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MI MPJE practice questions

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Question 1Federal and Michigan law, rules, and regulations governing pharmacy practice

Under Michigan law, a pharmacist may dispense a drug pursuant to a valid prescription that was transmitted orally by a prescriber. Which statement best describes the pharmacist's documentation obligation for an oral prescription for a non-controlled legend drug?

  1. The pharmacist must report every oral prescription to the Michigan Board of Pharmacy within 24 hours.
  2. The pharmacist may rely on memory and enter the drug only in the dispensing software without a prescription record.
  3. The pharmacist must obtain a written follow-up prescription from the prescriber before dispensing any quantity.
  4. The pharmacist must reduce the oral prescription to a written record promptly and retain it as required for prescriptions. Correct answer.

Explanation

Michigan permits oral prescriptions for legend drugs, but the pharmacist must promptly reduce the order to a written record and keep it as part of the prescription file. A written follow-up is not universally required, and routine reporting to the Board is not mandated.

Question 2Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy receives a prescription for a Schedule II controlled substance. Which dispensing limit applies to a prescription for a Schedule II drug under federal law?

  1. It may be refilled once within 30 days.
  2. It may be refilled indefinitely if the prescriber authorizes refills.
  3. It may not be refilled and is limited to the quantity authorized. Correct answer.
  4. It may be refilled up to five times within six months.

Explanation

Federal law prohibits refilling a Schedule II prescription; the pharmacist may dispense only the quantity specified, subject to partial-fill rules. Refills are permitted for Schedule III–V drugs within stated limits, not for Schedule II.

Question 3Federal and Michigan law, rules, and regulations governing pharmacy practice

A patient presents a Michigan prescription for a medication that is not a controlled substance. How long after the date of issue may a pharmacist generally dispense that prescription under Michigan law?

  1. Within 6 months of the date issued
  2. Within one year of the date issued Correct answer.
  3. Within 90 days of the date issued
  4. Within 30 days of the date issued

Explanation

Michigan generally allows a non-controlled prescription to be dispensed within one year of the date it was issued. Shorter windows in the options reflect controlled-substance or plan-specific limits rather than the general legend-drug rule.

Question 4Federal and Michigan law, rules, and regulations governing pharmacy practice

Which entity establishes the official compendium standards that Michigan pharmacies must follow for drug strength, quality, and purity?

  1. The Drug Enforcement Administration
  2. The United States Pharmacopeia–National Formulary Correct answer.
  3. The Michigan Department of Licensing and Regulatory Affairs
  4. The Michigan Board of Pharmacy alone

Explanation

The USP–NF is the recognized official compendium for drug standards of strength, quality, and purity referenced by federal and state pharmacy law. The Board, DEA, and LARA regulate practice and enforcement but do not set compendial drug standards.

Question 5Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy technician prepares a sterile compounded preparation. Which statement reflects the pharmacist's responsibility under Michigan law?

  1. The pharmacist must personally perform all compounding steps without assistance.
  2. The pharmacist has no responsibility if a written procedure exists.
  3. The pharmacist is responsible for supervising and verifying the compounded preparation before dispensing. Correct answer.
  4. The pharmacist may delegate final verification to another certified technician.

Explanation

Pharmacists retain responsibility for supervising pharmacy operations and verifying compounded preparations before they are dispensed. Delegation of tasks to technicians does not transfer the pharmacist's accountability for the final product.

Question 6Federal and Michigan law, rules, and regulations governing pharmacy practice

A prescriber telephones a pharmacy to authorize refills on an existing Schedule IV prescription. Which statement is correct under federal law?

  1. Refills are permitted only if the patient signs a refill log.
  2. Refills require a new written prescription each time.
  3. Schedule IV prescriptions may never be refilled.
  4. Refills on a Schedule IV prescription may be authorized orally, subject to the total refill and time limits. Correct answer.

Explanation

Schedule III–V prescriptions may be refilled, and federal rules permit oral authorization of refills as long as the total number of refills does not exceed five and dispensing occurs within six months of issue. Schedule IV drugs are not barred from refills.

