Dr. C's Comprehensive Review of Pharmacy Law for MPJE Preparation

Manuel is the pharmacist at a local chain pharmacy. Manuel and his pharmacy intern, Selena, are both authorized to provide immunizations. Which of the following vaccines would Selena be able to administer under the supervision of Manuel? Select all that apply.

A. HepA to a 24-month-old after receiving an order from a pediatrician

B. Influenza to a 10-year-old under a protocol

C. Varicella to a 19-year-old after receiving an order from a physician

D. Shingrix to a 50-year-old under a protocol

B. Influenza to a 10-year-old under a protocol

C. Varicella to a 19-year-old after receiving an order from a physician

D. Shingrix to a 50-year-old under a protocol

PA allows authorized pharmacists and interns (under the supervision of an authorized pharmacist) to administer any CDC-recommended vaccine but only to patients older than 18 years of age, except for influenza immunizations, which can be administered to patients 9 years of age and older. Administration may occur under an order or written protocol.

Manuel is a pharmacist that used to be authorized to administer immunizations. He allowed his authorization to lapse in 2022. Which of the following requirement(s) must Manuel meet to reactivate his authorization?

A. Complete the appropriate form provided by the PBOP

B. Complete the required 2 hours of related CE

C. A and B only

D. A, B, and C

D. A, B, and C

The PBOP requires a pharmacist who has had a lapsed authority for under 2 years and wants to reactivate it to complete a form provided by the PBOP and the required 2 hours of related CE. Authorization that has lapsed for 2 years or longer also requires the pharmacist to retake the required education

Which of the following drugs may be donated by a qualified donor to a pharmacy that is approved under the Cancer Drug Repository Program?

A. Arimidex (blister package)

B. Tramadol (unopened bottle)

C. VePesid (blister package)

D. Xanax (unit-dose package)

A. Arimidex (blister package)

The Pennsylvania Cancer Drug Repository Program allows approved pharmacies to accept eligible donated cancer drugs from approved donors. Eligible drugs include those in original unopened, sealed, and tamper-evident unit-dose packaging. Ineligible drugs include controlled substances and drugs that require refrigeration. Tramadol and Xanax are controlled (and not classified as a cancer drug), and VePesid is required to be stored under refrigeration

Which activities could be delegated to a pharmacy intern under the immediate supervision of a pharmacist? Select all that apply.

A. Take a verbal order from a prescriber's office

B. Counsel a patient on a medication

C. Compound medications

D. Final verification of product to be dispensed

A. Take a verbal order from a prescriber's office

C. Compound medications

Interns can take verbal orders and compound medications under the direct supervision of a pharmacist. Interns are not permitted to counsel patients or perform the final verification of a prescription

Which of the following OTC products is not required to be packaged in tamper-resistant packaging?

A. Cepacol throat lozenges

B. NyQuil liquid

C. Zaditor eye drops

D. Imodium caplets

A. Cepacol throat lozenges

Most OTC drugs are required to be packaged in tamper evident packaging. Exceptions exist for dermatologicals, dentifrices, insulin products, and lozenges

A community pharmacist receives a prescription for Lantus. Neither the prescriber nor the patient requests the brand to be dispensed. The pharmacy does stock Semglee. How should the pharmacist proceed with product substitution when dispensing this prescription?

A. The pharmacist is required to dispense Lantus

B. The pharmacist is required to dispense Semglee

C. The pharmacist may dispense Semglee, but notification to the prescriber would need to occur shortly after

D. The pharmacist would need to obtain a new prescription written for Semglee prior to dispensing it

C. The pharmacist may dispense Semglee, but notification to the prescriber would need to occur shortly after

When a pharmacist receives a prescription for a brand name biological product, they may substitute an interchangeable biologic unless requested otherwise by the purchaser or indicated by the prescriber. The pharmacist is to communicate to the prescriber within 72 hours the dispensing of an interchangeable product

Which of the following accurately describes the requirements for pharmacies to conduct an inventory of controlled substances?

A. Pharmacies are required to maintain a perpetual inventory of all controlled substances and must reconcile the perpetual inventory at least annually

B. Pharmacies are required to maintain a perpetual inventory of all Schedule II controlled substances and must reconcile the perpetual inventory at least annually and conduct a physical inventory for all Schedule III-V controlled substances biennially

C. Pharmacies may maintain a perpetual inventory of controlled substances but must take a physical inventory biennially

D. Pharmacies may maintain a perpetual inventory but must take a physical inventory of all Schedule II controlled substances biennially

C. Pharmacies may maintain a perpetual inventory of controlled substances but must take a physical inventory biennially

While many pharmacies maintain a perpetual inventory of controlled substances, there is no legal requirement to do so. State and federal laws only require a biennial inventory of all controlled substances

Which of the following are acceptable methods for storage of controlled substances in a pharmacy? Select all that apply.

A. Placing all controlled substances in a safe under lock and key

B. Placing all controlled substances in a secure cabinet that is locked

C. Placing Schedule II controlled substances in a safe and dispersing the Schedule III-V controlled substances on the pharmacy shelves throughout the non-controlled drugs

D. Dispersing all controlled substances on the pharmacy shelves throughout the non-controlled drugs

A. Placing all controlled substances in a safe under lock and key

B. Placing all controlled substances in a secure cabinet that is locked

C. Placing Schedule II controlled substances in a safe and dispersing the Schedule III-V controlled substances on the pharmacy shelves throughout the non-controlled drugs

D. Dispersing all controlled substances on the pharmacy shelves throughout the non-controlled drugs

All of these methods are considered acceptable security for controlled substances in a pharmacy under DEA rules

Pharmacist Suzy has a power of attorney to order Schedule II controlled substances at DrugsRUs Pharmacy and also has a CSOS Signing Certificate. After placing a CSOS order for several products, Suzy received a notification from the drug wholesaler that some of the required data fields were not completed and the order was rejected. What must Suzy do?

A. Immediately call the wholesaler and place a verbal emergency order for the products

B. Correct the order by filling in the missing data fields and resubmit the order

C. Electronically link the statement of nonacceptance to the original order and issue a new electronic order

D. Reorder the products using a paper DEA Form 222

C. Electronically link the statement of nonacceptance to the original order and issue a new electronic order

A defective CSOS order for a Schedule II controlled substance may not be corrected and reused. The purchaser must electronically link the statement of nonacceptance to the original order and would need to place a new order for the product. While the new order may be made using a paper DEA Form 222, it is not required

A pharmacist receives a prescription from a patient for escitalopram on May 15, 2023. It was ordered for a one-month supply with 11 refills. The prescription was issued by the prescriber on May 1, 2023. What day will any remaining refills on this prescription expire?

A. November 1, 2023

B. November 15, 2023

C. May 1, 2024

D. May 15, 2024

C. May 1, 2024

Refills for non-controlled substance medications expire one year from the data of the prescription

A pharmacist dispensed a prescription on the morning of May 1 for 60 pills of lorazepam with the instructions to take 1 tablet twice a day as needed. The patient paid cash for the medication, and there were 2 refills remaining. Which of the following dates would be considered an early refill request based on the PA PDMP definition? Select all that apply.

A. May 22

B. May 23

C. May 24

D. May 27

A. May 22

B. May 23

C. May 24

The PA PDMP denies an early refill as when the patient requests a refill prior to the date when they are eligible for insurance coverage, or when more than 15% of an earlier dispensed medication would remain when taken in compliance with the directions and quantity prescribed. For a cash patient for a 30-day supply, if more than 15% (4.5 days) remains, this would be considered an early refill request

A parenteral product in an institutional setting must be labeled with which of the following? Select all that apply.

