Exam 2 - 2023

Question 1

A DEA form 41 is used to:

a. order controlled substances in schedules III through V.
b. request coincident activities from the Drug Enforcement Administration.
c. record destruction of controlled substances.
d. report thefts and losses to the Drug Enforcement Administration.
e. register for a DEA number.

Answer 1

c. record destruction of controlled substances.

Question 2

A prescriber issued a prescription for eszopiclone on March 15 with three refills. The patient exhausted all authorized refills and asked the prescriber to call the pharmacy to issue additional refills on August 3. What is the maximum number of refills the prescriber may add to this prescription?

a. One
b. Four
c. Three
d. Two
e. Zero, no refills may be added, and a new prescription must be issued.

Answer 2

d. Two

Question 3

Which factors are considered when determining whether a drug should be scheduled? (SELECT ALL THAT APPLY)

a. Whether the product can be easily manufactured with common household substances.
b. Scientific evidence of the pharmacologic effect of the product.
c. Cost of the product.
d. Ease of use of the product.
e. Risk the product and misuse of the product poses to public health.

Answer 3

b. Scientific evidence of the pharmacologic effect of the product.
e. Risk the product and misuse of the product poses to public health.

Question 4

A pharmacist is finishing the official inventory at the close of business. Their technicians helped with inventory earlier and finished inventorying all schedule III through V products, but they still have the schedule II products to inventory. They would like to finish counting quickly, so they estimate the counts of these products after looking at each bottle. This pharmacist:

a. violated the law; inventories must be completed at open and cannot be completed at the close of business.
b. violated the law; schedule II products must be inventoried before all other substances.
c. violated the law; pharmacies must maintain a perpetual inventory, and there is no other official inventory.
d. proceeded legally; inventory counts may be estimated for these products as long as the pharmacist handled the bottle.
e. violated the law; products in this schedule must be exactly counted.

Answer 4

e. violated the law; products in this schedule must be exactly counted.

Question 5

A prescriber wants to call in a prescription for morphine, but they are unsure of the requirements. Which of the following is true regarding calling in this product?

a. There is never a situation where this medication can be called into a pharmacy.
b. Calling in this medication is limited to a 72-hour supply.
c. Calling in this medication has no additional requirements as long as all information required on a prescription is provided.
d. A covering prescription must be sent to the pharmacy within seven days of calling the prescription in.
e. This medication can only be called in if the patient is enrolled in a hospice program or resides in a long-term care facility.

Answer 5

d. A covering prescription must be sent to the pharmacy within seven days of calling the prescription in.

Question 6

The Drug Enforcement Administration reviewed the factors for scheduling related to a substance. The organization predicts the product will have abuse potential higher than ketamine and physical dependence symptoms greater than chlordiazepoxide. There is no medical use for the product in the United States. Which schedule will the drug likely be placed in?

a. Schedule V
b. Schedule II
c. Schedule I
d. Schedule III
e. Schedule IV

Answer 6

c. Schedule I

Question 7

All of the following are true about reporting thefts and losses EXCEPT:

a. Thefts and losses are reported on a DEA 106.
b. Information about the theft or loss must be provided when submitting the appropriate DEA form.
c. Only significant losses must be reported to the Drug Enforcement Administration.
d. Only thefts above 100 units are reported to the Drug Enforcement Administration.
e. Registrants must report thefts and losses within one business day of learning of the issue.

Answer 7

d. Only thefts above 100 units are reported to the Drug Enforcement Administration.

Question 8

A prescriber calls the pharmacy and mentions they would like to prescribe phentermine for a patient. They ask how they can send the prescription to the pharmacy. Which of the following would be a correct answer to provide this physician? (SELECT ALL THAT APPLY)

a. Provide a written prescription for the patient to bring to the pharmacy.
b. Send a prescription electronically to the pharmacy.
c. Call the pharmacy and issue an oral prescription over the phone.
d. Fax a prescription to the pharmacy.

Answer 8

All of the above

Question 9

A pharmacist sells a schedule V nonprescription product without a prescription. They know the patient, so they do not ask to see a form of identification. The pharmacist has violated the law.

True
False

Answer 9

False

Question 10

A pharmacist lives in a state where they are recognized as a prescriber. They want to obtain a DEA registration number and start prescribing controlled substances to patients. Which of the following is a correct statement regarding this pharmacist’s registration?

a. Pharmacists are not eligible for a DEA registration number and will never apply for a registration.
b. A pharmacist who is a recognized prescriber must apply for a dispensing or instructing registration to prescribe these medications.
c. A pharmacist who obtains a DEA registration number will have a registration number that starts with an A, B, F, or G.
d. Pharmacists are not required to obtain a separate DEA number; they may prescribe using their pharmacy’s DEA number.
e. Pharmacists interested in applying for a registration will use a DEA 510 to apply.

