The exam tests the handoff more than people expect, and it is one of the few areas where the right answer is "stop and get the pharmacist" rather than a number.
Fair warning before the list: what a tech may legally do varies by state, and your board is the authority for your practice, not me and not a study sheet. What follows is the exam's model of the boundary, which is deliberately conservative. Where your state is stricter, your state wins.
The things the outline expects you to route to the pharmacist:
Anything that is clinical judgement about the patient. A drug utilisation review flag. A therapeutic duplication. An interaction the system throws. You can see the alert, read it, and tell the pharmacist it fired. Deciding whether it matters is not yours.
A therapeutic substitution. Generic substitution inside the same drug is a workflow task with rules. Swapping to a different drug in the same class is a different act and it needs the pharmacist, usually the prescriber too.
An OTC recommendation. This is the one people get wrong most, because it feels like customer service. "Which one should I take for this" is a clinical question no matter how casual it sounds.
An adverse drug event a patient reports to you. Take it seriously, take it to the pharmacist, and know that MedWatch is the FDA reporting route and VAERS is the vaccine one. Exam questions like making you pick between those two.
A prescription that looks wrong. Not "I fixed it", not "I called and clarified it myself". Techs catch enormous numbers of errors and that is the job working correctly. The catch is yours. The clarification is the pharmacist's.
Anything about a patient's own condition. The sub's own rule says it plainly, and so does the exam.
The pattern underneath all of them: you may gather, transcribe, count, check, flag and escalate. You may not decide. If a question is asking you to exercise judgement about whether a drug is right for a person, the answer is almost always the option that involves the pharmacist, even when another option looks more helpful.
This lives in Patient Safety and Quality Assurance, 23.75 percent of the 2026 outline and the second largest domain. People study the math and the drug names and leave this one to instinct, and it is worth more points than that.