NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
What is the esophagus? - ANSWER>>>Musculofibrous tube approx. 10"
long.
What is the main function of the esophagus? - ANSWER>>>Convey food
bolus from pharynx to stomach.
What is the upper sphincter of the esophagus called and what is its
function? - ANSWER>>>-Pharyngoesophageal Sphincter
-Prevents air from entering esophagus during inspiration.
What is the lower sphincter of the esophagus called and what is its
function? - ANSWER>>>-Gastroesophageal Sphincter
-Prevents gastric acid reflux into esophagus.
What is dysphagia? - ANSWER>>>Difficulty swallowing.
Who typically has dysphagia? - ANSWER>>>Patients with
-CNS lesions from stroke
-Esophageal strictures or cancer
-Myasthenias gravis
-Multiple sclerosis
What is achalasia? - ANSWER>>>Failure of the lower esophageal
sphincter to relax.
What is the cause of achalasia? - ANSWER>>>Absence or problems of
vagal nerve fibers in the esophagus.
What does achalasia lead to? - ANSWER>>>-Difficulty passing food into
stomach
-Distended esophagus with erosions
-Increased risk for cancer
What type of people is achalasia more common in? - ANSWER>>>-
Children
,-Young adults
What can esophagus inflammation and GERD lead to? -
ANSWER>>>Increased risk for cancer.
What is esophageal diverticulum? - ANSWER>>>Outpouching of
esophageal wall.
What happens in esophageal diverticulum? - ANSWER>>>The food gets
trapped causing inflammation and erosion.
What are the symptoms of esophageal diverticulum? -
ANSWER>>>Belching and foul breath.
What is synonymous with esophageal lacerations? - ANSWER>>>Mallory-
Weiss syndrome/tears.
Who primarily gets esophageal lacerations? - ANSWER>>>-People with
severe vomiting
-Alcoholics
What can result from esophageal lacerations? - ANSWER>>>GI bleeding.
What is hiatal hernia? - ANSWER>>>Protrusion/herniation of the stomach
through esophageal hiatus of diaphragm.
What is the most common disorder of the esophagus? -
ANSWER>>>Gastroesophageal Reflux Disease (GERD).
What can persistent reflux from GERD cause? - ANSWER>>>Erosion and
mucosal damage.
What are the characteristics of GERD? - ANSWER>>>-Regurgitation of
gastric contents into esophagus.
-Exposure of esophageal mucosa to gastric acid and Pepsin.
What can GERD lead to? - ANSWER>>>Erosion and mucosal damage,
scarring, strictures, and cancer.
,When does acid reflux most often occur? - ANSWER>>>After evening
meal and at night.
What is the main symptom of GERD and what positions make it worse? -
ANSWER>>>-Heartburn
-Worsened by the recumbent position and bending over.
Who is most likely to have GERD? - ANSWER>>>-Pregnant women
-Over 40 years old
-Overweight people
What is GERD felt as? - ANSWER>>>Pain or burning in retrosternal area
and may radiate to the throat, shoulder, and back.
What happens in GERD especially after post-meals and at night? -
ANSWER>>>Effortless regurgitation of acidic fluid into the mouth.
What kind of respiratory symptoms can acid reflux cause? -
ANSWER>>>Wheezing, cough, and hoarseness.
What is the cause of GERD? - ANSWER>>>-Weak lower esophageal
sphincter and increased intra-abdominal pressure.
^Reflux of stomach contents into esophagus
^^Mucosal injury
What are the reflux-contributing factors? - ANSWER>>>-Foods
^Fatty
^Chocolate and caffeine because it decreases the tone of the sphincter
-Fluids
^Alcohol and caffeine
-Medications
^CNS depressants (sleep aids/opiates)
-Cigarette smoking
-Recumbent posture
How do you diagnose GERD? - ANSWER>>>-History of signs and
symptoms
-Xrays/scopes
, What are the medications used to treat GERD? - ANSWER>>>-Antacids:
temporary relief
-Histamine 2 receptor antagonists (H2RAs) or Proton Pump Inhibitors
(PPIs): inhibit gastric acid production
What should be taught about GERD? - ANSWER>>>-Avoid large meals
-Do not lie down after eating
-Avoid bending after meals
-Weight reduction
-Avoid aggravating foods
-Sleep with head elevated
What are the complications of GERD? - ANSWER>>>-Scar tissues in the
esophagus that narrow it
-Barrett's esophagus causes chronic changes in the mucosa of the
esophagus that can be precancerous
What are the main functions of the stomach? - ANSWER>>>-Serves as a
reservoir
-Churns/mixes food with digestive juices
-Secretes mucus, hydrochloric acid, enzymes, intrinsic factor (necessary
for vitamin B12 absorption)
-Initiates protein metabolism
-Only alcohol and some medications are absorbed in the stomach
What is the gastric mucosal barrier? - ANSWER>>>Tight junction in
epithelial cell to prevent acid penetration.
What covers the gastric mucosal barrier? - ANSWER>>>Hydrophobic lipid
layer.
What will cross the hydrophobic lipid layer? - ANSWER>>>Alcohol and
aspirin.
What is released to protect the mucosal layer? - ANSWER>>>Equal
release of HCl acid bicarbonate ions.
What is the role of prostagladins? - ANSWER>>>-Increase blood flow
-Mucus production
-Bicarb ion secretion (protect gastric mucosa)
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
What is the esophagus? - ANSWER>>>Musculofibrous tube approx. 10"
long.
What is the main function of the esophagus? - ANSWER>>>Convey food
bolus from pharynx to stomach.
What is the upper sphincter of the esophagus called and what is its
function? - ANSWER>>>-Pharyngoesophageal Sphincter
-Prevents air from entering esophagus during inspiration.
What is the lower sphincter of the esophagus called and what is its
function? - ANSWER>>>-Gastroesophageal Sphincter
-Prevents gastric acid reflux into esophagus.
What is dysphagia? - ANSWER>>>Difficulty swallowing.
Who typically has dysphagia? - ANSWER>>>Patients with
-CNS lesions from stroke
-Esophageal strictures or cancer
-Myasthenias gravis
-Multiple sclerosis
What is achalasia? - ANSWER>>>Failure of the lower esophageal
sphincter to relax.
What is the cause of achalasia? - ANSWER>>>Absence or problems of
vagal nerve fibers in the esophagus.
What does achalasia lead to? - ANSWER>>>-Difficulty passing food into
stomach
-Distended esophagus with erosions
-Increased risk for cancer
What type of people is achalasia more common in? - ANSWER>>>-
Children
,-Young adults
What can esophagus inflammation and GERD lead to? -
ANSWER>>>Increased risk for cancer.
What is esophageal diverticulum? - ANSWER>>>Outpouching of
esophageal wall.
What happens in esophageal diverticulum? - ANSWER>>>The food gets
trapped causing inflammation and erosion.
What are the symptoms of esophageal diverticulum? -
ANSWER>>>Belching and foul breath.
What is synonymous with esophageal lacerations? - ANSWER>>>Mallory-
Weiss syndrome/tears.
Who primarily gets esophageal lacerations? - ANSWER>>>-People with
severe vomiting
-Alcoholics
What can result from esophageal lacerations? - ANSWER>>>GI bleeding.
What is hiatal hernia? - ANSWER>>>Protrusion/herniation of the stomach
through esophageal hiatus of diaphragm.
What is the most common disorder of the esophagus? -
ANSWER>>>Gastroesophageal Reflux Disease (GERD).
What can persistent reflux from GERD cause? - ANSWER>>>Erosion and
mucosal damage.
What are the characteristics of GERD? - ANSWER>>>-Regurgitation of
gastric contents into esophagus.
-Exposure of esophageal mucosa to gastric acid and Pepsin.
What can GERD lead to? - ANSWER>>>Erosion and mucosal damage,
scarring, strictures, and cancer.
,When does acid reflux most often occur? - ANSWER>>>After evening
meal and at night.
What is the main symptom of GERD and what positions make it worse? -
ANSWER>>>-Heartburn
-Worsened by the recumbent position and bending over.
Who is most likely to have GERD? - ANSWER>>>-Pregnant women
-Over 40 years old
-Overweight people
What is GERD felt as? - ANSWER>>>Pain or burning in retrosternal area
and may radiate to the throat, shoulder, and back.
What happens in GERD especially after post-meals and at night? -
ANSWER>>>Effortless regurgitation of acidic fluid into the mouth.
What kind of respiratory symptoms can acid reflux cause? -
ANSWER>>>Wheezing, cough, and hoarseness.
What is the cause of GERD? - ANSWER>>>-Weak lower esophageal
sphincter and increased intra-abdominal pressure.
^Reflux of stomach contents into esophagus
^^Mucosal injury
What are the reflux-contributing factors? - ANSWER>>>-Foods
^Fatty
^Chocolate and caffeine because it decreases the tone of the sphincter
-Fluids
^Alcohol and caffeine
-Medications
^CNS depressants (sleep aids/opiates)
-Cigarette smoking
-Recumbent posture
How do you diagnose GERD? - ANSWER>>>-History of signs and
symptoms
-Xrays/scopes
, What are the medications used to treat GERD? - ANSWER>>>-Antacids:
temporary relief
-Histamine 2 receptor antagonists (H2RAs) or Proton Pump Inhibitors
(PPIs): inhibit gastric acid production
What should be taught about GERD? - ANSWER>>>-Avoid large meals
-Do not lie down after eating
-Avoid bending after meals
-Weight reduction
-Avoid aggravating foods
-Sleep with head elevated
What are the complications of GERD? - ANSWER>>>-Scar tissues in the
esophagus that narrow it
-Barrett's esophagus causes chronic changes in the mucosa of the
esophagus that can be precancerous
What are the main functions of the stomach? - ANSWER>>>-Serves as a
reservoir
-Churns/mixes food with digestive juices
-Secretes mucus, hydrochloric acid, enzymes, intrinsic factor (necessary
for vitamin B12 absorption)
-Initiates protein metabolism
-Only alcohol and some medications are absorbed in the stomach
What is the gastric mucosal barrier? - ANSWER>>>Tight junction in
epithelial cell to prevent acid penetration.
What covers the gastric mucosal barrier? - ANSWER>>>Hydrophobic lipid
layer.
What will cross the hydrophobic lipid layer? - ANSWER>>>Alcohol and
aspirin.
What is released to protect the mucosal layer? - ANSWER>>>Equal
release of HCl acid bicarbonate ions.
What is the role of prostagladins? - ANSWER>>>-Increase blood flow
-Mucus production
-Bicarb ion secretion (protect gastric mucosa)
