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Sig Codes Practice Test
25 PTCE-style questions, one at a time — just like exam day. Score and full explanations at the end. Free, no signup.
Sig codes are the shorthand of every prescription you will ever process, and misreading one changes a patient’s daily dose. These 25 questions drill the abbreviations you must translate on sight — bid, tid, qid, qhs, po, prn, ac, hs, and the rest — including the look-alike pairs that cause real dispensing errors. Each answer gives you the Latin origin and the plain-English meaning so the code sticks.
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Question 1 of 25.A prescription is written for "1 tab bid." How often should the patient take this medication?
Prefer to read? All 25 questions with answers
A prescription is written for "1 tab bid." How often should the patient take this medication?
- Once daily
- Three times daily
- Every other day
- Twice daily (correct answer)
The abbreviation "bid" comes from the Latin bis in die, meaning twice daily, so the patient takes one tablet two times each day. It should not be confused with "qod" (every other day) or "tid" (three times daily). Mixing up frequency abbreviations changes the total daily dose, which is why technicians must know them precisely.
What does the abbreviation "qid" on a prescription indicate?
- Four times daily (correct answer)
- Every 4 hours
- Every 4 days
- Once daily
"Qid" (quater in die) means four times daily, with doses generally spaced through the patient's waking hours. It is not the same as "q4h" (every 4 hours), which would produce six doses in a 24-hour period rather than four. Confusing qid with qd (once daily) is a classic error that would underdose the patient by 75 percent.
A sig reads "1 tab po ac." When should the patient take the medication?
- After meals
- In the morning
- Before meals (correct answer)
- At bedtime
"Ac" comes from the Latin ante cibum, meaning before meals; drugs like sucralfate and some oral diabetes agents are dosed this way so they start working as food arrives. Meal-timing codes are easy to swap, and reversing them can change how well a drug is absorbed or tolerated, so each abbreviation must be read carefully rather than guessed from context.
What does "pc" mean when it appears in a prescription sig?
- Before meals
- After meals (correct answer)
- With plenty of water
- At bedtime
"Pc" stands for post cibum, Latin for after meals, and is often used for drugs that are better tolerated with food already in the stomach. The most tempting wrong answer, "before meals," is the abbreviation "ac" — the exact opposite timing. Keeping the ac/pc pair straight matters because meal timing can change a drug's absorption and stomach tolerability.
A prescription for zolpidem reads "1 tab po hs prn." What does "hs" direct the patient to do?
- Take the tablet every hour
- Take the tablet at bedtime (correct answer)
- Take the tablet with food
- Take one half-strength tablet
"Hs" comes from hora somni, meaning at bedtime, which fits a sleep aid like zolpidem taken as needed. The distractor "half-strength" is exactly why ISMP lists "hs" as an error-prone abbreviation — the same letters have been misread as half-strength, so many prescribers now write out "at bedtime." It has nothing to do with hourly dosing or food.
What does the abbreviation "prn" mean on a prescription label?
- Take immediately
- Take at the same time every day
- Take before going to bed
- Take as needed (correct answer)
"Prn" comes from pro re nata, meaning as needed — the patient takes the drug only when the symptom (pain, nausea, anxiety) occurs, usually with a stated maximum frequency. It is not a scheduled daily direction, and "immediately" is the abbreviation "stat." A complete prn sig should also state the indication, such as "prn pain," so the patient knows when use is appropriate.
The route abbreviation "po" instructs the patient to take the medication by which route?
- Under the tongue
- Rectally
- By mouth (correct answer)
- Applied to the skin
"Po" stands for per os, Latin for by mouth, and is the most common route abbreviation on outpatient prescriptions. Several other short route codes look similar at a glance, so the route should always be verified against the dosage form being dispensed — a route error can make a drug ineffective or unsafe.
A prescription includes the route abbreviation "pr." What route of administration does this indicate?
- Rectally (correct answer)
- By mouth
- Vaginally
- In the right eye
"Pr" stands for per rectum, meaning the medication is administered rectally — the route used for suppositories and enema products. The distractor "vaginally" is the separate abbreviation "pv," and "in the right eye" plays on the eye abbreviation "od"; neither is related to "pr." Because a single letter separates several route codes, the route on the label must always be matched against the dosage form dispensed.
