Midterm Study Deck - Questions from Labs Flashcards
1
Q
Which area of pharmacy typically utilizes pharmacy automation the most?
A
Long-Term Care pharmacies
2
Q
There will always be a need for pharmacy assistants and technicians; technology cannot replace human interaction.
A
True
3
Q
Which of the following would be considered a disadvantage of dispensing robots?
A
Assumed accuracy of the technology
4
Q
Can a retirement home resident have access to an external care provider (i.e. a provider that does not have a contract with the Home)?
A
Yes, the Home must not interfere with the resident’s choice/delivery of care, unless it is necessary to protect the resident from harm.
5
Q
The Retirement Home has a duty to protect the resident from physical, sexual, emotional, verbal, and financial abuse.
A
True
6
Q
How many rights do residents have that live in a retirement home setting?
A
10
7
Q
The Retirement Home has a policy in place to encourage the use of PASD for assisting residents with routine activities of daily living, and can be used to restrain a resident where a caregiver deems it appropriate.
A
False
8
Q
Who is the current Minister of Long-Term Care in Ontario?
A
Paul Calandra
9
Q
At minimum, how often is a resident required to be bathed in a LTC facility?
A
Every resident must be bathed, at minimum, twice a week by the method of his or her choice and more frequently as determined by his/her hygiene requirements, unless contraindicated by a medical condition.
10
Q
The Home must document each time a drug is administered to restrain a resident under the common law duty.
The documentation must include all of the following:
A
The circumstances precipitating the administration of the drug.
Who made the order what drug was administered, the dosage given, how the drug was administered, the time or times when the drug was administered and who administered the drug.
The resident’s response to the drug.
All assessments, reassessments and monitoring of the resident.
11
Q
What do the regulations state regarding windows that are accessible to residents?
A
Every window in the Home that opens to the outdoors and is accessible to residents must have a screen and must not be able to be opened more than 15 centimetres.
12
Q
What is the minimum number of Registered Dietitions that must be employed by a long-term care home?
A
1
13
Q
How many hours per month (minimum) must a Dietitian be on site at a home that houses 200 residents?
A
100
14
Q
All of the following are specific and required therapies that are listed under “Therapy Services”
A
Occupational Therapy
Physiotherapy
Speech-language Therapy
15
Q
Over a 12 hour shift, how often would a registered nursing staff member (i.e. RPN, RN, RN EC) or their designate (i.e. a PSW) be required to “monitor” a resident who is in a physical restraint?
A
At minimum, at least once or as soon as staff determine that the resident’s behaviour no longer poses a significant risk to themselves/others. (every 8 hours)
16
Q
As discussed in the lecture, according to the Ontario Human Rights Commission, approximately _______ of seniors experience elder abuse in Ontario.
A
10%
17
Q
As discussed in the lecture, according to Statistics Canada (2013), who is most likely to abuse older adults?
A
family members
18
Q
Who is the current Minister of Health in Ontario?
A
Sylvia Jones
19
Q
Explore the following OCP link to determine the TWO types of Remote Dispensing Locations in Ontario:
A
- An automated pharmacy system
- Staffed by a regulated pharmacy technician & supervised remotely by a pharmacist who is present at the accredited pharmacy
20
Q
According to the MedAvail video, this RDL is able to process both new and refill prescriptions.
A
True
21
Q
According to the MedAvail FAQ, this RDL will accept patient drug cards for the purpose of submitting to the pharmacy claims to the third party plans.
A
True
22
Q
According to the MedAvail FAQ, patient data is stored in the kiosk for easy retrieval.
A
False
23
Q
According to the MedAvail FAQ, where will this type of remote dispensing system typically be used?
A
Hospitals
Large campus populations
Rural healthcare centers
Urgent care clinics
24
Q
Remote Dispensing Locations (RDLs) service a wide variety of community needs, and will also dispense controlled medications.
A
False
25
According to the Parata Max 2 video, the system is able to count, fill, labels, caps, and sorts up to _____ prescriptions before requiring intervention.
232
26
According to the Parata Max 2 video, the inventory and dispensing systems are separate, such that you can replenish the inventory of the system even while in operation.
True
27
A special feature unique to the Parata Max 2 is the built-in cell calibration. The system is able to automatically calibrate a new stock bottle, and will run a test-script to ensure accuracy of the tablet-drop once the barcode has been inputted in the system.
True
28
As discussed in class this week, the PacMed at the College is primarily able to prepare batches of pre-packs.
