Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

WA MPJE 2024 > MPJE Review Session > Flashcards

MPJE Review Session Flashcards

1
Q

describe the membership for the pharmacy commission

A

-10 pharmacists (licensed in WA for at least 5 years, geographically representative, and representing various areas of practice)
-4 public members, not affiliated with any aspect of pharmacy
-1 pharmacy technician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how long is a term for a pharmacy commission member

A

4 year terms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the practice of pharmacy from RCW 18.64.011

A

-interpreting prescription orders
-compounding, dispensing, labeling, administering and distributing of drugs and devices
-monitoring of drug therapy and use
-initiating or modifying drug therapy in accordance with written protocols approved for his or her practice by a practitioner authorized to prescribe
-participating in DUR and drug product selection
-proper and safe storage, distribution, record keeping
-providing of info on legend drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is considered monitoring of therapy from WAC 246-945-355

A

review of drug therapy regimen by a pharmacist for the purpose of evaluating or rendering advice to the prescribing practitioner or patient regarding the patients’ drug therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what can a pharmacist edit on a script

A
  1. change qty if: prescribed qty or pack size isn’t commercially available, change is relating to dosage form, change is intended to dispense up to the total amount authorized by the prescriber including refills, change extends a maintenance drug for the limited qty necessary to coordinate a patient’s refills in a med sync program
  2. change dosage form
  3. complete missing info
  4. documentation *** must document changes in the patient’s record
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the required training during the first year of licensure as an rph

A

suicide prevention training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when do you need to do the CE requirement for heath equity

A

at least once every 4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

do techs licensed in WA need to pass a national exam

A

yes, either the PTCE or ExCPT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how many hours of CE do techs need to perform

A

20 hours relating to pharmacy practice and directed to technicians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

do techs need to do certain CE

A

yes, 2 hours must be in pharmacy law and 1 hour must be in patient safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how many days may be included in the checked cassettes of unit-dose checking (tech-check-tech)

A

48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

is there a pharmacist to technician ratio

A

not anymore as of 9/2019. the ratio is to be determined by the responsible pharmacy manager, and the responsible pharmacy manager will ensure that the number of pharmacy techs on duty can be safely supported by the pharmacist on duty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how many times can you retake a failed exam in WA

A

up to 3 times within 3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

who are considered federal pharmacists

A

indian health service, PHS, armed forces, VA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

do WA licensed federal pharmacists who are on active duty or in the PHS pay fees or submit CE

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the requirement for Nuclear pharmacists in WA

A
  1. be certified by a specialty certification board or
  2. complete 200 hours in a structured educational program meeting requirements set in WAC 246-240-075(2), to obtain a written attestation to such successful completion from a preceptor-authorized nuclear pharmacist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how much CE is required to renew a pharmacist license

A

30 hours every 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the DEA form to apply for a new pharmacy and when do you need to have it done by

A

DEA form 224, 30 days prior to commission meeting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the pharmacy owner responsibilities

A

-place a pharmacist in charge
-pay license fee
-file a statement of ownership and location
-maintain records of prescriptions and dispensing for a min of 2 years
-maintain CSA records for a min of 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if there is a change in responsible pharmacy manager, when should you notify of the change

A

within 30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

community/outpatient label requirements

A

-drug qty
-number of refills
-unless a vet rx “warning: state or federal law prohibits transfer of this drug to any person other than the person for whom it was prescribed”
-name of facility if the “patient” is a facility or entity
-compounds meet USP
-exp date: take into account the nature of drug, container from manufacturer, patient’s container, expected shortage conditions, expected length of therapy
-vet meds: name and species of patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

WA facility standard

A

-Constructed and equipped for adequate security
-Properly equipped to ensure safe, clean, and sanitary conditions
-Staffed sufficiently to allow appropriate supervision, operate safely, and remain
open during posted hours
-Adequately stocked to maintain at all times a representative assortment of drugs to
meet needs of patients (WAC 246-945-415)
-Designate a RPM by opening and within 30 days of vacancy
-Create P&Ps
-DUR required before dispensing/delivery UNLESS emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what schedule of drugs must be kept in a separate file than c3-5 or legend drugs

