FedPharmPrac Flashcards
How should the pharmacist counsel a patient on various options for disposing of a used fentanyl patch? (Select ALL that apply.)
A. Flush the used patch down the toilet.
B. Throw away the used patch in a yellow chemotherapy trace waste container.
C. Mix the used patch with coffee grounds and throw it away in the household trash.
D. Store it safely and securely until it can be returned to a DEA-authorized collector or take-back program.
E. Throw away the used patch in a red sharps container.
A. Flush the used patch down the toilet.
D. Store it safely and securely until it can be returned to a DEA-authorized collector or take-back program.
Child-resistant containers are designed to protect children from accidentally ingesting drugs. Who can grant a blanket waiver for use of child-resistant containers?
A. Pharmacist
B. Prescriber
C. Patient
D. Prescriber and patient
E. None of the answer choices are correct
C. Patient
It is permissible to share protected health information (PHI) under each of the following situations EXCEPT:
A. A nurse practitioner asking a pharmacist to review a patient profile to give a recommendation on an antibiotic dose.
B. A pharmacy manager reviewing the opioid drug usage of a worker suspected of abusing drugs on the PDMP.
C. A pharmacist reporting adverse drug events to the FDA Adverse Event Reporting System.
D. Counseling a caregiver on the correct usage of a medication.
E. A nurse reporting influenza vaccine adverse events to the Vaccine Adverse Event Reporting System.
B. A pharmacy manager reviewing the opioid drug usage of a worker suspected of abusing drugs on the PDMP.
The following determination can be used to establish bioequivalence for generic substitution:
A. The drugs have the same inactive ingredients.
B. The drugs have in vitro and in vivo studies demonstrating similar pharmacokinetics.
C. The drugs have the same excipients and colorings.
D. The drugs have an identical dosage form.
E. The drugs are listed as interchangeable in the Pink Book.
B. The drugs have in vitro and in vivo studies demonstrating similar pharmacokinetics.
Based on the REMS program, what threshold must the ANC be at or above to initiate Versacloz treatment?
A. 500/mm³
B. 1,000/mm³
C. 1,500/mm³
D. 3,000/mm³
E. 4,500/mm³
C. 1,500/mm³
Agranulocytosis (loss of granulocytes, which are required to fight infection) limits the use of clozapine (Clozaril, Versacloz), along with a risk of seizures. Do not initiate clozapine if the ANC is below 1,500/mm³. Therapy must be interrupted if the ANC drops to < 1,000/mm³ during treatment.
A pharmacy is required to provide a MedGuide for Motrin in the following scenarios EXCEPT:
A. The first time the initial fill is dispensed from an outpatient pharmacy.
B. Every time a refill is dispensed from an outpatient pharmacy.
C. Whenever the patient requests the MedGuide.
D. Every time a nurse administers Motrin in a hospital.
E. Whenever the caregiver requests the MedGuide.
D. Every time a nurse administers Motrin in a hospital.
Medication Guides (MedGuides) provide information about serious and significant health concerns. The FDA requires that select drugs have MedGuides provided when a drug is dispensed from an outpatient pharmacy (initial fill and all refills), the first time a drug is dispensed to a healthcare provider for the administration to a patient (in the outpatient setting), whenever a MedGuide is revised and whenever a patient/caregiver requests a medication guide.
Which of the following is a covered entity under the Health Portability and Accountability Act (HIPAA)?
A. Food and Drug Administration
B. Insurance company
C. Law enforcement
D. Board of Pharmacy
E. Drug Enforcement Administration
B. Insurance company
Covered entities under HIPAA include insurance companies, healthcare professionals, and healthcare facilities (e.g., pharmacies, nursing homes, clinics).
When does the pharmacy need to provide the Notice of Privacy Practices to a patient? (Select ALL that apply.)
