After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman’s health problem?
Weight loss and administration of calcium channel blocking medications
Surgical correction of the incompetent pylorus
Antacids; avoiding positions that exacerbate reflux; a soft textured diet
Proton pump inhibitors; avoiding large meals; remaining upright after meals
The Correct Answer is D
Choice A reason: Weight loss helps GERD by reducing abdominal pressure, but calcium channel blockers can worsen reflux by relaxing the lower esophageal sphincter. This makes the regimen counterproductive, as it does not effectively reduce acid exposure, rendering it an incorrect treatment choice.
Choice B reason: Surgical correction of the pylorus addresses gastric outlet issues, not GERD, which involves lower esophageal sphincter dysfunction. Procedures like fundoplication target GERD, but surgery is reserved for severe cases, making this an incorrect primary treatment regimen.
Choice C reason: Antacids provide temporary relief but do not suppress acid production long-term. Avoiding exacerbating positions and soft diets help, but they are less effective without stronger acid suppression, making this regimen less comprehensive than proton pump inhibitors for managing GERD.
Choice D reason: Proton pump inhibitors reduce acid production, healing esophageal damage in GERD. Avoiding large meals and staying upright minimize reflux episodes by reducing stomach pressure and promoting gastric emptying. This comprehensive approach effectively manages symptoms, making it the best treatment regimen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Weight loss helps GERD by reducing abdominal pressure, but calcium channel blockers can worsen reflux by relaxing the lower esophageal sphincter. This makes the regimen counterproductive, as it does not effectively reduce acid exposure, rendering it an incorrect treatment choice.
Choice B reason: Surgical correction of the pylorus addresses gastric outlet issues, not GERD, which involves lower esophageal sphincter dysfunction. Procedures like fundoplication target GERD, but surgery is reserved for severe cases, making this an incorrect primary treatment regimen.
Choice C reason: Antacids provide temporary relief but do not suppress acid production long-term. Avoiding exacerbating positions and soft diets help, but they are less effective without stronger acid suppression, making this regimen less comprehensive than proton pump inhibitors for managing GERD.
Choice D reason: Proton pump inhibitors reduce acid production, healing esophageal damage in GERD. Avoiding large meals and staying upright minimize reflux episodes by reducing stomach pressure and promoting gastric emptying. This comprehensive approach effectively manages symptoms, making it the best treatment regimen.
Correct Answer is A
Explanation
Choice A reason: Acute pancreatitis is likely, given severe abdominal pain, elevated amylase and lipase, fever, hypotension (89/46 mm Hg), tachycardia (116 bpm), and alcohol history. These are classic signs, with C-reactive protein indicating inflammation, making this the first suspected diagnosis for this patient.
Choice B reason: Cholecystitis causes right upper quadrant pain and fever but is less associated with elevated amylase/lipase or severe hypotension. Pancreatitis aligns better with the patient’s alcohol use, vital signs, and lab results, so this is incorrect as the primary suspicion.
Choice C reason: Hepatitis C may cause liver inflammation but not acute abdominal pain or elevated amylase/lipase. The patient’s acute symptoms, alcohol history, and vital signs point to pancreatitis, not a chronic viral infection, making this incorrect for the first diagnosis.
Choice D reason: Liver cirrhosis is chronic, not acute, and doesn’t typically cause sudden pain or elevated amylase/lipase. Acute pancreatitis matches the patient’s acute presentation, alcohol use, and lab findings, so cirrhosis is incorrect as the initial suspected diagnosis.
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