CPJE Video 4: Pharmacy operations, part III
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Due to the many high profile medication errors with heparin recently, a pharmacy resident is
going to present a nursing in-service on heparin. Which of the following are key points to include
in the in-service?
Select all that applies:
1. Locate heparin products by the label color. For example, heparin flushes always have a yellow
label.
2. It is safest to use premixed heparin solutions when possible to avoid confusion and
unnecessary calculations.
3. Two people should check the initial settings on the infusion pump and all rate change settings.
4. Using "U" for units has been determined to be the safest way to write or type heparin doses in
medication orders. - CORRECT ANSWER - 2 & 3 only
Heparin is a High-Alert drug. Fatal errors have been attributed to mix-ups between the many
available concentrations (10,000 units/mL vs 10 units/mL) and relying on label colors to identify
products in this era of drug shortages. See the Medication Safety & Quality Improvement chapter
of the 2020 RxPrep Course Book.
A 16-year-old female comes to the 24-hour pharmacy early in the morning and asks for the
"morning-after pill" that works best. She states that she just had unprotected sex late the night
before. The patient wishes to have the EC covered by her insurance. Which products can the
pharmacist furnish to this patient under the statewide EC protocol?
Select all that applies:
1. Mirena
2. Plan B One-Step
3. Ella
4. Cytotec - CORRECT ANSWER - 2 & 3 only
,Cytotec = misoprostol
The pharmacist can independently furnish ("prescribe") Plan B One-Step and Ella under the
statewide protocol. Plan B One-Step (one dose regimen) and the generic versions are available
OTC. Cytotec is not for emergency contraception. Refer to the 2020 RxPrep CPJE Manual,
Regulation of Pharmacy Practice chapter, p. 75-78.
What is the primary reason why Evzio comes with two doses in each carton?
Answer
A. Each injection provides half of one dose.
B. Persons with opioid addiction generally socialize with other addicts.
C. A person who is at risk of opioid overdose may have repeat overdose situations.
D. The half-life of naloxone is short; two doses may be required before the arrival of emergency
medical personnel. - CORRECT ANSWER - D. The half-life of naloxone is short; two doses
may be required before the arrival of emergency medical personnel.
Due to the short duration of action of naloxone, the patient must be kept on continued
surveillance and repeat doses of naloxone should be administered, as necessary while waiting for
emergency medical assistance. Refer to the 2020 RxPrep CPJE Manual, Regulation of Pharmacy
Practice chapter, p. 80.
Opioids cause more overdose deaths than other prescription and illicit drugs. Select the signs of
opioid overdose:
Select all that applies:
1. Mydriasis
2. Unconsciousness
3. Respiratory depression
4. Tachycardia - CORRECT ANSWER - 2 & 3 only
Miosis (pinpoint pupils) will also be present, but can be due to other conditions; the triad of
symptoms will be present in an overdose situation. Refer to the 2020 RxPrep CPJE Manual,
Regulation of Pharmacy Practice chapter, p. 79.
,A 23-year-old male comes into the pharmacy wanting to purchase emergency contraception for
his girlfriend. He has insurance and would like Plan B One-Step at no charge. He states he needs
it quickly because he had unprotected sex 48 hours ago. Choose the correct statement:
Answer
A. He can purchase Plan B One-Step over-the-counter.
B. It would be preferable to recommend Ella.
C. His partner is the only one that can purchase Plan B One-Step over-the-counter.
D. He needs a prescription for Plan B One-Step in order for it to be covered by insurance. -
CORRECT ANSWER - A. He can purchase Plan B One-Step over-the-counter.
Anyone, regardless of age or gender, can purchase over-the-counter items. Refer to the 2020
RxPrep CPJE Manual, Regulation of Pharmacy Practice chapter, p. 77.
A 48-year-old male patient who is a long-term smoker with severe COPD, temporomandibular
joint disease and allergic rhinitis wants to quit smoking. His last quit attempt was over 5 years
ago. Which of the following is the MOST appropriate recommendation for the pharmacist to
make?
