716 Final
Question 7: A prescription for atorvastatin is valid for how long term from the date it was written? 6 months 1 year 90 days 30 days
1 year Non controlled & C5 - Rx valid for 12 months (unlimited refills) C3 and C4 - Rx valid for 6 months (5 refills) C2 - Rx valid for 90 days (0 refills)
A pharmacist is filling a CPMP by using atenolol 50 mg and HCTz 25 mg on 9/18/2014. The manufacturer's expiration date for atenolol is 7/1/15, what would be the correct expiration date of atenolol included in the CPMP?
11/17/2014 (Answer: 60 days from date of packaging it)
Question 7: The following prescription is presented at your pharmacy on 03/24/23: Amoxicillin 250 mg/5 mL suspension Take 10 mL by mouth every 8 hours for 5 days Qty: #1 bottle The pharmacy technician reconstitutes 1 bottle of amoxicillin 250 mg/mL (manufacturer expiration 05/04/2023) with water to make a 150 mL suspension. How many days from the date of dispensing (3/24/23) shall the BUD be dated for if the product is stored in the refrigerator? 14 days 30 days 10 days 5 days
14
What is the duration of an individual controlled substance registration (license) for a pharmacist in Michigan?
2 years
Question 5: The Pharmacist in Charge (PIC) may not be the PIC for more than ___pharmacies including remove pharmacies.
3
An employee (delegated agent) of a prescriber may transmit verbally to a pharmacist what schedule of controlled substance?
3-5 or non-control
The total number of continuing education hours required to be completed upon the 2nd renewal of a pharmacist license in Michigan is:
30
What is the quantity limit in terms of days supply of a CII drug for chronic use that a nurse practitioner in Michigan may write for 7 days 10 days 30 days Unlimited
30 days PA/MD/DO can rx unlimited
Which of the following is the maximum expiration date for a CPMP? 30 days 60 days 90 days 180 days
60 days
Question 8: The following prescription is presented at your pharmacy: Simvastatin 10 mg Sig: Take 1 tablet daily Qty: #90 Refills: 2 The prescription has been signed by a DO who is licensed only in Canada. How many simvastatin tablets may be dispensed to the patient? 30 Zero. It cannot be filled in Michigan. 90 60
90 can fill Canadian Rxs in Michigan if non-controlled.
Question 10: You approach your local pharmacist today (2/10) with a new Rx for Carvedilol 6.25 mg PO BID, 30 day supply for HFrEF with 10 refills. You are sad because you learned this past week that your family primary care physician who prescribed the medication on 01/10 died from a wild brown bear attack on his camping trip to Wyoming on 02/05. The pharmacist heard about this in the local news altering people to beware of trips to Yellowstone and is also aware of the passing of the family physician. This prescription: A) May NOT be filled (patient must obtain a new rx from another prescriber) B) May be filled as a 30 day supply only ONCE before getting a new rx C) May be filled for the rest of the 10 refills with no issues D) May be filled as a 3 day emergency supply only ONCE before getting an new rx
A
Question 1: A pharmacist practicing in community pharmacy in Michigan can NOT fill a prescription written by OUT-OF-STATE prescribers in which of the following scenarios? A nurse practitioner writing for a controlled substance prescription A Canadian physician writing for non controlled medications An MD physician writing for a controlled substance medication A dentist writing for a controlled substance medication
A
Question 3: Which of the following is generally NOT considered a violation of the Anti-Kickback Statute (AKS)? a) A pharmacy waiving a copy for a patient with Part D after good faith determination of patient financial need b) Any remuneration to a prescriber for referral to a pharmacy c) Paying patients cash for prescription transfers d) Coupons reducing or eliminating copayments for branded drugsfor Part D patients
A
Question 4: A prescription written by a podiatrist for meloxicam: Is valid, if prescribed within scope of practice or Is not valid, podiatrist cannot prescribe meloxicam
A
Question 7: Which of the following statements is true regarding dispersal of C2 controlled substances in the pharmacy? a) Can be dispensed throughout the stock of controlled medications b) Must be securely locked in a substantially constructed cabinet c) Must never kept in the pharmacy
A
Which of the following techniques would be classified as high-risk, category II for a pharmacist to perform based upon USP guidelines? Compounding an injection solution using non sterile drug powder and then passing the solution though a 0.22 micron filter Mixing several sterile solutions together to make a batch of TPN injections Pooling several vials of a chemotherapeutic drug injection for subsequent subdivision into individual minibags
A
Question 1: GoodDrugs Pharmacy received a prescription for the patient "Steve Erickson's Friend" for Naloxone. Which of the following is true? a) It may be dispensed with no restrictions b) It may be dispensed only if the naloxone is to be used for a patient older than 21 years of age c) It may not be dispensed; the prescription must be written with the name of the individual at risk of an opioid-related overdose
A Can give to friend/family - don't need patient's name to dispense
Question 7: Which of the following is true regarding a standing order for naloxone? a) Pharmacists who dispense under the standing order shall obtain training in the proper use and administration of opioid antagonists and opioid overdose response. b) The naloxone dispensed under the standing order must be dispensed in the name of the person who potentially will use the naloxone c) The standing order is issued by a county's chief medical officer d) A pharmacy with a standing order may sell naloxone over the counter
A can dispense to friend/family issued by chief medical executive A pharmacy with a standing order may sell naloxone over the counter I think technically as of April 2023 it is OTC - but not when we learned this section
Question 8: The Poison Prevention Packaging Act and the Federal Anti-Tampering Act both were enacted to protect patients (consumers). Which of the following statements is true? a) Generally speaking, most oral OTC or nonprescription medication must have tamper-proof indicator or barrier b) Sublingual nitroglycerin tablets dispensed by a pharmacy must be dispensed with a childproof top because it is a prescription medication. c) Dispensing a medication in a prescription vial without a child proof cap is appropriate if the pharmacist feels it would help the patient open the bottle easier.
A childproof cap must be patient or prescriber requested
Question 2: Which of the following is true regarding paperwork (DEA forms, prescriptions for controlled substances, inventory forms) in the State of Michigan (select all that are correct)? a) Prescriptions in a community pharmacy must be kept for at least 5 years from the date of the last fill/refill b) DEA form 41 (disposal) must be kept for 11 years c) Annual controlled substance inventory records must be sent to the local DEA office when completed d) DEA form 222 must be kept a minimum of 4 years
A form 41 must be kept for 2 years forms are kept at registered site 222 forms are kept for at least 2 years
Question 1: Which of the following is correct regarding an emergency C2 (CII) telephoned prescription? a) The quantity of medication must be only for the acute episode during the medication (short term) b) It can be called in by the physician office secretary if the physician is too busy to call c) A licensed pharmacy technician can take the telephone call and transcribe the prescription if the pharmacist is too busy immunizing patients. d) The prescriber must send a copy of the prescription to the pharmacy within 30 days of the telephone prescription
A if C2, rx has to be called in by the rxing doctor only interns or pharmacist can take the call copy of Rx needs to be sent within 7 days
Question 4: Remote pharmacies: a) Must have real time, continuous audiovisual camera system allowing the pharmacists to observe all dispensing activities ongoing in the remote pharmacy, including visually identification the markings on tablets and capsules b) May dispense a maximum average of 300 prescriptions per day c) Can be located in South Carolina as long as the parent pharmacy in Michigan d) Does not need to be under the same ownership of the parent pharmacy
A max 150 prescriptions average per day Both the parent pharmacy and remote pharmacy need to be in Michigan AND under the same common ownership Does need to be under same common ownership as parent
Question 6: You are a pharmacist working at a busy chain pharmacy who received a prescription for metronidazole 2 g x 1 (Single dose) for trichomoniasis treatment for the patient "Expedited Partner Therapy." Which of the following is true? a) The pharmacist may dispense the prescription as written b) The pharmacist must obtain the actual birthdate of the EPT patient and note it on the prescription c) The pharmacist must report quarterly to the Michigan Department of Health and Human Services for the number of EPT prescriptions dispensed d) The pharmacist should not dispense the prescription; EPT is only used for chlamydia or gonorrhea.
