The management of epilepsy involves more than just selecting the right medication; it requires pharmacists to navigate complex legal and ethical landscapes. The Patient Care VII: Brain and Behavior curriculum identifies these issues as a key “Transcending Concept,” with specific lectures on topics like driving for persons with epilepsy (PWE). This quiz will test your knowledge on the ethical principles, legal responsibilities, and professional duties that guide a pharmacist in providing safe, compassionate, and lawful care to patients with epilepsy.
1. A major legal and ethical issue in the management of epilepsy, as covered in the curriculum, involves a patient’s fitness to perform what activity?
- A. Cook a meal
- B. Vote in an election
- C. Drive a motor vehicle
- D. Use a computer
Answer: C. Drive a motor vehicle
2. State laws regarding driving for persons with epilepsy (PWE) typically require a specified:
- A. Minimum score on a driving test.
- B. Seizure-free interval before being eligible to drive.
- C. Maximum dose of anti-seizure medication.
- D. Number of anti-seizure medications.
Answer: B. Seizure-free interval before being eligible to drive
3. The ethical principle of “autonomy” refers to:
- A. The pharmacist’s right to make all decisions for the patient.
- B. The patient’s right to self-determination and to make informed decisions about their own healthcare.
- C. The duty to act in the best interest of the patient.
- D. The duty to do no harm.
Answer: B. The patient’s right to self-determination and to make informed decisions about their own healthcare
4. The ethical principle of “non-maleficence” means:
- A. To do good for the patient.
- B. To ensure fair distribution of healthcare resources.
- C. To respect the patient’s decisions.
- D. To do no harm.
Answer: D. To do no harm
5. A pharmacist is aware that their patient with poorly controlled seizures is still driving, in violation of state law. This situation creates an ethical conflict between the duty of patient confidentiality and the:
- A. Duty to maximize pharmacy profits.
- B. Duty to protect public safety.
- C. Duty to report the patient to their employer.
- D. Duty to dispense medications quickly.
Answer: B. Duty to protect public safety.
6. When counseling a patient on a new, sedating anti-seizure medication, which ethical principle most strongly supports advising them against driving until they know how the drug affects them?
- A. Justice
- B. Autonomy
- C. Non-maleficence (do no harm)
- D. Fidelity
Answer: C. Non-maleficence (do no harm)
7. A patient’s family member calls the pharmacy to ask if the patient’s recent seizure means they should stop driving. Due to HIPAA, the pharmacist’s most appropriate response is to:
- A. Provide the patient’s complete medical history to the family member.
- B. Refuse to speak to the family member.
- C. State that they cannot share patient-specific information but can provide general information about state driving laws and encourage the family to discuss concerns directly with the patient and their doctor.
- D. Tell the family member to take the patient’s car keys away.
Answer: C. State that they cannot share patient-specific information but can provide general information about state driving laws and encourage the family to discuss concerns directly with the patient and their doctor
8. The pharmacist’s responsibility to provide accurate and thorough counseling on the risks and benefits of an anti-seizure medication is rooted in which ethical principle?
- A. Beneficence (acting for the patient’s good) and Autonomy (ensuring informed consent).
- B. Justice only.
- C. Fidelity only.
- D. Paternalism.
Answer: A. Beneficence (acting for the patient’s good) and Autonomy (ensuring informed consent)
9. The stigma associated with epilepsy can be a major ethical issue. Pharmacists can help combat stigma by:
- A. Using outdated and offensive terminology.
- B. Treating patients with epilepsy with the same respect and professionalism as any other patient.
- C. Discussing the patient’s condition loudly with colleagues.
- D. Avoiding communication with patients who have epilepsy.
Answer: B. Treating patients with epilepsy with the same respect and professionalism as any other patient
10. A patient with epilepsy expresses that they do not want to take their medication due to side effects. To respect their autonomy, the pharmacist should first:
- A. Refuse to fill any more prescriptions for them.
- B. Tell them they have no choice in the matter.
- C. Explore their concerns, provide education on the risks of untreated seizures, and discuss potential management strategies for the side effects.
- D. Call the patient’s family to override their decision.
Answer: C. Explore their concerns, provide education on the risks of untreated seizures, and discuss potential management strategies for the side effects
11. The legal and ethical issues surrounding epilepsy are specifically designated as a “Transcending Concept” in which course?
- A. Patient Care VI: Skin and Musculoskeletal Disorders
- B. Patient Care VII: Brain and Behavior
- C. Patient Care IV: Gastrointestinal and Renal Disorders
- D. Patient Care V: Endocrinology and Women’s and Men’s Health
Answer: B. Patient Care VII: Brain and Behavior
12. Laws regarding physician reporting of patients with seizures to the DMV:
- A. Are the same in every state.
- B. Do not exist in the United States.
- C. Vary by state, with some states having mandatory reporting and others having permissive reporting or no specific reporting law.
- D. Require pharmacists to report patients directly to the DMV.
Answer: C. Vary by state, with some states having mandatory reporting and others having permissive reporting or no specific reporting law
13. A core ethical duty of a pharmacist is to maintain patient confidentiality. This is also a legal requirement under what federal law?
- A. The Controlled Substances Act
- B. The Food, Drug, and Cosmetic Act
- C. The Health Insurance Portability and Accountability Act (HIPAA)
- D. The Affordable Care Act
Answer: C. The Health Insurance Portability and Accountability Act (HIPAA)
14. A patient with epilepsy wishes to become pregnant. The ethical principle of beneficence would guide the pharmacist to counsel the patient on:
- A. The importance of immediately stopping all anti-seizure medications.
- B. The need for pre-conception counseling to switch to a safer medication and start folic acid.
- C. The fact that all anti-seizure medications are perfectly safe in pregnancy.
- D. The necessity of avoiding pregnancy altogether.
Answer: B. The need for pre-conception counseling to switch to a safer medication and start folic acid
15. If a dispensing error occurs with an anti-seizure medication, the primary ethical responsibility of the pharmacist is:
- A. To hide the error from the patient and prescriber.
- B. To disclose the error to the patient and prescriber and take steps to mitigate any harm.
- C. To blame the pharmacy technician for the error.
- D. To correct the error on the next refill only if the patient notices.
Answer: B. To disclose the error to the patient and prescriber and take steps to mitigate any harm
16. The principle of justice, when applied to epilepsy care, would be most concerned with:
- A. A patient’s specific medication choice.
- B. Ensuring all patients, regardless of socioeconomic status or race, have equitable access to appropriate epilepsy care.
- C. The pharmacist’s personal beliefs.
- D. The pharmacy’s profit margin.
Answer: B. Ensuring all patients, regardless of socioeconomic status or race, have equitable access to appropriate epilepsy care
17. A patient asks if they can drive home after receiving a sedating medication in the hospital. The pharmacist’s response should be guided by:
- A. The patient’s desire to go home quickly.
- B. The ethical principle of non-maleficence and the legal duty to provide appropriate counseling.
- C. The cost of a taxi or rideshare service.
- D. The patient’s driving record.
Answer: B. The ethical principle of non-maleficence and the legal duty to provide appropriate counseling
18. The curriculum on Pharmacy Law and Ethics provides the foundation for navigating complex patient care scenarios.
- A. True
- B. False
Answer: A. True
19. A parent of an adolescent with epilepsy demands to know all details of their child’s care. The ethical and legal approach is to:
- A. Provide all information to the parent without question.
- B. Navigate the situation by respecting the adolescent’s right to confidentiality while involving the parent in the care plan as appropriate and legally permitted.
- C. Refuse to speak to the parent.
- D. Tell the adolescent they are not allowed to speak with the pharmacist alone.
Answer: B. Navigate the situation by respecting the adolescent’s right to confidentiality while involving the parent in the care plan as appropriate and legally permitted.
20. The “Follow-up and Monitor” step of the PPCP has an ethical dimension because:
- A. It ensures the pharmacy gets paid for the medication.
- B. It demonstrates a commitment to the patient’s well-being beyond the initial act of dispensing.
- C. It is not an ethical consideration.
- D. It is the final step and no further action is needed.
Answer: B. It demonstrates a commitment to the patient’s well-being beyond the initial act of dispensing
21. A patient with epilepsy may be discriminated against in the workplace. A pharmacist can act as an advocate by:
- A. Calling the patient’s employer directly.
- B. Providing the patient with resources such as the Epilepsy Foundation or information on the Americans with Disabilities Act (ADA).
- C. Advising the patient to quit their job.
- D. Ignoring the patient’s concerns.
Answer: B. Providing the patient with resources such as the Epilepsy Foundation or information on the Americans with Disabilities Act (ADA).
22. It is an ethical imperative to ensure that a patient provides ___________ for treatment, which means they understand the risks, benefits, and alternatives.
