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 ["A","B","D"]
Explanation
Choice A reason: Yellowing of the sclera (icterus) is expected with high bilirubin in cirrhosis, as impaired liver function causes bilirubin accumulation. Conjugated bilirubin deposits in the sclera, visible early due to its vascularity, making this a correct clinical finding.
Choice B reason: Dark brown urine results from excess conjugated bilirubin excreted by the kidneys in cirrhosis. High bilirubin levels overwhelm liver clearance, leading to bilirubinuria, which darkens urine, making this a correct and common finding in this condition.
Choice C reason: Frothy light-colored urine is not associated with high bilirubin. Light urine suggests dilute urine or low bilirubin excretion, opposite to the dark urine seen in cirrhosis, making this an incorrect finding for this patient’s condition.
Choice D reason: Jaundice of the skin occurs with elevated bilirubin in cirrhosis, as bilirubin deposits in tissues. This yellowish discoloration is a hallmark of liver dysfunction, reflecting impaired bilirubin metabolism, making this a correct clinical manifestation.
Choice E reason: Bluish mucous membranes suggest cyanosis from hypoxemia, not related to high bilirubin. Cirrhosis causes jaundice, not oxygenation issues, unless complicated by other conditions, making this an incorrect finding for this patient.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason: Achalasia increases aspiration risk due to esophageal dysmotility. Oropharyngeal suctioning equipment at the bedside ensures airway safety, making this a critical intervention to prioritize in the care plan.
Choice B reason: Small, frequent meals reduce esophageal pressure in achalasia, easing swallowing and minimizing regurgitation. This dietary adjustment is essential for symptom management, making it a correct intervention to prioritize.
Choice C reason: Thickened fluids only may not be necessary; achalasia patients can often manage various consistencies with proper positioning. Other interventions like suctioning and small meals are more critical, so this is incorrect.
Choice D reason: Antiemetics before meals reduce nausea and vomiting, common in achalasia due to food retention. This improves patient comfort and nutrition, making it a correct intervention to prioritize in care.
Choice E reason: Elevating the head of the bed prevents regurgitation and aspiration in achalasia, especially during sleep. This positioning is a key safety measure, making it a correct intervention to prioritize.
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