A 50-year-old is diagnosed with gastroesophageal reflux disease (GERD). This condition is caused by:
loss of muscle tone at the lower esophageal sphincter (LES)
sympathetic nerve stimulation
fibrosis of the lower third of the esophagus
reverse peristalsis of the stomach
The Correct Answer is A
Choice A reason:
Loss of muscle tone at the lower esophageal sphincter (LES) is the primary cause of GERD. The LES normally prevents stomach contents from refluxing into the esophagus. When its tone is reduced, acidic gastric contents can flow back, leading to symptoms such as heartburn, regurgitation, and potential damage to the esophageal lining. Factors contributing to LES dysfunction include obesity, hiatal hernia, and certain dietary habits.
Choice B reason:
Sympathetic nerve stimulation is not a cause of GERD. The autonomic nervous system plays a role in regulating digestive functions, but GERD is primarily a mechanical issue involving the LES and is not directly related to sympathetic nervous activity.
Choice C reason:
Fibrosis of the lower third of the esophagus is typically associated with conditions such as scleroderma, which can lead to esophageal motility disorders. While fibrosis might contribute to esophageal dysfunction, it is not the primary cause of GERD.
Choice D reason:
Reverse peristalsis of the stomach is not a mechanism for GERD. GERD results from dysfunction of the LES, not from the backward movement of stomach contents due to altered motility.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Telling the patient to stop taking the medication if they experience constipation is not appropriate. While side effects should be reported to the healthcare provider, discontinuing the medication without professional guidance can lead to inadequate management of cholesterol levels. The nurse should advise the patient to consult their provider about any side effects.
Choice B reason:
Continuing an exercise program to increase HDL serum levels is important advice. Regular physical activity is beneficial in raising HDL (good cholesterol) levels, which help reduce the risk of heart disease. Exercise complements the effects of cholesterol-lowering medications and supports overall cardiovascular health.
Choice C reason:
Stating that the medication will replace other interventions is incorrect. Cholesterol-lowering medications should be part of a comprehensive treatment plan that includes lifestyle modifications such as diet, exercise, and weight management. These interventions work synergistically to improve lipid profiles and reduce cardiovascular risk.
Choice D reason:
Doubling the dose if a dose is missed is unsafe and not recommended. Patients should follow their prescribed dosing schedule and consult their healthcare provider for instructions if they miss a dose. Taking an extra dose can increase the risk of adverse effects and complications.
Correct Answer is B
Explanation
Choice A reason:
Hepatocellular jaundice occurs due to damage or dysfunction of the liver cells (hepatocytes). This type of jaundice is associated with liver diseases such as hepatitis or cirrhosis, where the liver cannot effectively process bilirubin. It is not directly related to increased red blood cell breakdown but rather to the liver’s inability to handle bilirubin.
Choice B reason:
Hemolytic jaundice results from an increased breakdown of red blood cells, leading to a higher production of bilirubin, which the liver cannot clear fast enough. This condition causes an overload of bilirubin in the blood, resulting in jaundice. Hemolytic jaundice is typically seen in conditions such as hemolytic anemia, where red blood cell destruction exceeds the liver's ability to process and excrete bilirubin.
Choice C reason:
Obstructive jaundice is caused by a blockage in the bile ducts, preventing bilirubin from being excreted into the digestive system. This blockage can result from gallstones, tumors, or strictures. It is not related to the increased breakdown of red blood cells but rather to the obstruction of bile flow, leading to bilirubin buildup in the liver and subsequently in the blood.
Choice D reason:
Metabolic jaundice results from metabolic disorders that affect bilirubin processing or liver function. These disorders can lead to abnormalities in bilirubin metabolism, but they are not directly caused by increased red blood cell breakdown. Metabolic jaundice is less common than other forms and typically involves inherited conditions affecting bilirubin conjugation and excretion.
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