Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What condition occurs when the stomach out-pouches into the esophagus due to a weak lower esophageal sphincter?

1. Esophageal varices

2. Hiatal hernia

3. Gastroesophageal reflux disease

4. Achalasia

The correct answer is: Hiatal hernia

A hiatal hernia occurs when the stomach protrudes through the diaphragm into the thoracic cavity, which can often happen due to a weak lower esophageal sphincter. This condition allows part of the stomach to slide up into the chest, which can create a path for gastric contents to reflux into the esophagus. The weakened sphincter may not maintain adequate pressure to prevent the backflow of stomach contents, leading to potential complications such as gastroesophageal reflux disease (GERD). The significance of identifying hiatal hernia lies in its association with symptoms such as heartburn, regurgitation, and chest pain, which can be exacerbated by increased abdominal pressure or certain positions. Understanding this condition helps healthcare professionals manage related reflux symptoms and alleviate discomfort effectively. Gastroesophageal reflux disease is closely related but is more about the clinical symptoms resulting from the reflux itself rather than the anatomical displacement indicated in hiatal hernia. Conditions like esophageal varices and achalasia pertain to other pathophysiological processes within the esophagus and do not involve a structural change wherein the stomach projects into the esophagus.