A. Diluent used to make the product

B. Initials of the pharmacist that prepared it

C. Quantity of each ingredient

D. Manufacturer lot number for each ingredient used

A. Diluent used to make the product

B. Initials of the pharmacist that prepared it

C. Quantity of each ingredient

Drug order for parenteral products in an institution must include the patient name, the product ingredients (name, strength, quantity, diluent, expiration date), and the initials of the pharmacist. The pharmacy label is not required to have the manufacturer lot number for each ingredient on the label

Original prescriptions (or readily retrievable images of the original prescription) must be kept by the pharmacy for how long?

A. 2 years from the issuance date

B. 2 years from the most recent filling date

C. 3 years from the issuance date

D. 3 years from the most recent filling date

B. 2 years from the most recent filling date

Original prescriptions (or images of the prescriptions) must be kept for 2 years from the date of most recent filling

Regarding hypodermic needles and syringes, which statement is correct?

A. A patient must provide the pharmacy with a prescription to obtain any quantity of needles/syringes

B. A patient can obtain up to 10 needles/syringes from the pharmacy without a prescriptions; larger quantities require a prescription

C. A patient can obtain up to 50 needles/syringes from the pharmacy without a prescriptions; larger quantities require a prescription

D. A patient is not required to have a prescription to obtain needles/syringes from the pharmacy

D. A patient is not required to have a prescription to obtain needles/syringes from the pharmacy

Hypodermic needles and syringes are to be kept in and sold by the pharmacy, and can be dispensed without a prescription

How often does an Automated Medication System located in an LTCF have to be inspected for expired medications?

A. Weekly

B. Once every 2 weeks

C. Monthly

D. Once every 2 months

C. Monthly

Automated Medication Systems used in LTCF must be checked at least monthly for expired medications

Which statement is true regarding a pharmacy returning to stock and redistributing undelivered medications?

A. This medication is never permitted to be returned to the same stock bottle

B. The medication can be returned to the same stock bottle if it hasn't been longer than 2 weeks

C. The medication can be returned to the same stock bottle if it hasn't been longer than 1 month

D. The medication can only be returned to the same stock bottle if the pharmacy tracks the lot numbers and expiration dates of the medications

D. The medication can only be returned to the same stock bottle if the pharmacy tracks the lot numbers and expiration dates of the medications

According to the PBOP, the only safe manner that undelivered medications can be returned to stock bottles to be re-dispensed is when pharmacies track all medications by lot numbers and expiration dates

Which statement is correct regarding a pharmacist that has a moral opposition to dispensing certain prescriptions?

A. The PBOP prohibits pharmacists from declining to dispense medications on moral beliefs

B. The PBOP is silent on the topic and does not provide any guidance on the matter

C. The PBOP has guidance for pharmacists to follow when there are moral objections to dispensing certain products

D. The PBOP only permits pharmacists to deny dispensing any medications when the pharmacy has a state-approved policy in place

C. The PBOP has guidance for pharmacists to follow when there are moral objections to dispensing certain products

PBOP has guidance for pharmacists when one is religiously, morally, or ethically opposed to providing pharmaceutical services that would reasonably be expected to be provided by pharmacists meeting their needs of their patients. This guidance includes taking steps to avoid neglecting a patient, which may involve notifying the employer in advance, scheduling to avoid any conflicts, and/or having a protocol in place to address the situation if it occurs

What is the amount of liability insurance that a pharmacist must obtain and maintain to participate in collaborative drug therapy management?

A. There is no minimum amount required; having any amount is acceptable

B. $500,000 per occurrence

C. $1,000,000 per occurrence

D. $2,000,000 per occurrence

C. $1,000,000 per occurrence

For pharmacists to participate in drug therapy management activities, a minimum amount of one million dollars (per occurrence or claim made) of professional liability insurance coverage is required

Pharmacist Phil reciprocates his license to PA and becomes licensed as a pharmacist halfway through a licensure period. When it comes time to renew his pharmacist's license in PA, what is the total amount of continuing education hours he will have to account for?

A. 10

B. 15

C. 25

D. 30

B. 15

Pennsylvania requires 30 hours of CE every licensure period (2 years). Pharmacists transferring in are only required to obtain a prorated amount, or 3.75 CEs per quarter. Half a licensure period (1 year) would require a total of 15 hours

Central processing centers are exempt from which of the following PBOP requirements?

A. Maintaining a minimum inventory of at least $5,000

B. Minimum size requirements for pharmacies

C. Having a sink used specifically for pharmacy practice purposes

D. All the answers listed are correct

D. All the answers listed are correct

Central processing centers are exempt from all the requirements listed

Which of the following Pennsylvania-specific continuing education courses is the PBOP NOT permitted to waive for pharmacists licensed by exam for their first renewal? Select all that apply.

A. Patient safety

B. Immunizations

C. Child abuse recognition

D. Opioid practices

C. Child abuse recognition

D. Opioid practices

Pharmacists that applied for licensure by examination are exempt from completing the regular pharmacist CE requirements for their first license renewal. However, the PBOP is not permitted to waive the child abuse and opioid/pain management CE requirements as those are required under separate state laws

Pharmacist Meera receives a prescription for a patient from an optometrist that is written for #10 tablets of Vicodin 5/300, to take 1 tab q 6hr prn. Which statement is accurate regarding this prescription?

A. Meera can dispense the prescription to the patient as ordered

B. Meera can only dispense 8 tablets to the patient, and explain that the other 2 tablets must be forfeited

C. Meera is not permitted to dispense this medication to the patient

D. Meera should contact the prescriber and have the medication changed to tramadol

A. Meera can dispense the prescription to the patient as ordered

Optometrists certified to prescribe in PA are permitted to prescribe from a limited formulary that includes a few controlled substances for analgesic use. For hydrocodone combination products, up to a 72-hour supply can be prescribed

Which statement regarding electronic prescribing is correct?

A. Pennsylvania requires all controlled and non-controlled prescriptions to be electronically prescribed

B. Pennsylvania requires all controlled substance prescriptions to be electronically prescribed

C. Federal law requires all controlled and non-controlled prescriptions to be electronically prescribed

D. Federal law requires all controlled substance prescriptions to be electronically prescribed

B. Pennsylvania requires all controlled substance prescriptions to be electronically prescribed

Pennsylvania requires all controlled substance prescriptions to be electronically prescribed. There are limited exceptions to the rule, and prescribers can also request a temporary waiver from complying with the law

Pharmacist Bill was disciplined by the PBOP for not meeting his continuing education requirements. In addition to any disciplinary actions, within what time frame will Bill have to complete his missing CE hours?

A. 30 days

B. 60 days

C. 90 days

D. 6 months

D. 6 months

When CE requirements are not met, pharmacists can be disciplined. In addition, any missing CEs must be completed within 6 months from notification

Which USP Chapter must a 503a pharmacy comply with when compounding nonsterile products?

A. USP 795

B. USP 797

C. USP 2750

D. USP 2760

A. USP 795

503a pharmacies involved in nonsterile compounding must comply with USP 795

Which statement regarding a pharmacist obtaining CE is correct?

A. At least 5 hours of their CEs must be from live programs

B. At least 10 hours of their CEs must be from live programs

C. At least 15 hours of their CEs must be from live programs

D. There is no set number of live CE programs required

D. There is no set number of live CE programs required

Both live and correspondence courses will be accepted by the PBOP. There are no requirements for pharmacists to obtain a certain number of live courses

Which drug would not be considered substitutable regardless of the bioequivalency rating in the Orange Book? Select all that apply.

A. Levothyroxine

B. Theophylline

C. Warfarin

D. Amitriptyline

A. Levothyroxine

B. Theophylline

C. Warfarin

NTI drugs would not be considered substitutable even if A rated in the Orange Book

How often must a hospital's P&T committee meet?

A. Weekly

B. Twice a month

C. Monthly

D. Quarterly

D. Quarterly

Hospitals must have a pharmacy and therapeutics (P&T) committee which includes physicians, nurses, and pharmacists. The P&T committee must meet at least quarterly

Which statement is correct regarding Collaborative Practice Agreements?

A. They are voluntary and must be renewed at least once a year

B. They are voluntary and must be renewed at least once every 2 years

C. They are required by insurance companies and must be renewed once a year

D. They are required by insurance companies and must be renewed at least once every 2 years

B. They are voluntary and must be renewed at least once every 2 years

CPAs are voluntary and must be renewed at least once every 2 years

Sales of products containing dextromethorphan are limited to patients that are:

A. 16 years of age and over

B. 18 years of age and over

C. 21 years of age and over

D. 25 years of age and over

B. 18 years of age and over

Pharmacies and other retailers may not knowingly or willfully sell a finished product containing any quantity of dextromethorphan to a person younger than 18 years of age

A patient enters your pharmacy and asks to obtain naloxone. Which is the best course of action to follow?

A. Use the state standing order and dispense it to the patient

B. If the patient has a profile at your pharmacy and has obtained controlled substances in the past, you can dispense the naloxone without a prescription

C. Confirm with the patient that they take a prescription opioid, then dispense the naloxone without a prescription

D. Inform the patient you need a prescription to dispense it, but you would be happy to contact their prescriber for them to obtain one

A. Use the state standing order and dispense it to the patient

The pharmacist can dispense the naloxone based on the state non-patient-specific standing order. There are no requirements for the patient to currently be on or have received in the past a prescription opioid medication

Matthew obtained his PA pharmacist license in 2015 by examination. In 2017, he reciprocated his license to Wisconsin and obtained a Wisconsin pharmacist license and did not renew his PA pharmacist license. After 6 years in Wisconsin, Matthew decided he needed to move back towards his family in PA and hoped to renew his Pennsylvania pharmacist license or obtain a new one. Which of the following is true?

A. Matthew can renew his PA license by paying the renewal fees for the past 6 years

B. Since Matthew's PA license was not renewed for 2 consecutive renewal periods, it is null and void

C. Matthew may obtain a new PA pharmacist license only be examination, which requires taking and passing both the NAPLEX and PAa MPJE

D. Matthew can renew his PA license by completing the renewal application, applying to reactivate his license, and providing information about his ongoing licensure in Wisconsin

D. Matthew can renew his PA license by completing the renewal application, applying to reactivate his license, and providing information about his ongoing licensure in Wisconsin

If a pharmacist lets their licenses lapse for more than 1 year, they can renew it by completing the renewal application and by showing proficiency in the practice of pharmacy. This will be met by showing they were actively practicing as a full-time pharmacist in a different state while the PA license was lapsed or through completion of CE

Which of the following would be considered an unlawful act under the Pennsylvania Pharmacy Act? Select all that apply.

A. Obtaining a driver's license through misrepresentation

B. Selling sample drugs from the pharmacy

C. A licensed pharmacy intern assisting with the practice of pharmacy under the supervision of a pharmacist

D. A pharmacy advertising prices of medications that would not mislead the public

A. Obtaining a driver's license through misrepresentation

B. Selling sample drugs from the pharmacy

Obtaining personal licenses through misrepresentation is considered unlawful, as is selling sample medications from the pharmacy. Interns practicing pharmacy under the supervision of a pharmacist is not unlawful, as are advertising prices that are not misleading to the public

A patient enters your pharmacy and asks to purchase Robitussin AC. What is the best course of action to follow?

A. Verify the patient is at least 18 years old and then sell no more than 4 ounces to them

B. Verify the patient is at least 21 years old and then sell no more than 4 ounces to them

C. Check your computer, and if you regularly dispense for the patient, make sure there is no interaction prior to selling the medication to them

D. Inform the patient that they must have a prescription to obtain the product

D. Inform the patient that they must have a prescription to obtain the product

The PBOP has a regulation that requires a prescription to dispense a CV cough preparation with codeine

A pharmacist may take a meal break in a community pharmacy without closing the prescription department for a period of time that does not exceed:

A. 20 minutes

B. 30 minutes

C. 60 minutes

D. 120 minutes

B. 30 minutes

The meal break rule allows a pharmacist to take a break without leaving the premises for not more than 30 minutes

A patient comes to your pharmacy on Sat. explaining how they still feel ill, after finishing the entire ABX Rx they got last week. They were unable to reach their physician and wants advice on whether to wait until Mon. to seek care. You do not see the ABX in the patient's profile. The patient tells you that the prescriber dispensed it from their office. How should you address this situation?

A. Tell the patient the prescriber has no authority to dispense medications, and that you are unable to help since you didn't dispense it

B. Tell the patient that the prescriber shouldn't have dispensed the medication, but you would be happy to try and page the prescriber

C. Tell the patient that the prescriber was permitted to dispense the medication, but since you didn't dispense it, you can't discuss their health concerns

D. Tell the patient that you would be happy to page the prescriber to discuss their health concerns

D. Tell the patient that you would be happy to page the prescriber to discuss their health concerns

Physicians can dispense medications to their patients after treating them, as long as the medication is provided to the patient by the physician

A Pennsylvania pharmacist lost their license to practice after pleading no contest to a felony charge related to controlled substances. What is the minimum amount of time that must pass before the individual could seek to become a licensed pharmacist again?

A. 5 years

B. 10 years

C. 15 years

D. The pharmacist will never be able to seek licensure in Pennsylvania again

B. 10 years

10 years must pass before an individual can apply for licensure and show the PBOP that they are no longer a risk to the public

What is the minimum age for one to obtain a Schedule B poison without a prescription?

A. 16

B. 18

C. 21

D. 25

A. 16

An individual must be at least 16 years old to obtain a poison in Schedule A or B

A hospital pharmacy experienced a spillage of a controlled substance that was not able to be recovered. What form should the pharmacy use to document this spillage?

A. DEA Form 222

B. DEA Form 41

C. DEA Form 106

D. An invoice

B. DEA Form 41

DEA Form 41 is to be used to document non-recoverable breakage or spillage

If an individual experiences an adverse event or reaction after receiving an immunization under an order, when must the pharmacist notify the ordering prescriber (and primary care provider if known and different than the prescriber) within what time frame?

A. 12 hours

B. 24 hours

C. 48 hours

D. 72 hours

B. 24 hours

In the event of any adverse event or reaction experienced by the patient under an order for an immunization, the pharmacist is to notify the ordering prescriber, and the patient's primary care provider, if known, as soon as practicable but no longer than 24 hours after learning of the adverse event

Pharmacist Bill orders and receives a bottle of generic glipizide from his supplier. Bill notices the label of the bottle is crooked and some of the lettering on the label appears to have different fonts in the same word. Bill calls the supplier to verify the transaction data and learns that the lot number on the bottle is not a valid lot number for that brand of glipizide. What is Bill required to do? Select all that apply.

