, Question 1
A Washington pharmacy's automated dispensing system (ADS) cabinet is
restocked by a certified pharmacy technician without a pharmacist's final
verification. Under WAC 246-945-XXX (or current equivalent), which legal
principle best determines whether this restocking violates the standard of
practice?
A. The ADS is exempt from pharmacist verification if the technician is
certified and the cabinet is in a licensed pharmacy.
B. Restocking is a non-discretionary task that may be delegated, but the
pharmacist-in-charge retains ultimate responsibility for accuracy and
must establish a system of checks.
C. Only a pharmacist may physically place any drug into an ADS,
regardless of the drug's schedule or packaging.
D. The violation depends solely on whether the drug is a controlled
substance; non-controlled drugs may be restocked freely.
Correct Answer: B - Restocking is a non-discretionary task that
may be delegated, but the pharmacist-in-charge retains ultimate
responsibility for accuracy and must establish a system of checks.
RATIONALE
Washington law allows delegation of non-discretionary tasks to
trained personnel, but the pharmacist-in-charge is legally responsible
for the accuracy and security of the ADS. Option A is incorrect
because pharmacist verification is not universally exempted. Option C
is too absolute; technicians may restock under specific conditions.
Option D is wrong because even non-controlled drugs require proper
oversight to ensure patient safety.
Question 2
Which of the following best describes the legal authority of a Washington
pharmacy intern who has not yet obtained a license but is enrolled in an
ACPE-accredited program?
Page 2
, A. The intern may practice independently if supervised by a pharmacist
who is physically present at all times.
B. The intern may perform all pharmacist functions except final
verification and counseling, provided they are registered as a pharmacy
intern with the Board.
C. The intern may only perform clerical tasks and cannot handle
controlled substances until licensed.
D. The intern may practice without registration as long as they are
enrolled in an accredited program and supervised by a pharmacist.
Correct Answer: B - The intern may perform all pharmacist
functions except final verification and counseling, provided they
are registered as a pharmacy intern with the Board.
RATIONALE
Washington requires pharmacy interns to be registered with the Board;
they may perform many pharmacist functions under supervision but
cannot perform final verification or provide patient counseling
independently. Option A is incorrect because independent practice is
not allowed. Option C is too restrictive; interns can handle controlled
substances under supervision. Option D is wrong because registration
is mandatory.
Question 3
A Washington pharmacy is considering implementing a telehealth protocol for
dispensing controlled substances. Which federal law most directly governs the
prescribing of controlled substances via telemedicine without a prior in-person
exam?
A. The Ryan Haight Online Pharmacy Consumer Protection Act of 2008
B. The Controlled Substances Act (CSA) as amended by the SUPPORT
Act
C. The Health Insurance Portability and Accountability Act (HIPAA)
D. The Federal Food, Drug, and Cosmetic Act (FDCA)
Page 3
, Correct Answer: B - The Controlled Substances Act (CSA) as
amended by the SUPPORT Act
RATIONALE
The Ryan Haight Act generally requires an in-person exam before
prescribing controlled substances via telemedicine, but the SUPPORT
Act and subsequent DEA flexibilities have modified this. However,
the CSA as amended by the SUPPORT Act is the primary federal law
governing telemedicine prescribing of controlled substances. HIPAA
and FDCA do not directly address controlled substance prescribing.
Question 4
Under Washington's Prescription Monitoring Program (PMP), which of the
following is a mandatory requirement for pharmacists before dispensing a
controlled substance?
A. Review the patient's PMP report for every controlled substance
prescription, including Schedule V.
B. Review the PMP report only for Schedule II and III opioids, with
exceptions for hospice and end-of-life care.
C. Review the PMP report only if the patient exhibits drug-seeking
behavior.
D. Review the PMP report only for the first fill of a controlled substance
and then annually.
Correct Answer: B - Review the PMP report only for Schedule II
and III opioids, with exceptions for hospice and end-of-life care.
RATIONALE
Washington law requires pharmacists to review the PMP before
dispensing Schedule II and III opioids, with exceptions for hospice,
palliative, and end-of-life care. Option A is too broad; Schedule V is
not included. Option C is subjective and not the legal standard. Option
D is incorrect; review is required at each dispensing, not just first fill.
