Exam 2 - 2022 Flashcards
When maintained at certain registered locations, which of the following products must be stored in a safe?
a. oxycodone
b. lamotrigine
c. thiafentanil
d. phenobarbital
e. methadone
c. thiafentanil
On April 5, 2022, a prescriber saw a patient and wanted to issue a tramadol prescription. The provider has a general idea of the information that must be listed, but they are unsure what information is required on a prescription for this product. They provide you with a list of information they believe they should add to a prescription. Which item is not required on a controlled substance prescription?
a. MG1234563
b. April 5, 2022
c. May cause drowsiness.
d. tramadol 50mg
e. Take one tablet by mouth every night at bedtime.
c. May cause drowsiness.
Select all of the following products that can be ordered using the single-sheet version of the DEA 222.
a. Lamictal
b. pentobarbital
c. ketamine
d. codeine/acetaminophen
e. Vyvanse
b, e
A pharmacist receives a prescription for a controlled substance and notes several red flags with the prescription. What is the most appropriate choice in this situation?
a. Refuse to dispense the medication and write notes on the prescription warning other pharmacists that it is fraudulent.
b. Call the provider to attempt to resolve the red flags identified.
c. Notify the police that the patient has forged a prescription.
d. Tell the patient the medication is out of stock, so they take it to a different pharmacy.
b. Call the provider to attempt to resolve the red flags identified.
On April 1, 2022, a patient requests you transfer all of their prescriptions to your pharmacy chain, YNWA Pharmacy. YNWA Pharmacy is a chain without a shared database. They have prescriptions across multiple pharmacies and pharmacy chains. Which prescription can you transfer to your location today?
a. Librium, at City Pharmacy, a chain with a shared database, written February 18, 2022, filled twice with three refills remaining, transferred previously from another City Pharmacy.
b. Lomotil, at a different YNWA Pharmacy, written September 29, 2021, filled once with one refill remaining, transferred previously from City Pharmacy.
c. Phentermine, at City Pharmacy, a chain with a shared database, written December 5, 2022, filled three times with one refill remaining, transferred previously from YNWA Pharmacy.
d. Ativan, at City Pharmacy, a chain with a shared database, written January 27, 2022, filled once with no refills remaining, never transferred.
e. codeine, at a different YNWA Pharmacy, written March 3, 2022, never filled.
a. Librium, at City Pharmacy, a chain with a shared database, written February 18, 2022, filled twice with three refills remaining, transferred previously from another City Pharmacy.
A provider is interested in obtaining a DATA-waived DEA number to treat patients in an office-based treatment program. They are not familiar with the process. Which of the following is an accurate statement the provider should know?
a. The provider may treat 30 patients before obtaining the required DATA-waived DEA number.
b. The provider can prescribe methadone as long as the patient is undergoing short-term detoxification.
c. The provider can only apply for a DATA-waived DEA number if they are a physician.
d. The DATA-waived DEA number must be on every prescription issued for maintenance or detoxification.
e. DATA-waived DEA numbers override regular DEA registrations, and the DATA-waived providers cannot prescribe or treat patients outside of DATA-waived situations.
d. The DATA-waived DEA number must be on every prescription issued for maintenance or detoxification.
A prescriber issued a written prescription for Valium for a patient. There was missing information and errors on the prescription. SELECT ALL OF THE FOLLOWING items a pharmacist could add or change on this prescription based on the actions noted without a prescriber issuing a new prescription.
a. Correct a missing DEA number after discussion with the provider.
b. Change the dose to a lower available dose after discussion with the provider.
c. Add directions when none were listed previously after discussion with the provider.
d. Clarify that we may dispense diazepam for the patient after discussion with the provider.
e. Add an address after consultation with the patient.
all of the above
On January 1, 2022, a provider issued a prescription for four triazolam tablets with one refill. The patient refills the prescription on March 7, 2022. On April 1, 2022, the patient requested additional refills from the prescriber. How many additional refills, if any, may the prescriber authorize on April 1, 2022?
a. 0
b. 3
c. 5
d. 4
e. 1
d. 4
SELECT ALL OF THE FOLLOWING prescriptions that we can accept for Provigil.
a. Electronic prescription electronically signed by the provider.
b. Telephone prescription immediately reduced to writing by the pharmacist receiving the prescription.
c. Faxed prescription manually signed by the provider.
d. Written prescription manually signed by the provider.
all of the above
Vimpat prescription labels must include the no transfer label.