Question 7Federal and Michigan law, rules, and regulations governing pharmacy practice

Which federal requirement applies to a pharmacy that dispenses a controlled substance and seeks to maintain a valid DEA registration?

  1. The pharmacy must maintain a current DEA registration for each registered location. Correct answer.
  2. The pharmacy may operate under the prescriber's DEA number.
  3. Registration is required only for Schedule II dispensing.
  4. Registration must be renewed annually with the state board only.

Explanation

Each location that dispenses controlled substances must hold its own current DEA registration. A pharmacy cannot operate under a prescriber's registration, and registration is not limited to Schedule II activity.

Question 8Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist receives a prescription that appears to have been altered in the quantity field. What is the most appropriate immediate action?

  1. Dispense the quantity as originally written and note the discrepancy.
  2. Dispense the altered quantity because the patient is waiting.
  3. Report the patient to law enforcement before any verification.
  4. Refuse to dispense and contact the prescriber to verify the prescription. Correct answer.

Explanation

A prescription that appears altered is not valid on its face, so the pharmacist should withhold dispensing and verify the order with the prescriber. Confirming the legitimate quantity resolves the ambiguity before any dispensing decision.

Question 9Federal and Michigan law, rules, and regulations governing pharmacy practice

Under the federal Controlled Substances Act, which schedule contains drugs with a currently accepted medical use and a high potential for abuse but no accepted medical use in the alternative?

  1. Schedule III
  2. Schedule I
  3. Schedule II Correct answer.
  4. Schedule IV

Explanation

Schedule II drugs have a currently accepted medical use but a high abuse potential that may lead to severe dependence. Schedule I drugs lack accepted medical use, while Schedules III and IV have progressively lower abuse potential.

Question 10Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy dispenses a prescription for a Schedule II stimulant to a patient. Which recordkeeping practice satisfies federal requirements for the dispensing?

  1. Recording only the total monthly quantity dispensed
  2. Recording the dispensing only on the prescription and not in any log
  3. Keeping records for 30 days and then destroying them
  4. Maintaining a readily retrievable record of the dispensing for at least two years Correct answer.

Explanation

Federal law requires registrants to keep records of controlled substances, including dispensing, in a readily retrievable form for at least two years. Records must be complete enough to account for the drugs received and dispensed.

Question 11Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy's automated counting device is used to fill prescriptions. Which statement best describes the pharmacist's duty regarding the accuracy of the final product?

  1. The pharmacist is relieved of verification duties because the device is automated.
  2. Only a technician needs to check the device output.
  3. The device manufacturer assumes responsibility for dispensing accuracy.
  4. The pharmacist must verify the accuracy of the filled prescription before it is dispensed. Correct answer.

Explanation

Automation assists counting and filling but does not displace the pharmacist's obligation to verify that the correct drug and quantity are dispensed. The pharmacist remains accountable for the final check.

Question 12Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist wants to substitute a therapeutically equivalent generic product for a brand-name prescription. Which condition must generally be met under Michigan law?

  1. The substitution must be permitted by the prescriber and the patient must be informed. Correct answer.
  2. The generic must cost less than 50 percent of the brand price.
  3. The patient must sign a written consent form for each substitution.
  4. The prescriber must be notified before every substitution.

Explanation

Michigan permits generic substitution when the prescriber has not prohibited it, and the patient must be informed of the substitution. The pharmacist also generally records the substitution on the prescription record.

Question 13Federal and Michigan law, rules, and regulations governing pharmacy practice

A patient asks a Michigan pharmacist to dispense a 90-day supply of a maintenance medication. Which consideration is most relevant under Michigan law?

  1. Only controlled substances may be dispensed in 90-day supplies.
  2. The pharmacist may extend any prescription to 90 days without prescriber authorization.
  3. Dispensing a larger supply is permissible when authorized by the prescriber and consistent with the prescription. Correct answer.
  4. Michigan law prohibits dispensing more than a 30-day supply of any drug.