A tablet is prescribed with the route abbreviation "sl." How should the patient take it?
- Chew the tablet and swallow
- Dissolve the tablet under the tongue (correct answer)
- Swallow the tablet whole with water
- Insert the tablet rectally
"Sl" means sublingual: the tablet is placed under the tongue and allowed to dissolve, so the drug absorbs through the oral lining directly into the bloodstream. Swallowing is the tempting distractor, but sublingual tablets are formulated for absorption in the mouth — swallowed whole, some of these drugs are largely inactivated by the liver before reaching circulation. Chewing or rectal insertion is likewise wrong for a sublingual dosage form.
A prescription carries the route abbreviation "top." What does this direct the patient to do?
- Instill into the eye
- Take by mouth
- Insert vaginally
- Apply to the skin (correct answer)
"Top" means topically — the medication is applied to the skin over the affected area. Topical products such as creams and ointments are not made to sterile ophthalmic standards, so instilling one into the eye would be both incorrect and potentially harmful. The oral and vaginal routes have their own abbreviations (po and pv) and their own formulations.
In the sig "ii gtt od bid," what does "gtt" represent?
- Drop (correct answer)
- Gram
- Drachm (dram)
- Tablet
"Gtt" comes from the Latin gutta, meaning drop, so this sig calls for two drops in the right eye twice daily. The abbreviation appears almost exclusively on eye, ear, and oral-drop prescriptions. "Gram" is abbreviated "g" and "tablet" is "tab," so neither fits, and the dram is an old apothecary volume unit with a different symbol entirely.
A prescription sig reads "ut dict" (or "ud"). What should the pharmacy label tell the patient?
- Take once daily
- Use in the right ear
- Use as directed by the prescriber (correct answer)
- Take during the day only
"Ut dict" is short for the Latin ut dictum, meaning as directed — the prescriber has given the patient instructions verbally or on a separate schedule, as with tapering steroid packs. It is not a frequency, so "once daily" is wrong, and "ud" should not be confused with ear abbreviations like "ad." Because "as directed" alone gives the pharmacy nothing to counsel from, staff should confirm the patient actually knows the intended directions.
How should the sig "i tab po bid pc" be translated on the prescription label?
- Take 1 tablet by mouth twice daily before meals
- Take 2 tablets by mouth once daily with meals
- Take 1 tablet by mouth three times daily after meals
- Take 1 tablet by mouth twice daily after meals (correct answer)
Reading each element in order: "i tab" is one tablet, "po" is by mouth, "bid" is twice daily, and "pc" is after meals. The closest distractor swaps "pc" for its opposite, "ac" (before meals) — a single-letter difference that reverses the meal timing. The Roman numeral "i" indicates quantity per dose (one), not the number of daily doses.
How should the sig "ii gtts au tid" be interpreted?
- Instill 2 drops in the left ear three times daily
- Instill 2 drops in both ears three times daily (correct answer)
- Instill 3 drops in both ears twice daily
- Instill 2 drops in both eyes three times daily
"Au" refers to both ears, "ii gtts" is two drops, and "tid" is three times daily. The most tempting distractor is "both eyes," which is the abbreviation "ou" — the a-series (ad, as, au) refers to ears and the o-series (od, os, ou) to eyes. Because these pairs are so easily confused, ISMP lists them as error-prone and recommends writing out "each ear" or "each eye."
A nitroglycerin prescription reads "i tab sl prn chest pain." Which label direction is correct?
- Dissolve 1 tablet under the tongue as needed for chest pain (correct answer)
- Place 1 tablet between cheek and gum every morning
- Dissolve 1 tablet under the tongue at bedtime every night
- Swallow 1 tablet by mouth every day to prevent chest pain
"Sl" means sublingual (under the tongue) and "prn chest pain" means the tablet is used only when chest pain occurs — not on a daily schedule. The scheduled-daily distractors are wrong because prn is by definition as-needed dosing, and "between cheek and gum" describes the buccal route, a different placement. Translating both the route and the prn indication accurately is essential for a rescue medication.
How should the sig "1 cap po q8h x 10d" appear on the patient's label?
