Community Pharmacy Practice FINAL REVIEW

Category X (pregnancy)

Animal or human studies have shown fetal abnormalities or toxicity, and the risk outweighs the benefits.

Category C (pregnancy)

Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in humans; the benefits from the use of the drug in pregnant women may be acceptable despite its potential risk OR there are no animal reproductive studies and no adequate studies in humans.

If you as a pharmacy technician receive a prescription that you suspect is a forgery, what should you do?

Ask the patient to please wait, then go consult with the pharmacist.

technical failure

Barcode scanner misreads the code

immunity

Bodily processes that provide protection against disease.

A pharmacy technician is constantly making errors in preparing medications to fill the automatic dispensing machine. You try to tell her that she needs to pay attention to details on the filling lists, but she says you are just criticizing her because you do not like her. What should you do?

Bring it to the attention of the supervisor to help resolve the issues.

The computer inventory says you have 60 mLs of insulin glargine pens in stock and you do not need to reorder until only 30mLs are left. When you check the refrigerator, you notice you only have 15 mLs in stock. What do you do first?

Correct the inventory in the computer

What form must be filled out when delivery of morphine sulfate 15 mg tablets is received at the pharmacy?

DEA 222

A national voluntary and confidential program for reporting medication errors is known as

MERP

medication education error

MedGuide is not dispensed with a antidepressant prescription

Even when a medical error has not occurred, a patient may experience an adverse drug reaction. What voluntary FDA program offers pharmacy staff and patients an avenue to anonymously report a serious adverse event related to a specific drug?

MedWatch

Pharmacists communicate serious or life-threatening adverse effects of drugs to the FDA through the ______________

MedWatch program.

The _____ government health plan is administered through individual states.

Medicaid

Category 3 (controlled substance)

Moderate and dependence abuse potential and accepted medical use.

The maximum inventory for doxycycline 100 mg is 500 tablets. At the end of the day, you have 213 on the shelf. The point of reorder is set at 200. Will an automatic reorder be sent and for how many?

N/A

Which of the following would be an example of adherence information on an MTM review sheet?

No, I sometimes forget to take my medication.

omission error

Nurse does not give morning dose metoprolol

Select the true statement about transferring a prescription.

Once a transfer out occurs, it is closed at the originating pharmacy.

adverse drug error

Patient allergic to sulfa drugs is dispensed Bactrim

Which of the following should alert the pharmacy technician that the patient may be a drug seeker?

Patient wants to pay cash but has prescription insurance.

Which of the following is an example of an independent pharmacy:

People's Pharmacy

What is the usual rationale for a pharmacy benefits manager to conduct an audit of a pharmacy's claims?

catch fraud and reduce waste

In what way can pharmacy personnel help to protect patient confidentiality when transmitting data electronically?

changing computer passwords frequently

What is the pharmacist's task after a compounded product has been prepared?

check the final product

quinine

cinchona tree

What is the term for the formal written document regarding professional behavior for a pharmacy technician?

code of ethics

A patient is picking up a medication from the community pharmacy. What should the pharmacy technician do to verify the patient identity?

confirm patient's date of birth

The transfer warning must be on all prescriptions for _______________________

controlled substances.

Workers' compensation _____

covers illness or injuries caused by or related to one's job.

Why is it important to make sure the powder does not get on the Reconstitube?

cross contamination could result

A disadvantage of the oral route of administration is the________________________

delayed onset of action.

An enteric-coated tablet (ECT) is an example of a _____ formulation.

delayed-released

Benadryl

diphenhydramine (antihistamine)

What does the prescription's sig refer to?

directions for the patient to follow

What is NOT a potential solution for the temporary unavailability of medication from a supplier?

discontinuing the drug

While a pharmacy technician is entering a new prescription for Ms. Anders, he takes a phone call from Ms. Anderson who is having side effects that the pharmacist needs to know about so the technician checks her profile to see which medication she is talking about. As a result, when he returns to entering the prescription, he accidentally enters Ms. Ander's new medication under Ms. Anderson's profile. This kind of error is known as a(n) ____

distraction error

When entering prescription information into the computer, the pharmacy technician should __

double check each piece of information once it is entered

A medication can be returned by a patient for credit or refund if the______________

drug is recalled.

