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Question 1Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

The Missouri Board of Pharmacy operates administratively within which of the following?

  1. The Division of Professional Registration Correct answer.
  2. The Missouri State Board of Healing Arts
  3. The Missouri Department of Health and Senior Services
  4. The Office of the Missouri Attorney General

Explanation

The Missouri Board of Pharmacy is a professional licensing board placed within the Division of Professional Registration, which is part of the Department of Commerce and Insurance. It licenses pharmacists, pharmacies, and related entities and enforces the Pharmacy Practice Act.

Question 2Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which activity falls within the practice of pharmacy under Missouri law?

  1. Interpreting and evaluating drug orders Correct answer.
  2. Making an independent medical diagnosis
  3. Performing surgical procedures
  4. Admitting patients for inpatient hospital care

Explanation

The statutory definition of pharmacy practice centers on interpreting, evaluating, compounding, dispensing, and administering drugs and devices, plus related patient care functions. Diagnosis and surgery remain medical acts, and hospital admission is a medical or administrative function.

Question 3Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Every Missouri-licensed pharmacy must designate which of the following?

  1. A certified pharmacy technician as supervisor
  2. A pharmacist-in-charge licensed in Missouri Correct answer.
  3. A physician medical director on the premises
  4. A Board-appointed auditor stationed in the store

Explanation

A licensed pharmacy must have a designated pharmacist-in-charge who holds a Missouri pharmacist license and is responsible for the pharmacy's compliance with the law and Board rules. The designation must be reported to the Board.

Question 4Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When may a Missouri pharmacy be open for business and dispense prescriptions?

  1. Only during the Board's regular business hours
  2. Whenever a certified technician is on the premises
  3. Whenever the pharmacist-in-charge can be reached by phone
  4. Only while a Missouri-licensed pharmacist is on duty Correct answer.

Explanation

A pharmacy may not operate unless a licensed pharmacist is on duty and in charge of dispensing activities. Telephone availability of the pharmacist-in-charge does not satisfy the on-site supervision requirement.

Question 5Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which statement about pharmacy technicians in Missouri is correct?

  1. They may perform nonjudgmental tasks delegated to them Correct answer.
  2. They may independently verify prescriptions filled by others
  3. They may counsel patients about new prescriptions
  4. They must hold a Board-issued license before handling drugs

Explanation

Missouri does not license or register pharmacy technicians; instead, a pharmacist may delegate technical, nonjudgmental functions and retains responsibility for the outcome. Counseling and final verification involve professional judgment and remain pharmacist duties.

Question 6Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Under Missouri rules, counseling for a new prescription must be:

  1. Offered by the pharmacist, and the patient may decline it Correct answer.
  2. Given only in writing, with no verbal offer required
  3. Provided by any trained employee working in the pharmacy
  4. Required only when the prescriber asks for it

Explanation

The pharmacist must offer counseling to the patient or the patient's agent each time a new prescription is dispensed. The offer is documented, and a patient is free to decline the consultation.

Question 7Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which item must appear on the label of a prescription dispensed in Missouri?

  1. The pharmacist's home telephone number
  2. The prescription number Correct answer.
  3. The prescriber's DEA registration number
  4. The patient's diagnosis and treatment plan

Explanation

Prescription labels must include identifying information such as the pharmacy name and address, the prescription number, the date, the patient and prescriber names, directions for use, and the drug name and quantity. A diagnosis and the prescriber's DEA number are not label requirements.

Question 8Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When a Missouri pharmacist substitutes a therapeutically equivalent generic drug, the pharmacist must:

  1. Report the substitution to the Board within 24 hours
  2. Inform the patient or the patient's agent of the substitution Correct answer.
  3. Return the brand product to the wholesaler for credit
  4. Obtain the prescriber's verbal consent before each substitution

Explanation

Substitution of a less expensive therapeutic equivalent is permitted unless the prescriber indicates that the brand product must be dispensed. The patient or the patient's agent must be told about the substitution and may refuse it, and the substitution is documented.

