Correct Answer: C

Rationale: A high specific gravity of urine typically indicates concentrated urine, which can occur in dehydration; however, moist mucous membranes suggest adequate hydration. This combination does not indicate severe dehydration. A low specific gravity of urine usually indicates dilute urine, which is not typical in dehydration; it suggests the kidneys are not concentrating urine due to good fluid intake or other factors. While pale skin can indicate poor perfusion, this option does not specifically indicate severe dehydration. A depressed fontanelle and a capillary refill time greater than 4 seconds are significant indicators of severe dehydration in infants. Depressed fontanelles suggest that the infant is not receiving enough fluids, and prolonged capillary refill time indicates poor perfusion and dehydration. Moist skin and mucous membranes indicate adequate hydration. Flushed skin may occur with certain conditions but does not suggest severe dehydration.

Correct Answer: D

Rationale: Borborygmi refers to the audible sounds produced by the movement of gas and fluid in the intestines. This can occur in dumping syndrome due to increased intestinal motility and rapid gastric emptying, making this a present manifestation. Nausea and vomiting can occur in dumping syndrome, particularly shortly after eating, due to the rapid movement of food into the small intestine, which can irritate the gut.
Therefore, this is a present manifestation. Dizziness can occur in dumping syndrome, often as a result of rapid shifts in blood volume and blood sugar levels after eating. This symptom can be attributed to the body's response to the sudden influx of food and fluid into the intestines, leading to symptoms like weakness and dizziness. Hence, this is a present manifestation. Hypertension is not typically associated with dumping syndrome. In fact, many individuals may experience hypotension (low blood pressure) due to the rapid shift of fluid to the intestines, which can reduce circulating blood volume.

Correct Answer: A

Rationale: Helicobacter pylori (H. pylori) is a type of bacteria that infects the stomach lining and is the most common cause of chronic gastritis. Aspirin and other NSAIDs can cause gastritis but are not the most common cause. Chronic alcohol consumption can lead to gastritis but is less common than H. pylori. Smoking exacerbates gastric conditions but is not a direct cause.

Correct Answer: D

Rationale: Bulimia involves episodes of binge eating followed by purging and can lead to a range of gastrointestinal issues, including esophageal damage and electrolyte imbalances. However, it is not a direct risk factor for the development of peptic ulcers. While it can affect the digestive system, it does not inherently increase the risk of ulcers. Green tea is generally considered to have health benefits and is not typically associated with an increased risk of peptic ulcers. In some cases, it may even provide protective effects against gastric ulcers due to its antioxidant properties. Moderate alcohol consumption can have varying effects on gastric mucosa. While excessive alcohol consumption is a risk factor for developing ulcers, moderate consumption, such as a glass of wine with dinner, is not typically considered a significant risk factor. Nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate the gastric lining and inhibit the production of protective mucus, leading to an increased risk of developing ulcers.

Correct Answer: C

Rationale: Sucralfate works by forming a protective barrier over the ulcer and is best taken on an empty stomach. Antacids can interfere with the effectiveness of sucralfate if taken simultaneously. It’s usually recommended to wait at least 30 minutes to 1 hour after taking sucralfate before taking an antacid. Sucralfate should be stored at room temperature, away from moisture and heat, but it does not need to be refrigerated. This guidance is essential to ensure that the medication maintains its effectiveness. Sucralfate is typically taken 1 hour before meals and at bedtime to optimize its protective effect on the stomach lining and ulcers. This timing allows it to coat the ulcer effectively before food intake. Sucralfate tablets should be swallowed whole and not crushed or chewed, as doing so may affect how the medication works. This instruction helps ensure that the sucralfate can properly adhere to the ulcer surface.