A. Notify FDA and all trading partners of this illegitimate product

B. Take steps to work with the manufacturer to prevent the illegitimate product from reaching patients

C. Order a Class I recall of the drug

D. Notify DEA

A. Notify FDA and all trading partners of this illegitimate product

B. Take steps to work with the manufacturer to prevent the illegitimate product from reaching patients

This product is illegitimate under the Drug Supply Chain Security Act (DSCSA). Both A and B are obligations of a pharmacy under the DSCSA once an illegitimate product is identified. C is incorrect because although a recall may be initiated, that is not the obligation of the pharmacy. D is incorrect because because the DSCSA is enforced by FDA, not DEA

Which of the following is not required on the bale of an OTC product?

A. Adequate directions for safe and effective use

B. Name and address of the manufacturer, packager, or distributor

C. Inactive ingredients

D. Patient Package Insert

D. Patient Package Insert

A Patient Package Insert is required for oral contraceptives and estrogen products, not OTC products

Fiorinal is classified as:

A. A listed chemical

B. A Schedule III controlled substance

C. A Schedule IV controlled substance

D. An exempt prescription product

B. A Schedule III controlled substance

Fiorinal (butalbital, aspirin, and caffeine) is a Schedule III controlled substance, as is Fioricet (butalbital, acetaminophen, caffeine) in PA

When utilizing a single-copy DEA Form 222 to order Schedule II controlled substances, who is responsible for making a copy of the form?

A. The supplier

B. The purchaser

C. The DEA

D. The PDMP manager

B. The purchaser

With a single-copy Form 222, the original form must be sent to the supplier, so the purchaser has to make a copy for their records before placing the order. This is required to be able to document the controlled substances that are received on the copy

The daily sales purchase limit for pseudoephedrine products is:

A. 0.6 of base product

B. 2.6 g of base product

C. 3.6 g of base product

D. 120 tablets

C. 3.6 g of base product

Under the Combat Methamphetamine Epidemic Act and the PCSDDCA, the daily sales limit for pseudoephedrine base product is 3.6 grams per day

Consultant pharmacists are required to perform a medication regimen review for long-term care patients:

A. When requested by the facility

B. At least weekly

C. At least every 30 days

D. When a medication error occurs

C. At least every 30 days

CMS requires a consultant pharmacist to perform a medication regimen review every 30 days and must report any irregularities to the attending physician, the facility's medical director, and the facility's director of nursing

Dr. Costa calls your pharmacy and asks if she can call in a prescription for Vicodin for Mr. Garcia, a cancer patient who is well known to you. Dr. Costa states that Mr. Garcia cannot get relief from any other pain medication, and that Mr. Garcia is unable to get to her office to pick up a prescription. She asks if you can fill the prescription and deliver if to Mr. Garcia's house. Which of the following is true?

A. You cannot take a verbal prescription for Vicodin under these circumstances because Mr. Garcia is not a hospice patient

B. You can take the verbal prescription, but Dr. Costa must send you a written or electronic prescription for the Vicodin within 3 days

C. You can take the verbal prescription and only dispense up to a 72-hour supply of the medication

D. Both B and C

B. You can take the verbal prescription, but Dr. Costa must send you a written or electronic prescription for the Vicodin within 3 days

This qualifies as an emergency situation where a pharmacist can take a verbal order for a Schedule II drug. One of the requirements to do this is that the prescriber must send an electronic or written prescription for the Schedule II drug within 3 days (don't confuse this with federal law, which is 7 days). There is not a requirement that the patient be in hospice. Furthermore, the amount that can be dispensed under an emergency verbal order for a Schedule II drug is the amount necessary to treat the patient during the emergency. It is not necessarily a 72-hour supply, which is often confused as the requirement (and may be in other states)

Which of the following drugs may be prescribed by a Qualifying Practitioner (DATA-waived practitioner) for treatment of narcotic addiction? Select all that apply.

A. Buprenorphine

B. A 3-day supply of any narcotic

C. Buprenorphine/Naloxone combination

D. Methadone

A. Yes, as long as the containers are all closed

C. Yes, but only after notifying patients that their prescription may have been exposed to smoke

A Qualifying Practitioner (DATA-waived practitioner) can only prescribed two drugs to treat narcotic addiction: buprenorphine and buprenorphine/naloxone combination. While they may be able to prescribe other narcotics, including methadone for pain control, no prescriber may prescribe those products to treat narcotic addiction

A fire broke out in the front part of Debra's pharmacy, but the flames did not reach the prescription department. Can the drugs still be dispensed?

A. Yes, as long as the containers are all closed

B. Yes, unless the drugs are heat sensitive

C. Yes, but only after notifying patients that their prescription may have been exposed to smoke

D. No, the smoke from the fire may have adulterated the drugs

D. No, the smoke from the fire may have adulterated the drugs

Remember that a drug can be adulterated, even if the container it was in is sealed, if it has been held under conditions where it may have been contaminated. The fact that the product was exposed to excessive heat and/or smoke is enough to make the product adulterated

Sterile preparations must be compounded in a primary engineering control device which is capable of maintaining at least:

A. ISO Class 3 conditions

B. ISO Class 5 conditions

C. ISO Class 7 conditions

D. ISO Class 8 conditions

B. ISO Class 5 conditions

Primary engineering control (PEC) devices must be capable of maintaining ISO Class 5 air quality, You should also be familiar with ISO Class requirements for anterooms and buffer rooms

The pharmacy you work at utilizes a separate central processing center and central fill pharmacy. Which of the following locations is responsible for offering counseling to the patient?

A. The originating pharmacy

B. The central processing center

C. The central fill pharmacy

D. The delivering pharmacy

D. The delivering pharmacy

PBOP rules require the delivering pharmacy to make the offer to counsel

Anabolic steroids are classified under which schedule?

A. Schedule II

B. Schedule III

C. Schedule IV

D. Schedule V

E. None of the above

B. Schedule III

Anabolic steroids are Schedule III controlled substances under federal and Pennsylvania law

Which of the following situations does NOT require a prospective drug review to be performed?

A. A pharmacist dispenses a drug to a medical practitioner which the practitioner will administer to a patient

B. A pharmacist fills a prescription for a patient who lives in a personal care home

C. A pharmacist fills a prescription for a patient in a nursing home

D. A pharmacist in a hospital pharmacy fills an outpatient prescription for a hospital employee

E. A pharmacist in a hospital dispenses a drug which will be administered to a patient in the hospital

A. A pharmacist dispenses a drug to a medical practitioner which the practitioner will administer to a patient

Prospective drug reviews are not required when a physician dispenses a drug to a patient being treated in the emergency room, a pharmacist dispenses a radiopharmaceutical to a physician who will administer it to a patient, a medical practitioner dispenses a drug, a pharmacist dispenses a drug to medical practitioner which the practitioner will administer to a patient, and when a pharmacist delivers naloxone to an employee of a correctional facility, prison, jail, or residential drug treatment facility for an individual pending release

A pharmacist receives an electronic prescription for fentanyl. The pharmacist consults with the prescriber of the medication. After such consultation, which of the following pieces of information may not be added or changed on the prescription even if the prescriber authorizes it?