A

c2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when does a pharmacy do a self inspection

A

annually in march

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when does the board give the inspection report

A

within 10 business days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are non-resident pharmacies

A

sell or ship drugs to patients in WA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

who do non-resident pharmacies need to register with

A

WA pharmacy commission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the requirements for inpatient hospital prescription labeling

A

-drug name
-strength
-compounded product must meet USP chapter labeling requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when can verbal orders be used in hospital and LTC facilities

A

only in emergencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

when can a patient use their meds brought from home in a hospital

A

a written policy must be in place, and can only be administered if properly ordered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

when can a patient self administer medication in hospital/rehab/LTC

A

may be done under a policy and approved protocols in a program of self care or rehab and the policy must be developed by hospital RPM and be approved by the admin/medical/nursing staff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

when do you do a controlled substance inventory

A

-every 2 years
-within 30 days of new RPM
-addition of new substance to the schedule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are the labeling requirements for prepacked meds in extended care facilities (skilled nursing facilities)

A

-drug name
-strength
-exp date
-manufacturer name
-lot #
-identity of pharmacist/provider responsible for prepacking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are the labeling requirements for unit dose packaging

A

-individual storage unit for each patient, clearly labeled with resident name
-individual package must have:
-name of drug
-strength
-lot #
-exp date
-CSA schedule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

can a pharmacy repackage and reuse unused drugs returned by a long-term care facility or hospice program to the pharmacy in per-use blister packaging (whether in unit dose or modified unit dose form) *except where prohibited by federal law

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are the labeling requirements for non-prescription drugs

A

-date of receipt by facility
-patient’s name
-manufacturer or pharmacy label
-doesn’t apply to selected bulk drugs used by the facility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

OBRA requirements for LTC facilities

A

-pharmacist must be involved in care of patient
-development of comprehensive care plan for each resident
-resident’s therapy must be free of unnecessary drugs (duplicate therapy, excessive duration, inadequate monitoring, inadequate indications for use, use of drugs in presence of ADRs)
-comprehensive reviews of psychotropic drugs and plan to reduce in each patient
-drug regimen review by pharmacist every 30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

where is the list of contents on an emergency kit

A

on the outside of the kit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the process where a pharmacy can outsource for LTC or hospice program residents

A

-Obtain approval from LTC/hospice
-Provide copy of prescription or chart order to pharmacy providing shared
pharmacy services
-Supplying pharmacy retains copy of prescription, dispensing record, and
notifies outsourcing pharmacy of service & quantity provided
-Only transfers one fill or partial fill to another pharmacy to meet needs of
patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

who is responsible for storage, security, and accountability of LTC supplemental dose kits

A

Pharmacy and PSC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

who determines the contents for LTC supplemental dose kits

A

PSC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

who can stock the ADDD (automatic drug dispensing devices)

A

pharmacist, intern, or technician (under pharmacist supervision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

who makes the list of emergency meds which are subject to retrieval without prospective pharmacist DUR

A

determined by PSC or P&T committee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

in what situations can a pharmacist NOT perform a prospective DUR

A

-subsequent dose from previously reviewed order
-prescriber in immediate vicinity and controls drug dispensing process
-system is used for emergency meds (pharmacist retrospective review within 24 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what can a medicare-approved dialysis center or facility operating a medicare-approved home dialysis program may sell/deliver/posses/dispense directly to its home dialysis patients in cases or full shelf package lots if prescribed:

A

-sterile heparin 1000 u/ml in vials
-sterile KCl 2 mEq/ml for injection
-commercially available dialysate
-sterile sodium chloride 0.9% for injection in containers of not less than 150ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what usp do nuclear pharmacies follow

A

usp 825

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

when should you notify the commission prior to closing a pharmacy (regardless of setting)

A

at least 30 days prior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what do you put in a commission notice of pharmacy closure

A

-intended date of closing
-names and addresses of persons who shall have custody of pharmacy’s records
-names and addresses of persons who will acquire any of the legend drugs of CSAs (if known)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

within 15 days after closing the pharmacy, what must be supplied to the commission