A no info on partner needed quarterly reporting is for naloxone EPT is for chlamydia, gonorrhea, and trich
Question 1: Implications of the Food Additives Amendment (Delaney Clause) and the Color Additive Amendment is: a) Additives and color additives must be found safe (dose not induce or cause cancer) b) Pharmacists could counsel patients who take red pills c) Promote medications that are not a mix of colors, such as a pill with red and blue color combined d) Pharmacist should recommend products that are a primary color only (such as red, blue, and other colors)
A pharmacists cannot promote one bio equivalent product over the other
Question 6: A pharmacy that compounds sterile pharmaceuticals based on the receipt of a prescription must: a) Comply with USP standards for compounding b) Be registered with FDA as a manufacturer c )Be registered with FDA as outsourcing facility d) Comply with CGMP standards for manufacturing
A registered with FDA as manufacturer Only if selling to other health systems (503b) If being used in house or selling to their own patients - not considered a manufacturer - therefore do not need to follow good manufacturing practices
Question 1: Which one of the following statements are true regarding the Michigan Board of Pharmacy? Select all that are correct. a) The Board of Pharmacy is an administrative agency in the Department of Licensing and Regulatory Affairs in Michigan b) Grants licenses only to pharmacies, pharmacists and pharmacy interns c) There are 11 members d) A total of 8 pharmacists are appointed to the Board of Pharmacy
A & C BOP Grants licenses to wholesalers and manufacturers as well as CS license BOP appoints only 6 pharmacists
A pharmacy begins to receive prescriptions for a capsule mixture that is not available commercially. The usual prescription is for 14 capsules. What is the maximum number of capsules the pharmacy may compound under FDA guidelines? 14 only 28 only 42 only Not more than 100 A sufficient quantity to meet anticipated prescriptions and refills
A sufficient quantity to meet anticipated prescriptions and refills
Question 4: Which of the following is true regarding the tasks delegated by the pharmacist? Select all the correct answers a) The delegated task must occur while under the personal charge of the pharmacist. b) Pharmacy interns may administer immunizations under personal charge of the pharmacist c) Written policies are procedures regarding delegated responsibilities must be kept in the pharmacy d) Pharmacy technicians may counsel patients on OTC medications
A, B, C only pharmacists and interns can do counseling
Question 10: Which of the following is or would qualify as Medicare/ Medicaid fraud and abuse? Select all that are correct. Pharmacist continues to refill and bill Jane Doe's brand name Lipitor on the first of every month even though they are aware she passed away 4 months ago. Pharmacy dispensing outdated lorazepam 0.5 mg #5 Pharmacist refills prescriptions with samples from manufacturer labeled, "not intended for sale." Pharmacist filling a prescription with a generic sertraline and billing for brand name Zoloft to receive a larger reimbursement
A, C
Which of the following is a requirement for the CPMP label? Select all that apply a) Date of expiration of CPMP b) Side effect statement is NOT required c) A separate serial number for the CPMP d) Expiration date no greater than 6 months e) Name, address, and telephone number of pharmacy
A, C, E side effect warning Required as warning/ other information for pertinent info expiration date no greater than 60 days from dispense
Question 7: The NDC number (select all that are correct) a) Is manufacturer-specific information on strength, dosage form, and formulation b) Indicates which pharmacy dispensed the medication c) Is a unique 8-digit, 2-segment identifier on medication bottles from manufacturers d) It indicates package size and type
A, D 10 digit, 3 segment code
Question 4: In Michigan, pharmacists must offer to counsel for which of the following situations? Only for controlled substance prescriptions All new prescriptions and refill prescriptions All new prescriptions only All refill prescriptions only
B
uestion 10: Dr. Erickson is a nurse practitioner at MM, and Dr. Kelley is a physician assistant at MM. What is the key, significant difference between their prescribing authorities? a) Dr. Kelley MUST indicate the delegating physician's name on CII-CV prescriptions (but not on non-controlled prescriptions) whereas Dr. Erickson does NOT have to indicate the delegating physician's name on ANY prescriptions. b) Dr. Erickson MUST indicate the delegating physician's name on CII-CV prescriptions (but not on non-controlled prescriptions) whereas Dr. Kelley does NOT have to indicate the delegating physician's name on ANY prescriptions c) Dr. Erickson MUST indicate the delegating physicians name on ALL prescriptions whereas Dr. Kelley does NOT have to indicate the delegating physician's name on ANY prescriptions. d) here is NO difference between their delegated prescribing authorities (both Dr. Erickson and Dr. Kelley have to indicate the delegating physician's name on ALL prescriptions)
B
Question 8: Which of the following statements regarding disposal of controlled substances in the pharmacy are true? a) There must be 3 employees witnessing destruction of controlled substances b) If destructing on site, making the controlled substance non-retrievable, includes incineration or chemical digestion c) a DEA form 107 is used for all controlled substances C2 through C5 when sending them to a reverse distributor
B 2 employees must witness form 107...no...form 222 is used when sending to reverse distributor
Question 3: A patient that you must well comes in the pharmacy and asks you to purchase Robitussin AC, a schedule 5 OTC cough medicine that contains codeine. Which of the following statements reflects the procedures that must be followed in order to sell the medication to the patient. a) The purchaser must be no younger than 21 years of age. b) A label containing the date sold, pharmacist name, and name/address of practice where dispensed must be affixed to the bottle c) An 8 oz (240 cc) bottle can be sold to the patient d) The pharmacy technician can assess the patient for appropriateness of use
B ?? purchaser must be 18 only the pharmacist can assess for appropriateness
Question 6: Which of the following statements is true regarding Automated Dispensing Machine (ADM) use? a) A small pharmacy chain store located in Toledo, Ohio can own and operate an ADM located in one of its pharmacies in Monroe, Michigan. b) Technologies shall be in place and utilized to ensure that correct drugs are stocked if pharmacy technicians are filling the machine c) Drugs dispensed (taken) from the ADM must have an order which is reviewed by a pharmacist within 72 hours of being removed. d) A pharmacy may own and operate an ADM in a physician's office.
B ADM must be in the same state as the pharmacy order must be reviewed within 48 hours an ADM in a physicians office is the physicians responsibility?
Question 5: Partial refills of controlled substance prescriptions can occur in several situations. Which of the following situations is correct regarding partial filling of medications by a pharmacy a) A patient brings a prescription for oxycontin 30 mg tablets for treatment of chronic pain. The prescription is written for 90 tablets. The patient asks that the pharmacist fill only 10 tablets at this moment. She does not want too many tablets at home. The patient can obtain the remaining 80 tablets over the next 60 days (Assuming the prescription was written today) b) A patient brings a prescription for diazepam 5 mg tablets, 30 tablets. The patient wants to try it and only wants 5 tablets at this time. The patient has 6 months from the date the prescription was written to obtain the remaining 25 tablets. c) A pharmacy is filling a prescription of Oxycontin 30 mg tablets. The prescription is written for 15 tablets. The pharmacy has 10 tablets. The prescription is filled for 10 tablets, and the patient is told they are allowed to receive the remaining when the pharmacy receives more stock of this medication. The pharmacy can dispense the rest to the patient if it orders the medication on the next warehouse order in one week.
