NUR 641E MIDTERM STUDY GUIDE SCRIPT
2026 FULL QUESTIONS ANSWERS
COMPREHENSIVE STUDY GUIDE GRADED
A+
⩥ Glucagon.
Answer: A protein hormone secreted by pancreatic endocrine cells that
raises blood glucose levels; an antagonistic hormone to insulin;
stimulates glycogenolysis by the liver
⩥ Dawn phenomenon (Dawn Effect).
Answer: occurs in the early morning hours (i.e., between 2 am and 8
am); blood glucose levels increase in patients with diabetes. There is no
nighttime hypoglycemia
⩥ Somogyi effect.
Answer: If a client fails to eat her bedtime snack she might experience
the Somogyi effect. This abrupt drop in the client's blood glucsose level
during the night is followed by a false elevation; occurs after an episode
of untreated , causing increased blood glucose levels in the morning;
treated by increasing food intake near bedtime or reducing the evening
insulin dose.
⩥ Gastrointestinal:
,Laxatives.
Answer: stimulants (e.g., senna, Bisacodyl, magnesium oxide [milk of
magnesia], magnesium citrate, castor oil), bulk (psyllium,
methylcellulose), stool softeners (e.g., docusate), sugars (e.g., lactulose),
osmotic agent trapping water in the GI lumen (e.g., polyethylene glycol),
mineral oil.
⩥ Linaclotide (Linzess).
Answer: IBS-*C* Therapy; for chronic idiopathic constipation (CIC)
⩥ The safest laxative for chronic use is.
Answer: methylcellulose (Citrucel, Metamucil)
⩥ Octreotide.
Answer: is a potent vasoconstrictor used in treating acute GI bleeds
⩥ Anti-emetic agents.
Answer: antihistamines, phenothiazines (e.g. prochlorperazine), 5HT3
receptor antagonists (e.g., ondansetron[Zofran], granisetron).
⩥ Ondansetron (Zofran).
Answer: Antiemetic; can cause constipation, headache, heart conduction
irregularities (prolonged QT interval).
, ⩥ 5HT3 receptor antagonists.
Answer: inhibit serotonin receptors inside the chemoreceptor trigger
zone (CTZ) and also inhibit serotonin receptors on vagal nerve
terminals; these pharmacologic actions reduce nausea and vomiting.
⩥ H2RAs.
Answer: cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid),
nizatidine (Axid)
⩥ Lactulose.
Answer: is used in hepatic encephalopathy; works by ion trapping of
ammonia.
⩥ Proton Pump Inhibitors (PPIs).
Answer: esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole
(Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex)
⩥ Heart patients taking clopidogrel (Plavix).
Answer: should avoid omeprazole; it blocks enzymatic conversion of
clopidogrel to its active metabolite.
⩥ Clopidogrel.
Answer: does not interact with pantoprazole, rabeprazole or lansoprazole
2026 FULL QUESTIONS ANSWERS
COMPREHENSIVE STUDY GUIDE GRADED
A+
⩥ Glucagon.
Answer: A protein hormone secreted by pancreatic endocrine cells that
raises blood glucose levels; an antagonistic hormone to insulin;
stimulates glycogenolysis by the liver
⩥ Dawn phenomenon (Dawn Effect).
Answer: occurs in the early morning hours (i.e., between 2 am and 8
am); blood glucose levels increase in patients with diabetes. There is no
nighttime hypoglycemia
⩥ Somogyi effect.
Answer: If a client fails to eat her bedtime snack she might experience
the Somogyi effect. This abrupt drop in the client's blood glucsose level
during the night is followed by a false elevation; occurs after an episode
of untreated , causing increased blood glucose levels in the morning;
treated by increasing food intake near bedtime or reducing the evening
insulin dose.
⩥ Gastrointestinal:
,Laxatives.
Answer: stimulants (e.g., senna, Bisacodyl, magnesium oxide [milk of
magnesia], magnesium citrate, castor oil), bulk (psyllium,
methylcellulose), stool softeners (e.g., docusate), sugars (e.g., lactulose),
osmotic agent trapping water in the GI lumen (e.g., polyethylene glycol),
mineral oil.
⩥ Linaclotide (Linzess).
Answer: IBS-*C* Therapy; for chronic idiopathic constipation (CIC)
⩥ The safest laxative for chronic use is.
Answer: methylcellulose (Citrucel, Metamucil)
⩥ Octreotide.
Answer: is a potent vasoconstrictor used in treating acute GI bleeds
⩥ Anti-emetic agents.
Answer: antihistamines, phenothiazines (e.g. prochlorperazine), 5HT3
receptor antagonists (e.g., ondansetron[Zofran], granisetron).
⩥ Ondansetron (Zofran).
Answer: Antiemetic; can cause constipation, headache, heart conduction
irregularities (prolonged QT interval).
, ⩥ 5HT3 receptor antagonists.
Answer: inhibit serotonin receptors inside the chemoreceptor trigger
zone (CTZ) and also inhibit serotonin receptors on vagal nerve
terminals; these pharmacologic actions reduce nausea and vomiting.
⩥ H2RAs.
Answer: cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid),
nizatidine (Axid)
⩥ Lactulose.
Answer: is used in hepatic encephalopathy; works by ion trapping of
ammonia.
⩥ Proton Pump Inhibitors (PPIs).
Answer: esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole
(Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex)
⩥ Heart patients taking clopidogrel (Plavix).
Answer: should avoid omeprazole; it blocks enzymatic conversion of
clopidogrel to its active metabolite.
⩥ Clopidogrel.
Answer: does not interact with pantoprazole, rabeprazole or lansoprazole