A

-The pharmacy license (voided)
-Written confirmation of:
-Proper transfer or destruction of legend drugs, including names and addresses of transferees
-Proper transfer of any CSAs and names and addresses of transferees
-Return of DEA registration and unused forms to DEA
-Destruction of pharmacy labels and prescription blanks
-Removal of all signs and symbols indicating the presence of pharmacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

when you’re closing a pharmacy, what do you tell the patients and how

A

-direct mail or newspaper ad and posting a sign near the pharmacy
-intended date of closing
-name and address of pharmacy to which prescriptions will be transferred
-instructions on how patients can arrange for transfer of their prescriptions to a pharmacy of their choice, and the last day a transfer may be initiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

how do shopkeepers register to sell otc drugs

A

register via Master License application system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

in what situation does a pharmacy not need to register as a wholesaler

A

if they sell to another pharmacy or practitioner for an emergency medical reason

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

pharmacy selling to another pharmacy or provider: what constitutes an emergency

A

when a patient requires the specific medication, with no alternative therapy,
and the other entity has no way of obtaining the medication from a licensed wholesaler to
meet the need. Additionally, it is not feasible for the patient to travel to the pharmacy with
the stock to get the medication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

drugs may not be introduced into commerce unless

A

proven safe (1938) and effective (1962) for intended use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

from the Wiley Act: what is adulteration

A

Impurities
Added injurious substances
Failure to meet compendial standards
Stored improperly or in unsanitary conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

from the Wiley Act: what is misbranding

A

In 1906, this meant false and fraudulent statements on the label
Now, means any false or misleading statements on the labeling (which
includes label and other statements made about the product by the
manufacturer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is the difference between a medguide and a patient package insert

A

-medguides are required for those drugs that pose the most serious and significant public health concern
-PPI (patient package inserts) are generally no considered by the FDA to carry the same serious and significant public health concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what may be included with REMS requirements

A

 Assessments at 18 months, 3 yrs, and 7 yrs post marketing
 MedGuide or PPI development
 Communication plan to health professionals
 Plans:
 Limit prescribing to physicians with special training
 Limit dispensing to certified providers
 Limit administration to certain settings
 Limit distribution to patients with documentation of safe-use conditions, such as lab
tests
 Monitoring for each patient using the drug  Enrollment of each patient in a registry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what changed on package inserts in 2006 when the FDA revised the format

A

PIs now follow a specified layout, with a “highlights” section which must be the first section of the insert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what are the requirements of a 7 point OTC label

A

-name of product
-name and address of manufacturer/packager/distributor
-net contents
-active ingredients and quantity of certain other ingredients
-name of any habit-forming drugs
-cautions and warnings
-adequate directions for use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what act requires child-resistant containers on all rx drugs

A

poison prevention packaging act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

do all over the counter meds require child resistant packaging

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what otc meds require child resistant packing

A

 Aspirin  Acetaminophen  NSAIDs  Iron preparations > 250 mg elemental
iron/pkg  Diphenhydramine > 66 mg/pkg  Fluoride > 50 mg/pkg  Lidocaine, Dibucaine  Loperamide  Minoxidil

 Methacrylic acid  Methyl salicylate  Ethylene glycol  Methyl alcohol  Hydrocarbons and solvents  NaOH, KOH, H2SO4  Permanent Wave Neutralizers  Drugs switched to OTC status after 2001

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what legend drugs do not require child resistant packaging

A

 Nitroglycerine SL  SL, chewable isosorbide <= 10 mg  NaF <= 110 mg/pkg  Cholestyramine and colestipol
powder  Oral corticosteroids in doses <=105
mg of prednisone equiv.  Mebendazole <= 600 mg/pkg

 K+ supplements <= 50 mEq/dose  EES granules <= 8 g/pkg, tabs <= 16 g  Aerosols for inhalation  Pancrelipase  OCs in memory aid containers;
MPG; other hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

information required on label of dispensed legend drug (federal law)

A

-name and address of dispenser
-serial (prescription) number
-date of the prescription or of its filling
-name of the prescriber
-if stated in the prescription, name of the patient
-the directions for use and cautionary statements, if any, contained in such prescription
-side effects statement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is the side effects statement

A

call your doctor for medical advice about side effects. you may report side effects to FDA at 1-800-FDA-1088

