Certified Medication Technician (CMT) Exam — Questions and Answers

Question 1: Pharmacokinetics is the study of how the body affects a drug. Which of the following correctly lists the four main processes of pharmacokinetics in the correct order?

Distribution, Metabolism, Absorption, Excretion
Absorption, Distribution, Metabolism, Excretion (Correct answer)
Excretion, Absorption, Metabolism, Distribution
Metabolism, Distribution, Excretion, Absorption

Correct answer: Absorption, Distribution, Metabolism, Excretion

Pharmacokinetics describes the journey of a drug through the body, commonly remembered by the acronym ADME: Absorption (into the blood), Distribution (throughout the body), Metabolism (breakdown), and Excretion (removal).

Question 2: The abbreviation 'IM' on a medication order refers to which route of administration?

Intramedullary
Intramuscular (Correct answer)
Intramucosal
Intermittent

Correct answer: Intramuscular

IM stands for intramuscular, meaning the medication is injected directly into muscle tissue.

Question 3: Which of the following is the CORRECT technique when using a metered-dose inhaler (MDI) for a resident?

Have the resident exhale, then inhale slowly as the MDI is actuated (Correct answer)
Have the resident hold their breath for only 1 second after inhalation
Use the MDI immediately after opening without priming
Shake the MDI, then actuate it directly into the resident's mouth without instructions

Correct answer: Have the resident exhale, then inhale slowly as the MDI is actuated

The resident should exhale first to empty the lungs, then inhale slowly and deeply during actuation to maximize drug deposition in the airways.

Question 4: A medication order reads: ibuprofen 400 mg PO q8h. How many milligrams will the resident receive in 24 hours?

800 mg
400 mg
1,600 mg
1,200 mg (Correct answer)

Correct answer: 1,200 mg

q8h means every 8 hours = 3 doses/day; 400 mg × 3 = 1,200 mg.

Question 5: According to DEA regulations, which schedule of controlled substances has the highest potential for abuse with no accepted medical use in the United States?

Schedule II
Schedule IV
Schedule I (Correct answer)
Schedule III

Correct answer: Schedule I

Schedule I substances (e.g., heroin, LSD) are classified as having the highest abuse potential and no currently accepted medical use.

Question 6: A resident has a new order for an antipsychotic medication. Before administering the first dose, the Certified Medication Technician (CMT) must ensure which of the following is completed?

A family member has been notified of the new medication.
The resident's vital signs have been taken within the last hour.
The medication has been added to the automated dispensing machine.
Informed consent for the medication has been obtained and documented. (Correct answer)

Correct answer: Informed consent for the medication has been obtained and documented.

Informed consent is a critical patient right. Before administering psychotropic medications, the patient or their legal representative must be educated about the medication's purpose, risks, benefits, and alternatives, and they must agree to the treatment. This consent must be properly documented.

Question 7: Which medication form should NEVER be crushed?

Effervescent tablets
Chewable tablets
Immediate-release tablets
Enteric-coated tablets (Correct answer)

Correct answer: Enteric-coated tablets

Enteric-coated tablets have a protective coating to prevent stomach irritation or to release the drug in the intestine; crushing destroys this coating.

Question 8: What is the correct technique for administering a sublingual tablet?

Dissolve it in water first, then drink
Swallow it with a full glass of water
Chew it thoroughly before swallowing
Place it under the tongue and allow it to dissolve (Correct answer)

Correct answer: Place it under the tongue and allow it to dissolve

Sublingual tablets are placed under the tongue where they dissolve and are rapidly absorbed into the bloodstream.

Question 9: A supervising nurse asks the medication technician to sign the MAR for a medication the nurse administered. What should the technician do?

Sign it and add a note that the nurse gave it
Ask a coworker to sign instead
Sign it to help the nurse save time
Refuse, because signing for something you did not do is falsification (Correct answer)

Correct answer: Refuse, because signing for something you did not do is falsification

Signing for a medication you did not administer is considered falsification of a medical record, which is illegal and grounds for termination.

Question 10: A CMT makes an incorrect entry on a resident's paper Medication Administration Record (MAR). What is the legally acceptable method for correcting this error?

Report the error to the nurse and ask them to start a new MAR page for the resident.
Draw a single line through the incorrect entry, write 'error' or 'mistaken entry,' and add the CMT's initials and the date. (Correct answer)
Use correction fluid to completely cover the incorrect entry and write over it.
Heavily black out the error with a marker to make it unreadable and document nearby.

Correct answer: Draw a single line through the incorrect entry, write 'error' or 'mistaken entry,' and add the CMT's initials and the date.

The standard and legal procedure for correcting an error in a paper medical record is to draw a single line through the entry so it remains legible, label it as an error, and then initial and date the correction. This maintains the integrity and transparency of the legal document.

Question 11: What is the purpose of a medication reconciliation process?

To dispose of expired medications safely
To decide which medications to discontinue based on cost
To train new CMTs on drug names
To compare a resident's current medication list against new orders to prevent discrepancies (Correct answer)

Correct answer: To compare a resident's current medication list against new orders to prevent discrepancies

Medication reconciliation compares all medication orders against the resident's known list to catch omissions, duplications, or errors during transitions of care.

Question 12: A resident has difficulty swallowing and has an order for a medication in tablet form. Before crushing the tablet, what is the MOST important action for the CMT to take?

Check with the pharmacist or a licensed nurse to ensure the medication can be safely crushed. (Correct answer)
Use a pill splitter to make the pieces smaller for the resident to swallow.
Document on the Medication Administration Record (MAR) that the tablet was crushed.
Mix the crushed tablet in the resident's favorite food, like pudding or applesauce.

Correct answer: Check with the pharmacist or a licensed nurse to ensure the medication can be safely crushed.