A. At the first time service is offered
B. Every time service is offered
C. When the privacy practice is updated
D. Annually
E. At the request of the patient
A. At the first time service is offered
C. When the privacy practice is updated
E. At the request of the patient
All of the following are prescription tamper-resistant security features EXCEPT:
A. A repetitive void pattern appears when the form is photocopied.
B. Checkboxes with the number of tablets or capsules prescribed.
C. Pre-printed serial numbers.
D. Microprint signature line.
E. Alternate color papers on the pad (e.g., yellow-white, yellow-white).
E. Alternate color papers on the pad (e.g., yellow-white, yellow-white).
Federal law requires that a tamper-resistant form be used for outpatient Medicaid prescriptions. CMS requires at least one feature of each of the following groups that prevent duplication (e.g., VOID appearing when photocopied), erasure/modification (e.g., quantity checkboxes) and counterfeit forms (e.g., microprint line, pre-printed serial numbers). Some states also require tamper-resistant security forms for prescriptions written for schedule II, all controlled substances or for all drugs.
A pharmacist receives a call from another pharmacy asking if they can borrow Claravis to fill a prescription for a female patient. Which of the following is the most appropriate response?
A. Claravis cannot be lent or sold to another pharmacy.
B. A DEA Form 222 will need to be sent to purchase Claravis.
C. Can you confirm that the patient has two negative pregnancy tests?
D. This drug was removed from the market for safety reasons.
E. Is your pharmacy enrolled in iPLEDGE REMS?
A. Claravis cannot be lent or sold to another pharmacy.
Isotretinoin (Absorica, Amnesteem, Claravis, Myorisan, Zenatane) has a required REMS program called iPLEDGE. The REMS program dictates that pharmacies can only purchase isotretinoin products from iPLEDGE-registered wholesalers. This means that a pharmacy cannot sell or lend isotretinoin to another pharmacy.
Which of the following is NOT an acceptable disposal method for unused Percocet tablets?
A. Dispose of it at a DEA National Prescription Drug Take-Back Day.
B. Take it to a pharmacy that is a DEA-authorized collector.
C. Mail it to a DEA-authorized collector through a mail-back program.
D. Mail it to the local DEA office in an unmarked package.
E. Flush the tablets down the toilet.
D. Mail it to the local DEA office in an unmarked package.
A 75-year-old patient recently expired and the family needs to dispose of his unused box of Duragesic patches. Which of the following is the FDA’s PREFERRED method of disposal of Duragesic?
A. Take to a local DEA-authorized collector.
B. Open the patches, mix with kitty litter, place them in a sealed bag and dispose of them in the trash can.
C. Flush the patches down the toilet, and place the empty box in the trash.
D. Donate the unopened box to a free clinic.
E. Send the unopened box to the manufacturers.
A. Take to a local DEA-authorized collector.
To dispose of prescription drugs, the best option is to take advantage of DEA-authorized collection receptacles (which include the take-back programs for controlled drugs) or other programs, such as household hazardous waste collection events. If a take-back program or a DEA-authorized collector is not readily available, fentanyl-containing products are on the FDA flush list and can be flushed for disposal.
Which of the following statements regarding unit-dose packaging is true?
A. It holds a single dose of medication for direct, oral administration.
B. It cannot be returned to the pharmacy under any circumstances.
C. Liquid medications cannot be packaged as unit doses.
D. It requires all of the same information required on a standard prescription label.
E. The beyond-use date (BUD) for the package is two years from the date it was prepared.
A. It holds a single dose of medication for direct, oral administration.
Unit-dose packaging holds a single dose of medication, which may include liquid formulations. In an institutional setting (e.g., hospital), the package can be returned to the pharmacy stock if the drug is not used and the container is intact. Because the packages are so small, less information is required than the standard prescription label requirements. The BUD (beyond-use date) is six months from the packaging date or the manufacturer’s expiration date, whichever is sooner.
The FDA reviews and approves which of the following written information for patients? (Select ALL that apply.)
A. Consumer medication information (CMI)
B. Mailers for OTC medications
C. Patient package inserts (PPI)
D. MedGuides
E. TV commercials for OTC medications
C. Patient package inserts (PPI)
D. MedGuides
OBRA requires the offer to counsel be made to which patient population?
A. Patients with Medicaid
B. Patients over the age of 65 years
C. Patients receiving schedules II or III medications
D. Patients under the age of 18 years
E. None of the answers are correct
A. Patients with Medicaid
Who does OBRA ‘90 require to have a drug utilization review program in order to receive reimbursement for Medicaid services?
