MISSOURI MPJE MAIN EXAMINATON 2026 EXAM
QUESTIONS AND SOLUTIONS GRADED A+
✔✔What C2 drugs can a PA prescribe? - ✔✔Only Hydrocodone, up to 5d supply
✔✔What non-c2 CS can a PA prescribe? - ✔✔5d supply of C3, unless hospice (then
30/90d with documentation), and no refills
C4-5, up to 90d supply
✔✔What CS can mid-level practitioners prescribe? - ✔✔30d supply of burprenorphine
for substance use disorder
✔✔What CS can Dentists prescribe? - ✔✔any legend drugs or CS related to dentistry
✔✔What CS can optometrists prescribe? - ✔✔Only Hydrocodone (C2)
any C3-4 related to eyes
✔✔What CS can veterinarians prescribe? - ✔✔Any CS but only for an animal and never
for a human
✔✔When do non-CS scripts expire? - ✔✔12 months after issue date
✔✔Requirements of non-control outpatient Rxs? - ✔✔- Date of Issue
- Name of Pt
- Prescriber name and signature
- Name, dose, strength, directions of drug
- refills and quantity
- generic substitution allowed?
if e-script: date/time of transmission, name of intended receiving pharmacy
✔✔Emergency supplies of non-CS requirements? - ✔✔if prescriber is dead or
incapacitated: up to 30d supply
if prescriber can't be reached for refill authorization: up to 7d supply
✔✔When can a pharmacist "add up" authorized refills? How many days? - ✔✔Up to
90d supply
only for maintentance meds that the pt has been on for at least 3mo
NO CS ALLOWED
✔✔When do CS prescriptions expire? - ✔✔6 months after issue date
,✔✔Requirements of a CS prescription? - ✔✔C2-4 must be issued ELECTRONICALLY
same requirements as non-CS, but prescriber DEA and address required too
✔✔Initial opioid Rxs for acute pain are limited to? - ✔✔A 7 day FIRST FILL SUPPLY,
unless authorized by prescriber...
this is for ACUTE PAIN, chronic pain can exceed this
✔✔C2 prescription day supply limitations? - ✔✔Limited to 30d supply dispensed at any
one time in MO, unless documented necessity
✔✔In the state of a true emergency, can a C2 script be issued verbally? - ✔✔Yes! but
the verbal must immediately be put to writing, and the quantity can't exceed that needed
for the emergency period
written or electronic Rx must be delivered to pharmacy for this Rx w/in 7 days
✔✔When can a C2 be faxed to a pharmacy? - ✔✔Hospice pt
LTC pt
Compounded narcotic for immediate administration
✔✔What can NOT BE CHANGED on a CS script (or in general) - ✔✔Drug name
Prescriber name/signature
pt name
✔✔What controls can be verbally ordered over the phone in a non-emergency
situation? - ✔✔C3-5
✔✔Can CS be prescribed for >30d supply generally? - ✔✔Yes, C3-5 can be given up to
90d supply
✔✔Expiration for C3-5 scripts? - ✔✔C3-4: 6 months after issue date
C5: 12 months after issue date
✔✔Can a prescriber issue an rx to obtain CS stock to dispense to their own patients? -
✔✔No.
✔✔How many refills can CS have? - ✔✔C2: none
C3-4: Up to 5 refills
C5: prn
✔✔Age restrictions for pharmacists to admin vaccines to? - ✔✔Must be at least 7 years
old
, ✔✔What must be done when ordering an FDA-approved vaccine by a pharmacist to a
pt? - ✔✔Pt must be given VIS (vax information statement)
Must report any ADR to VAERS
Must report vax administration to ShowMeVax
✔✔What can be dispensed by a pharmacist to a pt without a script? - ✔✔HIV PEP, if
pharmacist has completed HIV certification program, pt must also be at least 13 yrs
NRT
Naloxone
✔✔When MUST counseling be offered to pts? - ✔✔for every new rx
if a change is made to a previous Rx
if pt/caregiver unavailable at dispensing time, must provide a written offer to counsel a
pt w/ phone #
✔✔Can face-to-face med counseling be done via a video or printout? - ✔✔NO!, also
counseling not required for hospitalized pts
✔✔What to do if a pt declines counseling? - ✔✔MUST BE DOCUMENTED that an offer
was made in the pt profile
✔✔When can a C2 be transfered to another pharmacy? - ✔✔Only if the rx was sent
electronically, and also if the C2 script is UNFILLED
✔✔When can C3-5 scripts be transfered? - ✔✔Can only be transfered ONCE
✔✔When do transfer requests need to be fulfilled? - ✔✔Within 1 business day and no
exceptions
✔✔Can techs transfer Rxs? - ✔✔Yes, but only non-CS Rxs
✔✔When should C2-4 dispensing info be submitted to PDMP? - ✔✔Within 24h of
dispensing
✔✔When can PMP be given to a patient? - ✔✔Patient must make an official request
through the board or the official MO PMP dept, and not the pharmacy
✔✔If a brand to generic substitution was made, what must be included on the label? -
✔✔"generic for [brand name]"
QUESTIONS AND SOLUTIONS GRADED A+
✔✔What C2 drugs can a PA prescribe? - ✔✔Only Hydrocodone, up to 5d supply
✔✔What non-c2 CS can a PA prescribe? - ✔✔5d supply of C3, unless hospice (then
30/90d with documentation), and no refills
C4-5, up to 90d supply
✔✔What CS can mid-level practitioners prescribe? - ✔✔30d supply of burprenorphine
for substance use disorder
✔✔What CS can Dentists prescribe? - ✔✔any legend drugs or CS related to dentistry
✔✔What CS can optometrists prescribe? - ✔✔Only Hydrocodone (C2)
any C3-4 related to eyes
✔✔What CS can veterinarians prescribe? - ✔✔Any CS but only for an animal and never
for a human
✔✔When do non-CS scripts expire? - ✔✔12 months after issue date
✔✔Requirements of non-control outpatient Rxs? - ✔✔- Date of Issue
- Name of Pt
- Prescriber name and signature
- Name, dose, strength, directions of drug
- refills and quantity
- generic substitution allowed?
