NR 565 / NR565 Week 1 Quiz bank | Chapters
2, 7, 8 | LATEST, Q & A | Chamberlain College
Exam
1. Pharmacogenetic testing is required by the FDA prior to prescribing which
medication?
• A) Metoprolol
• B) Cetuximab
• C) Warfarin
• D) Codeine
• Correct Answer: B
• Rationale: Cetuximab requires KRAS mutation testing; patients with KRAS
mutations do not benefit.
2. Carbamazepine has a Black Box Warning for testing the HLA-B*1502 allele in
Asian patients due to risk of:
• A) Hepatotoxicity
• B) Stevens-Johnson syndrome (SJS)/Toxic epidermal necrolysis (TEN)
• C) Agranulocytosis
• D) QT prolongation
• Correct Answer: B
• Rationale: HLA-B*1502 positive patients have up to 10% risk of SJS/TEN.
3. A genetic variation in SN-38 (irinotecan metabolite) inactivation may lead to:
• A) Increased seizure risk
• B) Increased neutropenia and diarrhea
, • C) Hypertension
• D) Hyperglycemia
• Correct Answer: B
• Rationale: UGT1A1 poor metabolizers accumulate toxic SN-38.
4. Patients with a poor metabolism phenotype will have:
• A) Rapid drug excretion
• B) Slowed prodrug conversion → prodrug accumulation
• C) Increased active drug effect
• D) Decreased drug half-life
• Correct Answer: B
• Rationale: Poor metabolizers lack functional enzyme activity.
5. Ultra-rapid metabolizers of drugs may experience:
• A) Toxicity from active drugs
• B) Therapeutic failure from active drugs
• C) Both A and B depending on drug type
• D) No clinical effect
• Correct Answer: C
• Rationale: For prodrugs → toxicity; for active drugs → failure.
6. CYP2D6 testing before tamoxifen helps identify:
• A) Patients at risk for thrombosis
• B) Poor metabolizers who do not convert tamoxifen to endoxifen
• C) Patients who need higher doses
• D) Patients at risk for endometrial cancer
• Correct Answer: B
, • Rationale: Poor metabolizers have higher breast cancer recurrence.
7. Genetic polymorphisms account for differences in metabolism, including:
• A) Poor, intermediate, extensive, and ultra-rapid metabolizers
• B) Only poor and extensive metabolizers
• C) Only rapid and slow acetylators
• D) Only CYP3A4 variants
• Correct Answer: A
• Rationale: Four main phenotypes based on enzyme activity.
8. A poor metabolizer of codeine is at risk for:
• A) Respiratory depression
• B) Severe constipation
• C) Therapeutic failure (no pain relief)
• D) Serotonin syndrome
• Correct Answer: C
• Rationale: Cannot convert codeine to active morphine.
9. What is the primary role of CYP450 enzymes?
• A) Drug absorption
• B) Drug distribution
• C) Drug metabolism (oxidation)
• D) Drug excretion
• Correct Answer: C
• Rationale: Phase I metabolism via oxidation, reduction, hydrolysis.
10. Which is a nonspecific CYP450 inducer that causes oral contraceptive
failure?
• A) Ketoconazole
, • B) Rifampin
• C) Erythromycin
• D) Fluconazole
• Correct Answer: B
• Rationale: Induces CYP3A4 → faster estrogen/progestin metabolism.
11. A CYP2C9 poor metabolizer taking warfarin is at risk for:
• A) Elevated INR and bleeding
• B) Subtherapeutic INR
• C) Warfarin resistance
• D) Skin necrosis
• Correct Answer: A
• Rationale: Reduced warfarin metabolism → higher drug levels.
12. HLA-B*5701 screening is required before:
• A) Carbamazepine
• B) Allopurinol
• C) Abacavir
• D) Clopidogrel
• Correct Answer: C
• Rationale: Positive test → 60% risk of hypersensitivity.
13. DPYD gene variants increase toxicity risk from:
• A) Methotrexate
• B) Fluorouracil (5-FU) and capecitabine
• C) Mercaptopurine
• D) Cyclophosphamide
2, 7, 8 | LATEST, Q & A | Chamberlain College
Exam
1. Pharmacogenetic testing is required by the FDA prior to prescribing which
medication?
• A) Metoprolol
• B) Cetuximab
• C) Warfarin
• D) Codeine
• Correct Answer: B
• Rationale: Cetuximab requires KRAS mutation testing; patients with KRAS
mutations do not benefit.
2. Carbamazepine has a Black Box Warning for testing the HLA-B*1502 allele in
Asian patients due to risk of:
• A) Hepatotoxicity
• B) Stevens-Johnson syndrome (SJS)/Toxic epidermal necrolysis (TEN)
• C) Agranulocytosis
• D) QT prolongation
• Correct Answer: B
• Rationale: HLA-B*1502 positive patients have up to 10% risk of SJS/TEN.
3. A genetic variation in SN-38 (irinotecan metabolite) inactivation may lead to:
• A) Increased seizure risk
• B) Increased neutropenia and diarrhea
, • C) Hypertension
• D) Hyperglycemia
• Correct Answer: B
• Rationale: UGT1A1 poor metabolizers accumulate toxic SN-38.
4. Patients with a poor metabolism phenotype will have:
• A) Rapid drug excretion
• B) Slowed prodrug conversion → prodrug accumulation
• C) Increased active drug effect
• D) Decreased drug half-life
• Correct Answer: B
• Rationale: Poor metabolizers lack functional enzyme activity.
5. Ultra-rapid metabolizers of drugs may experience:
• A) Toxicity from active drugs
• B) Therapeutic failure from active drugs
• C) Both A and B depending on drug type
• D) No clinical effect
• Correct Answer: C
• Rationale: For prodrugs → toxicity; for active drugs → failure.
6. CYP2D6 testing before tamoxifen helps identify:
• A) Patients at risk for thrombosis
• B) Poor metabolizers who do not convert tamoxifen to endoxifen
• C) Patients who need higher doses
• D) Patients at risk for endometrial cancer
• Correct Answer: B
, • Rationale: Poor metabolizers have higher breast cancer recurrence.
7. Genetic polymorphisms account for differences in metabolism, including:
• A) Poor, intermediate, extensive, and ultra-rapid metabolizers
• B) Only poor and extensive metabolizers
• C) Only rapid and slow acetylators
• D) Only CYP3A4 variants
• Correct Answer: A
• Rationale: Four main phenotypes based on enzyme activity.
8. A poor metabolizer of codeine is at risk for:
• A) Respiratory depression
• B) Severe constipation
• C) Therapeutic failure (no pain relief)
• D) Serotonin syndrome
• Correct Answer: C
• Rationale: Cannot convert codeine to active morphine.
9. What is the primary role of CYP450 enzymes?
• A) Drug absorption
• B) Drug distribution
• C) Drug metabolism (oxidation)
• D) Drug excretion
• Correct Answer: C
• Rationale: Phase I metabolism via oxidation, reduction, hydrolysis.
10. Which is a nonspecific CYP450 inducer that causes oral contraceptive
failure?
• A) Ketoconazole
, • B) Rifampin
• C) Erythromycin
• D) Fluconazole
• Correct Answer: B
• Rationale: Induces CYP3A4 → faster estrogen/progestin metabolism.
11. A CYP2C9 poor metabolizer taking warfarin is at risk for:
• A) Elevated INR and bleeding
• B) Subtherapeutic INR
• C) Warfarin resistance
• D) Skin necrosis
• Correct Answer: A
• Rationale: Reduced warfarin metabolism → higher drug levels.
12. HLA-B*5701 screening is required before:
• A) Carbamazepine
• B) Allopurinol
• C) Abacavir
• D) Clopidogrel
• Correct Answer: C
• Rationale: Positive test → 60% risk of hypersensitivity.
13. DPYD gene variants increase toxicity risk from:
• A) Methotrexate
• B) Fluorouracil (5-FU) and capecitabine
• C) Mercaptopurine
• D) Cyclophosphamide