Not all medications can be crushed. Crushing certain medications, such as extended-release, sustained-release, or enteric-coated tablets, can alter their properties, leading to a rapid release of the drug and potential overdose or adverse effects. It is essential to verify with a pharmacist or nurse if a medication is safe to crush.

Question 13: A medication technician notices a bruise on a resident that was not previously documented. What is the required action?

Inform the supervising nurse and document the finding immediately (Correct answer)
Assume it is from normal aging and continue with medication pass
Ask other residents if they saw what happened
Wait to see if more bruises appear before reporting

Correct answer: Inform the supervising nurse and document the finding immediately

Any unexplained injury must be reported to the nurse immediately and documented to protect the resident and fulfill mandatory reporting obligations.

Question 14: What should be done if a medication is dropped on the floor?

Wipe it off and give it to the patient.
Continue using the medication after inspecting it.
Dispose of the medication and obtain a new dose. (Correct answer)
Use it only if the packaging is undamaged.

Correct answer: Dispose of the medication and obtain a new dose.

Medications dropped on the floor are considered contaminated and unsafe for administration, regardless of whether the packaging appears intact. Disposing of the medication and obtaining a new dose is essential to prevent the risk of infection or ingesting foreign particles. This protocol upholds strict hygiene and safety standards in medication administration.

Question 15: Which ethical principle supports a CMT's obligation to keep a resident's medication information confidential?

Autonomy
Beneficence
Fidelity (Correct answer)
Veracity

Correct answer: Fidelity

Fidelity refers to faithfulness and keeping one's obligations, including the duty to maintain confidentiality of resident health information.

Question 16: Which of the following is an example of a drug's agonist effect?

A drug blocking a receptor.
A drug binding to a receptor and causing a response. (Correct answer)
A drug that neutralizes the effect of another drug.
A drug preventing the absorption of a nutrient.

Correct answer: A drug binding to a receptor and causing a response.

An agonist drug is defined by its ability to bind to a specific receptor in the body and activate it, thereby producing a physiological response. This action mimics the effect of a natural substance, leading to the desired therapeutic outcome. Therefore, a drug binding to a receptor and causing a response is the direct definition of an agonist effect.

Question 17: What is the main purpose of maintaining an audit trail for controlled substances in a healthcare facility?

To determine which nurses work the most shifts
To record patient preferences for specific medications
To schedule patient medication refills automatically
To document all access, transactions, and discrepancies for accountability and investigation (Correct answer)

Correct answer: To document all access, transactions, and discrepancies for accountability and investigation

An audit trail creates a chronological, tamper-evident record of every controlled substance transaction that supports regulatory compliance, investigations, and accountability.

Question 18: What is the correct procedure when a medication technician cannot locate a resident's regularly scheduled medication?

Notify the charge nurse and contact the pharmacy for an emergency supply (Correct answer)
Borrow a dose from another resident's supply
Skip the dose and document it as not available
Administer a similar medication from the facility stock

Correct answer: Notify the charge nurse and contact the pharmacy for an emergency supply

When a medication is unavailable, the charge nurse must be notified and the pharmacy contacted to obtain the medication through proper channels.

Question 19: What is the role of the CMT in medication storage and handling?

Store medications in accordance with manufacturer guidelines. (Correct answer)
Mix medications for efficiency.
Keep medications in the patient's room.
Store medications anywhere convenient.

Correct answer: Store medications in accordance with manufacturer guidelines.

Proper medication storage is critical for maintaining the drug's efficacy, stability, and safety. Manufacturer guidelines specify conditions like temperature, light, and humidity to prevent degradation. Following these guidelines ensures the medication remains effective and safe for the patient, protecting them from potentially harmful or ineffective doses.

Question 20: After administering an oral medication to a resident who is in isolation for a Clostridioides difficile (C. diff) infection, what is the required method for hand hygiene?

No hand hygiene is needed if gloves were worn correctly.
Use an alcohol-based hand sanitizer thoroughly.
Washing hands vigorously with soap and water. (Correct answer)
Wiping hands with a disinfectant cloth from the isolation cart.

Correct answer: Washing hands vigorously with soap and water.

C. difficile forms spores that are resistant to alcohol-based hand sanitizers. The CDC recommends vigorously washing hands with soap and water, as the friction helps to physically remove the spores.

Question 21: A care plan notes that a resident has a new swallowing difficulty. How does this affect documentation?

Only the nurse is required to document swallowing-related observations
The technician should stop all oral medications without further documentation
No change to documentation is needed since swallowing is a nursing concern
The technician must document that the medication was given with the modified method and resident tolerated it (Correct answer)

Correct answer: The technician must document that the medication was given with the modified method and resident tolerated it

When a care plan modification exists, the medication technician must document adherence to the modified protocol and the resident's response.

Question 22: Which of the following is the MOST accurate description of an incident report's purpose?

To assign blame to the staff member who made the error
To identify errors and near-misses so the facility can improve safety systems (Correct answer)
To notify the resident's insurance company of a billing change
To replace nursing notes when an adverse event occurs

Correct answer: To identify errors and near-misses so the facility can improve safety systems

Incident reports are quality improvement tools designed to analyze events and prevent recurrence, not to punish individuals.

Question 23: Under HIPAA, a medication technician may share a resident's medication information with:

The resident's neighbor who expressed concern
Local news media if there is a public health concern
Only those directly involved in the resident's care (Correct answer)
Any staff member who asks

Correct answer: Only those directly involved in the resident's care

HIPAA's minimum necessary standard restricts sharing of protected health information to those with a legitimate care-related need to know.

Question 24: Which of the following actions best protects a patient's right to privacy when administering medications?