B for a, No later than 30 DAYS after the date the RX was written Diazepam is a Schedule 4 (C3 + 4 scripts are valid for 6 months from the date Rx was written) if the lower quantity is because of the pharmacy it must be done and refilled within 72 hours
Question 1: If Erickson's Pharmacy is selling a bottle of 500 tablets of Norco to Shabanowitz's Pharmacy, which of the following must be done? a) DEA 106 form must be filled out b) DEA 222 form must be filled out c) DEA 41 form must be filled out d) No DEA forms need to be filled out; this is a non controlled medication
B form 106 is for theft/significant loss form 41 is for destruction/disposal of CII
Which of the following are true? a) A pharmacy can compound drugs from any ingredients whether or not FDA approved b) A pharmacy can compound a limited amount ahead of time in anticipation of prescriptions c) A pharmacy can compound drugs and sell them to a third party who resells to individual patients d) A pharmacy can compound an exact duplicate of a commercially available product on a regular basis
B has to be FDA approved selling to 3rd party it would have to be 503b an duplicate if there's a shortage
Question 5: Which of the following are required for licensure of a Michigan pharmacist? a) must be able to type b) must pass the MPJE (licensing exam) with a scaled score of 75 c) Must be no less than 21 years of age d) Must be a resident of Michigan
B pharmacists must be 18 years of age
Question 9: Which of the following statements regarding scheduling of medication as a controlled substance is true? a) A drug can only be listed a scheduled controlled substance by the federal government (Attorney General with input from Health and Human Services) b) Criteria for listing a medication as a controlled substance is dependent on its abuse potential plus risk of dependence c) A schedule 1 has a high potential for abuse which may lead to severe psychological or physical dependence, but still has medical use
B states can list a drug as a control if they're having an issue
Question 1: Which of the following is true regarding the process for filling a prescription using the Central Fill pharmacy process? a) The retail pharmacy is responsible for submitting a MAPS report when the prescription is for a controlled substance. b) The prescription can be sent electronically, including FAX, from the retail pharmacy to the central fill pharmacy c) The central fill pharmacy must keep the original prescription on file. d) Only the retail pharmacy has corresponding responsibility to ensure the prescription was issued for a legitimate medical purpose.
B central fill pharmacy is responsible for MAPS retail pharmacy maintains the original both pharmacies have responsibility
Question 6: Which one of the following situations in which a pharmacist let their license lapse (did not renew on time) would the pharmacist need to take the MPJE (Michigan law licensure test) and the NAPLEX exam (both?) a) 3 years to 8 years past renewal date b) More than 8 years past date of renewal c) 6 months to 3 years past renewal date
B would have to take both if more than 8 years past renewal date. would have to retake the MPJE ONLY if 3-8 years past the renewal date
Question 2: What is the total number of pharmacies that a Pharmacist in Charge (PIC) may oversee? a) 2 b) 3 c) 5 d) 4
B (including remote pharmacies)
Question 3: The Kefauver-Harris Amendment of 1962: select all that are correct a) Transferred jurisdiction of prescription drugs from the FDA to the FTC b) requires that drugs be proved safe and effective c) Required informed consent for research subjects joining research studies
B, C for A, the act transferred from FTC --> FDA
Question 5: The pharmacy had a break in and 10,000 tablets of generic hydrocodone with acetaminophen were stolen. Which of the following are true? Select all that are correct. a) This is not a significant loss, so not reporting to the DEA is required b) A DEA form 106, (or letter explaining accounted for) is filed with the DEA c) A DEA form 41, must be filed with the DEA d) Upon discovery, notify the DEA in writing within one business day e) A DEA form 107, must be filed with the DEA
B, D DEA form 41 is for destruction/disposal not loss reporting 107 doesn't exist
Which of the following is true regarding counseling in Michigan? Select all that apply a) The pharmacist must do the counseling if done b) Counseling must be done if requested on a refill c) Counseling must be done for all prescriptions dispensed d) Counseling must be done for any drug the patient has not previously been prescribed
B, D note: a pharmacy intern can counsel under the supervision of a pharmacy. A pharmacy technician cannot counsel counseling must be offered for all prescriptions but must be DONE for all new Rx
Question 3 Which of the following regarding repositories is true? Select all that apply. Pharmacies may bill third party payers when dispensing from a repository program A designated pharmacist responsible for the repository program must be indicated when applying to LARA for permission to participate in drug repository programming Controlled substances are allowed to be accepted into the Cancer Drug Repository program for patients with cancer related pain Any resident in the state of Michigan who has cancer may use the CDR program
B, D can't bill third party payers no CS allowed
Question 10: Which of the following is true regarding a pharmacist being a preceptor for pharmacy interns? Select all that are correct. a) Must be practicing as a pharmacist for at least 5 years b) Must be licensed as a pharmacist in Michigan c) Must submit a completed application form to the department (LARA) d) Must ensure that interns are receiving training in drug distribution, control, pharmacy administration, law, drug, and product information, and ethical/ professional responsibilities of a pharmacist
B,C,D must be a practicing pharmacist for at least 1 year before being a preceptor
Question 10: A new product used to measure blood glucose continuously through a sensor place subcutaneously would be classified as: a) Drug b) Food c) Device d) Cosmetic
C
Question 10: A pharmacy is compounding a suspension of hydrochlorothiazide from tablets. Which of the following is true? Must comply with USP 900 Does not need to comply with USP 800 if complying with the safety data sheet Must comply with USP 795 Must comply with USP 797
C
Question 4: The prescription drug marketing act: a) allows pharmacies to sell drug samples to patients b) abolished record keeping requirements for drug samples c) prohibits hospital pharmacies from reselling their medications to other businesses
C
Question 6: A physician prescribed hydrocodone with acetaminophen 7.5 mg/ 325 mg PO q6h for TWO separate patients of hers. The first prescription is for acute pain, while the other prescription is for chronic cancer-related pain. Which of the following statements is true regarding MAXIMUM days of therapy that may be prescribed? a) 7 days for the acute pain patient; 90 days for the chronic cancer patient. b) 5 days from the acute pain patient; 90 days for the chronic cancer pain patient. c) 7 days for the acute pain patient; no limit on days of therapy for the chronic cancer pain patient. d) 30 days for both acute pain and chronic pain patients. e) No limit on days of therapy for either patient
C Physicians/ PAs: theoretically no limit for chronic pain (30 days for NP); acute pain 7 days (for all prescribers)
Question 8: Which of the following laws established incentivizes pharmaceutical manufacturers to develop and market medications to treat rare disease or conditions? a) Prescription Drug Market b) Food Drug and Cosmetic Act c) Orphan Drug Act d) Fair Packaging and Labeling Act
C The fair packaging drug act maintained the label must include certain information
Question 2: A prescription was written for metoprolol 100 mg tablets and the pharmacist accidently dispenses the atenolol 25 mg tablets. The label on the vial she dispensed has metoprolol 100 mg written. This is an example of: a) Adulteration b) Misinformation c) Misbranding
C This would be adulteration if the label was altered
Question 2: Customized patient medication packages can contain medications or dosage forms that a) Require dispensing in original packaging or container b) Are incompatible with the packaging or each other c) Are solid dosage forms d)Are liquid dosage forms
C can't fill incompatibles together or liquids ...duh
Question 8: A prescription written for oxycodone is missing the issue date (date it was written). Which of the following is the best course of action that the pharmacist can take to provide care for the patient in pain in a legally appropriate manner? a) Tell the patient that you cannot fill the prescription because it does not contain all the required information for a controlled substance prescription b) Fill the prescription as is. No need to contact the prescriber and no need to turn away a patient. c) Contact the prescriber to determine the date the prescription was written, write that date on the prescription, and make a note about the clarifying call.
