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NSG 533 EXAM 2 – 2026 WILKES ADVANCED
PHARMACOLOGY COMPLETE (110) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NSG
Prepare for the NSG 533 Exam 2 – Wilkes Advanced Pharmacology with this
comprehensive practice resource designed to strengthen your advanced
pharmacology knowledge and exam readiness. It features exam-style questions
covering drug classifications, mechanisms of action, pharmacokinetics,
pharmacodynamics, therapeutic uses, adverse effects, interactions, and evidence-
based medication management. Use it to reinforce essential concepts, assess your
understanding, and build confidence before test day. An excellent study aid for Wilkes
University nursing students preparing for the NSG 533 Advanced Pharmacology Exam
2.
MULTIPLE CHOICE.
SECTION 1: GENETICS, GENOMICS & PHARMACOGENOMICS (Questions
1–20)
Question 1: A nurse practitioner is explaining the difference between genetics
and genomics. Which statement accurately describes genetics?
A. The molecular analysis of the entire genome of a species
B. The study of inherited traits and their variation in an individual
C. The total genetic composition of an organism
D. The study of influences on gene expression without changing DNA
sequence
Correct answer: B. The study of inherited traits and their variation in an
individual
Rationale: Genetics focuses on the study of inherited traits and their variation
in an individual, examining specific genes and their effects. Genomics refers
to the total genetic composition of an organism or species .
, Page 2 of 41
Question 2: A patient asks why some medications work well for her friend but
not for her. The NP's best response incorporates which concept?
A. Drug-drug interactions are the primary reason for medication variation
B. Genetic variations affect how individuals metabolize medications
C. Age and weight are the only factors that matter in drug response
D. Brand-name medications work better than generic formulations
Correct answer: B. Genetic variations affect how individuals metabolize
medications
Rationale: Pharmacogenomics explains how genetic variations influence
individual responses to medications, including differences in metabolism,
efficacy, and adverse effects .
Question 3: Cytochrome P450 enzymes are responsible for which primary
function in pharmacology?
A. Drug absorption from the gastrointestinal tract
B. Drug distribution to target tissues
C. Drug metabolism, primarily in the liver
D. Drug excretion through the kidneys
Correct answer: C. Drug metabolism, primarily in the liver
Rationale: Cytochrome P450 enzymes are primarily located in the liver and
metabolize medications, making them more water-soluble for excretion.
Genetic polymorphisms in CYP450 enzymes can significantly affect drug
metabolism and response .
Question 4: A patient is prescribed warfarin and requires a lower-than-
expected dose. Genetic testing reveals a polymorphism in which enzyme
system?
A. CYP2D6 and CYP3A4
B. CYP2C9 and VKORC1
C. CYP3A4 and P-glycoprotein
D. CYP1A2 and NAT2
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Correct answer: B. CYP2C9 and VKORC1
Rationale: Warfarin is metabolized by CYP2C9, and its target enzyme is
VKORC1 (vitamin K epoxide reductase). Genetic variants in both CYP2C9 and
VKORC1 affect warfarin dosing requirements and bleeding risk .
Question 5: A patient with a genetic variant resulting in reduced CYP2C9
activity is started on warfarin. What is the most appropriate management
strategy?
A. Initiate warfarin at the standard dose
B. Initiate warfarin at a lower dose and monitor INR closely
C. Avoid warfarin entirely and use an alternative anticoagulant
D. Initiate warfarin at a higher dose to achieve therapeutic effect
Correct answer: B. Initiate warfarin at a lower dose and monitor INR
closely
Rationale: Reduced CYP2C9 activity leads to slower warfarin clearance,
increased INR, and bleeding risk. A lower starting dose with close INR
monitoring is recommended. Genotype-guided dosing improves safety and
time in therapeutic range .
Question 6: Which type of Mendelian inheritance requires the presence of
two copies of a gene mutation to express the phenotype?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. Mitochondrial inheritance
Correct answer: B. Autosomal recessive
Rationale: Autosomal recessive inheritance requires two copies of the
mutated gene (one from each parent) to express the phenotype. Both parents
must be carriers (heterozygous) .
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Question 7: Which of the following is an example of an autosomal dominant
disorder?
A. Cystic fibrosis
B. Sickle cell anemia
C. Huntington's disease
D. Tay-Sachs disease
Correct answer: C. Huntington's disease
Rationale: Huntington's disease is an autosomal dominant disorder, meaning
only one copy of the mutated gene is needed for disease expression. Cystic
fibrosis, sickle cell anemia, and Tay-Sachs are autosomal recessive
disorders .
Question 8: Which of the following is an example of an X-linked recessive
disorder?
A. Marfan syndrome
B. Duchenne muscular dystrophy
C. Fragile X syndrome
D. Huntington's disease
Correct answer: B. Duchenne muscular dystrophy
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder.
Fragile X syndrome is X-linked dominant. Marfan syndrome and Huntington's
disease are autosomal dominant .
Question 9: Pharmacogenomics is the study of:
A. How drugs interact with each other
B. How genetic variations affect drug response
C. How drugs affect gene expression
D. How environmental factors affect drug metabolism
Correct answer: B. How genetic variations affect drug response
Rationale: Pharmacogenomics is the study of how genetic variations
influence individual responses to medications, including differences in
NSG 533 EXAM 2 – 2026 WILKES ADVANCED
PHARMACOLOGY COMPLETE (110) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NSG
Prepare for the NSG 533 Exam 2 – Wilkes Advanced Pharmacology with this
comprehensive practice resource designed to strengthen your advanced
pharmacology knowledge and exam readiness. It features exam-style questions
covering drug classifications, mechanisms of action, pharmacokinetics,
pharmacodynamics, therapeutic uses, adverse effects, interactions, and evidence-
based medication management. Use it to reinforce essential concepts, assess your
understanding, and build confidence before test day. An excellent study aid for Wilkes
University nursing students preparing for the NSG 533 Advanced Pharmacology Exam
2.
MULTIPLE CHOICE.
SECTION 1: GENETICS, GENOMICS & PHARMACOGENOMICS (Questions
1–20)
Question 1: A nurse practitioner is explaining the difference between genetics
and genomics. Which statement accurately describes genetics?
A. The molecular analysis of the entire genome of a species
B. The study of inherited traits and their variation in an individual
C. The total genetic composition of an organism
D. The study of influences on gene expression without changing DNA
sequence
Correct answer: B. The study of inherited traits and their variation in an
individual
Rationale: Genetics focuses on the study of inherited traits and their variation
in an individual, examining specific genes and their effects. Genomics refers
to the total genetic composition of an organism or species .
, Page 2 of 41
Question 2: A patient asks why some medications work well for her friend but
not for her. The NP's best response incorporates which concept?
A. Drug-drug interactions are the primary reason for medication variation
B. Genetic variations affect how individuals metabolize medications
C. Age and weight are the only factors that matter in drug response
D. Brand-name medications work better than generic formulations
Correct answer: B. Genetic variations affect how individuals metabolize
medications
Rationale: Pharmacogenomics explains how genetic variations influence
individual responses to medications, including differences in metabolism,
efficacy, and adverse effects .
Question 3: Cytochrome P450 enzymes are responsible for which primary
function in pharmacology?
A. Drug absorption from the gastrointestinal tract
B. Drug distribution to target tissues
C. Drug metabolism, primarily in the liver
D. Drug excretion through the kidneys
Correct answer: C. Drug metabolism, primarily in the liver
Rationale: Cytochrome P450 enzymes are primarily located in the liver and
metabolize medications, making them more water-soluble for excretion.
Genetic polymorphisms in CYP450 enzymes can significantly affect drug
metabolism and response .
Question 4: A patient is prescribed warfarin and requires a lower-than-
expected dose. Genetic testing reveals a polymorphism in which enzyme
system?
A. CYP2D6 and CYP3A4
B. CYP2C9 and VKORC1
C. CYP3A4 and P-glycoprotein
D. CYP1A2 and NAT2
, Page 3 of 41
Correct answer: B. CYP2C9 and VKORC1
Rationale: Warfarin is metabolized by CYP2C9, and its target enzyme is
VKORC1 (vitamin K epoxide reductase). Genetic variants in both CYP2C9 and
VKORC1 affect warfarin dosing requirements and bleeding risk .
Question 5: A patient with a genetic variant resulting in reduced CYP2C9
activity is started on warfarin. What is the most appropriate management
strategy?
A. Initiate warfarin at the standard dose
B. Initiate warfarin at a lower dose and monitor INR closely
C. Avoid warfarin entirely and use an alternative anticoagulant
D. Initiate warfarin at a higher dose to achieve therapeutic effect
Correct answer: B. Initiate warfarin at a lower dose and monitor INR
closely
Rationale: Reduced CYP2C9 activity leads to slower warfarin clearance,
increased INR, and bleeding risk. A lower starting dose with close INR
monitoring is recommended. Genotype-guided dosing improves safety and
time in therapeutic range .
Question 6: Which type of Mendelian inheritance requires the presence of
two copies of a gene mutation to express the phenotype?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. Mitochondrial inheritance
Correct answer: B. Autosomal recessive
Rationale: Autosomal recessive inheritance requires two copies of the
mutated gene (one from each parent) to express the phenotype. Both parents
must be carriers (heterozygous) .
, Page 4 of 41
Question 7: Which of the following is an example of an autosomal dominant
disorder?
A. Cystic fibrosis
B. Sickle cell anemia
C. Huntington's disease
D. Tay-Sachs disease
Correct answer: C. Huntington's disease
Rationale: Huntington's disease is an autosomal dominant disorder, meaning
only one copy of the mutated gene is needed for disease expression. Cystic
fibrosis, sickle cell anemia, and Tay-Sachs are autosomal recessive
disorders .
Question 8: Which of the following is an example of an X-linked recessive
disorder?
A. Marfan syndrome
B. Duchenne muscular dystrophy
C. Fragile X syndrome
D. Huntington's disease
Correct answer: B. Duchenne muscular dystrophy
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder.
Fragile X syndrome is X-linked dominant. Marfan syndrome and Huntington's
disease are autosomal dominant .
Question 9: Pharmacogenomics is the study of:
A. How drugs interact with each other
B. How genetic variations affect drug response
C. How drugs affect gene expression
D. How environmental factors affect drug metabolism
Correct answer: B. How genetic variations affect drug response
Rationale: Pharmacogenomics is the study of how genetic variations
influence individual responses to medications, including differences in
