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1. Please select the statement about statistics that is TRUE:

A. In WV, opioids were the leading cause of drug-related deaths, increasing 550% from 1999 to 2004 (largest state increase in the United States) and 214% from 2001 to 2010. B. WV had the lowest age-adjusted rate of opioid-related deaths in 2012 and highest death rate involving prescription drugs in 2008. C. From 2009 to 2012, opioid exposure incidents reported to the WV Poison Control Center remained steady. D. Statistics mean the same things to clinicians and patients; most people just ignore them.

2. Which of the following is NOT a change made in the current American Psychiatric Association's Diagnostic and Statistical Manual (DSM) 2013?

A. It merged the criteria for “substance dependence” and “substance abuse.” B. It eliminated physiologic dependence as a diagnostic criterion. C. It refers to substance abuse and dependence as substance use disorder (SUD). D. It ignores combined opioid abuse and dependence.

3. Select the statement that is TRUE about discontinuing long-term opioid therapy:

A. All opioids doses are decreased in exactly the same way. B. Patients usually accept that they will experience pain. C. Prescribers should make decisions about tapering therapy on an individual basis. D. A dose of 30 mg/day is a “magic number”; below 30 mg/day, patients can stop the opioid with no untoward effects.

4. Which of the following is an appropriate way to protect pharmacy practices from becoming easy targets for drug diversion?

A. Constant vigilance against forged or altered prescriptions B. Dispensing controlled substances outside of the usual course of professional treatment C. Using drug quantity and prescription filling frequency as the sole indications of improper prescribing D. Advertising the availability of naloxone

5. Three patients arrive in the pharmacy within several minutes of each other. They all have prescriptions for oxycodone written by the same prescriber whose office is at some distance from your location. Each of them also has prescriptions for benzodiazepines. What should you suspect?

A. These are forged prescriptions B. This physician's office has relocated C. Your pharmacy's advertising is effective D. These prescriptions were not issued for a legitimate use

6. Select the statement that is FALSE about West Virginia's PDMP/Controlled Substance Automated Prescription Program.

A. Nurses who administer opioid analgesics to patients must register with CSAPP. B. Participants must update patient information in CSAPP at least annually. C. Pharmacists must enter information into CSAPP within 24 hours pertaining to controlled substances dispensed to WV residents. D. Before each patient search in CSAPP, pharmacists must certify that they will not allow access by unauthorized persons.

7. A long-time pain management patient who is on worker's compensation presents a prescription for OxyContin 40 mg daily, #28, written by a new physician and says he will pay cash for the prescription. He says he is still seeing his regular prescriber. What should you do?

A. Fill the prescription and allow him to pay cash B. Fill the prescription and allow him to pay cash, but make a note of it on his profile C. Fill the prescription but charge it to worker's compensation D. Tell Mr. Smith you need to ask his regular prescriber if it is acceptable to fill this prescription

8. Which of the following statements is TRUE?

A. Naloxone reverses the effects of benzodiazepines such as sedation, hypotension, and dysphoria. B. Naloxone has no effect when given to people who have overdosed on agonist–antagonists such as pentazocine or buprenorphine. C. Given to opioid-dependent patients, naloxone will produce withdrawal symptoms D. Naloxone's actions last a few minutes following intranasal administration

9. A physician tapers Mrs. Young's opioid dose to 30 mg daily over several weeks. She has no other changes to her regimen, and her laboratory tests and radiographs are unchanged. After 3 weeks at the 30 mg dose, Mrs. Young visits the local emergency department one evening and then presents a prescription for hydrocodone for breakthrough pain at your pharmacy. She says she will tell the doctor about this prescription when he sees him next week. Based on the facts presented here, which of the following is a possibility?

A. Pseudoaddiction B. Manipulation C. Drug interactions D. Opioid allergy

10. When a concerned bystander suspects an overdose and decides to administer naloxone, when should he or she call 911?

A. Before administering naloxone B. Immediately after administering naloxone C. After administering 5 minutes of rescue breathing D. Once the patient exhibits withdrawal symptoms