Question 1

Which processes of drug response are most subject to genetic variation?

Accepted Answer

A)  Drug dissolution in body fluids and drug binding to plasma proteins
B)  Rates of drug movement into and through the gastrointestinal tract
C)  Drug activation or deactivation and duration of drug actions
D)  Drug binding with receptors and drug blocking of receptorsE) B) and C)
F) All of the above

Question 2

Which condition or factor improves the initial bioavailability of a drug agonist that has extensive first-pass loss as a result of the patient's enhanced liver enzyme activity?

Accepted Answer

A)  Increasing the patient's fluid intake
B)  Co-administering the drug with an antagonist
C)  Administering the drug by the intravenous route
D)  Crushing the oral form of the drug before administrationE) A) and B)
F) A) and C)

Question 3

A patient has a very high concentration of insulin receptors on cells that require insulin for glucose to enter.How should insulin dosages be adjusted for this patient to have blood glucose levels within the normal range?

Accepted Answer

A)  Insulin dosages should be given less frequently because the drug will remain bound to receptors longer.
B)  Insulin dosages should be decreased because the drug will exert its actions at lower concentrations.
C)  Insulin dosages should be given more frequently because the drug will be eliminated at a faster rate.
D)  Insulin dosages should be increased because cells will be less sensitive to the presence of active insulin.E) All of the above
F) B) and C) B

Question 4

A patient is identified as an ultra-rapid metabolizer for drugs that are prepared for elimination by CYP2D6.What effect will this have on the patient's ability to benefit from any active drug that is metabolized by this enzyme?

Accepted Answer

A)  Intended responses increase while side effects decrease.
B)  Intended responses decrease while side effects increase.
C)  Both intended responses and side effects increase.
D)  Both intended responses and side effects decrease.E) A) and C)
F) B) and D)

Question 5

What would be the patient's response to a normal drug dose that because of a genetic variation in an enzyme that prepares the drug for elimination results in a blood drug level that is below the minimum effective concentration (MEC) ?

Accepted Answer

A)  Drug entry exceeds drug elimination.
B)  The risk for toxic side effects is increased.
C)  The intended response fails to be produced.
D)  The drug's duration of action is longer than expected.E) B) and D)
F) None of the above

Question 6

What is the most likely outcome for a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency when he or she takes aspirin or an antimalarial drug?

Accepted Answer

A)  Rapid elimination of the drug with no benefit
B)  Liver damage or failure
C)  Hemolytic anemia
D)  Fluid retentionE) All of the above
F) A) and D) C

Question 7

Which type of parent compound must undergo first phase metabolism to produce the intended response after it enters the body?

Accepted Answer

A)  A prodrug
B)  An active metabolite
C)  An inactive metabolite
D)  A sustained-released drugE) C) and D)
F) All of the above

Question 8

Which organ has the greatest concentration of cytochrome P (CYP) 450 enzymes?

Accepted Answer

A)  Stomach
B)  Kidney
C)  Brain
D)  LiverE) C) and D)
F) None of the above

Question 9

A patient with a fractured elbow in the emergency department states that he needs morphine for pain rather than codeine because the last time he had a painful injury,codeine was not effective in managing his pain.What is the nurse's best response or action?

Accepted Answer

A)  Ask the patient how much alcohol he ingests daily.
B)  Communicate this information to the admitting physician.
C)  Alert the health-care provider that this patient is "drug-seeking."
D)  Reassure the patient that he will receive progressively higher dosages of codeine until his pain is controlled.E) None of the above
F) A) and B) B

Question 10

An Asian American man and his Caucasian wife are both taking warfarin (Coumadin) daily because of atrial fibrillation.The husband asks why he is prescribed a much smaller than average dose of the drug to keep his international normalized ratio (INR) at 2.0 and his wife takes the average dose even though he is taller and heavier than she is.What is the nurse's best response?

Accepted Answer

A)  "Body size is not important for warfarin but gender differences are because testosterone improves its action."
B)  "You are probably anemic,which would reduce your ability to form blood clots,so your doses can be lower."
C)  "Many Asian Americans do not break down warfarin as fast as Caucasians,so the drug is more effective at lower dosages."
D)  "Caucasians have higher levels of the enzyme that breaks down warfarin,requiring higher dosages for the same effect on INR."E) None of the above
F) B) and D)

Question 11

How do genetic/genomic issues influence individual variation of the response to a specific drug?

