WASHINGTON MPJE ACTUAL FINAL EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔Which electrolytes have to be labeled with a warning if they exceed a certain
threshold in an OTC product?
What is the warning? - ✔✔Na
K
Mg
Ca
Ask a doctor before use if you have kidney stones/kidney disease or a Na/K/Mg/Ca
restricted diet
Must also list amount of electrolyte *per dose*
✔✔Which electrolytes require kidney *stone* warning? - ✔✔K, Mg, Ca (all but Na)
✔✔Which electrolytes require kidney *disease* warning? - ✔✔K, Mg
✔✔Sodium Threshold - ✔✔>140 mg per day (based on maximum daily dose)
✔✔Electrolyte thresholds are based on - ✔✔maximum daily dose
,✔✔Calcium Threshold - ✔✔>3.2 g per day (based on maximum daily dose)
✔✔Magnesium Threshold - ✔✔>600 mg per day (based on maximum daily dose)
✔✔Potassium Threshold - ✔✔>975 mg per day (based on maximum daily dose)
✔✔Sodium Free = - ✔✔<=5 mg per day
✔✔Very Low Sodium = - ✔✔<= 35 mg per day
✔✔Low Sodium = - ✔✔<= 140 mg per day
✔✔Emergency Contraceptive Pills and Rx vs. OTC - ✔✔Levonorgestrel (Rx and OTC)
Ulipristal = Ella (Rx Only)
✔✔Are there any gender or age restrictions for buying Plan B? - ✔✔NO
(Even though package may say for women 17+ on generics)
✔✔How long is emergency contraceptive approved for?
How long can pharmacists recommend it for? - ✔✔72 hrs
120 hrs
✔✔Preferred emergency contraception when >72 hrs - ✔✔Ulipristal (Ella) but Rx only...
✔✔Does the Affordable Care Act cover emergency contraception? - ✔✔Yes but only
with a prescription
✔✔Review WA laws for Pharmacists furnishing emergency contraceptions - ✔✔***
✔✔Behind the Counter drugs are technically considered... - ✔✔OTC
✔✔Rules for OTC Schedule V drugs - ✔✔Not allowed in WA state
✔✔How many members serve on the Board of Pharmacy? How many are public
members? - ✔✔10 pharmacists, licensed in WA for at least 5 years, geographically
representative, and representing various areas of practice
4 public members, not affiliated with any aspect of pharmacy, citizens of US and
resident of WA
1 pharmacy technician
4-year terms
May serve 2 terms
Members appointed by governor
Executive officer hired by Commission
,Executive officer reports to Undersecretary of DOH for Health Systems Quality
Assurance
Staff are employees of Department of Health, Health Professions Quality Assurance
Division
Commission currently has own investigators within HPQA pool
Licenses paid to HPQA Office
✔✔Which of the following can prescribe legend drugs: O.D., Nurse Practitioner, Clinical
Nurse Specialist,
Physician's Assistant, Midwife, Nurse Midwife,
Chiropractor, Naturopath, Clinical Psychologist,
Physical Therapist, Respiratory Therapist,
Pharmacist? - ✔✔Physicians (MD, DO, Podiatrist)
Dentists
Veterinarians
Mid-level practitioners (NP, PA, Naturopath, OD, PharmD, Midwife)
✔✔May any prescribers purchase legend drugs for use in their practice? -
✔✔Pharmacies may transfer legend drugs to other pharmacies or prescribers without
registering as wholesalers "to meet an urgent need"
May not exceed 5% of total sales during any previous 12 months
Commission has recently suggested that "routine" sales to physicians violate this rule
Repackaging may make the transferred drug misbranded, and should not be done
✔✔Which of the following can prescribe CSA drugs
(and which classes):
O.D., Nurse Practitioner, Clinical Nurse Specialist,
Physician's Assistant, Midwife, Nurse Midwife,
Chiropractor, Naturopath, Clinical Psychologist,
Physical Therapist, Pharmacist? - ✔✔MD or DO - all schedules
DMD, DDS - all schedules
DVM - all schedules
PodD, DPM - all schedules
ARNPs - all schedules to extent authorized by their state to prescribe CSAs
PA-C, Osteopathic PA - all schedules approved by supervising physician
Any of the above in any state in the US
British Columbia physicians, NPs, and PAs, can prescribe legend drugs, but not
controlled substances unless have a US-issued DEA No.