Question 9Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacist may dispense naloxone without a patient-specific prescription because:

  1. The patient must first be evaluated by a physician
  2. The Board writes a patient-specific prescription for each request
  3. Naloxone is not a prescription drug in Missouri
  4. A statewide standing order authorizes dispensing Correct answer.

Explanation

Missouri uses a statewide standing order that permits pharmacists to dispense an opioid antagonist to persons at risk of opioid overdose without a prescription naming the patient. The pharmacist provides the required education on administration.

Question 10Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Before administering immunizations, a Missouri pharmacist must:

  1. Complete immunization training and hold CPR certification Correct answer.
  2. Obtain a Board license for each vaccine product administered
  3. Limit practice to patients admitted to a hospital
  4. Have a physician on site for every dose administered

Explanation

Immunizing pharmacists must complete an approved immunization training program and maintain current CPR certification, and they administer vaccines under the authority established in the Pharmacy Practice Act and Board rules. Physician presence at each dose is not required.

Question 11Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which is required for a collaborative practice arrangement in Missouri?

  1. Renewal of the arrangement every 30 days
  2. Filing a copy of the arrangement with DEA
  3. A written agreement signed by both parties Correct answer.
  4. Prior approval of each arrangement by the Board

Explanation

A collaborative practice arrangement must be set out in a written agreement between the physician and the pharmacist defining the delegated authority, and it is subject to periodic review rather than Board pre-approval of each agreement.

Question 12Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Missouri-licensed pharmacies must maintain:

  1. A continuous quality improvement program Correct answer.
  2. A board-certified error investigator on staff
  3. A monthly inventory audit notarized by the pharmacist-in-charge
  4. A liability waiver signed by each patient

Explanation

Missouri requires each pharmacy to operate a continuous quality improvement program to identify, document, and analyze quality-related events such as dispensing errors. The goal is system improvement rather than assigning individual blame.

Question 13Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which of the following is grounds for Board of Pharmacy discipline?

  1. Telling a patient's physician about a dispensing error
  2. Honoring a patient's decision to decline counseling
  3. Dispensing a drug without a valid prescription Correct answer.
  4. Refusing to fill a prescription the pharmacist believes is forged

Explanation

Dispensing a prescription drug without a valid prescription is unlawful and constitutes grounds for discipline, as does failing to maintain records or practicing while impaired. Exercising professional judgment to refuse a suspicious prescription and reporting errors are proper practices.

Question 14Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacy license must be:

  1. Displayed conspicuously in the pharmacy Correct answer.
  2. Posted only at the corporate office
  3. Mailed to the Board with each renewal
  4. Kept at the pharmacist-in-charge's residence

Explanation

The pharmacy license must be displayed in a conspicuous place in the licensed premises where the public can see it. Pharmacist licenses are likewise subject to display or ready availability requirements.

Question 15Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A pharmacy discovers that controlled substances were stolen. The pharmacist-in-charge must:

  1. Report the loss to the Board and to DEA Correct answer.
  2. Replace the drugs and take no further action
  3. Disclose the loss at the next Board inspection
  4. Report the loss only to the local police department

Explanation

Significant thefts or losses of controlled substances must be reported promptly to the Board of Pharmacy and to DEA, with the DEA report made on the appropriate federal form. Local police reporting may also occur but does not satisfy the regulatory obligations.

Question 16Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Refills of a Schedule II prescription are:

  1. Permitted once within 72 hours
  2. Permitted up to five times in six months
  3. Permitted if the prescriber authorizes them in writing
  4. Prohibited Correct answer.

Explanation

Schedule II prescriptions cannot be refilled under any circumstance; a new prescription is required for additional dispensing. Missouri follows the federal controlled substances framework on this point.

Question 17Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Prescription records in a Missouri pharmacy must be:

  1. Kept only for controlled substances
  2. Destroyed once the patient picks up the drug
  3. Available to Board inspectors on request Correct answer.
  4. Forwarded to the Board each week

Explanation

Dispensing records must be maintained in the pharmacy and be readily retrievable for inspection by the Board and other authorized agents. Retention obligations apply to all prescriptions, not just controlled substances.