Explanation

Michigan does not impose a blanket 30-day limit on legend drugs; a larger supply may be dispensed when the prescriber authorizes it. The pharmacist should confirm the quantity is consistent with the prescription and any applicable controlled-substance limits.

Question 14Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy receives a prescription for a controlled substance from an out-of-state prescriber. Which statement reflects the general rule for such prescriptions?

  1. A prescription from an out-of-state prescriber may be valid if the prescriber is properly registered and the prescription meets federal requirements. Correct answer.
  2. Out-of-state prescriptions are valid only for non-controlled drugs.
  3. Only Schedule II prescriptions from out-of-state prescribers are valid.
  4. Out-of-state prescribers can never issue valid controlled-substance prescriptions for Michigan patients.

Explanation

Federal law permits a prescription written by a DEA-registered practitioner in another state to be filled, provided it complies with federal requirements and applicable state rules. Out-of-state prescribers are not categorically barred.

Question 15Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist discovers that a patient is receiving duplicate therapy from two prescribers and is at risk of an adverse interaction. What is the pharmacist's most appropriate action?

  1. Contact one or both prescribers to resolve the duplication before dispensing. Correct answer.
  2. Dispense both prescriptions without comment to avoid interfering with prescriber decisions.
  3. Report the prescribers to the Board of Pharmacy immediately.
  4. Refuse to dispense both prescriptions permanently and close the patient's profile.

Explanation

Pharmacists have a duty to screen for therapeutic duplication and interactions and to communicate concerns to prescribers before dispensing. Direct prescriber contact allows the therapy to be clarified safely.

Question 16Federal and Michigan law, rules, and regulations governing pharmacy practice

Which federal law requires pharmacies to provide a patient with a written medication guide when dispensing certain drugs with serious risks?

  1. The Health Insurance Portability and Accountability Act
  2. The Food, Drug, and Cosmetic Act as implemented by FDA medication guide regulations Correct answer.
  3. The Poison Prevention Packaging Act
  4. The Controlled Substances Act

Explanation

FDA regulations under the Food, Drug, and Cosmetic Act require that medication guides be provided with certain drug products that carry serious and significant public health concerns. The guides are part of the approved labeling and must be distributed with each dispensing.

Question 17Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy dispenses a prescription for a Schedule III anabolic steroid. Which statement best describes the DEA recordkeeping requirement for the pharmacy's biennial inventory?

  1. Inventory records must be destroyed after one year.
  2. Only Schedule II drugs must be inventoried.
  3. A complete inventory of all controlled substances must be taken every two years, with Schedule II counted exactly. Correct answer.
  4. Inventory is required only when the pharmacy changes ownership.

Explanation

DEA requires a biennial inventory of all controlled substances, with exact counts for Schedule II and either exact or estimated counts for Schedules III–V. The inventory must be maintained with other required records.

Question 18Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist receives a faxed prescription for a Schedule II controlled substance. Which statement is generally correct?

  1. A faxed Schedule II prescription may serve as the original only in limited situations recognized by federal law. Correct answer.
  2. A faxed Schedule II prescription is never acceptable under any circumstance.
  3. A faxed Schedule II prescription is acceptable only for Schedule III drugs.
  4. A faxed Schedule II prescription is acceptable if the patient signs it.

Explanation

Federal law permits a faxed Schedule II prescription to serve as the original only in specified circumstances, such as certain long-term care or emergency situations. A patient signature does not convert a fax into a valid original.

Question 19Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy is inspected and the inspector requests records. Which statement best describes the pharmacy's obligation?

  1. The pharmacy may refuse all inspection requests without a warrant.
  2. Only the pharmacist-in-charge may speak with inspectors.
  3. The pharmacy must make required records available for inspection by authorized agents. Correct answer.
  4. Records may be withheld until the end of the calendar year.

Explanation

Registered pharmacies must keep required records and make them available for inspection by authorized federal and state agents. Refusing inspection or delaying access can violate recordkeeping requirements.

