CCHP Pharmacy and Medication Management 1 — Questions and Answers
Question 1: Which of the following BEST describes the purpose of a formulary in a correctional healthcare setting?
- A list of all inmates currently receiving medications
- An approved list of medications available within the facility to guide prescribing and control costs (Correct answer)
- A federal mandate requiring specific brand-name drugs
- A record of all medication errors reported in the facility
Correct answer: An approved list of medications available within the facility to guide prescribing and control costs
A formulary standardizes drug selection within a correctional facility, promoting cost-effectiveness and appropriate prescribing.
Question 2: What does 'directly observed therapy' (DOT) mean in the context of correctional medication administration?
- A pharmacist reviews prescriptions remotely
- Health staff physically watch the patient swallow the medication and check for cheeking (Correct answer)
- Inmates self-administer medications in their cells without oversight
- A nurse documents medication administration without witnessing it
Correct answer: Health staff physically watch the patient swallow the medication and check for cheeking
DOT requires staff to observe ingestion and verify the medication is swallowed to prevent diversion, cheeking, or stockpiling.
Question 3: Which regulatory body governs the prescribing, dispensing, and storage of controlled substances in correctional facilities?
- NCCHC
- Drug Enforcement Administration (DEA) (Correct answer)
- Joint Commission
- Centers for Disease Control
Correct answer: Drug Enforcement Administration (DEA)
The DEA regulates controlled substances under the Controlled Substances Act, and correctional facilities must comply with DEA requirements.
Question 4: What is the MOST appropriate action when a nurse discovers a discrepancy in the controlled substance count during a shift change?
- Assume a documentation error and move on
- Document and immediately report the discrepancy to the supervisor and investigate per facility protocol (Correct answer)
- Adjust the count to match the record without reporting
- Wait until the next scheduled audit to address it
Correct answer: Document and immediately report the discrepancy to the supervisor and investigate per facility protocol
Controlled substance discrepancies must be immediately reported and investigated, as they may indicate diversion or theft.
Question 5: Which medication administration route requires the MOST caution regarding inmate diversion in a correctional setting?
- Topical creams
- Injectable medications given by staff
- Sublingual or crushed oral tablets (Correct answer)
- Transdermal patches checked by staff
Correct answer: Sublingual or crushed oral tablets
Sublingual tablets and crushed oral medications can be cheeked (held in the mouth) and later diverted, requiring careful DOT observation.
Question 6: Under NCCHC standards, how often should medication administration records (MARs) be reviewed for accuracy in a correctional facility?
- Only at annual audits
- Regularly, as part of ongoing quality improvement and nursing supervision (Correct answer)
- Only when an error is reported
- Once per fiscal year during budget reviews
Correct answer: Regularly, as part of ongoing quality improvement and nursing supervision
Regular MAR review is a quality assurance requirement to detect administration errors, omissions, and documentation gaps.
CCHP Pharmacy and Medication Management 1
Which of the following BEST describes the purpose of a formulary in a correctional healthcare setting?