Question 18Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A pharmacy intern practicing in Missouri must:

  1. Counsel patients independently
  2. Be registered with the Board Correct answer.
  3. Practice without pharmacist supervision
  4. Hold a current Missouri pharmacist license

Explanation

Pharmacy interns must be registered with the Board and may perform pharmacist functions only under the supervision of a licensed pharmacist. Interns are typically students or graduates of an accredited college of pharmacy.

Question 19Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

An oral prescription received by a Missouri pharmacy must be:

  1. Verified with the Board before dispensing
  2. Refused unless a written copy arrives within 24 hours
  3. Recorded only if the drug is a controlled substance
  4. Reduced to writing and retained by the pharmacy Correct answer.

Explanation

Oral prescription orders are valid, but the pharmacist must promptly reduce the order to writing and keep it in the prescription file. The same documentation duty applies whether or not the drug is a controlled substance.

Question 20Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Board of Pharmacy inspectors may:

  1. Search a pharmacist's home without cause
  2. Inspect only the controlled substance inventory
  3. Inspect only with a court-issued warrant
  4. Enter and inspect during business hours Correct answer.

Explanation

Authorized agents of the Board may enter and inspect a licensed pharmacy during business hours to determine compliance with the Pharmacy Practice Act and Board rules. The inspection authority covers the licensed premises generally.

Question 21Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacist receives a prescription that appears forged. The pharmacist should:

  1. Report it to the Board before contacting the prescriber
  2. Contact the prescriber to verify before dispensing Correct answer.
  3. Dispense it and document the concern afterwards
  4. Fill only half the quantity to limit the risk

Explanation

A pharmacist has a corresponding responsibility to resolve red flags before dispensing, and the first step is independent verification with the prescriber. If the order proves invalid, the pharmacist declines to dispense and may report the matter.

Question 22Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which statement about Missouri's prescription monitoring program is correct?

  1. Reporting is optional for chain pharmacies
  2. It replaces the pharmacy's duty to keep dispensing records
  3. Pharmacies must report controlled substance dispensing Correct answer.
  4. Only patients may request their own records from it

Explanation

Dispensing pharmacies are required to submit information about controlled substance prescriptions to the state monitoring program, and authorized prescribers and pharmacists may query it. The program supplements, but does not replace, the pharmacy's own recordkeeping duties.

Question 23Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

In Missouri, pharmacist administration of a drug by injection requires:

  1. A Class A pharmacy license
  2. Physician authorization and pharmacist training Correct answer.
  3. That the drug is not a controlled substance
  4. A signed waiver of physician oversight from the patient

Explanation

Pharmacists may administer drugs by injection when acting under a physician's order or protocol and when they have the required training and certification. Authority derives from the practice act and related statutes rather than from a patient waiver.

Question 24Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacist who works while impaired by alcohol:

  1. May keep working if the pharmacist-in-charge does not object
  2. Must be reported only to local law enforcement
  3. Commits unprofessional conduct Correct answer.
  4. Is excused if enrolled in a treatment program

Explanation

Practicing while impaired constitutes unprofessional conduct and exposes the licensee to Board discipline, including suspension or restrictions. Participation in a treatment program may be considered in resolving a case but does not authorize impaired practice.

Question 25Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which is required for a prescription drug order to be valid in Missouri?

  1. It is filled within 24 hours of issuance
  2. It includes the patient's insurance information
  3. It is handwritten on the prescriber's letterhead
  4. It is issued by an authorized prescriber Correct answer.

Explanation

A valid order must come from a practitioner licensed and authorized to prescribe the drug, and it must contain the elements required by law, including the patient, drug, directions, and prescriber identification. Letterhead, fill speed, and insurance data are not validity requirements.

Question 26Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

In a Missouri pharmacy, which function may be performed only by a licensed pharmacist?

  1. Entering prescription data into the computer
  2. Counting and pouring tablets
  3. Recording the date a prescription was filled
  4. Verifying the completed prescription Correct answer.

Explanation

Final verification of a dispensed prescription is a professional function reserved to the licensed pharmacist. Non-pharmacist personnel may assist with data entry, counting, and record keeping but may not perform the final check.

Question 27Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A person who will work as a pharmacy technician in a Missouri pharmacy must first:

  1. Pass the NAPLEX examination
  2. Register with the Missouri Board of Pharmacy Correct answer.
  3. Complete an ACPE-accredited residency
  4. Obtain a DEA registration number

Explanation

Missouri requires pharmacy technicians to be registered with the Board of Pharmacy before performing technician duties. Registration is separate from pharmacist licensure and carries its own application and fee requirements.

Question 28Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Each Missouri pharmacy is required to have:

  1. At least two registered technicians
  2. A 24-hour drive-through window
  3. A sterile compounding area
  4. A designated pharmacist-in-charge Correct answer.

Explanation

Missouri requires every licensed pharmacy to designate a pharmacist-in-charge who is accountable for the pharmacy's compliance with the law. The other features listed are not universal prerequisites for licensure.

Question 29Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

The Missouri Board of Pharmacy operates within which state entity?

  1. The Missouri Medicaid Audit and Compliance Unit
  2. The Department of Health and Senior Services
  3. The Office of the Attorney General
  4. The Division of Professional Registration Correct answer.

Explanation

The Board of Pharmacy is an administrative unit placed within the Division of Professional Registration, which is part of the Department of Commerce and Insurance. The Division supplies administrative support while the Board exercises its licensing and disciplinary functions.

Question 30Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacy receives a new prescription written by a physician who is licensed in Kansas and who has never been licensed in Missouri. How should the pharmacist treat the prescription?

  1. It may be filled as written Correct answer.
  2. It may be filled only as a seven-day emergency supply
  3. It may be filled only if a Missouri physician co-signs it
  4. It must be refused because the prescriber lacks Missouri licensure

Explanation

Missouri recognizes prescriptions issued by practitioners who are properly licensed in another jurisdiction, provided the order is otherwise valid and the pharmacist can verify it. There is no requirement that the prescriber hold a Missouri license or that a local practitioner co-sign.

Question 31Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When a Missouri pharmacy sells pseudoephedrine without a prescription, the pharmacy must:

  1. Require photo identification and record the sale Correct answer.
  2. Report each sale to the Board of Pharmacy
  3. Limit the sale to one box per customer
  4. Obtain verbal authorization from a pharmacist

Explanation

Missouri law restricts over-the-counter sales of ephedrine and pseudoephedrine products, requiring the purchaser to present photo identification and the seller to maintain a record of the transaction. Quantity limits also apply per day and per thirty-day period.

Question 32Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A pharmacy located in another state that ships prescription drugs to Missouri patients must:

  1. Employ at least one Missouri-licensed pharmacist
  2. Be registered with the Missouri Board of Pharmacy Correct answer.
  3. Hold a Missouri Class A pharmacy license
  4. Maintain a business address in Missouri

Explanation

Out-of-state pharmacies that dispense to Missouri patients must register with the Missouri Board of Pharmacy and comply with Missouri requirements for those prescriptions. They are not required to relocate or duplicate their in-state licensed staff.

Question 33Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

During hours when no pharmacist is present, a Missouri pharmacy must:

  1. Allow technicians to fill prescriptions already in process
  2. Post a notice listing the pharmacist's return time
  3. Be secure so that drugs cannot be removed Correct answer.
  4. Remain open for the sale of over-the-counter items

Explanation

A pharmacy must be locked and secured whenever a pharmacist is not on duty so that prescription drugs cannot be removed or dispensed. Dispensing activity cannot continue without pharmacist presence.

