A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer: D

Rationale: The correct answer is D. Elevating the head of the bed helps prevent acid reflux by keeping the stomach acid from flowing back into the esophagus while sleeping. This position helps gravity keep the acid in the stomach. Choice A is incorrect because certain foods can indeed trigger or worsen GERD symptoms. Choice B is incorrect as sleeping on the left side may worsen symptoms due to the position of the stomach. Choice C is incorrect as eating right before bed can increase the risk of acid reflux.

Correct Answer: C

Rationale: The correct answer is C: decreases peristalsis by inhibition of smooth muscle. The sympathetic nervous system inhibits gastrointestinal motility by decreasing peristalsis. This is achieved through the release of norepinephrine, which binds to adrenergic receptors on smooth muscle cells, leading to reduced contraction and motility. Choices A and B are incorrect because the sympathetic nervous system can still affect smooth muscle, not just skeletal muscle. Choice D is incorrect because sympathetic stimulation does not directly increase peristalsis.

Correct Answer: B

Rationale: The correct answer is B: falciform ligament. The falciform ligament attaches the liver to the anterior abdominal wall and separates the right and left lobes of the liver. It is a broad, thin ligament that resembles a sickle. The other choices are incorrect because: A: The coronary ligament attaches the liver to the diaphragm, not the abdominal wall. C: The quadrate ligament attaches the liver to the gallbladder and the lesser curvature of the stomach. D: The caudate ligament attaches the liver to the diaphragm and is not directly related to the abdominal wall attachment.

Correct Answer: D

Rationale: The correct answer is D. Salivary secretion is stimulated by the salivary nucleus in the brainstem and local reflexes in the tunica mucosa and submucosa of the oral cavity. The salivary nucleus receives input from higher brain centers and initiates the salivary reflex. Local reflexes in the oral cavity, such as mechanical stimulation of the mucosa, also trigger salivary secretion. Gastrin, as mentioned in option B and C, is not directly involved in the stimulation of salivary secretion. Option A is incorrect as salivary secretion is not solely stimulated by the salivary nucleus. Option D encompasses the comprehensive stimulation pathways involved in salivary secretion.

Correct Answer: A

Rationale: Parasympathetic stimulation triggers the release of gastrin from endocrine cells in the stomach. Gastrin plays a key role in promoting gastric acid secretion and stimulating gastric motility. This hormone is essential for regulating digestion. Incorrect choices: B: Pepsinogen is an inactive form of pepsin, which is not released by endocrine cells in the stomach. C: Histamine is released by mast cells and enterochromaffin-like cells, not endocrine cells in the stomach. D: Secretin is released by the S cells in the duodenum in response to low pH in the small intestine, not by endocrine cells in the stomach.