Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What condition occurs when stomach pressure exceeds lower esophageal sphincter (LES) pressure, allowing gastric acid to reflux into the esophagus?

1. Esophageal spasm

2. Gastroesophageal reflux disease (GERD)

3. Peptic ulcer disease

4. Hiatal hernia

The correct answer is: Gastroesophageal reflux disease (GERD)

The condition that occurs when stomach pressure exceeds the pressure in the lower esophageal sphincter (LES), allowing gastric acid to reflux into the esophagus, is gastroesophageal reflux disease (GERD). In GERD, the LES is unable to maintain a proper barrier against the stomach's acidic contents, resulting in symptoms such as heartburn, regurgitation, and discomfort. Factors such as increased intra-abdominal pressure due to obesity, pregnancy, or hiatal hernia can contribute to this condition by straining the LES and enabling acid to flow back into the esophagus. Other choices, while related to gastrointestinal issues, do not directly describe the reflux mechanism involving the LES. Esophageal spasm refers to involuntary contractions of the esophageal muscles, which can cause chest pain and difficulty swallowing, but it does not involve reflux. Peptic ulcer disease entails the formation of ulcers in the stomach lining or the upper intestine, primarily caused by factors such as H. pylori infection or the use of certain medications, rather than LES pressure dynamics. A hiatal hernia involves the stomach bulging through the diaphragm into the chest but does not inherently indicate that stomach pressure is exceeding LES pressure, although it may contribute to GERD symptoms.