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

Answer and Explanation

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.

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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.

A. Left ventricular heart failure B. Unstable angina C. Myocardial infarction (MI) D. Prinzmetal angina

Correct Answer is C

Explanation

Choice A reason:
Left ventricular heart failure can cause severe chest pain and elevated cardiac enzymes but is not as directly associated with elevated cardiac troponin levels as a myocardial infarction. The presence of elevated troponin levels specifically indicates myocardial cell injury, which is most consistent with an MI.

Choice B reason:
Unstable angina involves chest pain that is not relieved by rest and may indicate a higher risk for an MI. However, it typically does not result in elevated cardiac troponin levels unless there is actual myocardial damage. Elevated troponin is a marker for myocardial infarction rather than just unstable angina.

Choice C reason:
Myocardial infarction (MI) is the correct answer. Elevated levels of cardiac troponin are a key indicator of myocardial infarction as they reflect heart muscle damage. The patient's severe chest pain and elevated troponin levels strongly suggest that an MI has occurred.

Choice D reason:
Prinzmetal angina, or variant angina, is characterized by chest pain caused by coronary artery spasms. While it can cause significant pain, it does not typically lead to elevated cardiac troponin levels unless it results in myocardial damage, which is less common than in an MI.

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A 50-year-old is diagnosed with gastroesophageal reflux disease (GERD). This condition is caused by:

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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