IDAHO PHARMACIST LICENSURE
EXAM with Practice Questions And
Correct Answers (Verified Ans
1. Under Idaho pharmacy law, which of the following best describes the authority of a
pharmacist to administer immunizations to patients aged 7 and older?
A. Pharmacists may administer any CDC-recommended vaccine to patients aged 7 and
older without a prescription or protocol.
B. Pharmacists may administer vaccines only pursuant to a valid prescription from a
prescriber.
C. Pharmacists may administer vaccines to patients aged 7 and older under a statewide
protocol, but must complete additional training and report to the Idaho Immunization
Reminder Information System (IRIS).
D. Pharmacists may administer vaccines only to adults aged 18 and older, and only with
a patient-specific prescription.
Answer: C. Pharmacists may administer vaccines to patients aged 7 and older under a
statewide protocol, but must complete additional training and report to the Idaho
Immunization Reminder Information System (IRIS).
Rationale: Idaho law allows pharmacists to administer vaccines to patients aged 7 and
older under a statewide protocol, provided they complete ACPE-accredited training and
report to IRIS. Option A is incorrect because not all vaccines are covered and reporting is
required. Option B and D are incorrect because a prescription is not required for
protocol-based administration.
Page 1 of 77
,2. A patient with heart failure and reduced ejection fraction (HFrEF) is initiated on
sacubitril/valsartan. Which of the following monitoring parameters is most critical to
assess within the first 2 weeks of therapy?
A. Serum potassium and renal function
B. Liver function tests
C. Complete blood count with differential
D. Fasting lipid panel
Answer: A. Serum potassium and renal function
Rationale: Sacubitril/valsartan can cause hyperkalemia and renal impairment, especially
when combined with other RAAS inhibitors. Monitoring potassium and renal function is
essential. Liver function, CBC, and lipids are not primarily affected by this agent.
Page 2 of 77
,3. A prescriber orders a continuous infusion of heparin at 12 units/kg/hr for a patient
weighing 80 kg. The pharmacy stocks heparin 25,000 units in 250 mL D5W. What is
the infusion rate in mL/hr?
A. 9.6 mL/hr
B. 12.8 mL/hr
C. 16.0 mL/hr
D. 19.2 mL/hr
Answer: A. 9.6 mL/hr
Rationale: Dose = 12 units/kg/hr × 80 kg = 960 units/hr. Concentration = 25,000 units/250
mL = 100 units/mL. Rate = 960 units/hr ÷ 100 units/mL = 9.6 mL/hr. Options B, C, and D
result from calculation errors.
4. Which of the following statements regarding USP <800> requirements for handling
hazardous drugs is correct?
A. Respirators are required for all personnel handling hazardous drugs outside a
containment ventilated enclosure.
B. A closed-system transfer device (CSTD) must be used for administration of
antineoplastic hazardous drugs.
C. Hazardous drug compounding must occur in a negative-pressure room with at least 12
air changes per hour.
D. Personal protective equipment (PPE) is only required for drugs listed as NIOSH
Group 1.
Answer: C. Hazardous drug compounding must occur in a negative-pressure room
with at least 12 air changes per hour.
Rationale: USP <800> requires hazardous drug compounding in a negative-pressure room
with at least 12 ACPH and external exhaust. Respirators are not universally required;
CSTDs are required for administration but not all hazardous drugs; PPE is required for all
hazardous drugs, not just Group 1.
Page 3 of 77
, 5. A patient with type 2 diabetes and chronic kidney disease (eGFR 35 mL/min/1.73
m²) is prescribed empagliflozin. Which of the following is the most appropriate
recommendation?
A. Empagliflozin is contraindicated due to reduced renal function.
B. Empagliflozin can be initiated at 10 mg daily, but glycemic efficacy may be reduced;
monitor renal function.
C. Empagliflozin should be initiated at 25 mg daily for better glycemic control.
D. Empagliflozin should be replaced with a sulfonylurea due to renal impairment.
Answer: B. Empagliflozin can be initiated at 10 mg daily, but glycemic efficacy may be
reduced; monitor renal function.
Rationale: Empagliflozin can be used in CKD with eGFR 20 mL/min/1.73 m², but glycemic
efficacy diminishes as eGFR declines. The starting dose is 10 mg daily. It is not
contraindicated, and higher doses do not improve glycemic control in CKD. Sulfonylureas
are not preferred due to hypoglycemia risk.
6. Which of the following is a requirement under the Idaho Pharmacy Practice Act for
a pharmacist to substitute a generic equivalent for a brand-name drug?
A. The prescriber must explicitly authorize substitution on the prescription.
B. The generic must be AB-rated and the patient must consent to the substitution.
C. The pharmacist must notify the prescriber within 24 hours of the substitution.
D. Substitution is allowed only if the brand-name drug is not on the Idaho Medicaid
preferred drug list.
Answer: B. The generic must be AB-rated and the patient must consent to the
substitution.
Rationale: Idaho law permits generic substitution if the generic is AB-rated
(therapeutically equivalent) and the patient consents. Prescriber authorization is not
required unless the prescription indicates 'dispense as written.' Notification within 24 hours
is not required, and Medicaid formulary status is irrelevant.