- A. Implied consent
- B. Coerced consent
- C. Uninformed consent
- D. Informed consent
Answer: D. Informed consent
23. If a state has a mandatory reporting law for seizures, who is typically required to make the report to the DMV?
- A. The pharmacist
- B. The patient’s family
- C. The physician
- D. The patient themselves
Answer: C. The physician
24. Counseling a patient about the importance of not abruptly discontinuing their anti-seizure medication is both a clinical and an ethical duty related to:
- A. Non-maleficence (preventing harm from withdrawal seizures).
- B. Justice (ensuring fair drug prices).
- C. Autonomy (respecting their right to stop).
- D. Veracity (telling the truth).
Answer: A. Non-maleficence (preventing harm from withdrawal seizures)
25. A patient on an enzyme-inducing ASM is prescribed an oral contraceptive. The ethical issue at play if the pharmacist fails to manage this interaction is:
- A. The potential for an unintended pregnancy due to contraceptive failure.
- B. The high cost of the medication.
- C. The patient’s right to confidentiality.
- D. The pharmacist’s relationship with the prescriber.
Answer: A. The potential for an unintended pregnancy due to contraceptive failure.
26. The “corresponding responsibility” doctrine places a legal and ethical duty on the pharmacist to ensure a prescription for a controlled substance is for a __________.
- A. legitimate medical purpose
- B. low-cost generic
- C. brand name drug
- D. long-term supply
Answer: A. legitimate medical purpose
27. A patient with epilepsy and a history of substance abuse requests early refills of their benzodiazepine. The pharmacist has an ethical and legal obligation to:
- A. Refill it without question.
- B. Address the potential for misuse or diversion with the patient and prescriber.
- C. Accuse the patient of being an addict.
- D. Switch them to a different benzodiazepine.
Answer: B. Address the potential for misuse or diversion with the patient and prescriber.
28. Professionalism, a core concept in the PPD curriculum, is essential when managing ethical dilemmas because it:
- A. Ensures the pharmacist always makes the most profitable decision.
- B. Guides the pharmacist to act with integrity, respect, and compassion.
- C. Is not relevant to ethical decision-making.
- D. Makes difficult conversations easier to avoid.
Answer: B. Guides the pharmacist to act with integrity, respect, and compassion
29. An ethical conflict arises when a patient’s autonomous decision (e.g., to drive against medical advice) potentially violates the principle of:
- A. Justice for other drivers.
- B. Non-maleficence towards the public.
- C. Beneficence for the patient’s long-term health.
- D. Both A and B.
Answer: D. Both A and B.
30. The pharmacist’s primary ethical obligation is to:
- A. The patient’s well-being.
- B. The pharmacy owner.
- C. The insurance company.
- D. The pharmaceutical manufacturer.
Answer: A. The patient’s well-being
31. The “Code of Ethics for Pharmacists” serves as a framework for:
- A. A set of legally binding statutes.
- B. A public declaration of the profession’s principles and ethical standards.
- C. A guide for maximizing profits.
- D. A list of drugs that can be dispensed.
Answer: B. A public declaration of the profession’s principles and ethical standards.
32. When a patient with epilepsy is part of a clinical trial, the ethical principle of ________ requires that they are fully informed of all potential risks and benefits.
- A. Justice
- B. Autonomy
- C. Paternalism
- D. Veracity
Answer: B. Autonomy
33. An ethical pharmacist should always strive to communicate in a way that respects the patient’s:
- A. Wealth and status.
- B. Age only.
- C. Dignity and cultural values.
- D. Educational level only.
Answer: C. Dignity and cultural values
34. If a pharmacist has a moral objection to dispensing a certain medication, their primary professional and ethical duty is to:
- A. Refuse to fill the prescription and admonish the patient.
- B. Ensure the patient has timely access to their medication through another pharmacist or pharmacy.
- C. Fill the prescription but counsel the patient against taking it.
- D. Ignore the prescription.
Answer: B. Ensure the patient has timely access to their medication through another pharmacist or pharmacy.
35. The risk of teratogenicity with certain ASMs creates an ethical duty for the pharmacist to:
- A. Refuse to dispense to any woman of childbearing potential.
- B. Provide comprehensive counseling on the risks and the need for effective contraception.
- C. Assume the patient has already been counseled by their doctor.
- D. Dispense the medication without comment.
Answer: B. Provide comprehensive counseling on the risks and the need for effective contraception.
36. A patient reports they are splitting their expensive ASM tablets to save money. This presents an ethical dilemma that requires the pharmacist to:
- A. Report them to their insurance company.
- B. Counsel them on the dangers of altering the dosage form and explore lower-cost alternatives or assistance programs.
