NU 578 Controlled Substances Exam
ACTUAL EXAM 2026/2027 | Final
Exam | 100 Questions | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Federal Controlled Substances Act (CSA) & DEA Regulations (Questions 1–25)
Q1: A nurse practitioner prescribes a 30-day supply of alprazolam (Schedule IV) with 3 refills. The patient
requests a 4th refill 5 months after the original prescription date. According to DEA regulations, what
must the provider do? A. Issue a new prescription with a new DEA number
B. Authorize the 4th refill verbally over the phone
C. Deny the refill because Schedule IV allows only 3 refills within 6 months [CORRECT]
D. Transfer the remaining refills from another state's pharmacy
Correct Answer: C
Rationale: Under 21 CFR 1306.22, Schedule IV controlled substances may be refilled up to 5 times within
6 months from the issue date. However, since the original prescription specified only 3 refills, no
additional refills are permitted without a new prescription. Option A is incorrect because a new DEA
number is unnecessary—any valid DEA registration suffices. Option B is incorrect because verbal
authorization for additional refills beyond the original prescription is prohibited. Option D is incorrect
because refills cannot be transferred across state lines or between pharmacies for Schedule IV
substances without a new prescription.
Q2: Under the DEA's Fourth Temporary Extension effective through December 31, 2026, which
telemedicine prescribing flexibility remains in place? A. Schedule II narcotics may be prescribed via
audio-only telephone without any prior patient relationship
B. Schedule III-V controlled substances may be prescribed via audio-video telemedicine without prior in-
person evaluation [CORRECT]
C. All controlled substances may be prescribed via text message or email
D. Schedule II stimulants for ADHD may be prescribed via audio-only encounters to new patients
Correct Answer: B
Rationale: The Fourth Temporary Extension (effective January 1–December 31, 2026) permits DEA-
,registered practitioners to prescribe Schedule II-V controlled substances via audio-video telemedicine
without prior in-person evaluation, provided all other federal and state requirements are met . Option A
is incorrect because audio-only prescribing is limited to Schedule III-V narcotics for opioid use disorder
treatment, not Schedule II. Option C is incorrect because text message and email prescribing remain
prohibited under DEA security requirements. Option D is incorrect because Schedule II stimulants
require audio-video telemedicine, not audio-only.
Q3: A DEA-registered NP moves from California to Texas and wants to continue prescribing controlled
substances. Which action is required? A. Automatically retain the original DEA registration since it is
federally issued
B. Apply for a new DEA registration with the new Texas practice address [CORRECT]
C. Simply notify the DEA of the address change within 30 days
D. Surrender the DEA registration and reapply after 6 months of Texas licensure
Correct Answer: B
Rationale: DEA registrations are issued to a specific registrant at a specific physical address. Under 21
CFR 1301.51, a change of business address requires a new DEA registration application for the new
location. Option A is incorrect because DEA registrations are not automatically portable across state
lines. Option C is incorrect because a simple notification is insufficient—a new application is required.
Option D is incorrect because there is no 6-month waiting period; the NP may apply immediately upon
obtaining Texas licensure.
Q4: Which substance is correctly classified under the CSA Schedule I criteria? A. Oxycodone (high abuse
potential, accepted medical use)
B. Diazepam (low abuse potential, accepted medical use)
C. Heroin (high abuse potential, no accepted medical use) [CORRECT]
D. Buprenorphine (moderate abuse potential, accepted medical use with restrictions)
Correct Answer: C
Rationale: Schedule I substances are defined under 21 U.S.C. § 812(b)(1) as having a high potential for
abuse and no currently accepted medical use in treatment in the United States. Heroin meets both
criteria. Option A describes a Schedule II substance (oxycodone has accepted medical use). Option B
describes a Schedule IV substance (diazepam). Option D describes a Schedule III substance
(buprenorphine has accepted medical use with restrictions).
Q5: The Consolidated Appropriations Act of 2023 eliminated the X-waiver for buprenorphine
prescribing. What is the current requirement for NPs prescribing buprenorphine for opioid use disorder
as of 2026? A. An X-waiver plus 24 hours of specialized training
,B. Only a standard DEA registration number [CORRECT]
C. A special buprenorphine license from the state board of nursing
D. Board certification in addiction medicine
Correct Answer: B
Rationale: Effective January 12, 2023, the X-waiver (DATA 2000 waiver) was repealed. All practitioners
with a standard DEA registration may now prescribe buprenorphine for OUD without patient caps or
special waivers . Option A is incorrect because the X-waiver no longer exists. Option C is incorrect
because no state-specific buprenorphine license is federally required (though state laws vary). Option D
is incorrect because addiction medicine certification is not a federal prescribing requirement.
Q6: A patient presents with a valid prescription for a 90-day supply of a Schedule II controlled substance.
Under federal law, how many days' supply may be dispensed at one time? A. 30 days maximum, with
two refills
B. 90 days if the prescriber writes three separate 30-day prescriptions, each dated appropriately
[CORRECT]
C. 90 days in a single dispensing with one prescription
D. 60 days maximum, with one partial fill permitted
Correct Answer: B
Rationale: Under 21 CFR 1306.12, Schedule II controlled substances cannot be refilled. However, a
prescriber may issue multiple prescriptions authorizing up to a 90-day supply, provided each
prescription is dated for its intended fill date and the practitioner determines that immediate dispensing
is medically necessary. Option A is incorrect because Schedule II prescriptions cannot be refilled. Option
C is incorrect because a single 90-day dispensing violates the 30-day supply limit per prescription. Option
D is incorrect because the 60-day maximum is not a federal standard for Schedule II substances.
Q7: Which DEA form is required for the destruction of outdated or expired controlled substances by a
healthcare facility? A. DEA Form 222
B. DEA Form 41 [CORRECT]
C. DEA Form 224
D. DEA Form 106
Correct Answer: B
Rationale: DEA Form 41 is the official "Registrants Inventory of Drugs Surrendered" form used for
documenting and reporting the destruction or surrender of controlled substances to the DEA . Option A
(DEA Form 222) is used for tracking Schedule II substances between registrants. Option C (DEA Form
224) is the application for DEA registration. Option D (DEA Form 106) is used to report theft or loss of
controlled substances.
, Q8: Under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which requirement
applies to prescribing controlled substances via the internet? A. The prescribing practitioner must
conduct at least one in-person medical evaluation [CORRECT]
B. The patient must pick up the prescription in person at the pharmacy
C. The prescription must be transmitted via fax only
D. The practitioner must hold a special internet prescribing certification
Correct Answer: A
Rationale: The Ryan Haight Act requires at least one in-person medical evaluation before prescribing
controlled substances via the internet, unless an exception applies (such as the COVID-19 telemedicine
flexibilities extended through December 31, 2026) . Option B is incorrect because mail-order pharmacies
may dispense valid prescriptions. Option C is incorrect because electronic prescribing is permitted under
EPCS standards. Option D is incorrect because no special internet certification exists beyond standard
DEA registration.
Q9: A pharmacist receives a prescription for a Schedule II controlled substance that appears to have
been altered. What is the pharmacist's legal obligation? A. Fill the prescription and notify the DEA within
24 hours
B. Refuse to fill and report the suspected forgery to the DEA [CORRECT]
C. Fill the prescription but require the patient to show two forms of ID
D. Contact the prescriber and fill if verbally confirmed
Correct Answer: B
Rationale: Under 21 CFR 1306.04(a), pharmacists have a corresponding responsibility to ensure
prescriptions are issued for legitimate medical purposes. A forged or altered prescription must not be
filled, and suspected diversion should be reported to the DEA. Option A violates federal law. Option C is
insufficient because altered prescriptions are invalid regardless of patient identification. Option D is
incorrect because verbal confirmation cannot validate an altered written prescription for Schedule II
substances.
Q10: Which statement accurately describes the "corresponding responsibility" doctrine under the CSA?
