Andria Treat is a 68-year-old woman in reasonably good health, although overweight. She takes a daily multivitamin supplement and almost daily over-the-counter antacids for heartburn. She says she eats mainly lean meat, chicken, fish, and seasonal fruit and fresh vegetables from her garden. She now reports having severe heartburn. Also, over the past two days, she has had painful stomach cramps and diarrhea. She reports that she attended a family reunion picnic two days earlier. 1. Based on her history, which of the following is a likely explanation for Mrs. Treat's sudden onset diarrhea?

a. her age
b. spending time outdoors
c. foodborne illness
d. being overweight
e. the multivitamin
2. What might be a cause of Mrs. Treat's ongoing heartburn?

a. her age
b. spending time outdoors
c. foodborne illness
d. being overweight
e. the multivitamin
3. Mrs. Treat notes that her heartburn got worse while she was at the family reunion. Why might that be?

a. She took a 1-mile walk.
b. She was wearing loose clothes.
c. She ate slower than usual because she was busy talking to family members.
d. She was playing with her grandchildren.
e. She ate too much.
4. Mrs. Treat's niece, a registered dietitian nutritionist, or RDN, upon learning that her aunt takes antacids almost daily, advises her to quit relying on them so much because, in her professional opinion:

a. Antacids don't work.
b. Antacids cause gastroesophageal reflux.
c. Antacids cause ulcers.
d. Antacids are best for treating belching.
e. Regular use of antacids may mask a serious problem.
5. For treatment of the diarrhea, Mrs. Treat's doctor advises several strategies. Which of these strategies would the doctor not advise?

a. resting
b. drinking fewer liquids
c. avoiding strenuous activity
d. calling for medical help if diarrhea persists
e. drinking extra liquids
6. The doctor refers Mrs. Treat to a gastroenterologist for the reported heartburn and daily use of antacids she's using to treat it. What is a concern the doctor may have?

a. that she may be harming her esophagus
b. that she has ulcers
c. that she needs treatment for belching
d. that she may need to reduce her activity
e. that she may be harming her teeth
7. Mrs. Treat's niece, the RDN, offers her aunt some strategies for heartburn that she gives her patients with heartburn. Which of these strategies would be among those recommended?

a. Eat three main meals daily, no snacks.
b. Don't worry about eliminating any foods.
c. Wait 3 hours after eating before lying down.
d. Drink liquids with meals.
e. Keep head flat while sleeping.
8. The doctor asks Mrs. Treat why she thinks she has heartburn. He's looking to see if she has the usual heartburn symptoms, which include:

a. belching
b. pain on the lower left side of the abdomen
c. constipation
d. flatulence
e. acid taste in the mouth