- C. Ignore the comment as it is not a clinical issue.
- D. Tell them to double the dose every other day instead.
Answer: B. Counsel them on the dangers of altering the dosage form and explore lower-cost alternatives or assistance programs.
37. The legal concept of “standard of care” means a pharmacist must provide care that is:
- A. The best in the entire world.
- B. The same as what a reasonably prudent pharmacist would provide under similar circumstances.
- C. The bare minimum required by law.
- D. Perfect and free from any errors.
Answer: B. The same as what a reasonably prudent pharmacist would provide under similar circumstances.
38. Maintaining professional competence through continuing education is both a legal and an ethical requirement for pharmacists.
- A. True
- B. False
Answer: A. True
39. When a patient with epilepsy is non-adherent, an ethical approach involves:
- A. Labeling the patient as “non-compliant” and giving up.
- B. Exploring the reasons for non-adherence in a non-judgmental way.
- C. Forcing the patient to take their medication.
- D. Calling their family to complain about the patient.
Answer: B. Exploring the reasons for non-adherence in a non-judgmental way
40. The legal framework for pharmacy practice is covered in detail in which courses in the curriculum?
- A. Patient Care courses only
- B. Principles of Pharmacy Law & Ethics and Applications of Pharmacy Law & Ethics
- C. Skills labs only
- D. It is not covered in the curriculum.
Answer: B. Principles of Pharmacy Law & Ethics and Applications of Pharmacy Law & Ethics
41. An ethical issue arises if a pharmacy promotes a specific ASM over others based on:
- A. The patient’s clinical need.
- B. The latest evidence-based guidelines.
- C. The profit margin for the pharmacy.
- D. The drug’s side effect profile.
Answer: C. The profit margin for the pharmacy.
42. A pharmacist’s “duty to warn,” where it exists by law or precedent, represents a legal exception to the ethical principle of:
- A. Beneficence
- B. Justice
- C. Confidentiality
- D. Autonomy
Answer: C. Confidentiality
43. A pharmacist providing inaccurate information about state driving laws to a patient with epilepsy would be a breach of:
- A. Their ethical duty of competence.
- B. Their legal duty to provide correct information.
- C. The principle of veracity (truth-telling).
- D. All of the above.
Answer: D. All of the above.
44. The ethical principle of “justice” would require a pharmacist to:
- A. Give preferential treatment to wealthy patients.
- B. Allocate their time and resources fairly among all their patients.
- C. Only counsel patients who have good insurance.
- D. Refuse to serve patients with complex conditions like epilepsy.
Answer: B. Allocate their time and resources fairly among all their patients.
45. If a patient with epilepsy is unable to make decisions for themselves, the pharmacist should look to a(n) __________ to make healthcare decisions.
- A. friend
- B. neighbor
- C. legally authorized surrogate decision-maker (e.g., healthcare power of attorney)
- D. colleague
Answer: C. legally authorized surrogate decision-maker (e.g., healthcare power of attorney)
46. Counseling on the risk of bone demineralization with long-term use of certain ASMs is an example of upholding which ethical principle?
- A. Beneficence (acting for the patient’s good) and Non-maleficence (preventing harm).
- B. Justice
- C. Autonomy
- D. Fidelity
Answer: A. Beneficence (acting for the patient’s good) and Non-maleficence (preventing harm)
47. The potential for a medication to have a “black box warning” is a legal designation from the FDA that creates an ethical duty for the pharmacist to:
- A. Ignore the warning.
- B. Counsel the patient on the specific risks highlighted in the warning.
- C. Refuse to dispense the medication.
- D. Cover the warning with a sticker.
Answer: B. Counsel the patient on the specific risks highlighted in the warning.
48. An ethical pharmacist must advocate for:
- A. The interests of the pharmaceutical industry.
- B. The interests of the patient.
- C. The interests of the insurance company.
- D. Their own personal interests.
Answer: B. The interests of the patient
49. An ethical dilemma occurs when:
- A. There is a clear right and wrong answer.
- B. Two or more ethical principles are in conflict.
- C. The law is silent on an issue.
- D. A patient agrees with everything the pharmacist says.
Answer: B. Two or more ethical principles are in conflict.
50. Navigating the legal and ethical issues in epilepsy care requires the pharmacist to be not only a medication expert but also a(n):
- A. Law enforcement officer.
- B. Judge.
- C. Compassionate counselor and patient advocate.
- D. Insurance agent.
Answer: C. Compassionate counselor and patient advocate
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