Question 20Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is asked to fill a prescription written by a prescriber whose DEA registration has expired. The drug is a Schedule IV controlled substance. What is the most appropriate action?

  1. Fill the prescription and notify the DEA afterward.
  2. Decline to fill until the prescriber's DEA registration is valid. Correct answer.
  3. Fill the prescription because the prescriber's state license remains active.
  4. Fill the prescription only if the patient pays cash.

Explanation

A prescriber must hold a valid DEA registration to issue a controlled-substance prescription, so the pharmacist should decline until registration is restored. A state license alone does not authorize controlled-substance prescribing.

Question 21Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy discovers that a significant quantity of a Schedule II drug is missing during inventory reconciliation. What is the most appropriate action?

  1. Adjust the inventory records to match the physical count without reporting.
  2. Wait until the next biennial inventory to report the discrepancy.
  3. Report the loss only to the wholesaler.
  4. Notify the DEA field office and complete the required theft or loss report. Correct answer.

Explanation

Registrants must report significant thefts or losses of controlled substances to the DEA field office and complete the required DEA Form 106. Adjusting records to conceal a loss or delaying until the next inventory violates reporting duties.

Question 22Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is considering whether to dispense a prescription that was issued using telehealth by a prescriber who has never conducted an in-person exam. Which statement best reflects the applicable federal framework?

  1. Telehealth prescriptions for controlled substances are always prohibited.
  2. Telehealth prescribing of controlled substances is governed by federal rules that impose specific conditions, including registration and evaluation requirements. Correct answer.
  3. Telehealth prescriptions are valid only if the pharmacy waives its verification duties.
  4. Telehealth prescriptions are valid only for non-controlled drugs.

Explanation

Federal law and DEA rules set conditions for prescribing controlled substances via telehealth, including practitioner registration and evaluation requirements. Compliance depends on meeting those conditions, not on a blanket prohibition.

Question 23Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy compounds a preparation that is essentially a copy of a commercially available drug product. Which statement best describes the applicable federal restriction?

  1. Compounding copies is permitted only for controlled substances.
  2. Compounding a copy of a commercially available drug is generally restricted unless a documented clinical need exists. Correct answer.
  3. Compounding copies is permitted if the patient requests it in writing.
  4. Compounding a copy of a commercially available drug is permitted without restriction.

Explanation

Federal law restricts compounding drugs that are essentially copies of commercially available products unless the prescriber documents a clinical need for the compounded version. The restriction applies regardless of the drug's schedule.

Question 24Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy receives a request from a patient's attorney for a copy of the patient's prescription records. Which statement best describes the appropriate response?

  1. The pharmacy may release records only after notifying the DEA.
  2. The pharmacy must release the records to any attorney who requests them.
  3. The pharmacy must refuse all attorney requests without exception.
  4. The pharmacy should release records only with proper patient authorization or as otherwise permitted by law. Correct answer.

Explanation

Patient records are confidential and generally may be disclosed only with the patient's authorization or as otherwise permitted or required by law. An attorney's request alone does not override that protection.

Question 25Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is asked to dispense a prescription for a drug that requires a Risk Evaluation and Mitigation Strategy (REMS) program. Which statement best describes the pharmacist's obligation?

  1. REMS applies only to controlled substances.
  2. The pharmacist must comply with the REMS requirements, which may include certification and documentation. Correct answer.
  3. REMS compliance is the prescriber's responsibility alone.
  4. The pharmacist may bypass REMS requirements if the patient signs a waiver.

Explanation

REMS programs impose requirements on the healthcare system, including pharmacies and pharmacists, such as certification, training, and documentation. Compliance is a shared responsibility and cannot be waived by the patient.

Question 26Federal and Michigan law, rules, and regulations governing pharmacy practice

Under Michigan law, a pharmacist may dispense a prescription drug pursuant to a valid prescription issued by a prescriber licensed in another state. Which condition must the Michigan pharmacist verify before dispensing?

