PTCB schedule II prescriptions and refills practice questions, with every answer explained

1. Fill it and honor both refills within 6 months
2. Fill the original quantity; the refills are not valid
3. Fill it and honor only one refill within 30 days
4. Refuse the whole prescription because of the refill error

Answer: B. Federal law prohibits refills of Schedule II prescriptions. The pharmacy may dispense the original quantity, but the patient needs a new prescription for each additional fill.

Why not A: The 6-month refill window applies to Schedules III to V. Methylphenidate is Schedule II.

Why not C: Federal law allows no Schedule II refills at all, not even one.

Why not D: The refill line does not void the prescription. The original quantity may still be filled.

Exam tactic: C-II refills written on the Rx are ignored; fill the first quantity only.

1. Within 30 days of the date written
2. Within 60 days of the date written
3. Within 7 days of the partial fill
4. Within 72 hours of the partial fill

Answer: D. When a pharmacy cannot supply the full Schedule II quantity, the remainder must be filled within 72 hours. If it cannot be, the pharmacist notifies the prescriber, and no further quantity may be supplied without a new prescription.

Why not A: 30 days applies when the patient or prescriber requests a partial fill, not when the pharmacy is short.

Why not B: 60 days applies to patients in long-term care facilities or with a terminal illness.

Why not C: 7 days is the deadline for the written prescription after an emergency oral C-II order.

Exam tactic: C-II partial because the pharmacy is short = 72 hours.

1. Within 7 days after authorizing the emergency fill
2. Within 72 hours after authorizing the emergency fill
3. Within 30 days after authorizing the emergency fill
4. Within 1 business day after authorizing the emergency fill

Answer: A. After an emergency oral Schedule II order, the prescriber must deliver a written prescription (or transmit an electronic one) within 7 days. A paper prescription must say "Authorization for Emergency Dispensing" and the date of the oral order.

Why not B: 72 hours is the limit for completing a C-II partial fill when the pharmacy is short.

Why not C: 30 days is the window for partial fills requested by the patient or prescriber.

Why not D: 1 business day is the deadline for notifying the DEA of a theft or significant loss.

Exam tactic: Emergency oral C-II: written Rx due within 7 days.

1. Up to a 30-day supply, as stated by the prescriber on the phone
2. Up to a 90-day supply, if the prescriber confirms the DEA number
3. Only the amount needed for the emergency period
4. Any quantity, as long as the written copy follows within 7 days

Answer: C. An emergency oral Schedule II order is limited to the quantity needed to treat the patient during the emergency period. The pharmacist reduces the order to writing right away, and the prescriber follows up with a prescription within 7 days.

Why not A: A 30-day supply goes beyond the emergency period. Only the emergency quantity is allowed.

Why not B: 90 days is the limit for multiple C-II prescriptions with fill dates, not emergency oral orders.

Why not D: The written follow-up does not remove the quantity limit for the emergency period.

Exam tactic: Emergency oral C-II: just enough for the emergency.

1. Dispense it now, since the fax serves as the original
2. Refuse it, since faxed Schedule II orders are illegal
3. Dispense it now, if the prescriber calls to confirm
4. Prepare it, but dispense only once the original arrives

Answer: D. For most outpatients, a faxed Schedule II prescription lets the pharmacy prepare the order in advance, but the original signed prescription must be presented and checked before the drug is dispensed.

Why not A: A fax serves as the original only for long-term care, hospice and home infusion patients.

Why not B: Faxes are allowed for preparation. They are not illegal; they just cannot replace the original here.

Why not C: A phone confirmation does not turn a fax into a valid original for an outpatient.

Exam tactic: C-II fax for outpatient = prepare only. Hand over after the original arrives.

1. Patient address and prescriber DEA number
2. The patient's date of birth and phone number
3. The diagnosis and the prescriber's NPI number
4. The patient's insurance ID and the pharmacy's name

Answer: A. Federal rules (21 CFR 1306.05) require a controlled substance prescription to include the patient's full name and address and the prescriber's name, address and DEA registration number, in addition to the drug details and a manual signature.

Why not B: Date of birth is used for identification, but federal controlled substance rules require the address, not DOB or phone.

Why not C: Diagnosis and NPI may be needed for billing, but the federal CS rule requires the DEA number.

Why not D: Insurance and pharmacy details are not elements the prescriber must write on the prescription.

Exam tactic: CS Rx extras: patient address + prescriber DEA number.

1. It is valid if the stamp also includes the DEA number
2. It is valid once the prescriber's office confirms it by phone
3. It is not valid; paper CS orders need a manual signature
4. It is valid for Schedule II but not for Schedule V

Answer: C. Federal rules require a paper controlled substance prescription to be manually signed by the practitioner. A stamped signature does not meet the requirement.

Why not A: Including the DEA number does not replace the manual signature requirement.

Why not B: A phone confirmation does not cure a missing manual signature on a C-II paper prescription.

Why not D: Every paper controlled substance prescription must be manually signed, whatever the schedule.

Exam tactic: Paper CS Rx: manual signature only. No stamps.

1. Oxycodone 5 mg tablets, #30
2. Lorazepam 1 mg tablets, #30
3. Morphine ER 15 mg tablets, #60
4. Amphetamine salts 20 mg tablets, #30

Answer: B. Under federal law, Schedule III to V prescriptions may be given orally and reduced to writing by the pharmacist. Lorazepam is Schedule IV. Schedule II drugs need a written or electronic prescription except in a true emergency.

Why not A: Oxycodone is Schedule II. It can be phoned in only as an emergency oral order.

Why not C: Morphine is Schedule II. A non-emergency oral order is not allowed.

Why not D: Amphetamine salts are Schedule II, so a routine oral order is not allowed.

Exam tactic: Phone-in OK for C-III to C-V. C-II only in an emergency.

1. The transfer is allowed because refills still remain
2. The transfer is allowed if Pharmacy A gives consent
3. The transfer is allowed if fewer than 6 months passed
4. The transfer is not allowed; a new prescription is needed

Answer: D. Federal rules allow a Schedule III to V prescription to be transferred for refills only one time between pharmacies that do not share a real-time online database. A second transfer is not allowed, so the patient needs a new prescription.

Why not A: Remaining refills do not reset the one-time transfer limit.

Why not B: Consent from the original pharmacy does not override the one-time limit.

Why not C: The 6-month limit concerns refills. It does not permit a second transfer.

Exam tactic: C-III to C-V transfer: once only, unless the pharmacies share a real-time database.

1. A technician at each of the two pharmacies
2. Two licensed pharmacists, one at each pharmacy
3. The patient, by bringing in the labeled vial
4. The prescriber's office staff, by phone or fax

Answer: B. 21 CFR 1306.25 states that the transfer of a Schedule III to V prescription is communicated directly between two licensed pharmacists. Both pharmacies record the transfer details.

Why not A: Federal rules call for licensed pharmacists to communicate controlled substance transfers.

Why not C: A patient's vial is not a transfer. Pharmacist-to-pharmacist communication is required.

Why not D: Transfers happen between pharmacies. The prescriber's office is not part of a transfer.

Exam tactic: CS transfer = pharmacist to pharmacist.