True
False
False
A pharmacy is busy and is running behind in filling prescriptions. The pharmacist decides to send some prescriptions to a central fill pharmacy to alleviate the filling burden. When transmitting a prescription for zolpidem, the pharmacist sent a note saying they did not have time to call the prescriber to correct the prescription information and asked that the central fill pharmacist complete that step. Determine whether the main pharmacy made an error sending the prescription to the central fill pharmacy and, if so, what error the main pharmacy made.
a. This prescription was sent to a central fill pharmacy without being complete, and a central fill pharmacy cannot make corrections to prescriptions.
b. Prescriptions can only be sent to the central fill pharmacy at predetermined times, and they cannot be sent just because the main pharmacy is busy.
c. This prescription is a schedule that can never be filled at a central fill pharmacy.
d. The main pharmacy did not make an error in transmitting this prescription to the central fill pharmacy.
a. This prescription was sent to a central fill pharmacy without being complete, and a central fill pharmacy cannot make corrections to prescriptions.
Which of the following registrations is a valid registration for an institution called Happy Hospital?
a. IH1234564
b. HA1234560
c. MH1234563
d. RH1234567
e. BH1234563
e. BH1234563
A new drug is being put on the market. After reviewing the factors for scheduling, the DEA determines the product should be scheduled. The product has a higher dependence liability than codeine/guaifenesin and lower abuse potential than Xyrem. Which schedule is this product likely to be placed?
a. III
b. IV
c. I
d. V
e. II
b. IV
A pharmacist placed a prescription label on a product. After dispensing, the pharmacist realized that no cautionary statements were included on the prescription label. They are worried they have misbranded the product. Which reason bests describes why this may not be the case?
a. Cautionary statements are minor issues and would not contribute to a patient’s understanding of medication use.
b. Cautionary statements should be provided in the product’s labeling and are not needed on the label.
c. Cautionary statements are not a part of labeling, so this issue is never misbranding.
d. Cautionary statements should be provided verbally to a patient during counseling and are not needed on the label.
e. Cautionary statements are not required on a label unless written on the prescription.
e. Cautionary statements are not required on a label unless written on the prescription.
SELECT ALL OF THE FOLLOWING statements that are true regarding controlled substance distribution.
a. Dispensers may not distribute more than three percent of their total controlled substance dispensing volume
b. Practitioners must always use a DEA 222 when purchasing drugs from a pharmacy.
c. The supplier must ensure the purchaser is registered to handle the controlled substance they ask to purchase.
d. A regular invoice is used when distributing products in schedule III through V.
e. Pharmacies may distribute to other registrants.
c, d, e
SELECT ALL OF THE FOLLOWING items registration is based on.
a. Registration is based on the size of the facility.
b. Registration is based on the amount of drugs handled.
c. Registration is based on the activities a person engages in.
d. Registration is based on the schedules of drugs handled.
e. Registration is based on the location of the facility.
c. Registration is based on the activities a person engages in.
d. Registration is based on the schedules of drugs handled.
A foreign-trained physician issued a prescription using an institutional DEA number and suffix. The physician is a hospitalist and discharged the patient from the hospital today. They prescribed Norco 5/325mg for 14 days to get the patient through until their follow-up appointment with their primary care provider. What is the most appropriate choice and reasoning when considering filling the prescription noted in this situation?
a. Cannot fill, the prescription was issued for a schedule that is not eligible to be prescribed on an institutional DEA number.
b. Can fill, this prescription was issued appropriately.
c. Can fill, it is not a pharmacist’s job to check the legitimacy of institutional DEA use.
d. Cannot fill, foreign-trained physicians cannot use an institutional DEA number.
e. Cannot fill, institutional DEA numbers only authorize providers to prescribe at most a seven-day supply of medication.
b. Can fill, this prescription was issued appropriately.
All of the following drugs can be transferred, except:
a. Lomotil
b. Ultram
c. Restoril
d. Duragesic
e. Subutex
d. Duragesic
Select the best option that differentiates a schedule I product from all other schedules.
a. Schedule I products have very high abuse potential.
b. Schedule I products have no medical use in the US.
c. Schedule I products have a higher risk for dependence liability than products in other schedules.
d. Schedule I products can only be used for research purposes.
e. Schedule I products are the only products used illicitly.
b. Schedule I products have no medical use in the US.
A pharmacy is due to complete its official inventory on April 15, 2022. A non-controlled substance will become a controlled substance on April 14, 2022. What is the most appropriate choice in this case?
a. Count the newly controlled product on the day it becomes controlled and again the next day in the official inventory.
b. Count the newly controlled product on the day it becomes controlled, use that number in the official inventory the next day, and wait to count it again in the next official inventory.
c. Estimate the count on the day the product becomes controlled and exactly count the product the next day with the official inventory.
d. Wait to count the newly controlled product with the official inventory since it is the day after it becomes controlled.
a. Count the newly controlled product on the day it becomes controlled and again the next day in the official inventory.
A student pharmacist was previously convicted of a felony relating to a controlled substance. The board of pharmacy is aware, granted them an intern permit, and required that they notify all rotations sites of the conviction. What is the most likely reason the board noted the student must notify all rotation sites of this issue?
a. The student pharmacist needs to apply for a waiver to have rotations at sites with controlled substance registrations, and the rotation sites must keep a copy of the waiver on file.
b. All rotations sites with controlled substance registrations will need to apply for a waiver to allow the student pharmacist at the site.
c. The student pharmacist should model ethical behavior and share past transgressions openly as an example to others.
d. Notifying rotation sites allows preceptors to challenge the student’s future pharmacist licensure.
b. All rotations sites with controlled substance registrations will need to apply for a waiver to allow the student pharmacist at the site.
SELECT ALL OF THE FOLLOWING appropriate timeframes noted in the Controlled Substance Act.
a. A pharmacy has 60 days from the date written to complete the partial fills for a terminally ill patient.
b. A supplier has 72 hours to complete filling an order for schedule II substances.
c. Records relating to controlled substances must be maintained for two years.
d. Official inventory must be completed at least once a year.
e. A registrant may start maintaining records centrally 14 days after notifying the DEA unless they receive a denial.
a, c, e
A resident on an orthopedic rotation writes a prescription for a patient. The patient is a college friend who called and noted they hurt their knee and were nervous about getting an MRI the next day. The resident decided to prescribe two alprazolam tablets to help with anxiety. They call the pharmacy and leave a voicemail with the prescription. On the voicemail, they leave the hospital’s DEA number and the suffix D01. Which of the following is true?
a. Providers cannot call in prescriptions for friends.
b. This prescription was not issued in the usual course of employment.
c. The indicator, D01, provided with the DEA number, means the resident cannot prescribe more than one pill at a time.
d. This prescription is a schedule that cannot be called in.
e. The prescription may be filled at your pharmacy.
b. This prescription was not issued in the usual course of employment.
A prescriber issued a prescription after the patient paid a high fee to obtain a specific controlled substance. This practice is a red flag that the prescription has not been issued in the usual course of practice or for a legitimate medical use.
True
False
True
Certain individuals are exempt from DEA registration. Which of the following individuals would not be included in an exemption?
a. Patient receiving a controlled substance via a prescription.
b. Nurse working under a practitioner and administering medication.
c. Pharmacist who has prescribing authority to prescribe controlled substances in a state.
d. Delivery driver who works for a distributor and whose daily task is to deliver drugs to pharmacies.
e. Official in an armed service authorized to prescribe as part of their official duties.
c. Pharmacist who has prescribing authority to prescribe controlled substances in a state.
On April 1, 2022, a prescriber sees a patient for a follow-up appointment after prescribing Ritalin LA at the last appointment. The medication is working well, and the prescriber would like to provide a three-month supply of medication and see the patient after that time to re-evaluate the therapy. SELECT ALL OF THE FOLLOWING OPTIONS the prescriber can use to provide this medication to the patient.
a. Write three prescriptions, each dated for the future date they should be filled, for 30-day supplies.
b. Write a single prescription dated April 1, 2022, for a 30-day supply and ask the patient to return to the office each month to pick up a new prescription when needed.
c. Write a single prescription dated April 1, 2022, for a 90-day supply.
d. Write three prescriptions, each dated April 1, 2022, for 30-day supplies and write do not fill before dates on two prescriptions.
e. Write a single prescription dated April 1, 2022, for a 30-day supply with two refills.
b, c, d
Interns can complete controlled substance prescription transfers if authorized by their supervising pharmacist.
True
False
False
A pharmacist is completing a controlled substance inventory. The pharmacist is counting a Klonopin bottle with 5000 tablets. They picked up the bottle, estimated the number of tablets inside, and indicated that the count was approximately 2700 tablets. Determine whether an error was made when inventorying this product and, if so, what error occurred.
a. Made an error; the estimated count should be verified with computer records to ensure accuracy of the estimation.
b. Did not make an error; this pharmacist appropriately inventoried this product.
c. Made an error; the product is a schedule required to be exactly counted.
d. Made an error; the bottle size should be exactly counted.
e. Made an error; the bottle should be weighed when a pharmacist estimates the inventory to provide a more accurate count.
d. Made an error; the bottle size should be exactly counted.
An intern was recently caught stealing two tablets of Adderall 5mg from the pharmacy. All of the following are true regarding this situation, except:
a. The Board of Pharmacy must be notified of the situation within one day.
b. When completed, the appropriate reporting form should be sent to the DEA and Board of Pharmacy.
c. The quantity of product taken must be reported.
d. The theft of two tablets is not a significant loss, so it would not need to be reported.
e. A DEA form 106 must be completed.
d. The theft of two tablets is not a significant loss, so it would not need to be reported.
Which of the following pharmacy records must be maintained at the registered location?
a. Copies of forms used for registration and renewal.
b. DEA 106s completed after a robbery.
c. DEA 222s that were voided due to completion errors and never sent to the supplier.
d. Invoices related to controlled substance distributions to another registered location.
e. Invoices related to purchasing schedule III through V products.
c. DEA 222s that were voided due to completion errors and never sent to the supplier.
The DEA is re-evaluating the factors for scheduling for the drug atomoxetine after recent dispensing trends were brought to light. After this review, the DEA noted that this product has a higher abuse potential than previously realized and it is concerning. Based on this information, what is most likely to occur in this case?
a. This drug would likely move from schedule III to a lower schedule.
b. This drug would likely become a scheduled product after previously being a non-controlled product.
c. No change is likely to occur with scheduling because scheduling is not based on the abuse potential of a product.
d. This drug would likely move from schedule III to schedule II.
e. This drug would likely become a non-controlled product after previously being a schedule V product.
b. This drug would likely become a scheduled product after previously being a non-controlled product.
A dentist is interested in obtaining a DEA registration but is unsure about this process and registration numbers in general. SELECT ALL OF THE FOLLOWING that would be accurate regarding this dentist’s registration process or registration.
a. Registration allows no coincident activities.
b. Register as a dispenser.
c. Registration number starts with a G.
d. Register with a form 222a.
e. Register to handle schedule I substances.
b, c
A pharmacy needs to destroy outdated controlled substances. They have three products to destroy - 10 tablets of Desoxyn, 500 tablets of diazepam, and 73 milliliters of hydrocodone/acetaminophen liquid. Which of the following is true regarding the disposal of these products?
a. Disposal of these products would require forms 41 and 222.
b. Disposal of these products would require forms 222 and 106.
c. A form 106 would be required for disposal because it is used to notify the DEA of losses, and disposals are a loss of substances.
d. A form 222 would not be required in this situation because the pharmacy is not disposing of more than 100 units of a schedule II product.
e. A form 41 is not required for disposal because that is only used when destroying more than 1000 dosage units.
a. Disposal of these products would require forms 41 and 222.
SELECT ALL OF THE FOLLOWING factual statements around completing a DEA 222.
a. Anyone in the pharmacy can sign a paper 22.2
b. When ordering on a paper 222, the purchaser must indicate the last line completed on the form.
c. Only schedule II products can be ordered on an electronic 222.
d. A supplier must report paper 222 purchases to ARCOS or forward a copy of the form to the DEA by the end of the month the order was filled.
e. The pre-printed information on the 222 must be correct, or the DEA must issue new forms.
b, d, e
The Drug Enforcement Administration administers all parts of the Controlled Substance Act.
True
False
True
A physician calls and wants to issue a prescription for oxycodone for a homebound patient. Assuming the prescription is issued appropriately, which of the following is true regarding a prescription of this type?
a. This medication can always be issued in this manner without additional requirements.
b. This prescription is limited to a 72 hour supply of medication.
c. The prescription can only be filled by authorized pharmacies since the patient is homebound.
d. This physician must fax in a matching prescription within 48 business hours.
e. The covering prescription must have “authorization for emergency dispensing” on the face of the prescription or noted on the electronic prescription.
e. The covering prescription must have “authorization for emergency dispensing” on the face of the prescription or noted on the electronic prescription.
Records for all of the following products can be stored together, except:
a. carisoprodol
b. gabapentin
c. testosterone
d. pentobarbital
e. Compazine
d. pentobarbital
All of the following are true regarding Suboxone EXCEPT:
a. It is a CIII product approved by the FDA to treat opioid addiction.
b. It may be prescribed for medication-assisted treatment for addiction.
c. Only specially registered providers can prescribe the medication in an office-based treatment program.
d. It cannot be dispensed from a retail pharmacy unless prescribed for pain.
e. It may be prescribed to treat pain.
d. It cannot be dispensed from a retail pharmacy unless prescribed for pain.
A pharmacist is checking in a controlled substance order. They pick up a bottle of a schedule III controlled substance. When picking up the product, they note the bottle does not weigh anything, and there is no sound of tablets inside. They take off the bottle top and see that the product is sealed with foil and shows no signs of tampering. This situation must be reported on a DEA 106.
True
False
False
SELECT ALL OF THE FOLLOWING situations where a fax can be used as the original prescription.
a. cocaine for a patient in hospice.
b. methylphenidate for a patient in hospice.
c. Lyrica for a patient in hospice.
d. Roxanol for a patient in a long-term care facility.
e. hydrocodone/ibuprofen for an outpatient.
a, c, d
