A Virginia pharmacist discovers that a prescriber has issued multiple
prescriptions for the same controlled substance to the same patient on the same
day, each for a 30-day supply, with instructions to fill sequentially. Under
Virginia law, which action is most appropriate?
A. Dispense all prescriptions immediately as written, since they are valid
prescriptions.
B. Contact the prescriber to verify the intent and document the
clarification, as multiple prescriptions for the same drug on the same day
may indicate abuse or diversion.
C. Refuse to fill any of the prescriptions and report the prescriber to the
Board of Pharmacy.
D. Fill only the first prescription and notify the patient that the others
cannot be filled.
Correct Answer: B - Contact the prescriber to verify the intent
and document the clarification, as multiple prescriptions for the
same drug on the same day may indicate abuse or diversion.
RATIONALE
Virginia law permits multiple prescriptions for Schedule II controlled
substances to be filled sequentially if issued for a legitimate medical
purpose, but pharmacists must verify intent and document. Immediate
dispensing without verification may violate corresponding
responsibility. Refusing all or reporting without cause is premature.
Thus, contacting the prescriber is the correct professional and legal
action.
Question 2
Which of the following best describes the legal requirement for a pharmacist to
counsel a patient on a new prescription under Virginia law?
A. Counseling is required only for controlled substances.
B. Counseling is required for all new prescriptions unless the patient
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, refuses or the pharmacist deems it unnecessary due to prior counseling.
C. Counseling is optional and at the pharmacist's discretion for all
prescriptions.
D. Counseling is required only for Medicaid patients.
Correct Answer: B - Counseling is required for all new
prescriptions unless the patient refuses or the pharmacist deems it
unnecessary due to prior counseling.
RATIONALE
Virginia regulations mandate patient counseling for all new
prescriptions, with exceptions for refills, patient refusal, or when the
pharmacist determines counseling is not necessary due to prior
counseling. Counseling is not limited to controlled substances or
Medicaid patients. Therefore, option B accurately reflects the legal
requirement.
Question 3
A Virginia pharmacy technician is asked to perform a final check on a
compounded sterile preparation. According to Virginia law, which of the
following is true regarding this task?
A. Technicians may perform final checks if they have completed a
Board-approved training program.
B. Technicians may never perform final checks on sterile preparations;
only pharmacists may do so.
C. Technicians may perform final checks under direct pharmacist
supervision.
D. Technicians may perform final checks only for non-sterile
preparations.
Correct Answer: B - Technicians may never perform final checks
on sterile preparations; only pharmacists may do so.
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, RATIONALE
Virginia law restricts final verification of compounded sterile
preparations to pharmacists; technicians cannot perform this task
regardless of training or supervision. This ensures patient safety and
compliance with USP standards. Options A, C, and D incorrectly
expand technician scope.
Question 4
Under Virginia law, which of the following is required for a pharmacy to
operate a remote dispensing site?
A. The remote site must be staffed by a pharmacist at all times.
B. The remote site must be under the continuous supervision of a
pharmacist via telepharmacy.
C. The remote site must be located within 10 miles of the supervising
pharmacy.
D. The remote site must obtain a separate pharmacy license and have a
pharmacist on-site during all hours of operation.
Correct Answer: B - The remote site must be under the
continuous supervision of a pharmacist via telepharmacy.
RATIONALE
Virginia permits remote dispensing sites under continuous pharmacist
supervision via telepharmacy, not requiring an on-site pharmacist. A
separate license is not required if it operates under the supervising
pharmacy's license. Distance restrictions are not specified. Thus,
option B is correct.
Question 5
A physician writes a prescription for a Schedule II controlled substance with a
quantity of 120 tablets, but the pharmacist determines that the quantity exceeds
the maximum allowed by Virginia law for a 30-day supply without additional
documentation. What is the pharmacist's best course of action?
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