdrawn liquid with a needle.
At this time, no transfer device to accomplish this activity within a closed system.
Content must be filtered due to risk of having glass particles in solution from the ampule
that came off when neck of the ampule was snapped open
Rank the following sterile preparation areas should be cleaned and disinfected
general supply area( unclassfied area)
buffer area
ante area
PEC - answer- PEC
Buffer
ante
general suppl area
Cleaning should be done from cleanest area to the dirtiest area
what type of gloves are needed to make nonHD compounded sterile products? -
answer- sterile gloves
powder free
IF HD==> 2 PAIRS!!!!
NONHD==> 1 PAIR!!
Need to constantly get disinfected with 70% as they become decontaminated (rather
than replace it)when the compounder is handling non sterile products during the
compounding process.
Min number of air changes per hour when compounding non sterile HD drugs in
ambient air
30
12
45 - answer- in space where non sterile HD are compounded==> at least 12 ACPH
in sterile HD are compounded==> at least 30 ACPH
correct statements regarding labeling/storage/stability of NON STERILE compounded
products
,1)store all bulk products off the floor and rotate so the nearest expiration is in front and
used first
2)statement of product has been compounded by pharmacy must be placed on the label
of the container
3)guidelines for handling and storing HD drugs are provided by USP 800
4)the BUD for nonAQ is 12 months or whichever comes first of any API
5)BUD must be no later than the expiration date of any container of any individual
components - answer- 1)store all bulk products off the floor and rotate so the nearest
expiration is in front and used first
2)statement of product has been compounded by pharmacy must be placed on the label
of the container
3)guidelines for handling and storing HD drugs are provided by USP 800
5)BUD must be no later than the expiration date of any container of any individual
components
WRONG:
4)the BUD for nonAQ is 12 months or whichever comes first of any API
==> it is 6 months
what is considered containment secondary engineering controls
class I biological safety cabinet
containment segregated compounding area
buffer room where chemo drugs are made
laminar horizontal airflow workbench
compounding asceptic isolator - answer- C-SEC
buffer room
containment segregatd compounding area
PEC-
class I
Laminar workbench
Compounding asceptic isolator
** for HD only
-Class II- chemo hood for sterile chemo drugs and other sterile HD, this is the
contaiment PEC or CPEC
-CACI ( compound asceptic containment isolator)- isolator glove box for HD
-PEC (sterile hood) used for HD are called containment PEC or CPEC. THe room
where the CPEC is located is the containment secondary engineering control or
C-SEC
, containment segregatd compounding area. If the hood is not in the CSEC, then it has to
be the compounding asceptiv containment isolator CACI.
which of the following room needs at least 30 ACPH?
1)buffer room used to make sterile HD drugs
2)room used to store HD API
3)CSCA(containment segregated compounding area) used to the prepare sterile HD
drug - answer- buffer room used to make sterile HD drugs
note: CSCA
ISO unclassified containment secondary engineering control (C-SEC) with minimal
requirements for airflow and room pressure.
Still, C-SCAs are segregated, maintain negative pressure, and have appropriate air
exchange. A C-SCA can replace a C-SEC during sterile compounding only for low- and
medium-risk drugs with BUD of 12 hours only
Overall, a C-SCA is a less expensive option, providing a benefit to clinics that do not
have the required infrastructure.
A type of PEC which needs materials to be passed through a chamber into an enclosed
working area that is accessed through glove ports is called - answer- glove box- when
cleanroom is not possible in space.
this glove box should be placed in a SEGREGATED COMPOUNDING AREA which
should be set apart from the rest of pharmacy
spilled cyclophosphamide solution on his gloves and gown inside the PEC. He feels the
drug seeping under his gloves and his eyes begin to burn. Which of the following should
the technician do first?
1) remove the gloves and gown that had drug on it
2) wash eyes for at least 5 min
3) clean skin with 2% sodium hydrochlorite
4) to keep incident between technician and pharmacist only
5) contact hospital ID team - answer- 1) remove the gloves and gown that had drug on
it
wrong:
2) wash eyes for at least 5 min ==> 15 min with isotonic eyewash or water
3) clean skin with 2% sodium hydrochlorite==> don't clean clean with bleach, soap and
water is fine
with complete solutions
Nurse is adminstering IV Bulsufan to a patient. What PPE should she wear? - answer-
bulsufan is for chronic myeloid leukemia.
High RISK PPE needed during adminstration
1) 2 pairs of chemo gloves
2) chem gown
oncology nurse dropped a vial of reconstituted carmustine solution==> 2 foot spill.What
product can be used to decontaminate the area
1) 70%
2) sodium hypochloride
3) sodium thiosulfate
4) phenolics
5) quaternary ammonium compounds - answer- sodium hypoclorite( bleach)
common agent to decontaminate and deactivate surfaces that have been exposed to
hazardous drugs
order of sanitization
1) deactivate 2) decontaminate
- same product= 2% bleach( sodium hypochlorite or peroxide by reducing HD toxicity
first then removing HD residue
3) clean
-use a germicidal detergent such as Quat ammonium , phenolics
-this removes direct and microbial contamination
4) disinfect
- inhibits and destroys microorganism - required step in sterile compounding
closed system transfer device( phaseal and equashield) should be used when
compounding HD drugs, if dosage form allows. Which activities can't utilized this?
1) injecting solution into an IV bag
2) opening glass ampule and withdrawing solution from ampule
3) transferring solution from syringe to syringe
4) reconstitute a drug powder in vial
,5) withdrawing solution from vial - answer- 2) opening glass ampule and withdrawing
solution from ampule
- because you have to break the neck of the ampule and withdrawn liquid with a needle.
At this time, no transfer device to accomplish this activity within a closed system.
Content must be filtered due to risk of having glass particles in solution from the ampule
that came off when neck of the ampule was snapped open
Rank the following sterile preparation areas should be cleaned and disinfected
general supply area( unclassfied area)
buffer area
ante area
PEC - answer- PEC
Buffer
ante
general suppl area
Cleaning should be done from cleanest area to the dirtiest area
what type of gloves are needed to make nonHD compounded sterile products? -
answer- sterile gloves
powder free
IF HD==> 2 PAIRS!!!!
NONHD==> 1 PAIR!!
Need to constantly get disinfected with 70% as they become decontaminated (rather
than replace it)when the compounder is handling non sterile products during the
compounding process.
Min number of air changes per hour when compounding non sterile HD drugs in
ambient air
30
12
45 - answer- in space where non sterile HD are compounded==> at least 12 ACPH
in sterile HD are compounded==> at least 30 ACPH
correct statements regarding labeling/storage/stability of NON STERILE compounded
products
,1)store all bulk products off the floor and rotate so the nearest expiration is in front and
used first
2)statement of product has been compounded by pharmacy must be placed on the label
of the container
3)guidelines for handling and storing HD drugs are provided by USP 800
4)the BUD for nonAQ is 12 months or whichever comes first of any API
5)BUD must be no later than the expiration date of any container of any individual
components - answer- 1)store all bulk products off the floor and rotate so the nearest
expiration is in front and used first
2)statement of product has been compounded by pharmacy must be placed on the label
of the container
3)guidelines for handling and storing HD drugs are provided by USP 800
5)BUD must be no later than the expiration date of any container of any individual
components
WRONG:
4)the BUD for nonAQ is 12 months or whichever comes first of any API
==> it is 6 months
what is considered containment secondary engineering controls
class I biological safety cabinet
containment segregated compounding area
buffer room where chemo drugs are made
laminar horizontal airflow workbench
compounding asceptic isolator - answer- C-SEC
buffer room
containment segregatd compounding area
PEC-
class I
Laminar workbench
Compounding asceptic isolator
** for HD only
-Class II- chemo hood for sterile chemo drugs and other sterile HD, this is the
contaiment PEC or CPEC
-CACI ( compound asceptic containment isolator)- isolator glove box for HD
-PEC (sterile hood) used for HD are called containment PEC or CPEC. THe room
where the CPEC is located is the containment secondary engineering control or
C-SEC
, containment segregatd compounding area. If the hood is not in the CSEC, then it has to
be the compounding asceptiv containment isolator CACI.
which of the following room needs at least 30 ACPH?
1)buffer room used to make sterile HD drugs
2)room used to store HD API
3)CSCA(containment segregated compounding area) used to the prepare sterile HD
drug - answer- buffer room used to make sterile HD drugs
note: CSCA
ISO unclassified containment secondary engineering control (C-SEC) with minimal
requirements for airflow and room pressure.
Still, C-SCAs are segregated, maintain negative pressure, and have appropriate air
exchange. A C-SCA can replace a C-SEC during sterile compounding only for low- and
medium-risk drugs with BUD of 12 hours only
Overall, a C-SCA is a less expensive option, providing a benefit to clinics that do not
have the required infrastructure.
A type of PEC which needs materials to be passed through a chamber into an enclosed
working area that is accessed through glove ports is called - answer- glove box- when
cleanroom is not possible in space.
this glove box should be placed in a SEGREGATED COMPOUNDING AREA which
should be set apart from the rest of pharmacy
spilled cyclophosphamide solution on his gloves and gown inside the PEC. He feels the
drug seeping under his gloves and his eyes begin to burn. Which of the following should
the technician do first?
1) remove the gloves and gown that had drug on it
2) wash eyes for at least 5 min
3) clean skin with 2% sodium hydrochlorite
4) to keep incident between technician and pharmacist only
5) contact hospital ID team - answer- 1) remove the gloves and gown that had drug on
it
wrong:
2) wash eyes for at least 5 min ==> 15 min with isotonic eyewash or water
3) clean skin with 2% sodium hydrochlorite==> don't clean clean with bleach, soap and
water is fine
