MCQ Quiz: Professional Pharmacist Liability

With the pharmacist’s expanding clinical role comes significant professional responsibility and legal accountability. Understanding professional liability, or malpractice, is essential for every practicing pharmacist to ensure patient safety and protect their license. This topic is a cornerstone of the Principles of Pharmacy Law and Ethics course “. This quiz will test your knowledge on the essential elements of negligence, the pharmacist’s standard of care, and the common sources of liability in pharmacy practice.

1. Professional liability in pharmacy is most accurately described as:

• a. A tax paid by pharmacists.
• b. Negligence, where a pharmacist fails to provide the established standard of care, resulting in patient harm.
• c. A disagreement between a pharmacist and a physician.
• d. The act of dispensing a controlled substance.

Answer: b. Negligence, where a pharmacist fails to provide the established standard of care, resulting in patient harm.

2. For a patient to successfully sue a pharmacist for malpractice, they must prove four elements. Which of the following is NOT one of those elements?

• a. Duty
• b. Dereliction (Breach of Duty)
• c. Damages
• d. Deceit

Answer: d. Deceit

3. A pharmacist fills a prescription for a patient who has regularly used their pharmacy. The existence of a pharmacist-patient relationship establishes which element of negligence?

• a. Duty
• b. Breach
• c. Damages
• d. Causation

Answer: a. Duty

4. The “standard of care” for a pharmacist is defined as what:

• a. A perfect pharmacist would do.
• b. A minimally competent pharmacist would do.
• c. A reasonably prudent pharmacist would do under similar circumstances.
• d. The pharmacy’s owner would do.

Answer: c. A reasonably prudent pharmacist would do under similar circumstances.

5. A pharmacist dispenses amoxicillin instead of the prescribed amlodipine, and the patient suffers harm. This is a clear example of:

• a. A breach of duty (dereliction).
• b. A non-preventable adverse drug reaction.
• c. A systems failure only.
• d. An acceptable error.

Answer: a. A breach of duty (dereliction).

6. The “Principles of Pharmacy Law and Ethics” is a core course in the curriculum.

• a. True
• b. False

Answer: a. True

7. A patient must demonstrate that they suffered a physical, emotional, or financial injury to fulfill which element of negligence?

• a. Duty
• b. Breach
• c. Causation
• d. Damages

Answer: d. Damages

8. The legal doctrine “respondeat superior” (vicarious liability) means that:

• a. The pharmacist is solely responsible for all errors.
• b. An employer (e.g., a pharmacy corporation) can be held legally responsible for the negligent acts of its employees.
• c. The patient is responsible for checking their own prescriptions.
• d. Technicians are exempt from all liability.

Answer: b. An employer (e.g., a pharmacy corporation) can be held legally responsible for the negligent acts of its employees.

9. The most common source of malpractice claims against pharmacists has traditionally been:

• a. Clinical errors like failing to perform a DUR.
• b. Dispensing errors (e.g., wrong drug, wrong strength).
• c. Counseling errors.
• d. Billing errors.

Answer: b. Dispensing errors (e.g., wrong drug, wrong strength).

10. Which of the following is the best way for a pharmacist to minimize liability risk?

• a. Avoid talking to patients.
• b. Consistently practice at or above the established standard of care and maintain meticulous documentation.
• c. Rely solely on the pharmacy’s computer system to catch all errors.
• d. Fill prescriptions as quickly as possible, regardless of questions.

Answer: b. Consistently practice at or above the established standard of care and maintain meticulous documentation.

11. Identifying and resolving drug-related problems is a key objective for student pharmacists in their experiential rotations.

• a. True
• b. False

Answer: a. True

12. A pharmacist fails to identify a clinically significant drug-drug interaction that leads to a patient’s hospitalization. This could be considered a breach of duty related to:

• a. Compounding
• b. Dispensing accuracy
• c. Prospective Drug Utilization Review (Pro-DUR)
• d. Inventory management

Answer: c. Prospective Drug Utilization Review (Pro-DUR)

13. A pharmacist provides a patient with a medication to which they have a known, documented allergy. The patient suffers an anaphylactic reaction. This action likely fulfills which elements of negligence?

• a. Duty and Breach only
• b. Duty, Breach, and Damages only
• c. Duty, Breach, Damages, and Direct Causation
• d. None of the above

Answer: c. Duty, Breach, Damages, and Direct Causation

14. A pharmacist’s “duty to counsel” is established by:

• a. Federal laws like OBRA ’90.
• b. State laws and regulations.
• c. Professional standards of practice.
• d. All of the above.

