PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
Chapter 1. m m
An Introduction to Pharmacogenetics
m m m
Multiple Choice m
Identify the choice that best completes the statement or answers the question.
m m m m m m m m m m m
m 1. Genetic polymorphisms account for differences in metabolism, including:
mmmm m m m m m m m m
1. Poor metabolizers, who lack a working enzyme
m m m m m m
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant
m m m m m m m m m m
3. Extensive metabolizers, with two normally functioning alleles
m m m m m m
4. All of the above m m m
m 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
mmmm m m m m m m m m m m m
1. A need to monitor drugs metabolized by 2D6 for toxicity
m m m m m m m m m
2. Increased dosages needed of drugs metabolized by 2D6, such as th
m m m m m m m m m m
e selective seroto reuptake inhibitors
m m m m
3. Decreased conversion of codeine to morphine by CYP 2D6
m m m m m m m m
4. The need for lowered dosages of drugs, such as beta blockers
m m m m m m m m m m
m 3. Rifampin is a nonspecific CYP450 inducer that may:
mmmm m m m m m m m m
1. Lead to toxic levels of rifampin and must be monitored closely
m m m m m m m m m m
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
m m m m m m m m m m
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic
m m m m m m m m m m m
4. Cause nonspecific changes in drug metabolism
m m m m m
m 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
mmmm m m m m m m m m m m m m
1. Decreased therapeutic levels of quinidine m m m m
2. Increased therapeutic levels of quinidine m m m m
3. Decreased levels of a coadministered drug, such as digoxin, that r
m m m m m m m m m m
equires P-glycopr absorption and elimination
m m m m
4. Increased levels of a coadministered drug, such as digoxin, that re
m m m m m m m m m m
quires P-glycopro absorption and elimination
m m m m
m 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
mmmm m m m m m m m m m m m m
1. Toxic levels of warfarin building up
m m m m m
2. Decreased response to warfarin m m m
,PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
3. Increased risk for significant drug interactions with warfarin
m m m m m m m
4. Less risk of drug interactions with warfarin
m m m m m m
m
6. Genetic testing for VCORC1 mutation to assess potential war
mmmm m m m m m m m m m
farin resistance is required prior to prescribing warfarin.
m m m m m m m
1. True
2. False
m
7. Pharmacogenetic testing is required by the U.S. Food and Dr
mmmm m m m m m m m m m m
ug Administration prior to prescribing:
m m m m
1. Erythromycin
2. Digoxin
3. Cetuximab
,PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
4. Rifampin
m
8. Carbamazepine has a Black Box Warning recommending testing
mmmm m m m m m m m m
mfor the HLA-
m m
B*1502 allele in patients with Asian ancestry prior to starting therapy
m m m m m m m m m m m
due to: m
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients wit
m m m m m m m m m m
HLA-B*1502 allele m
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
m m m m m m m m m m m
3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-
m m m m m m m m m
B*1502 a m
4. Patients who have the HLA- m m m m
B*1502 allele being more likely to have a resistance to carbamaze
m m m m m m m m m m
pine
m
9. A genetic variation in how the metabolite of the cancer
mmmm m m m m m m m m m m m
drug irinotecan SN-38 is inactivated by the body may lead to:
m m m m m m m m m m
1. Decreased effectiveness of irinotecan in the treatment of cancer
m m m m m m m m
2. Increased adverse drug reactions, such as neutropenia
m m m m m m
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
m m m m m m m m m m
4. Increased concerns for irinotecan being carcinogenic
m m m m m
m 10. Patients who have a poor metabolism phenotype will have:
mm m m m m m m m m m
1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of p
m m m m m m m m m m m m m
r
2. Accumulation of inactive metabolites of drugs m m m m m
3. A need for increased dosages of medications
m m m m m m
4. Increased elimination of an active drug m m m m m
m 11. Ultra-rapid metabolizers of drugs may have:
mm m m m m m m
1. To have dosages of drugs adjusted downward to prevent drug accumulation
m m m m m m m m m m
2. Active drug rapidly metabolized into inactive metabolites, leading
m m m m m m m m
to potential thera failure
m m m
3. Increased elimination of active, nonmetabolized drug
m m m m m
4. Slowed metabolism of a prodrug into an active drug, leading to an accumulation o
m m m m m m m m m m m m m
, PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
f
m
12. A provider may consider testing for CYP2D6 variants prio
mm m m m m m m m m m
r to starting tamoxifen for breast cancer to:
m m m m m m m
1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
m m m m m m m m m m m m
2. Identify potential drug-drug interactions that may occur with tamoxifen
m m m m m m m m
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
m m m m m m m m
4. Identify poor metabolizers of tamoxifen
m m m m
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
Chapter 1. m m
An Introduction to Pharmacogenetics
m m m
Multiple Choice m
Identify the choice that best completes the statement or answers the question.
m m m m m m m m m m m
m 1. Genetic polymorphisms account for differences in metabolism, including:
mmmm m m m m m m m m
1. Poor metabolizers, who lack a working enzyme
m m m m m m
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant
m m m m m m m m m m
3. Extensive metabolizers, with two normally functioning alleles
m m m m m m
4. All of the above m m m
m 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
mmmm m m m m m m m m m m m
1. A need to monitor drugs metabolized by 2D6 for toxicity
m m m m m m m m m
2. Increased dosages needed of drugs metabolized by 2D6, such as th
m m m m m m m m m m
e selective seroto reuptake inhibitors
m m m m
3. Decreased conversion of codeine to morphine by CYP 2D6
m m m m m m m m
4. The need for lowered dosages of drugs, such as beta blockers
m m m m m m m m m m
m 3. Rifampin is a nonspecific CYP450 inducer that may:
mmmm m m m m m m m m
1. Lead to toxic levels of rifampin and must be monitored closely
m m m m m m m m m m
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
m m m m m m m m m m
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic
m m m m m m m m m m m
4. Cause nonspecific changes in drug metabolism
m m m m m
m 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
mmmm m m m m m m m m m m m m
1. Decreased therapeutic levels of quinidine m m m m
2. Increased therapeutic levels of quinidine m m m m
3. Decreased levels of a coadministered drug, such as digoxin, that r
m m m m m m m m m m
equires P-glycopr absorption and elimination
m m m m
4. Increased levels of a coadministered drug, such as digoxin, that re
m m m m m m m m m m
quires P-glycopro absorption and elimination
m m m m
m 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
mmmm m m m m m m m m m m m m
1. Toxic levels of warfarin building up
m m m m m
2. Decreased response to warfarin m m m
,PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
3. Increased risk for significant drug interactions with warfarin
m m m m m m m
4. Less risk of drug interactions with warfarin
m m m m m m
m
6. Genetic testing for VCORC1 mutation to assess potential war
mmmm m m m m m m m m m
farin resistance is required prior to prescribing warfarin.
m m m m m m m
1. True
2. False
m
7. Pharmacogenetic testing is required by the U.S. Food and Dr
mmmm m m m m m m m m m m
ug Administration prior to prescribing:
m m m m
1. Erythromycin
2. Digoxin
3. Cetuximab
,PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
4. Rifampin
m
8. Carbamazepine has a Black Box Warning recommending testing
mmmm m m m m m m m m
mfor the HLA-
m m
B*1502 allele in patients with Asian ancestry prior to starting therapy
m m m m m m m m m m m
due to: m
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients wit
m m m m m m m m m m
HLA-B*1502 allele m
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
m m m m m m m m m m m
3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-
m m m m m m m m m
B*1502 a m
4. Patients who have the HLA- m m m m
B*1502 allele being more likely to have a resistance to carbamaze
m m m m m m m m m m
pine
m
9. A genetic variation in how the metabolite of the cancer
mmmm m m m m m m m m m m m
drug irinotecan SN-38 is inactivated by the body may lead to:
m m m m m m m m m m
1. Decreased effectiveness of irinotecan in the treatment of cancer
m m m m m m m m
2. Increased adverse drug reactions, such as neutropenia
m m m m m m
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
m m m m m m m m m m
4. Increased concerns for irinotecan being carcinogenic
m m m m m
m 10. Patients who have a poor metabolism phenotype will have:
mm m m m m m m m m m
1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of p
m m m m m m m m m m m m m
r
2. Accumulation of inactive metabolites of drugs m m m m m
3. A need for increased dosages of medications
m m m m m m
4. Increased elimination of an active drug m m m m m
m 11. Ultra-rapid metabolizers of drugs may have:
mm m m m m m m
1. To have dosages of drugs adjusted downward to prevent drug accumulation
m m m m m m m m m m
2. Active drug rapidly metabolized into inactive metabolites, leading
m m m m m m m m
to potential thera failure
m m m
3. Increased elimination of active, nonmetabolized drug
m m m m m
4. Slowed metabolism of a prodrug into an active drug, leading to an accumulation o
m m m m m m m m m m m m m
, PHARMACOTHERAPEUTICS mFOR mADVANCED mPRACTICE mNURSEmPRESCRIBERS,QUESTIONS m&mANS
WERSmFULLY mANALYSED mEDITION mEXAMm100%mCORRECTLY/VERIFIEDmANSWERSmWITHmSATISFA
CTION mGUARANTEED mSUCCESSmLATESTmUPDATE m2023/2024m5THmEDITION mWOOmROBINSON mTESTmB
ANK mGRADED mA+
f
m
12. A provider may consider testing for CYP2D6 variants prio
mm m m m m m m m m m
r to starting tamoxifen for breast cancer to:
m m m m m m m
1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
m m m m m m m m m m m m
2. Identify potential drug-drug interactions that may occur with tamoxifen
m m m m m m m m
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
m m m m m m m m
4. Identify poor metabolizers of tamoxifen
m m m m