C could also change quantity Rxd what you CANT change: Prescriber name Patient name Drug prescribed
Question 3: What is true regarding the Pharmacist in Charge (PIC)? Select all that are correct. a) Must have participated for at least 2 years before coming a PIC b) Is the sole entity responsible for compliance of rules and regulations in the pharmacy c) Must be licensed in Michigan as a Pharmacist d) Must notify the Board within 30 days of a change in the PIC
C & D
Question 8: Which of the following statements is false? a) Administrative agencies in the government implement and enforce laws b) The legislative branch of government enacts laws c) When a federal and state law conflict, the federal law always takes precedence (Trumps the state law) d) An example of a Federal statute is the Controlled Substances Act
C is false whichever is more strict takes precedent
Which of the following can be sold without a prescription? A. Pregabalin #12 (Schedule V) B. Triazolam #10 (Schedule IV) C. Loperamide #48 D. Ibuprofen 400mg #24 (Ibuprofen above 200 mg) E. Codeine 10mg/5ml with guaifenesin 120 ml
C. Loperamide #48 E. Codeine 10mg/5ml with guaifenesin 120 ml
When selling a schedule 5 exempt CS, the pharmacist must do which of the following? A. Determine the purchaser is at least 16 years old B. Must obtain valid photo identification from the ultimate user C. Record the medical purpose for which the med is used D. Determine the purchaser is not presently using any narcotic CS
C. Record the medical purpose for which the med is used
Question 9: Which of the following is true regarding a single sale of OTC 100 tablets of pseudoephedrine 60 mg? Must be reported to the DEA Must be reported to NPLEx Cannot be sold Must be reported in MAPS
Cannot be sold → this is 6000 mg/ 6 g (60 mg x 100 tabs); restricted to 3.6 g/day
Question 9: The FDA can, with just cause, recall medications. Below are the 3 levels of recall based on the likelihood that a medication or medical device can cause harm. Match the Class of recall on the left with the definition of the recall on the right. reasonable probability will cause serious adverse health consequences or death. Product not likely to cause adverse health consequences. May cause temporary or medically reversible health consequences.
Class 1, 3, 2 least serious --> most serious: 3, 2, 1
Question 10: DEA registration is required when handling controlled substances for all of the following entities, EXCEPT: a) Pharmacy b) Manufacturer c) Distributor (wholesaler) d) Pharmacist
D
Question 3: A pharmacist may request which of the following information from MAPS? Information on any patient of the pharmacy, past or present Information on any patient of the pharmacy and/or any prescriber whose prescriptions were filled by the pharmacy Information on a current patient and the prescriber of the current patient Information on a current patient only
D
Question 9: Which of the following prescriptions does NOT fall within the scope of a veterinarian (DVM)? Prednisone for snake with poison ivy rash Cephalexin for a cat Ketorolac for a groundhog Amoxicillin for her 6 year old son's ear infection
D
Question 4: The hospital pharmacy received a controlled substance order from it's wholesaler. Before the currier leaves (the driver), the pharmacist opens the box and notices that the order is missing one box of morphine 5 mg vials, 25 count. Which of the following is true? a) The pharmacy must report loss by submitting the DEA Form 41 to DEA b) The supplier must report loss by submitting DEA Form 41 to DEA c) The pharmacy must report loss by submitting a DEA form 106 to DEA. d) The supplier must report loss by submitting DEA Form 106 to DEA
D form 41 is for drug disposal/destruction the supplier is the one who has to report it because the pharmacy did not claim it
Question 3: Which of the following is true regarding sales of pseudoephedrine? a) Self-certification is not required if the site has a current DEA registration b) Identification of purchaser is only required if purchaser is not known to pharmacy staff c) Purchaser must sign the logbook (NPLEx) when purchasing pseudoephedrine dispensed pursuant to a prescription d) The logbook must include the date and time of the purchase Since there are limits on quantity dispensed within certain time frames
D identification required for all purchasers signature not needed with Rx date and time must be logged because there are limits on quantity dispensed within certain time frames
Question 9: A new pharmacy graduate took but failed the MPJE on their first attempt. Which of the following is a correct statement regarding taking the exam again? a) They must wait a minimum of 60 days before taking it again b) They must enroll and complete a pharmacy law course before taking the exam again c) Must also retake the NAPLEX again, even if they passed on their initial attempt d) If they take it again but fail 2 more times (3 total attempts), they shall request pre approval from the board of a live or interactive exam preparation course or instruction with an instructor with pharmacy law expertise
D must wait 30 days until next attempt law course if they fail 5x wouldn't have to retake NAPLEX *I don't quite understand why B isn't the same thing?*
Question 6: Which of the following statements is true regarding a pharmacy conducting a controlled substance inventory in the community pharmacy located in Michigan. a) Must conduct exact counts on all controlled substances in the pharmacy (C2 through C5) b) Must be conducted every 2 years c) May be conducted anytime between September 1st and October 31st. d) Must be kept on site (registered location)
D need exact count of CII, C2-5 can round if under 1000 must be conducted annually always conducted around may
Question 5: A pharmacy experienced a leaky roof. Rainwater poured all over cases of new medicine vials used to dispense medications. The pharmacist who discovered the damaged boxes noted that many of the vials were wet with rain water. He placed them on a shelf to dry off, then used them to fill prescriptions for patients. Based on the FDCA, prescriptions dispensed with these vials are an example of a _________________product a) Misbranded b) none of these options; the prescription vials were just fine c) Toxic d) Adulterated
D because the product was subject to damage
All prescribers who prescribe controlled substances must have a: NPI number DEA number ARCOS number Number from the Controlled Substance Advisory Commission of the state they practice in
DEA
How should the pharmacist handle a prescription that was emailed from a delegated employee of a physician to the email of the pharmacy?
Don't fill → not an acceptable method of obtaining an Rx (handwritten, fax, e-script)
Which of the following can be sold without a prescription? A. Insulin aspart B. Insulin lispro C. Insulin detemir D. Insulin glargine E. Insulin regular
E. Insulin regular (Humulin N, R, 70/30, 50/50) or (Novolin N,R, or 70/30)
Methadone can be prescribed and dispensed for opioid treatment True False
False (can be dispensed for pain only or Medication Assisted Treatment (MAT)) discuss?
Question 7: A pharmacy can deposit its outdated controlled substances in a takeback receptacle True False
False → would need to be destroyed onsite or sent to reverse distributor with appropriate DEA Form 41 and/or DEA Form 222 if C2s
You inadvertently disclosed a patient's profile to the wrong patient. Which of the following has occurred? Nothing, it was an accident Violation of HIPPA Violation of OBRA 90- insurance Violation of the USP/NF
HIPPA
What are the rules pertaining to "returning to stock" medications that have not been picked up by the patient? Can medication be added back into the open bottle, or must it remain in the prescription vial that was prepared for dispensing?
If the same lot # and expiration date from which the drug was originally filled, it is not misbranding and can be done. If the lot # and expiration dates are different, or it I left in the vial without an expiration date or lot number, it would be considered misbranding
Question 6: How many years must a pharmacist be licensed and actively practicing to be eligible for serving on the Michigan Board of Pharmacy? Licensed for 1 year, practicing for 1 year Licensed for 2 years, practicing for 1 year Licensed for 1 year, practicing for 0 years Licensed for 2 years, practicing for 0 years
Licensed for 2 years, practicing for 0 years
Question 5: Which of the following can delegate prescribing (select all that are correct?) DPM MD DO DDS DVM
MD/DO
If a physician's assistant write an Rx for C2, does the script need both doctor and PA signatures?
No → independent authority - does not require physician signature or DEA # → you would in the case of an NP
Question 3: An MD or DO can delegate prescriptive authority of controlled substances to a: Nurse Practitioner Registered Nurse Physicians Assistant
NP RNS cannot be delegated to rx PAs already have authority from MD/DO
Question 6: A pharmacist in Michigan receives a prescription for buprenorphine to be used for medication assisted treatment for opioid addiction. Does the pharmacist need to check that the prescriber has a DATA waiver (X-DEA number)? Yes No
No Michigan used to but no longer requires special license for CS treatment programs
Is a stamped signature allowed for a controlled substance prescription?