When would a chain pharmacy utilize just-in-time (JIT) purchasing from a local wholesaler versus the chain's own warehouse?

drugs needed within 24 hours & order items are out of stock at their own warehouse

What type of prescription is the most difficult to controlled substance prescription to forge?

e-prescription

The first step in the prescription filling process is to receive and review a prescription. What is the second step?

entering a prescription into the computer

A pharmacy technician might help with MTM by

entering accurate patient history.

What is the most effective way to help a customer locate a product?

escorting a customer to the location and pointing out the product

What is the term for the study of standards of conduct and moral judgment that outline the rights and wrongs of human conduct and character?

ethics

A pharmacy technician can help Mrs. Lang, an elderly patient who is diabetic on Medicare Part B, by

explaining the insurance Part B coverage for diabetic supplies.

What is the most common reason for not reporting a medication error in most pharmacies or healthcare settings?

fear of punishment or being sued

What payment option is administrated by employee benefits plans?

flex card

What is the purpose of the FDA-and CDC-run VAERS program?

for reporting adverse drug events from vaccines

A preferred drug list established by the insurer and administered by a Pharmacy Benefits Manager is called a(n) _______

formulary.

ubstituting Amitriptyline for Elavil is an example of a _____.

generic substitute

Mixing instructions for a bottle of powdered medication can usually be found on the back of the bottle or in the _____.

package insert

Counting the change back from a purchase price of $29.69 in which the patient has handed you $40, what would be the first coin you will give back?

penny

vincristine

periwinkle

The field of study that examines the relationship between an individual's genes and his or her body's response to drugs is known as _____________

pharmacogenomics.

What information would you NOT find in the medication information sheet for the patient?

pharmacokinetics

In community pharmacies, the _____ is most likely to be the last person to handle a medication before it reaches the patient.

pharmacy technician

What do you call the process of updating inventory in the pharmacy software database and reconciling any differences between the new and current stock?

posting

Why does the FDA require OTC product labeling to list active and inactive ingredients?

prevent allergic reactions

What may be required if a physician prescribes a medication that is NOT on the insurance company's formulary?

prior authorization

Which of the following is not a goal of the MMA of 2003?

provide safe prescribing practices to physicians

The advantage of the transmucosal route of administration is __________________________

quick onset of action.

What is online adjudication?

real-time insurance claims processing via wireless telecommunications

What is the best response to an incident of rudeness?

respond with kindness

What is the definition of markup?

retail selling price - acquisition price

What is an unexpected occurrence resulting from a medication that involves death or serious physical or psychological injury called?

sentinel event

A pharmacy technician may offer information to a patient on an OTC product that includes _______

showing the active and inactive ingredients.

Who is responsible for determining the rate of sales tax to be added?

state government

The difference between naproxen sodium available over the counter versus prescribed?

strength

streptomycin

streptomyces griseus

The _____ takes final responsibility and liability for a pharmacy technician's actions.

supervising pharmacist

A designer drug made in home chemistry laboratories by modifying chemical structures is an example of a ______________

synthesized drug.

What are the two most common types of oral dosage forms?

tablets and capsules

The before adding the diluent to a powder to reconstitute, you should

tap the bottle to loosen powder

incorrect assumption error

technician misread a poorly written abbreviation.

A pharmacy technician breached the confidentiality of a patient. As a result, the technician may be

terminated

Pharmacy technicians can help decrease medication errors by ___

verifying information at each step of the prescription-filling process before pharmacist approval.

Taxol

pacific yew tree

Lotrimin

(clotrimazole) antifungal

Category B (pregnancy)

Animal studies have not demonstrated a risk to the fetus, but there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have not demonstrated a risk to the fetus during the first trimester and there is no evidence of risk is later trimesters.

organizational failure

Inadequate staffing done to save money.

Select the true statement regarding an active ingredient.

It exerts the desired therapeutic effect.

What is a reason a physician might prescribe a delayed-release tablet?

It has a reduced dosing schedule.

