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NEBRASKA MPJE EXAM 2024 | REAL EXAM
QUESTIONS WITH CORRECT DETAILED ANSWERS |
LATEST 2024/
T or F. All pharmacies must have a PIC, even mail order. ANSWER True Define PIC ANSWER Pharmacist responsible for practice of pharmacy on Pharmacy's License Works w/in the physical confines unless remote dispensing pharmacy PIC duties ANSWER - Develop/implement policies/procedures (hosp)
- Ensure that pharmacist review medical orders prior to first dose (with exceptions) (hosp)
- Operational Law Conformance
- Initial Inspection presence
- File Required Reports
- Notify Dept. of HHS and patients if pharmacy closing
- Supervision and performance assessment
- Employee credentialing verification T or F. Pharmacist review is required of all medical orders prior to first dose being administered to patient in hospital. ANSWER T (with exceptions)
- STAT Orders (given immediately and ONCE)
- Harm to patient Is telepharmacy allowed in hospitals to allow pharmacist review of orders? ANSWER Yes When is pharmacist review of medical order not required in hospital? ANSWER When practitioner controls ordering/dispensing/administration of the drug *OR *Endoscopy suite *ER *Etc. When time does not permit pharmacist review ANSWER *Stat order (x1)
*When status of patient would be significantly compromised by the delay Does a hospital need a separate pharmacy license? ANSWER Only if serving patients outside of the hospital (but ok to do for any hospital within the healthcare system) What reports are required for PIC to submit? ANSWER *Annual Pharmacy Quality Assurance Report *Semiannual as required by Parkinson's Disease Registry Act Details submitted in semiannual report required by Parkinson's Disease Registry Act ANSWER - List ofPatients taking registered PD Drugs
- Name & Address of Patient/Prescriber
- SSN How to change PIC ANSWER - Notify DHHS immediately
- Control Substance Inventory
- Contain all info required in biennial inventory
- Maintain in pharmacy for 5 years
- Forward to Dept within 30 days Do you need to send controlled substance inventories to anybody? ANSWER Forward to the Department What to do if pharmacy ceases legal existence or discontinues business ANSWER Notify the Department within 15 days:
- Sale/Disposition of any pharmaceutical product or device. (including legend/controls) - Invoices/inventory records
- Location of all patient records
- Return Pharmacy Licence, DEA Registration, unused 222 forms (including a and d) What to do if pharmacy has change of ownership Notify the Department within 15 days
- How to transfer CIIs? - How long must transfer records be kept? - 222 form
- 2 years How to transfer schedule III-V medications (to a pharmacy, wholesaler, etc.) Must
- Actions deceiving/defrauding public
- Actions detrimental to public interest Can you prescribe a controlled substance to yourself? No Can you prescribe a controlled substance to family members, etc.? Only in case of medical emergency
- spouse
- child
- parent
- sibling
- living in household Can an employer or employer's agent coerce a pharmacist to dispense a drug product against the professional judgment of the pharmacist or as ordered by prescriber? No Define delegated dispensing Joint, voluntary agreement to practice pharmacy with others under a protocol authorizing dispensing with specification of conditions/limitations §38- 2872 to §38- 2889 Components of a delegated dispensing agreement - Address
- Name/license # of each pharmacist
- Name/signature of other dispensers
- Inspection Procedures by delegated pharmacist
- Any other info required by the board Not effective until permit issued by department with recommendation of the board Define consultant pharmacist Actively practicing NE RPH who holds an unrestricted license
- designated on the drug dispensing permit as the pharmacist who is responsible for dispensing requirements in Nebraska statutes, the term "consultant pharmacist" refers specifically to those working with a Public health clinic How can public health clinics dispense legend drugs/devices? - Have a consultant pharmacist listed on Drug Dispensing Permit
Duties of a consultant pharmacist - Be in clinic once q30 days
- Monthly inspections
- Policies/Procedures around pharm products
- Approve info/instructions dispensed to patients
- Annual assessment/record of clinical proficiency for workers dispensing contraceptives
- Approve training of the clinic workers
- Report inventory discrepancies to the Board and the clinic administrator
- Periodically review fridge storage conditions Define availability of a constultant pharmacist - Pharmacist available in person or by phone while dispensing taking place
- Notify clinic if won't be available during the required time-must be documented Can dispensing occur in a public health clinic if there is no consultant pharmacist or on-call pharmacist? No Copy of initial inventories taken pursuant to a PIC change must be forwarded to the Dept. within of completion 30 days When a pharmacy goes out of business, the unused DEA 222 forms must be:Returned to DHHS
- Includes forms A and D A delegated dispensing agreement shall include what things: - Address of dispensing site
- Name & License # of each RPH
- Name/Signature of each dispenser
- Inspection procedures