No → stamps are not allowed for and Rx - needs to be manual (wet) or electronic depending on Rx (Fax, electronic, paper)
Which of the following can be sold without a prescription? NovoLog-Insulin aspart Humalog-Insulin lispro Lantus-Insulin glargine Novolin R-Insulin regular
Novolin R-Insulin regular
What can NOT be changed on a C II prescription by a pharmacist?
Patient, Drug prescribed, Prescriber, Do not fill until date can change quantity, to other clarifying questions like when the rx was written if they forgot to write it. if forgot to write DEA# RPH can look it up if confirmed by prescriber
Question 7: The McLaren Health System DEA Investigation was initiated when Pharmacies acquired by McLaren Health system were somewhat careless in monitoring controlled substances dispensing, a leading to a pharmacist diverting controlled substances A nurse practitioner was convicted of writing fraudulent prescriptions in Michigan There were 49 Schedule II (2) controlled substance transfers completed without the proper DEA 106 form The automated dispensing machines in the Flint McLaren hospital were not secured, and several nurses were diverting controlled substances
Pharmacies acquired by McLaren Health system were somewhat careless in monitoring controlled substances dispensing, a leading to a pharmacist diverting controlled substances
Question 6: The False Claims Act: Prohibits billing a different drug than is dispensed Allows the pharmacist to refill medication without patient requesting or authorization Allows for the splitting of prescriptions to receive additional fees
Prohibits billing a different drug than is dispensed Laws to Prevent Federal Fraud & Abuse FCF (False Claims Act) prohibits: Knowingly presenting/causing to be presented a false or fraudulent claim for payment or approval Knowingly making/using/causing/have used false record or statement material to false or fraudulent claim Examples: Billing different drug than dispensed or not dispensed at all Splitting RXs to receive additional fees Refilling meds without pt authorization
Question 5: Which of the following information is required to be on the label of a customized patient medication package (CPMP) a) Only the name of each drug in the CPMP b) The DEA number of the dispensing pharmacist when a controlled substance is included c) The NDC for each medication in the CPMP d) Serial number for the CPMP
Requires a lot of information about every drug contained/ prescriber of each drug, etc.
Question 7: Which of the following MUST be recorded in the patient's record when a vaccine is administered? Which arm or leg the vaccine was administered into The vaccine manufacturer Expiration date of the vaccine The email address of the immunizer
The vaccine manufacturer Required Documentation for Vaccination Manufacturer Lot # Date administered Name, office address, title of provider administering vaccine VIS edition date Date VIS given to pt, parent, guardian Federally required info should be permanent + accessible Federal law does NOT require parent, pt, guardian to sign consent form
Question 1: A community pharmacy can compound sterile productions if it follows which of the following rules? USP <795> USP <797> USP <800> Section 503A of the Federal Food, Drug, and Cosmetic Act
USP <797> 795 is for non sterile compounding 800 for hazardous drugs
You have compounded fiximab at your pharmacy, an FDA unapproved drug. You are shipping this directly to patients per prescription all over the US. Which of the following has occurred? Violated Food, Drug and Cosmetic Act Nothing as it is compounded per patient Violated the Prescription Drug Marketing Act Nothing as it is allowed under the Orphan Drug Act
Violated Food, Drug and Cosmetic Act
What is the DEA number? What is it? Who uses it? How do prescribers get it? How do you authenticate it?
What is the DEA number? What is it? Identifier assigned to a HCP (Physician, PA, NP, optometrist, podiatrist, dentist, veterinarian) by DEA Who uses it? Prescribers listed above, pharmacists to confirm legit DEA #s when filling, government, etc. How do prescribers get it? Register with DEA - get CS license How do you authenticate it?
Are non controlled prescriptions written by an out of state mid level prescriber valid?
Yes (not for controls)
If an Rx for a C2 is presented to a pharmacy without a prescriber DEA number, can the DEA number be added to the Rx by the pharmacist after consultation with and approval by the prescriber
Yes → RPh can look it up and write it in
Is a prescription written by a NP valid if the name of the delegating prescriber is handwritten and not pre-printed on the prescription document?
Yes → as long as it's on there
Computer generated prescription with one computer generated medication but 4 handwritten medications added. Is this legal? How would you handle it in the pharmacy? MDs manual signature needs to be on a prescription?
Yes → up to 4 on a handwritten Rx, up to 6 on an electronic prescription If it's for a mid-level practitioner (NP, etc.) then yes
Question 4: Which of the following medications CAN be billed under Medicare Part D prescription drug benefit? Cialis (tadalafil) for pulmonary hypertension OTC Advil (ibuprofen for tension headaches) Viagra (sildenafil) for erectile dysfunction Ascorbic Acid (vitamin C) for nutritional supplementation
a
Question 9: Which of the following is true regarding medication coverage by Medicare Part D? Part D must cover medications in the antidepressant class Part D must cover all antihypertensive medications marketed in the US Part D does not cover prenatal vitamins Part D must cover all OTC medications
a
Question 1 Which of the following situations is required to be included in a download of a MAPS report sent from a dispenser (pharmacy, dispensing physician office) to the MAPS site at LARA? a) A prescription for Norco tablets, #90, dispensed from a community pharmacy. b) Administration of two doses of hydromorphone to a patient in sickle cell crisis in an emergency room. c) One oral dose (tablet) of Tramadol 50mg dispensed to and taken by a patient in a physician's office for the treatment of pain of a sprained ankle. d) Valium (diazepam) 2 tablets given to a patient who is about to have a colonoscopy in a gastrointestinal specialist out-patient procedure suite
a <48 hr dispensing exempt > Exempt: inpatient admin, practitioner dispensing < 48hr supply
Question 10: Which of the following situations is it absolutely mandatory to check MAPS? a) A physician before prescribing to a patient a controlled substance that exceeds a 3 day supply b) A pharmacist working in a hospital dispensing a controlled substance for an in-patient c) A physician when prescribing a controlled substance in any day supply d) A pharmacist who suspects drug-seeking behavior from a patient who comes to the pharmacy
a inpatient and <48h supply exempt
Question 3: Which of the following is true regarding pharmacy intern licenses and work in Michigan? a) Must be admitted to and actively enrolled in an accredited college of pharmacy b) Must be at least 17 years of age to apply c) Must complete 1200 hours of internship before applying to take the licensing exams d) Must be seeking enrollment in a college of pharmacy
a no age requirement must complete 1600 hours must be actively enrolled
Which of the following actions is (are) permissible under the FDA rules for prescription compounding by pharmacies? a) Advertising to eye doctors that the pharmacy can compound sterile, isotonic ophthalmic solutions b) Sending brochures to nurse practitioners that indicate that the pharmacy compounds topical ointments for the treatment of skin rashes c) Informing an allergy specialist that the pharmacy can economically compound 50 mg diphenhydramine capsules
a, b
Question 5: A pharmacist must maintain records of compounded drug products in the same manner as other prescription records and must also include the: (Select all that are correct): a) A lot number of each ingredient used in the compound b) The formula to compound the drug product, including mixing instructions c) Prescription number d) Date of sale
a, b, c
The Prescription Drug Monitoring Program in Michigan is a database that can be accessed by (select all that apply): A pharmacist before filling a Rx A physician before prescribing to a patient A prescriber to see what RXs they've written have been dispensed A prescriber to monitor a colleague's prescribing activity A patient
a, b, c
Question 1: Which of the following regarding Medicare Conditions of Participation are true? Select all that apply. a) Established rules and regulations for pharmacist supervision and general security and storage of medications b) Is the origin of the requirement for formularies and drug information availability to staff c) Excluded medication errors as criteria d) Placed foundational guidance for stop orders and drug loss reporting
a, b, d
