Electronic prescribing (EP) systems, or e-prescribing, enable clinicians and pharmacists to create, transmit, and manage prescriptions electronically. These systems improve medication safety, reduce prescribing errors, and support clinical decision support (CDS) features such as drug–drug interaction checks, allergy alerts, and dosage guidance. B. Pharm students should understand standards (NCPDP SCRIPT, HL7/FHIR), controlled-substance e-prescribing (EPCS), interoperability with EHRs and pharmacy management systems, audit trails, privacy regulations, and workflow integration. Knowledge of EP benefits and common challenges (usability, alert fatigue, data integrity) is essential for modern pharmacy practice. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary purpose of an electronic prescribing (EP) system?
- To replace pharmacists with automated dispensing machines
- To electronically create and transmit prescriptions to pharmacies
- To manage hospital staffing and billing
- To perform laboratory tests remotely
Correct Answer: To electronically create and transmit prescriptions to pharmacies
Q2. Which standard is most commonly used in the US for transmitting prescription messages between prescribers and pharmacies?
- NCPDP SCRIPT
- HL7 CDA
- DICOM
- ICD-10
Correct Answer: NCPDP SCRIPT
Q3. What does EPCS stand for in the context of electronic prescribing?
- Electronic Patient Care System
- Electronic Prescribing for Controlled Substances
- Enterprise Pharmacy Compliance Software
- Electronic Procedure Coding Standard
Correct Answer: Electronic Prescribing for Controlled Substances
Q4. Which of the following is a key clinical decision support (CDS) feature in EP systems?
- Automated invoicing
- Drug–drug interaction alerts
- Pharmacy inventory reordering
- Patient appointment reminders
Correct Answer: Drug–drug interaction alerts
Q5. Interoperability between EP systems and electronic health records (EHRs) is important because:
- It allows EP vendors to control pharmacy workflows
- It supports sharing structured medication data and clinical context
- It reduces the need for pharmacy staff
- It eliminates the need for prescribing clinicians
Correct Answer: It supports sharing structured medication data and clinical context
Q6. Which of the following helps verify patient identity and prevent diversion in EPCS?
- Two-factor authentication for prescribers
- Barcode scanning at the pharmacy counter
- Automatic refill denial
- Patient satisfaction surveys
Correct Answer: Two-factor authentication for prescribers
Q7. What is an important privacy regulation to consider when using EP systems in the United States?
- PATIENT Act
- HIPAA
- FDA 21 CFR Part 11 only
- DMCA
Correct Answer: HIPAA
Q8. Which message type indicates that a pharmacy has accepted and filled an electronic prescription?
- Cancel request
- Dispense message
- New prescription request
- Reconciliation report
Correct Answer: Dispense message
Q9. Alert fatigue in EP systems most commonly results from:
- Too few alerts for severe interactions
- Excessive or low-value alerts causing overrides
- Slow network performance
- Insufficient user training materials
Correct Answer: Excessive or low-value alerts causing overrides
Q10. Which interoperability standard is gaining importance for exchanging medication data via APIs?
- DICOM
- FHIR
- HL7 v2 only
- CSV files exchanged by email
Correct Answer: FHIR
Q11. Medication reconciliation in the context of EP systems is primarily intended to:
- Track pharmacy revenues
- Ensure medication lists are accurate across care transitions
- Automatically adjust doses based on age
- Schedule pharmacy staff
Correct Answer: Ensure medication lists are accurate across care transitions
Q12. Which function helps prescribers select preferred products covered by a patient’s insurance?
- Formulary and benefit checks
- Clinical trial enrollment
- Automated refilling
- Barcode verification
Correct Answer: Formulary and benefit checks
Q13. In EP systems, structured data for medication (e.g., coded drug, strength, dose) is important because:
- It makes prescriptions longer
- It enables accurate CDS, analytics, and interoperability
- It prevents any need for pharmacist verification
- It replaces clinical judgment
Correct Answer: It enables accurate CDS, analytics, and interoperability
Q14. Which of the following is a major benefit of e-prescribing for pharmacies?
- Increased paper storage
- Reduced transcription errors and clearer prescription data
- Automatic therapeutic substitution without verification
- Elimination of counseling obligations
Correct Answer: Reduced transcription errors and clearer prescription data
Q15. Audit trails in EP systems are used to:
- Provide training to patients
- Record user actions and maintain accountability for prescription events
- Generate marketing lists
- Automatically resolve drug shortages
Correct Answer: Record user actions and maintain accountability for prescription events
Q16. Which entity typically enforces certification requirements for EP systems in the US?
- State pharmacy boards only
- ONC and DEA in relevant contexts
- World Health Organization
- Local pharmacy chains
Correct Answer: ONC and DEA in relevant contexts
Q17. A successful medication decision support alert should be:
- Always displayed regardless of relevance
- Clinically relevant, specific, and actionable
- So frequent that clinicians ignore it
- Only visible to pharmacists
Correct Answer: Clinically relevant, specific, and actionable
Q18. Which of the following best describes “Rx routing” in electronic prescribing?
- Selecting the manufacturing route for drug synthesis
- Directing an electronic prescription to a specific pharmacy or pharmacy network
- Transporting medication packaging logistics
- Changing a patient’s insurance plan
Correct Answer: Directing an electronic prescription to a specific pharmacy or pharmacy network
Q19. Which practice helps reduce wrong-patient errors in EP workflows?
- Using generic drug names only
- Confirming patient identifiers at the point of prescribing
- Allowing anonymous prescriptions
- Disabling patient photos in the chart
Correct Answer: Confirming patient identifiers at the point of prescribing
Q20. Which is a common challenge when integrating EP systems with pharmacy management systems?
- Perfect semantic mapping of all drug codes
- Mismatch in message formats and data fields requiring mapping or middleware
- Excessive standardization across all vendors
- Automatic reconciliation without configuration
Correct Answer: Mismatch in message formats and data fields requiring mapping or middleware
Q21. What role does a formulary benefit check play at the time of e-prescribing?
- It verifies the patient’s insurance eligibility and preferred drugs to minimize cost
- It automatically denies all non-formulary drugs
- It replaces clinical judgment for prescribing
- It schedules delivery of medications
Correct Answer: It verifies the patient’s insurance eligibility and preferred drugs to minimize cost
Q22. Which feature helps EP systems detect potential overdose or duplicate therapy?
- Medication adherence scoring only
- Duplicate therapy and cumulative dose checks
- Prescription printing speed
- Automated appointment booking
Correct Answer: Duplicate therapy and cumulative dose checks
Q23. Which of these is essential for legal validity of an electronic prescription for controlled substances?
- Digital signature compliant with EPCS rules
- Scanned handwritten signature attached as an image
- Only an email confirmation from the prescriber
- Printed copy without digital audit trail
Correct Answer: Digital signature compliant with EPCS rules
Q24. How can EP systems improve antimicrobial stewardship?
- By removing all infection-related alerts
- By providing indication-based prescribing, duration prompts, and guideline links
- By automatically prescribing broad-spectrum antibiotics
- By preventing pharmacists from questioning prescriptions
Correct Answer: By providing indication-based prescribing, duration prompts, and guideline links
Q25. Which data element is critical to include in an e-prescription to avoid dispensing errors?
- Pharmacist personal phone number
- Precise dose, route, frequency, and formulation
- Clinician’s office address only
- Patient’s income level
Correct Answer: Precise dose, route, frequency, and formulation
Q26. What is a common safety check when transmitting e-prescriptions for pediatric patients?
- Ignoring weight-based dosing
- Weight-based dose calculations and age-appropriate warnings
- Defaulting to adult doses
- Using only brand names
Correct Answer: Weight-based dose calculations and age-appropriate warnings
Q27. Which of the following supports quality measurement and research using EP system data?
- Unstructured free-text only
- Structured, coded medication and prescribing metadata
- Handwritten prescription scans
- Oral orders recorded without metadata
Correct Answer: Structured, coded medication and prescribing metadata
Q28. When an e-prescription is “cancelled” electronically, what should the pharmacy system do?
- Ignore the cancellation and fill the medication
- Accept and record the cancellation, and notify staff to halt dispensing
- Automatically reorder the medication
- Delete all patient records
Correct Answer: Accept and record the cancellation, and notify staff to halt dispensing
Q29. Which pharmacist action is appropriate when receiving an EP with an unclear dose or route?
- Assume the most common dose and dispense
- Contact the prescriber for clarification before dispensing
- Cancel the prescription without informing anyone
- Substitute an alternative unrelated medication
Correct Answer: Contact the prescriber for clarification before dispensing
Q30. Which practice improves user adoption and safe use of an EP system in a pharmacy setting?
- Deploy system without training to simulate real usage
- Provide role-based training, workflow customization, and ongoing support
- Disable audit logs to simplify screens
- Limit access to only senior management
Correct Answer: Provide role-based training, workflow customization, and ongoing support
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com