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

does the side effects statement need to be included on the label?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

where can the side effects statement be printed

A

-on a sticker attached to package (or label)
-on preprinted vial cap
-on separate sheet of paper
-in consumer med info
-in FDA-approved medguide containing the statement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what info is required on label of legend drug

A

 Complete directions for use (“UD” not valid)
 Expiration date
 Quantity dispensed
 Number of refills remaining, if any
 Name and strength of drug
 Initials of pharmacist (can be in computer system)
 “Warning: State or federal law prohibits transfer of this medication to any person
other than the person for whom it is prescribed.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what are the only controlled substances that a naturopath can prescribe

A

codeine and testosterone products only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what practitioners do not have prescriptive authority in WA

A

Naturopath, optometrist
pharmacist, midwife

70
Q

can you accept any script from BC

A

only legend drugs unless they’re registered with the DEA

71
Q

can PT or OT prescribe? what can they do

A

no, may order and use certain legend drugs (from a wholesaler and for office use). only can administer drugs appropriate to physical or occupational therapy

72
Q

do prescriptions “die” with the prescriber

A

not in WA but best practice is to encourage patient to find new prescriber

73
Q

when receiving a transferred Rx – what must you ask the transferring pharmacist

A

if the original was written on a tamper-resistant pad

74
Q

what are the requirements for electronic prescribing in WA

A

-must meet standards for security and integrity
-must be approved by the commission
-staff must sign and adhere to security and integrity policy and procedures
-must allow for communicating preferences for substitution
-C2 are allowed via electronic prescribing as long as the prescriber and pharmacy are in compliance with regulations required by the DEA

75
Q

all legend drugs expire after how long in WA

A

1 year

76
Q

the full qty of the prescription refill may be dispensed up to what day

A

last day before the rx expires

77
Q

for non-CSA drugs, an emergency supply for what may be given once in 6 months

A

up to 30 days or most recent fill (which ever is less)

78
Q

can prescribers delegate refill auth to a nurse or staff under protocol

A

no

79
Q

can you sell syringes/needles in WA

A

yes a retailer may sell needles/syringes if he/she is satisfied that the device will be used for the legal use intended

80
Q

how old do you need to be to purchase needles/syringes otc

A

persons > 18 years old

81
Q

do retailers need to sell syringes/needles to public

A

NO not required

82
Q

what did the drug quality and security act of 2013 do

A

new compounding standards resulting from improper oversight at NECC
- outlines steps to build an electronic, interoperable system by 11/27/13 which will identify and trace certain prescription drugs as they are distributed within the US (will enhance the FDA’s ability to help protect US consumers by improving detection and removal of potentially dangerous products from the pharmaceutical supply chain)

83
Q

what are the prohibited products for compounding

A

Prohibited Products  May not compound products that are listed by FDA as having been
removed from market due to lack of safety or efficacy  May not compound “regularly or in an inordinate amount”
products that are essentially copies of commercially available drug
products.  May not compound products that are listed by FDA as having
demonstrable difficulties in compounding.

84
Q

what does WA consider to not be “manufacturing”

A

 “Manufacturing” does NOT include:  Office Use – Compounded by a pharmacy on order of licensed practitioner for
use in practitioner’s professional practice for administration to patients;  Limited repackaging – Repackaging of commercially available medication in
“small, reasonable quantities” for office use by a practitioner;  Centralized compounding – Distribution of a compounded product to other
appropriately licensed entities under the ownership or control of the facility in
which the compounding takes place; or  Delivery - Delivery of finished and appropriately compounded products
dispensed pursuant to a prescription to “alternative delivery locations, other
than the patient’s residence, when requested by the patient, or the prescriber to
administer to the patient, or to another licensed pharmacy to dispense to the
patient.

