First Exam Flashcards
A pharmacy is permitted to re-dispense a returned prescription drug product as long as it is in the original, unopened, tamper evident packaging.
A. True
B. False
A. True
OBRA 90 mandates prospective drug use review and patient counseling on all new prescriptions in Texas.
A. True
B. False
A. True
General requirements for inventories include:
I. Estimated count of all controlled substances in Schedules II, IV, V
II. Exact count of all Schedule II controlled substances
III. Schedule II controlled substances listed separately on inventory
A. I only
B. I and II only
C. II and III only
D. I, II, and III
C. II and III only
A community pharmacy received a prescription from a medical resident of a local hospital. The hospital’s DEA registration number was on the prescription with the internal code number assigned to the resident. The prescription was signed by the resident but the resident’s name was nowhere else on the prescription. Which of the following would be correct:
A. A prescription from a resident using a hospital registration number is not valid outside the hospital pharmacy.
B. The prescription is not facially valid because the resident’s name must be stamped, typed or handprinted on the prescription.
C. The prescription is facially valid
D. Statements A & B are correct
E. Statements A & C are correct
B. The prescription is not facially valid because the resident’s name must be stamped, typed or handprinted on the prescription.
HIPPA. True or False. A covered entity may not disclose protected health information to law enforcement officials without first providing the patient with an opportunity to object to the
disclosure.
A. True
B. False
B. False
A designated agent is allowed to communicate a prescription to the pharmacist over the phone.
A. True
B. False
A. True
A drug product’s label states that the drug is 0.25 mg. Tests show that the product is actually 0.5 mg. This product is: A. Adulterated B. Misbranded C. Neither adulterated or misbranded D. Both adulterated and misbranded
D. Both adulterated and misbranded
A faxed prescription for any C-II drug from the prescriber to the pharmacy is acceptable in place of the original for which of the following:
A. In any situation
B. A resident of a skilled nursing facility
C. An emergency situation
D. For terminally ill patients
D. For terminally ill patients
A pharmacist has a bottle of expired Demerol tablets that he sends to the reverse distributor for destruction. Which form is used to record this transaction? A. DEA Form 222 B. DEA Form 41 C. DEA Form 225 D. TX Official Prescription Form
A. DEA Form 222
A pharmacist may dispense up to a 90-day supply of a drug pursuant to a valid prescription that specifies the dispensing of a lesser amount followed by periodic refills of that amount provided conditions are met.
A. True
B. False
A. True
A pharmacist received a prescription from a prescriber for a very suspicious person from out of state. The pharmacist suspected that the person was a diverter and not really a patient but could not confirm it and dispensed the prescription anyway. Later the pharmacist was visited by the DEA and the BOP who told the pharmacist that the person had been duping physicians all over the area into writing controlled substance prescriptions and was selling the drugs on the street. Which of the following is the best answer:
A. The pharmacist has not violated the law since the prescription was facially valid from an authorized prescriber.
B. The pharmacist has violated the law since the prescriptions was not for a legitimate medical purpose.
C. The pharmacist has not violated the law unless it can be established that the pharmacist acted negligently
D. The pharmacist has not violated the law unless it can be established that he filled the prescription knowing it was not for a legitimate medical purpose
D. The pharmacist has not violated the law unless it can be established that he filled the prescription knowing it was not for a legitimate medical purpose. (Look for clues in law book when Rx is not a diverter)
A pharmacist received a prescription for 500 oxycodone tablets with the directions such that the patient was to significantly taper down the dosage over the next 4 weeks. The pharmacist called the prescriber who informed the pharmacist that the patient is an addict and that the prescriber is trying to detoxify the patient. Which of the following would be correct:
A. This prescription is not for a legitimate medical purpose and should not be dispensed.
B. This prescription is for a legitimate medical purpose and should be dispensed
C. This prescription would be valid under DATA.
D. Statements A &C are correct
A. This prescription is not for a legitimate medical purpose and should not be dispensed.
A pharmacist received a prescription for Zostat with the direction to take tid for migrane headaches. Zostat is indicated for anxiety and labeled for once a day use. Which of the following would be the best answer?
