Some older adults have impaired inflammation and wound healing because of which problem?

Choice A reason: A fracture is a bone break, not a joint surface misalignment. Subluxation describes partial joint displacement, matching John’s injury with pain and limited motion, so this is incorrect for the shoulder injury.

Choice B reason: A sprain involves ligament stretching or tearing, not joint surface displacement. Subluxation is partial joint misalignment, fitting the described trauma, so this is incorrect for John’s specific shoulder injury.

Choice C reason: Subluxation is the partial loss of contact between joint surfaces, causing pain and limited motion, as seen in John’s shoulder after trauma. This matches the imaging findings, making it the correct term.

Choice D reason: Dislocation is complete joint displacement, not partial. John’s injury involves partial contact loss, aligning with subluxation, not full dislocation, so this is incorrect for the described shoulder injury.

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.