- Documentation of inspections Q4: Which of the following activities is (are) the responsibility of a pharmacist-in-charge? (Select ALL that apply.) A) Must be present for the initial on-site inspection B) Notify patients of pharmacy closing C) Annually submit a report to DEA of all CII sales D) Annually submit a completed Pharmacy Quality Assurance Report A B D
examinations approved by the board How long is an intern license valid for? 15 months after graduation or at time ofprofessional licensure If based on graduation from non-accredited program, expires 15 months from date of issuance or at time of professional licensure Components of intern application - Name
- Place/DOB
- SSN
- Mailing Address
- Permanent Address
- Phone/email/fax (optional)
- Name/location of Pharm School
- Official documentation of month/year of enrollment and graduation
- Statement that must not practice w/o immediate supervision of licensed pharmacist
- Statement that all info is correct
- Fee
- Birth certificate/marriage license/driver's license/other age verification Intern identification requirements - Registration card at all times.
- Intern name tag, etc... Intern supervision requirements At all times by Nebraska pharmacist
- Does not apply to IPPE/APPE students (experiential training) Interns can't supervise other interns/techs Supervision ratio Up to 3 techs/interns (in combination) Q1: Who may counsel a patient, according to Nebraska Pharmacy Law? (Select ALL that apply.) A) Pharmacists B) Certified pharmacy technicians C) Pharmacist interns D) Registered pharmacy technicians E) Cashiers employed by a pharmacyA C Q2: A pharmacy technician may perform all of the following duties EXCEPT:
A) Entering prescription data into a data processing system B) Taking a new oral medical order from a prescriber C) Receiving refill authorization requests D) Reconstituting medications E) Compounding sterile preparations of medicationsB Q3: A registered pharmacy technician shall: (Select ALL that apply.) A) Be a high school graduate or be officially recognized by the State Department of Education as possessing the equivalent degree of education B) Have never been convicted of any nonalcohol, drug-related misdemeanor or felony C) Become certified within a period of six months D) Submit to a mandatory preliminary urine drug screen A B Q4: Which of the following statements are TRUE according to Nebraska Pharmacy Law? (Select ALL that apply.) A) A pharmacist may supervise up to three pharmacy technicians at any time B) A pharmacist may supervise up to three pharmacist interns at any time C) A pharmacist may supervise any combination of pharmacy technicians and pharmacist interns at any time up to a total of three people D) Supervision ratios do not apply to pharmacist interns receiving experiential training E) Ratios for pharmacist supervision of technicians and pharmacist interns are not explicitly definedA B C D Q5: What combination of pharmacy employees is allowed by law? A) One pharmacist, two technicians, and one student who is receiving experiential training, directed by their accredited school B) One pharmacist, one intern, and three technicians C) One pharmacist, one intern, two technicians, and one APPE student D) A and C only E) All of the above D
Fair Packaging and Labeling Act of 1967 Requires consumer products in interstate commerce to be properly labeled (including OTC) Prescription Drug Marketing Act of 1987 - Products manufactured domestically and exported can only be re-imported by original manufacturer
- States required to establish controls on wholesale distribution of legend drugs
- Resale of purchased drugs prohibited Sale/purchase/trade of drug purchased by public/private hospital/other health care entity is prohibited
- No drug sample resale Sale/purchase/trade of Drug sample/coupon is prohibited Drug Supply Chain Security Act (DSCSA) OR TRACK AND TRACE - Provide product tracing information (lot-level)
- Handle suspect/illegitimate product: quarantine and investigate suspect product and notify FDA/immediate trading partners if illegitimate
- Confirm licensure of authorized trading partners Can retail pharmacist receive or dispense prescription samples? No - only starter packs
- Not considered samples, intended for initiation of therapy Possession of prescription drug samples by retail pharmacies would be considered by the FDA Drug diversion Can institutional pharmacies receive samples? Yes, if
- Requested by licensed prescriber
- Disposition recorded
- Stored separately How to licensed practitioners get samples? Provide written requiets
- drug manufacturer/distributor must keep requests for 3 years Temperature requirements Fridge: 36 - 46 F Freezer: - 4 to 14 F Cool place: 46-59 F (or fridge) Controlled room temp: 59 - 86 F Can food be in fridge with drugs, etc.? Must be in separate compartment Requirements for storage of prescription inventory/prescription records must
be maintained in a secure location when there is no pharmacist on the premises. Loss of prescription inventory or prescription records due to theft or any other cause resulting from failure to secure the inventory or records are grounds for disciplinary action Define distribute Deliver drug/device other than by administration/dispensing Does intracompany sale of prescription drugs constitute wholesale drug distribution? No
5% of sales in 12 month period = wholesale distribution Wholesale drug distribution does not include: - Intracompany
- Charitables, Nonprofits, etc...
- Emergency medical reasons (Disasters/shortages)
- Prescription
- Samples
- Blood/components intended for transfusion Emergency medical reasons for distribution Alleviation of temporary shortage by transfers of drugs btwn: *Holders of pharmacy licenses *Healthcare practitioner facilities *Hospitals Natural disaster/other Q1: Samples of prescription drugs received by a physician from medical representatives can be: (Select ALL that apply.) A) Given to patients B) Sold to a chain pharmacy store C) Sold to another physician D) Sold to a hospital pharmacy E) Sold at a discount to public health clinics A Q2: A pharmacy must register as a wholesale drug distributor if it distributes more than: A) 2% of gross dollar value of the total prescription drug sales revenue in a 12 - month period B) 5% of gross dollar value of the total prescription drug sales revenue in a 12 - month period C) 3% of gross dollar value of the total prescription drug sales revenue in a 24 - month period D) 4% of gross dollar value of the total prescription drug sales revenue in a 6 - month period
Class IV felony Define short-term detoxification <= 30 days Define long-term detoxification 31 - 180 days Define maintenance treatment (in regards to administration of narcotics to a narcotic dependent person)Administer/dispense narcotic in the treatment of a narcotic-dependent person for more than 21d Naloxone: immunity? Yes
- Person likely to experience OD
- Family/friend/other who administers
- Emergency responder
- Peace officer/law enforcement Drug Addiction Treatment Act of 2000 (DATA) Enables qualifying physicians to receive waiver from the special registration requirements in the CSA for the provision of medication- assisted opioid therapy
- Allows them to practice this with Schedule III, IV, or V meds
- "X" DEA #
- Must put X-DEA and regular DEA# on buprenorphine prescriptions for opioid addiction therapy Optometrists (OD) prescribing authority Legend drugs for eyes only CII-only topical ophthalmics CIII-CV for eyes only Also
- epi autoinjector
- oral steroid
- oral glaucoma agent
- oral immunosuppressive CS to spouse/child/parent/sibling/household member (NOT self) only in ophthalmic emergency Advanced practice registered nurse (APRN) prescribing authority APRN-NP, APRN-CRNA, CNM (midwife)
- samples incident to practice
- limited to scope of practice (see cards)
APRN-CNS (clinical nurse specialisti)
- no prescribing authority in scope of practice
- no sample medications APRN-NP prescribing authority Legend drugs CII-CV Contraception Smoking cessation Anti- anxiety Weight loss Limited to scope of practice CS to spouse/child/parent/sibling/other household member (NOT self) only in emergency APRN-CRNA duties In consultation and collaboration with and with consent of the licensed practitioner
- Preanesthesia evaluation
- Selection and application of monitoring devices
- Selection and administration of anesthetic techniques
- Evaluation and direction of proper postanesthesia MGMT and dismissal
- Evaluation and recording of postanesthesia course of patients
the PA*
- MD/DO name if needed for reimbursement purposes Dentist (DDS, DMD) prescribing authority • C2-C6 for human teeth or jaws, or adjacent structures only
- Anti-anxiety for dental visit only
- Controlled substances to spouse, child, parent, sibling, or any other person living in the same household as prescriber for human teeth or jaws, or adjacent structures for an emergency only NOT: contraception, wt loss, CS to self Veterinarian (DVM) prescribing authority ONLY to treat animals
- C2-C
- Contraception
- Anti-anxiety
- Weight loss Podiatrist (DPM) prescribing authority Only for human foot, ankle, and related structures
- C2-C
- Anti-anxiety for office visit only
- Controlled substances to spouse, child, parent, sibling, or any other person living in the same household as prescriber NOT: contraception, nicotine cessation, wt loss, CS to self MD and DO prescribing authority • CII-CV
- Legend drugs
- Contraception
- Anti-anxiety
- Nicotine cessation
- Weight loss
- Controlled substances to spouse, child, parent, sibling, or any other person living in the same household as prescriber for emergency only
- Cannot prescribe controlled substances to self Q1: How can a pharmacist verify that a prescriber is allowed to prescribe buprenorphine for treatment of
opioid addiction? (Select ALL that apply.) A) Confirm that the prescriber has been granted a waiver via SAMHSA B) Check the prescriber's regular DEA registration number: It ends with "X" C) The pharmacist must contact the prescriber to verify prescriber eligibility D) Check the prescriber's special Drug Enforcement Administration (DEA) number; physicians granted a waiver under DATA 2000 are issued a special DEA number that always begins with "X" E) The pharmacist must contact the State medical board to verify prescriber eligibility A D Q2: According to Nebraska Pharmacy Law, which of the following practitioners may prescribe a narcotic Schedule II controlled substance in the course of their professional practices? (Select ALL that apply.) A) Physician assistant B) Nurse Practitioner (APRN-NP) C) Veterinarian D) Optometrist E) Physical therapist A B C D Q3: According to Nebraska Pharmacy Law, if a prescription is issued by a physician assistant, both the name of the physician assistant and the name of the supervising physician must appear on prescription when: A) Each prescription is issued B) The prescription is for a controlled substance C) The physician assistant has less than 2 years of practice experience D) It is issued for greater than a 30 day supply E) It is needed for billing purposes only E Q4: A licensed veterinarian, in the course of his professional practice, may prescribe a drug for: (Select ALL that apply.)
- Unable to send Written/e-script Can CII scripts be faxed? Yes
- If original presented prior to dispensing
- Narcotic: to be compounded for direct parenteral administration for home infusion
- Says "Hospice Patient"
- LTC Residents Partial CII fill? Yes,
- Notation of # filled on Rx or Electronic Record
- Remainder must be filled w/in 30 days from WRITTEN DATE
- Notify prescriber if remainder not filled
- LTC (see card) Partial CII fills for LTC - Terminal Illness Dx
- Bear words "terminally ill" or "LTCF patient" on Rx or EHR
- Date, # filled & remaining, dispensing pharmacist recorded on BACK of Rx/EHR
- Rx valid for 60d from WRITTEN DATECIII-V expiration? 6 months CIII-V transfers? Yes Required components of CIII-V prescription *Pt name *Pt address *Name of drug *strength *dosage form *quantity *directions for use *date *Refills (different from CII) *prescriber name *prescriber address *DEA # *signature (manual or digital) pretty much the same as CII except refills CIII-V refills? Yes, *5 refills
w/in 6 months*
- Total of 6 fills on one script
- Can be PRN CIII-V faxed scripts? Yes, serves as the original CIII-V partial fills? Yes
- each partial fill recorded in same manner as refilling
- # dispensed <= total # prescribed
- each partial fill dispensed w/in 6 months What changes can pharmacist make on CII prescription? After discussing with prescriber, pharmacist can add or change:
- dosage form
- strength
- quantity
- directions
- issue date NO CHANGING
- pt name
- CS prescribed (except generic substitution)
- prescriber's signature Procedures for CII oral prescription order - Emergency only (see card)
- Practitioner phones pharmacist
- Hard Copy within 7 days (In person/via mail)
- "Authorization for Emergency Dispensing" and date of oral order)
- Limited quantity
- Immediately transcribed by RPh
- Pharmacist reasonably verifies prescriber identity
- Attach hard copy to oral Rx / document receipt in EHR (include date of oral order) Emergency CII oral prescription order: what if practitioner fails to deliver written prescription? Notify the nearest office of the Administration ID required for receipt of opiates? Must be provided unless personally known (For C2-C4):
- Driver/Operator License
- State ID card
- Military ID
- Alien Registration