A. Under the FDCA the physician may legally prescribe and the pharmacist may legally dispense Zostat for this purpose and in this dose
B. The pharmacist should confirm the accuracy of this prescription with the prescriber and if confirmed exercise professional judgment regarding the reasonableness of the risk in deciding whether to dispense the prescription or not.
C. The pharmacist should confirm the accuracy of this prescription with the prescriber and if confirmed dispense the drug without further consideration
D. Statements A and C together constitute the best answer
B. The pharmacist should confirm the accuracy of this prescription with the prescriber and if confirmed exercise professional judgment regarding the reasonableness of the risk in deciding whether to dispense the prescription or not.
A pharmacy has on hand several tablets and capsules of various controlled drugs. The wholesaler and manufacturer will not take them back and the pharmacy wants to destroy them. Which of the following would be correct:
A. The pharmacy must notify the DEA in advance and destroy the drugs in the presence of DEA agents
B. The pharmacy must notify the DEA in advance and destroy the drugs in the presence of a DEA agent or other authorized person
C. The pharmacy must notify the DEA and the state board of pharmacy and destroy the drugs in the presence of DEA agents or BOP agents.
D. The pharmacy must send the drugs to the DEA for destruction
B. The pharmacy must notify the DEA in advance and destroy the drugs in the presence of a DEA agent or other authorized person
A pharmacy is never allowed to sell, purchase, trade, or possess prescription drug samples.
A. True
B .False
B. False
A pharmacy may distribute what percentage of the total controlled substance units it distributes and dispenses in a year without having to register as a distributor? A. 5 B. 1 C. 10 D. 20
A. 5
>5%/yr considered wholesaler
A pharmacy receive a prescription for a C-III medication. The strength of the medication was not indicated on the prescription.
Which of the following would be the best answer:
A. The pharmacist may legally add it without contacting the prescriber
B. The pharmacist may legally add it after contacting the prescriber and documenting that the prescriber agreed to the strength
C. The prescription is not valid and cannot be dispensed
D. The prescription is not valid and cannot be dispensed, however, the pharmacist may contact the prescriber and execute a new oral order.
B. The pharmacist may legally add it after contacting the prescriber and documenting that the prescriber agreed to the strength
A pharmacy received a prescription from Dr. Robert Jed. The DEA registration number on the prescription reads BJ2385121. Which one of the following is most correct:
A. The number is clearly valid
B. The number is clearly invalid
C. The number could be valid
D. There is no way to tell if the number could be valid or not
C. The number could be valid
A physician calls a pharmacy from the golf course and says he is calling in a two week supply of a C-II Rx for a patient for hydrocodone. The pharmacist is familiar with the patient and the physician and knows the patient is terminally ill and has received hydrocodone Rxs before. The physician says the patient’s wife will be in to pick up the medication in about an hour.
Which of the following would be the best response from the pharmacist to the physician, combining federal and state law:
A. “We cannot dispense a two week supply, but only enough hydrocodone for the emergency period. We must receive an original written prescription with the notation “Authorization for Emergency Dispensing” within 7 days.”
B. “We cannot dispense a two week supply, but only enough hydrocodone for the emergency period.”
C. “We can dispense a two week supply. We must receive an original written prescription with the notation “Authorization for Emergency Dispensing” within 7 days.”
D. “This is most likely not an emergency situation and we cannot dispense the prescription.”
A. “We cannot dispense a two week supply, but only enough hydrocodone for the emergency period. We must receive an original written prescription with the notation “Authorization for Emergency Dispensing” within 7 days.”
A prescriber calls a pharmacist seeking the pharmacist’s advice. The prescriber says that a particular patient, whom the pharmacist knows well as a regular patient of the pharmacy, will require maintenance therapy on a particular C-II drug for at least the next six months. The physician and the patient want to make obtaining the drug as easy as possible. Which of the following represent legal options for the patient and the prescriber assuming legitimacy is not an issue.