Answer: d. All of the above.

15. Professional liability insurance is important for pharmacists because:

• a. It is required to get a job.
• b. It provides financial protection against malpractice claims, even if their employer also has insurance.
• c. It is free for all pharmacists.
• d. It prevents them from ever making a mistake.

Answer: b. It provides financial protection against malpractice claims, even if their employer also has insurance.

16. The concept of professionalism, as taught in the PPD courses, is directly linked to reducing liability risk.

• a. True
• b. False

Answer: a. True

17. The “standard of care” is a static concept that does not evolve over time.

• a. True
• b. False

Answer: b. False

18. Which of the following can be used in a malpractice case to help define the standard of care?

• a. Expert witness testimony from other pharmacists.
• b. Published professional standards and guidelines.
• c. State and federal pharmacy laws.
• d. All of the above.

Answer: d. All of the above.

19. A pharmacist who does not feel competent to compound a complex prescription has a professional duty to:

• a. Attempt to compound it anyway.
• b. Decline to fill the prescription and help the patient find a pharmacy that can do it safely.
• c. Tell the patient the ingredients are not available.
• d. Ask a technician to compound it without supervision.

Answer: b. Decline to fill the prescription and help the patient find a pharmacy that can do it safely.

20. A key risk management strategy is to create a “culture of safety” in the pharmacy.

• a. True
• b. False

Answer: a. True

21. “Proximate cause” means that:

• a. The pharmacist was physically close to the patient when the harm occurred.
• b. The patient’s harm was a direct and foreseeable result of the pharmacist’s breach of duty.
• c. The patient also contributed to the harm.
• d. The harm was caused by something else entirely.

Answer: b. The patient’s harm was a direct and foreseeable result of the pharmacist’s breach of duty.

22. A pharmacist correctly dispenses a medication, but a known, common side effect occurs. Is this typically considered malpractice?

• a. Yes, because a side effect occurred.
• b. Yes, if the pharmacist failed to counsel the patient on that common side effect.
• c. No, because an adverse drug reaction is a known risk and not necessarily due to negligence.
• d. Both b and c are important considerations.

Answer: d. Both b and c are important considerations.

23. The “Medication Safety” module in the curriculum is directly related to preventing pharmacist liability.

• a. True
• b. False

Answer: a. True

24. An active learning session on pharmacy law is a key part of which course?

• a. PHA5703 Principles of Pharmacy Law and Ethics
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5703 Principles of Pharmacy Law and Ethics

25. Documentation is a pharmacist’s best friend in preventing and defending against liability claims.

• a. True
• b. False

Answer: a. True

26. A pharmacist who rushes through the verification process due to high volume and makes an error has:

• a. An acceptable excuse for the error.
• b. Not breached the standard of care.
• c. Breached the standard of care, as being busy does not excuse negligence.
• d. Committed a criminal act.

Answer: c. Breached the standard of care, as being busy does not excuse negligence.

27. Which of the following would NOT be considered a breach of duty?

• a. Dispensing the wrong strength of a medication.
• b. Failing to counsel on a new warfarin prescription.
• c. An unpredictable, idiosyncratic adverse reaction to a correctly dispensed drug.
• d. Failing to identify a therapeutic duplication between two different prescribers.

Answer: c. An unpredictable, idiosyncratic adverse reaction to a correctly dispensed drug.

28. A pharmacist’s duty to a patient begins when:

• a. The patient enters the pharmacy.
• b. The patient accepts the offer to counsel.
• c. The pharmacist accepts a prescription to be filled for the patient.
• d. The patient pays for the prescription.

Answer: c. The pharmacist accepts a prescription to be filled for the patient.

29. The use of “tall man” lettering and separating look-alike, sound-alike drugs are system-based strategies to reduce:

• a. The risk of dispensing errors and liability.
• b. Pharmacy profits.
• c. The need for pharmacists.
• d. Patient counseling time.

Answer: a. The risk of dispensing errors and liability.

30. The law course PHA5703 provides the foundation for understanding liability.

• a. True
• b. False

Answer: a. True

31. In a malpractice claim, the “plaintiff” is:

• a. The pharmacist being sued.
• b. The patient who alleges they were harmed.
• c. The expert witness.
• d. The judge.

Answer: b. The patient who alleges they were harmed.

32. A pharmacist who continues to make the same type of dispensing error after being retrained could be seen as demonstrating:

• a. A normal learning curve.
• b. Gross negligence.
• c. A commitment to quality improvement.
• d. An acceptable level of practice.

Answer: b. Gross negligence.

33. The concept of the pharmacist’s expanding clinical role means that the “standard of care” is also expanding to include more cognitive services.

• a. True
• b. False

Answer: a. True

34. A key way to prevent liability claims is to:

• a. Never speak to patients.
• b. Communicate effectively and empathetically with patients, especially when an error occurs.
• c. Blame the patient for any problems.
• d. Make sure the pharmacy is profitable.

Answer: b. Communicate effectively and empathetically with patients, especially when an error occurs.

35. A pharmacist is not liable for the actions of their technicians.

• a. True
• b. False

Answer: b. False

36. Maintaining competence through continuing education is a key part of upholding the standard of care.

• a. True
• b. False

Answer: a. True

37. Which of the following could lead to a malpractice claim for failure to perform a DUR?

• a. Dispensing a drug to which the patient has a known allergy documented in the profile.
• b. Dispensing a drug that has a severe interaction with another drug on the patient’s profile.
• c. Dispensing a dose that is clearly subtherapeutic or toxic.
• d. All of the above.

Answer: d. All of the above.

38. The “Introduction to Medication Errors” module in the skills lab provides a basis for understanding liability.

• a. True
• b. False

Answer: a. True

39. A pharmacist correctly fills a prescription for sildenafil for a patient who is also taking nitroglycerin, but fails to counsel on the deadly interaction. If the patient is harmed, the pharmacist has likely breached their duty to:

• a. Dispense accurately.
• b. Perform a prospective DUR and counsel appropriately.
• c. Keep accurate records.
• d. Manage inventory.

Answer: b. Perform a prospective DUR and counsel appropriately.

40. An active learning session covering pharmacy law is part of which course?

• a. PHA5703 Principles of Pharmacy Law and Ethics
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5703 Principles of Pharmacy Law and Ethics

41. The best defense against a malpractice claim is:

• a. Arguing that the patient was also negligent.
• b. Having a good lawyer.
• c. Demonstrating through clear documentation that the standard of care was met.
• d. Claiming ignorance of the standard of care.

Answer: c. Demonstrating through clear documentation that the standard of care was met.

42. Which of the following is NOT a dispensing error?

• a. Wrong drug
• b. Wrong strength
• c. Wrong directions
• d. Failure to identify a therapeutic duplication

Answer: d. Failure to identify a therapeutic duplication

43. A pharmacist’s professional liability insurance will typically cover:

• a. The cost of a Board of Pharmacy fine.
• b. Legal defense costs and judgments/settlements from a malpractice lawsuit.
• c. Lost wages if the pharmacy closes.
• d. The cost of stolen inventory.

Answer: b. Legal defense costs and judgments/settlements from a malpractice lawsuit.

44. A pharmacist’s duty has expanded beyond technical accuracy to include ensuring that a medication is _______ for the patient.

• a. cheap
• b. new
• c. appropriate
• d. a brand name

Answer: c. appropriate

45. Adhering to a pharmacy’s policies and procedures can help demonstrate that the standard of care was met.

• a. True
• b. False

Answer: a. True

46. A patient is harmed by a medication error. The pharmacist’s first professional and ethical response should be to:

• a. Alter the prescription records.
• b. Ensure the patient’s immediate safety and seek medical help for them.
• c. Blame the patient.
• d. Say nothing to anyone.

Answer: b. Ensure the patient’s immediate safety and seek medical help for them.

47. The curriculum includes a transcending concept on communicating with patients when an error occurs.

• a. True
• b. False

Answer: a. True

48. An active learning session on professionalism and ethics is part of which course series?

• a. Personal and Professional Development
• b. Patient Care
• c. Skills Lab
• d. Drug Delivery Systems

Answer: a. Personal and Professional Development

49. The overall trend in pharmacy liability has been toward:

• a. Holding pharmacists less accountable for patient outcomes.
• b. Holding pharmacists more accountable for the clinical and cognitive aspects of their practice.
• c. Eliminating pharmacist liability altogether.
• d. Focusing only on the liability of technicians.

Answer: b. Holding pharmacists more accountable for the clinical and cognitive aspects of their practice.

50. The ultimate reason for a pharmacist to understand professional liability is to:

• a. Avoid lawsuits at all costs.
• b. Practice in a way that prioritizes patient safety and minimizes the risk of preventable harm.
• c. Be able to shift blame to others.
• d. Pass the pharmacy law exam.

Answer: b. Practice in a way that prioritizes patient safety and minimizes the risk of preventable harm.