CPJE STANDARD EXAMS ANSWERS AND
QUESTIONS SET A+
✔✔SubQ injections (p. 59) - ✔✔≥ 12 months old: fatty tissue over the triceps
< 12 months old: anterolateral thigh muscle
23-25 gauge needle
45ºangle
✔✔IM injections (p. 59) - ✔✔≥ 3 yrs: deltoid
< 3: anterolateral thigh muscle
Deltoid and thigh: for small volumes
Gluteus Maximus: for large volumes
90º angle
2 fingers width *below* the acromion proces
Length of needles: 5/8 - 1.5 inch needles
✔✔Initiating and Administering Immunizations (p. 60) - ✔✔3+ yrs old
Routine immunizations recommended by the *ACIP* and published by the *CDC*
Can also *initiate and administer:*
1. Epinephrine
2. diphenhydramine by injection
Required to initiate and give immunizations
1. CDC or ACIP approved immunization training program
2. maintain basic life support certification
3. comply with all federal and state record keeping
✔✔Furnishing Emergency Contraception (p. 60 bottom) - ✔✔3 types of meds
,1. *levonorgestrel*
2. *Ulipristal*
3. High dose birth control pills (pharmacist *CAN* furnish as off-label EC)
Both can be recommended up to 5 days after unprotected sex
Ulipristal: Rx ONLY
Ulipristal > levonorgestrel at 3-5 days post unprotected sex
✔✔EC can be obtained by 3 options - ✔✔1. OTC
2. Rx
3. Furnished by a CA pharmacist under the board's EC protocol
✔✔Levonorgestrel (p. 61) - ✔✔Progestin ONLY EC
Plan B 1-Step
1. No age restrictions
2. OTC, kept next to condoms/family planning supplies
3. can be purchased even if pharmacy section in the store is closed
Plan B (2 pills)
1. Only for 17+ years old (must check ID)
2. Kept behind the counter
✔✔No product quantity limits for EC (p. 62) - ✔✔A pt can purchase EC for future use
*an EC fact sheet* MUST be provided to the pt when furnishing emergency
contraception
✔✔Condoms - ✔✔A pharmacist can provide up to 12 condoms under Medi-Cal and
Family PACT for each client who obtains EC
✔✔Furnishing Naloxone (p. 64) - ✔✔*Covers ALL forms of Naloxone*
1. Autoinjector (Evzio)
2. Injection (generic naloxone)
3. Nasal spray (Narcan)
Naloxone can be given if opioid overdose is suspected:
1. Respiratory depression
2. CNS depression
*if there is a question about whether to use Naqloxone, USE IT, since fatality can result
w/ lack of use*
Anyone administering MUST *also call 911*
, ✔✔Sxs of Opioid Overdose - ✔✔1. extreme or unusual somnolence
2. Respiratory difficulty (slow shallow breathing to respiratory arrest)
3. Miosis (pinpoint pupils)
4. Bradycardia
✔✔Steps to follow if Furnishing Naloxone (p. 64 bottom) - ✔✔1. complete *1 hour of
CE* on the use of Naloxone
2. Ask if pt uses opioids or knows someone who does
3. Ask pt if known naloxone hypersensitivity
4. Provide reciptient w/ traning in opioid overdose:
--prevention
--recognition
--response
--administration of naloxone
5. Provide the board approved fact sheet
6. With pt's permission, notify PCP that naloxone was furnished
*Pt counseling canNOT be waived* when dispensing Naloxone
*keep records x 3 years*
✔✔naloxone injection (p. 65) - ✔✔Inject *1 mL* into upper arm or thigh muscle
if no reaction in *3 minutes* inject another dose
✔✔Naloxone nasal spray (p. 65) - ✔✔1. Take off yellow cap
2. screw on white cone
3. take purple cap off of naloxone capsule
4. screw naloxone capsule into barrel of syringe
5. short strong push of the plunger
6. half of capsule into each nostril
If no reaction in *3 minutes* give second dose
✔✔Nicotine Replacement therapy (p. 66) - ✔✔Rx: inhaler and nasal spray
Req to furnish NRT therapy:
1. *2 hours of CE or equivalent curriculum based training program in the last 2 years of
pharmacy school*
2. ongoing CE on smoking cessation every 2 years
3. Reviews pts current tobacco use and quit attempts
4. Asks the pt:
--Pregnant (if yes, do NOT furnish NRT)
--Heart attack w/in 2 weeks? furnish w/ caution
--Hx of heart palpitations? furnish w/ caution