Asking family members to verify the patient's identity
Announcing the medication name loudly so all staff are aware
Leaving the medication cup on the bedside table for later
Closing the room door or curtain before medication administration (Correct answer)

Correct answer: Closing the room door or curtain before medication administration

Closing the door or curtain during medication administration protects the patient's privacy and dignity.

Question 25: A resident develops sudden difficulty breathing, throat swelling, and low blood pressure after a new antibiotic injection. This presentation is most consistent with:

Drug tolerance
A mild allergic reaction
A common expected side effect
Anaphylaxis (Correct answer)

Correct answer: Anaphylaxis

The combination of respiratory distress, throat swelling, and hypotension is the classic presentation of anaphylaxis, a severe life-threatening allergic reaction.

Question 26: Which route of administration delivers medication directly into the muscle tissue?

Intravenous
Subcutaneous
Intradermal
Intramuscular (Correct answer)

Correct answer: Intramuscular

Intramuscular (IM) injections deliver medication directly into muscle tissue for faster absorption than subcutaneous routes.

Question 27: Which term refers to the movement of drugs within the body?

Pharmacokinetics (Correct answer)
Pharmacology
Pharmacotherapeutics
Pharmacodynamics

Correct answer: Pharmacokinetics

Pharmacokinetics refers to the study of how the body handles a drug, encompassing the processes of absorption, distribution, metabolism, and excretion (ADME). It describes the movement of drugs within the body over time, influencing how quickly and effectively a medication reaches its target site and is eliminated.

Question 28: When a patient refuses a scheduled controlled substance, the medication technician should:

Document the refusal in the MAR and notify the nurse (Correct answer)
Waste the medication without obtaining a witness
Save the dose in the medication cart for later
Administer it without consent to maintain the schedule

Correct answer: Document the refusal in the MAR and notify the nurse

Patient refusal must be documented accurately in the MAR and the nurse must be notified so clinical decisions can be made, while the medication must be wasted with a witness.

Question 29: What is the definition of an adverse drug reaction (ADR)?

An unintended, harmful response to a medication given at a normal dose (Correct answer)
A patient's refusal to take a medication
A desired therapeutic effect of a medication
A medication error caused by incorrect dosing

Correct answer: An unintended, harmful response to a medication given at a normal dose

An adverse drug reaction is an unintended and harmful response occurring at a normal therapeutic dose, distinguishing it from errors or intentional effects.

Question 30: 1 kilogram (kg) is equal to how many pounds (lb)?

3.0 lb
1.8 lb
2.2 lb (Correct answer)
4.4 lb

Correct answer: 2.2 lb

1 kg = 2.2 lb is the standard conversion used in clinical settings.

Question 31: Which action is required when a medication error occurs?

Assess the resident, notify the nurse, and complete an incident report (Correct answer)
Administer a corrective medication immediately
Wait to see if the resident shows symptoms before reporting
Correct the MAR and say nothing

Correct answer: Assess the resident, notify the nurse, and complete an incident report

A medication error requires immediate resident assessment, nurse notification, and completion of an incident report per facility policy.

Question 32: If a resident experiences a fall during the medication pass, what is the correct documentation sequence?

Finish the medication pass first, then report the fall at the end of the shift
Ensure resident safety, notify the nurse, complete an incident report, and document observations in the record (Correct answer)
Only document the fall if there is a visible injury
Ask the resident if they want the fall reported before documenting

Correct answer: Ensure resident safety, notify the nurse, complete an incident report, and document observations in the record

Resident safety is the first priority, followed by immediate nurse notification and concurrent incident reporting regardless of injury status.

Question 33: A resident signs a consent form but later verbally withdraws consent before the medication is given. The CMT should:

Ask the resident to sign a refusal form before stopping
Honor the verbal withdrawal and notify the nurse (Correct answer)
Administer the medication since the written consent is already on file
Consult the family before making a decision

Correct answer: Honor the verbal withdrawal and notify the nurse

Consent can be withdrawn at any time, and a verbal withdrawal immediately before administration must be honored; the CMT should then notify the nurse.

Question 34: An order reads: digoxin 0.125 mg daily. Available tablets are 125 mcg each. How many tablets should be given?

1 tablet (Correct answer)
2 tablets
0.5 tablet
4 tablets

Correct answer: 1 tablet

0.125 mg = 125 mcg; 125 mcg ÷ 125 mcg = 1 tablet.

Question 35: Which of the following medications must be stored in the refrigerator?

Multivitamins
Aspirin tablets
Insulin (Correct answer)
Ibuprofen tablets

Correct answer: Insulin

Insulin must be refrigerated at 36°F to 46°F (2°C to 8°C) until opened to preserve its potency.

Question 36: A resident is prescribed an oral suspension with a concentration of 125 mg/5 mL. The order is for 250 mg. How many milliliters (mL) should the CMT pour?

10 mL (Correct answer)
2.5 mL
5 mL
7.5 mL

Correct answer: 10 mL

Using the formula (Desired Dose / Dose on Hand) x Quantity = Amount to administer: (250 mg / 125 mg) x 5 mL = 10 mL. The CMT should administer 10 mL of the suspension to provide the correct 250 mg dose.

Question 37: A physician writes 'cap i PO qhs.' What does 'qhs' indicate?

Four times daily
Every night at bedtime (Correct answer)
Every hour
Every other day

Correct answer: Every night at bedtime

QHS means 'quaque hora somni,' indicating the medication should be taken every night at bedtime.

Question 38: What is the difference between a side effect and a toxic effect of a medication?

Side effects only occur with controlled substances
Toxic effects are always allergic reactions
Side effects are mild and expected at normal doses; toxic effects are dangerous and typically occur from excessive doses (Correct answer)
They are the same thing

Correct answer: Side effects are mild and expected at normal doses; toxic effects are dangerous and typically occur from excessive doses

Side effects are predictable, mild effects at therapeutic doses, while toxic effects are dangerous reactions from overdose or drug accumulation.

Question 39: What does the abbreviation 'NPO' mean in a medication order?

No prescription ordered
Nothing by mouth (Correct answer)
Notify physician only
Normal pain observation

Correct answer: Nothing by mouth

NPO stands for 'nil per os,' a Latin phrase meaning nothing by mouth, indicating the patient should not eat or drink.

Question 40: Which of the following is an example of the least restrictive environment principle in medication administration?

Requesting a court order to force medication compliance
Locking medications away from patient access at all times
Offering medication in different acceptable forms before considering other interventions (Correct answer)
Using physical restraints to administer medication to an uncooperative patient

Correct answer: Offering medication in different acceptable forms before considering other interventions

Trying alternative acceptable formulations (liquid vs. tablet) is a least-restrictive approach before escalating to more intrusive interventions.

Question 41: How many micrograms (mcg) are in 1 milligram (mg)?

10 mcg
1,000 mcg (Correct answer)
10,000 mcg
100 mcg

Correct answer: 1,000 mcg

1 mg = 1,000 mcg in the metric system.

Question 42: A resident is prescribed eye drops with the instruction '2 gtt O.D. q12h'. Which of the following correctly describes the administration of this medication?

Instill 2 drops in the left eye every 12 hours.
Instill 2 drops in the left ear every 12 hours.
Instill 2 drops in both eyes every 12 hours.
Instill 2 drops in the right eye every 12 hours. (Correct answer)

Correct answer: Instill 2 drops in the right eye every 12 hours.

In medical abbreviations, 'gtt' means drops, 'O.D.' (oculus dexter) means right eye, and 'q12h' means every 12 hours. Therefore, the instruction is to instill 2 drops in the right eye every 12 hours. 'O.S.' (oculus sinister) would indicate the left eye, and 'O.U.' (oculus uterque) would indicate both eyes.

Question 43: Which of the following is an example of an allergic reaction to a medication?

Increased urination from a diuretic
Hives (urticaria) after taking penicillin (Correct answer)
Drowsiness from an antihistamine
Dry mouth from an anticholinergic

Correct answer: Hives (urticaria) after taking penicillin

Hives after penicillin represent an immune-mediated allergic reaction, which is a type of adverse drug reaction.

Question 44: What should a medication technician do if a resident shows signs of anaphylaxis after medication administration?

Wait to see if symptoms resolve on their own
Call 911 and notify the nurse immediately (Correct answer)
Administer another medication to counteract the reaction
Document the reaction and continue the medication schedule

Correct answer: Call 911 and notify the nurse immediately

Anaphylaxis is a life-threatening emergency requiring immediate activation of emergency services and nursing notification without delay.

Question 45: Nitroglycerin tablets should be stored in which type of container?

Original amber glass container (Correct answer)
Paper envelope
Clear plastic bag
Standard plastic prescription bottle

Correct answer: Original amber glass container

Nitroglycerin is highly sensitive to light, heat, and moisture and must remain in its original amber glass container to remain effective.

Question 46: Which right protects a long-term care resident from being discharged from a facility without proper notice and reason?

Right to refuse treatment
Right to a safe and adequate discharge with notice (Correct answer)
Right to privacy
Right to confidentiality

Correct answer: Right to a safe and adequate discharge with notice

Residents have the right to receive proper advance notice and a safe transfer plan before any involuntary discharge or transfer.

Question 47: Which of the following is NOT one of the 'Six Rights' of Medication Administration?

Right Cost (Correct answer)
Right Patient
Right Documentation
Right Dose

Correct answer: Right Cost

The 'Six Rights' of Medication Administration are a fundamental safety checklist for medication passers. They are: Right Patient, Right Medication, Right Dose, Right Time, Right Route, and Right Documentation. Right Cost is not part of this essential safety check.

Question 48: When a patient is unable to swallow tablets, which action requires nurse or physician authorization before the medication technician proceeds?

Offering water to help the patient swallow
Reporting the swallowing difficulty to the nurse
Documenting the administration attempt
Crushing the tablet and mixing it with food or liquid (Correct answer)

Correct answer: Crushing the tablet and mixing it with food or liquid

Crushing medications alters the dosage form and requires specific authorization, as some medications must never be crushed.

Question 49: While preparing a resident's morning medications, a CMT notices that the medication order for a blood pressure drug includes the parameter to "hold if pulse is less than 60." The resident's pulse is 55 bpm. What is the CMT's most appropriate initial action?

Cut the pill in half to give a lower dose.
Ask the resident if they feel dizzy before giving the medication.
Administer the medication as ordered to maintain the schedule.
Hold the medication and immediately report the finding to the supervising nurse. (Correct answer)

Correct answer: Hold the medication and immediately report the finding to the supervising nurse.

When a prescribed medication has specific parameters for administration, such as vital sign measurements, the CMT must adhere to them strictly. A pulse of 55 is below the specified parameter of 60. The correct and safe action is to withhold the medication and report the vital sign and situation to the supervising nurse for further direction.

Question 50: A resident has difficulty swallowing tablets. Before crushing any medication, the medication technician should:

Switch to a different medication independently
Check with the nurse or pharmacist to confirm the medication is safe to crush (Correct answer)
Dissolve it in hot water
Crush it if it looks like a simple tablet

Correct answer: Check with the nurse or pharmacist to confirm the medication is safe to crush

Not all medications can be safely crushed; the nurse or pharmacist must verify before altering the dosage form.

Question 51: When wasting a partial dose of a controlled substance, what documentation is required?