Answer 10

b. A pharmacist who is a recognized prescriber must apply for a dispensing or instructing registration to prescribe these medications.

Question 11

Which of the following would be an appropriate DEA number for a dentist with the last name George?

a. BL1234563
b. MS2461351
c. AG1234567
d. ZA1234567
e. CG6543213

Answer 11

a. BL1234563

Question 12

A pharmacist received a controlled substance prescription that contained red flags. They are unsure of their obligations in resolving red flags and ask for your help. Which of the following accurately describes a pharmacist’s responsibility in resolving red flags?

a. Pharmacists must attempt to resolve red flags to the best of their ability before dispensing a prescription.
b. Pharmacists must wait at least 72 hours before dispensing a prescription when red flags are identified.
c. Pharmacists must call the Drug Enforcement Administration to notify the agency of poor prescribing practices whenever red flags are identified in a prescription.
d. Pharmacists are not responsible for resolving red flags.
e. Pharmacists can only resolve red flags after a discussion with the provider; if they cannot speak to the prescriber, they must refuse the prescription.

Answer 12

a. Pharmacists must attempt to resolve red flags to the best of their ability before dispensing a prescription.

Question 13

Schedule V products have the lowest potential for abuse of all controlled substances.

True
False

Answer 13

True

Question 14

A physician recently started treating patients for substance use disorders. The physician only has an instructing/dispensing registration. A pharmacy receives prescriptions written by this physician for buprenorphine/naloxone and methadone to maintain a patient’s disorder. The pharmacist refused to fill the methadone prescription but filled the buprenorphine/naloxone prescription. This pharmacist:

a. violated the law; physicians must have a narcotic treatment program registration to prescribe buprenorphine/naloxone.
b. proceeded legally.
c. violated the law; physicians must have a prescribing registration to prescribe controlled substances for maintenance.
d. violated the law; no controlled substance can be prescribed to maintain patients with a substance use disorder.
e. violated the law; pharmacists cannot refuse to dispense prescriptions.

Answer 14

b. proceeded legally.

Question 15

A patient asks to purchase a controlled substance over the counter. The product is a liquid nonprescription product that does NOT contain opium. What is the maximum amount the pharmacist can sell at one time, and what is the time frame before the patient can purchase more?

a. Zero; liquid products cannot be sold over the counter.
b. 240 milliliters in 48 hours.
c. 24 milliliters in 72 hours.
d. 480 milliliters in 24 hours.
e. 120 milliliters in 48 hours.

Answer 15

e. 120 milliliters in 48 hours.

Question 16

A patient filled a prescription for Marinol with three refills at City Pharmacy last month and needs a refill today. City Pharmacy is out of stock of the medication, but United Pharmacy next door has the product in stock. The patient would like to transfer the prescription to United Pharmacy for this fill and then transfer the prescription back to City Pharmacy next month. Which of the following statements about this transfer are accurate?

a. This prescription can be transferred to United Pharmacy this month and back to City Pharmacy next month as the patient wishes.
b. This prescription cannot be transferred to United Pharmacy because the drug is in a schedule that cannot be transferred.
c. The prescription can be transferred to United Pharmacy this month, but the prescription must stay at United Pharmacy for the remaining refills.
d. City Pharmacy can transfer one refill to United Pharmacy to fill this month and maintain the rest of the refills to fill in the future.
e. Controlled substance prescriptions cannot be transferred, so the patient will need the prescriber to send a new prescription to United Pharmacy.

Answer 16

c. The prescription can be transferred to United Pharmacy this month, but the prescription must stay at United Pharmacy for the remaining refills.

(marinol = CIII)

Question 17

Which of the following are true regarding treatment for maintenance and detoxification in substance use disorders? (SELECT ALL THAT APPLY)

a. Only prescribers with a narcotic treatment program registration may dispense a three-day supply of a narcotic medication while a patient waits for space in a treatment program.
b. A prescriber must have a special DEA number to prescribe buprenorphine products in an office-based treatment program.
c. Hospitals may continue a patient’s maintenance or detoxification treatment when the patient is hospitalized for another issue.
d. Prescribers with a narcotic treatment program registration may prescribe methadone for maintenance and detoxification.
e. Prescribers may issue a prescription for office use for injectable or implantable products and have the pharmacy deliver the product to the office for administration to a patient.

