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NR507 WEEK 5-8 EXAM | NR507
ADVANCED PATHOPHYSIOLOGY (GI,
NEURO, ENDO, CNS, DERM) ACTUAL
EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | 100%
GUARANTEED PASS (MOST
RECENT!!!)
MULTIPLE CHOICES
The nurse practitioner (NP) diagnoses a client with gastroesophageal reflux disease (GERD). The NP
explains to the client that the condition is caused by which of the following?
A. Excessive salivation and swallowing
B. Loss of muscle tone at the lower esophageal sphincter
C. Reverse peristalsis of the stomach
D. Increased production of bile in the stomach
B.
Gastroesophageal reflux disease (GERD) is commonly associated with the loss of muscle tone at the
lower esophageal sphincter (LES). The LES is a muscular ring that separates the esophagus from the
stomach, and its relaxation or incompetence can lead to the backward flow of stomach contents into
the esophagus, causing the symptoms characteristic of GERD, such as heartburn and regurgitation.
Reverse peristalsis, where the stomach contracts in the opposite direction of normal peristalsis, is not a
typical mechanism associated with GERD.
Excessive salivation and swallowing do not typically cause GERD. In fact, swallowing can help clear
refluxed material from the esophagus.
GERD is more related to issues with the LES and the reflux of acidic stomach contents into the
esophagus than the increased production of bile.
1 SUCCESS!!!
, 2|Page
When an individual consumes a very large meal, the nurse practitioner (NP) knows the gastric
emptying rate will be _________. When an individual receives a hypertonic gastric tube feeding
solution, the NP knows the gastric emptying rate will be __________.
increased, decreased, or unchanged.
increased, decreased, or unchanged
Increased, decreased
Larger volumes of gastric contents generally increase gastric pressure, stimulating peristalsis and
promoting a faster rate of gastric emptying. Hypertonic solutions, having a higher osmotic pressure than
the surrounding tissues, tend to delay gastric emptying.
The nurse practitioner (NP) evaluates a client with complaints of a burning sensation in the chest that
often occurs after meals and is exacerbated when lying down. Which of the following findings should
the NP recognize as risk factors for gastroesophageal reflux disease (GERD)? Select all that apply.
A. Drinks three cups of chamomile tea daily
B. Smokes 1 pack of cigarettes per day
C. Has a sliding hiatal hernia
D. Takes aspirin daily for coronary artery disease
E. Body mass index (BMI) of 32
B, C, E
Increased body mass index (BMI), especially in the overweight or obese range, is a recognized risk factor
for gastroesophageal reflux disease (GERD). Increased abdominal pressure due to excess weight can
contribute to the reflux of stomach contents into the esophagus. Smoking is a known risk factor for
GERD. Smoking can weaken the lower esophageal sphincter, which contributes to the development or
exacerbation of GERD symptoms. Hiatal hernias, especially sliding hiatal hernias, are associated with
GERD. The herniation of the stomach through the diaphragmatic opening can disrupt the normal
anatomical barrier, allowing gastric acid to flow back into the esophagus and causing symptoms such as
heartburn.
While aspirin use is associated with an increased risk of gastrointestinal issues such as ulcers, it is not a
direct risk factor for GERD. Drinking chamomile tea is not recognized as a risk factor for GERD. It is often
considered soothing and may have mild anti-inflammatory properties.
Typical, Atypical, and Associated symptoms of GERD
The nurse practitioner (NP) is evaluating a client who presents with a complaint of heartburn and
regurgitation. Which question(s) should the nurse practitioner ask the client? Select all that apply.
2 SUCCESS!!!
, 3|Page
A. "Do you have trouble swallowing?"
B. "Do you experience hoarseness?"
C. "Have you noticed changes in your sense of taste?"
D. "Do you experience pain in your upper abdomen after eating?"
E. "Do you have difficulty sleeping?"
A, B, D, E
Inquiring about difficulty sleeping helps assess the impact of positional changes on symptoms, providing
insights into nighttime reflux, which is a common feature of gastroesophageal reflux disease (GERD).
Hoarseness can be an atypical symptom associated with GERD. It may indicate irritation of the larynx
due to stomach acid reflux. Difficulty swallowing (dysphagia) can be an associated symptom of GERD,
suggesting potential complications. Pain in the upper abdomen after eating is also an associated
symptom of GERD.
Changes in taste are not commonly associated with GERD symptoms. While GERD may cause a sour or
bitter taste in the mouth due to acid reflux, the question does not specifically address this symptom and
is overly general. Focusing on symptoms directly related to reflux, such as heartburn or regurgitation, is
more clinically relevant.
Which of the following risk factors have the greatest effect on the rate of gastric emptying?
A. Obesity
B. Hiatal hernia
C, Smoking,
D. Eating fried food
A, D
Obesity is associated with delayed gastric emptying, as excess body weight can slow the digestive
process, leading to a prolonged stay of food in the stomach.
Consuming fried food can contribute to delayed gastric emptying due to the high-fat content, which
slows down the digestive process.
Which of the following risk factors have the greatest effect on the function of the lower esophageal
sphincter?
A. Obesity
B. Hiatal hernia
3 SUCCESS!!!
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C, Smoking,
D. Eating fried food
B, C
A hiatal hernia often involves a weakening or disruption of the lower esophageal sphincter, making it
less effective in preventing the backflow of stomach contents into the esophagus. Smoking is known to
affect the function of the lower esophageal sphincter, which can heighten the risk of acid reflux into the
esophagus.
The nurse practitioner (NP) evaluates a client with complaints of pyrosis and regurgitation with a
bitter taste that occurs daily. The NP prescribes ___________ and recommends the client take the
medication __________.
omeprazole, ondansetron, or oseltamivir
before bed, in the morning, or when experiencing heartburn
omeprazole, in the morning
Omeprazole is a proton pump inhibitor (PPI) commonly used to treat GERD. PPIs work by inhibiting the
proton pump in the stomach lining, reducing the production of gastric acid. Taking PPIs regularly ensures
consistent and sustained acid suppression, providing effective control of acid levels over an extended
period. PPIs are usually prescribed once a day and should be taken first thing in the morning. If
prescribed twice a day, the second dose should be taken before dinner.
Ondansetron is an antiemetic medication commonly used to prevent nausea and vomiting, particularly
in the context of chemotherapy or surgery. Oseltamivir is an antiviral medication used to treat influenza
(flu).
The nurse practitioner (NP) evaluates a client who was prescribed omeprazole eight weeks ago to
treat suspected gastroesophageal reflux disease (GERD). The client reports the symptoms are not
improving after adhering to the prescribed medication regimen and lifestyle change
recommendations. Which of the following actions should the NP take?
A. Discontinue omeprazole and recommend antacids as needed
B. Increase the dosage of the omeprazole
C. Refer the client for a fundoplication
D. Order an esophageal endoscopy
D.
Given the lack of improvement in symptoms despite adherence to treatment, ordering an esophageal
endoscopy is the best action to further investigate the underlying cause. This procedure can provide
4 SUCCESS!!!
NR507 WEEK 5-8 EXAM | NR507
ADVANCED PATHOPHYSIOLOGY (GI,
NEURO, ENDO, CNS, DERM) ACTUAL
EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | 100%
GUARANTEED PASS (MOST
RECENT!!!)
MULTIPLE CHOICES
The nurse practitioner (NP) diagnoses a client with gastroesophageal reflux disease (GERD). The NP
explains to the client that the condition is caused by which of the following?
A. Excessive salivation and swallowing
B. Loss of muscle tone at the lower esophageal sphincter
C. Reverse peristalsis of the stomach
D. Increased production of bile in the stomach
B.
Gastroesophageal reflux disease (GERD) is commonly associated with the loss of muscle tone at the
lower esophageal sphincter (LES). The LES is a muscular ring that separates the esophagus from the
stomach, and its relaxation or incompetence can lead to the backward flow of stomach contents into
the esophagus, causing the symptoms characteristic of GERD, such as heartburn and regurgitation.
Reverse peristalsis, where the stomach contracts in the opposite direction of normal peristalsis, is not a
typical mechanism associated with GERD.
Excessive salivation and swallowing do not typically cause GERD. In fact, swallowing can help clear
refluxed material from the esophagus.
GERD is more related to issues with the LES and the reflux of acidic stomach contents into the
esophagus than the increased production of bile.
1 SUCCESS!!!
, 2|Page
When an individual consumes a very large meal, the nurse practitioner (NP) knows the gastric
emptying rate will be _________. When an individual receives a hypertonic gastric tube feeding
solution, the NP knows the gastric emptying rate will be __________.
increased, decreased, or unchanged.
increased, decreased, or unchanged
Increased, decreased
Larger volumes of gastric contents generally increase gastric pressure, stimulating peristalsis and
promoting a faster rate of gastric emptying. Hypertonic solutions, having a higher osmotic pressure than
the surrounding tissues, tend to delay gastric emptying.
The nurse practitioner (NP) evaluates a client with complaints of a burning sensation in the chest that
often occurs after meals and is exacerbated when lying down. Which of the following findings should
the NP recognize as risk factors for gastroesophageal reflux disease (GERD)? Select all that apply.
A. Drinks three cups of chamomile tea daily
B. Smokes 1 pack of cigarettes per day
C. Has a sliding hiatal hernia
D. Takes aspirin daily for coronary artery disease
E. Body mass index (BMI) of 32
B, C, E
Increased body mass index (BMI), especially in the overweight or obese range, is a recognized risk factor
for gastroesophageal reflux disease (GERD). Increased abdominal pressure due to excess weight can
contribute to the reflux of stomach contents into the esophagus. Smoking is a known risk factor for
GERD. Smoking can weaken the lower esophageal sphincter, which contributes to the development or
exacerbation of GERD symptoms. Hiatal hernias, especially sliding hiatal hernias, are associated with
GERD. The herniation of the stomach through the diaphragmatic opening can disrupt the normal
anatomical barrier, allowing gastric acid to flow back into the esophagus and causing symptoms such as
heartburn.
While aspirin use is associated with an increased risk of gastrointestinal issues such as ulcers, it is not a
direct risk factor for GERD. Drinking chamomile tea is not recognized as a risk factor for GERD. It is often
considered soothing and may have mild anti-inflammatory properties.
Typical, Atypical, and Associated symptoms of GERD
The nurse practitioner (NP) is evaluating a client who presents with a complaint of heartburn and
regurgitation. Which question(s) should the nurse practitioner ask the client? Select all that apply.
2 SUCCESS!!!
, 3|Page
A. "Do you have trouble swallowing?"
B. "Do you experience hoarseness?"
C. "Have you noticed changes in your sense of taste?"
D. "Do you experience pain in your upper abdomen after eating?"
E. "Do you have difficulty sleeping?"
A, B, D, E
Inquiring about difficulty sleeping helps assess the impact of positional changes on symptoms, providing
insights into nighttime reflux, which is a common feature of gastroesophageal reflux disease (GERD).
Hoarseness can be an atypical symptom associated with GERD. It may indicate irritation of the larynx
due to stomach acid reflux. Difficulty swallowing (dysphagia) can be an associated symptom of GERD,
suggesting potential complications. Pain in the upper abdomen after eating is also an associated
symptom of GERD.
Changes in taste are not commonly associated with GERD symptoms. While GERD may cause a sour or
bitter taste in the mouth due to acid reflux, the question does not specifically address this symptom and
is overly general. Focusing on symptoms directly related to reflux, such as heartburn or regurgitation, is
more clinically relevant.
Which of the following risk factors have the greatest effect on the rate of gastric emptying?
A. Obesity
B. Hiatal hernia
C, Smoking,
D. Eating fried food
A, D
Obesity is associated with delayed gastric emptying, as excess body weight can slow the digestive
process, leading to a prolonged stay of food in the stomach.
Consuming fried food can contribute to delayed gastric emptying due to the high-fat content, which
slows down the digestive process.
Which of the following risk factors have the greatest effect on the function of the lower esophageal
sphincter?
A. Obesity
B. Hiatal hernia
3 SUCCESS!!!
, 4|Page
C, Smoking,
D. Eating fried food
B, C
A hiatal hernia often involves a weakening or disruption of the lower esophageal sphincter, making it
less effective in preventing the backflow of stomach contents into the esophagus. Smoking is known to
affect the function of the lower esophageal sphincter, which can heighten the risk of acid reflux into the
esophagus.
The nurse practitioner (NP) evaluates a client with complaints of pyrosis and regurgitation with a
bitter taste that occurs daily. The NP prescribes ___________ and recommends the client take the
medication __________.
omeprazole, ondansetron, or oseltamivir
before bed, in the morning, or when experiencing heartburn
omeprazole, in the morning
Omeprazole is a proton pump inhibitor (PPI) commonly used to treat GERD. PPIs work by inhibiting the
proton pump in the stomach lining, reducing the production of gastric acid. Taking PPIs regularly ensures
consistent and sustained acid suppression, providing effective control of acid levels over an extended
period. PPIs are usually prescribed once a day and should be taken first thing in the morning. If
prescribed twice a day, the second dose should be taken before dinner.
Ondansetron is an antiemetic medication commonly used to prevent nausea and vomiting, particularly
in the context of chemotherapy or surgery. Oseltamivir is an antiviral medication used to treat influenza
(flu).
The nurse practitioner (NP) evaluates a client who was prescribed omeprazole eight weeks ago to
treat suspected gastroesophageal reflux disease (GERD). The client reports the symptoms are not
improving after adhering to the prescribed medication regimen and lifestyle change
recommendations. Which of the following actions should the NP take?
A. Discontinue omeprazole and recommend antacids as needed
B. Increase the dosage of the omeprazole
C. Refer the client for a fundoplication
D. Order an esophageal endoscopy
D.
Given the lack of improvement in symptoms despite adherence to treatment, ordering an esophageal
endoscopy is the best action to further investigate the underlying cause. This procedure can provide
4 SUCCESS!!!