After the pharmacy technician completes the fill, the pharmacist initials the prescription. What does this mean?

The pharmacist assumes legal responsibility for the correctness of the prescription and fill.

What is a reason a customer might decide that a local pharmacy is NOT being professional?

The pharmacy employees looked soiled and sloppy.

What happens when a pharmacy technician triages customer needs?

The pharmacy technician prioritizes various customer requests

Select the true statement about Medicare Part D.

The plan allows Medicare beneficiaries to purchase drug insurance for an additional charge

Which of the following attributes is most important in filling a prescription?

accuracy

A risk evaluation and mitigation strategy (REMS) must be developed by a drug manufacturer when _________________

the benefit of using a high-risk drug outweighs the adverse effects in certain patient populations.

n the tiered copay prescription system, ___________________

there are escalating costs for generic drugs, preferred brands, and nonpreferred brands

What is the purpose of pharmacodynamic agents?

to alter body functioning

What is the purpose of the DEA number on a prescription?

to authorize the prescriber to prescribe controlled substances

In what way do drug manufacturers use inert ingredients?

to ensure sterility of injectable products & to help mask unpleasant oral drugs for pediatric patients

What is the rationale for inventory management?

to establish and maintain adequate levels of needed and often used materials in stock

What is the purpose of USP Chapter <795>?

to identify quality standards for nonsterile compounding

What is the mission of the Institute for Safe Medication Practices (ISMP)?

to provide medication error reduction strategies

What is the purpose for applying auxiliary labels to prescription containers?

to reinforce the most important instructions for taking the drug

What is the purpose of auxiliary labels?

to supplement the information on the drug label

What would be the role of the automation specialist?

to train others on use of technology

What is the purpose of the MedGuide?

to warn patients of potential adverse side-effects of high-risk medications

Ginger

treats nausea and motion sickness

A prescription is received for " doxycycline 100 mg 1 po BID." How often should the medication be taken?

twice a day

A drug that is administrated sublingually is absorbed _________________________

under the tongue.

In a pharmacy setting, saying "please" and "thank you" as well as using formal titles, such as "Doctor" and "Nurse," may be________

unwritten rules

After an MTM appointment, which of the following adjustments may occur?

use of less expensive medication, identification of potential medication interactions or adverse reactions, counseling on complying with the medication regimen

Which of the following is a good nonverbal communication technique?

using minimal facial expression when a patient shares a sensitive diagnosis

During flu season, a patient who is coughing and sneezing may be asked to ___

wear a mask to avoid spreading the contagion.

If you see a customer wandering the aisle, what should you do or say?

"May I help you?"

Which of the following is an example of an open-ended question?

"Please describe your headache pain for me."

Select the phrase that demonstrates courteous speech to a customer ordering a refill for a prescription.

"Thank you for calling ahead for your refill"

Which of the following phrases would be unwelcoming to a customer?

"What do you need?"

The Coppertone sunscreen is purchased from the wholesaler at $105.59 per case of 12 bottles. The mark up for seasonal items is 25%. How much will each bottle sell for?

$11.00

Mr. Smith's prescription insurance card says he needs to copay $5 for preferred generic, $25 for non-preferred generics, and $100 for non-preferred brand name drugs. He has 3 prescriptions: hydrochlorothiazide 12.5 mg, Synthroid 125 mcg, Pradaxa 150 mg. The hydrochlorothiazide and levothyroxine (Synthroid) are preferred generics, and the Pradaxa and Synthroid are non-preferred brand names. He requests the brand name Synthroid. What will his copay be for all the drugs?

$205, The Pradaxa and Synthroid would be $100 each, and the hydrochlorothiazide would be $5, for a total of $205.

A patient's total bill is $15.29. She hands you a $20 bill, and you enter that into the cash register. It says to give $4.71 change. But the patient now states she has the correct change of $0.29 and hands you a quarter and four pennies. How much change will you now give back?

$5.00

The pharmacy pays $150 for #1,000 fluoxetine 20 mg capsules. The AWP is $350 per #1,000. Cash customers are usually charged AWP for their prescriptions, but you want to give this patient a 20% discount. How much will you charge the patient for 30 capsules, and how much profit are you making?