A. Patient's address

B. Patient's name

C. Drug strength

D. Prescriber's address

E. Directions for use

B. Patient's name

Most things can be added or changed on an electronic Schedule II prescription by calling the prescriber and documenting the conversation and additions/changes on the prescription. However, adding or changing the name of the person for whom the prescription was prescribed is not something that can be added or changed, even by calling the prescriber. It would require a new electronic prescription

A nursing home patient who is prescribed estrogen must receive a copy of the Patient Package Insert:

A. After one week of therapy

B. Prior to the administration of the first dose and then every 30 days

C. Annually

D. If the doctor specifically requests it to be given

B. Prior to the administration of the first dose and then every 30 days

Institutionalized patients prescribed an estrogen or oral contraceptive, including nursing home and hospitalized patients, are supposed to be given a Patient Package Insert prior to receiving the first dose and every 30 days thereafter. This is one of those things that does not often happen in practice, but is technically required under federal rules

For which class of recall is there a reasonable probability that the product could cause serious adverse effects or death?

A. Class I

B. Class II

C. Class III

D. Class IV

A. Class I

Class I recalls are the most serious recalls, and are those in which there is a reasonably probability of serious adverse effects or death

Dr. Galloway writes a prescription for Percocet on July 7, 2023. What is the last day the prescription can be dispensed?

A. July 14, 2023

B. August 7, 2023

C. January 7, 2024

D. July 7, 2024

C. January 7, 2024

Schedule II prescriptions in Pennsylvania cannot be filled more than 6 months from the date of the prescription. The pharmacist should use professional judgement in determining if this would be appropriate

Place the following in order from the shortest time to the longest time.

A. Time limit a supplier has to fill an order on a DEA 222 Form for fentanyl

B. Time limit for obtaining all authorized refills on a prescription for carisoprodol

C. Time limit for obtaining all partial fills of a prescription for methylphenidate if requested by the patient

D. Time limit for obtaining a written or electronic prescription after receiving an emergency verbal order for meperidine

D. Time limit for obtaining a written or electronic prescription after receiving an emergency verbal order for meperidine -- 3 days

C. Time limit for obtaining all partial fills of a prescription for methylphenidate if requested by the patient -- 30 days

A. Time limit a supplier has to fill an order on a DEA 222 Form for fentanyl -- 60 days

B. Time limit for obtaining all authorized refills on a prescription for carisoprodol -- 6 months

Which of the following is NOT a permissible use or disclosure of protected health information under HIPAA?

A. Providing a list of all prescription medications to a patient's primary care physician

B. Sending prescription information to a third-party insurance company for payment purposes

C. Sending coupons for diapers to all pharmacy customers taking prenatal vitamins

D. Providing a face-to-face recommendation of an OTC product to a patient based on the patient's symptoms and drug allergy profile

C. Sending coupons for diapers to all pharmacy customers taking prenatal vitamins

Sending diaper coupons to patients taking prenatal vitamins would be considered marketing because you are using the patients' protected health information (i.e., the fact that they are taking prenatal vitamins) to try to sell them a product -- diapers. Sending a physician a list of a patient's medications fits within the treatment definition under HIPAA and does not require a patient's consent. Sending information to a third-party insurance plan is part of payment. Although recommending an OTC drug product sounds like it could be considered marketing, HIPAA has a specific exemption that allows this

Pharmacy technicians may: (Select all that apply)

A. Enter prescription information in a patient profile

B. Remain in the pharmacy while the pharmacist takes a break in the mall food court

C. Print pharmacy labels

D. Accept new verbal telephone prescription orders

E. Assist with reconstituting parenteral products

A. Enter prescription information in a patient profile

C. Print pharmacy labels

E. Assist with reconstituting parenteral products

A pharmacy technician is permitted to do the activities listed in A, C, and E under the direct supervision of a pharmacist, The pharmacy technician may stay in the pharmacy when the pharmacist is on a break, but the pharmacist must remain within the immediate building. A pharmacy technician is also prohibited from taking verbal orders

Which of the following products requires a prescription to be dispensed?

A. Humalog

B. Humulin N

C. Lantus

D. Both A and C

D. Both A and C

Both Humalog and Lantus are brands of insulin that require a prescription. Be sure to know those that require a prescription and those that do not

Secobarbital in suppository form is classified under what schedule?

A. Schedule II

B. Schedule III

C. Schedule IV

D. Schedule V

B. Schedule III

Secobarbital in suppository form is Schedule III, but in other dosage forms is Schedule II

Which of the following is not part of the transaction data required to be maintained by a pharmacy when it purchases most prescription drugs from a wholesaler or manufacturer?

A. Transaction Information

B. Transaction History

C. Transaction Statement

D. Transaction Certification

D. Transaction Certification

Under the DSCSA, Transaction Data that must be provided for each purchase of a drug includes a transaction history, transaction statement, and transaction information. It does not include a transaction certification

Under the iPLEDGE Risk Evaluation and Mitigation strategy (REMS) for isotretinoin, the maximum quantity that can be dispensed is a:

A. 7-day supply

B. 14-day supply

C. 30-day supply

D. 60-day supply

C. 30-day supply

The iPLEDGE Risk Evaluation and Mitigation Strategy (REMS) for isotretinoin is one of the most common REMS, and you should know the details of this program, including the limitation of a 30-day supply

Patient enters a pharmacy on 5/1/23 and provides the pharmacy w/ a new RX for an antidepressant written on 2/1/23 (1-month supply w/ 1 refill). Patient says they were waiting to obtain and start the med until they finished a lot of traveling. The pharmacist noticed the prescriber on file is one that retired the prior month and is no longer in practice. How should the pharmacist handle this situation?

A. Give the patient the med w/ 1 refill on file to fill prior to 2/1/24

B. Tell the patient they can get this 1st fill, but will need a new RX for the next fill

C. Give the patient the med w/ 1 refill, but replace the ordering prescriber w/ another prescriber in the same office as the retired physician

D. Tell the patient they are unable to fill the RX, offer to contact the patient's new physician about the med

E. Give the patient 3 days of the med, inform her she must obtain a new RX to receive additional med

D. Tell the patient they are unable to fill the RX, offer to contact the patient's new physician about the med

The current PBOP rule states that no prescription may be knowingly filled or refilled for a patient whose prescription was written for prior use by a prescriber who is deceased or no longer in practice. While this may not seem like the best answer regarding patient care, it does comply with the PBOP rule

Pharmacist Vincent has some expired morphine tablets he would like to send to a reverse distributor for destruction. What documentation is required to accomplish this?

A. DEA Form 222

B. DEA Form 41

C. DEA Form 106

D. An invoice

A. DEA Form 222

This is a transfer from one DEA registrant (the pharmacy) to another DEA registrant (the reverse distributor). Since morphine is a Schedule II drug, all transfers of Schedule II drugs must be made using DEA Form 222. Dea Form 41 is not used because the pharmacy is not destroying the drug. An invoice would be the correct answer if the drug involved were a Schedule III-V product.

A nonprescription bottle of 1 and 1/4 grain aspirin tablets cannot contain more than:

A. 24 tablets

B. 36 tablets

C. 50 tablets

D. 100 tablets

B. 36 tablets

This is from those sets of federal regulations that apply to certain OTC products that include special labeling requirements. Within those rules are special requirements for pediatric (1 and 1/4 grain) aspirin tablets that restrict sales to bottles of no more than 36 tablets). It also requires a warning regarding Reye's syndrome

A pharmacist received a bottle of generic tetracycline capsules from a wholesaler. The label stated that each capsule contained 500 mg of the drug when it only contained 250 mg of the drug. There was nothing about the drug that would indicate to the pharmacist that this problem existed. The pharmacist dispensed several prescriptions before the problem was detected. Which of the following statements is true regarding the tetracycline?

