Hospitals & Other Institutional Dispensers

Question 1

Controlled substances prescribed or ordered for a specific patient in quantities which would not exceed a 72-hour supply may be stored…

Answer 1

with the patient’s other medications at the patient care unit, provided that they are kept in a securely locked medication cart or other storage unit approved by the department.

Question 2

Institutional dispensers and limited institutional dispensers can store controlled substances as floor stock on patient care units.

Answer 2

True

Question 3

Schedule I, II, III and IV controlled substances shall be kept in stationary…

Answer 3

locked double cabinets. Both cabinets, inner and outer, shall have key-locked doors with separate keys; spring locks or combination dial locks are not acceptable. For new construction, cabinets shall be made of steel or other approved metal.

Question 4

Schedule V controlled substances shall be stored in a stationary…

Answer 4

securely locked cabinet of substantial construction.

Question 5

Limited supplies of controlled substances for use in emergency situations may be stocked…

Answer 5

in sealed emergency medication kits.

Question 6

Schedule II controlled substances may…

Answer 6

not be stocked in medication carts.

Question 7

Schedule I and II controlled substances shall be kept in either…

Answer 7

(i) A GSA class 5 rated steel cabinet or equivalent safe approved by the Bureau of Narcotic Enforcement
(ii) a vault, constructed of substantial masonry and having a multiple position combination lock, a relocking device or the equivalent, and a door having a thickness of steel plate of at least one-half inch.

Question 8

Any cabinet or safe weighing less than 750 pounds shall be…

Answer 8

bolted or cemented to the floor or wall in such a way that it cannot be removed.

Question 9

The door of the cabinet or safe shall contain…

Answer 9

a multiple position combination lock, a relocking device or the equivalent, and steel plate having a thickness of at least one-half inch.

Question 10

For new construction, floor, walls and ceiling shall not be less…

Answer 10

than 8 inches of reinforced concrete, but less may be accepted where there are compensating extra safeguards.

Question 11

Schedule III, IV and V controlled substances shall be stored in…

Answer 11

a stationary, securely locked cabinet of substantial construction.

Question 12

Working stocks of controlled substances of a registered pharmacy may be dispersed throughout the stocks of noncontrolled substances.

Answer 12

True. Controls must be locked up if not dispersed.

Question 13

For institutional dispensers (hospitals, veterinary hospitals and mental hospitals), P.R.N. orders for controlled substances are not valid…

Answer 13

beyond 72 hours and must be rewritten.

Question 14

In an emergency situation in hospitals, a practitioner may have a controlled substance administered by oral order provided that such oral order shall be signed by the practitioner…

Answer 14

within 48 hours. A notation should be made of the emergency condition which required the administration of the drug.

Question 15

In an institutional setting, each emergency kit may contain up to a 24-hour supply of…

Answer 15

a maximum of 10 different controlled substances in unit dose packaging (no more than 3 may be in an injectable form)

Question 16

Each emergency kit shall be…

Answer 16

secured in a stationary, double-locked system or other secure method approved by the Department.

Question 17

Medication carts may be utilized to stock Schedule III, IV and V controlled substances provided they are in a secure location and equipped with:

Answer 17

(a) . double-keyed locks;
(b) . when not in use, anchored to a floor or wall device or maintained in another secure location;
(c) . locked drawer system; and
(d) . independent locking device.

Question 18

Access to medication carts shall be limited to an identified individual at all times. Such carts are to be used only…

Answer 18

in conjunction with a pharmacy maintained patient profile summary.

Question 19

For all institutional dispensers (e.g. hospitals, veterinary hospitals, mental hospitals, or similar facilities) standing orders or specific controlled substances orders for individual patients to be administered at specified times shall not be valid after…

Answer 19

7 days and for continuing validity shall be rewritten at least every 7 days.

**Law also applies to patients in residential health care facilities, or in prisons, which possess class 3 controlled substances licenses.