- Take 1 capsule by mouth every 8 hours for 10 doses
- Take 8 capsules by mouth daily for 10 days
- Take 1 capsule by mouth every 8 hours for 10 days (correct answer)
- Take 1 capsule by mouth every 10 hours for 8 days
"Q8h" means every 8 hours (three doses per day) and "x 10d" means for 10 days, a typical antibiotic course. The trap is misreading "x 10d" as 10 doses — the "d" stands for days, so the full course is 3 doses/day × 10 days = 30 capsules. The other options scramble the interval and duration numbers.
A prescription reads "1 tab po bid x 30 days." What quantity should be dispensed?
- 60 tablets (correct answer)
- 30 tablets
- 120 tablets
- 90 tablets
"Bid" means twice daily, so the patient uses 2 tablets per day; over 30 days that is 2 × 30 = 60 tablets. Answering 30 comes from misreading bid as once daily, and 90 would correspond to tid (three times daily). Matching the dispensed quantity to the sig and day supply is a routine technician check that also matters for insurance billing.
Amoxicillin 500 mg capsules are prescribed "1 cap po tid x 7d." How many capsules are needed to complete the course?
- 14 capsules
- 28 capsules
- 7 capsules
- 21 capsules (correct answer)
"Tid" means three times daily, so the daily use is 3 capsules; over 7 days the total is 3 × 7 = 21 capsules. Choosing 14 reflects misreading tid as bid (2 × 7), and 28 reflects qid (4 × 7). Dispensing the exact course quantity for an antibiotic helps the patient finish therapy without leftover doses.
An order is written as "insulin glargine 10U at bedtime." According to ISMP safety recommendations, why is this order dangerous as written?
- Glargine is a long-acting insulin, so bedtime administration is too late in the day
- The dose should have been expressed in milliliters of insulin rather than in units
- A handwritten "U" can be misread as a zero, so the dose could be given as 100 units (correct answer)
- The order does not name an injection site, which is required for insulin orders
The abbreviation "U" is on the ISMP error-prone list because a handwritten U can be mistaken for a zero or a four — "10U" read as "100" is a 10-fold insulin overdose that can cause severe hypoglycemia. The safe practice is to write out the word "units." Bedtime dosing of glargine is clinically routine, insulin is dosed in units rather than milliliters, and a missing injection site is handled by ordinary clarification — none of those is the safety issue ISMP highlights here.
Why does ISMP recommend against using the abbreviation "IU" (as in "vitamin D 5000 IU")?
- It can be confused with "IM," suggesting an intramuscular injection
- Handwritten, it can be mistaken for "IV" (intravenous) or the number 10 (correct answer)
- The abbreviation refers to an obsolete unit that the USP replaced with milligrams
- Different manufacturers define an international unit differently for the same drug
"IU" (international units) is on the ISMP error-prone abbreviation list because, handwritten, it can be mistaken for "IV" (intravenous) or the number 10 — either misreading could cause a serious administration error. The safe practice is to spell out "units." IU remains a current, substance-specific unit found on many oral vitamin products; it is unrelated to the IM route, and its definition for a given substance is standardized rather than manufacturer-dependent.
A pharmacist rejects a written order containing "Q.D." and asks the prescriber to rewrite it. What is the safety concern with "Q.D."?
- The period after the Q can make it look like "qid," four times daily (correct answer)
- "Q.D." is the Latin abbreviation for every other day, not once daily
- It can be confused with "q.s.," the abbreviation for a sufficient quantity
- It can be mistaken for "OD" and applied as a right-eye direction
"Q.D." (once daily) appears on both the ISMP error-prone list and the Joint Commission do-not-use list because the period after the Q, or a sloppy tail on the Q, can be read as an "i" — turning one dose a day into "qid," four times daily. The remedy is to write the word "daily." "Every other day" is "qod" (itself error-prone), "q.s." is a quantity notation rather than a frequency, and the right-eye confusion is documented for "OD," not "Q.D."
A prescriber writes "warfarin 1.0 mg daily." Why do safety guidelines prohibit writing the dose this way?
- "1.0 mg" can be misread as 0.1 mg, giving a 10-fold underdose
- Warfarin tablets are not manufactured in a 1 mg strength
- A missed decimal point can make "1.0 mg" read as 10 mg (correct answer)
- "1.0" can be confused with the Roman numeral "i" used for quantities
A trailing zero ("1.0 mg") is prohibited because a faint or missed decimal point turns the order into 10 mg — a 10-fold overdose that is especially dangerous with a narrow-therapeutic-index anticoagulant like warfarin. The correct form is simply "1 mg." The documented misreading runs upward to 10 mg, not down to 0.1 mg; warfarin does come in a 1 mg tablet; and Roman numerals in sigs denote quantities per dose, not strengths, so they are not the concern here.
An order reads "digoxin .125 mg po daily." What correction does safe medication practice require?
- Add a trailing zero so the dose reads ".1250 mg"
- Add a leading zero so the dose reads "0.125 mg" (correct answer)
- Write the strength as the fraction "1/8 mg"
- Shorten the frequency "daily" to "qd" on the order
A "naked" decimal (".125 mg") risks the decimal point being overlooked, so the order could be read as 125 mg — a thousand-fold overdose of digoxin. Safe practice places a leading zero before any dose less than one: "0.125 mg." Adding a trailing zero introduces a second error-prone element instead of fixing the first, apothecary-style fractions are not used for metric strengths, and "qd" is itself on the ISMP error-prone list — "daily" should stay written out.
Why are the abbreviations "MS" and "MSO4" on the ISMP error-prone list?
- "MS" can be misread as "mg," turning the drug name into a strength
- "MSO4" can be confused with "MTX," the shorthand for methotrexate
- The "4" in "MSO4" can be misread as a 4 mg dose
- They can mean either morphine sulfate or magnesium sulfate (correct answer)
"MS" and "MSO4" have historically been used for morphine sulfate, while "MgSO4" means magnesium sulfate — but readers confuse the abbreviations, and giving an opioid in place of an electrolyte (or vice versa) can be fatal. ISMP and the Joint Commission therefore require these drug names to be written out in full. The documented danger is this two-drug ambiguity, not confusion with "mg," with methotrexate shorthand, or with a numeric dose.
A hospital order is written as "give 5 cc of the suspension q12h." What is the recommended way to express this volume?
- 5 gtt
- 5 tsp
- 5 mL (correct answer)
- 5 grains
One cubic centimeter equals one milliliter, so the volume should be written "5 mL" — ISMP lists "cc" as error-prone because, handwritten, it can be mistaken for "u" (units) or misread as zeros. "Gtt" means drops and a grain is a unit of weight, so neither expresses this volume, and household units like teaspoons are discouraged for dosing accuracy even though 1 tsp nominally equals 5 mL.
FAQ: Sig Codes on the PTCE
Which sig codes should I know cold for the PTCE?
Frequencies (bid, tid, qid, q4h, qhs), routes (po, sl, pr, top), timing (ac, pc, hs, prn), and quantities (gtt for drops; i, ii, iii Roman numerals). Eye and ear abbreviations — od, os, ou for right, left, and both eyes; ad, as, au for the ears — still appear on real prescriptions even though safety groups discourage them, so you must recognize them on sight.
Why are some abbreviations on a "do not use" list?
Because they cause real errors: qd (daily) misread as qid (four times daily) quadruples a dose, and u (units) misread as a zero multiplies one by ten. ISMP publishes the error-prone abbreviation list, and many pharmacies ban those abbreviations internally — but technicians still have to translate them correctly when a prescriber uses one, which is exactly what this drill trains.
How do sig codes show up on the actual exam?
Inside the Order Entry and Processing domain, usually one of two ways: translate a full sig into plain patient directions, or combine the sig with a dispensed quantity to compute a days supply. Our 90-question simulator includes both styles so you can see them in exam context.
Are these questions taken from the real PTCE?
No. Real PTCE items are confidential and belong to PTCB — be wary of any site claiming to have them. Our questions are original, written to mirror the style, difficulty, and published content outline of the exam. Scoring well here is strong evidence you are ready, not a preview of the exact questions you will see.
Is this practice test really free?
Yes. Every question, explanation, and score report on PharmacyTechTest is free, with no signup, no credit card, and no trial that expires. Retake any test as many times as you want.
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