A. It is adulterated only

B. It is misbranded only

C. It is neither adulterated nor misbranded but is instead a minor technical violation of the potency requirements

D. It is both adulterated and misbranded

E. it is in violation of the Poison Prevention Packaging Act

D. It is both adulterated and misbranded

Remember that when the label states something that is false or misleading, the product is misbranded. Here, the product lists one strength but inside the bottle is a different strength, so the product is misbranded. However, because this involves the strength of the product, it is also adulterated because the definition of adulteration includes when the drug's quality or strength falls below that which it represents

Which products are required to be dispensed with the warning "Caution Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed"? Select all that apply.

A. Buprenorphine

B. Naloxone

C. Robitussin AC

D. Lipitor

E. Klonopin

A. Buprenorphine

C. Robitussin AC

E. Klonopin

This is one of those tricky questions because most pharmacies put this warning on every prescription label, but it is only required for Schedule II-V controlled substances. A, C, and E are all controlled substances. While the warning is not required for Schedule V products under federal law, it is required in Pennsylvania

Which of the following is likely to be outside the scope of practice for a dentist to prescribe?

A. Alprazolam

B. Amoxicillin

C. Oral contraceptives

D. Lidocaine gel

C. Oral contraceptives

A dentist can only prescribe drugs that are related to the practice of dentistry, and it is not likely that would include prescribing oral contraceptives

Dr. Smith sets up a new private practice near your pharmacy. Soon after, you begin to receive several prescriptions for methadone written by Dr. Smith. You call Dr. Smith and she explains to you that she is treating patients for opioid addiction. You should:

A. Document this conversation and continue to fill the methadone prescriptions

B. Ask Dr. Smith for her Drug Addiction Treatment Act (DATA) waiver ID code or "X" number and continue to fill the methadone prescriptions

C. Explain to Dr. Smith that she cannot prescribe methadone to treat opioid addiction and that you must refuse to fill any further prescriptions for methadone from Dr. Smith

D. Fill prescriptions for methadone 10 mg from Dr. Smith but refuse to fill prescriptions for methadone 40 mg

C. Explain to Dr. Smith that she cannot prescribe methadone to treat opioid addiction and that you must refuse to fill any further prescriptions for methadone from Dr. Smith

While methadone can be used to treat opioid addiction, it cannot be prescribed by a practitioner or dispensed by a pharmacy for this purpose. It can only be provided at a narcotic treatment center, and a pharmacy is not registered as a narcotic treatment center. A DATA-waived practitioner also cannot prescribe methadone for the treatment of opioid addiction. They can only prescribe buprenorphine and buprenorphine/naloxone combination. Do not get narcotic treatment centers confused with DATA-waived practitioners

On 9/3/23, Dr. Galloway issues 3 prescriptions to Sally for Adderall. Each prescription is for a 30-day supply. The prescriptions are each written on separate prescription forms and all are dated 9/3/23. Prescription #1 contains no additional instructions. On Prescription #2, Dr. Galloway writes, "Do not fill before 10/1/23." On Prescription #3, Dr. Galloway writes, "Do not fill before 11/1/32." Which of the following is true?

A. Dr. Galloway can't postdate Schedule II controlled substance prescriptions in this manner; therefore, Prescription #2 and Prescription #3 are not valid

B. All the prescriptions are valid and the earliest fill dates must be followed

C. None of the prescriptions are valid because Adderall cannot be prescribed on written prescriptions

D. None of the prescriptions are valid because Adderall can only be prescribed for a 10-day supply

B. All the prescriptions are valid and the earliest fill dates must be followed

The issuance of multiple Schedule II prescriptions on the same date is permitted by DEA if the subsequent prescriptions indicate the earliest fill date and the total quantity prescribed does not exceed a 90-day supply. While Pennsylvania does not require electronic prescriptions for controlled substances, there are exceptions so one may still see written prescriptions. There is also no federal or Pennsylvania law that restricts the quantity of a Schedule II prescription to a 10-day supply

A pharmacist receives prescriptions for 12 different patients from the same physician over a 3-hour period. All of the prescriptions are written for patients from out of state and for the same combination of Vicodin, Xanax, and Soma. Which of the following are true? Select all that apply

A. If the pharmacist confirms that the physician has a valid license and DEA number, the prescriptions are likely valid and can be filled

B. If the pharmacist calls the physician and the physician confirms that he or she wrote the prescriptions and saw the patients, the prescriptions are likely valid and can be filled

C. The prescriptions are not likely to be valid because they appear to have not been issued for a legitimate medical purpose

D. If the pharmacist fills the prescriptions, he or she could be subject to disciplinary action by the State Board of Pharmacy

C. The prescriptions are not likely to be valid because they appear to have not been issued for a legitimate medical purpose

D. If the pharmacist fills the prescriptions, he or she could be subject to disciplinary action by the State Board of Pharmacy

This is a clear example of a situation which requires a pharmacist to exercise their corresponding responsibility to ensure that controlled substance prescriptions are being issued for a legitimate medical purpose and in the usual course of professional practice. Simply relying on the fact that the prescriber has a valid DEA number, or even calling the prescriber to confirm that the patients were seen, is not enough to clear the numerous "red flags" in this situation. The prescriptions are not valid, and a pharmacist could face disciplinary action if he or she fills these prescriptions

Pharmacist Fred believes that customers would like to buy small quantities of nonprescription drugs and decides to repackage bottles of 100 ibuprofen 200 mg tablets into amber prescription vials of 10 tablets and then sell them to the public. The vials are labeled with the name of the drug, the manufacturer, the lot number, and the expiration date from the original bottles. Which of the following statements are true? Select all that apply.

A. Pharmacist Fred can repackage in this manner because it is for his own use in the pharmacy.

B. Pharmacist Fred has misbranded the ibuprofen

C. The repackaging by Pharmacist Fred is considered compounding and within the practice of pharmacy.

D. The repackaging by Pharmacist Fred is considered manufacturing

B. Pharmacist Fred has misbranded the ibuprofen

D. The repackaging by Pharmacist Fred is considered manufacturing

The repackaging of drug products, including OTC products, is considered manufacturing by the FDA. The products would be misbranded because they do not contain all the required information on the label of an OTC product as required by FDA. While FDA does recognize some exceptions that allow pharmacists to prepackage drugs for their own use, such as packaging into unit-dose or compliance packaging, it does not include the repackaging of OTC products that are sold to the public

For which of the following prescriptions can a fax serve as the original prescription?

A. A prescription for Demerol tablets for a 30-year-old postal worker

B. A prescription for Ritalin tablets for a 12-year-old boy who lives with his parents

C. A prescription for methamphetamine tablets for a 78-year-old LTCF patient

D. A prescription for a morphine injection for an 86-year-old hospice patient

E. Both C and D

E. Both C and D

Pennsylvania requires Schedule II prescriptions to be electronic but permits written under certain circumstances. Fax prescriptions are generally treated like verbal prescriptions and are not valid for Schedule II drugs. However, Pennsylvania and DEA recognize a few exceptions to this rule, which includes any Schedule II drug for patients in long-term care facilities and Schedule II narcotics for patients in hospice. Neither of the prescriptions for Demerol tablets or Ritalin tablets meet the exceptions

All partial dispensings of Schedule II controlled substances for a nursing home patient must be completed within:

A. 72 hours

B. 7 days

C. 30 days

D. 60 days

D. 60 days

The time limit for obtaining all partial fills of Schedule II prescriptions depends on a few factors. If the pharmacist is unable to dispense the full quantity, then the remaining amount must be dispensed within 72 hours. If the patient or prescriber requests a partial fill, the remaining quantity must be dispensed within 30 days. If the patient is in a long-term care facility or has a terminal illness, the remaining quantity must be dispensed within 60 days. Remember, these are not refills

When is a dispenser required to query the PDMP?