Answer 17

c. Hospitals may continue a patient’s maintenance or detoxification treatment when the patient is hospitalized for another issue.

Question 18

A physician assistant prescribed oxycodone to a patient. The patient was leaving the country for several months, so the physician assistant issued a prescription for an eight-month supply of the medication. The pharmacist found no red flags with the prescription and dispensed the entirety of the prescription. This pharmacist:

a. violated the law; this medication is an opioid, and opioids cannot be dispensed for more than seven days due to the risk of developing substance use disorder.
b. violated the law; pharmacists cannot fill prescriptions without verifying with the prescriber.
c. violated the law; physician assistants cannot prescribe this medication to patients.
d. violated the law; schedule II prescriptions cannot be filled for more than 90 days at a time.
e. proceeded legally.

Answer 18

e. proceeded legally.

Question 19

A prescriber is interested in obtaining triazolam for use in their office before procedures. They write a prescription for four bottles of 10 tablets with the patient’s name as Office Use and directions to dispense as needed in the office. The pharmacist who received the prescription evaluated the prescription for red flags and found no issues but did not call the provider. They dispensed the prescription. This pharmacist:

a. violated the law; prescribers cannot write prescriptions for office use and must purchase the medication on an invoice.
b. violated the law; pharmacists must call providers to verify all controlled substance prescriptions before dispensing.
c. violated the law; prescriptions for office use are limited to no more than ten tablets.
d. violated the law; prescriptions for office use must list the patient names the product will be used for in the directions.
e. proceeded legally.

Answer 19

a. violated the law; prescribers cannot write prescriptions for office use and must purchase the medication on an invoice.

Question 20

Which of the following agencies is responsible for enforcing all laws in the Controlled Substance Act?

a. Food and Drug Administration
b. Board of Pharmacy
c. Drug Enforcement Administration
d. Federal Bureau of Investigation
e. State Police

Answer 20

c. Drug Enforcement Administration

Question 21

Which individual would not require an employer waiver when hired in a job with access to controlled substances?

a. A technician who was convicted of a felony related to selling marijuana.
b. A physician whose DEA registration has been revoked.
c. A pharmacist who has previously surrendered their pharmacy’s DEA registration for cause.
d. A nurse who admitted to using controlled substances that had not been prescribed to them.
e. A medical resident whose DEA registration was denied.

Answer 21

d. A nurse who admitted to using controlled substances that had not been prescribed to
them.

Question 22

A new medical resident has started at your hospital. The institution has given them the authority to prescribe using the institution’s DEA number by assigning them a suffix. The medical resident would like to prescribe three days of Dilaudid for a patient on their service who is being discharged from the hospital. They call you to ask for help in this process. What should you tell this resident?

a. They cannot prescribe this medication; any outpatient prescription is limited to a single days supply.
b. They cannot prescribe this medication; it is a narcotic, and narcotics cannot be prescribed using an institutional DEA number.
c. They cannot prescribe this medication; medical residents cannot prescribe medication when a patient is discharged from the hospital.
d. They may prescribe this medication if they add their suffix to the institution’s DEA when prescribing.
e. They cannot prescribe this medication; they are not working in the scope of their employment.

Answer 22

d. They may prescribe this medication if they add their suffix to the institution’s DEA when prescribing.

(dilaudid = CII)

Question 23

All of the following are true regarding recordkeeping except:

a. When storing records centrally, all records must be electronically maintained.
b. Records for dexmethylphenidate must be maintained separately from all other records.
c. When stored with records for amoxicillin, temazepam records must be readily retrievable.
d. Inventories must be stored at the registered location.
e. All records for controlled substances must be maintained.

Answer 23

a. When storing records centrally, all records must be electronically maintained.

Question 24

Kelly Doe issued a temazepam prescription for a patient Alex James. The directions were to take one capsule by mouth at bedtime. The prescription was issued for 30 capsules with two refills on March 5. Which of the following items must be listed on the prescription label? (SELECT ALL THAT APPLY)

a. Kelly Doe
b. Rx #5029343
c. Take one capsule by mouth at bedtime.
d. Two refills
e. 30 capsules

Answer 24

a. Kelly Doe
b. Rx #5029343
c. Take one capsule by mouth at bedtime.

Question 25

A patient asks to purchase a pseudoephedrine product over the counter. All of the following are true about the sale EXCEPT: a. Purchasers must sign a logbook to complete the sale. b. Pharmacies must record sales in a written or electronic logbook. c. A patient must provide a state or federal form of identification for the sale to proceed. d. These products cannot be sold without a prescription. e. The pharmacy cannot sell a product containing more than 3.6 grams of pseudoephedrine in a single transaction.

Answer 25

d. These products cannot be sold without a prescription.

Question 26

A pharmacist wants to rearrange where controlled substances are stored in the pharmacy. They ask for your help in clarifying where to store certain drugs. Which of the following products may be dispersed amongst the regular stock of drugs in the pharmacy? (SELECT ALL THAT APPLY) a. meperidine b. lorazepam c. Methylin d. Vimpat e. testosterone

Answer 26

all of the above

Question 27

A pharmacy is purchasing methylphenidate using a paper DEA 222. The pharmacist made a mistake when filling out the order and listed the wrong dosage form. Since this was a small mistake, the pharmacist crossed out capsules and wrote tablets instead. They added their initials next to the change to ensure the supplier knew it was purposeful and completed by the individual with the Power of Attorney. They completed the remainder of the order correctly and sent it to the supplier. This pharmacist: a. violated the law; paper DEA 222s are not used to order this drug product. b. violated the law; pharmacies cannot change a DEA 222 before sending it to the supplier. c. violated the law; pharmacies must send a certified statement of change to suppliers if a change is made on the order form. d. violated the law; pharmacists with power of attorney cannot complete DEA 222s. e. proceeded legally.

Answer 27

b. violated the law; pharmacies cannot change a DEA 222 before sending it to the supplier.

Question 28

Which of the following is true about ordering controlled substances on a DEA 222? a. Purchasers must maintain orders for 60 days from the date products are received. b. All pharmacies may order using an electronic DEA 222 when their registration is issued. c. Zolpidem must be ordered using a paper DEA 222. d. Suppliers cannot endorse an order to another supplier unless the purchaser ordered a narcotic. e. Suppliers must report to the Automation of Reports and Consolidated Orders System (ARCOS) or send a copy directly to the Drug Enforcement Administration.

Answer 28

e. Suppliers must report to the Automation of Reports and Consolidated Orders System (ARCOS) or send a copy directly to the Drug Enforcement Administration.

Question 29

A prescriber issued a prescription for Vyvanse for a patient on January 29. The patient requested a partial fill of the prescription on February 27 and received a seven-day supply. The patient returned ten days later and requested another partial fill, and the pharmacist dispensed another seven-day supply. Five days later, the patient returned, requested the remainder of the prescription, and the pharmacist filled it. This pharmacist: a. proceeded legally; this medication can always be partially filled multiple times when requested by the patient. b. proceeded legally; this medication is in a schedule that can always be partially filled. c. violated the law; products in this schedule can only be partially filled one time. d. violated the law; this medication cannot be partially filled the second or third time because it has been longer than 30 days from the date written. e. violated the law; products in this schedule may be partially filled, but the patient must pick up the remainder within 72 hours.

Answer 29

d. violated the law; this medication cannot be partially filled the second or third time because it has been longer than 30 days from the date written.

Question 30

All of the following items are required on a prescription for phenobarbital EXCEPT: a. Quantity prescribed. b. Prescriber's DEA number. c. Number of refills. d. Patient's name. e. Date prescription was written.

Answer 30

c. Number of refills.

Question 31

A pharmacy maintains a bound book for over-the-counter controlled substance sales. How long must the pharmacy maintain the records for these sales? a. 60 days from the date of the first entry in the book. b. One year from the first entry in the book. c. Five years from the date of the first entry in the book. d. 180 days from the date of the last entry in the book. e. Two years from the date of the last entry in the book.

Answer 31

e. Two years from the date of the last entry in the book.

Question 32

Which of the following items must be listed on a controlled substance prescription? (SELECT ALL THAT APPLY) a. Drug name. b. Prescriber name. c. Patient name. d. Patient birth date. e. Directions for use.

Answer 32

a, b, c, e (all but d)

Question 33

A prescriber calls to ask for help issuing prescriptions for hydrocodone/ibuprofen. They want to issue multiple prescriptions to the patient to avoid the patient having to come back each month, but they need help understanding the requirements. Which of the following statements is a correct statement about this practice? a. The prescriptions not filled immediately must contain instructions noting the earliest date the prescription can be filled. b. A prescriber can issue multiple prescriptions for up to a 180-day supply of a schedule II product. c. Multiple prescriptions can only be issued for non-narcotic products, and hydrocodone/ibuprofen is not eligible, so the patient must return each month. d. A prescriber must have a special registration to issue multiple prescriptions; this registration number must be on all prescriptions issued under this provision. e. The prescriber must put the date they want the prescription filled as the date written.

Answer 33

a. The prescriptions not filled immediately must contain instructions noting the earliest date the prescription can be filled.