A. The prescriber could issue one C-II Rx for a six-month supply.
B. The prescriber could issue 3 prescriptions, each for a 60 day supply. Each Rx except the first specifying the earliest date upon which the prescription can be filled.
C. The prescriber could issue 3 prescriptions, each for a 30 day supply. Each Rx except the first specifying the earliest date upon which the prescription can be filled. The patient must get a new Rx or new set of Rxs for the remaining 90 day supply.
D. Statements A &C are legally permissible
D. Statements A and C are legally permissible
A prescription that contains narcotics in an amount greater than the maximum allowed for Schedule V then becomes a Schedule II.
A. True
B. False
B. False
A state decided to reschedule all opioid drug products scheduled as C-III under federal law to C-II pursuant to state law. Which of the following would be correct?
A. The federal CSA preempts states from scheduling drug products
B. The state law would not conflict with federal law and thus likely not be preempted
C. If the state law is valid, pharmacists should follow federal law and dispense the products as C-III
B. The state law would not conflict with federal law and thus likely not be preempted
According to a recent law change, the Texas Controlled Substances Act allows pharmacists to dispense prescriptions for controlled substances under a written, oral, or telephonically prescription from an out-of-state physician assistant (PA).
A. True
B. False
B. False
According to Federal law, all of the following information is required on written or verbal Schedule II prescriptions EXCEPT: A. date dispensed B. drug name C. DEA number of practitioner D. age of the patient
A. date dispensed
According to Federal law, Schedule II prescriptions for patients in a long-term care facility are valid for no longer than \_\_\_\_\_\_ days from the date of issuance. A. 30 B. 60 C. 45 D. 120
B. 60
According to Federal law, there is no time limit for filling a Schedule II prescription.
A. True
B. False
A. True
According to the Official Prescription Form, which of the following information is allowed to be changed by the pharmacist with permission of the prescriber? A. Practitioner's name B. Dosage Form C. Name of drug D. Name of patient
B. Dosage Form
According to the Official Prescription Program, partial filling is allowed for patients that do not reside in a long-term care facility as long as the balance is dispensed with \_\_\_\_\_\_ hours. A. 24 B. 48 C. 72 D. 96
C. 72
It is a violation of the Food, Drug, and Cosmetic Act to sell a drug that has been adulterated.
A. True
B. False
A. True
All of the following are classified as registrants EXCEPT: A. pharmacists B. physicians C. researchers D. hospitals
A. pharmacists
An intern may transfer a prescription to another intern.
A. True
B. False
B. False
An oncologist contacts your pharmacy and informs you that he would like to use your pharmacy as a distributor of controlled substances. Your pharmacy has dispensed 30,000 units of controlled substances in the past year. Additionally, your pharmacy has already distributed 300 units of controlled substances to another physician. How many doses of controlled substances may you distribute to the oncologist without the need for a "distributor" registration from the DEA? A. 1,200 Units B. 2,700 Units C. 27,000 Units D. 1,500 Units
A. 1,200 Units
APNs and PAs may not “carry out” or “sign” a prescription drug order for controlled substances for:
A. a refill that has been authorized after consulting with the delegating physician
B. more than a 90 day supply
C. less than a 30 day supply
D. a drug in schedule III, IV, or V
B. more than a 90 day supply
Approved drugs that are considered therapeutically equivalent in the Orange Book would be rated A. AB B. BA C. BC D. TA
A. AB
Which of the following is necessary for a pharmacist to order Schedule II controlled substances on behalf of a pharmacy? A. Power of the Purse B. Power of Attorney C. Power Arranger D. Power Ball
B. Power of Attorney
Auto-Refill programs may be used for refills of dangerous drugs and Schedule III through V controlled substances.
A. True
B. False
B. False
Bling Pharmacy called Zing Phamacy requesting a transfer of a C-III Rx to Bling for a patient. The prescription had 2 refills remaining. Which of the following would be correct (assume that Bling and Zing do not share common electronic files).
A. The pharmacist at Zing could instruct the technician to orally transfer the required prescription information to Bling.
B. If the patient wants the last refill at Zing, Bling could subsequently transfer the prescription back to Zing.
C. Bling must record on the prescription it transcribes from Zing the word “transfer” together with several other points of information including Zing’s prescription number.
D. B &C
C. Bling must record on the prescription it transcribes from Zing the word “transfer” together with several other points of information including Zing’s prescription number. (only one transfer unless shared among same database)
Bulk containers shipped to manufacturers, wholesalers, pharmacies (not intended for household use) are exempt from the child-resistant containers requirement.
A. True
B. False
A. True
Which of the following would be an appropriate method for storing C-IIs within a retail pharmacy? (SELECT ALL THAT APPLY)
A. On one shelf mixed with other controlled substances from different schedules.
B. On multiple shelves mixed in with regular stock and non-controlled substances.
C. In a locked safe or cabinet.
D. Over-the-counter with cough and cold products.
B. On multiple shelves mixed in with regular stock and non-controlled substances.
C. In a locked safe or cabinet.
Which of the following is/are a valid method used to convey a prescription for diazepam? I. Oral II. Written III. Facsimile A. I only B. III only C. I and II only D. II and III only E. I, II, and III
E. I, II, and III
Dr. Jones is a new dentist in town. He asks the pharmacist at Friendly Pharmacy if he can obtain Ativan, a schedule IV anti-anxiety drug, to use on his patients in the office prior to procedures. Dr. Jones would like to write a prescription for office use. Is this allowable?
A. Yes. Practitioners have no restrictions in writing controlled substance prescriptions for office use.
B. Yes. Dr. Jones is an individual practitioner under the law and is permitted to obtain schedule III-V medications in this manner.
C. No. Dr. Jones is a dentist and not a physician, and therefore is unable to obtain Ativan in this manner for office use.
D. No. Pharmacies are restricted from filling controlled substance prescriptions written for office use.
D. No. Pharmacies are restricted from filling controlled substance prescriptions written for office use.
Dr. New is out of town for a conference and receives a call from a cancer patient of his that needs a new prescription for Oxycontin (schedule II). Dr. New calls pharmacist Phil to see if he can call in a verbal order for Oxycontin since he will be at the conference for 5 days. Which of the following would be allowable for Phil to do?
1. Phil could take an emergency phone order from Dr. New for the Oxycontin under the given circumstances.
2. Phil should inform Dr. New that a written prescription will have to be delivered within 7 days.
3. Phil should inform Dr. New that only a three day supply of the drug can be called in.
A. I
B. I and II
C. II and III
D. I, II, and III
B. I and II
Drug classes requiring Medication Guides include (Select all). A. Naprosyn B. Jantoven C. Relafen D. MsContin
A. Naprosyn
B. Jantoven
C. Relafen
D. MsContin
Which of the following Recall Classifications would indicate a reasonable possibility that use of the product will cause serious adverse effects on health, or even death? A. Class I B. Class II C. Class III D. None of the Above
A. Class I
How long is a prescription for amphetamine salts 5 mg valid? A. 14 days B. 21 days C. 6 months D. 1 year
B. 21 days
In an emergency situation, a pharmacist may fill an oral prescription from a prescriber for a Schedule II controlled substance, but it is limited to a 72 hour supply.
A True
B False
B False
A pharmacist may refill a prescription for Tylenol with Codeine for a 72 hours supply without physician approval as long as which of the following criteria are met?
A. Failure to refill may result in interruption of therapy or create patient suffering.
B. Either a natural or man-made disaster has occurred; or, the pharmacist has been unable to contact the physician.
C. The pharmacist informs the physician as well as the patient or their agent as soon as reasonably possible thereafter.
D. All of the above.
E. None of the above.
D. All of the above.
