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Question 1

The retail sale of pseudoephedrine is limited to a max of ______ per day per individual.

A
3.6 grams
B
7.5 grams
C
9 grams
D
12 grams
E
30 grams
Question 1 Explanation: 
For Scheduled Listed Chemical Products (SLCPs), which include pseudoephedrine and ephedrine, the daily sales limit is 3.6 grams per individual. The 30-day sales limit for SLCPs is 9 grams per individual.

These limits are for the over-the-counter, retail sale of pseudoephedrine and ephedrine. These limits do not apply if the patient has a prescription for SLCP’s.
Question 2

Records of administration for injectable medications, biologicals, and immunizations should include all of the following EXCEPT:

A
Name and address of patient’s primary health care provider
B
Name or initials of the administering pharmacist
C
Manufacturer of the medication, biological, or immunization
D
Name or initials of the person preparing the product for administration
E
Lot number of the medication, biological, or immunization
Question 2 Explanation: 
Records of administration for injectable medications, biologicals, and immunizations should include the: patient name, address, date of birth; name and address of the patient’s primary health care provider; name or initials of the administering pharmacist; the drug/vaccine name, dose, manufacturer, lot number, and expiration date; documented informed consent for administration; date of administration and site of injection; and any adverse reaction that occurred, the nature of the event, and who was notified.
Question 3

Under supervision of a pharmacist, a pharmacy intern may:

I. Provide immunizations

II. Accept oral prescriptions

III. Counsel patients on drugs

A
I only
B
II only
C
I and III only
D
II and III only
E
I, II, and III
Question 3 Explanation: 
Pharmacy interns may perform procedures and skills which require professional training when under the direct supervision of a pharmacist. Pharmacy interns may accept oral prescriptions, provide immunizations, counsel patients on drugs, etc. Pharmacy interns may not enter or be in a pharmacy if a pharmacist is not on duty.
Question 4

Computerized systems used by pharmacies must be able to retrieve all prescription information of prescriptions filled within the previous 24 months within _______ working days.

A
3
B
5
C
7
D
14
E
30
Question 4 Explanation: 
Pharmacies must be able to provide all prescription information of prescriptions filled within the previous 12 to 24 months within 3 working days. The information retrieved must include:

1) The information normally required to be on prescriptions.

2) The identification of the pharmacist responsible for prescription information entered into the computer.
Question 5

For how long is a collaborative practice agreement effective?

A
1 year
B
2 years
C
3 years
D
5 years
E
10 years
Question 5 Explanation: 
A collaborative practice agreement is effective for a period of 2 years after the date of signing. The agreement should be reviewed after the 2 years and either renewed,
Question 6

A pharmacist dispenses a prescription for alprazolam on a Saturday. The pharmacy is closed on Sunday and reopens on Monday. When does the pharmacy need to report information on the dispensed alprazolam to the Prescription Drug Monitoring Program (PDMP) by?

A
On Saturday, the same day, before the pharmacy closes
B
Within 24 hours of dispensing
C
Before close of the business day on Monday, in 2 days
D
Before close of the business day on Sunday, the next day
E
Within 72 hours of dispensing, regardless of business hours
Question 6 Explanation: 
The pharmacy needs to report controlled substance prescription information to the PDMP by closing of the next business day. In this case, the alprazolam was dispensed on Saturday. The pharmacy is closed on Sunday, so the next business day is Monday. Therefore, the pharmacy will need to report the alprazolam dispensing before the pharmacy closes on Monday. At some pharmacies, the system will automatically report the dispensing information to the PDMP when the patient picks up the medication.
Question 7

A mother presents a prescription for amphetamine/dextroamphetamine (Adderall) that is written for her child. The prescription is for a 90-day supply, and it was issued 30 days ago. How may the pharmacist proceed?

A
The pharmacist may fill the prescription
B
The pharmacist cannot fill the prescription because the child is a minor under 18 years of age
C
The pharmacist cannot fill the prescription because it has been over 7 days since the date of issue
D
The pharmacist cannot fill the prescription because the quantity is more than a 7-day supply
E
The pharmacist cannot fill the prescription because it is for an opioid
Question 7 Explanation: 
The pharmacist may fill this prescription for amphetamine/dextroamphetamine (Adderall). Adderall is a stimulant and categorized as a Schedule II controlled substance.

In Pennsylvania, prescriptions for Schedule II controlled substances are valid for 6 months from date of issue. There is not a specific quantity limit for controlled substances, but note that there is a day supply limit in certain situations (i.e. opioid prescribing to minors). A pharmacist should always use their professional judgement when evaluating the quantity and day supply.

Since the child is a minor, the parent is the legal guardian and may pick up the child’s prescription.
Question 8

Garrison comes into the pharmacy on a Friday night and tells the pharmacist he forgot to refill his prescription earlier and he just ran out of his metformin. The pharmacist is unable to reach the authorized prescriber and there are zero refills on the prescription. The pharmacist can dispense an emergency refill of up to how many hours supply?

A
Twenty-four
B
Thirty-six
C
Forty-eight
D
Seventy-two
E
Ninety-six
Question 8 Explanation: 
Pharmacists can dispense an emergency refill of up to a 72-hour supply of any medication that is not a controlled substance if a prescriber cannot be reached for a refill authorization. The emergency fill must have the same directions as the original prescription. This is in the setting of a medication where interruption of therapy could create patient harm or throw off a therapeutic regimen. The patient must be informed that future refills need authorization from the prescriber and the prescriber must be notified of the filling within 72 hours.
Question 9

In an institutional setting where a drug therapy protocol is created for a pharmacist to be able to manage drug therapy, the written agreement or protocol must be sent to:

I. The Pennsylvania Board of Pharmacy

II. The State Board of Medicine and/or Osteopathic Medicine

III. The Bureau of Consumer Protection

A
I only
B
II only
C
I and II
D
I and III
E
I, II, and III
Question 9 Explanation: 
A written agreement or protocol regarding a pharmacist managing drug therapy in an institutional setting must be signed by all collaborating physicians and pharmacists and sent to the Pennsylvania Board of Pharmacy and the State Board of Medicine and/or Osteopathic Medicine.
Question 10

A pharmacist receives a written, out-of-state prescription for hydrocodone-acetaminophen (Norco) that was prescribed by a physician. The prescription is legal in the state it was written in. The pharmacist also verifies with the prescriber’s office that the prescription is valid. In addition, the patient is new to the pharmacist. The pharmacist runs a report through the prescription drug monitoring program (PDMP) and determines no suspicious activity. The pharmacist:

A
May fill the prescription
B
May not fill the prescription because it is for a controlled substance
C
May not fill the prescription because the physician is out-of-state
D
May not fill the prescription because is it a written prescription and it needs to be e-prescribed instead
E
May not fill the prescription because the pharmacist has to run the PDMP report at least twice
Question 10 Explanation: 
Pennsylvania allows pharmacists to fill out-of-state prescriptions that are legal in the state that they are written in. Physicians have prescriptive authority to prescribe controlled substances, so the prescription is still valid. The electronic prescribing of controlled substances requirement applies to practitioners in Pennsylvania; other states may have different laws. In our case, the written prescription is legal in the originating state.

Since the patient is new to the pharmacist, the pharmacist must query the PDMP prior to dispensing, but does not have to query it twice.
Question 11

Given that the minor’s parents have provided signed consent, a prescriber cannot prescribe more than a _______ supply of opioids to a minor.

A
24-hour
B
48-hour
C
72-hour
D
5-day
E
7-day
Question 11 Explanation: 
A prescriber cannot prescribe more than a 7-day supply of opioids to a minor with the consent of a parent, unless indicated per their professional medical judgement. Required documentation includes the patient’s medical condition and why a non-opioid would not be appropriate. Other exceptions to the day supply limit are if the patient has cancer, is in palliative or hospice care, or has chronic pain not associated with cancer.
Question 12

Which information must appear on a prescription blank of a nurse practitioner?

I. Nurse practitioner name and title

II. Nurse practitioner certification number

III. Supervising physician name

IV. Supervising physician license number

A
I only
B
I and II
C
I, III, and IV
D
I, II, and III
E
I, II, III, and IV
Question 12 Explanation: 
Prescriptions must bear the name, title, and Pennsylvania CRNP certification number of the Certified Registered Nurse Practitioner. When appropriate, the CRNP’s National Provider Identifier (NPI) number must appear on the prescription. Prescriptions may not be pre-signed.
Question 13

Pennsylvania pharmacies must post public lists of commonly used generically equivalent drugs from the Department Formulary. These lists must include all of the following EXCEPT:

A
Brand names
B
Generic equivalent names
C
Manufacturer names
D
Regular and customary retail prices
E
Medications that particular pharmacy stocks
Question 13 Explanation: 
Pennsylvania pharmacies must post public lists of commonly used generically equivalent drugs from the Department Formulary. These lists must include the brand names, generic equivalent names, and manufacturer names, and there must also be a list of regular and customary retail prices.
Question 14

Rodriguez recently picked up a prescription from the pharmacy for his cyclobenzaprine that he had been using as needed for his back. It was given to him in one of the pharmacy’s prescription bottles. Mr. Rodriguez calls the pharmacy and says he has not opened the bottle and would like to return the bottle so the medication can be used for others, as he hasn’t needed it anymore. Which of the following is true?

A
The medication can be taken back and redistributed as long as it has been unopened
B
The medication cannot be taken back and redistributed because it has left the pharmacy area
C
The medication can be taken back and redistributed, as long as it is compared to the original medication bottle and there appears to be no tampering
D
The medication can be taken back and redistributed if the pharmacist deems it was kept under proper storage conditions
E
The medication can be taken back and redistributed if the pharmacist inspects the medication for impurities and deems it is appropriate
Question 14 Explanation: 
Medications that have left the prescription area cannot be taken back and redistributed to others unless it is the original sealed bottle with the manufacturer’s label, lot number, and expiration date.
Question 15

Prescription information for Schedule II–V dispensed prescriptions must be reported to the Pennsylvania Prescription Drug Monitoring Program (PDMP) within what timeframe of dispensing?

A
Within 3 hours
B
No later than the close of the subsequent business day
C
Within 24 hours
D
Within 5 business days
E
Within 10 business days
Question 15 Explanation: 
Prescription information for Schedule II–V dispensed prescriptions must be reported to the Prescription Drug Monitoring Program (PDMP) no later than the end of the subsequent business day.
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