Effective procedures for inpatient and outpatient prescription control are essential for B. Pharm students to ensure patient safety, regulatory compliance, and accurate dispensing. This introduction covers key concepts such as prescription components, controlled substances management, medication reconciliation, e-prescribing, documentation, labeling, storage, and audit trails. Understanding hospital inpatient order protocols versus outpatient prescription workflows helps pharmacists prevent medication errors, maintain chain-of-custody for controlled drugs, and implement pharmacovigilance. Familiarity with legal requirements, batch records, unit-dose systems, and electronic health record integration is vital for safe dispensing and quality assurance. Master these principles to improve clinical outcomes and regulatory adherence. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary difference between an inpatient medication order and an outpatient prescription?
- Inpatient orders are handwritten, outpatient prescriptions are electronic
- Inpatient orders are active within the hospital chart, outpatient prescriptions are intended for community dispensing
- Inpatient orders do not require a prescriber signature, outpatient prescriptions always do
- Inpatient orders can be refilled, outpatient prescriptions cannot
Correct Answer: Inpatient orders are active within the hospital chart, outpatient prescriptions are intended for community dispensing
Q2. Which element is essential on both inpatient orders and outpatient prescriptions to ensure accurate dispensing?
- Patient’s insurance provider
- Medication name, strength, dosage form, route, frequency, and duration
- Prescriber’s home address
- Pharmacist’s preferred brand
Correct Answer: Medication name, strength, dosage form, route, frequency, and duration
Q3. What is medication reconciliation in the context of inpatient care?
- Reconciling pharmacy invoices with the hospital budget
- Comparing and updating a patient’s medication list at transitions of care to prevent errors
- Balancing controlled substance inventory at shift change
- Matching prescribed medications to available stock in the ward
Correct Answer: Comparing and updating a patient’s medication list at transitions of care to prevent errors
Q4. Which practice helps control diversion of controlled substances in a hospital?
- Allowing nurses to take controlled meds home for later administration
- Maintaining secure storage, record logs, and regular audits
- Leaving controlled drugs unlocked in patient rooms
- Using verbal orders exclusively for opioid administration
Correct Answer: Maintaining secure storage, record logs, and regular audits
Q5. For outpatient prescriptions, which information ensures legal validity in many jurisdictions?
- Patient’s date of birth, prescriber signature, date of issuance, and drug details
- Pharmacist’s name and company logo
- Only the drug name and quantity
- Prescriber’s medical school
Correct Answer: Patient’s date of birth, prescriber signature, date of issuance, and drug details
Q6. What is the role of an electronic prescribing (e-prescribing) system in prescription control?
- To allow patients to edit prescriptions before dispensing
- To reduce transcription errors, improve legibility, and enable audit trails
- To bypass pharmacy checks entirely
- To generate marketing emails to prescribers
Correct Answer: To reduce transcription errors, improve legibility, and enable audit trails
Q7. Which record is critical when dispensing Schedule II opioids in many systems?
- Temperature log for the refrigerator
- Controlled substances administration record (CSAR) with patient and prescriber details
- Inventory list of OTC vitamins
- Patient satisfaction survey
Correct Answer: Controlled substances administration record (CSAR) with patient and prescriber details
Q8. What is a major advantage of unit-dose dispensing in hospitals?
- Increases the volume of medication stock stored in wards
- Reduces medication administration errors and waste
- Allows nurses to alter doses without consulting pharmacy
- Eliminates need for medication reconciliation
Correct Answer: Reduces medication administration errors and waste
Q9. Which action is recommended when a prescriber gives a verbal order for a critical medication in an emergency?
- Implement the order and document it immediately with prescriber countersignature as soon as possible
- Ignore it until a written order is received
- Ask a nurse to sign instead of the prescriber
- Fill the prescription for outpatient use
Correct Answer: Implement the order and document it immediately with prescriber countersignature as soon as possible
Q10. What does medication dispensing documentation typically include for outpatient controlled drugs?
- Only the drug name and the shelf location
- Patient ID, drug name, strength, quantity, prescriber details, date, and pharmacist initials
- Just the prescriber’s phone number
- Manufacturing batch number and hospital budget code only
Correct Answer: Patient ID, drug name, strength, quantity, prescriber details, date, and pharmacist initials
Q11. Which practice reduces look-alike/sound-alike medication errors in prescription control?
- Using Tall Man lettering, separate storage, and double-checking at dispensing
- Storing all similar drugs together for convenience
- Relying solely on handwriting interpretation
- Allowing nurses to pick drugs without verification
Correct Answer: Using Tall Man lettering, separate storage, and double-checking at dispensing
Q12. In outpatient dispensing, what is the significance of “validity period” of a prescription?
- The time the pharmacist has to deliver the medication to the patient’s home
- The timeframe within which a prescription may be legally dispensed
- The shelf life of the drug once opened
- The time a pharmacy must keep records before disposal
Correct Answer: The timeframe within which a prescription may be legally dispensed
Q13. What should a pharmacist do if a hospital inpatient medication order lacks dose information?
- Estimate a standard dose based on other patients
- Hold administration and contact the prescriber for clarification
- Administer the lowest available strength without consultation
- Ask the patient for their usual dose
Correct Answer: Hold administration and contact the prescriber for clarification
Q14. Which of the following is a key component of controlled substances inventory management?
- Random dispensing without records
- Daily reconciliation, secure access, and destruction documentation
- Allowing all staff to access controlled substances freely
- Discarding expired controlled drugs without records
Correct Answer: Daily reconciliation, secure access, and destruction documentation
Q15. Which abbreviation should be avoided or clarified to prevent prescription errors?
- qd (once daily)
- mg (milligram)
- tablet
- 5 mL
Correct Answer: qd (once daily)
Q16. What is the purpose of a pharmacist performing a DUR (Drug Utilization Review) on outpatient prescriptions?
- To recommend brand-name products only
- To evaluate appropriateness, interactions, allergies, and duplicate therapy
- To increase sales of expensive medications
- To delay dispensing by adding extra administrative steps
Correct Answer: To evaluate appropriateness, interactions, allergies, and duplicate therapy
Q17. Which step is essential when receiving a returned unused controlled medication from an inpatient ward?
- Place it back on the ward shelf for reuse
- Record return in controlled drugs log and follow destruction policy with witness
- Ask the nurse to give it to another patient
- Discard it in regular waste immediately
Correct Answer: Record return in controlled drugs log and follow destruction policy with witness
Q18. For outpatient prescriptions, generic substitution is allowed when:
- The prescriber permits substitution or law allows substitution and bioequivalence is established
- The pharmacist decides based on cost regardless of law
- The patient requests the brand only
- The drug is a narrow therapeutic index product
Correct Answer: The prescriber permits substitution or law allows substitution and bioequivalence is established
Q19. Which documentation is important after administering a PRN (as-needed) inpatient medication?
- Only record the medication name in a logbook at month end
- Record time, dose, reason, patient response, and administering staff signature
- No documentation required for PRN medications
- Just record the stock level change
Correct Answer: Record time, dose, reason, patient response, and administering staff signature
Q20. How does medication labeling for outpatient use contribute to prescription control?
- It provides patient-specific instructions, warnings, and identification to ensure safe use
- It primarily advertises the pharmacy
- It lists every ingredient including inactive components only
- It replaces the need for patient counselling
Correct Answer: It provides patient-specific instructions, warnings, and identification to ensure safe use
Q21. What is a common requirement when transcribing a paper inpatient order into the pharmacy system?
- Omit allergy information to save time
- Verify order details with the original order and document the transcriber
- Change drug names to local brands without notification
- Transcribe only the drug and dose, not route or frequency
Correct Answer: Verify order details with the original order and document the transcriber
Q22. Which practice enhances outpatient prescription safety for pediatric patients?
- Prescribing doses in adult tablets only
- Expressing doses in weight-based units (mg/kg) and providing clear measuring devices
- Using household spoons for administration
- Ignoring caregiver counselling
Correct Answer: Expressing doses in weight-based units (mg/kg) and providing clear measuring devices
Q23. What is the pharmacist’s role in pharmacovigilance related to inpatient and outpatient prescriptions?
- Only dispensing without monitoring adverse events
- Detecting, documenting, reporting adverse drug reactions, and recommending risk mitigation
- Designing new clinical trials for every adverse event
- Withholding adverse events from prescribers to avoid conflict
Correct Answer: Detecting, documenting, reporting adverse drug reactions, and recommending risk mitigation
Q24. Which control measure is important for storing temperature-sensitive medications in both settings?
- Storing at room temperature regardless of label
- Maintaining validated cold-chain storage with continuous temperature monitoring and logs
- Keeping all drugs in a single unlocked refrigerator
- Relying on memory for temperature checks
Correct Answer: Maintaining validated cold-chain storage with continuous temperature monitoring and logs
Q25. What action should be taken if a dispensed outpatient medication has an error discovered after the patient leaves the pharmacy?
- Ignore it since the patient has left
- Contact the patient immediately, advise on correction or return, and document the incident
- Wait for the next refill to correct it
- Charge the patient extra for the inconvenience
Correct Answer: Contact the patient immediately, advise on correction or return, and document the incident
Q26. Which factor determines whether an inpatient order should be changed to a new outpatient prescription at discharge?
- Whether the drug is cheaper in the hospital
- Clinical stability, indication for continued therapy, and appropriate outpatient dosing and monitoring
- Pharmacy stock availability only
- Patient preference for hospital brand names
Correct Answer: Clinical stability, indication for continued therapy, and appropriate outpatient dosing and monitoring
Q27. How should expired or recalled medications be handled in inpatient and outpatient settings?
- Return to stock for future use
- Quarantine immediately, record removal, and follow recall/destruction procedures
- Mix with other waste and discard
- Give them to patients with warnings
Correct Answer: Quarantine immediately, record removal, and follow recall/destruction procedures
Q28. Which audit practice helps maintain high standards in prescription control?
- Annual audits only with no follow-up
- Regular audits of records, dispensing accuracy checks, and corrective action tracking
- Audits focused only on non-medical supplies
- Avoiding audits to reduce staff workload
Correct Answer: Regular audits of records, dispensing accuracy checks, and corrective action tracking
Q29. What is the importance of patient counseling at the point of outpatient dispensing?
- To speed up the dispensing process by skipping details
- To ensure the patient understands dosing, storage, side effects, and adherence, reducing errors
- To offer marketing materials only
- To transfer responsibility entirely to the patient
Correct Answer: To ensure the patient understands dosing, storage, side effects, and adherence, reducing errors
Q30. Which system-level control can reduce prescription-related medication errors across inpatient and outpatient care?
- Implementing decision support in e-prescribing, standardized order sets, and interdisciplinary communication
- Allowing handwritten ambiguous abbreviations
- Restricting communication between pharmacy and clinical teams
- Removing formularies and allowing any medication to be prescribed
Correct Answer: Implementing decision support in e-prescribing, standardized order sets, and interdisciplinary communication
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