  1. That the out-of-state prescriber holds a current license in good standing in the state of issuance Correct answer.
  2. That the out-of-state prescriber has applied for Michigan licensure
  3. That the out-of-state prescriber practices within 50 miles of the Michigan border
  4. That the out-of-state prescriber is board-certified in the relevant specialty

Explanation

Michigan recognizes prescriptions written by practitioners licensed in another state, provided the prescriber's license is current and in good standing in that jurisdiction. The pharmacist's corresponding responsibility is to confirm the prescriber's authority and the legitimacy of the order, not to require Michigan licensure or geographic proximity.

Question 27Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy technician may perform which of the following tasks without direct pharmacist supervision under Michigan law?

  1. Administering a vaccine to an adult patient
  2. Performing the final verification of a filled prescription
  3. Counseling a patient about a new prescription's side effects
  4. Entering prescription data into the pharmacy system for pharmacist review Correct answer.

Explanation

Michigan law permits trained pharmacy technicians to perform supportive tasks such as data entry and product preparation, with the pharmacist retaining responsibility for verification and counseling. Final verification and patient counseling are reserved to the pharmacist, and vaccine administration requires separate authorization and training.

Question 28Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy receives a written prescription for a Schedule II controlled substance that lacks the prescriber's DEA number. Which action best complies with federal and Michigan requirements?

  1. Decline to dispense and return the prescription to the patient without comment
  2. Verify the prescriber's DEA registration and document the number before dispensing Correct answer.
  3. Dispense the prescription and add the DEA number from the pharmacy's prescriber file
  4. Dispense the prescription and document that the DEA number was unavailable

Explanation

A prescription for a controlled substance must include the prescriber's DEA registration number, and the pharmacist may verify and document it from an authoritative source before dispensing. Supplying or omitting the number without verification undermines the prescription's validity.

Question 29Federal and Michigan law, rules, and regulations governing pharmacy practice

Which federal agency administers the registration system that a Michigan pharmacy must maintain in order to dispense controlled substances?

  1. The Food and Drug Administration
  2. The Centers for Medicare & Medicaid Services
  3. The Drug Enforcement Administration Correct answer.
  4. The Michigan Board of Pharmacy

Explanation

The DEA administers the registration system under the Controlled Substances Act, and a pharmacy must hold a valid DEA registration to dispense controlled substances. The FDA regulates drug approval and labeling, CMS administers federal payment programs, and the Michigan Board of Pharmacy handles state licensure.

Question 30Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist fills a prescription for a drug that carries a boxed warning. Which statement best describes the pharmacist's obligation regarding the medication guide?

  1. The guide is required only for controlled substances
  2. The guide may be replaced by a verbal warning at the pharmacist's discretion
  3. The guide may be provided only if the patient requests it
  4. The guide must be provided when the drug meets the federal criteria for a medication guide Correct answer.

Explanation

Federal regulations require that a medication guide be provided to the patient when the drug is one for which the FDA has determined a guide is necessary for safe and effective use. The obligation is not discretionary and is not limited to controlled substances.

Question 31Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy is closing permanently and must dispose of its remaining controlled substances. Which statement best describes the required handling?

  1. The drugs may be sold to another pharmacy without DEA involvement
  2. The drugs may be discarded in the regular trash after being rendered unusable
  3. The drugs may be kept by the pharmacist for personal use
  4. The drugs must be transferred or destroyed in accordance with DEA requirements and documented Correct answer.

Explanation

Disposal or transfer of controlled substances on closure must follow DEA requirements, including proper documentation and use of authorized methods or registrants. Unregulated disposal or personal retention violates the Controlled Substances Act.

Question 32Federal and Michigan law, rules, and regulations governing pharmacy practice

Under Michigan law, which individual is authorized to prescribe a prescription drug?

  1. A pharmacy intern working under a preceptor
  2. A licensed practitioner acting within the scope of the practitioner's license Correct answer.
  3. A certified pharmacy technician
  4. A pharmacy student on an experiential rotation

Explanation

Prescriptive authority belongs to licensed practitioners acting within the scope of their license, such as physicians, dentists, and other authorized prescribers. Interns, technicians, and students may participate in the dispensing process but cannot prescribe.

Question 33Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is asked to dispense a prescription for a drug that is not FDA-approved but is legally available through a specific regulatory pathway. Which statement best describes the pharmacist's role?

  1. The pharmacist may dispense it without any documentation because it is not a controlled substance
  2. The pharmacist may dispense it only if all federal requirements for that pathway are satisfied Correct answer.
  3. The pharmacist may dispense it only after obtaining a Michigan Board of Pharmacy variance
  4. The pharmacist may dispense it only if the patient signs a waiver of all liability

Explanation

Drugs available through special federal pathways, such as investigational or unapproved-product mechanisms, may be dispensed only when the applicable federal requirements are met. A patient waiver or state variance is not the governing standard.

Question 34Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy receives a prescription for a Schedule II opioid for a patient who has not previously received opioids from this pharmacy. Which action best supports the pharmacist's corresponding responsibility?

  1. Dispensing a partial quantity and referring the patient elsewhere
  2. Dispensing the prescription and noting that the patient was new to the pharmacy
  3. Refusing to dispense solely because the patient is new to the pharmacy
  4. Contacting the prescriber and reviewing the patient's controlled-substance history before dispensing Correct answer.

Explanation

The pharmacist's corresponding responsibility requires a good-faith evaluation of the prescription's legitimacy, which may include verifying with the prescriber and reviewing the patient's controlled-substance history. Refusing solely because the patient is new, or dispensing without evaluation, does not satisfy that duty.

Question 35Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy's prescription department is being remodeled, and the pharmacy will be closed for two weeks. Which statement best describes the required notification?

  1. No notification is required because the closure is temporary
  2. The Michigan Board of Pharmacy must be notified in accordance with its rules Correct answer.
  3. Only the DEA must be notified of the closure
  4. Only the pharmacy's wholesaler must be notified of the closure

Explanation

Michigan rules require a pharmacy to notify the Board of Pharmacy of changes affecting its operation, including temporary closure, so that licensure records remain accurate. Notice to the wholesaler or DEA alone does not satisfy the state requirement.

Question 36Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist receives a prescription for a Schedule V cough preparation containing codeine. Which statement best describes the federal dispensing requirements?

  1. The prescription must be written on a tamper-resistant form
  2. The prescription may be refilled indefinitely if the prescriber authorizes it
  3. The prescription may be dispensed without a prescription only if state law permits and specific conditions are met Correct answer.
  4. The prescription is subject to the same recordkeeping as Schedule II drugs

Explanation

Certain Schedule V products may be sold without a prescription only when state law allows and the federal conditions, such as recordkeeping and quantity limits, are satisfied. Schedule V prescriptions are not subject to Schedule II tamper-resistant form rules and cannot be refilled indefinitely.

Question 37Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist discovers that a prescription was dispensed with the wrong drug strength, and the patient has already taken one dose. Which action best reflects the pharmacist's professional obligation?

  1. Adjust the patient's record to reflect the intended strength without notifying anyone
  2. Wait for the patient to return to the pharmacy before addressing the error
  3. Contact the patient and prescriber, document the intervention, and report as required Correct answer.
  4. Document the error internally and take no further action if the patient reports no symptoms

Explanation

A dispensing error requires prompt disclosure to the patient and prescriber, documentation of the intervention, and reporting when required by law or policy. Silence or record alteration does not meet the pharmacist's professional and legal obligations.

Question 38Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy wants to provide a prescription refill to a patient whose prescriber cannot be reached and whose medication is not a controlled substance. Which statement best describes the pharmacist's authority?

  1. The pharmacist may never refill without prescriber contact
  2. The pharmacist may refill only if the patient signs a release
  3. The pharmacist may authorize a limited emergency refill under Michigan law when specific conditions are met Correct answer.
  4. The pharmacist may refill indefinitely as long as the patient has taken the drug before

Explanation

Michigan law permits a pharmacist to provide a limited emergency refill of certain non-controlled maintenance medications when the prescriber cannot be reached and defined conditions are satisfied. The authority is limited and does not permit indefinite refilling.