Accepted Answer

A)  Polymorphisms of genes encoding metabolizing enzymes
B)  Age-related loss of alleles within the cells lining the intestinal tract
C)  Single gene disorders that reduce the function of the kidneys or the liver
D)  Genetic-based behavior problems that promote poor adherence to prescribed drug regimensE) None of the above
F) B) and D)

Question 12

How are the actions of naturally occurring estrogen changed when a patient is taking a drug that is an estrogen agonist?

Accepted Answer

A)  Actions are increased.
B)  Actions are decreased.
C)  Actions are eliminated.
D)  Actions are unchanged.E) A) and D)
F) C) and D)

Exam 15: Assessing Genomic Variation in Drug Response

Which processes of drug response are most subject to genetic variation?

Correct Answer
verified

Which condition or factor improves the initial bioavailability of a drug agonist that has extensive first-pass loss as a result of the patient's enhanced liver enzyme activity?

Correct Answer
verified

A patient has a very high concentration of insulin receptors on cells that require insulin for glucose to enter.How should insulin dosages be adjusted for this patient to have blood glucose levels within the normal range?

Correct Answer
verified
B

A patient is identified as an ultra-rapid metabolizer for drugs that are prepared for elimination by CYP2D6.What effect will this have on the patient's ability to benefit from any active drug that is metabolized by this enzyme?

Correct Answer
verified

What would be the patient's response to a normal drug dose that because of a genetic variation in an enzyme that prepares the drug for elimination results in a blood drug level that is below the minimum effective concentration (MEC) ?

Correct Answer
verified

What is the most likely outcome for a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency when he or she takes aspirin or an antimalarial drug?

Correct Answer
verified
C

Which type of parent compound must undergo first phase metabolism to produce the intended response after it enters the body?

Correct Answer
verified

Which organ has the greatest concentration of cytochrome P (CYP) 450 enzymes?

Correct Answer
verified

A patient with a fractured elbow in the emergency department states that he needs morphine for pain rather than codeine because the last time he had a painful injury,codeine was not effective in managing his pain.What is the nurse's best response or action?

Correct Answer
verified
B

Correct Answer
verified

How do genetic/genomic issues influence individual variation of the response to a specific drug?

Correct Answer
verified

How are the actions of naturally occurring estrogen changed when a patient is taking a drug that is an estrogen agonist?

Correct Answer
verified

Exam 15: Assessing Genomic Variation in Drug Response

Which processes of drug response are most subject to genetic variation?

Correct AnswerverifiedShow Answer

Which condition or factor improves the initial bioavailability of a drug agonist that has extensive first-pass loss as a result of the patient's enhanced liver enzyme activity?

Correct AnswerverifiedShow Answer

A patient has a very high concentration of insulin receptors on cells that require insulin for glucose to enter.How should insulin dosages be adjusted for this patient to have blood glucose levels within the normal range?

Correct AnswerverifiedB

A patient is identified as an ultra-rapid metabolizer for drugs that are prepared for elimination by CYP2D6.What effect will this have on the patient's ability to benefit from any active drug that is metabolized by this enzyme?

Correct AnswerverifiedShow Answer

What would be the patient's response to a normal drug dose that because of a genetic variation in an enzyme that prepares the drug for elimination results in a blood drug level that is below the minimum effective concentration (MEC) ?

Correct AnswerverifiedShow Answer

What is the most likely outcome for a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency when he or she takes aspirin or an antimalarial drug?

Correct AnswerverifiedC

Which type of parent compound must undergo first phase metabolism to produce the intended response after it enters the body?

Correct AnswerverifiedShow Answer

Which organ has the greatest concentration of cytochrome P (CYP) 450 enzymes?

Correct AnswerverifiedShow Answer

A patient with a fractured elbow in the emergency department states that he needs morphine for pain rather than codeine because the last time he had a painful injury,codeine was not effective in managing his pain.What is the nurse's best response or action?

Correct AnswerverifiedB

Correct AnswerverifiedShow Answer

How do genetic/genomic issues influence individual variation of the response to a specific drug?

Correct AnswerverifiedShow Answer

How are the actions of naturally occurring estrogen changed when a patient is taking a drug that is an estrogen agonist?

Correct AnswerverifiedShow Answer

Correct Answer
verified

Correct Answer
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Correct Answer
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B

Correct Answer
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Correct Answer
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Correct Answer
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C

Correct Answer
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Correct Answer
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Correct Answer
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B

Correct Answer
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Correct Answer
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Correct Answer
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