$8.40 _ $3.90

A month's supply of an allergy medication costs the pharmacy $49.60. The selling price is $58.13. What is the amount of markup and the markup percentage?

$8.53, 17%

Select the appropriate numerical notation(s) on a prescription.

0.2

When adding water to reconstitute an antibiotic suspension, what would the maximum beyond-use date be?

14 days

In the state of Texas, at what age can a patient receive a vaccine in a community pharmacy using a standing order? (not including the influeza vaccine)

14+

At what temperature should a stand alone refrigerator be kept at to maintain proper vaccine storage?

2°C to 8°C (36°F to 46°F)

How many separate NDC checks for accuracy should the pharmacy technician take when filling a prescription?

3

You receive a prescription in which equal parts of three different ingredients are to be mixed together. How much of each ingredient will you need to make 120 mL of a solution?

40ml

The pharmacy likes to have a PAR of 5 but not more than 8 of the azithromycin 250 mg 6-tablet packets on the shelf at the start of each day. When you are ordering for tomorrow, you notice there are only 3 packs on the shelf. How many will you order?

5

Category A (pregnancy)

Adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester of pregnancy and there is no evidence of risk in later trimesters.

In the state of Texas, at what age can an influeza vaccine be administered to a patient without a prescription?

7+

In the state of Texas, a drug must have a rating of _____ to be considered a generic equivalent.

A

A man walks up to the pharmacy counter and wants to talk to a man instead of you, a woman. Why should you not take offense?

A sensitive gender issue may need to be discussed like erectile dysfunction.

antigen

A toxin introduced into the body--sometimes to produce immunity to a specific disease.

Select the correct statement regarding e-prescriptions.

E-prescriptions can mean decreased wait time for patients.

Which of the following statements about the administration of ear and eye medications is true?

Eye drops can be used in the ear.

Based on the significant incidents of adverse drug reactions, who has the power to recall, or pull off the market, a drug?

FDA

To determine generic equivalency of a brand name product, which reference source would you use?

FDA Electronic Orange Book

Pharmacy technicians assist in the MTM process by helping with research and counseling patients.

False

What agency is responsible to monitor for the deceptive advertising of dietary supplements?

Federal Trade Commission

wrong drug error

Fluoxetine dispensed for fluvoxamine.

antiseptic

Germ-killing substances and procedure.

Which of the following is an example of a grocery store store pharmacy:

HEB Pharmacy

Category 2 (controlled substance)

High abuse and dependence potential and accepted medical use.

Category 1 (controlled substances)

High abuse and dependence potential and no accepted medical use

Which drug is produced using DNA technology?

Humulin

Which of the following is an appropriate marking for a commercial controlled substance container?

IV & C-IV

wrong formulation error

Lamictal tablets are dispensed for Lamictal ODT.

List 5 classifications of drugs found in the community pharmacy setting we discussed in class.

Legend Drugs, Controlled Substances, OTC, Dietary Supplements, and Homeopathic medications

Category 5 (controlled substance)

Limited abuse and dependence potential and accepted medical use.

What can happen to vaccines if there is a break in the cold chain?

Loss of potency and vaccine becomes useless.

Category 4 (controlled substance)

Low abuse and dependence potential and accepted medical use.

__ is an Internet-based program used by healthcare professionals and institutions to anonymously document, analyze, and track medication errors specific to an institution.

MEDMARX

What is the difference between a pharmaceutically equivalent drug product and a pharmaceutical alternative product?

Pharmaceutical equivalents have to have the same active ingredients, strength, route of administration, and dose form. A theraputic equivalent has to have the same bioequivalent/clinical effect, and contain the same amount of active drug ingredients in the same dose form and route of administration.

A prescription for ofloxacin otic drops has the directions, "5 gtt as bid". What directions should be typed on the label?

Place 5 drops in the left ear two times a day.

Select the statement regarding Schedule III and IV prescription refills that is correct.

Prescriptions may be refilled up to five times within six months.

antibody

Product of the immune system that identifies and neutralizes foreign substances in the body.

You notice that the prescription for a 3-month's supply of narcotic is written by a dentist. What should be the pharmacy technician's action?

Refuse to fill the prescription and tell pharmacist

What are the patient's five rights concerning medication errors?

Right patient, right drug, right dose, right route, and right time

Which one of the following in NOT one of the 5 Patient Rights in Prescription Drug Dispensing?

Right pharmacy

_____ be dispersed among other prescription drugs stocked in the community pharmacy

Schedule III-V medications may

At your annual review, the manager gives you a list of ten ways to improve, how should you handle this constructive criticism?

Take the list as counsel that can help you do better.

Mrs. Anderson read on the Internet that she should be using a specific OTC product for her migraine symptoms but the label does not give the dose for her particular condition and symptoms. What should the pharmacy technician tell Mrs. Anderson?

Talk to her doctor or the pharmacist.

Which drug is not a brand form of isotretinoin and isotroin needing a REMS?

Thalidomide

Why does the FDA require the drug isotretinoin, which is used for acne, to have a REMS?

The drug is teratogenic.

An incorrect birthdate is in the pharmacy database and the PBM database of the insurance company. What step would NOT be appropriate?

The patient asks the pharmacy to correct the date and send a change notification to the insurance company.

Select the correct statement about pharmacy technicians and new prescriptions in most states.

The technician may take written prescriptions from walk-in customers.

Category D (pregnancy)

There is evidence if human fetal risk, but the potential benefits from the use of the drug in pregnant women may be acceptable despite its potential risks.

Which of the following statements about pharmacy technicians is true?

They act as cashiers, inventory managers, and check patient demographics for accuracy.

Which of the following statements is TRUE regarding mail-order pharmacies?

They are more likely to dispense a 90-day supply of medication than an independent pharmacy.

What is the reason patients often prefer creams over ointments?

They vanish once applied.

How is the Prescription Drug Monitoring Program used by a technician to combat drug abuse?

To check it to see if the patient is receiving controlled substances from other pharmacies.

What is the purpose of prescribing a rectal dosage form?

To treat a vomiting or nauseated patient.

___ is designed to cover active and retired members of the military and their dependents.

Tricare

MTM requires significant communication and documentation, and its success can be measured by the improved health outcomes of patients

True

Pharmacy technicians can help with improved health outcomes by coordinating care, establishing MTM appointments, and collecting data.

True

Where should vaccine errors be reported to?

VAERS

List vaccines that should be kept in the freezer

VAR, ZVL, MMRV, MMR

Which of the following is an example of a chain pharmacy:

Walgreen's Pharmacy

In terms of billing in community pharmacy, pharmacy technicians __

cannot dispense a refill of a drug if the prescription is more than one year old.

You have an insurance that requires you to pay up front 20% of all costs. This is an example of

a coinsurance payment

Medication therapy management is

a patient-focused, multistep process where the pharmacist meets with a patient and recommends adjustments to the patient's medication therapy for better results.

What must a customer provide prior to the purchase of pseudoephedrine-containing tablets?

a proof of age and identity

Mrs. Smith is a newly diagnosed insulin-dependent diabetic. She is picking up her first vial of insulin and syringes. What else should she also be advised to purchase?

a sharps container

What is root-cause analysis?

a systematic approach to analyzing pharmacy data to determine common reasons for typical errors to prevent them in the future

Tylenol

acetaminophen (analgesic; headache or pain)

What is the term for the contacted amount a pharmacy pays a wholesaler for a drug?

acquisition cost

What can a pharmacy technician NOT do when working with the immunization pharmacist?

administer the immunization with the pharmacist overseeing

Pharmaceutical care _____.

allows the pharmacist to include appropriate medication use to achieve positive outcomes with prescribed drug therapy

Which of the following is a violation of sharing patient's private health information?

an insurer providing PHI to the patient's employer

A "patient not covered" rejection from an insurance company could mean that the patient has recently changed insurance companies. If that is the case, the pharmacy technician should

ask for the patient's insurance card, make a copy of it, then enter that new insurance information in the pharmacy computer, then resubmit the claim to the new insurance company.