Question 3: In Michigan, which of the following statements is (are) true? Choose all that are correct. When renewing a pharmacy license, a pharmacy compounding sterile products must provide verification of current accreditation by an accepted training and accrediting organization. A pharmacy preparing sterile compounds must keep records of products prepared for a minimum of 5 years. A pharmacy that prepares compounds under 'outsourcing' regulations may also prepare compounds for individual patients, per prescription in the same facility All compound sterile products must submit verification of being accredited by an accepted training and accrediting organization
a, b, d
Which of the following is true regarding the Health Professional Recovery Program a) It is free for the impaired pharmacist b) An impaired licensee can voluntarily enter HPRP c) Part of all health professionals licensing fees pay for the HPRP program d) HPRP records are confidential if the licensee satisfactorily completes the treatment plan and has voluntarily entered HPRP e) HPRP program submits a quarterly list of licensees in the program to the Board
a, b, d
Question 10: A pharmacist is required to report which of the following to the MI Board of Pharmacy? Select all that apply. a) A pharmacy technician with alcohol use disorder affecting work performance b) A felony conviction c) A contested divorce d) An employee reprimanded for having their coffee cup in the sterile compounding are of the pharmacy e) A disciplinary action by another state on the pharmacist's license
a, b, e
Which of the following may result in the Board of Pharmacy taking action on a pharmacist's license: a) Failure to report a significant loss of a CS to the Board b) Failure to report a change of name or mailing address c) Employment termination (too many tardies) d) Getting a speeding ticket e) Being charged with murder f) Conviction involving a controlled substance g) Having a substance use disorder
a, b, f, g NO a charge is an allegation → need to be convicted of it (court declaration of a person's guilt)
Question 2: Under the Program for Utilization of Unused Prescription Drugs, donated drugs may be dispensed to whom in Michigan? Select all that apply: a) an uninsured patient who is a resident of the state of Michigan b) a patient with Blue Cross Blue Shield who is a resident of the state of Michigan c) Cannot have Private insurance like BCBS d) a patient with Medicaid who is a resident of the state of Michigan e) a patient with Medicare who is a resident of the state of Indiana f) an uninsured patient who is a resident of the state of Ohio
a, c needs to be a Michigan resident and does not have private insurance
The Department (BOP) will review your licensing file if which of the following occur? a) The Board receives a written notice of a felony b) The Board receives written notice of a divorce c) The Board receives written notice of default on a mortgage loan d) The Board receives a notice that you failed to notify the Board of a change in employment e) The Board receives a notice from a hospital you were discharged for stealing Vicodin
a, d, e
Question 4 Who may donate to a Cancer Drug Repository (CDR)? Select all that apply. a) A 45 year old family member of a cancer patient b) A 17 year old cancer patient c) A good Samaritan who acquired cancer medications through black market transactions for the sole purpose of donation d) A retail pharmacy e) Michigan Medicine (the health system)
a, d, e need to be >18 Who can donate? People Age > 18, Manufacturer, Wholesaler, Pharmacy (if not previously dispensed)
What type of law is the Board of Pharmacy usually enforcing? Civil Judicial Criminal Administrative
administrative
Question 4: USP <800> Hazardous Drugs regulations regarding compounding and handling hazardous drugs include which of the following? Choose all that are correct. Hazardous products may be purchased in 'unit dose' or 'unit of use' forms to mitigate exposure to healthcare personnel Compounds of hazardous drugs must be prepared in a manner that protects healthcare personnel When compounding, must be in a dedicated room with negative pressure and externally vented If dispensing a tablet or capsule in a bulk container, must be counted in a dedicated counting tray and spatula
all
Question 6: Which of the following does the FDA regulate? Select all that are correct. a) Vaccines b) Medical devices c) Tobacco d) Cosmetics e) Food
all
Which of the following entities could be fined, reprimanded, placed on probation, or a sanction license? Applicant Partner Officer of company (pharmacy) Member of board of directors of a pharmacy, manufacturer, wholesale distributor Stockholder of a pharmacy that is privately held corporation
all
Which of the following is/are true regarding the PIC? A. A pharmacist may be the PIC for more than 1 pharmacy B. A change in PIC must be reported to the department within 30 days C. The PIC and the pharmacy are jointly responsible for pharmacy's compliance with public health code and rules
all
Question 2: Which of the following sanctions may be imposed on a pharmacist's license? Choose all that are correct. Fine Pay double on any outstanding student loans Reprimand Suspension Probation
all but b
Question 9: Which of the following would allow admittance into the Health Professional Recovery Program? Select all that apply Alcohol addiction Schizophrenia, not controlled Blood pressure of 180/95 Oxycodone addiction
all but bp
Question 1: The ultimate user comes into a pharmacy with a bag of medications he was hoping to place into the collection receptacle. Which of the following can be placed into the collection receptacle by the ultimate user? Select all that apply Hydralazine Famotidine Methylphenidate Medical marijuana Lorazepam
all but marijuana (no C1 meds)
Which of the following sanctions could be imposed on a pharmacist license? Fine Suspension Restitution Community service take the MPJE exam
all except community service which is no longer an option
Which of the following techniques would be classified as low risk for pharmacists to perform based on USP guidelines? Placing 20 mEq of KCl into a 1 liter bag of sterile D5W using a needle and syringe Mixing 500 mL of a sterile amino acids with a 500 mL of D50 by gravity flow Aseptically transferring 20 mL of sterile morphine sulfate injection into a 50 mL elastomeric device
all of them
Question 8: Surprise! A Michigan Board of Pharmacy inspector shows up to your pharmacy. Which of the following is a recommended thing you should do? Wait to tell your supervisor - you can handle the situation by yourself Ask for their credentials If you don't know an answer to their question, provide your best guess, because you will probably be right
b
Question 8: Which of the following statements is true regarding a DEA inspection of a pharmacy? a) It is very difficult for the DEA to obtain a warrant if a pharmacy owner refuses to allow a DEA agent access to the pharmacy for an inspection b) DEA inspectors, when they arrive at the pharmacy, will present their credentials, a written explanation of authority, and consent (or authority) to inspect document c) DEA inspections may occur only at a scheduled, pre-arranged time d) The DEA inspector will always request employee performance records to look for persons with poor moral character
b
Question 9: All of the following situations are valid grounds for action to be taken by LARA except: a)Incompetence on the part of a pharmacist b)Yelling at a soccer referee from the stands at your child's soccer game c) Betrayal of a professional confidence (HIPAA violation) d) Fraud or misleading advertising
b
Question 9: In which of the following circumstances must the pharmacy department be locked (no dispensing activity occurring)? a) Pharmacist helping a patient at the counter of the pharmacy b) Pharmacist is outside the back door of the pharmacy for a smoking break c) Pharmacist is on the phone with a doctor while sitting at the pharmacy counter
b
Question 10: Which of the following is true regarding drugs donated to the cancer drug repository program? a) May include controlled substances b) Must be accompanied by a drug donor form c) Must not be adulterated but can be misbranded d) Must have at least an expiration date of one year or more
b donated drugs must have expiration date at least 6 months
Question 5: A pharmacy received a prescription for patient "Expedited Partner Therapy." Which of the following is true? a) It may be dispensed only if the name of the individual who is going to use the prescription is noted or added to the prescription b) It may be dispensed if the patient is being treated for gonorrhea c) December 31st of the current year can be used as the date of birth if the partner's name is unknown d) May be written for partners if exposure occurred within 90 days prior to filling the prescription
b ok for gonorrhea, Also trichomoniasis and chlamydia jan 1st of current year exposure within 60 days of acquiring the rx
Which of the following is a true statement regarding sales of pseudoephedrine? A. Sales of PSE must be reported to MAPS B. All employees who sell PSE must be trained C. Identification is only required if purchaser is not known D. Can sell 9 grams of PSE in one day to a single customer, as long as they have not purchased any PSE in the previous 30 days.