Only the amount wasted needs to be recorded
The nurse completes all waste documentation without technician involvement
The amount wasted, the witness's signature, and the administering technician's signature (Correct answer)
Waste documentation is only required for Schedule II substances

Correct answer: The amount wasted, the witness's signature, and the administering technician's signature

Controlled substance waste must be witnessed and co-signed to verify the disposal and prevent diversion.

Question 52: What is the purpose of a drug's side effects?

To enhance the drug's primary effect.
To prevent the drug from working.
To cause unintended reactions in the body. (Correct answer)
To provide additional benefits.

Correct answer: To cause unintended reactions in the body.

Side effects are any effects of a drug other than the primary therapeutic effect for which it was administered. These are unintended and often undesirable reactions that can occur even when the medication is used correctly. While some side effects are mild, others can be severe and require medical attention.

Question 53: Which action by a medication technician violates the standard of safe medication storage?

Returning unused medications to the proper storage location
Keeping the medication cart locked when not in use
Storing medications at the required temperature per pharmacy instructions
Leaving the medication cart unlocked while stepping away to answer a call light (Correct answer)

Correct answer: Leaving the medication cart unlocked while stepping away to answer a call light

Medication carts must remain locked whenever the technician is not actively administering medications to prevent unauthorized access.

Question 54: Which of the following changes in a resident's condition MUST be reported and documented by a medication technician?

A visitor arriving during medication pass
The resident asking for an extra blanket
The resident preferring a different juice with their pills
New rash appearing shortly after medication administration (Correct answer)

Correct answer: New rash appearing shortly after medication administration

A new rash after medication administration is a potential adverse reaction that must be reported to the nurse and documented immediately.

Question 55: A patient tells the medication technician that another staff member took money from their wallet. What should the technician do?

Report the allegation immediately to the supervisor and follow facility policy (Correct answer)
Ignore it because the patient has dementia and may be confused
Confront the accused staff member directly
Ask other residents if they have noticed missing items

Correct answer: Report the allegation immediately to the supervisor and follow facility policy

All allegations of theft or financial exploitation must be reported to the supervisor immediately regardless of the patient's cognitive status.

Question 56: Which common side effects of opioid medications require close monitoring?

Constipation and respiratory depression (Correct answer)
Increased urination and elevated heart rate
Excessive salivation and diarrhea
Hypertension and hyperactivity

Correct answer: Constipation and respiratory depression

Opioids routinely cause constipation and, particularly at higher doses, can cause life-threatening respiratory depression requiring close monitoring.

Question 57: A CMT drops a resident's medication, which is still sealed in its unit-dose packaging, onto the floor of the resident's room. What is the correct action?

Pick up the medication, open it, and place the pill in a new, clean medication cup.
Administer the medication, as the packaging protected it from germs.
Pick it up, wipe the package with an alcohol pad, and administer the medication.
Discard the medication according to facility policy and obtain a new dose. (Correct answer)

Correct answer: Discard the medication according to facility policy and obtain a new dose.

The floor in a healthcare setting is always considered a highly contaminated surface. To prevent any risk of cross-contamination, the safest and most appropriate action is to discard the dropped medication, even if packaged, and retrieve a new one. This adheres to the principles of medical asepsis and patient safety.

Question 58: When using the 'seven rights' of medication administration, which right ensures the correct documentation is reviewed before giving a drug?

Right medication (Correct answer)
Right route
Right time
Right documentation

Correct answer: Right medication

The right medication right ensures the medication technician checks the label against the MAR to confirm the correct drug.

Question 59: Which group of side effects is characteristic of anticholinergic medications?

Dry mouth, urinary retention, constipation, and blurred vision (Correct answer)
Increased salivation and diarrhea
Nausea and vomiting only
Decreased heart rate and low blood pressure

Correct answer: Dry mouth, urinary retention, constipation, and blurred vision

Anticholinergic drugs block acetylcholine receptors, causing the classic ABCD effects: Anhidrosis, Blurred vision, Constipation/urinary retention, Dry mouth.

Question 60: Under HIPAA, which situation would be a violation of patient confidentiality by a medication technician?

Telling the charge nurse about a patient's allergic reaction
Reporting a medication error to the supervisor
Discussing a patient's medications with the patient's adult child without consent (Correct answer)
Documenting medication administration in the patient's chart

Correct answer: Discussing a patient's medications with the patient's adult child without consent

Sharing a patient's medication information with family members without the patient's explicit consent violates HIPAA privacy rules.

Question 61: What information should be included when reporting an adverse drug reaction?

Resident name, medication name and dose, time given, symptoms observed, and actions taken (Correct answer)
Only the medication name and symptoms
Only the resident's name
Nurse's name and medication name only

Correct answer: Resident name, medication name and dose, time given, symptoms observed, and actions taken

A complete ADR report documents the resident's name, medication details, timing, symptoms observed, and all actions taken to ensure continuity of care.

Question 62: A resident is ordered a medication 'PRN for pain'. What does the abbreviation 'PRN' mean?

Give immediately
At bedtime
As needed (Correct answer)
Give with meals

Correct answer: As needed

PRN is a medical abbreviation from the Latin phrase 'pro re nata,' which means 'as needed.' This indicates the medication should be administered only when the resident requires it for the specified condition, within the parameters of the order.

Question 63: Which of the following medications requires the CMT to check the resident's pulse before administration?

Vitamins
Stool softeners
Digoxin (a cardiac glycoside) (Correct answer)
Antacids

Correct answer: Digoxin (a cardiac glycoside)

Digoxin is held and the nurse notified if the apical pulse is below 60 bpm because it can further slow the heart rate.

Question 64: What is the primary responsibility of a Certified Medication Technician (CMT)?

To prescribe medications.
To diagnose medical conditions.
To administer medications as prescribed. (Correct answer)
To perform medical procedures.

Correct answer: To administer medications as prescribed.

