, Question 1
Under West Virginia law, which circumstance most accurately triggers
mandatory reporting to the Controlled Substances Monitoring Program
(CSMP) by a dispensing pharmacy?
A. Dispensing of any Schedule V controlled substance pursuant to a
prescription.
B. Dispensing of a controlled substance to a patient who pays cash and
declines insurance.
C. Dispensing of an opioid antagonist under a standing order.
D. Dispensing of a controlled substance in a quantity exceeding a 30-day
supply.
Correct Answer: A - Dispensing of any Schedule V controlled
substance pursuant to a prescription.
RATIONALE
West Virginia requires dispensers to report all Schedule II-V
controlled substance prescriptions to the CSMP, regardless of payment
method or quantity. Opioid antagonists dispensed under standing
orders and cash payments are not independent triggers. Quantity
thresholds do not alter the reporting obligation.
Question 2
A pharmacist seeks to initiate a collaborative practice agreement (CPA) with a
physician in West Virginia. Which element is absolutely required for the CPA
to be valid?
A. The CPA must be approved by the West Virginia Board of Medicine
prior to implementation.
B. The CPA must be in writing, signed by both parties, and specify the
scope of practice and conditions treated.
C. The CPA must limit the pharmacist to dispensing only, with no
therapeutic interchange authority.
Page 2
, D. The CPA must be renewed every 6 months and filed with the DEA.
Correct Answer: B - The CPA must be in writing, signed by both
parties, and specify the scope of practice and conditions treated.
RATIONALE
West Virginia law requires CPAs to be written, signed by both the
pharmacist and physician, and to delineate the scope, conditions, and
protocols. Board of Medicine approval is not a prerequisite, and DEA
filing is not required. CPAs may include therapeutic interchange if
specified.
Question 3
Which of the following best describes the recordkeeping requirement for a
pharmacy that compounds sterile preparations in West Virginia?
A. Records must be maintained for 2 years and include lot numbers of all
ingredients.
B. Records must be maintained for 5 years and include beyond-use dating
and sterilization logs.
C. Records must be maintained for 10 years and include patient-specific
prescriptions only.
D. Records must be maintained for 1 year and include only final product
testing results.
Correct Answer: B - Records must be maintained for 5 years and
include beyond-use dating and sterilization logs.
RATIONALE
West Virginia adopts USP <797> standards, requiring 5-year retention
of compounding records, including beyond-use dating, sterilization
logs, and ingredient lot numbers. Two-year and 1-year retention
periods are insufficient. Patient-specific prescriptions are not the sole
record required.
Page 3
, Question 4
A pharmacy technician inadvertently dispenses a Schedule II medication
without a pharmacist's final verification. Under West Virginia law, who bears
ultimate legal responsibility?
A. The pharmacy technician, because they performed the final dispensing
act.
B. The pharmacist-in-charge, because they are responsible for all
operations.
C. The prescribing physician, because they authorized the medication.
D. The pharmacy owner, because they employ both parties.
Correct Answer: B - The pharmacist-in-charge, because they are
responsible for all operations.
RATIONALE
West Virginia law holds the pharmacist-in-charge ultimately
responsible for compliance with all dispensing laws, including
technician actions. Technicians may be individually liable, but the PIC
bears ultimate legal responsibility. Physicians and owners are not
directly liable for dispensing errors.
Question 5
Which of the following is a permissible basis for a pharmacist to refuse to fill a
prescription for a controlled substance under West Virginia law?
A. The patient appears nervous and asks questions about the medication.
B. The prescription is for a legitimate medical purpose but the pharmacist
disagrees with the therapy.
C. The pharmacist has a good-faith belief that the prescription is forged or
not issued for a legitimate medical purpose.
D. The patient refuses to provide a phone number for the pharmacy's
records.
Correct Answer: C - The pharmacist has a good-faith belief that
Page 4
Under West Virginia law, which circumstance most accurately triggers
mandatory reporting to the Controlled Substances Monitoring Program
(CSMP) by a dispensing pharmacy?
A. Dispensing of any Schedule V controlled substance pursuant to a
prescription.
B. Dispensing of a controlled substance to a patient who pays cash and
declines insurance.
C. Dispensing of an opioid antagonist under a standing order.
D. Dispensing of a controlled substance in a quantity exceeding a 30-day
supply.
Correct Answer: A - Dispensing of any Schedule V controlled
substance pursuant to a prescription.
RATIONALE
West Virginia requires dispensers to report all Schedule II-V
controlled substance prescriptions to the CSMP, regardless of payment
method or quantity. Opioid antagonists dispensed under standing
orders and cash payments are not independent triggers. Quantity
thresholds do not alter the reporting obligation.
Question 2
A pharmacist seeks to initiate a collaborative practice agreement (CPA) with a
physician in West Virginia. Which element is absolutely required for the CPA
to be valid?
A. The CPA must be approved by the West Virginia Board of Medicine
prior to implementation.
B. The CPA must be in writing, signed by both parties, and specify the
scope of practice and conditions treated.
C. The CPA must limit the pharmacist to dispensing only, with no
therapeutic interchange authority.
Page 2
, D. The CPA must be renewed every 6 months and filed with the DEA.
Correct Answer: B - The CPA must be in writing, signed by both
parties, and specify the scope of practice and conditions treated.
RATIONALE
West Virginia law requires CPAs to be written, signed by both the
pharmacist and physician, and to delineate the scope, conditions, and
protocols. Board of Medicine approval is not a prerequisite, and DEA
filing is not required. CPAs may include therapeutic interchange if
specified.
Question 3
Which of the following best describes the recordkeeping requirement for a
pharmacy that compounds sterile preparations in West Virginia?
A. Records must be maintained for 2 years and include lot numbers of all
ingredients.
B. Records must be maintained for 5 years and include beyond-use dating
and sterilization logs.
C. Records must be maintained for 10 years and include patient-specific
prescriptions only.
D. Records must be maintained for 1 year and include only final product
testing results.
Correct Answer: B - Records must be maintained for 5 years and
include beyond-use dating and sterilization logs.
RATIONALE
West Virginia adopts USP <797> standards, requiring 5-year retention
of compounding records, including beyond-use dating, sterilization
logs, and ingredient lot numbers. Two-year and 1-year retention
periods are insufficient. Patient-specific prescriptions are not the sole
record required.
Page 3
, Question 4
A pharmacy technician inadvertently dispenses a Schedule II medication
without a pharmacist's final verification. Under West Virginia law, who bears
ultimate legal responsibility?
A. The pharmacy technician, because they performed the final dispensing
act.
B. The pharmacist-in-charge, because they are responsible for all
operations.
C. The prescribing physician, because they authorized the medication.
D. The pharmacy owner, because they employ both parties.
Correct Answer: B - The pharmacist-in-charge, because they are
responsible for all operations.
RATIONALE
West Virginia law holds the pharmacist-in-charge ultimately
responsible for compliance with all dispensing laws, including
technician actions. Technicians may be individually liable, but the PIC
bears ultimate legal responsibility. Physicians and owners are not
directly liable for dispensing errors.
Question 5
Which of the following is a permissible basis for a pharmacist to refuse to fill a
prescription for a controlled substance under West Virginia law?
A. The patient appears nervous and asks questions about the medication.
B. The prescription is for a legitimate medical purpose but the pharmacist
disagrees with the therapy.
C. The pharmacist has a good-faith belief that the prescription is forged or
not issued for a legitimate medical purpose.
D. The patient refuses to provide a phone number for the pharmacy's
records.
Correct Answer: C - The pharmacist has a good-faith belief that
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