QUESTIONS SET A+
✔✔SubQ injections (p. 59) - ✔✔≥ 12 months old: fatty tissue over the triceps
< 12 months old: anterolateral thigh muscle
23-25 gauge needle
45ºangle
✔✔IM injections (p. 59) - ✔✔≥ 3 yrs: deltoid
< 3: anterolateral thigh muscle
Deltoid and thigh: for small volumes
Gluteus Maximus: for large volumes
90º angle
2 fingers width *below* the acromion proces
Length of needles: 5/8 - 1.5 inch needles
✔✔Initiating and Administering Immunizations (p. 60) - ✔✔3+ yrs old
Routine immunizations recommended by the *ACIP* and published by the *CDC*
Can also *initiate and administer:*
1. Epinephrine
2. diphenhydramine by injection
Required to initiate and give immunizations
1. CDC or ACIP approved immunization training program
2. maintain basic life support certification
3. comply with all federal and state record keeping
✔✔Furnishing Emergency Contraception (p. 60 bottom) - ✔✔3 types of meds
,1. *levonorgestrel*
2. *Ulipristal*
3. High dose birth control pills (pharmacist *CAN* furnish as off-label EC)
Both can be recommended up to 5 days after unprotected sex
Ulipristal: Rx ONLY
Ulipristal > levonorgestrel at 3-5 days post unprotected sex
✔✔EC can be obtained by 3 options - ✔✔1. OTC
2. Rx
3. Furnished by a CA pharmacist under the board's EC protocol
✔✔Levonorgestrel (p. 61) - ✔✔Progestin ONLY EC
Plan B 1-Step
1. No age restrictions
2. OTC, kept next to condoms/family planning supplies
3. can be purchased even if pharmacy section in the store is closed
Plan B (2 pills)
1. Only for 17+ years old (must check ID)
2. Kept behind the counter
✔✔No product quantity limits for EC (p. 62) - ✔✔A pt can purchase EC for future use
*an EC fact sheet* MUST be provided to the pt when furnishing emergency
contraception
✔✔Condoms - ✔✔A pharmacist can provide up to 12 condoms under Medi-Cal and
Family PACT for each client who obtains EC
✔✔Furnishing Naloxone (p. 64) - ✔✔*Covers ALL forms of Naloxone*
1. Autoinjector (Evzio)
2. Injection (generic naloxone)
3. Nasal spray (Narcan)
Naloxone can be given if opioid overdose is suspected:
1. Respiratory depression
2. CNS depression
*if there is a question about whether to use Naqloxone, USE IT, since fatality can result
w/ lack of use*
Anyone administering MUST *also call 911*
, ✔✔Sxs of Opioid Overdose - ✔✔1. extreme or unusual somnolence
2. Respiratory difficulty (slow shallow breathing to respiratory arrest)
3. Miosis (pinpoint pupils)
4. Bradycardia
✔✔Steps to follow if Furnishing Naloxone (p. 64 bottom) - ✔✔1. complete *1 hour of
CE* on the use of Naloxone
2. Ask if pt uses opioids or knows someone who does
3. Ask pt if known naloxone hypersensitivity
4. Provide reciptient w/ traning in opioid overdose:
--prevention
--recognition
--response
--administration of naloxone
5. Provide the board approved fact sheet
6. With pt's permission, notify PCP that naloxone was furnished
*Pt counseling canNOT be waived* when dispensing Naloxone
*keep records x 3 years*
✔✔naloxone injection (p. 65) - ✔✔Inject *1 mL* into upper arm or thigh muscle
if no reaction in *3 minutes* inject another dose
✔✔Naloxone nasal spray (p. 65) - ✔✔1. Take off yellow cap
2. screw on white cone
3. take purple cap off of naloxone capsule
4. screw naloxone capsule into barrel of syringe
5. short strong push of the plunger
6. half of capsule into each nostril
If no reaction in *3 minutes* give second dose
✔✔Nicotine Replacement therapy (p. 66) - ✔✔Rx: inhaler and nasal spray
Req to furnish NRT therapy:
1. *2 hours of CE or equivalent curriculum based training program in the last 2 years of
pharmacy school*
2. ongoing CE on smoking cessation every 2 years
3. Reviews pts current tobacco use and quit attempts
4. Asks the pt:
--Pregnant (if yes, do NOT furnish NRT)
--Heart attack w/in 2 weeks? furnish w/ caution
--Hx of heart palpitations? furnish w/ caution