85
Q

what does the USP 795 apply to

A

non sterile preparations

86
Q

when do non-aqueous liquids and solids expire according to 795

A

6 months or 25% of mfr label if made from manufactured product
*not greater than 6 months if USP of NF ingredient is source

87
Q

aqueous expiration date according to 795

A

14 days, stored in cold place

88
Q

all other (not non-aqueous liquids/solids or aqueous preparations) expiration date

A

30 days or intended duration of therapy

89
Q

what does USP 797 apply to

A

sterile products and responsibilities of pharmacy personnel in their preparation

90
Q

what does the USP 800 apply to

A

handling of hazardous drugs

91
Q

what group requires hazard communication program

A

OSHA

92
Q

when must you assess USP 800 job function

A

every 12 months

93
Q

what are the types of exposure of hazardous drugs

A

dermal, mucosal, inhalation, ingestion, injection

94
Q

groups of HDs determined by NIOSH

A

1-antineoplastic drugs
2-non-antineoplastic drugs
3-drugs that primarily pose reproductive risks to those actively trying to conceive and women who are pregnant or breast feeding

95
Q

USP labeling standards for compounded products

A

-name of preparation
-internal identification number
-beyond use date
-initials of compounder
-storage requirements
-other items required by state law

96
Q

is certification from the pharmacy compounding accreditation board mandatory

A

no but may be required by insurance companies for sterile compounding

97
Q

what is the new WA definition from 2021 for compounding

A

“Compounding” means the act of combining two or more ingredients in the
preparation of a prescription. Reconstitution and mixing of (a) sterile
products according to federal food and drug administration-approved
labeling does not constitute compounding if prepared pursuant to a
prescription and administered immediately or in accordance with package
labeling, and (b) nonsterile products according to federal food and drug
administration-approved labeling does not constitute compounding if
prepared pursuant to a prescription.

98
Q

who can receive prescription drug samples

A

ONLY prescribers or to hospitals at request of prescribers

99
Q

what kind of clinic may possess and distribute drug samples

A

free

100
Q

in what instance can retail pharmacies have drug samples

A

only when part of a drug donation program

101
Q

should you repack legend drugs while transferring between pharmacies

A

no

102
Q

what is the definition of a class 1 recall

A

likelihood of injury or death from use of product; may include public warning

103
Q

what is the definition of a class 2 recall

A

temporary or reversible health problems from use of product

104
Q

what is the definition of a class 3 recall

A

use of product NOT likely to cause health problems

105
Q

when would a drug be withdrawn from the market

A

minor health risk or minor FDA violation

106
Q

what does the federal controlled substances act establish

A

a closed system of inventory and accounting for distribution of controlled substances

107
Q

out of the schedules, 1-7, which are considered controleld

A

1-5

108
Q

washington law allows naloxone scripts to be filled for who in case of accidental overdose

A

caregiver or friend of opiate user

109
Q

terminally ill (death expected within how many months) competent adult WA residents may request a script they may take to end their life

A

6

110
Q

how many physicians must certify the terminally ill patient is competent

A

2

111
Q

what does the terminally ill patient need to do to actually request the prescription to end their life

A

make an oral and written request to the physician

112
Q

how long must the terminally ill patient wait between the oral and written request for a prescription to end their life

A

15 days

113
Q

how many witnesses does the written request for a med to end life need

A

2; 1 of which may not be related to the patient, be entitled to share the patient’s real estate, or be employed by the institution providing care

114
Q

how much time must elapse between the second oral request for a med to end life and issuance of the prescription

A

48 hours

115
Q

what are the restrictions for prescriptions under the DWDA

A

-must be for a drug the patient can ingest by him/herself (no injections)
-physician may dispense drug directly to patient or with pt permission can contact willing pharmacist and explain nature of script

116
Q

What are the individual provider rights within the DWDA

A

-no rph or physician may be compelled to participate in aid-in-dying
-no rph or physician may be disciplined or otherwise adversely treated for participating in aid-in-dying

117
Q

what other registration do internet pharmacies need to dispense controlled substances

A

registered under Ryan Haight Online Pharmacy Consumer Protection Act of 2008

118
Q

what are the optometrist WA CSA prescribing limits

A

-no C2
-no more than 7 days supply of CSA
-no more than 30 dosage units of 3 or 4
-single dose BZDs for pre-procedure use

119
Q

which employee of hospital may use hospital DEA number with permission in the course of his/her duties if otherwise authorized to prescribe

A

any

120
Q

do public health service or bureau of prisons employees need a DEA #

A

no, use social security number as DEA #

121
Q

do military practitioners need a DEA to prescribe CSA on base

A

no, but they need if prescribing off base

122
Q

for physical CSA inventories, when do you need to actually count C3-5

A

if container have > 1000 doses and has been opened

123
Q

what does a completed CSA rx need

A

Completed CSA Rx
 Patient name
 Patient address
 Date written
 Drug, Quantity, Directions
 Physician Address
 Physician DEA Number
 Physician Signature or Name
 Other information required by state
 Pharmacies must have on file diagnosis for use of amphetamines
 ICD10 code for opioids from episodic care prescriber
 WA Commission has indicated that a pharmacist may add any missing information after
consultation with prescriber, may add DEA number without consultation if it is already known
with certainty. (changing the drug or patient is not allowed)

124
Q

according to the DEA, can you use a faxed request for refills of CSA as need rx?

A

no: prescriber must generate new Rx, sign it and fax that to the pharmacy

125
Q

in WA, when do C2 scripts expire

A

6 months

126
Q

when do you need a confirming/covering Rx from a Emergency C2 phoned/faxed script by

A

postmarked or received at pharmacy within 7 days

127
Q

if you don’t receive a covering rx for an emergency c2 script what are the next steps

A

must notify BOP and/or DEA

128
Q

in what situations can you use a faxed c2 script as an original

A

-LTC facilities
-home infusion practices (only injectables)
-hospice patients

129
Q

what can an RPh change in a C2 rx after consult with the prescriber

A

-dosage form
-drug strength
-drug qty
-directions for use
-issue date

130
Q

what can an RPh not change on a C2 rx

A

patients name (other than spelling) or the controlled substance prescribed (other than brand/generic)

131
Q

what can the RPh change without prescriber consult

A

patients address after verification and DEA number if known

132
Q

When can you partial fill a controlled substance

A

IF
1. requested by either prescriber or patient
2. not prohibited by state law
3. total dispensed in partial fillings doesn’t

133
Q

what is the transfer warning for CSA prescriptions in WA vs Federal

A

Federal; “caution: federal law prohibits transfer of this medication to any person other than the person for whom it was prescribed”

WA; “Caution: State or Federal Law prohibits transfer of this medication to any person other than the person for whom it was prescribed”

134
Q

Does WA require the transfer warning on only CSA scripts

A

no – on all

135
Q

where should all non cancer patients should receive scripts from …

A

1 practitioner and 1 pharmacy whenever possible

136
Q

when should periodic reviews happen for narcotics in non-cancer pain

A

every 6 months

137
Q

in what situation would periodic reviews happen for narcotics in non-cancer pain happen annually

A

stable chronic non-cancer pain involving non-escalating daily doses of 40 mg MED or less

138
Q

what is necessary for a provider to write for long-acting opioids (like methadone)

A

completed at least 1 CME of 4 contact hours on the safe use of long acting opioids

139
Q

what are the requirements for opioid prescriptions written by episodic care practitioners

A

include indications for use or the ICD10 code and shall be written to require photo ID of the person picking up the script in order to fill

140
Q

when is counseling mandatory for narcotics for non-cancer pain

A

patient reaches or exceeds 120mg MED

141
Q

when are prescribers exempted from the mandatory counseling if pt is taking MED > 120mg

A

if they are pain management specialists, or have completed 12 category 1 CME hours on chronic pain management with at least 2 hours devoted to long-acting opioids within the prior 2 years

142
Q

in what scenarios are controlled substance scripts not entered into the PMP

A

inpatient scripts or drugs dispensed in correctional facilities (except for substances dispensed to inmates at time of release)

143
Q

what schedule of controlled substance MUST be filed by itself in WA

A

C2

144
Q

what are the acceptable indications for non-narcotic stimulants in WA

A

-narcolepsy
-hyperkinesis
-epilepsy
-differential psychiatric diagnosis of depression
-multiple sclerosis
-moderate to severe binge eating disorder in adults

145
Q

what are the acceptable non-narcotic stimulants in WA

A

-amphetamine salts and combinations
-dextroamphetamine salts and combinations
-phenmetrazine (preludin)
-methylphenidate (ritalin)

146
Q

what qualifies as a practitioners e signature

A

verified by 2/3:
-biometric
-knowledge factor
-a device separate from the computer

147
Q

how long must your keep log book for methamphetamine precursor sales

A

2 years

148
Q

how old do you need to be to buy sudafed in WA

A

18

149
Q

what is the sudafed daily limit in WA

A

3.6g

150
Q

what is the sudafed monthly limit in WA

A

9g

151
Q

what is the electronic system to track pseudoephedrine sales in WA

A

national precursor log exchange (NPLEx)

152
Q

what is the exception for methadone prescribing at NTP site

A

if methadone is being used for pain

153
Q

what are the hospital schedule 2 requirements in WA

A

-Perpetual inventory of C-IIs in pharmacy
-Record of drugs distributed to other units of hospital
-Records of administration or disposal of C-IIs, usually done in the MAR
-Wastage of unused CIIs must be witnessed -Policies maintained on destruction (see DEA form 41 requirements)
-Monitoring to assure chart records are correct
-Use of multiple dose vials of a controlled substance is discouraged
-Physical counts of C-II or C-III drugs stored as floor stock required at each shift change

154
Q

in a hospital and the full amount of a CSA isn’t used, how many people must observe the wastage

A

2 individuals who are licensed to administer

155
Q

who is responsible for creating and maintaining policies on the proper destruction of C2s in a hospital

A

the director of pharmacy

156
Q

what are the non unit dose system nursing home CSA rules

A

 Non-unit dose systems
 C-II stored separately under lock  C-III stored separately from other drugs but may be stored
with C-II
 Bound log book for all C-II or C-III drugs
 Physical prescription counts q 24 h for C-II and weekly for C-III
 Community pharmacies serving LTC facilities will be able to provide a collection receptacle for the disposal of residents’ discontinued or outdated controlled substances

157
Q

what are the unit dose requirements for CSAs in nursing homes

A

 Unit dose – may follow above rules or develop alternative system with equivalent record keeping
 C-III unit dose may be stored with other UD drugs
 Discontinued unit dose drugs other than C-II may be returned to pharmacy

158
Q

all other drugs than c2s must be destroyed within …..

A

90 days

159
Q

what is WRAPP

A

established in 1983 by WSPA and WSSHP with goals of protecting health and safety of the public and to provide a health resource and rehab support for the impaired pharmacist

160
Q

if a pharmacist self reports to WRAPP do they make a notification to the commission

A

no and details are kept confidential

161
Q

when would the commission be notified in an involuntary WRAPP referral

A

if a drug theft is linked to the discovery of an individual’s impairment

162
Q

in what instances is patient counseling required

A

-upon initial fill for a new or change of therapy
-when the pharmacist using professional judgement determines it is necessary
-does not apply when meds are administered by licensed health professional

163
Q

does WA require documentation of counseling

A

no

164
Q

when is the deadline to obtain an NPI after licensure (or an update of information)

A

30 days

165
Q

when you deidentify information, what do you remove

A

-name
-address
-ZIP
-city
-DOB
-admission date
-discharge date
-age
-telephone number
-fax number
-electronic mail address
-social security number
-medical record numbers
-vehicle identification numbers
-pictures

166
Q

what is the time limit for records retrieval in WA

A

ASAP with 15 day limit for initial response and a 21 day max

167
Q

what is the time limit for amendment of records in WA

A

10 days for response; 21 days max

168
Q

WA regulation restricts communication of PHI with ….

A

family who are not obvious agents or caregivers

169
Q

in what instances are minors treated like adults in WA

A

emancipated minors or minors married to a person who is not a minor are treated as adults

170
Q

what is the age limit for minors ability to consent to treatment for STDs in WA

A

14 and over

171
Q

what is the age limit for minors ability to consent to contraceptives or pregnancy termination services

A

any age

172
Q

what is the age limit for minors ability to consent to inpatient or outpatient mental health treatment

A

13 and over

173
Q

what is the age limit for minors ability to consent to outpatient chemical dependency treatment

A

13 and over

174
Q

before you self report — even WRAPP — what should you do

A

get an attorney

175
Q
A

WA MPJE 2024 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions