MCQ Quiz: Filling Prescriptions

The process of filling prescriptions is a core function of pharmacy practice, demanding meticulous attention to detail, a strong understanding of legal and ethical responsibilities, and a commitment to patient safety. For PharmD students and pharmacists, mastering the intricacies of the dispensing process—from receiving and interpreting a prescription to final verification and patient counseling—is paramount. This involves navigating various prescription formats, ensuring accuracy, performing Drug Utilization Reviews (DUR), and adhering to state and federal regulations. This quiz will test your knowledge on the essential steps and considerations involved in accurately and legally filling prescriptions.

1. Before filling any prescription, what is a crucial initial step for the pharmacist?

a) Immediately counting the medication.
b) Verifying the authenticity and completeness of the prescription.
c) Calling the patient to confirm their address.
d) Checking the pharmacy’s stock level for the medication.

Answer: b) Verifying the authenticity and completeness of the prescription.

2. Which of the following elements is generally required on a written prescription for it to be considered valid?

a) The patient’s preferred pharmacy.
b) The prescriber’s signature and date of issuance.
c) The manufacturer of the drug.
d) The pharmacy’s license number.

Answer: b) The prescriber’s signature and date of issuance.

3. The “dispensing requirements for prescriptions” include:

a) Only counting the correct medication.
b) Ensuring accurate medication, dosage, labeling, and providing appropriate counseling.
c) Giving the patient a discount.
d) Calling the prescriber for every prescription.

Answer: b) Ensuring accurate medication, dosage, labeling, and providing appropriate counseling.

4. According to the PHA5703 syllabus, pharmacists must understand their responsibilities regarding various prescription formats. Which format typically requires the original signed prescription to be on file if it’s for a controlled substance (with some exceptions for emergencies or electronic prescribing)?

a) E-prescribing
b) Faxed prescriptions (for some controlled substances or depending on state law)
c) Phoned-in prescriptions (for Schedule II controlled substances, generally not permitted except in emergencies)
d) Hand-written prescriptions

Answer: d) Hand-written prescriptions (though all forms have specific retention requirements). More specifically, for phoned-in Schedule II, a follow-up written Rx is required.

5. A Drug Utilization Review (DUR) performed during the prescription filling process is primarily intended to:

a) Determine the cost of the medication.
b) Identify potential drug therapy problems such as drug interactions, allergies, or inappropriate dosage.
c) Check the patient’s insurance eligibility.
d) Order more stock of the medication.

Answer: b) Identify potential drug therapy problems such as drug interactions, allergies, or inappropriate dosage.

6. The prescription label affixed to the medication container for the patient must include:

a) The wholesale price of the drug.
b) The name of the drug, strength, and directions for use.
c) The pharmacist’s home phone number.
d) The prescriber’s medical school.

Answer: b) The name of the drug, strength, and directions for use.

7. What is the “final verification” step in the prescription filling process performed by the pharmacist?

a) The initial data entry of the prescription.
b) A critical check to ensure the accuracy of the filled prescription against the original order before it is dispensed to the patient.
c) The patient counseling session.
d) Contacting the insurance company.

Answer: b) A critical check to ensure the accuracy of the filled prescription against the original order before it is dispensed to the patient.

8. If a prescription has “PRN” refills indicated for a non-controlled substance, it generally means:

a) No refills are allowed.
b) The prescription can be refilled as needed by the patient for up to one year from the date written (or as per state law).
c) Only one refill is permitted.
d) The prescriber must be called for every refill.

Answer: b) The prescription can be refilled as needed by the patient for up to one year from the date written (or as per state law).

9. When transferring a prescription for a non-controlled substance to another pharmacy, the transferring pharmacy must:

a) Destroy the original prescription.
b) Void the original prescription or document the transfer and provide necessary information to the receiving pharmacy.
c) Inform the FDA.
d) Charge the patient a transfer fee.

Answer: b) Void the original prescription or document the transfer and provide necessary information to the receiving pharmacy.

10. Patient counseling by the pharmacist is crucial for:

a) Increasing pharmacy sales.
b) Ensuring the patient understands how to use their medication safely and effectively.
c) Meeting a daily quota.
d) Avoiding interaction with the patient.

Answer: b) Ensuring the patient understands how to use their medication safely and effectively.

11. Which of the following is NOT typically considered a required component of a valid written prescription?

a) Patient’s full name and address.
b) Prescriber’s name, address, and DEA number (if for a controlled substance).
c) Drug name, strength, dosage form, quantity, and directions for use.
d) Patient’s occupation.

Answer: d) Patient’s occupation.

12. E-prescribing (electronic prescribing) offers which potential advantage over handwritten prescriptions?

a) It is always cheaper for the patient.
b) It can reduce medication errors due to improved legibility and clinical decision support.
c) It does not require pharmacist verification.
d) It eliminates the need for patient counseling.

Answer: b) It can reduce medication errors due to improved legibility and clinical decision support.

13. When a pharmacist receives a phoned-in (oral) prescription from a prescriber, they should:

a) Reduce it to writing (or electronic form) immediately and include all necessary information.
b) Tell the prescriber to send a written prescription instead, refusing all oral orders.
c) Fill it based on memory later.
d) Only allow technicians to take oral prescriptions.

Answer: a) Reduce it to writing (or electronic form) immediately and include all necessary information.

14. The primary concern with faxed prescriptions, especially for controlled substances, is:

a) The cost of fax paper.
b) The potential for diversion and ensuring the fax originated from the licensed prescriber.
c) The time it takes for the fax to transmit.
d) The poor image quality.

Answer: b) The potential for diversion and ensuring the fax originated from the licensed prescriber.

15. If a prescription is written for a quantity that seems unusually large or a dosage that seems too high, the pharmacist has a professional responsibility to:

a) Dispense it as written without question.
b) Contact the prescriber to clarify and confirm the order before dispensing.
c) Dispense a smaller quantity without informing the prescriber.
d) Tell the patient the prescriber made a mistake.

Answer: b) Contact the prescriber to clarify and confirm the order before dispensing.

16. The “directions for use” (Sig) on a prescription should be:

a) Abbreviated as much as possible to save label space.
b) Clear, concise, and easily understood by the patient.
c) Written in medical jargon.
d) Optional if the patient has taken the medication before.

Answer: b) Clear, concise, and easily understood by the patient.

17. Auxiliary labels are used on prescription vials to:

a) Advertise the pharmacy.
b) Provide supplementary information or warnings to the patient (e.g., “May cause drowsiness,” “Take with food”).
c) Indicate the price of the medication.
d) List the pharmacist’s name.

Answer: b) Provide supplementary information or warnings to the patient (e.g., “May cause drowsiness,” “Take with food”).

18. Before dispensing a refilled prescription, it is good practice for the pharmacy staff to:

a) Assume nothing has changed with the patient’s condition or other medications.
b) Verify if the patient still needs the medication and if there have been any changes (e.g., new allergies, other medications).
c) Only check if the patient’s insurance is still active.
d) Offer the patient a discount for refilling early.

Answer: b) Verify if the patient still needs the medication and if there have been any changes (e.g., new allergies, other medications).

19. Which of the following situations might require a pharmacist to perform compounding as part of filling a prescription?

a) The medication is available as a standard manufactured tablet.
b) The patient requires a specific dosage strength or formulation (e.g., a liquid for a child) that is not commercially available.
c) The medication is an OTC product.
d) The patient requests a 90-day supply.

Answer: b) The patient requires a specific dosage strength or formulation (e.g., a liquid for a child) that is not commercially available.

20. Documentation is a critical part of the prescription filling process. Which of the following typically needs to be documented?

a) The color of the patient’s car.
b) Any clarifications with the prescriber, DUR alerts overridden, and patient counseling provided.
c) The pharmacist’s lunch break schedule.
d) The weather on the day the prescription was filled.

Answer: b) Any clarifications with the prescriber, DUR alerts overridden, and patient counseling provided.

21. “Beyond-Use Date” (BUD) on a dispensed prescription refers to:

a) The original manufacturer’s expiration date.
b) A date assigned by the pharmacy after which the dispensed medication should not be used, based on stability and storage conditions.
c) The date the prescription was written.
d) The date the patient’s insurance expires.

Answer: b) A date assigned by the pharmacy after which the dispensed medication should not be used, based on stability and storage conditions.

22. If a prescription is for a Schedule II controlled substance, which of the following is generally true regarding refills?

a) Unlimited refills are allowed for one year.
b) Refills are generally prohibited; a new prescription is required.
c) Up to 5 refills are allowed in 6 months.
d) The pharmacist can authorize refills if the patient needs them.

Answer: b) Refills are generally prohibited; a new prescription is required.

23. Assisting patients and caregivers in addressing insurance/prescription coverage issues is a part of the pharmacist’s role. This may involve:

a) Refusing to fill prescriptions for uninsured patients.
b) Helping to identify lower-cost alternatives, explaining formularies, or assisting with prior authorization processes.
c) Telling patients to change insurance companies.
d) Paying the patient’s copay.

Answer: b) Helping to identify lower-cost alternatives, explaining formularies, or assisting with prior authorization processes.

24. What is a “prior authorization” (PA) in the context of prescription filling?

a) The patient authorizing the pharmacy to fill their prescription.
b) A requirement from an insurance company that the prescriber obtains approval before the plan will cover a specific medication.
c) The pharmacist authorizing an emergency refill.
d) The FDA authorizing the sale of a new drug.

Answer: b) A requirement from an insurance company that the prescriber obtains approval before the plan will cover a specific medication.

25. When a patient presents a prescription from an out-of-state prescriber, the pharmacist should:

a) Always refuse to fill it.
b) Verify the prescriber’s credentials and ensure the prescription is valid according to state laws before filling.
c) Fill it without any additional checks.
d) Only fill it if it’s for an OTC medication.

Answer: b) Verify the prescriber’s credentials and ensure the prescription is valid according to state laws before filling.

26. The “Orange Book” published by the FDA is used by pharmacists to determine:

a) The price of medications.
b) Therapeutic equivalence of generic drug products.
c) State pharmacy laws.
d) Compounding formulas.

Answer: b) Therapeutic equivalence of generic drug products.

27. If a patient has a known allergy to an ingredient in the prescribed medication, the pharmacist should:

a) Dispense the medication and tell the patient to take an antihistamine.
b) Not dispense the medication and contact the prescriber to discuss alternatives.
c) Dispense a lower dose of the medication.
d) Ignore the allergy if it’s not severe.

Answer: b) Not dispense the medication and contact the prescriber to discuss alternatives.

28. The information required on a prescription label is mandated by:

a) Only the pharmacy’s policy.
b) Federal and state laws.
c) The patient’s request.
d) The pharmaceutical manufacturer.

Answer: b) Federal and state laws.

29. Computer-generated prescriptions that are printed and manually signed by the prescriber are generally treated as:

a) Electronic prescriptions.
b) Phoned-in prescriptions.
c) Hand-written prescriptions.
d) Faxed prescriptions.

Answer: c) Hand-written prescriptions.

30. What is meant by “pharmacist’s corresponding responsibility” when filling controlled substance prescriptions?

a) The pharmacist is only responsible for counting the correct pills.
b) The pharmacist shares responsibility with the prescriber for ensuring that a controlled substance prescription is issued for a legitimate medical purpose in the usual course of professional practice.
c) The pharmacist must always call the prescriber before filling any controlled substance.
d) The pharmacist is not responsible if the prescriber made an error.

Answer: b) The pharmacist shares responsibility with the prescriber for ensuring that a controlled substance prescription is issued for a legitimate medical purpose in the usual course of professional practice.

31. A key component of effective patient counseling on a new prescription includes:

a) Reading the package insert verbatim.
b) Discussing the name of the medication, its purpose, how and when to take it, common side effects, and storage.
c) Only telling the patient the price.
d) Asking the patient if they have any questions and ending the session if they say no.

Answer: b) Discussing the name of the medication, its purpose, how and when to take it, common side effects, and storage.

32. If a prescription is illegible, the pharmacist should:

a) Make their best guess to avoid bothering the prescriber.
b) Contact the prescriber for clarification.
c) Ask the patient what the prescription says.
d) Refuse to fill the prescription and send the patient away.

Answer: b) Contact the prescriber for clarification.

33. The act of filling a prescription involves both technical tasks and professional judgment. Which part requires significant professional judgment?

a) Counting pills.
b) Placing pills in a vial.
c) Conducting a DUR, assessing appropriateness, and counseling.
d) Applying the label to the vial.

Answer: c) Conducting a DUR, assessing appropriateness, and counseling.

34. Maintaining accurate records of dispensed prescriptions is important for:

a) Only for billing purposes.
b) Legal compliance, patient safety (e.g., recall tracking, refill history), and continuity of care.
c) Marketing to patients.
d) Increasing pharmacy clutter.

Answer: b) Legal compliance, patient safety (e.g., recall tracking, refill history), and continuity of care.

35. Which of the following is an example of a potential medication error that could occur during the filling process?

a) The patient arrives on time to pick up their medication.
b) Dispensing the wrong drug or wrong strength.
c) The patient has good insurance coverage.
d) The prescriber uses e-prescribing.

Answer: b) Dispensing the wrong drug or wrong strength.

36. “Look-alike, sound-alike” (LASA) medications are a common source of dispensing errors. Strategies to prevent these errors include:

a) Storing all LASA drugs next to each other.
b) Using tall man lettering, shelf reminders, and careful verification.
c) Rushing through the filling process.
d) Allowing technicians to perform the final verification.

Answer: b) Using tall man lettering, shelf reminders, and careful verification.

37. When a new pharmacy technician is being trained, who is ultimately responsible for the accuracy of prescriptions they help fill?

a) The technician alone.
b) The supervising pharmacist.
c) The patient.
d) The pharmacy manager, even if not a pharmacist.

Answer: b) The supervising pharmacist.

