Pharmacogenomics: An Introduction and Clinical
Perspective
Joseph S. Bertino Jr, C. Lindsay DeVane, Uwe Fuhr, Angela D. Kashuba,
Joseph D. Ma
,Chapter 1: Developing Perspectives on Pharmacogenomics
1. A nurse is caring for a patient newly prescribed a medication known to have variable
responses based on genetic makeup. The nurse explains that pharmacogenomics can:
A. Ensure the medication will not cause any adverse effects.
B. Replace the need for routine lab monitoring.
C. Predict how a patient may respond to a specific drug based on their genes.
D. Eliminate the need for dose adjustments.
Correct Answer: C
Rationale: Pharmacogenomics helps predict patient response to medications by
analyzing genetic factors. It doesn’t guarantee no side effects, nor does it replace
monitoring or dose adjustments.
2. A patient asks the nurse how pharmacogenomics differs from pharmacogenetics. The
most appropriate response is:
A. "Pharmacogenomics focuses solely on adverse drug reactions."
B. "Pharmacogenomics examines how a person’s entire genome influences drug
response."
C. "They are the same term used interchangeably."
D. "Pharmacogenomics only applies to cancer treatments."
Correct Answer: B
Rationale: Pharmacogenomics is broader, studying the impact of the entire genome on
drug response, while pharmacogenetics focuses on individual genes.
3. A nurse is teaching a group of nursing students about pharmacogenomics. Which
example best demonstrates its clinical utility?
A. Giving every patient the same starting dose of warfarin.
B. Adjusting chemotherapy based on tumor location.
C. Prescribing abacavir only after HLA-B57:01 screening.
D. Administering insulin to all type 1 diabetics.
Correct Answer: C
Rationale: Pharmacogenomic screening prevents hypersensitivity to abacavir in patients
with HLA-B57:01 allele. Other options reflect standard practices not tied to genetics.
4. A patient asks the nurse why two people taking the same antidepressant may have
different side effects. The nurse correctly responds:
A. "Some people exaggerate their symptoms."
,B. "It depends on how consistently they take the medication."
C. "Genetic differences affect how drugs are metabolized."
D. "All medications cause the same reactions eventually."
Correct Answer: C
Rationale: Genetic variation in drug-metabolizing enzymes (e.g., CYP450 system) leads to
different responses or side effects among individuals.
5. A nurse is preparing discharge instructions for a patient starting codeine. Genetic testing
revealed the patient is a CYP2D6 ultrarapid metabolizer. Which instruction is most
appropriate?
A. “Expect reduced pain relief, and you may need a higher dose.”
B. “You should avoid codeine due to risk of toxicity.”
C. “This genetic result has no effect on codeine.”
D. “The medication will last longer in your system.”
Correct Answer: B
Rationale: Ultrarapid metabolizers convert codeine to morphine quickly, increasing the
risk of morphine toxicity. Avoidance is often recommended.
6. In discussing pharmacogenomic research with a nursing student, the preceptor
emphasizes that the greatest benefit lies in:
A. Eliminating all adverse drug effects.
B. Providing universal medication dosing.
C. Reducing trial-and-error prescribing.
D. Making genetic testing mandatory.
Correct Answer: C
Rationale: Pharmacogenomics aims to personalize therapy and reduce guesswork in
medication selection and dosing.
7. Which scenario best reflects the nursing application of pharmacogenomic knowledge?
A. Automatically adjusting doses based on weight.
B. Administering all medications at fixed times.
C. Anticipating drug response based on genotype information.
D. Referring patients to the hospital's billing department.
Correct Answer: C
, Rationale: Nurses must understand how genotypes can impact medication safety and
efficacy, using this to advocate for patient care.
8. A nurse notes that a patient is prescribed warfarin and has a known variant in VKORC1
and CYP2C9 genes. The most appropriate action is:
A. Inform the provider that genetic data is irrelevant.
B. Document the result without further action.
C. Review INR trends and notify the provider of increased sensitivity.
D. Suggest the patient be switched to aspirin.
Correct Answer: C
Rationale: VKORC1 and CYP2C9 variants can increase warfarin sensitivity, requiring close
INR monitoring and potential dose reduction.
9. Which statement best demonstrates understanding of pharmacogenomic nursing
ethics?
A. “Genetic testing should be mandatory before every prescription.”
B. “Results should be kept confidential and used to guide care.”
C. “Insurance companies need access to patient genetic data.”
D. “Only physicians need to understand genetic testing.”
Correct Answer: B
Rationale: Nurses must uphold confidentiality and advocate for ethical use of genetic
data in clinical decision-making.
10. A nurse reads a journal article suggesting that pharmacogenomics may reduce
healthcare costs. Which explanation supports this?
A. It reduces nurse staffing requirements.
B. It eliminates the need for medications.
C. It minimizes adverse drug reactions and ineffective therapies.
D. It replaces physician evaluations.
Correct Answer: C
Rationale: Targeted drug selection and dosing reduce costs from complications and
hospitalizations due to ADRs.