When is beyond-use dating initiated?

at the time of compounding

n which of the following scenarios would the pharmacy technician not be in compliance with the Corporate Integrity Act?

backdating a refill for an expired prescription

The measurement of the amount of active ingredient and time it takes for it to be absorbed, metabolized, distributed, or eliminated from the body is called ____________

bioavailability.

Echinacea, Zinc, Vitamin C

boost immune system

Which of the following customer service activities is likely to ensure that patients return to your pharmacy in the future?

greeting patients by name having a welcoming smile using a courteous voice

P&T Committee

group that develops drug policies, educates professionals on med use, develops & revises list of approved drugs in a hospital

Mucinex

guaifenesin (expectorant)

Mr. Green is a new patient to the pharmacy. Besides obtaining the necessary healthcare and billing information, the pharmacy technician must ___

have the patient give signed consent for the notice of privacy practice.

When Jackie Jones comes into the pharmacy requesting help selecting a product for her head cold, the pharmacy technician should

have the pharmacist help the patient.

An advantage of having a check reader connected to the cash register is _____________

having immediate bank approval for a transaction by check.

Which of the following would be classified as drugs by the FDA?

homeopathic medications

Limulus Amebocyte Lysate

horseshoe crab

A pharmacy technician has pulled a medication bottle from the shelf based on memory without any cross-referencing. What type of failure can occur?

human failure

Motrin

ibuprofen (NSAID; headache or pain)

When can the Food and Drug Administration (FDA) regulate diet supplements?

if proven safety concerns exist

Calcium, Vitamin D

improve bone strength

Ginko

improves memory

septic

infected with bacteria

Aerosols and sprays are common dosage forms for the _____ route of administration.

inhalation

What is NOT a parenteral route of administration?

intrauterine

Prevacid

lansoprazole (PPI; heartburn)

What is the appropriate way to deal with an angry customer?

listen, explain, acknowledge, discuss

Claritin

loratadine (antihistamine)

The wholesaler is out of stock of the generic brand of propranolol 40 mg tablets you usually buy at $9.87 per #100 tablets (AWP $15.92 per #100). The next least expensive product is 19.57 per #100 tablets (AWP $22.99 per #100). What is the difference in profit for a prescription for # 100 tablets if the insurance reimbursement formula is AWP - 10% + $1.95?

loss of $3.34 with the new generic

What dosage form provides a fast onset of action for a localized condition with minimal systemic side effects?

lotion

What is an advantage of a primary wholesale purchasing agreement?

lower inventory and inventory-associated costs

Policosanol, Garlic, and Red Yeast Rice

maintains healthy cholesterol

What is compounding?

making a medication in the pharmacy following a doctor's prescription for a specific patient

Miss Ordan does not have prescription drug insurance, but she needs monthly prescriptions to control her asthma. She has lost her job. What options might the technician recommend to help her pay for her medication?

manufacturer coupons, local free or low-cost healthcare clinic, pharmacy discount on drugs if pharmacist says available

What is any preventable event that may cause or lead to inappropriate medication use or patient harm called?

medication error

When measuring liquids, you can ensure accuracy by making sure the _____ rests on the desired line.

meniscus

What handheld, propellant-driven device would a patient with asthma commonly use?

metered-dose inhaler

A pharmacy technician is reading the Policy and Procedure (P&P) Manual. What information is likely not addressed in the manual?

methods for counting capsules

Monistat

miconazole (antifungal)

Dealing with various duties at once by retaining individual focus and shifting it carefully without losing track is the definition of _____

multitasking

The e-prescriber's signature for all e-prescriptions _____________________

must be through a secure network approved by the state Board of Pharmacy

Aleve

naproxen (NSAID; headache or pain)

On May 2, 4, 7, 15, 22, and 23, you sell Sudafed 30 mg tablets #48 to the same customer. On which date has your pharmacy exceeded the monthly maximum allowed for one patient?

none of the above

The pharmacist is going to administer the shingles vaccine to a patient. How can a technician help?

notify primary care physician

What is the name of the route of administration when a drug is administrated into the eye?

ocular

Prilosec

omeprazole (PPI; heartburn)