"State" includes US territories (e.g., Guam, Puerto Rico)
Mid-level practitioners in WA
ARNPs: Schedule II-V, in accordance with specialty area
May dispense up to a 72 hour supply of CSAs to own patients
PAs - All schedules approved by supervising MD
Optometrists - limited list, may include III, IV, V
No more than a 7-day supply of CSAs
, No more than 30 dosage units of III or IV
Single doses of benzodiazepines for pre-procedure use
Naturopaths - C-III and C-IV testosterone and codeine products
Pharmacists - any schedule within scope of authorizing prescriber
✔✔What providers are out of state prescriptions allowed? - ✔✔Out of state
prescriptions are acceptable. WA allows the following prescribers who are licensed in
any state or US territory, or in British Columbia, to issue prescriptions for legend drugs
that are valid
in WA. (Note: Canadian prescribers cannot issue prescriptions for controlled substances
unless they are also licensed in the US and registered with the DEA.)
Physicians (MD, DO)
Podiatrists (PodD, DPM)
Dentists (DDS, DMD)
Veterinarians (DVM)
Nurse Practitioners (ARNP)
Physician Assistants (PA-C)
When licensed in any state, territory, or British Columbia (legend drugs only from BC)
✔✔Who can prescribe from British Columbia? Controlled or legend? - ✔✔British
Columbia physicians, NPs, and PAs, can prescribe legend drugs, but not controlled
substances unless have a US-issued DEA No.
✔✔How long are prescriptions for legend drugs valid
from the date issued? - ✔✔All legend drugs expire after 1 year in WA
✔✔Is there a maximum number of refills allowed for
legend drugs? What is it? - ✔✔All legend drugs expire after 1 year in WA
Refill PRN = 1 year
Refills must be consistent with directions
If Rx expired, a refill should be treated as a new Rx and given new number
The full quantity of a prescription refill may be dispensed up to the last day before the
Rx expires
Non-CSA drugs: an emergency supply for up to 72-hours may be given (see WAC 246-
869-100(f))
Refills must be consistent with directions for use and patients monitored for overuse of
drugs
Prescribers cannot delegate refill authorization to a nurse or staff
NQAC has ruled out "refill protocols" for RNs
✔✔How long are prescriptions for each of the
following valid: C-2s, C-3s, C-4s, C-5s? - ✔✔C2: No expiration date on Rx under federal
law; 6 months in WA
C3-5: May refill up to 5 times within 6 months; Rx expires after 6 months
QUESTIONS AND ANSWERS SURE A+
✔✔Which electrolytes have to be labeled with a warning if they exceed a certain
threshold in an OTC product?
What is the warning? - ✔✔Na
K
Mg
Ca
Ask a doctor before use if you have kidney stones/kidney disease or a Na/K/Mg/Ca
restricted diet
Must also list amount of electrolyte *per dose*
✔✔Which electrolytes require kidney *stone* warning? - ✔✔K, Mg, Ca (all but Na)
✔✔Which electrolytes require kidney *disease* warning? - ✔✔K, Mg
✔✔Sodium Threshold - ✔✔>140 mg per day (based on maximum daily dose)
✔✔Electrolyte thresholds are based on - ✔✔maximum daily dose
,✔✔Calcium Threshold - ✔✔>3.2 g per day (based on maximum daily dose)
✔✔Magnesium Threshold - ✔✔>600 mg per day (based on maximum daily dose)
✔✔Potassium Threshold - ✔✔>975 mg per day (based on maximum daily dose)
✔✔Sodium Free = - ✔✔<=5 mg per day
✔✔Very Low Sodium = - ✔✔<= 35 mg per day
✔✔Low Sodium = - ✔✔<= 140 mg per day
✔✔Emergency Contraceptive Pills and Rx vs. OTC - ✔✔Levonorgestrel (Rx and OTC)
Ulipristal = Ella (Rx Only)
✔✔Are there any gender or age restrictions for buying Plan B? - ✔✔NO
(Even though package may say for women 17+ on generics)
✔✔How long is emergency contraceptive approved for?
How long can pharmacists recommend it for? - ✔✔72 hrs
120 hrs
✔✔Preferred emergency contraception when >72 hrs - ✔✔Ulipristal (Ella) but Rx only...
✔✔Does the Affordable Care Act cover emergency contraception? - ✔✔Yes but only
with a prescription
✔✔Review WA laws for Pharmacists furnishing emergency contraceptions - ✔✔***
✔✔Behind the Counter drugs are technically considered... - ✔✔OTC
✔✔Rules for OTC Schedule V drugs - ✔✔Not allowed in WA state
✔✔How many members serve on the Board of Pharmacy? How many are public
members? - ✔✔10 pharmacists, licensed in WA for at least 5 years, geographically
representative, and representing various areas of practice
4 public members, not affiliated with any aspect of pharmacy, citizens of US and
resident of WA
1 pharmacy technician
4-year terms
May serve 2 terms
Members appointed by governor
Executive officer hired by Commission
,Executive officer reports to Undersecretary of DOH for Health Systems Quality
Assurance
Staff are employees of Department of Health, Health Professions Quality Assurance
Division
Commission currently has own investigators within HPQA pool
Licenses paid to HPQA Office
✔✔Which of the following can prescribe legend drugs: O.D., Nurse Practitioner, Clinical
Nurse Specialist,
Physician's Assistant, Midwife, Nurse Midwife,
Chiropractor, Naturopath, Clinical Psychologist,
Physical Therapist, Respiratory Therapist,
Pharmacist? - ✔✔Physicians (MD, DO, Podiatrist)
Dentists
Veterinarians
Mid-level practitioners (NP, PA, Naturopath, OD, PharmD, Midwife)
✔✔May any prescribers purchase legend drugs for use in their practice? -
✔✔Pharmacies may transfer legend drugs to other pharmacies or prescribers without
registering as wholesalers "to meet an urgent need"
May not exceed 5% of total sales during any previous 12 months
Commission has recently suggested that "routine" sales to physicians violate this rule
Repackaging may make the transferred drug misbranded, and should not be done
✔✔Which of the following can prescribe CSA drugs
(and which classes):
O.D., Nurse Practitioner, Clinical Nurse Specialist,
Physician's Assistant, Midwife, Nurse Midwife,
Chiropractor, Naturopath, Clinical Psychologist,
Physical Therapist, Pharmacist? - ✔✔MD or DO - all schedules
DMD, DDS - all schedules
DVM - all schedules
PodD, DPM - all schedules
ARNPs - all schedules to extent authorized by their state to prescribe CSAs
PA-C, Osteopathic PA - all schedules approved by supervising physician
Any of the above in any state in the US
British Columbia physicians, NPs, and PAs, can prescribe legend drugs, but not
controlled substances unless have a US-issued DEA No.
"State" includes US territories (e.g., Guam, Puerto Rico)
Mid-level practitioners in WA
ARNPs: Schedule II-V, in accordance with specialty area
May dispense up to a 72 hour supply of CSAs to own patients
PAs - All schedules approved by supervising MD
Optometrists - limited list, may include III, IV, V
No more than a 7-day supply of CSAs
, No more than 30 dosage units of III or IV
Single doses of benzodiazepines for pre-procedure use
Naturopaths - C-III and C-IV testosterone and codeine products
Pharmacists - any schedule within scope of authorizing prescriber
✔✔What providers are out of state prescriptions allowed? - ✔✔Out of state
prescriptions are acceptable. WA allows the following prescribers who are licensed in
any state or US territory, or in British Columbia, to issue prescriptions for legend drugs
that are valid
in WA. (Note: Canadian prescribers cannot issue prescriptions for controlled substances
unless they are also licensed in the US and registered with the DEA.)
Physicians (MD, DO)
Podiatrists (PodD, DPM)
Dentists (DDS, DMD)
Veterinarians (DVM)
Nurse Practitioners (ARNP)
Physician Assistants (PA-C)
When licensed in any state, territory, or British Columbia (legend drugs only from BC)
✔✔Who can prescribe from British Columbia? Controlled or legend? - ✔✔British
Columbia physicians, NPs, and PAs, can prescribe legend drugs, but not controlled
substances unless have a US-issued DEA No.
✔✔How long are prescriptions for legend drugs valid
from the date issued? - ✔✔All legend drugs expire after 1 year in WA
✔✔Is there a maximum number of refills allowed for
legend drugs? What is it? - ✔✔All legend drugs expire after 1 year in WA
Refill PRN = 1 year
Refills must be consistent with directions
If Rx expired, a refill should be treated as a new Rx and given new number
The full quantity of a prescription refill may be dispensed up to the last day before the
Rx expires
Non-CSA drugs: an emergency supply for up to 72-hours may be given (see WAC 246-
869-100(f))
Refills must be consistent with directions for use and patients monitored for overuse of
drugs
Prescribers cannot delegate refill authorization to a nurse or staff
NQAC has ruled out "refill protocols" for RNs
✔✔How long are prescriptions for each of the
following valid: C-2s, C-3s, C-4s, C-5s? - ✔✔C2: No expiration date on Rx under federal
law; 6 months in WA
C3-5: May refill up to 5 times within 6 months; Rx expires after 6 months