A. Prior to dispensing any opioids

B. When patients obtain benzodiazepines from multiple prescribers

C. Prior to refilling a CIII medications for existing patient

D. When existing patients use insurance coverage for a new CII prescription

B. When patients obtain benzodiazepines from multiple prescribers

The PDMP must b queried when a patient is getting opioid drug products or benzodiazepines from more than one prescriber. Other mandated situations include when the patient is new to the pharmacy, when the patient pays cash when they have insurance, and when the patient requests an early refill

Which of the following is true regarding a pharmacy that is an Authorized Collector?

A. The inner liner of a collection receptacle must be removed by or under the supervision of at least two employees of the pharmacy

B. The inner liner of a collection receptacle may not be removed by employees of the pharmacy

C. The contents in a collection receptacle must be inventoried before being destroyed or being sent for destruction

D. Collection receptacles may be placed anywhere within the pharmacy

A. The inner liner of a collection receptacle must be removed by or under the supervision of at least two employees of the pharmacy

The inner liner of a collection receptacle for drugs must be removed by or under the supervision of at least two employees of the pharmacy. The drugs placed into a collection receptacle should not be inventoried, counted, handled, or removed by anyone at the pharmacy. Collection receptacles must be in the immediate proximity of the pharmacy department. They cannot be placed just anywhere

Which of the following statements regarding pharmacist management of drug therapy is correct?

A. When authorized, pharmacists may prescribe medications, adjust a drug regimen, and administer medications

B. Management of drug therapy is only permitted in institutional settings

C. Written protocols and collaborative agreements are effective for at least 3 years

D. Notification of permitted activities is required to be communicated to the authorizing physician within 72 hours

D. Notification of permitted activities is required to be communicated to the authorizing physician within 72 hours

Activities that are permitted must be communicated within 72 hours. Pharmacists do not have prescriptive authority, management of drug therapy may occur in additional practice settings, and agreements are only valid for up to 2 years at a time

Which OTC product label must contain a warning about liver toxicity?

A. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

B. Phenacetin

C. Acetaminophen

D. Ipecac Syrup

C. Acetaminophen

See Chapter 2 on special warning requirements for OTC drugs

A prescriber orders a female patient a month's supply of birth control pills and states refills are "prn." How should the pharmacist address this?

A. Enter unlimited refills for the prescription and tell the patient refills will only end after the prescriber informs the pharmacist to no longer fill any

B. Enter refills for the prescription with an expiration of 1 year from the issuance date

C. Enter 5 refills on the prescription and tell the patient they will need to obtain a new prescription once those 5 refills are complete or after 6 months, whichever comes first

D. Decline to fill the prescription and tell the patient the prescriber has to specify a specific number of refills for the prescription to be valid

B. Enter refills for the prescription with an expiration of 1 year from the issuance date

Prescriptions for non-controlled medications can be refilled for 1 year from the date of the prescription if refills were authorized. This includes "prn" refills

A physician assistant would like to start a patient on Ritalin. What is the maximum days' supply that the physician assistant can prescribe for the patient at this time?

A. 3 days

B. 7 days

C. 30 days

D. There is no limit

A. 3 days

A physician assistant may prescribe a Schedule II controlled substance for initial therapy, up to a 72-hour dose. The prescription must clearly state on its face that it is for initial therapy

Which of the following may be in possession of prescription drug samples? Select all that apply.

A. A hospital pharmacy that has been requested to maintain samples by a physician associated with the hospital

B. A physician assistant who has prescriptive authority in a state

C. A community pharmacy located in a medical office building that has been requested to maintain samples by the physicians located in the same building

D. A mail-service pharmacy

A. A hospital pharmacy that has been requested to maintain samples by a physician associated with the hospital

B. A physician assistant who has prescriptive authority in a state

Under the Prescription Drug Marketing Act, pharmacies are prohibited from having samples of prescription drugs. There is an exception for hospital pharmacies that are storing prescription drug samples on behalf of physicians affiliated with the hospital. Just having a pharmacy in a medical office building does not qualify for this exception. If a prescriber such as a physician assistant has the authority to prescribe prescription drugs in a state, he or she can also request and store prescription drug samples

An outsourcing facility must report serious adverse effects related to any drug they product within:

A. 3 days

B. 10 days

C. 15 days

D. 20 days

C. 15 days

Outsourcing facilities must report serious adverse effects to the FDA for any drug they produce within 15 days. See discussion on outsourcing facilities in Chapter 1

Which of the following products are exempt from the requirements of the Poison Prevention Packaging Act? Select all that apply.

A. Isosorbide dinitrate 2.5 mg chewable tablets

B. Nitroglycerin 2.5 mg extended release capsules

C. Isosorbide dinitrate 10 mg tablets

D. Nitrostat 0.4 mg sublingual tablets

A. Isosorbide dinitrate 2.5 mg chewable tablets

D. Nitrostat 0.4 mg sublingual tablets

This question points out that you must know the details of the exemptions under the Poison Prevention Packaging Act, as even the same products may not be exempt depending on the strength and/or dosage form

Which of the following is true regarding refill reminder programs?

A. Since the purpose of these programs is to encourage the sale of future prescriptions, they are considered marketing programs and require a HIPAA authorization from the patient

B. If the refill reminder program is for prescription drugs currently prescribed for a patient, they are considered treatment and do not require a HIPAA authorization from the patient

C. Refill reminders may not be sent via text message

D. Refill reminders are not allowed for controlled substances

B. If the refill reminder program is for prescription drugs currently prescribed for a patient, they are considered treatment and do not require a HIPAA authorization from the patient

HIPAA allows refill reminders for drugs a patient is currently taking or was taking in the last 90 days. This falls under the treatment exception under HIPAA, so it is not considered marketing. There is no federal or Pennsylvania restriction regarding refill reminders for controlled substances

You receive a prescription calling for you to compound and dispense a one-pint bottle of a solution containing 120 mg of acetaminophen and 16 mg of codeine per teaspoon mixed with cherry flavoring. What schedule would this product be in?

A. Schedule II

B. Schedule III

C. Schedule IV

D. Schedule V

B. Schedule III

Always check to be sure the narcotic substance, codeine in this question, is being compounded with another therapeutic ingredient first because if it is not, the answer will be Schedule II, regardless of the concentration. In this case the codeine is being compounded with acetaminophen, so you need to calculate the concentration of codeine, which for this example is 16 mg/5 mL (teaspoon) or 320 mg/100 mL. This is greater than the maximum concentration for Schedule V of 200 mg/100 mL and less than the maximum concentration for Schedule III of 1.8 g/100 mL, so this is a Schedule III prescription

What information is required to be documented by the pharmacist receiving a transferred prescription? Select all that apply.

A. Date of issuance of original prescription

B. Complete refill record

C. Original numbers of refills authorized on prescription

D. Pharmacist name and license number from pharmacy it was transferred from

A. Date of issuance of original prescription

B. Complete refill record

C. Original numbers of refills authorized on prescription

Transferred prescriptions must include date of issuance of original prescription, date of original filing of the prescription, original number of refills authorized, complete refill record, number of refills remaining, location and prescription number of the pharmacy it is being transferred from, and the name of the pharmacy and pharmacist that it was transferred from. The pharmacist's license number is not required

You work in a community pharmacy across the street from a large teaching hospital. You receive a prescription for Percocet written for a 12-year-old child who was seen in the emergency room of the hospital. The prescription is written by Dr. Anh, an internal medicine resident at the hospital, on a hospital prescription pad, and has the hospital's DEA number followed by "A16." Which of the following is true?

A. A prescription for Percocet for a 12-year-old child cannot be dispensed

B. The prescription is valid but may only be dispensed by the hospital's outpatient pharmacy

C. The A16 is an indication that only a quantity of 16 may be dispensed

D. The prescription may be filled at your pharmacy

D. The prescription may be filled at your pharmacy

An intern or resident in a hospital can issue controlled substance prescriptions using the hospital's DEA registration as long as it is for a patient that was treated at the hospital and the hospital uses a code or suffix on the DEA number to identify who the prescriber is. That is the A16 on this question. These prescriptions are valid and can be dispensed by any pharmacy, not just the hospital outpatient pharmacy

Which of the following statements regarding emergency refill prescriptions is correct?

A. A pharmacist can dispense an emergency refill prescription for controlled and non-controlled medications

B. A pharmacist can dispense up to a 30-day supply emergency refill prescription for a medication not available to be dispensed in a 72-hour supply

C. A pharmacist can only dispense emergency refill prescriptions for acute medical conditions

D. A pharmacist is to notify the prescriber of dispensed emergency refill prescriptions within 48 hours

B. A pharmacist can dispense up to a 30-day supply emergency refill prescription for a medication not available to be dispensed in a 72-hour supply

Emergency prescription refills are not permitted for controlled substances. The maximum quantity allowed is a 72-hour supply however, if the medication can't be dispensed that way, then it can be a quantity of a month's supply (e.g., insulin). The medication must be prescribed for a chronic condition, and the pharmacist has to inform the prescriber within 72 hours

DEA Form 41 would be used to document which of the following? Select all that apply.

A. Destruction of expired Demerol tablets in a hospital pharmacy

B. Wasting of a partial quantity of a morphine 10 mg ampule in a hospital

C. Destruction of controlled substances from a collection receptacle by a pharmacy that is an authorized collector

D. Sending an expired bottle of tramadol to a reverse distributor

A. Destruction of expired Demerol tablets in a hospital pharmacy

C. Destruction of controlled substances from a collection receptacle by a pharmacy that is an authorized collector

DEA Form 41 is used to document the destruction of a controlled substance on the premises, but it is also used to document the destruction of a controlled substance from a collection receptacle if a pharmacy is an Authorized Collector. It is not used to document a transfer to a reverse distributor or for wasting a partial quantity

Which of the following is true regarding DEA Form 106?

A. It should be used to document waste of a controlled substance

B. It must be signed by two witnesses

C. It must be sent to DEA within one business day of discovery of a significant loss or theft of controlled substances

D. It must be used to report any theft or a controlled substance

D. It must be used to report any theft or a controlled substance

DEA Form 106 is used to document a theft or significant loss of controlled substances. While an initial notice to DEA must be made in writing within one business day of discovery, this does not mean the DEA 106 has to be completed by then. A pharmacy may need time to investigate the extent and scope of the theft or loss because DEA Form 106 requires listing each controlled substance that was lost or stolen, and that may take some time. No witnesses are required to sign DEA Form 106

When dispensing generic medications, which of the following statements is correct?

A. Narrow Therapeutic Index drugs are automatically considered generically equivalent drugs

B. Only prescribers can request pharmacists to not dispense generic medications

C. Patients do not have to be notified regarding generic substitution or the price difference

D. Refills using a different generic product require patient and prescriber notification or authorization

D. Refills using a different generic product require patient and prescriber notification or authorization

Refills using a different generic product require patient and prescriber notification or authorization. Patients can also request the brand name to be dispensed. Pharmacies must notify patients of the generic being dispensed and the price difference. Also, NTI drugs are excluded from the definition of a generic equivalent drug

Which of the following information is required on the pharmacy label of a dispensed prescription medication? Select all that apply.

A. Pharmacy name and address

B. Patient's birthdate

C. "Do not use after (manufacturer's expiration date)" if date is less than 1 year

D. If a generic is dispensed, the generic name and manufacturer

E. Patient's address

A. Pharmacy name and address

C. "Do not use after (manufacturer's expiration date)" if date is less than 1 year

D. If a generic is dispensed, the generic name and manufacturer

The patient's birthdate and address are not required on the label. In addition to A, C, and D, the telephone and DEA number of the pharmacy, the name of the patient, directions for use, name of the prescriber, prescription number and original/refill date, and the name of the drug/strength/dosage form/quantity dispensed are also required. The "Caution" warning is also required on controlled substances

Emergency medication kits:

A. Are prohibited by federal law to be used at facilities without an on-site pharmacy

B. Are to be stocked by the hospital pharmacy

C. Are not permitted to be placed at long-term care facilities

D. Can only be accessed by a pharmacist

B. Are to be stocked by the hospital pharmacy

Emergency medication kits in hospitals are to be stocked by the hospital pharmacy. LTCFs must have an emergency medication kit available. Also, other approved practitioners are permitted to access the kits

Compounding sterile antineoplastic agents must comply with which of the following USP chapters?

A. USP 795 and 1161

B. USP 795 and 800

C. USP 797 and 800

D. USP 797 and 1161

C. USP 797 and 800

Compounding sterile hazardous drugs must comply with both USP 797 and 800

Pharmacist Kurt reconstitutes a pharmacy bulk package of vancomycin to make a batch of 10 IV bags for dispensing today. What is the risk level of the batch preparations he is compounding?

A. Immediate Use

B. Low Risk

C. Medium Risk

D. High Risk

C. Medium Risk

A pharmacy bulk package is a conventionally manufactured dosage form. Any batch from all sterile components is a medium risk preparation

A pharmacy is required to:

A. Be at least 250 square feet in size

B. Have a prescription counter of at least 10 linear feet in length and 2 linear feet in width for up to 2 pharmacists working at the same time

C. Display licenses/permits in a conspicuous place in the pharmacy

D. All of the above

D. All of the above

To obtain and maintain a pharmacy permit, all the answers listed must be met. This includes the pharmacy and the pharmacy counter being a minimum size and licenses/permits being displayed properly

Pharmacist Kevin is preparing the Assessment of Risk required by USP 800 to identify the hazards and mitigating strategies for his health system. Which organization maintains the list of drugs that are hazardous to healthcare personnel?

A. National Association of Boards of Pharmacy

B. American Pharmacists Association

C. Occupational Safety and Health Administration

D. National Institute of Occupational Safety and Health

D. National Institute of Occupational Safety and Health

NIOSH is the organization that maintains the list of drugs that are hazardous to healthcare professionals

Which of the following statements regarding discipline of a pharmacist is correct?

A. A pharmacist disciplined in another state must report this to Pennsylvania within 30 days

B. Suspensions of a pharmacist can only occur after the pharmacist has received their due process regarding hearings

C. Grossly unprofessional conduct cannot result in discipline

D. Revocation of a pharmacist's license is permanent, and one is barred from applying for reinstatement in the future

A. A pharmacist disciplined in another state must report this to Pennsylvania within 30 days

Pharmacists must report discipline from another state within 30 days. There are also limited circumstances where the pharmacist's license can be temporarily or automatically suspended prior to due process hearings. Revocation in Pennsylvania does allow for one to reapply for licensure after a specific time has passed