A. Only the prescribing practitioner is responsible for ensuring legitimate medical purpose
B. Both the prescriber and the dispensing pharmacist share responsibility for ensuring legitimate
medical purpose [CORRECT]
C. Only the pharmacist is responsible for verifying medical necessity
D. The patient bears ultimate responsibility for proper use
ACTUAL EXAM 2026/2027 | Final
Exam | 100 Questions | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Federal Controlled Substances Act (CSA) & DEA Regulations (Questions 1–25)
Q1: A nurse practitioner prescribes a 30-day supply of alprazolam (Schedule IV) with 3 refills. The patient
requests a 4th refill 5 months after the original prescription date. According to DEA regulations, what
must the provider do? A. Issue a new prescription with a new DEA number
B. Authorize the 4th refill verbally over the phone
C. Deny the refill because Schedule IV allows only 3 refills within 6 months [CORRECT]
D. Transfer the remaining refills from another state's pharmacy
Correct Answer: C
Rationale: Under 21 CFR 1306.22, Schedule IV controlled substances may be refilled up to 5 times within
6 months from the issue date. However, since the original prescription specified only 3 refills, no
additional refills are permitted without a new prescription. Option A is incorrect because a new DEA
number is unnecessary—any valid DEA registration suffices. Option B is incorrect because verbal
authorization for additional refills beyond the original prescription is prohibited. Option D is incorrect
because refills cannot be transferred across state lines or between pharmacies for Schedule IV
substances without a new prescription.
Q2: Under the DEA's Fourth Temporary Extension effective through December 31, 2026, which
telemedicine prescribing flexibility remains in place? A. Schedule II narcotics may be prescribed via
audio-only telephone without any prior patient relationship
B. Schedule III-V controlled substances may be prescribed via audio-video telemedicine without prior in-
person evaluation [CORRECT]
C. All controlled substances may be prescribed via text message or email
D. Schedule II stimulants for ADHD may be prescribed via audio-only encounters to new patients
Correct Answer: B
Rationale: The Fourth Temporary Extension (effective January 1–December 31, 2026) permits DEA-
,registered practitioners to prescribe Schedule II-V controlled substances via audio-video telemedicine
without prior in-person evaluation, provided all other federal and state requirements are met . Option A
is incorrect because audio-only prescribing is limited to Schedule III-V narcotics for opioid use disorder
treatment, not Schedule II. Option C is incorrect because text message and email prescribing remain
prohibited under DEA security requirements. Option D is incorrect because Schedule II stimulants
require audio-video telemedicine, not audio-only.
Q3: A DEA-registered NP moves from California to Texas and wants to continue prescribing controlled
substances. Which action is required? A. Automatically retain the original DEA registration since it is
federally issued
B. Apply for a new DEA registration with the new Texas practice address [CORRECT]
C. Simply notify the DEA of the address change within 30 days
D. Surrender the DEA registration and reapply after 6 months of Texas licensure
Correct Answer: B
Rationale: DEA registrations are issued to a specific registrant at a specific physical address. Under 21
CFR 1301.51, a change of business address requires a new DEA registration application for the new
location. Option A is incorrect because DEA registrations are not automatically portable across state
lines. Option C is incorrect because a simple notification is insufficient—a new application is required.
Option D is incorrect because there is no 6-month waiting period; the NP may apply immediately upon
obtaining Texas licensure.
Q4: Which substance is correctly classified under the CSA Schedule I criteria? A. Oxycodone (high abuse
potential, accepted medical use)
B. Diazepam (low abuse potential, accepted medical use)
C. Heroin (high abuse potential, no accepted medical use) [CORRECT]
D. Buprenorphine (moderate abuse potential, accepted medical use with restrictions)
Correct Answer: C
Rationale: Schedule I substances are defined under 21 U.S.C. § 812(b)(1) as having a high potential for
abuse and no currently accepted medical use in treatment in the United States. Heroin meets both
criteria. Option A describes a Schedule II substance (oxycodone has accepted medical use). Option B
describes a Schedule IV substance (diazepam). Option D describes a Schedule III substance
(buprenorphine has accepted medical use with restrictions).
Q5: The Consolidated Appropriations Act of 2023 eliminated the X-waiver for buprenorphine
prescribing. What is the current requirement for NPs prescribing buprenorphine for opioid use disorder
as of 2026? A. An X-waiver plus 24 hours of specialized training
,B. Only a standard DEA registration number [CORRECT]
C. A special buprenorphine license from the state board of nursing
D. Board certification in addiction medicine
Correct Answer: B
Rationale: Effective January 12, 2023, the X-waiver (DATA 2000 waiver) was repealed. All practitioners
with a standard DEA registration may now prescribe buprenorphine for OUD without patient caps or
special waivers . Option A is incorrect because the X-waiver no longer exists. Option C is incorrect
because no state-specific buprenorphine license is federally required (though state laws vary). Option D
is incorrect because addiction medicine certification is not a federal prescribing requirement.
Q6: A patient presents with a valid prescription for a 90-day supply of a Schedule II controlled substance.
Under federal law, how many days' supply may be dispensed at one time? A. 30 days maximum, with
two refills
B. 90 days if the prescriber writes three separate 30-day prescriptions, each dated appropriately
[CORRECT]
C. 90 days in a single dispensing with one prescription
D. 60 days maximum, with one partial fill permitted
Correct Answer: B
Rationale: Under 21 CFR 1306.12, Schedule II controlled substances cannot be refilled. However, a
prescriber may issue multiple prescriptions authorizing up to a 90-day supply, provided each
prescription is dated for its intended fill date and the practitioner determines that immediate dispensing
is medically necessary. Option A is incorrect because Schedule II prescriptions cannot be refilled. Option
C is incorrect because a single 90-day dispensing violates the 30-day supply limit per prescription. Option
D is incorrect because the 60-day maximum is not a federal standard for Schedule II substances.
Q7: Which DEA form is required for the destruction of outdated or expired controlled substances by a
healthcare facility? A. DEA Form 222
B. DEA Form 41 [CORRECT]
C. DEA Form 224
D. DEA Form 106
Correct Answer: B
Rationale: DEA Form 41 is the official "Registrants Inventory of Drugs Surrendered" form used for
documenting and reporting the destruction or surrender of controlled substances to the DEA . Option A
(DEA Form 222) is used for tracking Schedule II substances between registrants. Option C (DEA Form
224) is the application for DEA registration. Option D (DEA Form 106) is used to report theft or loss of
controlled substances.
, Q8: Under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which requirement
applies to prescribing controlled substances via the internet? A. The prescribing practitioner must
conduct at least one in-person medical evaluation [CORRECT]
B. The patient must pick up the prescription in person at the pharmacy
C. The prescription must be transmitted via fax only
D. The practitioner must hold a special internet prescribing certification
Correct Answer: A
Rationale: The Ryan Haight Act requires at least one in-person medical evaluation before prescribing
controlled substances via the internet, unless an exception applies (such as the COVID-19 telemedicine
flexibilities extended through December 31, 2026) . Option B is incorrect because mail-order pharmacies
may dispense valid prescriptions. Option C is incorrect because electronic prescribing is permitted under
EPCS standards. Option D is incorrect because no special internet certification exists beyond standard
DEA registration.
Q9: A pharmacist receives a prescription for a Schedule II controlled substance that appears to have
been altered. What is the pharmacist's legal obligation? A. Fill the prescription and notify the DEA within
24 hours
B. Refuse to fill and report the suspected forgery to the DEA [CORRECT]
C. Fill the prescription but require the patient to show two forms of ID
D. Contact the prescriber and fill if verbally confirmed
Correct Answer: B
Rationale: Under 21 CFR 1306.04(a), pharmacists have a corresponding responsibility to ensure
prescriptions are issued for legitimate medical purposes. A forged or altered prescription must not be
filled, and suspected diversion should be reported to the DEA. Option A violates federal law. Option C is
insufficient because altered prescriptions are invalid regardless of patient identification. Option D is
incorrect because verbal confirmation cannot validate an altered written prescription for Schedule II
substances.
Q10: Which statement accurately describes the "corresponding responsibility" doctrine under the CSA?
A. Only the prescribing practitioner is responsible for ensuring legitimate medical purpose
B. Both the prescriber and the dispensing pharmacist share responsibility for ensuring legitimate
medical purpose [CORRECT]
C. Only the pharmacist is responsible for verifying medical necessity
D. The patient bears ultimate responsibility for proper use