Question 20

Except that for a stabilized patient with convulsive disorders or chronic spasticity or minimal brain dysfunction in an institutional setting, and for patients in residential health care facilities, or in prisons, which possess class three controlled substances licenses, such orders shall be valid for…

Answer 20

30 days but shall be rewritten at least every 30 days.

Question 21

Written controlled substances orders for hospitalized patients may, if permissible under the bylaws, rules and regulations of the hospital, be signed by a physician’s assistant for…

Answer 21

patients under the care of the physician or physicians to whom the registered physician’s assistant is assigned for supervision, subject to compliance by the registered physician’s assistant with any of the foregoing conditions set forth in this section that are applicable to his/her supervising physicians.

Question 22

Written controlled substances orders shall be countersigned by the PA’s supervising physician within…

Answer 22

24 hours if deemed necessary and appropriate by the supervising physician or the hospital. Countersignature by the supervising physician is not required before the execution of the order.

Question 23

Orders for PRN controlled substances in an institutional setting are valid for how many administrations?

Answer 23

Only one administration (can be given anytime within the 72 hours)

Question 24

An institutional dispenser may dispense how much of controlled substance to a medical attendant accompanying a patient in a transfer if it is expected to exceed 3 hours?

Answer 24

A single dose of a controlled substance

Question 25

Institutional dispensers with limited licenses (3a) must keep a separate daily running record of all prescribed controlled substances received, indicating the:

Answer 25

(i) date
(ii) name and quantity of prescribed controlled substances
(iii) name of the prescriber
(iv) name of the patient
(v) name of the pharmacy
(vi) pharmacy Rx number of the prescription containing the controlled substance

Question 26

Institutional dispensers with limited licenses (3a) must keep a separate daily running record of the administration of prescribed controlled substances indicating the:

Answer 26

(i) date and hour of administration
(ii) name and quantity of controlled substances
(iii) name of the prescriber
(iv) patient’s name
(v) signature of person administering
(vi) the balance of the controlled substances on hand after such administration

Question 27

A hospital physician may supervise up to how many physician assistants (PAs)?

Answer 27

6

Question 28

Class 3 facilities may purchase stocks of controlled substances from a licensed manufacturer or distributor for inpatient and…

Answer 28

outpatient use through an appropriately registered pharmacy. Controlled substances are distributed within the facility from the registered pharmacy.

Question 29

Class 3 and 3A licensees may administer controlled substances to patients only pursuant to…

Answer 29

to a prescription issued by an authorized physician or other authorized practitioner and filled by a registered pharmacy

Question 30

Patient information required to be on a prescription issued on an official New York State prescription form includes…

Answer 30

(i) Patient name, address (city, zip code)
(ii) Patient gender
(iii) Patient age or DOB

Question 31

All of the following are able to prescribe therapeutic drugs in New York within their scope of practice EXCEPT:

Answer 31

Doctor of Chiropractic

Question 32

Hospitals must report medication errors that results in:

Answer 32

Permanent harm, near death of a patient, death of a patient

Question 33

What facilities may qualify for a class 3 license (institutional dispenser)?

Answer 33

Hospitals, veterinary clinics, mental hospitals, and similar facilities. Nursing homes may also qualify.

Question 34

For what purposes can controlled substances be used under a class 3 license?

Answer 34

Only for treating inpatients and/or outpatients seen in the facility.

Question 35

Before handling controlled substances, an institutional dispenser must obtain a…

Answer 35

Certificate of Approval from the Commissioner of Health.

Question 36

Institutions obtaining official New York State prescriptions shall establish a system of control and security, which will include the following:

Answer 36

• a record of all such Rxs received
• a record of all such Rxs assigned to staff practitioners
• a system requiring that such Rxs be kept under lock and key when not in use
• a system whereby official Rxs are surrendered to the institution if the practitioner to whom they were assigned terminates his affiliation with the institution
• a system whereby the BNE, NYDOH, is notified immediately of the loss, destruction or theft of any such official prescriptions assigned to the institution
• a system whereby the institution has a sufficient number of official Rxs in reserve for use by the institution

Question 37

As of April 2021, registered techs are allowed to compound in which settings?

Answer 37

only in hospitals and health-system