PNR 309 TEST 2 QUESTIONS AND ANSWERS
2025/2026 UPDATE WITH COMPLETE SOLUTION!!
Gastro-esophageal reflux disease (GERD) Answer - Any clinically significant
symptomatic condition or histopathological alteration presumed to be
secondary to reflux of gastric contents into the lower esophagus.
What is onset for chronic thyroiditis and what causes this? Answer - Often
asymptomatic for a long time. Caused by abnormal blood antibodies and WBC
attacking/damaging thyroid cells
Predisposing conditions of GERD (4) Answer - 1. hiatal hernia
2. incompetent lower esophageal sphincter (LES)
3. decreased esophageal clearance from impaired esophageal motility
4. decreased gastric emptying
Complications of GERD Answer - Esophagitis (inflammation of the esophagus),
Barrett's esophagus (esophageal metaplasia),
respiratory complications,
aspiration pneumonia,
dental erosion.
,Risk factors for Esophagitis Answer - hiatal hernia, chemical irritation from lye,
and physical irritants such as smoking, cold or hot liquids, and excessive
alcoholic intake. Trauma to the esophagus may also produce inflammation.
Diagnosing GERD Answer - Endoscopy, barium swallow
GERD treatments Answer - lifestyle modifications,
nutritional therapy,
drug therapy,
surgical/endoscopy therapy
What lifestyle modifications are suggested? Answer - smoking/alcohol
cessation (or at least avoidance), avoid caffeine, lose weight if able (maintain
healthy wt)
What nutritional modifications? Answer - decrease high-fat foods, milk
products, mints, carbonated beverages, acidic foods/drinks
Drug therapy for GERD targets what? Answer - focused on improving LES
function, increasing esophageal clearance, decreasing volume and acidity of
reflux, and protecting the esophageal mucosa.
What drugs can treat GERD (give name, class)? Answer - H2R blockers - Pepsid,
Zantac;
PPIs - Losec, Pantoloc, Prevacid;
Antacids - Gaviscon, maalox (mylanta);
Prokinetic drugs - Metoclopramide
,Following administration of a dose of metoclopramide to the client, the nurse
determines that the medication has been effective when which of the following
is noted?
a) Decreased blood pressure
b) Absence of muscle tremors
c) Relief of nausea and vomiting
d) absence of diarrhea Answer - C
The nurse administered a dose of metoclopramide to a client and the client has
symptoms of nausea. The nurse would teach the client to report which of the
following potential adverse effects?
a) Tremors
b) Constipation
c) Double vision
d) Numbness in the fingers and nose Answer - A - Extrapyramidal adverse
effects, including tremors and dyskinesias, may occur as a result of
metoclopramide administration.
The nurse is caring for a client with a diagnosis of diverticulitis and a history of
irritable bowel disease and gastro-esophageal reflux disease (GERD) who has
received a dose of Mylanta 30 mL PO. The nurse would evaluate its
effectiveness by questioning the client as to whether which of the following
symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)constipation
, d) Lower abdominal pain Answer - B
Hiatal hernia Answer - herniation of a portion of the stomach into the
esophagus through an opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: Answer - sliding and paraesophageal (rolling).
Predisposing factors of herniation Answer - increased intra- abdominal
pressure (including obesity, pregnancy, ascites, tumours, tight corsets),
intense physical exertion,
heavy lifting on a continual basis, increased age,
trauma,
poor nutrition,
prolonged bed rest.
**Occurs more often in women
Diagnosing a hiatal hernia Answer - xray, barium swallow, endoscopy
Complications with hiatal hernias Answer - hemorrhage,
stenosis of esophagus, regurgitation/aspiration,
ulcers in herniated portion of stomach,
strangulation of hernia.
H Hernia treatments: Answer - similar to GERD;
lifestyle modifications, elevate HOB, antacids/H2R blockers, surgical therapy (all
variations of fundoplication)
2025/2026 UPDATE WITH COMPLETE SOLUTION!!
Gastro-esophageal reflux disease (GERD) Answer - Any clinically significant
symptomatic condition or histopathological alteration presumed to be
secondary to reflux of gastric contents into the lower esophagus.
What is onset for chronic thyroiditis and what causes this? Answer - Often
asymptomatic for a long time. Caused by abnormal blood antibodies and WBC
attacking/damaging thyroid cells
Predisposing conditions of GERD (4) Answer - 1. hiatal hernia
2. incompetent lower esophageal sphincter (LES)
3. decreased esophageal clearance from impaired esophageal motility
4. decreased gastric emptying
Complications of GERD Answer - Esophagitis (inflammation of the esophagus),
Barrett's esophagus (esophageal metaplasia),
respiratory complications,
aspiration pneumonia,
dental erosion.
,Risk factors for Esophagitis Answer - hiatal hernia, chemical irritation from lye,
and physical irritants such as smoking, cold or hot liquids, and excessive
alcoholic intake. Trauma to the esophagus may also produce inflammation.
Diagnosing GERD Answer - Endoscopy, barium swallow
GERD treatments Answer - lifestyle modifications,
nutritional therapy,
drug therapy,
surgical/endoscopy therapy
What lifestyle modifications are suggested? Answer - smoking/alcohol
cessation (or at least avoidance), avoid caffeine, lose weight if able (maintain
healthy wt)
What nutritional modifications? Answer - decrease high-fat foods, milk
products, mints, carbonated beverages, acidic foods/drinks
Drug therapy for GERD targets what? Answer - focused on improving LES
function, increasing esophageal clearance, decreasing volume and acidity of
reflux, and protecting the esophageal mucosa.
What drugs can treat GERD (give name, class)? Answer - H2R blockers - Pepsid,
Zantac;
PPIs - Losec, Pantoloc, Prevacid;
Antacids - Gaviscon, maalox (mylanta);
Prokinetic drugs - Metoclopramide
,Following administration of a dose of metoclopramide to the client, the nurse
determines that the medication has been effective when which of the following
is noted?
a) Decreased blood pressure
b) Absence of muscle tremors
c) Relief of nausea and vomiting
d) absence of diarrhea Answer - C
The nurse administered a dose of metoclopramide to a client and the client has
symptoms of nausea. The nurse would teach the client to report which of the
following potential adverse effects?
a) Tremors
b) Constipation
c) Double vision
d) Numbness in the fingers and nose Answer - A - Extrapyramidal adverse
effects, including tremors and dyskinesias, may occur as a result of
metoclopramide administration.
The nurse is caring for a client with a diagnosis of diverticulitis and a history of
irritable bowel disease and gastro-esophageal reflux disease (GERD) who has
received a dose of Mylanta 30 mL PO. The nurse would evaluate its
effectiveness by questioning the client as to whether which of the following
symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)constipation
, d) Lower abdominal pain Answer - B
Hiatal hernia Answer - herniation of a portion of the stomach into the
esophagus through an opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: Answer - sliding and paraesophageal (rolling).
Predisposing factors of herniation Answer - increased intra- abdominal
pressure (including obesity, pregnancy, ascites, tumours, tight corsets),
intense physical exertion,
heavy lifting on a continual basis, increased age,
trauma,
poor nutrition,
prolonged bed rest.
**Occurs more often in women
Diagnosing a hiatal hernia Answer - xray, barium swallow, endoscopy
Complications with hiatal hernias Answer - hemorrhage,
stenosis of esophagus, regurgitation/aspiration,
ulcers in herniated portion of stomach,
strangulation of hernia.
H Hernia treatments: Answer - similar to GERD;
lifestyle modifications, elevate HOB, antacids/H2R blockers, surgical therapy (all
variations of fundoplication)