A Certified Medication Technician (CMT) is specifically trained and authorized to administer medications to patients as prescribed by a licensed healthcare provider. Their primary responsibility focuses on the safe and accurate delivery of medications according to established protocols and physician orders. CMTs do not have the authority to prescribe, diagnose, or perform complex medical procedures.

Question 65: Which federal law established the requirement for child-resistant packaging for most medications?

Omnibus Budget Reconciliation Act
Federal Food, Drug, and Cosmetic Act
Drug Enforcement Administration Act
Poison Prevention Packaging Act (PPPA) (Correct answer)

Correct answer: Poison Prevention Packaging Act (PPPA)

The Poison Prevention Packaging Act (PPPA) of 1970 requires child-resistant closures on most prescription and over-the-counter medications.

Question 66: Which residents are at highest risk for adverse drug reactions?

Young healthy adults under 30
Elderly residents taking multiple medications with multiple medical conditions (Correct answer)
Children under 5 years old only
Residents taking only one medication

Correct answer: Elderly residents taking multiple medications with multiple medical conditions

Elderly residents face the highest ADR risk due to polypharmacy, age-related changes in drug metabolism, reduced kidney and liver function, and multiple comorbidities.

Question 67: A patient tells a medication technician they feel their nurse is not listening to their pain complaints. What is the best response?

Dismiss the concern and continue with the medication pass
Acknowledge the concern and encourage the patient to also speak with the charge nurse or use the grievance process (Correct answer)
Tell the patient the nurse is very busy and to be patient
Tell the patient to speak with the physician directly

Correct answer: Acknowledge the concern and encourage the patient to also speak with the charge nurse or use the grievance process

Patients have the right to voice grievances; the technician should validate the concern and inform the patient of appropriate channels, including the grievance process.

Question 68: A medication is labeled 250 mg per capsule. The order is for 0.75 g. How many capsules should be given?

3 capsules (Correct answer)
4 capsules
2 capsules
1 capsule

Correct answer: 3 capsules

0.75 g = 750 mg; 750 mg ÷ 250 mg = 3 capsules.

Question 69: A medication is labeled 'ac'. When should this medication be administered?

At bedtime
After meals
Every other day
Before meals (Correct answer)

Correct answer: Before meals

The abbreviation 'ac' (ante cibum) means before meals.

Question 70: Which of the following statements is the BEST example of objective documentation that a CMT should use in a resident's chart?

Resident was angry and uncooperative this morning.
Resident complained that his roommate is annoying.
Resident appears to be depressed today.
Resident ate 25% of his breakfast and stated, 'I have no appetite.' (Correct answer)

Correct answer: Resident ate 25% of his breakfast and stated, 'I have no appetite.'

Objective documentation includes factual, measurable, and observable information. Stating the percentage of a meal eaten is a measurable fact, and quoting the resident directly is reporting factual data. The other options are subjective interpretations or opinions of the resident's mood or behavior.

Question 71: The abbreviation 'pc' on a medication order means the drug should be given:

As needed
After meals (Correct answer)
At bedtime
Before meals

Correct answer: After meals

PC (post cibum) is Latin for 'after meals.'

Question 72: When administering a sublingual medication, the Certified Medication Technician should place the tablet:

Between the cheek and gum
Under the tongue (Correct answer)
On top of the tongue to be swallowed with water
In a nasogastric tube

Correct answer: Under the tongue

The sublingual (SL) route involves placing medication under the tongue where it dissolves and is absorbed rapidly into the bloodstream through the mucous membranes.

Question 73: When transporting medications to a resident's room, what is the correct procedure?

Leave medications on the cart while attending to other tasks
Transport only one resident's medications at a time in a covered container (Correct answer)
Allow the resident to retrieve their own medications from the cart
Carry multiple residents' medications together to save trips

Correct answer: Transport only one resident's medications at a time in a covered container

Medications must be transported for one resident at a time in a covered container to prevent mix-ups and maintain security.

Question 74: What does the prefix 'brady-' mean in medical terminology?

Painful
Fast
Large
Slow (Correct answer)

Correct answer: Slow

Brady- means slow, as seen in bradycardia (slow heart rate) and bradypnea (slow breathing).

Question 75: Which of the following is a clinically significant drug-food interaction?

Taking a multivitamin with breakfast
Taking an antacid between meals
Taking warfarin while consuming large amounts of leafy green vegetables daily (Correct answer)
Taking aspirin with a full glass of water

Correct answer: Taking warfarin while consuming large amounts of leafy green vegetables daily

Vitamin K found in leafy greens can significantly reduce warfarin's anticoagulant effect, making consistent dietary vitamin K intake critical for stable INR levels.

Question 76: A resident asks a medication technician for a copy of their medical records. How should the technician respond?

Tell the patient that records are only available to physicians
Provide the records immediately from the chart
Deny the request to protect other patients' information in the chart
Inform the patient of their right to request records and direct them to the appropriate person or department (Correct answer)

Correct answer: Inform the patient of their right to request records and direct them to the appropriate person or department

Patients have a legal right to access their medical records; the technician should acknowledge this right and direct the patient to the appropriate person.

Question 77: Under the Controlled Substances Act, Schedule II medications require:

A written prescription and strict documentation of waste (Correct answer)
The same handling procedures as OTC medications
Only a verbal order from the physician
No special documentation if administered in a nursing facility

Correct answer: A written prescription and strict documentation of waste

Schedule II controlled substances require a written prescription and detailed documentation including witness signatures when any portion is wasted.

Question 78: A medication technician observes a coworker giving a patient medication that is not on the patient's medication administration record (MAR). What should the technician do?

Assume the coworker has verbal orders and continue working
Ask the coworker to stop after the shift ends
Report the observation to the supervising nurse immediately (Correct answer)
Tell the patient's family about the incident

Correct answer: Report the observation to the supervising nurse immediately

Administering medications not documented on the MAR is a safety violation that must be reported to the supervising nurse immediately.

Question 79: What is the primary function of pharmacodynamics?

The drug's storage in the body.
The body's ability to metabolize the drug.
The drug's effect on the body. (Correct answer)
The drug's absorption rate.

Correct answer: The drug's effect on the body.

Pharmacodynamics is the study of how a drug interacts with the body to produce its effects. It encompasses the mechanisms of action, the therapeutic effects, and any adverse effects of the medication. Essentially, it describes what the drug does to the body at a cellular and systemic level.

Question 80: A CMT notices a blister pack has two tablets missing but the MAR shows only one was given yesterday. What should the CMT do?

Report the discrepancy to the nurse or supervisor immediately (Correct answer)
Assume a count error and move on
Take the extra tablet back from the resident
Document nothing since it is only one tablet

Correct answer: Report the discrepancy to the nurse or supervisor immediately

Any medication count discrepancy must be reported immediately to the supervising nurse, as it could indicate diversion or a documentation error.

Question 81: What is the significance of a drug's therapeutic index?

It measures how long the drug remains active.
It tracks how quickly the drug is absorbed.
It indicates the drug's safety margin. (Correct answer)
It determines the drug's shelf life.

Correct answer: It indicates the drug's safety margin.

The therapeutic index is a critical measure that compares the dose of a drug that produces a therapeutic effect to the dose that causes toxicity. A higher therapeutic index indicates a wider margin between the effective dose and the toxic dose, signifying a safer drug. Thus, it directly reflects the drug's safety margin, guiding appropriate dosing to maximize benefits while minimizing risks.

Question 82: Which action is MOST important when administering eye drops to a resident?

Pull down the lower eyelid to create a conjunctival sac (Correct answer)
Use the same dropper for both eyes without cleaning
Ask the resident to squeeze their eyes shut immediately
Drop the medication directly onto the cornea

Correct answer: Pull down the lower eyelid to create a conjunctival sac

Pulling down the lower eyelid creates the conjunctival sac, the correct target for ophthalmic drops to avoid corneal damage.

Question 83: What is the difference between a generic drug and a brand-name drug?

Generic drugs are more expensive than brand-name drugs.
Generic drugs have the same chemical composition and effect as brand-name drugs. (Correct answer)
Generic drugs are made with different ingredients.
Generic drugs are not as effective as brand-name drugs.

Correct answer: Generic drugs have the same chemical composition and effect as brand-name drugs.

Generic drugs are required by regulatory bodies to be bioequivalent to their brand-name counterparts. This means they contain the same active pharmaceutical ingredient, in the same dosage form, and are identical in strength, route of administration, quality, and intended use. Consequently, generic drugs produce the same therapeutic effect as brand-name drugs, offering a cost-effective alternative.

Question 84: A resident is prescribed an oral tablet to be taken once daily. The process by which the tablet is broken down in the liver into a form that can be eliminated from the body is known as:

Metabolism (Correct answer)
Excretion
Distribution
Absorption

Correct answer: Metabolism

Metabolism, also called biotransformation, is the process where the body, primarily the liver, chemically alters a drug to make it easier to excrete. Absorption is the drug entering the bloodstream, distribution is its movement throughout the body, and excretion is its removal.

Question 85: What should you do if a patient shows signs of a medication overdose?

Administer an antidote.
Stop the medication and contact a healthcare provider immediately. (Correct answer)
Wait for the symptoms to subside.
Give the patient more of the same medication.

Correct answer: Stop the medication and contact a healthcare provider immediately.

If a patient shows signs of a medication overdose, the immediate priority is to stop the medication to prevent further exposure and potential harm. Following this, it is crucial to contact a healthcare provider or emergency services immediately for professional assessment and intervention. Prompt action can be life-saving in an overdose situation.

Question 86: A resident taking a loop diuretic complains of muscle cramps and weakness. This may indicate:

A normal expected response with no concern
A medication allergy requiring immediate drug discontinuation
Normal muscle fatigue from daily activity
Electrolyte imbalance, particularly low potassium (hypokalemia) (Correct answer)

Correct answer: Electrolyte imbalance, particularly low potassium (hypokalemia)

Loop diuretics like furosemide can deplete potassium, causing hypokalemia, which manifests as muscle cramps, weakness, and potentially dangerous cardiac arrhythmias.

Question 87: During a medication pass, a resident's family member pulls the CMT aside and asks for the names and purposes of all the medications their loved one is taking. How should the CMT respond to protect the resident's rights?

Ask the resident for permission in front of the family member before sharing the information.
Refer the family member to the supervising nurse to discuss information sharing, in accordance with HIPAA and facility policy. (Correct answer)
Tell the family member they are not allowed to have that information.
Provide a complete list of the medications and their uses to the family member.

Correct answer: Refer the family member to the supervising nurse to discuss information sharing, in accordance with HIPAA and facility policy.

Under the Health Insurance Portability and Accountability Act (HIPAA), a patient's health information is protected. A CMT cannot disclose this information without the patient's consent or as permitted by law. The appropriate action is to refer the family member to the licensed nurse, who can verify if a release of information is on file and handle the request according to legal and facility guidelines.

Question 88: A CMT is administering a new medication to a resident. The resident suddenly develops hives and difficulty breathing. This type of reaction is best described as:

A toxic effect
A side effect
An adverse event
An allergic reaction (Correct answer)

Correct answer: An allergic reaction

An allergic reaction involves an immune system response to a medication and can range from mild (like hives) to severe and life-threatening (like difficulty breathing). Side effects are known, predictable reactions that do not involve the immune system.

Question 89: What is a drug-drug interaction?

A patient's ability to swallow different pill sizes
The process of a drug being metabolized in the liver
A scheduled medication administration time
When one medication alters the effectiveness, metabolism, or toxicity of another medication (Correct answer)

Correct answer: When one medication alters the effectiveness, metabolism, or toxicity of another medication

A drug-drug interaction occurs when one medication alters how another medication works, either increasing its effect, reducing its effect, or causing new harmful effects.

Question 90: A CMT discovers they administered a medication to the wrong resident. After ensuring the immediate safety of both residents involved, what is the CMT's next critical responsibility?

Report the medication error to the supervising nurse immediately. (Correct answer)
Ask the other residents not to say anything about the mistake.
Complete another resident's medication pass to stay on schedule.
Wait until the end of the shift to see if any adverse effects occur.

Correct answer: Report the medication error to the supervising nurse immediately.

Patient safety is the highest priority. After a medication error occurs, it must be reported immediately to the supervising nurse or appropriate authority. This allows for prompt assessment of the patient who received the wrong medication and the patient who missed their dose, and for the initiation of corrective actions and proper documentation.

Question 91: Which of the following actions by a CMT best demonstrates the principle of medical asepsis?

Requiring all residents to wear a mask during medication pass.
Sterilizing all medication cups in an autoclave before use.
Using sterile gloves to administer oral medications.
Washing hands before preparing each resident's medications. (Correct answer)

Correct answer: Washing hands before preparing each resident's medications.

Medical asepsis, or clean technique, involves practices that reduce the number of microorganisms and prevent their spread. Handwashing is a cornerstone of medical asepsis. Sterilizing items (autoclave) and using sterile gloves for a non-sterile procedure are components of surgical asepsis, which is a higher level of infection control.

Question 92: Which safety practice helps prevent medication errors related to look-alike or sound-alike drug names?

Memorizing which medications look similar
Reading the medication label three times: before, during, and after preparation (Correct answer)
Grouping similar-looking medications together for easy access
Relying on the pharmacist to catch errors before dispensing

Correct answer: Reading the medication label three times: before, during, and after preparation

The three-check rule — verifying the label before, during, and after preparation — is a standard safety practice to prevent errors with look-alike or sound-alike drugs.

Question 93: What is a 'black box warning' on a medication label?

A reminder that the medication is a controlled substance
A label indicating the medication requires refrigeration
The FDA's strongest warning about serious or life-threatening risks (Correct answer)
A standard dosing reminder

Correct answer: The FDA's strongest warning about serious or life-threatening risks

A black box warning is the FDA's most severe safety alert, indicating the medication carries serious or potentially life-threatening risks.

Question 94: Which of the following identifies a patient's right related to participation in their own care plan?

Patients have the right to participate in planning their own care and to be informed of changes (Correct answer)
Family members determine the care plan for all residents over age 65
Care plans are developed solely by the interdisciplinary team without patient input
Patients are informed of the care plan only after it is finalized

Correct answer: Patients have the right to participate in planning their own care and to be informed of changes

Patients and residents have the federally protected right to participate in developing and revising their care plans.

Question 95: Which schedule of controlled substances has the highest potential for abuse and no accepted medical use in the United States?

Schedule III
Schedule IV
Schedule I (Correct answer)
Schedule II

Correct answer: Schedule I

Schedule I drugs have the highest abuse potential and no currently accepted medical use, making them illegal for most purposes.

Question 96: In the chain of infection, a contaminated medication cart surface is considered which of the following?

Portal of entry
Susceptible host
Reservoir
Fomite (Correct answer)

Correct answer: Fomite

A fomite is an inanimate object or surface that can become contaminated with infectious agents and serve as a vehicle for transmission. The medication cart surface, if contaminated, can transfer pathogens to the CMT's hands and then to a resident.

Question 97: How should a medication technician respond when a resident refuses their medication?

Document the refusal, report to the nurse, and respect the resident's right to refuse (Correct answer)
Skip documenting if the resident seems calm and cooperative otherwise
Administer it anyway since it is prescribed by the physician
Crush and hide the medication in food without informing the resident

Correct answer: Document the refusal, report to the nurse, and respect the resident's right to refuse

Residents have a legal and ethical right to refuse medications; refusals must always be documented on the MAR and reported to the nurse for follow-up.

Question 98: What should you check before administering medication to ensure patient safety?

Only check the patient's allergies.
Check the patient's name and ID.
Check the medication's expiration date.
Both the patient's ID and the medication's details. (Correct answer)

Correct answer: Both the patient's ID and the medication's details.

To ensure patient safety, it is critical to perform multiple checks before administering medication. This includes verifying the patient's identity using at least two identifiers (e.g., name and date of birth) and meticulously checking the medication's label against the order for the correct drug, dose, route, and expiration date. These steps are part of the 'rights of medication administration' and help prevent errors.

Question 99: What action should a medication technician take if they discover that a scheduled medication was not given to a patient during a previous shift?

Administer a double dose to make up for the missed one
Document that the medication was given to keep the MAR accurate
Skip the next dose to balance the schedule
Report the omission to the nurse and document it; do not give both doses (Correct answer)

Correct answer: Report the omission to the nurse and document it; do not give both doses

Missed doses should never be doubled; the omission must be reported to the nurse and accurately documented on the MAR.

Question 100: What does 'QOD' or 'Q2D' mean on a medication order?

Every other day (Correct answer)
Every two hours
Every day
Four times a day

Correct answer: Every other day

QOD means every other day, though this abbreviation is on the ISMP error-prone list and should ideally be written out.

Certified Medication Technician (CMT) Exam

This exam assesses the knowledge and skills required for safe and accurate medication administration by certified medication technicians.

100

Questions

120 min

Time Limit

80%

To Pass

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