38. Federal law requires that prescriptions for most controlled substances in Schedules III, IV, and V can be refilled:

a) Indefinitely.
b) A maximum of 5 times within 6 months from the date of issue.
c) Only once.
d) Not at all, a new prescription is always required.

Answer: b) A maximum of 5 times within 6 months from the date of issue.

39. What information should be collected from a patient or their representative when they are dropping off a new prescription?

a) Their favorite color.
b) Date of birth, allergy information, and current contact information.
c) Their opinion on the pharmacy’s decor.
d) Their social media handles.

Answer: b) Date of birth, allergy information, and current contact information.

40. If a patient requests that their prescription label not state the name of the medication due to privacy concerns, the pharmacist should:

a) Comply with the request without question.
b) Explain that state and/or federal law may require the drug name on the label for safety and identification, and generally cannot omit it.
c) Replace the drug name with a code.
d) Refuse to fill the prescription.

Answer: b) Explain that state and/or federal law may require the drug name on the label for safety and identification, and generally cannot omit it.

41. The act of physically handing the filled prescription to the patient or their agent is known as:

a) Prescribing.
b) Dispensing.
c) Administering.
d) Compounding.

Answer: b) Dispensing (this is part of the overall dispensing process which includes filling).

42. When handling prescriptions for cytotoxic or hazardous drugs, pharmacy personnel should:

a) Use the same procedures as for any other drug.
b) Follow specific safety precautions and handling guidelines (e.g., USP <800>) to minimize exposure.
c) Avoid filling these prescriptions altogether.
d) Only compound these drugs in a non-sterile environment.

Answer: b) Follow specific safety precautions and handling guidelines (e.g., USP <800>) to minimize exposure.

43. Can a pharmacist add or change information on a prescription (e.g., add a missing date of birth, clarify directions) for a non-controlled substance?

a) Never, any change requires a new prescription.
b) Yes, for minor clarifications or missing non-critical information, often after consultation with the patient or prescriber and with proper documentation, depending on state law and professional judgment.
c) Only if the patient gives verbal permission.
d) Yes, they can change the drug prescribed if they think another is better.

Answer: b) Yes, for minor clarifications or missing non-critical information, often after consultation with the patient or prescriber and with proper documentation, depending on state law and professional judgment.

44. What is the “show and tell” technique in patient counseling?

a) Showing the patient a picture of the drug manufacturer’s CEO.
b) Showing the patient the actual medication (tablet/capsule) and explaining its key features and how to take it.
c) Telling the patient a story about another patient who took the medication.
d) Showing the patient the pharmacy’s financial reports.

Answer: b) Showing the patient the actual medication (tablet/capsule) and explaining its key features and how to take it.

45. A prescription drop-off area in a pharmacy should ideally be designed to:

a) Be as open as possible to encourage casual conversation.
b) Provide a degree of privacy for patients discussing their health information.
c) Have loud music playing.
d) Be located far from the pharmacist.

Answer: b) Provide a degree of privacy for patients discussing their health information.

46. If a prescriber is not available and a patient needs an urgent refill for a life-sustaining medication for which there are no refills, the pharmacist may, according to state law and professional judgment:

a) Refuse the refill under all circumstances.
b) Dispense a small emergency supply to prevent interruption of therapy, then document and notify the prescriber.
c) Dispense a full 90-day supply.
d) Tell the patient to go to the emergency room.

Answer: b) Dispense a small emergency supply to prevent interruption of therapy, then document and notify the prescriber.

47. The patient’s profile or medication record in the pharmacy computer system is used to:

a) Only store their address and phone number.
b) Track their medication history, allergies, and perform DUR checks.
c) Determine their credit score.
d) Order magazines for the waiting area.

Answer: b) Track their medication history, allergies, and perform DUR checks.

48. Who is authorized to receive a new verbal prescription over the phone from a prescriber?

a) Any pharmacy employee.
b) Only the patient.
c) A licensed pharmacist or, in many states, a registered pharmacy intern under direct pharmacist supervision.
d) The delivery driver.

Answer: c) A licensed pharmacist or, in many states, a registered pharmacy intern under direct pharmacist supervision.

49. What is the primary reason for separating the data entry/filling tasks from the final verification task in the dispensing workflow?

a) To make the process slower.
b) To provide an independent double-check, reducing the risk of errors.
c) To give technicians more responsibility.
d) To save money on pharmacist salaries.

Answer: b) To provide an independent double-check, reducing the risk of errors.

50. When filling a prescription, adhering to both federal and state laws is essential. If there’s a conflict, which law should typically be followed?

a) The less strict law.
b) The federal law always.
c) The state law always.
d) The stricter of the two laws.

Answer: d) The stricter of the two laws.

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