The nurse is assessing a client with suspected Gastroesophageal Reflux Disease (GERD). Which word or statement is an accurate characteristic of GERD?

Choice A reason: Cognitive enhancers like donepezil or memantine are prescribed based on Alzheimer’s disease stage. Cholinesterase inhibitors are effective in mild-to-moderate stages, enhancing acetylcholine levels to improve cognition. Memantine, an NMDA receptor antagonist, is used in moderate-to-severe stages to regulate glutamate activity, slowing cognitive decline. This statement is accurate, as treatment is tailored to symptom severity.

Choice B reason: Cognitive enhancers are not equally effective in all Alzheimer’s stages. Cholinesterase inhibitors benefit mild-to-moderate cases, while memantine is used in severe stages. Their efficacy diminishes in advanced disease due to extensive neuronal loss, making this statement inaccurate, as stage-specific prescribing is critical for therapeutic benefit.

Choice C reason: Medications for anxiety and depression, like SSRIs, remain helpful in Alzheimer’s to manage behavioral symptoms, even with cognitive enhancers. These drugs address mood disorders, which often coexist, improving quality of life. This statement is inaccurate, as combination therapy is common and beneficial in managing neuropsychiatric symptoms.

Choice D reason: Cognitive enhancers are not used for seizure management. Anticonvulsants like levetiracetam manage seizures, which may occur in Alzheimer’s due to neuronal excitability. Cognitive enhancers target cognitive decline via cholinergic or glutamatergic pathways, not seizure control, making this statement inaccurate and unrelated to their pharmacological role.

Choice A reason: Glipizide, a sulfonylurea, stimulates insulin release from pancreatic beta cells by blocking ATP-sensitive potassium channels, increasing insulin secretion. This can cause hypoglycemia, especially if meals are skipped or with excessive dosing. Monitoring blood glucose is critical, as hypoglycemia can lead to symptoms like sweating, shakiness, or confusion, making this the primary adverse effect.

Choice B reason: Glipizide does not significantly affect potassium levels. Hyperkalemia is more associated with drugs like ACE inhibitors or potassium-sparing diuretics. Sulfonylureas primarily impact glucose metabolism, not electrolyte balance, making this an inaccurate adverse effect to monitor in patients taking glipizide.

Choice C reason: Glipizide often causes weight gain, not weight loss, due to increased insulin levels promoting glucose uptake and fat storage. Weight loss is more associated with drugs like metformin or SGLT-2 inhibitors. This statement is inaccurate, as weight gain is a more likely concern with sulfonylureas.

Choice D reason: Hypertension is not a common adverse effect of glipizide. Sulfonylureas primarily affect glucose metabolism, not blood pressure. While diabetes increases cardiovascular risk, glipizide does not directly cause hypertension, making this an inaccurate adverse effect to prioritize in monitoring for this medication.