A nurse is providing teaching for a client who has gastroesophageal reflux disease (GERD) about ways to manage his condition. Which of the following instructions should the nurse include?

Correct Answer: D

Rationale: The correct answer is D: Wait to go to bed for 1 hr after eating. This instruction helps prevent acid reflux by allowing time for digestion, reducing the likelihood of stomach contents flowing back up the esophagus while lying down. Sleeping on the left side (A) may also be helpful to reduce reflux, but it is not as effective as the correct answer. Drinking milk (B) can temporarily alleviate symptoms but may not address the underlying issue. Eating four small meals each day (C) can help manage GERD by preventing overeating, but the timing of meals in relation to bedtime is crucial for symptom management.

Correct Answer: B

Rationale: The correct answer is B: stratified squamous. The epithelium of the mouth, oropharynx, esophagus, and anal canal is stratified squamous because these areas are subject to mechanical stress and friction. Stratified squamous epithelium provides protection against abrasion and wear. Simple squamous (A) is found in areas involved in filtration like the kidneys. Simple columnar (C) is found in the intestines for absorption. Pseudostratified columnar (D) is typically found in the respiratory tract to help with mucus production and movement.

Correct Answer: C

Rationale: The correct answer is C: stratified squamous epithelium. The oral cavity and oropharynx are exposed to mechanical stress and potential abrasion from food particles and pathogens, requiring a protective lining. Stratified squamous epithelium is ideal for providing protection due to its multiple layers of cells, with the outermost layer being flat and scale-like. This structure helps to resist damage and maintain integrity in areas of high wear and tear. Simple squamous (A) is too thin and delicate for this function. Simple columnar (B) is typically found in areas involved in absorption and secretion, not in protective roles. Stratified cuboidal (D) is rare in the body and not suited for the mechanical stress experienced in the oral cavity and oropharynx.

Correct Answer: C

Rationale: The correct answer is C: mucus. The esophagus secretes mucus to facilitate the passage of food from the mouth to the stomach, providing lubrication and protection to the esophageal lining. Bile (A) is produced by the liver and stored in the gallbladder, amylase (B) is an enzyme produced by the pancreas to break down carbohydrates in the small intestine, and hydrochloric acid (D) is produced by the stomach to aid in digestion. None of these substances are major secretions of the esophagus.

Correct Answer: A

Rationale: Rationale: 1. Gastrin is released by the stomach to stimulate gastric acid secretion. 2. Gastrin is also released by the small intestine to regulate digestive processes. 3. Secretin is released by the small intestine to stimulate bicarbonate secretion. 4. Cholecystokinin is released by the small intestine to stimulate bile release. 5. Gastric inhibitory polypeptide is released by the small intestine to inhibit gastric acid secretion. Summary: A: Gastrin is the correct answer as it is released by both the stomach and small intestine. B: Secretin is only released by the small intestine. C: Cholecystokinin is only released by the small intestine. D: Gastric inhibitory polypeptide is only released by the small intestine.