NU 578 Unit 2 Exam (2026 / 2027 Update): University of South Alabama – Practice Questions with Bold Answers & Explanations | pdf

NU 578 Unit 2 Exam ( Update): University
of South Alabama – Practice Questions with Bold
Answers & Explanations | pdf

Introduction

This practice exam is designed for students enrolled in NU 578: Advanced Pharmacology at
the University of South Alabama. The Unit 2 exam covers key concepts in:

 Controlled Substances (DEA schedules, prescribing regulations, and federal/state requirements)
 Opioid Analgesics (morphine, oxycodone, tramadol, and opioid antagonists)
 CNS Pharmacology (blood-brain barrier, drug tolerance, physical dependence)
 Migraine & Headache Management (triptans, prophylaxis with beta-blockers, anticonvulsants, TCAs)
 Psychopharmacology (antipsychotics – first-generation vs. second-generation, adverse effects including
EPS, tardive dyskinesia, NMS)
 Bipolar Disorder Treatment (lithium, monitoring requirements, drug interactions)
 ADHD Pharmacotherapy (stimulants – methylphenidate formulations, side effects)

Each question includes the correct answer in bold and an italicized rationale to reinforce learning.




Section 1: Controlled Substances – DEA Schedules & Prescribing Regulations
(Questions 1-20)
1. Under the Controlled Substances Act (CSA), which schedule of drugs has the
highest potential for abuse and no approved medical use in the United States?
A. Schedule II
B. Schedule III
C. Schedule I
D. Schedule IV
Rationale: Schedule I drugs have a high potential for abuse and no approved
medical use in the US. Examples include heroin, LSD, and marijuana (at the federal
level). Schedule II-V all have approved medical applications .

,2. A prescriber writes a prescription for oxycodone (a Schedule II controlled
substance). Which of the following is TRUE regarding this prescription?
A. It can be refilled up to 5 times within 6 months
B. It cannot be refilled; a new prescription must be written each time
C. It can be called in orally without any written follow-up
D. It is valid for 12 months from the date written
Rationale: Schedule II prescriptions cannot be refilled. A new, written (or
electronically prescribed) prescription is required for each fill. While oral
prescriptions may be called in for emergencies, a written prescription must follow
within 72 hours .

3. A patient with chronic pain has been stable on hydrocodone/acetaminophen for 2
years. The provider writes a new prescription with 5 refills. The pharmacist refuses to
fill the refills. Why?
A. Hydrocodone is a Schedule I drug
B. Hydrocodone is a Schedule II drug and cannot be refilled
C. The prescription is expired
D. The patient does not have a valid DEA number
Rationale: Hydrocodone combination products were rescheduled from Schedule III
to Schedule II by the DEA in 2014. As a Schedule II drug, it cannot be refilled. A new
prescription must be written for each fill .

4. A provider writes a prescription for alprazolam (Xanax), a Schedule IV controlled
substance, with authorization for refills. What is the maximum number of refills
permitted within what time period?
A. 2 refills within 3 months
B. 5 refills within 6 months
C. 10 refills within 12 months
D. Unlimited refills for 12 months
Rationale: Schedule III and IV prescriptions may be refilled up to 5 times within 6
months of the original order. If additional medication is needed beyond this, a new
prescription must be written .
5. A patient with ADHD has been stable on methylphenidate (Ritalin) for several
months. The provider writes three separate prescriptions for the patient, each dated
for sequential months. Is this permissible?
A. No, this is considered illegal prescription drug diversion
B. Yes, a DEA rule allows a prescriber to write multiple prescriptions on the same day
for the same patient and same Schedule II drug to be filled sequentially for up to a 90-
day supply

, C. No, Schedule II drugs must be dispensed one month at a time with a new office visit
each month
D. Yes, but only if the patient pays cash
*Rationale: A DEA rule issued in 2007 allows prescribers to write multiple prescriptions on
the same day, for the same patient and same Schedule II drug, to be filled sequentially for
up to a 90-day supply. Each prescription must be written in ink, dated the same day as
signed, with no refills indicated .*

6. A Schedule II prescription must be written in ink or indelible pencil, dated the same
day as signed, and include which of the following?
A. The patient's social security number
B. The prescriber's DEA number
C. The patient's insurance information
D. The name of the pharmacy
Rationale: Schedule II prescriptions require the prescriber's DEA number, written
signature, date, patient information, drug name, strength, quantity, and directions for
use. The prescription cannot be refilled .
7. Which statement about Schedule V controlled substances is TRUE?
A. They cannot be dispensed without a prescription under any circumstances
B. They may be dispensed without a prescription by a pharmacist if the amount is
limited, the recipient is at least 18 years old, and local laws do not prohibit it
C. They have the highest abuse potential of all schedules
D. They are not regulated by the DEA
*Rationale: Schedule V drugs (e.g., low-dose codeine cough syrups) may be dispensed
without a prescription provided: the drug is dispensed by a pharmacist, the amount is very
limited, the recipient is at least 18 years old, and local laws permit it. The pharmacist must
maintain a record of the transaction .*

8. If a state law regarding controlled substance prescribing is more stringent than the
federal Controlled Substances Act (CSA), which law takes precedence?
A. The federal law (CSA) supersedes all state laws
B. The state law takes precedence if it is more stringent
C. The prescriber may choose which law to follow
D. The DEA makes a case-by-case determination
Rationale: States may require more stringent regulations than the CSA mandates.
However, no state may place a substance in a lower schedule than the federal
government has .