Answer
A. Nicotrol inhaler
B. Nicorette gum
C. Nicotrol nasal spray
D. Nicorette lozenge - CORRECT ANSWER - D. Nicorette lozenge
The lozenge is the best option provided due to his past medical history. Refer to the 2020 RxPrep
CPJE Manual, Regulation of Pharmacy Practice chapter, p. 81.
The California Board of Pharmacy has received reports of dispensing mix-ups between Lamisil
and Lamictal. All of the following methods would help to reduce this medication error EXCEPT:
Answer
A. Pharmacists asking patients if they know what the medication is intended to treat.
, B. Providers writing the "indication for use" on the prescription.
C. Patients instructed on the medication look/dose/purpose so that they can catch dispensing
errors.
D. Lamisil should be dispensed OTC only; Lamictal is only available by prescription. -
CORRECT ANSWER - D. Lamisil should be dispensed OTC only; Lamictal is only available
by prescription.
Refer to the Medication Safety & Quality Improvement chapter of the RxPrep Course Book.
A pharmacist dispensed Plavix to a patient who had been prescribed Protonix. The pharmacist
realized the error when the patient returned to the pharmacy to complain that the stomach pills
had made her stomach feel worse. Choose the correct course of action for the pharmacist to take:
Select all that applies:
1. The pharmacist should attempt to conceal the error by telling the patient that the manufacturer
was different, and provide them with correct Protonix tablets.
2. The pharmacist should provide steps to the patient to help avoid injury or mitigate the error.
3. The pharmacist should contact the patient's prescriber to inform them of the error.
4. The pharmacist must report the medication error to the board. - CORRECT ANSWER -2&
3 only
Dont need to report to BOP
The pharmacist must inform the patient that a medication error has occurred and should inform
the patient of any steps that can be taken to avoid further injury. Refer to the 2020 RxPrep CPJE
Manual, Regulation of Pharmacy Practice chapter, p. 95-96.
According to the California Board of Pharmacy self-administered hormonal contraception
protocol, which of the following forms of contraception are considered "self-administered"?
Select all that applies:
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Due to the many high profile medication errors with heparin recently, a pharmacy resident is
going to present a nursing in-service on heparin. Which of the following are key points to include
in the in-service?
Select all that applies:
1. Locate heparin products by the label color. For example, heparin flushes always have a yellow
label.
2. It is safest to use premixed heparin solutions when possible to avoid confusion and
unnecessary calculations.
3. Two people should check the initial settings on the infusion pump and all rate change settings.
4. Using "U" for units has been determined to be the safest way to write or type heparin doses in
medication orders. - CORRECT ANSWER - 2 & 3 only
Heparin is a High-Alert drug. Fatal errors have been attributed to mix-ups between the many
available concentrations (10,000 units/mL vs 10 units/mL) and relying on label colors to identify
products in this era of drug shortages. See the Medication Safety & Quality Improvement chapter
of the 2020 RxPrep Course Book.
A 16-year-old female comes to the 24-hour pharmacy early in the morning and asks for the
"morning-after pill" that works best. She states that she just had unprotected sex late the night
before. The patient wishes to have the EC covered by her insurance. Which products can the
pharmacist furnish to this patient under the statewide EC protocol?
Select all that applies:
1. Mirena
2. Plan B One-Step
3. Ella
4. Cytotec - CORRECT ANSWER - 2 & 3 only
,Cytotec = misoprostol
The pharmacist can independently furnish ("prescribe") Plan B One-Step and Ella under the
statewide protocol. Plan B One-Step (one dose regimen) and the generic versions are available
OTC. Cytotec is not for emergency contraception. Refer to the 2020 RxPrep CPJE Manual,
Regulation of Pharmacy Practice chapter, p. 75-78.
What is the primary reason why Evzio comes with two doses in each carton?
Answer
A. Each injection provides half of one dose.
B. Persons with opioid addiction generally socialize with other addicts.
C. A person who is at risk of opioid overdose may have repeat overdose situations.
D. The half-life of naloxone is short; two doses may be required before the arrival of emergency
medical personnel. - CORRECT ANSWER - D. The half-life of naloxone is short; two doses
may be required before the arrival of emergency medical personnel.