Question 34Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

The pharmacist-in-charge of a Missouri pharmacy is primarily responsible for:

  1. Setting the salaries of pharmacy employees
  2. Personally working every shift the pharmacy is open
  3. Approving the Board's annual budget
  4. Ensuring compliance with pharmacy laws Correct answer.

Explanation

The pharmacist-in-charge is accountable for the pharmacy's compliance with the Pharmacy Practice Act and Board rules, including record keeping and supervision of personnel. The role does not require working every shift.

Question 35Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

To serve as pharmacist-in-charge of a Missouri pharmacy, a person must:

  1. Hold a PharmD degree
  2. Hold a current Missouri pharmacist license Correct answer.
  3. Have practiced for at least five years
  4. Reside in the county where the pharmacy is located

Explanation

Only a pharmacist currently licensed in Missouri and in good standing may serve as pharmacist-in-charge. Practice experience, degree type, and local residency are not conditions of the role.

Question 36Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When a Missouri pharmacy appoints a new pharmacist-in-charge, the pharmacy must:

  1. Notify the Board of Pharmacy Correct answer.
  2. Repeat the pharmacy's initial inspection
  3. Obtain a new DEA registration
  4. Apply for a new pharmacy license

Explanation

A change in pharmacist-in-charge must be reported to the Board so that the registration record identifies the responsible pharmacist. The pharmacy license itself continues in effect and is not reissued for this change.

Question 37Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

In a Missouri hospital pharmacy, a drug may be dispensed for an inpatient pursuant to:

  1. An entry in the pharmacy's purchase log
  2. A chart order in the patient's record Correct answer.
  3. A verbal order given to a technician
  4. A standing order written by a nurse

Explanation

Institutional pharmacies may dispense drugs for inpatients on the basis of the prescriber's order recorded in the patient's medical record, often called a chart order. Orders cannot originate from technicians, nursing standing orders, or inventory documents.

Question 38Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Missouri pharmacy rules require that a patient medication record be maintained for:

  1. Only patients enrolled in Medicaid
  2. Only patients receiving controlled substances
  3. Each patient for whom a prescription is dispensed Correct answer.
  4. Only patients who request counseling

Explanation

Pharmacies must keep a patient record system covering every patient for whom a prescription is dispensed, so that the pharmacist can screen for interactions, allergies, and duplicative therapy. The requirement is not limited by payer or drug schedule.

Question 39Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When a Missouri pharmacist transfers a prescription to another pharmacy, the pharmacist must:

  1. Document the transfer in the prescription record Correct answer.
  2. Obtain approval from the Board of Pharmacy
  3. Send the original hard copy to the receiving pharmacy
  4. Cancel all remaining refills on the original

Explanation

A transfer must be communicated completely and documented on the transferring pharmacy's record, including the receiving pharmacy and the pharmacist involved. The original prescription is retained by the transferring pharmacy.

Question 40Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacist license is renewed:

  1. Every three years
  2. Every year
  3. Only when the pharmacist changes employment
  4. Every two years Correct answer.

Explanation

Missouri pharmacist licenses are renewed on a biennial cycle, with continuing education completed during each renewal period. Renewal is not tied to a change of employer.

Question 41Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

To renew a Missouri pharmacist license, the pharmacist must complete:

  1. No continuing education once licensed for 20 years
  2. 40 hours of continuing education every two years
  3. 10 hours of continuing education each year
  4. 30 hours of continuing education every two years Correct answer.

Explanation

Missouri requires 30 contact hours of continuing education per biennial renewal period, obtained from approved providers. There is no exemption based on years of licensure.

Question 42Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Prescription records maintained by a Missouri pharmacy may be released to a third party:

  1. Only if the pharmacy's owner approves the release
  2. Whenever a law enforcement officer asks informally
  3. Only as permitted or required by law Correct answer.
  4. Whenever the patient's employer requests them

Explanation

Patient prescription information is confidential and may be disclosed only when the law permits or compels it, such as with patient authorization, a valid subpoena, or a Board inquiry. Informal requests from employers or officers do not create authority to release records.

