PEBC PEBC Pharmacy Practice Management 4 — Questions and Answers
Question 1: A pharmacy technician notices a discrepancy between the narcotic inventory count and the narcotic register. What is the pharmacist's FIRST required action?
- Immediately notify Health Canada and local police
- Investigate the discrepancy and document findings before reporting (Correct answer)
- Suspend the technician pending an internal investigation
- Report the loss to the provincial pharmacy regulatory authority within 24 hours
Correct answer: Investigate the discrepancy and document findings before reporting
The pharmacist must first investigate and document the discrepancy to determine if it is a counting error or an actual loss before deciding on reporting obligations.
Question 2: Under the Controlled Drugs and Substances Act (CDSA), which record must a pharmacy retain for a minimum of 2 years?
- Patient counselling notes
- Narcotic purchase invoices and receipts (Correct answer)
- Employee scheduling records
- Pharmacy benefit manager contracts
Correct answer: Narcotic purchase invoices and receipts
The CDSA requires that records of controlled substance purchases, sales, and transfers be retained for at least 2 years for audit purposes.
Question 3: A patient requests a copy of their prescription history for insurance purposes. Under PIPEDA, the pharmacy must:
- Refuse because prescription records are confidential health information
- Provide access within a reasonable time and at minimal cost (Correct answer)
- Require a court order before releasing any records
- Only release records directly to the insurer, not the patient
Correct answer: Provide access within a reasonable time and at minimal cost
PIPEDA grants individuals the right to access their own personal information held by organizations, including pharmacies, within a reasonable timeframe.
Question 4: A pharmacist is the designated manager of a pharmacy. Which of the following is a direct professional responsibility of the designated manager?
- Setting the retail prices for all over-the-counter products
- Ensuring the pharmacy operates in compliance with all applicable legislation (Correct answer)
- Approving all purchase orders placed by pharmacy buyers
- Negotiating contracts with generic drug manufacturers
Correct answer: Ensuring the pharmacy operates in compliance with all applicable legislation
The designated manager bears professional accountability for ensuring the pharmacy's operations comply with all relevant federal and provincial laws and regulations.
Question 5: A pharmacy wishes to implement an automated dispensing cabinet (ADC) for bedside narcotic access in a hospital. Which step is MOST critical before activation?
- Obtaining pricing approval from the provincial formulary committee
- Ensuring the ADC is registered as a controlled substance storage site per applicable regulations (Correct answer)
- Installing the cabinet in a room with at least two security cameras
- Obtaining written consent from every nurse who will access the cabinet
Correct answer: Ensuring the ADC is registered as a controlled substance storage site per applicable regulations
Controlled substance storage equipment and locations must be registered with the appropriate authority under the CDSA before any narcotics are placed in an ADC.
Question 6: Which principle guides the management of a pharmacy's 'slow-moving' inventory to minimize waste and financial loss?
- LIFO (Last In, First Out) stock rotation
- FIFO (First In, First Out) stock rotation (Correct answer)
- Ordering slow-moving items in bulk to reduce unit cost
- Returning all slow-moving products to the wholesaler monthly
Correct answer: FIFO (First In, First Out) stock rotation
FIFO rotation ensures that older stock (earliest expiry) is dispensed first, reducing the risk of expired product remaining on the shelf.
Question 7: A patient's provincial drug plan rejects a claim for a brand-name drug because a generic equivalent is listed. The prescriber has NOT indicated 'no substitution.' What should the pharmacist do?
- Dispense the brand-name drug and charge the patient full cost without informing them of alternatives
- Dispense the generic equivalent after informing the patient and obtaining their consent (Correct answer)
- Contact the plan to override the rejection without speaking to the patient
- Refuse to fill the prescription until the prescriber changes the order
Correct answer: Dispense the generic equivalent after informing the patient and obtaining their consent
Pharmacists must counsel patients about therapeutic substitution and obtain consent; dispensing the covered generic after informing the patient satisfies both the plan requirements and professional obligations.
PEBC PEBC Pharmacy Practice Management 4
A pharmacy technician notices a discrepancy between the narcotic inventory count and the narcotic register.
What is the pharmacist's FIRST required action?