MPharm Master of Pharmacy Master of Pharmacy: Pharmacy Law and Ethics 4 — Questions and Answers
Question 1: A pharmacist refuses to fill a legally valid prescription for mifepristone based on personal moral objections. This situation illustrates a conflict between which two ethical principles?
- Beneficence vs. nonmaleficence
- Conscience rights vs. patient autonomy and access to care (Correct answer)
- Justice vs. fidelity
- Veracity vs. confidentiality
Correct answer: Conscience rights vs. patient autonomy and access to care
Conscientious objection by a pharmacist can conflict with the patient's right to autonomous healthcare decisions and equitable access.
Question 2: Which of the following Schedule II controlled substance records must be maintained separately from all other prescription records?
- Only records of refusals to fill
- Completed DEA Form 222 and Schedule II prescriptions (Correct answer)
- Prescriptions filled under emergency authorizations only
- CSOS electronic records submitted within 48 hours
Correct answer: Completed DEA Form 222 and Schedule II prescriptions
Federal law requires Schedule II prescriptions and DEA Form 222 orders to be kept in a separate file, distinct from other controlled substance records.
Question 3: A patient presents a prescription signed by a nurse practitioner for a Schedule II opioid. In states where NPs have full prescribing authority and a DEA registration, this prescription is:
- Invalid because only physicians may prescribe Schedule II substances
- Valid provided the NP has a valid DEA registration and state prescribing authority (Correct answer)
- Valid only if cosigned by a supervising physician
- Invalid unless the NP specifies the diagnosis on the prescription
Correct answer: Valid provided the NP has a valid DEA registration and state prescribing authority
Nurse practitioners with DEA registration and state-granted prescribing authority may legally prescribe Schedule II controlled substances.
Question 4: Under the principle of 'pharmaceutical care,' which responsibility extends BEYOND the traditional dispensing role of a pharmacist?
- Verifying the authenticity of a prescriber's DEA number
- Taking ownership of patient drug therapy outcomes (Correct answer)
- Maintaining controlled substance inventory records
- Reporting prescription forgeries to law enforcement
Correct answer: Taking ownership of patient drug therapy outcomes
Pharmaceutical care, as defined by Hepler and Strand, requires pharmacists to accept responsibility for patient drug therapy outcomes, not merely dispense medications.
Question 5: When must a pharmacist file a DEA Form 106 (Report of Theft or Significant Loss of Controlled Substances)?
- Within 24 hours of discovering any controlled substance discrepancy
- Upon discovery of theft or significant loss, before completing the biennial inventory
- Within 1 business day of a robbery or burglary of controlled substances (Correct answer)
- At the time of the annual DEA audit of controlled substance logs
Correct answer: Within 1 business day of a robbery or burglary of controlled substances
DEA Form 106 must be filed upon discovery of theft or significant loss, and law enforcement must be notified simultaneously; the DEA requires timely reporting for robbery or burglary.
Question 6: Which landmark legal case established that pharmacists have a duty to warn patients of known risks associated with prescribed medications?
- Hooks SuperX v. McLaughlin
- Fidelity Mutual Life v. Milete
- Riff v. Morgan Pharmacy (Correct answer)
- Pharmaceutical Society of NY v. Lefkowitz
Correct answer: Riff v. Morgan Pharmacy
Riff v. Morgan Pharmacy (1986) established that pharmacists have a duty to warn patients of foreseeable risks associated with medications they dispense.
Question 7: A pharmacy technician discovers that the dispensing pharmacist inadvertently filled a prescription with twice the intended dose. The error is caught before the patient leaves. What is the MOST appropriate ethical action?
- Correct the error quietly without documenting to protect the pharmacist's license
- Correct the error, document it per institutional policy, and counsel the patient (Correct answer)
- Report the pharmacist to the state board immediately before correcting the error
- Fill the original error and note it on the patient profile only
Correct answer: Correct the error, document it per institutional policy, and counsel the patient
Correcting the error, documenting it per policy (for quality improvement), and counseling the patient upholds patient safety, transparency, and professional accountability.
MPharm Master of Pharmacy Master of Pharmacy: Pharmacy Law and Ethics 4
A pharmacist refuses to fill a legally valid prescription for mifepristone based on personal moral objections.
This situation illustrates a conflict between which two ethical principles?