APC APC Compounding and Dispensing Practices 2 — Questions and Answers
Question 1: A pharmacist discovers a dispensing error after the patient has left the pharmacy. The correct first action according to APC standards is to:
- Wait to see if the patient reports symptoms before acting
- Contact the patient immediately, assess clinical risk, and notify the prescriber (Correct answer)
- Document the error internally and take no further action
- Dispense the correct medication when the patient next attends
Correct answer: Contact the patient immediately, assess clinical risk, and notify the prescriber
APC standards require immediate patient contact to assess and mitigate harm, followed by notification of the prescriber and completion of an incident report.
Question 2: In the context of APC dispensing standards, 'counseling' at the point of dispensing must include:
- Only the drug name and dose
- Drug name, indication, dose, administration method, common side effects, and when to seek medical advice (Correct answer)
- Price of the medication and insurance information
- A full pharmacological description of the drug's mechanism of action
Correct answer: Drug name, indication, dose, administration method, common side effects, and when to seek medical advice
APC competency standards require dispensing counseling to cover practical information including indication, dosing, administration, side effects, and safety information relevant to the patient.
Question 3: When checking a prescription label before dispensing, which critical element must always be verified?
- Font size and color of the label
- Patient name, drug name, strength, dose, directions, prescriber name, and dispensing date (Correct answer)
- Whether the label was printed on the correct paper stock
- The pharmacy's logo placement on the label
Correct answer: Patient name, drug name, strength, dose, directions, prescriber name, and dispensing date
All mandatory label elements — patient identity, drug details, directions, prescriber information, and dispensing date — must be verified to ensure the correct medication reaches the correct patient.
Question 4: Hazardous drug compounding (e.g., chemotherapy agents) requires which specific environmental control?
- A standard laminar airflow workbench (LAFW)
- A biological safety cabinet (BSC) or containment primary engineering control (C-PEC) (Correct answer)
- A standard clean room with HEPA filtration only
- Room temperature preparation with standard PPE only
Correct answer: A biological safety cabinet (BSC) or containment primary engineering control (C-PEC)
Hazardous drugs must be compounded in a negative-pressure containment primary engineering control such as a BSC to protect both the preparer and the environment from toxic exposure.
Question 5: When a prescription is presented with a dose that appears excessive for the patient's age and weight, the pharmacist should:
- Dispense as written since the prescriber is responsible for dosing
- Query the prescription with the prescriber before dispensing and document the clarification (Correct answer)
- Reduce the dose to what appears appropriate without consulting the prescriber
- Refuse dispensing without providing any reason to the patient
Correct answer: Query the prescription with the prescriber before dispensing and document the clarification
APC professional standards require pharmacists to clarify clinically concerning prescriptions with the prescriber before dispensing to ensure patient safety.
Question 6: The 'right patient' check in the 'Five Rights of Medication Administration' is best confirmed by:
- Asking the patient to state their full name and date of birth (Correct answer)
- Checking the patient's facial appearance against their records
- Verifying only the surname on the prescription label
- Accepting verbal confirmation of the patient's name from a family member
Correct answer: Asking the patient to state their full name and date of birth
Confirming full name and date of birth is the standard two-identifier check used to positively identify the correct patient before dispensing medication.
APC APC Compounding and Dispensing Practices 2
A pharmacist discovers a dispensing error after the patient has left the pharmacy.
The correct first action according to APC standards is to: