It depends. The federal portion has not changed much in at least 20 years in terms of certain questions. The feeling is that if you memorize the answers to those questions (e.g. most anabolic steroids are in which schedule and why (and the Schedule I exceptions), what are the rules for Schedule I (One) use in non-clinical settings, etc.), that fits the purpose of the exam. But the psychometrics of writing good questions is not easy, and it's always done by committee for test-retest validity. Most Board questions on law are such that even if compromised, it would not necessarily be changed all that much as the questions are direct anyway.
The problem with CA has been the incessant tendency to put trivia questions on their Boards because of a couple of egomaniacs/sadists on the exam committee. I've seen the bank a couple of times and have heavily criticized it on the basis of practicality ("who cares about this side effect of this particular beta lactam as it is extremely rare for it to happen clinically"), the basis of reading ("this question could be read from multiple perspectives, and the answer is not practical" and the example that is like this is to solve this math question: 6/2(1+2) = ?, which is 9 but it's intrinsically unfair due to the artificiality of the statement), and the basis of "when/why would you actually need to know this" (a question on amphoterin B between formulations that was nitpicky and has no clinical or storage implication), I actually feel that CA can learn much from how the Canadians set their PEBC in what questions stay, which questions rotate, and what new concepts show up every year in the approval pool. It's not just pharmacy. The Bar in CA is also notorious for nonstandard questions and other games. But what I dislike is CA's tendency to accept volunteers with agendas rather than recruit actual faculty or members of the public who know how to properly write and test questions out.
But to answer your broader question in a practical way, it's really not a question writing as much as exam integrity. CA Board of Pharmacy blew that up hard, there are clear exam security ways to do the psychometrics to suss out cheaters and the like. They ought to hire a PhD psychometrician to supervise the next round of writing questions for face and crossover validty, but also, they need to sit down and think about what it takes to run an exam. If it means that they can only offer it twice annual due to the preparations, so be it, but this is going to happen again at this rate if their own behavior does not change. Cheaters always exist, but you can respond better than just panic. All the good questions in the world are not going to survive if integrity checks are not built in.
Again, I'm long licensed so the situation does not affect me directly, but I can easily put myself as well as the rest of you in their shoes about being angry with someone screwing with my livelihood. Yeah, I do agree that there is some joint culpability on the parts of the candidates where you were told explicitly that you needed to license in more than just one state especially if CA was the primary. That said, I'm underwhelmed at the examples in the news reports. I did not realize that literacy was at such a low standard in our soon-to-be colleagues. But that is immaterial for the argument that they deserve a fair chance, and it should be argued that the cheater(s) and the Board took that away from them in a timely manner.
In the end, I want the entirety of the exam administration and accountability overhauled. Either CA drops their unique MPJE requirement, or they resource it properly to supervise it. I wish that NABP would force CA to conform with the other 49 states in making the MPJE strictly a practice law exam, because the clinical exam masquerading as the law has not been shown to have different care outcomes in CA than in other states. In the era we practice in right now, I am very much for forced integration of CA into the rest of the country.
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