Download TN-MPJE Exam Final Questions: Pharmacy Regulations and Controlled Substances and more Exams Pharmacy in PDF only on Docsity!
TN-MPJE With 445 Exam Final
Questions
What required warning statement is required on controls II,III, and IV?
- ✔ ✔ CAUTION federal law prohibits the transfer of this drug to any person other than the person for whom it was prescribed
Can controls be transferred? - ✔ ✔ Schedule III, IV, and V can be transfered but only once unless it is in the same chain of pharmacies such as Kroger that all have the same computer system to access the information. The pharmacy that is losing the prescription should write void on the front of the prescription.
Schedule IIs can not be transferred. If received via paper prescription, can give it back to the patient, but if received via e-prescribing then physciian will have to send it to another pharmacy.
For drugs that are OTC but are controls such as cough syrups how old do you have to be to purchase and what is the max quantity you can purchase? - ✔ ✔ Have to 18 years old
Max amount every 2 days
opium products 240 ml
codeine products 120 ml
Have to keep a record of it to verify that it hasn't been purchased within the time period.
Can a pharmacy place an automated dispensing cabinet in a long term care facility?
Whos medication stock is it consider, the facility or the pharmacy?
Why is this beneficial?
Can the machine have the same DEA registration as the pharmacy? - ✔ ✔ Yes
The pharmacy
Cuts costs for patients who die, etc because only what is needed is taken each day
No it has to have its own DEA registration
Is methadone used for pain and opioid addiction? do the different doses have different indications? - ✔ ✔ Yes
It comes in 5,10 and 40 mg but the 40 mg is only indicated for addiction treatment
What was DATA 2000 - ✔ ✔ this federal legislation allowed controls III, IV, or V to be used for opiod addiction outside of a methadone clinic but only suboxone is approved at this time.
Gives prescriber the X DEA number
When doing controlled inventory every two years, how particular do you need to be with your counts? - ✔ ✔ you have to know how many bottles of each product you have.
if its a sealed bottle you can just use the amount provided by the manufacturer on the bottle
All CII require an exact count
as a probationary employee , or if it is a pharmacy tech student then they don't have to be registered but must have their name badge
What is a certified tech allowed to do that a regular tech is not allowed to do? - ✔ ✔ Receive new or transferred prescriptions and verify unit dose carts when an additional verification is needed
Every prescription being dispensed must be checked by a pharmacist prior to leaving the store - ✔ ✔ True - exception is that an intern could do this process as well I think
What is the pharmacist/technician ratio law? - ✔ ✔ 2 techs to 1 pharmacist unless more are needed in which anything above 2 has to be certified and the max is 4
All staff or students at a pharmacy site have to have a name badge with their title T or F - ✔ ✔ True
1140-
Can a medication guide replace face to face counseling - ✔ ✔ No but it can be an addition to face to face counseling
If a prescription is dropped off and the person picking it up is not the patient or their caregiver what is the pharmacist legally required to do regarding counseling? - ✔ ✔ "the pharmacist has to provide every effort to counsel through alternative means"
If a hospital is dispensing medications when a patient is being discharged what is required regarding counseling? - ✔ ✔ The
patient still has to be counseled but it is not required while the patient is inpatient for their daily meds on the MAR
What is the law regarding counseling with refills. - ✔ ✔ Counseling must be offered but is not required unless the pharmacist has concerns
Can a patient refuse counseling and can the pharmacist still dispense if refused? - ✔ ✔ The pharmacist can still dispense the medication the patient is allowed to refuse counseling.
What must the patients medical record in a pharmacy contain? - ✔ ✔ Past dispensing record, name, address, telephone number, DOB, gender, medical history when possible, allergies or previous drug reactions,
When a pharmacist is reviewing a new prescriptions what interactions and concerns are they required to look for? - ✔ ✔ 1. over-utilization or under-utilization;
- therapeutic duplication;
- drug-disease contraindication;
- drug-drug interactions;
- incorrect drug dosage or duration of drug treatment;
- drug-allergy interactions
- clinical abuse/misuse
If a patient has an adverse drug reaction to a prescription, is the pharmacist supposed to notify the physician? - ✔ ✔ Yes
MD DEA number
What is required in the computerized medical record for each new scrip dispensed or refill? - ✔ ✔ Patient name
Prescriber name
prescription serial number
Date filled
Product name
strength
dosage form
quantity
directions for use
date dispensed
dispensing pharmacist
Pharmacist is required to either sign a book/refill log or a hardcopy print out each day saying that the refills filled were correct and placed in computer correctly and the pharmacy must maintain this record for how long? - ✔ ✔ 2 years
The computerized system must be able to print a refill report stating when each refill was obtained including all the normal information for each fill and if an authorized board member requests this print out how quickly must the pharmacy get it to the board? If it is a controlled substance what additional item would need to be present (of things not already mentioned such as patient address)? - ✔ ✔ 48 hours that
excludes weekends (Sat/Sun) and legal holidays. On the print out controlled substance must be separated or asterisked or identifiable from all the rest of the prescriptions that were not controlled substances.
If a computerized system has a down time the pharmacy must have a back up system to ensure that refills are being filled appropriately and have a system that all prescriptions filled will get put into the system appropriately once the computers are back up - ✔ ✔ True
A pharmacist must look at the original hard copy when dispensing a refill - ✔ ✔ False - they can use the computerized system to evaluate whether a refill is due assuming the computerized patient profile contains all the needed information
The patient profile contains a medication dispensed list or prescriptions received list how are medications differentiated between controls and non controls. - ✔ ✔ The computer system can do this in many different ways such as a symbol like an asterisk , or have controls underlined in red
Refill history has to be kept for how long and be readily retrievable? - ✔ ✔ 2 years
A pharmacist can substitute a therapeutically equivalent drug that contains the same ingredient and has the same dosage form and strength - ✔ ✔ True
If the physician writes on a prescription that it can be filled anytime when needed, what is the law on what the pharmacist can refill - ✔ ✔ Match the dose and quantity and refill at the necessary time
Prescriptions can be received via fax or facsimile but a pharmacy can never provide a fax machine to a prescriber. - ✔ ✔ Weird but true that a law states pharmacies cannot buy doctors fax machines
Prescriptions that are received via fax can be used as the hard copy and kept for records like a hand written scrip would be. But can they be transferred to another pharmacy after being faxed - ✔ ✔ The original prescription has to be dispensed by the pharmacy it was faxed to, it is possible that it can be transferred after that (not sure) 1140-03- .04 f
Can a physician electronically transmit a medical order/prescription to a hospital pharmacist for a patient who is inpatient or outpatient ( this does not pertain to medical gases) - ✔ ✔ Yes (CPOE can be used in this way, remember! )
An electronic order can be sent to a pharmacy what must it contain?
It can also be kept as the original prescription to maintain and keep as a hard copy. - ✔ ✔ (i) The telephone number of the authorized prescriber
(ii) The correct time and date of the transmission;
(iii) The name of the pharmacy to which the order is being transmitted
(iv) The prescribing practitioner's electronic signature or other secure method of validation.
(v) If the transmission is delegated by the prescriber to an agent of the prescriber, the identity of the agent shall be included in the transmission.
Electronic Signature - ✔ ✔ is defined as the process that secures the user authentication (proof of claimed identify, such as by biometrics, fingerprints, retinal scans, hand written signature verification, etc.) at the time the signature is generated and creates the logical manifestation of a signature.
Can a pharmacy be run out of a mobile building? ( trailer or mobile home) - ✔ ✔ NO
1140-03-.05 AREAS OF RECEIPT AND DISPENSING.
All medical and prescription orders shall be received or accepted and compounded and dispensed from a pharmacy practice site which is in a building permanently located and non-mobile in nature. In case of emergency, the board may waive this rule upon request.
What must be contained on the prescription label on the bottle dispensed to the patient at a retail pharmacy? ( does not apply to inpatients) - ✔ ✔ 1) name and address and telephone number of pharmacy practice site
the medical or prescription order serial number,
name of prescriber;
name of patient;
directions for use;
6)date medical or prescription order originally dispensed, and/or refill date
- "poison", "shake", "caution", or other appropriate advisory label
include a list, including amounts, of such prescription drugs or controlled substances or medical devices or related materials lost or damaged. - ✔ ✔ Board of pharmacy
If your pharmacy was flooded or partially burned, can the insurance company take any of the medications with them while investigating or reporting the claim? Can the products that do not appear to be damaged be sold? - ✔ ✔ Not unless approved by the board of pharmacy. The board of pharmacy would have to approve any products that you want to sell.
Destroying expired or damaged controlled medication can be done by who? - ✔ ✔ Only a board approved vendor
Certain items that do not require a prescription can be kept away from public by being stored in a pharmacy and can only be dispensed by a pharmacist - name some of these items - ✔ ✔ Controlled substances that do not require a prescription, regular insulin, needles
Does the board keep a record of who the pharmacist in charge is each pharmacy location? - ✔ ✔ Yes
If a pharmacist in charge dies, gets fired, quits, or is on leave for more than 30 days the board has to be notified in what length of time? - ✔ ✔ Immediately
When a pharmacist in charge is quitting and another is taking over what should be with controlled inventory? - ✔ ✔ Both parties should go through the inventory together BUT if the leaving pharmacist in charge does not do this the new pharmacist in charge still has to.
If a pharmacist in charge goes on a leave of more than 30 days what must happen with the inventory of controlled substances when they return? - ✔ ✔ Inventory of controlled substances should again be inventoried with both pharmacists in charge before the temporary one leaves.
When controlled substance inventory is done what should it include and how long do you have to keep the record? - ✔ ✔ (a) the name and address of the pharmacy practice site;
(b) the name, strength, dosage form, and quantity of each controlled substance on hand;
(c) the date of inventory; and
(d) whether the inventory was taken as of the opening or close of business on that date.
2 years
If you sell a pharmacy, a controlled substance inventory must be completed with the current and new owner or pharmacist in charge and the inventory record must be sent to the board within how many days? - ✔ ✔ 30 days
Can one pharmacist be the pharmacist in charge at more than one site or pharmacy? - ✔ ✔ Not unless the board determines it is beneficial to public health
How many hours per week must the pharmacist in charge be present in the pharmacy - ✔ ✔ at least 50% of the hours they are open but not to exceed 40 hours per week
also only using unit dose packaging of medications in the drawers
Schedule two drugs have to be in a _______________ locked secured system. - ✔ ✔ Double - so inside a locked cabinet inside a locked institutional pharmacy would provide this.
Drugs that have been dispensed and then wasted by a nurse have to be recorded and miantained for two years. What should go on this record for each incidence of wasting? - ✔ ✔ (a) the identification of patient;
(b) drug name, strength, dosage form, and quantity;
(c) the date and method of destruction; and
(d) the identification of authorized personnel witnessing the destruction and its record.
What is an emergency medicine kit? - ✔ ✔ It is a supply of medications that may be needed in an emergency situation where other sources of obtaining the medication would take substantially more time and could potentially put a patient at risk
Who should be responsible for determining what medications should be allowed in the emergency medicine kit? - ✔ ✔ Committee that contains nurses, medical staff, and the pharmacist in charge
The emergency kit must be sealed or electronically secured, the expiration date on it should be of the drug that expires the _____________. When the ER kit is opened it must be returned to the _____________ , restocked, resealed and replaced. - ✔ ✔ earliest / pharmacy
What can a homecare kit contain? - ✔ ✔ A home care kit may contain:
(i) Sodium Chloride for Injection 0.9% Bacteriostatic
(ii) Sterile Water for injection Bacteriostatic or Preservative Free
(iii) Epinephrine injection 1mg/ml
(iv) Diphenhydramine
(v) Heparin Flush <or = 100units/ml
(vi) Naloxone
(vii) Sodium Chloride for Irrigation
(viii) Sterile Water for Irrigation
(ix) Dextrose 50%
(x) Urokinase 5000units
(xi) Any other legend drug as approved by the board.
When a homecare kit is opened for any reason can it be left in the home incase any of the other supplies are needed? - ✔ ✔ No - When a home care kit is opened for any reason, the pharmacy practice site shall be notified and the kit shall be restocked and resealed within a reasonable time so as to prevent risk of harm to patients.
Institutional or Infusion centers - if products are returned to the pharmacy when would you dispose of them versus when could you reuse them? - ✔ ✔ Discontinued, outdated, defective, or deteriorated drugs, devices, or related materials and containers with worn, illegible, or missing labels shall be returned to the pharmacy
to an adult family member to be taken home or they are held in the pharmacy at a secure location until discharge.
Recalls - how are they handled? - ✔ ✔ Each pharamacy site is required to have a policy and procedure to make sure recalls are identified and taken back into the pharmacy.
In hospitals that do not have 24 hour pharmacies do the pharmacists have to be available at all times? - ✔ ✔ Yes a pharmacist has to be on call anytime the pharmacy is closed
In institutional pharmacy has to keep medications locked up in automated dispensing cabinets or other cabinets. How often does the pharmacy have to inventory these items? - ✔ ✔ Once a month
If storing medications for over night use in an institutional pharmacy , in a locked cabinet, the pharmacist is going to make the volume of the medication not last longer than how many days or hours? ( assuming its not a manufactured package that the pharmacy has no control over) - ✔ ✔ 72 hours of use
The after hours locked cabinet of medications used in institutional pharmacies that close have to keep a record of what was used. What information should this record include? - ✔ ✔ (i) the date and time of removal of a drug;
(ii) the patient's name and location;
(iii) the name, strength, dosage form, and quantity of the prescription drug; and
(iv) the identification of the authorized personnel removing the drug.
The pharmacy needs to verify all orders for medications used after hours taken from the locked cabinet in an institutional pharmacy, needs to keep these records for 3 years, and will need to replace used items. T-F - ✔ ✔ False --2 years
When staff enter the pharmacy after hours, they should enter with two people, be allowed via policy and procedure to enter after hours, and all of the other rules apply regarding getting in to a locked cabinet after hours however how much medication can be taken if entering the locked pharmacy? - ✔ ✔ The amount needed for the immediate dosage plus one additional dose
Automated dispensing cabinets
pharmacists are responsible for this system T/F - ✔ ✔ True
Automated dispensing cabinets
The pharmacist must stock it T/F - ✔ ✔ False - but policy and procedure should support who is filling it, and regardless the pharmacist is the one accountable for it
Automated dispensing cabinets
The pharmacy is responsible for running reports and looking for diversion concerns with the automating dispensing cabinets T/F - ✔ ✔ True
Automated dispensing cabinets
Nurses can teach other nurses how to use the automated dispensing cabinet, its not difficult T/F - ✔ ✔ False - there has to be official
