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Exam Review

Key Facts: PTCB CSDP Exam

60

Total Questions

PTCB

1h 20m

Exam Time

PTCB

38%

Largest Domain Weight

DEA Requirements

$89

Exam Fee

PTCB

1 day

Initial DEA Theft Notice

Written notice within 1 business day; Form 106 within 45 days

ABC

Credential Type

Assessment-Based Certificate (no expiration)

The PTCB Controlled Substances Diversion Prevention (CSDP) Certificate is an Assessment-Based Certificate (ABC) — not a full certification — administered by PTCB. The exam consists of 60 multiple-choice questions across 4 domains in 1 hour 20 minutes with a passing scaled score of 300. The fee is $89. Eligibility requires an active CPhT credential plus completion of a PTCB-Recognized education program. DEA Requirements is the largest domain at 38%, followed by Diversion Prevention Program (30%), Surveillance and Investigation (23%), and Controlled Substance Diversion fundamentals (9%). It does not expire and counts toward Advanced CPhT.

Sample PTCB CSDP Practice Questions

Try these sample questions to review concepts for the PTCB CSDP exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 115+ question experience with AI tutoring.

1Which of the following is the BEST definition of controlled substance diversion in a pharmacy practice setting?
A.Returning expired controlled substances to the manufacturer
B.Transferring controlled substances from one DEA registrant to another using DEA Form 222
C.The illegal movement of legally manufactured controlled substances from a lawful purpose to an illicit one
D.Shifting a CII medication from a Pyxis cabinet to a vault for storage
Explanation: Diversion is defined as the unlawful redirection of legally produced controlled substances away from a lawful medical use toward an illicit purpose, typically by an employee with authorized access. ASHP, DEA, and state boards all use this functional definition because it captures both theft and substitution scenarios.
2A nurse on a med-surg unit has worked overtime for several weeks, frequently volunteers to administer PRN narcotics for other nurses' patients, and has been observed in the medication room when not assigned there. These findings are MOST consistent with which category of indicator?
A.Procedural compliance indicator
B.Behavioral indicator of possible diversion
C.Pharmacokinetic indicator
D.Inventory variance indicator
Explanation: Volunteering to administer narcotics for other nurses' patients, presence in the medication room when not assigned, and irregular hours are classic behavioral red flags for an impaired or diverting healthcare worker. Behavioral indicators are usually noticed before data analytics flag a pattern, which is why peer awareness is essential.
3Which of the following is the MOST significant patient-safety consequence of diversion by tampering or substitution of an injectable opioid?
A.Increased pharmacy purchasing costs
B.Patient receives subtherapeutic dose AND risk of bloodborne pathogen exposure
C.Increased ADC restocking workload for technicians
D.Slight delay in DEA Form 222 processing
Explanation: Tampering (e.g., withdrawing fentanyl and refilling the vial with saline) exposes patients to two harms: the patient receives no analgesia (subtherapeutic dose, leading to uncontrolled pain) and may be exposed to bloodborne pathogens such as HCV, HIV, and HBV from the diverter's used needle. Multiple U.S. outbreaks have been traced to this pattern.
4Which of the following is NOT typically considered a primary motivation for diversion by a healthcare worker?
A.Personal substance use disorder (self-use)
B.Financial gain through resale
C.Family member with addiction
D.Curiosity about the pharmacology of CII medications
Explanation: Diversion is driven primarily by personal addiction, financial profit (resale on the street), and supply for a friend or family member with a substance use disorder. Academic curiosity is not recognized in published frameworks (ASHP, NADDI) as a meaningful motivator.
5An organization that fails to detect and report ongoing diversion may face which combination of consequences?
A.Only internal disciplinary action against the employee
B.DEA civil monetary penalties, loss of registration, and possible criminal indictment of the corporate registrant
C.A simple written warning from the state board with no monetary impact
D.Loss of accreditation only, with no DEA involvement
Explanation: Federal Controlled Substances Act violations can result in DEA civil monetary penalties (per-violation fines), suspension or revocation of the institution's DEA registration, and criminal charges against the registrant for failure to maintain effective controls against diversion under 21 CFR 1301.71. Settlements in the millions have been reported.
6Which of the following physical signs is MOST suggestive of acute opioid intoxication in a coworker?
A.Mydriasis (dilated pupils) and tremor
B.Pinpoint pupils, drowsiness, and slurred speech
C.Diaphoresis with hypertension and agitation
D.Bilateral ankle edema and shortness of breath
Explanation: Opioid toxicity classically presents with miosis (pinpoint pupils), CNS depression (drowsiness, slurred speech), and respiratory depression. Mydriasis and agitation suggest stimulant intoxication or withdrawal, not opioid use.
7A pharmacy technician convicted of a felony involving controlled substances will MOST likely face which professional consequence?
A.A 90-day suspension only, after which licensure is automatically reinstated
B.Permanent disqualification from holding a DEA registration and likely revocation of state pharmacy technician licensure
C.A mandatory $500 fine with no impact on licensure
D.Mandatory transfer to a different pharmacy practice setting
Explanation: A felony controlled-substance conviction creates a federal disqualification from being associated with a DEA registrant under 21 USC 824 and triggers state board action that typically results in license revocation. PTCB also revokes certification for felony drug convictions.
8Which of the following is the BEST example of how diversion can directly contribute to a healthcare-associated infection outbreak?
A.A diverter switches one bottle of acetaminophen for ibuprofen on the shelf
B.A diverter withdraws fentanyl from a vial with a contaminated syringe and refills it with saline, returning it for patient use
C.A diverter takes a sealed bag of dextrose 5% from the IV room
D.A diverter signs out a controlled substance for a discharged patient and self-administers it at home
Explanation: Tampering by reusing a contaminated needle or syringe to refill a vial creates a direct pathogen exposure pathway to patients. The CDC has documented hepatitis C outbreaks involving multiple patients caused by tampering diverters; this is the canonical patient-harm scenario in CSDP literature.
9Which of the following statements BEST captures the scope of the diversion problem in U.S. healthcare?
A.Diversion is rare and limited to a few isolated outpatient pharmacies
B.Diversion occurs across all settings (hospital, ambulatory infusion, long-term care, retail) and at every step from procurement to waste
C.Diversion only occurs in pain clinics that prescribe high-dose opioids
D.Diversion is essentially eliminated by automated dispensing cabinets and no longer requires active surveillance
Explanation: Published surveys (Mayo, ASHP, Premier) consistently show diversion occurs across all settings and at every node of the medication-use process: ordering, receiving, storage, preparation, dispensing, administration, waste, and disposal. ADCs reduce, but do not eliminate, opportunity, which is why ongoing surveillance is required.
10Which of the following is the MOST appropriate FIRST step when a coworker is suspected of being impaired on duty?
A.Immediately call the police to make an arrest
B.Confront the coworker privately and ask if they are using drugs
C.Notify the immediate supervisor and follow the organization's established impaired-worker protocol
D.Ignore the behavior unless a patient is actively harmed
Explanation: Suspected impairment is a safety issue that must be escalated through the chain of command using the organization's documented impaired-worker (or 'fitness-for-duty') process. This protects patients, the suspected employee, and the integrity of any subsequent investigation.

About the PTCB CSDP Exam

PTCB Assessment-Based Certificate (ABC) for pharmacy technicians supporting controlled substance diversion prevention programs. The certificate validates knowledge of diversion identification (behavioral indicators, vulnerability points), prevention program design (ADC configuration, chain of custody, physical security, waste witnessing, just culture), DEA regulatory requirements (Forms 41/106/107/222, CSOS, EPCS, recordkeeping under 21 CFR), and surveillance and investigation processes (vault reconciliation, diversion analytics, evidence chain, fact-finding interviews). This is a Certificate (not a certification) — no post-nominal acronym, does not expire.

Exam sponsor: PTCB. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

60 questions

Time Limit

1 hour 30 minutes (1h 20m exam)

Passing Score

Scaled 300 (0-400)

Exam / Certification Fees

$89

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

9%

Controlled Substance Diversion

Definition, scope, motivations, consequences, impaired worker recognition, tampering outbreaks

30%

Controlled Substance Diversion Prevention Program

Vulnerability mapping, ADC controls, chain of custody, physical security, waste witnessing, just culture, EAP

38%

DEA Requirements

DEA Forms, CSOS, EPCS, registration and DEA number validation, biennial inventory, recordkeeping, robbery/theft response, restricted OTC and pseudoephedrine sales

23%

Surveillance and Investigation

Vault reconciliation, diversion analytics, product tampering signs, fraudulent prescription detection, evidence chain, fact-finding, for-cause drug testing, naloxone, RCA

Preparing for the PTCB CSDP Exam

What You Need to Know

  • Passing score: Scaled 300 (0-400)
  • Exam length: 60 questions
  • Time limit: 1 hour 30 minutes (1h 20m exam)
  • Exam / certification fees: $89 Official sources

Using Our Practice Resources

  • Work through all 115 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

PTCB CSDP: Suggested Study Strategy

1Master DEA Form purposes: 222 = Schedule II ordering (paper, being phased out for CSOS); 41 = pharmacy destruction of controlled substances (DEA-witnessed or via reverse distributor); 106 = theft/significant loss of controlled substances (written notice to DEA within 1 business day, Form 106 within 45 days); 107 = theft/loss of DEA listed chemicals such as pseudoephedrine (written report within 15 days)
2Know reporting timelines: written notice to your local DEA Diversion Field Office within 1 business day of discovering a theft or significant loss, with DEA Form 106 filed through the Theft/Loss Reporting system within 45 days of discovery; state board timelines vary (often 24-72 hours); biennial inventory at least every 2 years with no fixed federal calendar date; pharmacy DEA registration renewal every 3 years
3Understand ADC override analytics red flags: high frequency of overrides by single user, override outside care window, waste without witness, partial waste with no documentation, removal for discharged patients
4Distinguish just culture from punitive: just culture separates human error (console), at-risk behavior (coach), and reckless behavior (sanction). It supports reporting and learning while still holding individuals accountable for reckless conduct
5Know SUPPORT Act partial-fill expansion: pharmacist may partial-fill a Schedule II prescription at the request of patient or prescriber (≤30 days for the partial); remainder dispensed within 30 days of original Rx date

Frequently Asked Questions

Is the PTCB CSDP Certificate a certification?

No. PTCB classifies this as an Assessment-Based Certificate (ABC), not a certification. It does not award a post-nominal acronym after your name and does not expire. ABCs validate working knowledge in a focused practice area and count toward the Advanced CPhT (CPhT-Adv) credential, which requires four ABCs.

What are the eligibility requirements?

You need an active PTCB CPhT credential plus completion of a PTCB-Recognized Controlled Substances Diversion Prevention Education/Training Program. The PTCB-Recognized program is required — you cannot bypass it with experience alone. After completing the program, you can register for the exam and schedule with Pearson VUE (online-proctored or test center).

What is the most heavily weighted CSDP domain?

DEA Requirements is the largest domain at 38%. This domain emphasizes the DEA Forms (222 for Schedule II ordering, 41 for pharmacy destruction of controlled substances, 106 for theft or significant loss of controlled substances, 107 for theft or loss of listed chemicals such as pseudoephedrine), CSOS for electronic Schedule II ordering, EPCS for e-prescribing of controlled substances, biennial inventory requirements, recordkeeping under 21 CFR 1304, prescription rules under 21 CFR 1306 (including partial fills under the SUPPORT Act), and disposal under 21 CFR 1317.

What reporting timelines should I memorize?

Theft or significant loss of controlled substances requires written notice to your local DEA Diversion Field Office within ONE business day of discovery, followed by a completed DEA Form 106 filed through DEA's Theft/Loss Reporting system within 45 days of discovery. DEA Form 107 is a different form: it reports theft or loss of DEA listed chemicals such as pseudoephedrine, with an oral report as soon as practicable and a written report within 15 days. State board reporting timelines vary — most states require notification within 24-72 hours. Pharmacy DEA registration renews every 3 years, and a biennial inventory is required at least every 2 years, with no fixed federal calendar date.

How should I study for this exam?

Plan for 30-50 hours of study over 4-6 weeks (in addition to the required PTCB-Recognized education program). Focus heaviest on DEA Requirements (38%) and Diversion Prevention Program (30%) — together 68% of the exam. Master the DEA Form purposes and reporting timelines, ADC override pattern analytics, waste witnessing requirements, and the just-culture framework for investigation.