Question 39Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy dispenses a controlled substance to a patient and later learns that the patient presented a forged prescription. Which statement best describes the pharmacy's obligation?

  1. The pharmacy must report the forgery only to the prescriber
  2. The pharmacy must absorb the loss and take no further action
  3. The pharmacy must report the forgery to law enforcement and document the incident Correct answer.
  4. The pharmacy may report the forgery only if the value exceeds a statutory threshold

Explanation

A forged prescription involving a controlled substance should be reported to law enforcement and documented in the pharmacy's records. Reporting to the prescriber alone does not satisfy the obligation, and there is no value threshold that excuses reporting.

Question 40Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is asked to dispense a prescription written by a physician assistant. Which statement best describes the requirement for the prescription to be valid?

  1. The prescription is invalid because physician assistants cannot prescribe
  2. The prescription is valid only if the physician assistant personally delivers it
  3. The prescription is valid only for non-controlled substances
  4. The prescription must be within the physician assistant's scope and any required supervision or delegation arrangement Correct answer.

Explanation

A prescription from a physician assistant is valid when it falls within the PA's scope of practice and complies with any supervision, delegation, or practice-agreement requirements. Physician assistants may prescribe, including controlled substances where authorized.

Question 41Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy maintains a perpetual inventory of Schedule II drugs. Which statement best describes the purpose of this practice?

  1. It allows the pharmacy to dispense without a prescription in emergencies
  2. It helps the pharmacy reconcile receipts, dispensings, and losses to detect diversion Correct answer.
  3. It satisfies the DEA requirement for a perpetual inventory of all controlled substances
  4. It replaces the requirement to take a biennial inventory

Explanation

A perpetual inventory is an internal accountability tool that helps a pharmacy reconcile Schedule II receipts, dispensings, and losses and detect diversion. It does not replace the federally required biennial inventory or create dispensing authority.

Question 42Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist receives a request to transfer a prescription for a non-controlled drug to another pharmacy. Which statement best describes the transfer?

  1. The transfer requires the prescriber's prior approval in every case
  2. The transfer may be made once and the original pharmacy must retain a record Correct answer.
  3. The transfer may be made only with the patient's written consent notarized by a third party
  4. The transfer is prohibited for all non-controlled drugs

Explanation

Transfers of non-controlled prescriptions are permitted between pharmacies with appropriate documentation, and the transferring pharmacy must retain a record of the transfer. Notarized consent and prescriber approval in every case are not required.

Question 43Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy is asked to dispense a drug that is the subject of a Risk Evaluation and Mitigation Strategy with elements to assure safe use. Which statement best describes the pharmacy's obligation?

  1. The pharmacy may dispense if the prescriber assures the pharmacist verbally that requirements are met
  2. The pharmacy may dispense if the patient signs a general consent form
  3. The pharmacy may dispense because REMS requirements apply only to manufacturers
  4. The pharmacy must be certified or enrolled as required by the REMS before dispensing Correct answer.

Explanation

When a REMS includes elements to assure safe use that apply to dispensing, the pharmacy must satisfy the certification or enrollment requirements before dispensing. Verbal assurances or general consent forms do not substitute for the required REMS conditions.

Question 44Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is reviewing a prescription for a patient receiving warfarin and is asked to add an over-the-counter product. Which action best reflects the pharmacist's role in preventing a drug interaction?

  1. Refer the patient to the prescriber without providing any information
  2. Refuse to discuss nonprescription products with the patient
  3. Dispense the product without discussion because it is nonprescription
  4. Recommend the product and counsel the patient on interaction risk and monitoring Correct answer.

Explanation

The pharmacist should evaluate the interaction potential, counsel the patient on risk, and recommend monitoring or alternatives as appropriate. Simply dispensing without discussion or refusing to engage fails the pharmacist's counseling role.