Page 4 of 77
EXAM with Practice Questions And
Correct Answers (Verified Ans
1. Under Idaho pharmacy law, which of the following best describes the authority of a
pharmacist to administer immunizations to patients aged 7 and older?
A. Pharmacists may administer any CDC-recommended vaccine to patients aged 7 and
older without a prescription or protocol.
B. Pharmacists may administer vaccines only pursuant to a valid prescription from a
prescriber.
C. Pharmacists may administer vaccines to patients aged 7 and older under a statewide
protocol, but must complete additional training and report to the Idaho Immunization
Reminder Information System (IRIS).
D. Pharmacists may administer vaccines only to adults aged 18 and older, and only with
a patient-specific prescription.
Answer: C. Pharmacists may administer vaccines to patients aged 7 and older under a
statewide protocol, but must complete additional training and report to the Idaho
Immunization Reminder Information System (IRIS).
Rationale: Idaho law allows pharmacists to administer vaccines to patients aged 7 and
older under a statewide protocol, provided they complete ACPE-accredited training and
report to IRIS. Option A is incorrect because not all vaccines are covered and reporting is
required. Option B and D are incorrect because a prescription is not required for
protocol-based administration.
Page 1 of 77
,2. A patient with heart failure and reduced ejection fraction (HFrEF) is initiated on
sacubitril/valsartan. Which of the following monitoring parameters is most critical to
assess within the first 2 weeks of therapy?
A. Serum potassium and renal function
B. Liver function tests
C. Complete blood count with differential
D. Fasting lipid panel
Answer: A. Serum potassium and renal function
Rationale: Sacubitril/valsartan can cause hyperkalemia and renal impairment, especially
when combined with other RAAS inhibitors. Monitoring potassium and renal function is
essential. Liver function, CBC, and lipids are not primarily affected by this agent.
Page 2 of 77
,3. A prescriber orders a continuous infusion of heparin at 12 units/kg/hr for a patient
weighing 80 kg. The pharmacy stocks heparin 25,000 units in 250 mL D5W. What is
the infusion rate in mL/hr?
A. 9.6 mL/hr
B. 12.8 mL/hr
C. 16.0 mL/hr
D. 19.2 mL/hr
Answer: A. 9.6 mL/hr
Rationale: Dose = 12 units/kg/hr × 80 kg = 960 units/hr. Concentration = 25,000 units/250
mL = 100 units/mL. Rate = 960 units/hr ÷ 100 units/mL = 9.6 mL/hr. Options B, C, and D
result from calculation errors.
4. Which of the following statements regarding USP <800> requirements for handling
hazardous drugs is correct?
A. Respirators are required for all personnel handling hazardous drugs outside a
containment ventilated enclosure.
B. A closed-system transfer device (CSTD) must be used for administration of
antineoplastic hazardous drugs.
C. Hazardous drug compounding must occur in a negative-pressure room with at least 12
air changes per hour.
D. Personal protective equipment (PPE) is only required for drugs listed as NIOSH
Group 1.
Answer: C. Hazardous drug compounding must occur in a negative-pressure room
with at least 12 air changes per hour.
Rationale: USP <800> requires hazardous drug compounding in a negative-pressure room
with at least 12 ACPH and external exhaust. Respirators are not universally required;
CSTDs are required for administration but not all hazardous drugs; PPE is required for all
hazardous drugs, not just Group 1.
Page 3 of 77
, 5. A patient with type 2 diabetes and chronic kidney disease (eGFR 35 mL/min/1.73
m²) is prescribed empagliflozin. Which of the following is the most appropriate
recommendation?
A. Empagliflozin is contraindicated due to reduced renal function.
B. Empagliflozin can be initiated at 10 mg daily, but glycemic efficacy may be reduced;
monitor renal function.
C. Empagliflozin should be initiated at 25 mg daily for better glycemic control.
D. Empagliflozin should be replaced with a sulfonylurea due to renal impairment.
Answer: B. Empagliflozin can be initiated at 10 mg daily, but glycemic efficacy may be
reduced; monitor renal function.
Rationale: Empagliflozin can be used in CKD with eGFR 20 mL/min/1.73 m², but glycemic
efficacy diminishes as eGFR declines. The starting dose is 10 mg daily. It is not
contraindicated, and higher doses do not improve glycemic control in CKD. Sulfonylureas
are not preferred due to hypoglycemia risk.
6. Which of the following is a requirement under the Idaho Pharmacy Practice Act for
a pharmacist to substitute a generic equivalent for a brand-name drug?
A. The prescriber must explicitly authorize substitution on the prescription.
B. The generic must be AB-rated and the patient must consent to the substitution.
C. The pharmacist must notify the prescriber within 24 hours of the substitution.
D. Substitution is allowed only if the brand-name drug is not on the Idaho Medicaid
preferred drug list.
Answer: B. The generic must be AB-rated and the patient must consent to the
substitution.
Rationale: Idaho law permits generic substitution if the generic is AB-rated
(therapeutically equivalent) and the patient consents. Prescriber authorization is not
required unless the prescription indicates 'dispense as written.' Notification within 24 hours
is not required, and Medicaid formulary status is irrelevant.
Page 4 of 77