b sales kept in NPLEx or logbook all purchasers need ID can sell 3.6g in 24h period up to 9g per month
Question 1: A pharmacy technician, working in Michigan, must be licensed in order to do which of the following tasks? a) Completing a credit card transaction when a patient is purchasing a prescription b) Compound drugs c) Assisting a patient completing an entry for an OTC Schedule 5 cough medication d) Received verbal order for controlled substance prescription
b) Compound drugs
Question 9: According to the DQSA of 2013, which of the following has LIKELY, occurred in the given situation: a licensed pharmacy, currently in compliance with current good manufacturing practices (cGMP), is compounding and then selling some non-hazardous OTC drug products to physicians for office use without obtaining individual prescriptions for the patients who need the compounded medications. a) The drugs have been adulterated because cGMP is not sufficient in this situation, USP 800 must be applied and followed b) The drugs that have been misbranded because they were compounded and dispensed not pursuant to prescriptions c) The drugs are neither adulterated or misbranded d) The drugs have been both misbranded and adulterated for the reasons listed above.
b) The drugs that have been misbranded because they were compounded and dispensed not pursuant to prescriptions
uestion 2: Which of the following must be on a verbal order (telephone) for warfarin 2 mg communicated by the medical assistant to the pharmacy technician? Select all that are correct. Time Name of prescriber Date Name of medical assistant
b, c others are good practice only things you MUST include are things that you need to process the prescription A Medical Assistant is considered an agent of the prescriber to call in a non-CS medication - this is a Non-CS medication
Question 2: Which of the following is true regarding the Robinson-Patman Act (1936)? Select all that are correct Only applies to non-competing buyers Is applied when the effect of discrimination may injure competition Is the origin of "Own Use" exemption
b, c Robinson-Patman Act (1936) Illegal for sellers to discriminate in prices between purchasers of like products, when effect of discrimination may injure competition Only if between competing buyers Community & hospital pharmacies NOT seen as competitors Established Nonprofit Institutions Act ("Own Use") Exempts schools, colleges, universities, charitable institutions from this act when purchases are for their "own use"
Question 9 Which of the following are true regarding emergency boxes (kits) in a nursing home? Select all that are correct. a) A pharmacist must inspect the emergency box within 24 hours after a drug has been removed b) The pharmacy supplying the box must obtain an order/prescription for drugs removed from the box c) The emergency box must be sealed/locked d) The emergency box must be secured and immediately available
b, c, d box inspected At least weekly or once expired or once opened
Which of the following compounded by a pharmacy could result in action by the FDA and/or the Board of Pharmacy a) Compounding a drug product using an approved FDA drug ingredient b) Compounding a drug product using a drug withdrawn from the US market c) Compounding a drug, this is a duplicate of a commercially available product d) Compounding a drug and selling it to a physician, not based on a prescription e) Compounding a drug based on a prescription using a drug not approved by the FDA
b, c, d, e
Question 1: You are talking with a pharmacist co-worker in a hospital pharmacy, discussing their summer vacation they took 4 months ago. During the conversation, the pharmacist tells you they were convicted of drunk driving offense while on vacation. They hope the Michigan Board of Pharmacy never finds out. By law (mandatory reporting) who are you required to report them to? DEA College of Pharmacy they attended The hospital pharmacy director Board of Pharmacy
bop
Question 4: A pharmacy is required to report to MAPS the required controlled substance prescriptions dispensed: by the next business day twice a month monthly by the following week
by the next business day
Question 2 What is MAPS? MAPS provide medication-assisted treatment (MAT) for people diagnosed with an opioid use disorder MAPS refers to the laws established that outline the procedures for approving and licensing practitioners involved in the treatment of opioid addiction as well as improving the quality and delivery of that treatment Prescription Monitoring Program used to identify and prevent drug diversion at the prescriber, pharmacy, and patient level for C2-5.
c
Question 2: Which of the following must be recorded and submitted to the department on a quarterly basis if a pharmacy dispenses naloxone under the standing order? a) lot number and expiration date of naloxone dispensed b) Identification of the individual naloxone is dispensed to c) Total number of doses of naloxone dispensed
c
Question 3: A patient comes to the pharmacy with a new prescription. The patient does not speak or understand English and only speaks Spanish. Neither you nor your pharmacy staff speaks Spanish. What is your responsibility when counseling the patient. a) Nothing. It's not your job to try to counsel patients who do not speak English b) Call the prescribers office and ask them to counsel the patient since they wrote the prescription and therefore must be able to speak Spanish c) The pharmacy should have access to Spanish speaking interpretive service who can assist in the counseling process. d) Send the patient to another pharmacy across town where you know the pharmacy employs a technician who is fluent in Spanish
c
What is the Consumer Information Notice? a) A list of hours the pharmacy is open b) Identifies for the patients who the pharmacist in charge (PIC) is c) Notified patients they can obtain the prescription drug price before it is dispensed d) Notifies patients which pharmacist(s) have a conscientious objection to dispensing certain prescriptions
c
Which of the following is a true statement regarding compounding? a) A pharmacy may advertise that it provides compounding services as well as emphasizing/ advertising its coal tar compound is the best around town b) A pharmacy may legally compound a drug product using a drug withdrawn from the US market. c) Compounding drug products that are essentially copies of a commercially available product is permitted via federal law if there is a documented drug shortage d) Reconstituting doxycycline powder per the approved manufacturers labeling/ direction to make a suspension is considered compounding per the state of Michigan
c
Question 5: Which of the following is true? a) Medications dropped in on-site medication receptacles must be logged and inventoried b) DEA form 222 is used to document the quantity of schedule 2 drugs collected from citizens during a drug take-back event co-sponsored between a pharmacy and a local law enforcement organization c) DEA form 41 is used by a pharmacy to document what controlled substance medications were destroyed on-site once permission was received from the local DEA office d) A pharmacy sending outdated C2 medications to a reverse distributor initiates a DEA form 41. It is used to document the medications sent to the reverse distributor
c Contents in receptacle not counted or inventoried - RPh is technically not supposed to know what's in there DEA form 222 for C2
Question 8: Which of the following statements about immunization is true? a) In Michigan, a pharmacist can only administer the seasonal influenza, HPV and the varicella vaccine b) If an adverse event occurs to a patient during immunization, the pharmacist only needs to document the event in their immunization log book. c) May share immunization information with a child's school
c Pharmacist can administer any vaccine - under protocol/ standing orders of a physician (all age groups)
Question 6: A pharmacist runs a MAPS report on a current patient. Which of the following is true regarding what they can do with the report? a) The pharmacist, detecting possible illegal activity, can give the MAPS report to a law enforcement agency. b) The pharmacist cannot discuss the report with the patient c) The pharmacist can document MAPS findings in their records (patient profile comments, for example).