Question 43Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When a Missouri pharmacy discovers an expired drug in stock, the pharmacy must:

  1. Return it to the shelf until the end of the month
  2. Remove it from dispensing stock Correct answer.
  3. Sell it at a discount as an over-the-counter item
  4. Dispense it with a revised expiration date on the label

Explanation

Outdated drugs must be quarantined and removed from active dispensing stock so they cannot be dispensed to patients. Altering dates or continuing to hold them in the dispensing area is prohibited.

Question 44Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Which statement about a prescription drug returned by a patient to a Missouri pharmacy is correct?

  1. It may not be redispensed to another patient Correct answer.
  2. It may be redispensed if returned within 30 days
  3. It may be redispensed if the seal is unbroken
  4. It may be redispensed after pharmacist inspection

Explanation

Once a prescription drug has left the pharmacy's control, the pharmacy cannot assure its identity, strength, or storage conditions, so the product may not be returned to stock and dispensed to another patient. It must be handled for disposal in accordance with the law.

Question 45Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

A Missouri pharmacist facing disciplinary action by the Board of Pharmacy is entitled to:

  1. A jury trial in circuit court
  2. An administrative hearing on the charges Correct answer.
  3. Free legal counsel provided by the Board
  4. An automatic stay of all Board action

Explanation

Disciplinary proceedings before the Board are conducted as contested cases with a hearing at which the licensee may appear, present evidence, and be represented by counsel of their choosing. Judicial review of the Board's final decision is available afterward in the circuit court.

Question 46Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

In Missouri, a prescription-only drug may be dispensed to a patient only:

  1. Pursuant to a valid prescription Correct answer.
  2. After the patient signs a written consent
  3. When the pharmacist decides it is appropriate
  4. With prior approval from the Board of Pharmacy

Explanation

Legend drugs require a valid prescription from a licensed prescriber before they may be dispensed, with only narrow statutory exceptions. A pharmacist's clinical judgment or a patient's consent does not substitute for a prescription.

Question 47Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Absent a collaborative practice arrangement or other specific authorization, a Missouri pharmacist may not:

  1. Administer a vaccine to an adult
  2. Substitute a therapeutically equivalent generic
  3. Initiate drug therapy for a patient Correct answer.
  4. Dispense a drug on a physician's prescription

Explanation

Missouri pharmacists do not have independent prescribing authority; initiating therapy requires a collaborative practice arrangement or another specific statutory authorization. Dispensing, immunizing within authorized limits, and generic substitution are all within ordinary practice.

Question 48Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

When a Missouri pharmacy closes permanently, the owner must:

  1. Notify only the pharmacy's wholesaler
  2. Provide for the transfer of prescription records Correct answer.
  3. Return the license within 90 days
  4. Destroy all prescription records on site

Explanation

A closing pharmacy must notify the Board and make arrangements for patients' prescription records to be preserved and made available, typically by transfer to another pharmacy or a designated custodian. Records may not simply be destroyed at closing.

Question 49Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

The Missouri Board of Pharmacy is composed of:

  1. Three pharmacists and two physicians
  2. Seven members, including one public member Correct answer.
  3. Nine pharmacists appointed by the governor
  4. Five members elected by licensees

Explanation

The Board has seven members appointed by the governor: five pharmacists, one pharmacy technician, and one public member who is not a licensee. The public and technician seats broaden the perspective of the body beyond pharmacist interests.

Question 50Missouri Pharmacy Practice Act, Board of Pharmacy rules, and scope of practice

Administrative rules adopted by the Missouri Board of Pharmacy are codified in the Code of State Regulations under which title?

  1. 19 CSR 30
  2. 13 CSR 70
  3. 12 CSR 10
  4. 20 CSR 2220 Correct answer.

Explanation

Board of Pharmacy rules appear under 20 CSR 2220 in the Code of State Regulations, while the underlying statutes are in Chapter 338 of the Revised Statutes of Missouri. Practitioners should consult both the statute and the corresponding rule.