Page 4
A Washington pharmacy's automated dispensing system (ADS) cabinet is
restocked by a certified pharmacy technician without a pharmacist's final
verification. Under WAC 246-945-XXX (or current equivalent), which legal
principle best determines whether this restocking violates the standard of
practice?
A. The ADS is exempt from pharmacist verification if the technician is
certified and the cabinet is in a licensed pharmacy.
B. Restocking is a non-discretionary task that may be delegated, but the
pharmacist-in-charge retains ultimate responsibility for accuracy and
must establish a system of checks.
C. Only a pharmacist may physically place any drug into an ADS,
regardless of the drug's schedule or packaging.
D. The violation depends solely on whether the drug is a controlled
substance; non-controlled drugs may be restocked freely.
Correct Answer: B - Restocking is a non-discretionary task that
may be delegated, but the pharmacist-in-charge retains ultimate
responsibility for accuracy and must establish a system of checks.
RATIONALE
Washington law allows delegation of non-discretionary tasks to
trained personnel, but the pharmacist-in-charge is legally responsible
for the accuracy and security of the ADS. Option A is incorrect
because pharmacist verification is not universally exempted. Option C
is too absolute; technicians may restock under specific conditions.
Option D is wrong because even non-controlled drugs require proper
oversight to ensure patient safety.
Question 2
Which of the following best describes the legal authority of a Washington
pharmacy intern who has not yet obtained a license but is enrolled in an
ACPE-accredited program?
Page 2
, A. The intern may practice independently if supervised by a pharmacist
who is physically present at all times.
B. The intern may perform all pharmacist functions except final
verification and counseling, provided they are registered as a pharmacy
intern with the Board.
C. The intern may only perform clerical tasks and cannot handle
controlled substances until licensed.
D. The intern may practice without registration as long as they are
enrolled in an accredited program and supervised by a pharmacist.
Correct Answer: B - The intern may perform all pharmacist
functions except final verification and counseling, provided they
are registered as a pharmacy intern with the Board.
RATIONALE
Washington requires pharmacy interns to be registered with the Board;
they may perform many pharmacist functions under supervision but
cannot perform final verification or provide patient counseling
independently. Option A is incorrect because independent practice is
not allowed. Option C is too restrictive; interns can handle controlled
substances under supervision. Option D is wrong because registration
is mandatory.
Question 3
A Washington pharmacy is considering implementing a telehealth protocol for
dispensing controlled substances. Which federal law most directly governs the
prescribing of controlled substances via telemedicine without a prior in-person
exam?
A. The Ryan Haight Online Pharmacy Consumer Protection Act of 2008
B. The Controlled Substances Act (CSA) as amended by the SUPPORT
Act
C. The Health Insurance Portability and Accountability Act (HIPAA)
D. The Federal Food, Drug, and Cosmetic Act (FDCA)
Page 3
, Correct Answer: B - The Controlled Substances Act (CSA) as
amended by the SUPPORT Act
RATIONALE
The Ryan Haight Act generally requires an in-person exam before
prescribing controlled substances via telemedicine, but the SUPPORT
Act and subsequent DEA flexibilities have modified this. However,
the CSA as amended by the SUPPORT Act is the primary federal law
governing telemedicine prescribing of controlled substances. HIPAA
and FDCA do not directly address controlled substance prescribing.
Question 4
Under Washington's Prescription Monitoring Program (PMP), which of the
following is a mandatory requirement for pharmacists before dispensing a
controlled substance?
A. Review the patient's PMP report for every controlled substance
prescription, including Schedule V.
B. Review the PMP report only for Schedule II and III opioids, with
exceptions for hospice and end-of-life care.
C. Review the PMP report only if the patient exhibits drug-seeking
behavior.
D. Review the PMP report only for the first fill of a controlled substance
and then annually.
Correct Answer: B - Review the PMP report only for Schedule II
and III opioids, with exceptions for hospice and end-of-life care.
RATIONALE
Washington law requires pharmacists to review the PMP before
dispensing Schedule II and III opioids, with exceptions for hospice,
palliative, and end-of-life care. Option A is too broad; Schedule V is
not included. Option C is subjective and not the legal standard. Option
D is incorrect; review is required at each dispensing, not just first fill.
Page 4