11. A patient taking thiopurines shows low TPMT enzyme activity. The nurse recognizes
that:
Perspective
Joseph S. Bertino Jr, C. Lindsay DeVane, Uwe Fuhr, Angela D. Kashuba,
Joseph D. Ma
,Chapter 1: Developing Perspectives on Pharmacogenomics
1. A nurse is caring for a patient newly prescribed a medication known to have variable
responses based on genetic makeup. The nurse explains that pharmacogenomics can:
A. Ensure the medication will not cause any adverse effects.
B. Replace the need for routine lab monitoring.
C. Predict how a patient may respond to a specific drug based on their genes.
D. Eliminate the need for dose adjustments.
Correct Answer: C
Rationale: Pharmacogenomics helps predict patient response to medications by
analyzing genetic factors. It doesn’t guarantee no side effects, nor does it replace
monitoring or dose adjustments.
2. A patient asks the nurse how pharmacogenomics differs from pharmacogenetics. The
most appropriate response is:
A. "Pharmacogenomics focuses solely on adverse drug reactions."
B. "Pharmacogenomics examines how a person’s entire genome influences drug
response."
C. "They are the same term used interchangeably."
D. "Pharmacogenomics only applies to cancer treatments."
Correct Answer: B
Rationale: Pharmacogenomics is broader, studying the impact of the entire genome on
drug response, while pharmacogenetics focuses on individual genes.
3. A nurse is teaching a group of nursing students about pharmacogenomics. Which
example best demonstrates its clinical utility?
A. Giving every patient the same starting dose of warfarin.
B. Adjusting chemotherapy based on tumor location.
C. Prescribing abacavir only after HLA-B57:01 screening.
D. Administering insulin to all type 1 diabetics.
Correct Answer: C
Rationale: Pharmacogenomic screening prevents hypersensitivity to abacavir in patients
with HLA-B57:01 allele. Other options reflect standard practices not tied to genetics.
4. A patient asks the nurse why two people taking the same antidepressant may have
different side effects. The nurse correctly responds:
A. "Some people exaggerate their symptoms."
,B. "It depends on how consistently they take the medication."
C. "Genetic differences affect how drugs are metabolized."
D. "All medications cause the same reactions eventually."
Correct Answer: C
Rationale: Genetic variation in drug-metabolizing enzymes (e.g., CYP450 system) leads to
different responses or side effects among individuals.
5. A nurse is preparing discharge instructions for a patient starting codeine. Genetic testing
revealed the patient is a CYP2D6 ultrarapid metabolizer. Which instruction is most
appropriate?
A. “Expect reduced pain relief, and you may need a higher dose.”
B. “You should avoid codeine due to risk of toxicity.”
C. “This genetic result has no effect on codeine.”
D. “The medication will last longer in your system.”
Correct Answer: B
Rationale: Ultrarapid metabolizers convert codeine to morphine quickly, increasing the
risk of morphine toxicity. Avoidance is often recommended.
6. In discussing pharmacogenomic research with a nursing student, the preceptor
emphasizes that the greatest benefit lies in:
A. Eliminating all adverse drug effects.
B. Providing universal medication dosing.
C. Reducing trial-and-error prescribing.
D. Making genetic testing mandatory.
Correct Answer: C
Rationale: Pharmacogenomics aims to personalize therapy and reduce guesswork in
medication selection and dosing.
7. Which scenario best reflects the nursing application of pharmacogenomic knowledge?
A. Automatically adjusting doses based on weight.
B. Administering all medications at fixed times.
C. Anticipating drug response based on genotype information.
D. Referring patients to the hospital's billing department.
Correct Answer: C
, Rationale: Nurses must understand how genotypes can impact medication safety and
efficacy, using this to advocate for patient care.
8. A nurse notes that a patient is prescribed warfarin and has a known variant in VKORC1
and CYP2C9 genes. The most appropriate action is:
A. Inform the provider that genetic data is irrelevant.
B. Document the result without further action.
C. Review INR trends and notify the provider of increased sensitivity.
D. Suggest the patient be switched to aspirin.
Correct Answer: C
Rationale: VKORC1 and CYP2C9 variants can increase warfarin sensitivity, requiring close
INR monitoring and potential dose reduction.
9. Which statement best demonstrates understanding of pharmacogenomic nursing
ethics?
A. “Genetic testing should be mandatory before every prescription.”
B. “Results should be kept confidential and used to guide care.”
C. “Insurance companies need access to patient genetic data.”
D. “Only physicians need to understand genetic testing.”
Correct Answer: B
Rationale: Nurses must uphold confidentiality and advocate for ethical use of genetic
data in clinical decision-making.
10. A nurse reads a journal article suggesting that pharmacogenomics may reduce
healthcare costs. Which explanation supports this?
A. It reduces nurse staffing requirements.
B. It eliminates the need for medications.
C. It minimizes adverse drug reactions and ineffective therapies.
D. It replaces physician evaluations.
Correct Answer: C
Rationale: Targeted drug selection and dosing reduce costs from complications and
hospitalizations due to ADRs.
11. A patient taking thiopurines shows low TPMT enzyme activity. The nurse recognizes
that:
