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You're caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?
- A. Flushed, dry skin
- B. Headache and bradycardia.
- C. Dizziness and sweating.
- D. Dyspnea and chest pain.
Correct Answer: C
Rationale: Rationale: Dumping syndrome is a common complication post-Billroth II procedure due to rapid emptying of gastric contents into the small intestine. Choice C (dizziness and sweating) align with early dumping syndrome symptoms like vasomotor symptoms and hypoglycemia. Flushed, dry skin (A) is not typical, headache and bradycardia (B) are more indicative of vagal reaction, and dyspnea and chest pain (D) are not usually associated with dumping syndrome.
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What is the role of the stomach in digestion?
- A. Mechanical digestion of food
- B. Chemical digestion of proteins
- C. Absorption of nutrients
- D. Neutralization of stomach acid
Correct Answer: B
Rationale: The correct answer is B: Chemical digestion of proteins. The stomach produces hydrochloric acid and enzymes like pepsin to break down proteins into peptides and amino acids. This process is essential for protein digestion. Mechanical digestion (A) occurs mainly in the mouth and intestines. Absorption of nutrients (C) primarily takes place in the small intestine. Neutralization of stomach acid (D) is not the primary role of the stomach; rather, the stomach maintains an acidic environment for digestion.
Trypsinogen when activated by ______ will break down proteins in the ______.
- A. enterokinase; pancreatic ducts
- B. trypsin; small intestine
- C. secretin; pancreatic ducts
- D. enterokinase; small intestine
Correct Answer: D
Rationale: The correct answer is D: enterokinase; small intestine. Enterokinase is an enzyme that activates trypsinogen into trypsin in the small intestine. Trypsin is then responsible for breaking down proteins in the small intestine. Enterokinase is not found in the pancreatic ducts, eliminating choices A and C. Trypsinogen is not activated by itself, so choice B is incorrect. In summary, enterokinase activates trypsinogen into trypsin in the small intestine, allowing for protein digestion.
Which of the nurse's assigned patients should be referred to the dietitian for a complete nutritional assessment? (Select all that apply.)
- A. A 35-yr-old patient who reports intermittent nausea for the past 2 days
- B. A 48-yr-old patient with rheumatoid arthritis who takes prednisone daily
- C. A 23-yr-old patient who has a history of fluctuating weight gains and losses
- D. A 64-yr-old patient who is admitted for debridement of an infected surgical wound
Correct Answer: A
Rationale: The correct answer is A. This patient reporting intermittent nausea may have altered nutritional intake, which warrants a referral to the dietitian for a complete nutritional assessment. Nausea can affect food intake and nutrient absorption, potentially leading to malnutrition. Options B, C, and D do not directly indicate a need for a dietitian referral based on the information provided. The patient with rheumatoid arthritis taking prednisone may benefit from dietary interventions, but the information provided does not specify any nutritional concerns. The patient with fluctuating weight gains and losses may have nutritional issues, but further details are needed to justify a dietitian referral. The patient admitted for debridement of an infected wound may have increased nutritional needs due to wound healing, but this alone does not warrant a dietitian referral without additional information on the patient's nutritional status.
Which of the following statements is true regarding arterioles?
- A. they are less muscular than arteries, and the principle site of blood pressure regulation
- B. they are the most muscular of the major vessels, and have low blood flow velocity
- C. they are thin walled with little innervation
- D. they have no smooth muscle or connective tissue, and relatively low rates of blood flow
Correct Answer: A
Rationale: Step 1: Arterioles are smaller branches of arteries that lead to capillaries.
Step 2: Arterioles are indeed less muscular than arteries but more muscular than capillaries.
Step 3: Arterioles play a crucial role in regulating blood pressure through vasoconstriction and vasodilation.
Step 4: Choice A is correct as it accurately describes arterioles' role in blood pressure regulation.
Summary: Choice B is incorrect as arterioles are not the most muscular of major vessels. Choice C is incorrect as arterioles have significant innervation. Choice D is incorrect as arterioles do have smooth muscle and connective tissue, and they regulate blood flow efficiently.
The nurse is caring for a patient who has been experiencing severe diarrhea and can now resume solid foods. The nurse educates the patient about appropriate food choices. Which food choice indicates that the nurse's teaching has been successful?
- A. Whole-grain rice
- B. Wheat toast
- C. Applesauce
- D. Grapes
Correct Answer: C
Rationale: The correct answer is C: Applesauce. Applesauce is a low-fiber, easily digestible food that is gentle on the digestive system, making it an appropriate choice for someone recovering from severe diarrhea. It helps to bind stool and prevent further irritation. Whole-grain rice (choice A) and wheat toast (choice B) are high-fiber foods that may worsen diarrhea. Grapes (choice D) are high in natural sugars and can also aggravate diarrhea. In summary, the nurse's teaching is successful when the patient chooses applesauce because it is gentle on the digestive system and helps in recovery from diarrhea.