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:
Arterial emboli from a heart valve are not the most common cause of myocardial ischemia. While emboli can obstruct blood flow and cause ischemia, they are a less common cause compared to atherosclerosis. Embolic events typically result from conditions like atrial fibrillation or valvular heart disease but do not account for the majority of myocardial ischemia cases.
Choice B reason:
Atherosclerosis is the most common cause of myocardial ischemia. It involves the buildup of plaque within the coronary arteries, leading to reduced blood flow and oxygen supply to the heart muscle. This condition is a leading cause of coronary artery disease and is responsible for the majority of myocardial ischemia cases.
Choice C reason:
Idiopathic vasospasm, although a cause of myocardial ischemia, is not as common as atherosclerosis. Vasospasm refers to the sudden constriction of a coronary artery, which can reduce blood flow to the heart muscle. However, it accounts for a smaller percentage of ischemia cases compared to the widespread prevalence of atherosclerosis.
Choice D reason:
Venous emboli are typically associated with conditions such as deep vein thrombosis and pulmonary embolism, affecting the venous circulation rather than the coronary arteries. They do not commonly cause myocardial ischemia, which primarily involves the coronary arteries and arterial blockages.
Correct Answer is C
Explanation
Choice A reason:
Bowel obstruction can cause abdominal pain, but it typically presents with symptoms such as vomiting, absence of bowel movements, and abdominal distention rather than localized right lower quadrant pain and rebound tenderness. Therefore, this choice is less likely.
Choice B reason:
Hepatitis usually presents with symptoms like jaundice, fatigue, and generalized abdominal discomfort rather than localized right lower quadrant pain with rebound tenderness. This makes hepatitis an unlikely diagnosis in this case.
Choice C reason:
Appendicitis is characterized by right lower quadrant pain, rebound tenderness, and low-grade fever, making it the most likely diagnosis for this patient. These symptoms are classic for appendicitis, a common surgical emergency in young adults.
Choice D reason:
Colon cancer can cause abdominal pain, but it is typically associated with older age, changes in bowel habits, and weight loss. The presentation of right lower quadrant pain and rebound tenderness with fever is not typical for colon cancer, making it an unlikely diagnosis in this young patient.
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