True
29
As discussed in class this week, a batch of pre-packs would primarily be used for PRN/ward stock orders in Long-Term Care pharmacy.
True
30
According to the PacMed video, which of the following statements is TRUE?
a) PacMed can package for both individual patients as well as entire homes/locations.
b) A special system tray is integrated into PacMed, such that medications outside of the PacMed formulary can still be added into patients' paks
c) The Lot and Expiry Date of medications can be tracked within the PacMed System
d) ALL
31
According to the PacMed video, there are three main features toted by this particular system to empower healthcare.
Improve patient safety
Reduce inventory
Increase efficiency
32
According to the PacVision video, when an error is detected, it is automatically rejected (without human intervention) and sent back through the system to be re-processed.
False
33
According to the PacVision video, all individual packages are checked for accuracy by the Registered Pharmacy Technician when the PACMED system is first implemented (even ones that do not have any errors detected).
True
34
McKesson is the company created and oversees the PacMed systems.
True
35
According to the ScriptPro Automation Solutions video, their particular prescription dispensing systems are able to package vials, pouch paks, and blister paks.
True
36
According to the ScriptPro Automation Solutions video, this company has developed a robot to manage bagged prescriptions waiting for patient pick-up.
True
37
According to the ScriptPro Automation Solutions video, their prescription dispensing machines use air pressure to dispense pills.
False
38
Unlike other systems (PacMed), ScriptPro machines dispense directly from the medication cells into the vials that will be dispensed to the patient. This is done to avoid:
cross-contamination
39
What is our VERB for prescriptions that are being dispensed to patients < 12 years old?
Give
40
What "term" are we looking for (in Kroll) if a patient calls and is looking for something they have on hold (i.e they have never filled it)?
"Unfill"
41
Should we consider the pack size of a product (selection based on what we have 'in stock' at the Virtual Dispensary) when inputting the medication into Kroll?
Yes - in practice, Kroll will deduct inventory from that particular pack size of the medication. This helps the pharmacy keep proper inventory control.
42
What must we include on our SIG line for oral (solid) antibiotics?
"UNTIL FINISHED"
43
What must we include/consider on our SIG line for oral (liquid) antibiotics?
If the quantity required for treatment (i.e. 100mL) matches the pack size of the bottle we have in stock (100mL bottle available), we would include "UNTIL FINISHED" at the end of the SIG line.
If the quantity required for treatment (i.e. 97mL) does NOT match the pack size of the bottle we have in stock (100mL bottle available), we would include "DISCARD UNUSED PORTION" at the end of the SIG line.
44
What does "NKA" stand for?
No Known Allergies
45
This week we have discussed common community pharmacy requests by patients, prescribers, and other pharmacies.
What method of verification should always be asked (in addition to patient name) when we are providing information about a patient on our files?
D.O.B.
46
What is the most plausible (most likely) reason that your pharmacy ran out of Prednisone stock?
The pharmacy assistant/technician who is filling the prescriptions at Entry must have been selecting the wrong pack size.
47
Now that you have successfully transferred the prescription out to the pharmacy in Hensall, what are some things you feel we should do to "finish up" with this prescription?
Fax the original prescription to the pharmacy in Thunder Bay so that they have a copy.
Call Dr. Lacerte's office to let them know to cancel/redirect our prescription reauthorization request to the new pharmacy in Thunder Bay.
Use a pen/marker to black out the patient details on the prescription vial, and secure the vial to the Prednisone stock bottle with an elastic.
Remove the balance owing from our owing queue and set all unnecessary paperwork/receipts to shred in the confidential shredding bin.
48
Scenario: Millie is a 17 year-old public high school student who wishes to complete her required volunteer hours at a Retirement home.
Does Millie require a Police Background (Record) Check?
No, Millie is 17 years-old and is not required to submit to a screening/Record Check.
49
When discussing MARs and TARs during the lecture this week, all of the following would typically be found on a "TAR" record, EXCEPT:
Tylenol 3s "PRN"
50
Why do you think there is so much detail in the LTC Homes Act and little to no mention of medication in the Retirement Homes Act?
Medication administration is typically 'in the hands' of the resident themselves (or their family), as this type of living situation is suitable for relatively independent individuals.
51
When a LTC pharmacy provider such as CareRx is closed, in order to adhere to the Pharmacy Service Provider section of the LTC Homes Act, the pharmacy must:
Provide medication to the home 24-hours/day, 7 days a week, and arrange for another pharmacy be able to provide these services (such as "Walmart") in the interim.