A. Dispensing pharmacist
B. Individual states
C. DEA
D. FDA
E. Pharmacy and Therapeutics Committee
B. Individual states
Omnibus Budget Reconciliation Act of 1990 (OBRA ‘90) is a law that requires each state to have a drug utilization review (DUR) program to receive reimbursement for services provided to Medicaid beneficiaries.
There are two required types of DURs: prospective and retrospective. Pharmacists must perform prospective DURs for individual Medicaid patients prior to dispensing a new prescription or refill. The state is responsible for performing retrospective DURs.
Which of the following is considered protected health information? (Select ALL that apply.)
A. The patient’s de-identified study research number
B. The patient’s insurance bill for her hysterectomy
C. The patient’s laboratory test results
D. The patient’s prescription number
E. A piece of paper that says, “a 65-year-old female”
B. The patient’s insurance bill for her hysterectomy
C. The patient’s laboratory test results
D. The patient’s prescription number
Which of the following is an acceptable incidental disclosure of protected health information?
A. A hospital visitor overhears two physicians discussing a patient case by the workstation.
B. A nurse finds printed patient notes on the ground outside the cafeteria.
C. The prescriptions in a retail pharmacy are kept in clear bags, and a patient sees the drug name and name of the next patient.
D. Pharmacists discussing a specific patient case are overheard in the elevator.
E. A nurse sits down at a computer that has another nurse’s patient chart open.
A. A hospital visitor overhears two physicians discussing a patient case by the workstation.
Who must perform the prospective drug utilization review before a prescription is dispensed to a patient?
A. Pharmacist
B. State Board of Pharmacy
C. DEA
D. FDA
E. Pharmacy and Therapeutics Committee
A. Pharmacist
Which of the following references should the pharmacist consult with when determining the therapeutic equivalence of levothyroxine products?
A. The Purple Book
B. The Red Book
C. The Orange Book
D. Facts and Comparisons
E. The Pink Book
C. The Orange Book
What program implemented by the DEA includes over 3,000 collection sites nationwide that participate in a national program to collect unneeded prescription drugs?
A. Take-control
B. Alert
C. Take-back
D. Take-away
E. ReUse-and-ReCycle
C. Take-back
All of the following are correct regarding medication guides (MedGuides) EXCEPT:
A. They are required for products that pose a serious and significant concern.
B. The MedGuide must be approved by the FDA.
C. The physician is required to provide it when a new prescription is provided for a drug with a MedGuide.
D. They may be part of a REMS program.
E. They are required for all prescription NSAIDs and antidepressants.
C. The physician is required to provide it when a new prescription is provided for a drug with a MedGuide.
A 28-year-old female who is currently taking the oral contraceptive Yaz is admitted to the hospital. How often does the patient package insert for Yaz need to be provided while she is in the hospital? (Select ALL that apply.)
A. When the first dose is administered.
B. Every time a dose is administered.
C. Every 15 days.
D. Every 30 days.
E. Every 60 days.
A. When the first dose is administered.
D. Every 30 days.
The purpose of the prospective drug utilization is to look for all of the following EXCEPT:
A. Therapeutic duplication
B. Incorrect dose
C. Incorrect treatment duration
D. Lower-cost drug therapy options
E. Drug-drug interactions
D. Lower-cost drug therapy options
The pharmacist intern is packaging a prescription for 30 tablets of Celexa on May 10, 2021. The manufacturer’s container states that the drug expires in 12/2021. Per USP Standards, what expiration date should be written on the prescription label that will be dispensed to the patient?
A. May 10, 2022
B. May 31, 2022
C. November 10, 2021
D. December 10, 2021
E. December 31, 2021
E. December 31, 2021
A patient has many empty plastic prescription containers around the house. He asks the pharmacy if he can reuse them to fill his following month’s prescriptions. How many times can a plastic container and child-resistant cap be reused?
A. Once
B. Twice
C. No limit
D. Zero
E. Determined by pharmacist’s professional judgment
D. Zero
Per federal law, all of the following are required on prescription labels EXCEPT:
A. Indication
B. Patient name
C. Address of the dispenser
D. Serial number
E. Cautionary statements
A. Indication
How long must the signed Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice be kept by the pharmacy?
A. 30 days
B. 2 years
C. 1 year
D. 3 years
E. 6 years
E. 6 years
Which of the following drugs are permitted by the FDA (and the DEA) to be flushed in order to reduce the risk of accidental exposure or diversion? (Select ALL that apply.)
A. Percocet
B. AndroGel
C. Opana
D. Tramadol
E. Actiq
A. Percocet
C. Opana
E. Actiq
When is patient authorization required for the release of protected health information (PHI)?
A. Upon admission to the hospital for a planned surgical procedure.
B. When patient information is to be shared among two clinicians involved in the care of the patient.
C. When the pharmacy mails the patient a refill reminder for his Glucophage prescription.
D. When the pharmacy sells a list of patients to a drug company so the drug company can advertise an antidiabetic drug.
E. When patient information is used for billing a private insurer for the surgical treatment of a diabetic foot.
D. When the pharmacy sells a list of patients to a drug company so the drug company can advertise an antidiabetic drug.
When administering estrogen to a long-term care facility resident, how often does a patient package insert (PPI) need to be given?
A. With each dose.
B. With the first dose and every 30 days thereafter during continuous therapy.
C. With the first dose and every 60 days thereafter during continuous therapy.
D. With the first dose and every 90 days thereafter during continuous therapy.
E. It does not need to be given to the patients in a long-term care facility.
B. With the first dose and every 30 days thereafter during continuous therapy.
Which of the following written information for patients is available for all prescription drugs, and is generally stapled to or placed in the bag in which the medication container is placed?
A. Consumer medication information (CMI)
B. Patient package inserts (PPI)
C. MedGuides
D. Printout from the Risk Evaluation and Mitigation Strategy (REMS)
E. None of the answers are correct
A. Consumer medication information (CMI)
A 24-year-old female is picking up her birth control pill Loestrin 24 FE from her neighborhood pharmacy. How often does the pharmacy need to provide her with the patient package insert for Loestrin 24 FE?
A. On an annual basis, if the patient is still receiving Loestrin 24 FE.
B. Every time Loestrin 24 FE is dispensed.
C. Every 6 months if the patient is still receiving Loestrin 24 FE.
D. Dispensing this information is the responsibility of the prescriber.
E. Dispensing this information is at the pharmacist’s discretion.
B. Every time Loestrin 24 FE is dispensed.
The provisions of the Poison Prevention Packaging Act apply to which of the following populations?
A. Hospital inpatients
B. Nursing home residents
C. Residents of senior citizen apartment complexes
D. Long-Term Care Facility residents
E. Animals seen in a veterinarian’s office
C. Residents of senior citizen apartment complexes
Each of the following medications should have the patient package insert dispensed with the medication EXCEPT:
A. Yasmin
B. LoSeasonique
C. Ortho Tri-Cyclen
D. Vyvanse
E. Sprintec 28
D. Vyvanse
All of the following are Risk Evaluation and Mitigation Strategy (REMS) requirements for long-acting opioids EXCEPT:
A. Counsel patients on the safe use
B. Counsel patients on the safe disposal
C. Counsel patients to take on an empty stomach
D. Dispense a MedGuide
E. Educate providers about monitoring pain
C. Counsel patients to take on an empty stomach
A 75-year-old patient had been using clopidogrel, aspirin, lisinopril, carvedilol, furosemide, and potassium. The patient recently expired and the family is asking the pharmacist what to do with his medications. Which of the following is the best disposal method for these drugs?
A. A community “take-back” program for unwanted drugs.
B. Removing identifying information and disposing of it in the trash.
C. Flushing pills down the toilet and throwing empty containers in the trash.
D. Donating to a charitable organization.
E. Sending back to the manufacturers.
A. A community “take-back” program for unwanted drugs.
A 70-year-old male found a website based in another state that asks a few questions online and, if the responses are deemed safe, sends a prescription for Viagra to the patient’s local pharmacy. Should the patient’s local pharmacy fill this prescription?
A. No, because the prescriber is located in another state.
B. Yes, if the patient is provided a toll-free phone number to call with any medication questions.
C. Yes, if the prescriber reviews home medications for drug interactions.
D. Yes, if the patient provides the prescriber with an at-home blood pressure reading.
E. No, because the prescriber is unable to perform an appropriate exam.
E. No, because the prescriber is unable to perform an appropriate exam.
A patient with Medicaid drops off a new prescription for Keppra at the pharmacy. When should the prospective drug utilization review be performed?
A. Upon the patient’s request
B. Before dispensing the prescription
C. After dispensing the prescription
D. Never, the prescriber is responsible for performing the prospective drug utilization review
E. Never, the state is responsible for performing the prospective drug utilization review
B. Before dispensing the prescription
The technician is packaging a prescription for 30 tablets of Zestoretic on May 15, 2022. The prescription was issued on May 13, 2022. The manufacturer’s container says that the drug expires on December 23, 2023. According to USP guidelines, what beyond-use date should be written on the prescription label that will be dispensed to the patient?
A. May 13, 2023
B. May 15, 2023
C. November 13, 2022
D. November 15, 2022
E. December 23, 2023
B. May 15, 2023
On February 1, 2021, a pharmacist pulls an unopened container of 60 tablets of bupropion 150 mg off the shelf with an expiration date of 11/2021. The pharmacist is refilling a prescription for bupropion 150 mg one tablet by mouth twice daily. The pharmacy label is placed on the unopened manufacturer’s container. What beyond-use date should the pharmacist place on the label per USP Standards?
A. February 1, 2022
B. November 30, 2021
C. August 1, 2021
D. 60 days from the date the medication was dispensed
E. November 1, 2021
B. November 30, 2021
A patient has the following medications at home which she needs to dispose of: pregabalin, Strattera, Oxycontin, diltiazem, and sertraline. According to the FDA, which of the following medications is permissible to flush down the toilet?
A. Strattera
B. Oxycontin
C. Pregabalin
D. Diltiazem
E. Sertraline
B. Oxycontin
Which of the following drugs is exempt from child-resistant packaging?
A. Loperamide 2 mg capsules
B. Topical minoxidil
C. Acetaminophen 500 mg powder packet
D. Aspirin 325 mg tablets
E. Clarithromycin 500 mg tablets
C. Acetaminophen 500 mg powder packet
A patient has tramadol 50 mg tablets at her house that she no longer needs. There is no local drug take-back program in her area. How should the pharmacist instruct her to safely dispose of this medication?
A. Flush the tramadol tablets down the toilet.
B. Crush the tablets, mix the powder with water, and rinse it down the sink.
C. Mix the tablets with used coffee grounds in a sealable bag and discard them in the household trash.
D. Mail the tablets back to the manufacturer.
E. Hold the tablets in a safe place until a take-back program is scheduled in the area.
C. Mix the tablets with used coffee grounds in a sealable bag and discard them in the household trash.
The pharmacist receives a prescription for Calan 120 mg. He would like to dispense the generic version since it will be less expensive. When determining the therapeutic equivalence of the reference listed drug (branded drug) to the generic drug product, which rating means that the two drug products are interchangeable?
A. A rating
B. B rating
C. C rating
D. D rating
E. E rating
A. A rating
Which of the following drugs require child-resistant packaging?
A. Nitrostat sublingual tablets
B. Fiorinal tablets
C. Pancrelipase capsules
D. Yaz tablets
E. Medroxyprogesterone tablets
B. Fiorinal tablets
Which of the following information does NOT need to be recorded in a patient profile?
A. Allergies
B. Gender
C. Over-the-counter medications, herbals, and/or natural products
D. Prescription medications
E. If female, number of pregnancies
E. If female, number of pregnancies
A pharmacy can disclose protected health information (PHI) without the patient’s written authorization for all of the following EXCEPT:
A. To a patient’s spouse for a divorce hearing
B. To coordinate healthcare
C. Counseling of patients
D. To a pharmacy board inspector investigating drug abuse
E. To insurance companies for reimbursement
A. To a patient’s spouse for a divorce hearing