Due to the short duration of action of naloxone, the patient must be kept on continued
surveillance and repeat doses of naloxone should be administered, as necessary while waiting for
emergency medical assistance. Refer to the 2020 RxPrep CPJE Manual, Regulation of Pharmacy
Practice chapter, p. 80.
Opioids cause more overdose deaths than other prescription and illicit drugs. Select the signs of
opioid overdose:
Select all that applies:
1. Mydriasis
2. Unconsciousness
3. Respiratory depression
4. Tachycardia - CORRECT ANSWER - 2 & 3 only
Miosis (pinpoint pupils) will also be present, but can be due to other conditions; the triad of
symptoms will be present in an overdose situation. Refer to the 2020 RxPrep CPJE Manual,
Regulation of Pharmacy Practice chapter, p. 79.
,A 23-year-old male comes into the pharmacy wanting to purchase emergency contraception for
his girlfriend. He has insurance and would like Plan B One-Step at no charge. He states he needs
it quickly because he had unprotected sex 48 hours ago. Choose the correct statement:
Answer
A. He can purchase Plan B One-Step over-the-counter.
B. It would be preferable to recommend Ella.
C. His partner is the only one that can purchase Plan B One-Step over-the-counter.
D. He needs a prescription for Plan B One-Step in order for it to be covered by insurance. -
CORRECT ANSWER - A. He can purchase Plan B One-Step over-the-counter.
Anyone, regardless of age or gender, can purchase over-the-counter items. Refer to the 2020
RxPrep CPJE Manual, Regulation of Pharmacy Practice chapter, p. 77.
A 48-year-old male patient who is a long-term smoker with severe COPD, temporomandibular
joint disease and allergic rhinitis wants to quit smoking. His last quit attempt was over 5 years
ago. Which of the following is the MOST appropriate recommendation for the pharmacist to
make?
Answer
A. Nicotrol inhaler
B. Nicorette gum
C. Nicotrol nasal spray
D. Nicorette lozenge - CORRECT ANSWER - D. Nicorette lozenge
The lozenge is the best option provided due to his past medical history. Refer to the 2020 RxPrep
CPJE Manual, Regulation of Pharmacy Practice chapter, p. 81.
The California Board of Pharmacy has received reports of dispensing mix-ups between Lamisil
and Lamictal. All of the following methods would help to reduce this medication error EXCEPT:
Answer
A. Pharmacists asking patients if they know what the medication is intended to treat.
, B. Providers writing the "indication for use" on the prescription.
C. Patients instructed on the medication look/dose/purpose so that they can catch dispensing
errors.
D. Lamisil should be dispensed OTC only; Lamictal is only available by prescription. -
CORRECT ANSWER - D. Lamisil should be dispensed OTC only; Lamictal is only available
by prescription.
Refer to the Medication Safety & Quality Improvement chapter of the RxPrep Course Book.
A pharmacist dispensed Plavix to a patient who had been prescribed Protonix. The pharmacist
realized the error when the patient returned to the pharmacy to complain that the stomach pills
had made her stomach feel worse. Choose the correct course of action for the pharmacist to take:
Select all that applies:
1. The pharmacist should attempt to conceal the error by telling the patient that the manufacturer
was different, and provide them with correct Protonix tablets.
2. The pharmacist should provide steps to the patient to help avoid injury or mitigate the error.
3. The pharmacist should contact the patient's prescriber to inform them of the error.
4. The pharmacist must report the medication error to the board. - CORRECT ANSWER -2&
3 only
Dont need to report to BOP
The pharmacist must inform the patient that a medication error has occurred and should inform
the patient of any steps that can be taken to avoid further injury. Refer to the 2020 RxPrep CPJE
Manual, Regulation of Pharmacy Practice chapter, p. 95-96.
According to the California Board of Pharmacy self-administered hormonal contraception
protocol, which of the following forms of contraception are considered "self-administered"?
Select all that applies:
