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Nurse Practitioner:
doi: 10.1097/01.NPR.0000433052.44407.6a
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Evidence-based recommendations for GERD treatment

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INSTRUCTIONS Evidence-based recommendations for GERD treatment

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Evidence-based recommendations for GERD treatment

General Purpose: The purpose of this learning activity is to provide information about the diagnosis and management of GERD in adults. Learning Objectives: After reading this article and taking this test, the reader will be able to: 1. Identify the signs, symptoms, and causes of GERD. 2. List health problems associated with GERD. 3. Describe GERD treatment.

  1. The prevalence of GERD in the United States ranges as high as
    1. 0.1%.
    2. 5%.
    3. 10%.
    4. 20%.
  2. Co-occurring conditions associated with GERD include
    1. Crohn disease.
    2. ulcerative colitis.
    3. pancreatitis.
    4. asthma.
  3. GERD is associated with the use of
    1. aspirin.
    2. tobacco.
    3. calcium antagonists.
    4. benzodiazepines.
  4. GERD is primarily due to
    1. increased gastric acid production.
    2. gastric acid pH less than 3.5.
    3. lower esophageal sphincter alterations.
    4. underactive parietal cells.
  5. Which of the following is most likely to cause GERD?
    1. hiatal hernia
    2. hypersalivation
    3. long abdominal length
    4. increased gastric emptying
  6. GERD is a major cause of
    1. iron malabsorption.
    2. Clostridium difficile-associated diarrhea.
    3. disrupted sleep.
    4. renal impairment.
  7. What percentage of people with chronic GERD have Barrett esophagus?
    1. 10%
    2. 20%
    3. 30%
    4. 40%
  8. Typical GERD symptoms include
    1. chest pain.
    2. pyrosis.
    3. globus sensation.
    4. nausea.
  9. Alarm symptoms of GERD include
    1. globus sensation.
    2. water brash.
    3. laryngitis.
    4. anemia.
  10. Which of the following is most likely to decrease GERD symptoms?
    1. carbonated beverages
    2. peppermint
    3. raising the head of bed 6 in (15.2 cm)
    4. tight abdominal support binder
  11. Dietary restrictions for GERD management include
    1. corn.
    2. sodium.
    3. chocolate.
    4. wheat.
  12. Which of the following medications is an acid suppressant?
    1. famotidine
    2. calcium carbonate
    3. bethanechol
    4. sucralfate
  13. H2 receptor antagonists should be taken
    1. an hour before eating.
    2. with the first bite of food.
    3. at the end of a meal.
    4. an hour after a meal.
  14. Cimetidine should be avoided in patients with
    1. fair skin.
    2. risk of falling.
    3. gastric ulcer.
    4. creatinine clearance over 50 mL/minute.
  15. Which of the following is the mainstay of GERD management?
    1. H2 receptor antagonists
    2. reflux inhibitors
    3. prokinetic agents
    4. PPIs
  16. Which statement about treatment with rabeprazole is accurate?
    1. Maximal effect occurs within 24 hours.
    2. Esophageal healing is equal to treatment with famotidine.
    3. Discontinuation should be gradual.
    4. Esophagogastroduodenoscopy should precede initiation.
  17. There is evidence that gastric acid suppression may lead to
    1. cancer.
    2. pneumonia.
    3. strong bones.
    4. hemochromatosis.
  18. Patients taking both clopidogrel and omeprazole may be at increased risk for
    1. death.
    2. bleeding.
    3. constipation.
    4. fractures.
  19. Up to what percentage of people taking a PPI will still have reflux symptoms?
    1. 10%
    2. 20%
    3. 30%
    4. 40%
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