c can give MAPS if warrant can discuss with patient but can't give report to patient
Question 4: Which of the following is true? a) If a non-controlled prescription has no indication on it regarding refills, it can be refilled one time b) A prescriber can use a signature stamp to sign the paper prescription handed to the patient c) A fax-to-fax transmission of a non-controlled prescription must have the manual signature of the prescriber d) A prescription for a non-controlled substance is valid for one year from the date of the first filing
c only listed refills are valid need manual signature valid 1 year from date rx'd C2: 90 days C3-5: 6mo
When selling a schedule 5 exempt CS, the pharmacist must do which of the following? A. Determine the purchaser is at least 16 years old B. Must obtain valid photo identification from the ultimate user From purchases C. Record the medical purpose for which the med is used D. Determine the purchaser is not presently using any narcotic CS
c purchaser must be >18 photo ID must be of the purchaser
Which of the following ways may a controlled substance prescription be transmitted to a central fill pharmacy? Select all that apply. a) Verbally b) Original c) Facsimile d) Electronically
c, d
Question 2: Which of the following compounding action (s) by a traditional community pharmacy (not an outsourcing pharmacy) is/are considered acceptable practice by the Board of Pharmacy and the FDA? (choose all that are correct) a) Compounding a drug and selling it to a health system to be distributed to its clinic offices b) Compounding a drug product using a drug withdrawn by the FDA from the US market c) Compounding a drug product using an approved FDA drug ingredient d) Compounding a small batch of a drug routinely dispensed from the pharmacy based on anticipated need
c, d Cannot sell to other health systems - then they become a manufacturer and need to be under 503B
Question 6: Which of the following is true regarding emergency drug box procedures? Select all that apply. a) The type and quantity of medication stored in the box must be approved and reviewed by pharmacist and medical director periodically, but not less than every 6 months b) Pharmacy technicians can be the only and final check/signer of a recently restocked box c) Must be inspected weekly d) Each medication must be labeled and include the name of the medication, the strength, the expiration date, and the lot number
c, d box reviewed at least annually pharmacist is the final check hospital emergency boxes must be inspected weekly
A licensee is required to report which of the following? a) Default on a student loan b) Default on a house mortgage loan c) Action taken on license by another state d) Another licensee who is impaired at work e) A personal felony conviction for homicide
c, d, e
Which of the following can delegate prescribing? DDS DO MD DPM DVM
md/do
Question 7: Use of protected patient health information is allowable by HIPAA in which of the following circumstances: a) A pharmacist providing a medication profile to the girlfriend who wants to know if a patient is taking antiviral medication b) A pharmacy selling patient prescription date to a pharmaceutical manufacturer who will use the information to directly contact patients with incentives to change their current drug therapy to the new drug offered by the manufacturer c) A potential employer can obtain a copy of a prospective employee's medical record to help them make a hiring decision d) Use an interpreter when the patient and care provider do not speak the same language
d
Which of the following is true for central fill pharmacies when filling prescriptions a) Cannot fill schedule 2 prescriptions b) Must deliver the prescription to the patient c) Must have same ownership as the retail pharmacy d) Must protect the confidentiality of the patient's protected health information
d
Which of the following is true on determining the final decision of a sanction on a pharmacist? The entire Board of Pharmacy votes with a majority in favor of the discipline The disciplinary subcommittee of the Board votes with a majority vote in favor of the discipline The entire Board of Pharmacy votes with a majority vote in favor of the discipline with at least one public member voting with the majority The disciplinary subcommittee of the Board votes with a majority vote in favor of the discipline with at least one public member voting with the majority
d
Question 10: You own a pharmacy and want to expand your business to include dispensing medications using the internet to interact with patients. Which of the following is INCORRECT regarding what is required for you to be an internet pharmacy. a) If dispensing controlled substances, must register with the DEA to have a Modified DEA Registration b) State Boards of Pharmacy must be informed of the intent to dispense using the internet c) Your pharmacy must meet all licensing and inspection requirements in the state it is located d) The pharmacy can mail controlled substances to addresses outside of the country without any restrictions
d cannot mail outside US
Question 7: Which of the following statements is correct when determining if a DEA number is legitimate? a) If the prescriber was a physician, the DEA number would start with the letter P b) When you add the totals together, the first digit in the total is the check digit c) Take the 2nd, 4th, and 6th digit, add together, then multiple this number by 4 d) Take the 1st, 3rd, and 5th digit and add together
d first letter would start with an A, B, or F the second digit in the total is the check digit would multiply numbers 2, 4, &6 by 2
Question 4: A pharmacist can dispense a prescription prescribed to a patient, Local Youth Recreation Camp, for which of the following? Any non controlled drug for emergency use Auto-injectable epinephrine Azithromycin Epinephrine vials
epipen
Question 5: When selling a schedule 5 exempt controlled substance (for example, OTC cough medicine containing codeine), the pharmacist must report the sale to MAPS. True False
f
Optometrists can write prescriptions for hypertension medications True False
false unless related to eye condition
Question 8: The liners used in the collection box of controlled substances from the ultimate user must: when full can be sealed by one employee to prepare for removal have a unique identification number be tamper-evident be tear-resistant
have a unique identification number
A pharmacy may supply and control an automated dispensing device at which of the following locations? Select all that apply Hospital Nursing home Doctor's office Skilled Nursing Facility Free standing surgical care facility
hospital, nursing home, SNF
Question 9: Which of the following is true? A pharmacist can dispense a prescription human drug for an animal prescribed by a veterinarian (DVM) A pharmacist cannot dispense a drug for an animal Only a pharmacy licensed as a veterinary pharmacy may dispense drugs for an animal
key says C but I think it's A
An electronically prepared prescription is printed out in the physician's office which the patient then hand delivers to the pharmacy - what type of signature is required? Electronic Stamped Manual All of the above
manual
can a pharmacist fill a prescription for a controlled substance written by an out of state mid level prescriber?
no could fill if it was non controlled
How many insulin syringes may be sold at one time without a prescription?
no limit
Which of the following mandates child resistant packaging for prescription drugs? Orphan drug act Drug marketing act Federal anti-tampering act Poison prevention packaging act
poison prevention packaging act anti tamper act: Most ORAL OTC drug products and many dietarysupplements must have tamper-proof indicatoror barrier that shows if package has beenopened or tampered with
Which step in the drug review process is the drug studied in animals? Pre clinical phase Phase 1- limited number of pts Phase 2- dosage at which efficacy occurs Phase 3 -expansion
pre clinical phase
Question 3: Which of the following parts of a prescription for morphine sustained release tablet can be changed by a pharmacist? The question was written with the notion that the pharmacist would have contacted the prescriber and received approval for any changes that could legally be made. Prescriber name Quantity prescribed Patient name Drug prescribed
quantity rxd
Who, in the pharmacy, can accept a verbal prescription for a CIII to CV?
rph, intern
Is there a conflict between federal and Michigan law, which law should you follow? Federal law Michigan law Stricter law It doesn't matter, as long as you indicate which one you followed
stricter law
Question 5: The National Childhood Vaccine Injury Act requires that providers must document any adverse event following the vaccination that a patient experiences and that becomes known to the provider, whether or not it is felt to be caused by the vaccine. t or f
t
A resident may utilize a hospital's institutional DEA number to prescribe controlled substances True False
true
Question 7: A pharmacy technician can run a MAPS report for a pharmacist. True False
true
Question 8: A 17 year old male is asking to purchase an OTC emergency contraceptive for his 18 year old girl friend. Which of the following could NOT be sold to him? My Way Ella (ulipristal) Plan B One-Step Next Choice One-Dose
ulipristal (this is Rx) OTC products (Progestin-only EC available on shelf without age/gender restriction) Plan B One-Step Take Action Next Choice One-Dose My Way Other generics
Question 2: What is the quantity limit in terms of days supply for a CII drug for chronic use that a physician's assistant in Michigan may write for? Unlimited 7 days 30 days 10 days
unlimited NPs can only write for 30 day C2 (C3-5 without limitations)
Which of the following is/are considered dietary supplements (select all that apply) Herb Vitamin Mineral Sunscreen Fluoride toothpaste
vitamins & minerals
Preprinted Controlled Substance prescription with checkbox next to preprinted quantity OK?
yes
Are prescribers allowed to write for a 90 day supply of a C-2 via multiple prescription issuances?
yes, but have do not fill until date
Can MI pharmacist accept C2 prescription written by a physician who is licensed to practice in Florida? How about a prescription written by a dentist?
yes, independent prescribers
A pharmacist can dispense a prescription made out to patient "Lansing School Board" for which of the following? • A. Glucose tablets • B. Epinephrine vials • C. Naloxone injection • D. Auto-injectable epinephrine
• C. Naloxone injection • D. Auto-injectable epinephrine