Question 45Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy stores a small amount of a Schedule II drug in a locked cabinet. Which statement best describes the federal security requirement?

  1. The drug may be stored in any unlocked area if the pharmacy is staffed
  2. The drug may be stored in the refrigerator with other medications
  3. The drug must be stored in a bank vault at all times
  4. The drug must be stored in a securely locked, substantially constructed cabinet or dispersed to deter diversion Correct answer.

Explanation

Federal regulations require Schedule II drugs to be stored in a securely locked, substantially constructed cabinet or dispersed throughout the stock in a manner that deters diversion. A bank vault is not required, and unlocked storage is not permitted.

Question 46Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy is audited and the auditor requests the power of attorney for a DEA Form 222 used to order a Schedule II drug. Which statement best describes the recordkeeping requirement?

  1. The power of attorney must be filed with the Michigan Board of Pharmacy
  2. The power of attorney is required only for Schedule III drugs
  3. The power of attorney may be discarded once the order is received
  4. The power of attorney must be retained with the executed order forms for the required period Correct answer.

Explanation

A power of attorney authorizing an agent to execute DEA order forms must be retained with the executed forms for the required records period. It is not discarded after receipt and is not filed with the state Board.

Question 47Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist receives a prescription for a Schedule II drug written on a form that lacks the prescriber's signature but includes a stamped signature. Which statement best describes the validity of the prescription?

  1. The stamped signature is acceptable if the patient signs the back of the form
  2. The stamped signature is acceptable for Schedule II drugs if the pharmacy verifies by phone
  3. The prescription is invalid because a stamped signature is not acceptable for Schedule II drugs Correct answer.
  4. The stamped signature is acceptable if the prescriber's DEA number is present

Explanation

A Schedule II prescription must bear the prescriber's manual signature; a stamped or reproduced signature does not satisfy the requirement. Verification by phone or the patient's signature does not cure the defect.

Question 48Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy discovers a discrepancy between the quantity of a Schedule II drug received and the quantity recorded on the invoice. Which action best reflects the required handling?

  1. Document the discrepancy and resolve it with the supplier and, if diversion is suspected, report it Correct answer.
  2. Correct the invoice to match the recorded quantity without notifying anyone
  3. Discard the drug and record it as a loss without further documentation
  4. Adjust the perpetual inventory to match the invoice without investigation

Explanation

A receipt discrepancy must be documented and resolved with the supplier, with investigation and reporting if diversion is suspected. Altering records to force agreement undermines accountability and may conceal diversion.

Question 49Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacist is considering whether a prescription for a controlled substance issued via telehealth by a prescriber the pharmacist has never encountered is valid. Which approach best reflects the applicable legal framework?

  1. The prescription is valid only if the prescriber is physically located in Michigan
  2. The prescription is valid if the patient confirms a prior relationship with the prescriber
  3. The prescription is automatically invalid because it was issued via telehealth
  4. The pharmacist should verify the prescriber's registration and applicable federal and state telehealth requirements before dispensing Correct answer.

Explanation

Validity depends on the prescriber's registration and compliance with applicable federal and state telehealth prescribing requirements, which the pharmacist should verify. Telehealth prescriptions are not automatically invalid, and physical location in Michigan is not the sole test.

Question 50Federal and Michigan law, rules, and regulations governing pharmacy practice

A Michigan pharmacy compounds a preparation that is essentially a copy of a commercially available drug. Which statement best describes the federal restriction?

  1. Compounding a copy of a commercially available drug is permitted if the patient requests it
  2. Compounding a copy is prohibited unless the commercially available product is on the FDA shortage list or a clinical difference exists Correct answer.
  3. Compounding a copy is permitted if the pharmacy documents a cost savings
  4. Compounding a copy is permitted only for controlled substances

Explanation

Federal law restricts compounding of essentially copies of commercially available drugs unless the commercially available product appears on the FDA shortage list or the prescriber determines a clinical difference for the patient. Patient request or cost savings does not create an exception.