52
Which of the following statements regarding Narcotic/Controlled medication in LTC facilities is NOT correct?
Narcotic record "counts" are only kept for capsules and tablets (it is not possible to keep records of liquids, i.e. if a spill happens, it is left undocumented).
53
All of the following are examples of personal assistive service devices (PASD), EXCEPT:
Device used to restrain a resident to a commode or toilet.
54
The Point-Click-Care eMARs video posted on FOL highlights all of the following
Improves the speed with which a 'med pass' is able to be completed by the nursing team, which in turns facilitates more one-on-one time with each individual patient.
The reporting system allows the DNPC to see when medication has been administered, and where the nursing team is at in terms of completing their rounds.
Reduces medication error by improving accuracy (eliminates illegibility of prescriber's handwriting, etc).
55
Which of the following statements regarding medication destruction in a LTC facility is NOT correct?
If a medication is still contained within its sealed blister packaging/unit dose packaging, the facility can return to the pharmacy to be credited for the unused medication.
56
Scenario: Millie is a 17 year-old public high school student who wishes to complete her required volunteer hours at a Retirement home.
All of the following are key areas that Millie must be trained in prior to volunteering at the home:
Millie will need to be trained in the "emergency plan" procedures for that particular facility.
Millie must adhere to the 'zero tolerance of abuse and neglect of residents' that is mentioned in subsection 67 (4) of the act.
Millie will need to be trained in procedures relating to infection prevention and control for the facility.
57
If a LTC facility is closed, can an outside pharmacy, such as Walmart, Shoppers Drug Mart or Rexall, charge a dispensing fee if they are required to fill a prescription for a resident in a facility?
True
58
All of the following are examples of the "standards of practice" (SOPs) for pharmacists and pharmacy technicians, EXCEPT:
All of the above are SOPs for pharmacists and pharmacy technicians.
59
Of the available labelling solutions made by Richards Pharma Solutions, which two products are "tamper-evident"?
Speciality
Permanent
60
Dispill is a "heat seal" system.
False
61
If an error is made during the packaging process, modification is difficult and therefore it is best to repackage the entire card.
False
62
After watching the modification video, we determine that the intention is for the patient to access their medication from:
the FRONT of the card, by ripping open the tab
63
Dispill cards are only able to be dispensed by an actual person (not possible to automate in a machine).
False
64
Dispill is made from 100% recyclable material, and is 100% shreddable.
True
65
Richards Pharma Solutions produce ONLY multidose card systems.
False
66
Which of the following is considered our provincial 'public' plan?
Ontario Drug Benefit
67
Who processes the claims for pharmacy dispensing reimbursements?
Third Party Plans
68
A patient can choose when to pay off their deductible, as long as it is paid within the calendar year.
False
69
Which of the following statements are incorrect regarding Third Party Carrier/Plans?
We are able to tell a patient exactly what would be covered just by looking at the prescription and at their insurance card.
70
An example of a "second line" therapy may be:
The more expensive option within a therapeutic class of drugs
A newer drug
71
Which third-party plan pays out the claims for Fanshawe College's drug plan?
Claimsecure
72
When a claim submission response indicates that the patient must pay $0.35 for each prescription, this is an example of a:
Co-Pay
73
A "frozen" plan is characterized by which of the following?
The formulary remains constant and is reviewed periodically (usually on a specific date).
74
As discussed during class, which of the following might result in a claim being rejected:
The prescription is for a 'lifestyle' drug
The patient's name on the profile does not match the name on their Health Card.
We are trying to submit for a spouse but the plan is only 'single' coverage
75
A 'mark-up' is the dispensing fee that the pharmacy charges in addition to the drug cost.
False
76
After our discussion regarding commonly restricted drugs, what is problematic about not including drugs from these particular conditions/ailments?
They are not forward-thinking with respect to preventative care
They insinuate that certain conditions are worthy of treatment while others are not, and/or may be the fault/lifestyle choice of the patient
They do not reflect current views of mental health
77
All individuals who receive benefits under the Senior Drug Plan will pay a $100 deductible on August 1st each year.
False
78
As discussed during class, we would include a 'prefix' along with the Health Card # for certain programs under Ontario Drug Benefit.
P
79
For all programs that fall under the Ontario Drug Benefit 'umbrella', the client identification number will be the 10-digit health card number of the patient.
True
80
How much will a Long-Term Care pharmacy provider be reimbursed (with respect to dispensing fee) for a patient in a LTC facility, and is on 7 prescription medications?
The pharmacy will be reimbursed a set fee per bed (currently ~$100/month)
81
When pharmacies submit claims to Ontario Drug Benefit - no matter what pharmacy they are submitting from - all claims are centralized on the Health Network.
True
82
Scenario: We receive a prescription for Biaxin XL, and receive a claim response message that the patient's chronic medication, Crestor, interacts with this medication. The prescriber has also written, "Stop Crestor for duration of treatment" on the bottom of the prescription.
Which intervention code will the pharmacy use to get the claim processed for them?
UA (Consulted with prescriber)
83
Scenario: the pharmacy has received a fax from a prescriber indicating that the patient is now to take 2 tablets daily instead of 1. Upon submission, the claim is rejected because it appears that it is "too soon" to fill.
Which intervention code will the pharmacy use to get the claim processed for them?
MN (Dose increase)
84
Scenario: our "snow birds" are flying south for the Winter, and will not return to Ontario for 4 months. Ontario Drug Benefit restricts claim submissions to a 100-day (~3 month) supply.
Which intervention code will the pharmacy use to get the claim processed for them?
MV (Vacation Supply)
85
Which of the following ODB intervention codes would be most appropriate when submitting a claim for a new limited use medication?
LU
86
The Drug Utilization Review (DUR) is mainly for the pharmacist to review when we receive a response on a claim.
False
87
When submitting multiple claims for a high cost drug, we must do all of the following:
(Select all that apply!)
Waive the dispensing fee on all claims except the FIRST claim
Enter the claim code: MM
Enter the claim code: MP
88
The OHIP+ program covers ALL individuals in Ontario who are 24 years of age or under.
False
89
We have just confirmed that the OHIP+ recipient we are filling a prescription for also has a private plan.
The appropriate special service code that we would use to process this claim on Ontario Drug Benefit would be "U - NO-PRIVATE-INSURANCE ATTESTATION".
False
90
Without inserting the special service code "U" for our OHIP+ recipients, the claim will not go through.
True
91
Patients on OHIP+ do not pay a dispensing fee, deductible, or any co-payment.
True
92
For our First Nations/Inuit populations who are 24 years-old and under, and who are also covered under the Non-Insured Health Benefits (NIHB) plan, we are still able to process claims on OHIP+.
True
93
The quarterly deductible for individuals who are covered by the Trillium Drug Plan is the same for each individual/household.
False
94
The Trillium Drug Plan (TDP) is the most complex of all Ontario Drug Benefit plans. In many cases, the patient pays the pharmacy 'out of pocket' and will remit their claim manually for reimbursement.
True
95
For a senior who turned 65 on May 2nd, their coverage under the Senior Plan begins:
June 1st
96
Seniors can only be on one Ontario Drug Benefit Program (i.e. the Senior Plan). They cannot also be recipients of Ontario Works, Ontario Disability Support Program, or Home Care.
False
97
Which of the following characterizes a "Low Income" senior?
Yearly income below $22,200
98
Which of the following characterizes a "High Income" senior?
Must pay $100 deductible
99
If a senior's DOB is August 31st, the amount of their FIRST-YEAR deductible will be:
$91.67
100
When attempting to gain coverage for a drug that is not currently listed in the eFormulary, certain healthcare professionals can advocate on behalf of the patient, and would apply to:
EAP
101
Which program may fund an expensive, injectable cancer drug that would be administered in hospitals and cancer centres?
NDFP
102
Which of the following is common to the Ontario Works, Ontario Disability Support, and Home Care programs?
A patient enrolled in one of these programs is automatically covered by ODB.
103
A patient who is receiving benefits under ODB presents a prescription for Elavil 25mg at the pharmacy. You discover that all LPIs are currently on backorder.
In order to dispense the brand name (and receive reimbursement for the Drug Benefit Price), the pharmacy must:
Use the intervention code "MI"
104
Blank 1: How many test strips are patients managing diabetes with insulin allowed per year?
3000
105
Blank 2: How many boxes on average (to ONE decimal place) would they be allowed per month? (Hint: There are 100 test strips/box!)
2.5
106
We receive the following ongoing prescription for a patient who is receiving support through Ontario Works:
SIG: Take 2 tablets once daily, Mitte: 200
What is the maximum quantity (in tablets) that we can dispense under this program?
70
107
What is the "capped dispensing fee" set by Ontario Drug Benefit for all urban community pharmacies?
$8.83
108
Once we have processed a claim on Ontario Drug Benefit, the pharmacy has 30 days to reverse it online, after which time we would have to submit a manual (paper) claim reversal.
False
109
A patient who is receiving benefits under ODB presents a prescription for Pariet 20mg at the pharmacy. The patient indicates that they do not want any other generic brand except Apo brand. When you look up Apo-Rabeprazole 20mg on the eFormulary, you discover that this particular generic is slightly more expensive per tablet than the other generic brands.
In this case, the appropriate pharmacy response will be:
Indicate to the patient that they would have to pay the difference between the LPI and the requested-brand price
110
Which of the following would NOT be an appropriate reason to dispense less than prescribed?
The pharmacy does not have the full amount in stock.
111
A patient who is receiving benefits under ODB presents a prescription for Crestor 40mg where the prescriber has indicated "no sub". The pharmacy has noted that the patient has one documented ADR on file for this particular drug.
In this case, the appropriate pharmacy response will be:
Indicate to the patient that an additional ADR would need to be documented by the prescriber in order for the brand name product to be covered.
112
How much will a community pharmacy be reimbursed (with respect to dispensing fee) for an ODB-recipient who resides in an area where there are no other pharmacies within 25kms?
$13.25/rx
113
What is the "Carrier ID" for all plans that fall under Ontario Blue Cross?
OB
114
While NIHB is paid out by the third-party carrier ESI (a private plan), this program is technically considered a government plan.
True
115
If there are no changes to patient name or other personal details that we know will restrict the claim from going through (i.e. gender-related or patient name is different from our main Patient Card), do we need to fill in the "Patient Override Values" when we enter drug plans?
No
116
Which of the following plans pay out their OWN claims (i.e. they are both the insurance company, and also the third-party plan)?
Green Shield Canada
117
Is it important to select the "Relationship" of the individual to the cardholder (Cardholder, Spouse, Overage Dependent, etc) when entering a plan?
Yes
118
Which of the following is TRUE regarding Coordination of Benefits?
If eligible for an Ontario Drug Benefit program, this plan is usually the first plan in the "order" of drug plans on the Patient Card
119
When a patient is on the OHIP+ program, we would not be able to bill to a patient assistance program because OHIP+ is not able to coordinate with private insurance plans.
False
120
All of the following programs fall under the Medavie Blue Cross "umbrella", EXCEPT:
NIHB
121
Which of the following is CORRECT with respect to the Non-Insured Health Benefits Program (NIHB):
An eligible client may qualify to receive coverage under both NIHB and OHIP+.
122
Based on our understanding of the Workplace Safety and Insurance Board (WSIB), which drug is most likely to be covered by this particular plan?
Percocet
123
Which of the following scenarios would be MOST appropriate with respect to Patient Assistance Programs?
A prescriber giving their patient an RxHelp card so that they may receive a brand name drug for the generic price.
124
If the patient's name is on the front of a benefit card, we should automatically assume that they are the "cardholder" of that plan.
False
125
Which of the following pharmacy professionals are able to sign the "official receipt" on a prescription?
Registered Pharmacy Technicians
Pharmacists
126
When considering that not all drug plans accept electronic submissions from pharmacies, what should we always provide to our patients?
Official Receipt
127
Which of the following is CORRECT regarding Government Programs (and their applicable drug coverage)?
Government plans are considered to be more aligned with private plans
128
If the pharmacy receives a "pharmacy code error" when submitting a claim - as explained during practice labs this week - what is the most likely cause of this DUR response?
The patient's plan is now part of a Preferred Provider Network
129
If a patient is 24 years-old or under, and they qualify for OHIP+, we would submit to ODB as the first plan, and then we can bill to their private insurance(s) as the second (and third) plan.
False
130
All of the following statements are correct regarding Patient Assistance Programs, EXCEPT:
The pharmacy is able to provide the patient with the card to encourage them to receive the brand name drug at the generic drug price.
131
When a patient must submit 'manually' to their drug plan, this means that they must:
Pay the pharmacy the full prescription price 'up front'
132
A patient comes to your pharmacy. She inquires about how to get a naloxone kit, but is unwilling to give you her name or ID.
Therefore, you are unable to give her a naloxone kit.
True or False?
False
133
You access the Guide to the Long-Term Care Homes Act to reassure Beth that the following rules apply under Regulation Section 110 with respect to "requirements relating to restraining by a physical device":
Resident must be monitored while restrained at least every hour by a member of the registered nursing staff or by another authorized member.
Resident must be reassessed and the effectiveness of the restraint must be evaluated at least every eight hours.