if e-script: date/time of transmission, name of intended receiving pharmacy
✔✔Emergency supplies of non-CS requirements? - ✔✔if prescriber is dead or
incapacitated: up to 30d supply
if prescriber can't be reached for refill authorization: up to 7d supply
✔✔When can a pharmacist "add up" authorized refills? How many days? - ✔✔Up to
90d supply
only for maintentance meds that the pt has been on for at least 3mo
NO CS ALLOWED
✔✔When do CS prescriptions expire? - ✔✔6 months after issue date
,✔✔Requirements of a CS prescription? - ✔✔C2-4 must be issued ELECTRONICALLY
same requirements as non-CS, but prescriber DEA and address required too
✔✔Initial opioid Rxs for acute pain are limited to? - ✔✔A 7 day FIRST FILL SUPPLY,
unless authorized by prescriber...
this is for ACUTE PAIN, chronic pain can exceed this
✔✔C2 prescription day supply limitations? - ✔✔Limited to 30d supply dispensed at any
one time in MO, unless documented necessity
✔✔In the state of a true emergency, can a C2 script be issued verbally? - ✔✔Yes! but
the verbal must immediately be put to writing, and the quantity can't exceed that needed
for the emergency period
written or electronic Rx must be delivered to pharmacy for this Rx w/in 7 days
✔✔When can a C2 be faxed to a pharmacy? - ✔✔Hospice pt
LTC pt
Compounded narcotic for immediate administration
✔✔What can NOT BE CHANGED on a CS script (or in general) - ✔✔Drug name
Prescriber name/signature
pt name
✔✔What controls can be verbally ordered over the phone in a non-emergency
situation? - ✔✔C3-5
✔✔Can CS be prescribed for >30d supply generally? - ✔✔Yes, C3-5 can be given up to
90d supply
✔✔Expiration for C3-5 scripts? - ✔✔C3-4: 6 months after issue date
C5: 12 months after issue date
✔✔Can a prescriber issue an rx to obtain CS stock to dispense to their own patients? -
✔✔No.
✔✔How many refills can CS have? - ✔✔C2: none
C3-4: Up to 5 refills
C5: prn
✔✔Age restrictions for pharmacists to admin vaccines to? - ✔✔Must be at least 7 years
old
, ✔✔What must be done when ordering an FDA-approved vaccine by a pharmacist to a
pt? - ✔✔Pt must be given VIS (vax information statement)
Must report any ADR to VAERS
Must report vax administration to ShowMeVax
✔✔What can be dispensed by a pharmacist to a pt without a script? - ✔✔HIV PEP, if
pharmacist has completed HIV certification program, pt must also be at least 13 yrs
NRT
Naloxone
✔✔When MUST counseling be offered to pts? - ✔✔for every new rx
if a change is made to a previous Rx
if pt/caregiver unavailable at dispensing time, must provide a written offer to counsel a
pt w/ phone #
✔✔Can face-to-face med counseling be done via a video or printout? - ✔✔NO!, also
counseling not required for hospitalized pts
✔✔What to do if a pt declines counseling? - ✔✔MUST BE DOCUMENTED that an offer
was made in the pt profile
✔✔When can a C2 be transfered to another pharmacy? - ✔✔Only if the rx was sent
electronically, and also if the C2 script is UNFILLED
✔✔When can C3-5 scripts be transfered? - ✔✔Can only be transfered ONCE
✔✔When do transfer requests need to be fulfilled? - ✔✔Within 1 business day and no
exceptions
✔✔Can techs transfer Rxs? - ✔✔Yes, but only non-CS Rxs
✔✔When should C2-4 dispensing info be submitted to PDMP? - ✔✔Within 24h of
dispensing
✔✔When can PMP be given to a patient? - ✔✔Patient must make an official request
through the board or the official MO PMP dept, and not the pharmacy
✔✔If a brand to generic substitution was made, what must be included on the label? -
✔✔"generic for [brand name]"
