What condition should the nurse anticipate when caring for a patient with a history of a total gastrectomy?

Correct Answer: D

Rationale: The correct answer is D: Cobalamin (vitamin B12) deficiency. After a total gastrectomy, the patient lacks the intrinsic factor needed for vitamin B12 absorption in the ileum, leading to deficiency. This can result in megaloblastic anemia, neurological symptoms, and fatigue. A: Constipation is not typically associated with total gastrectomy. B: Dehydration may occur postoperatively but is not a specific consequence of total gastrectomy. C: Elevated total serum cholesterol is not a direct effect of total gastrectomy.

Correct Answer: D

Rationale: The correct answer is D: parasympathetic. The parasympathetic nervous system is responsible for rest and digest functions, including stimulating digestion. It slows heart rate, increases intestinal activity, and promotes the secretion of digestive enzymes. The somatic nervous system (A) controls voluntary movements, the sympathetic nervous system (B) is responsible for the fight or flight response, and the central nervous system (C) consists of the brain and spinal cord, serving as the main control center of the body.

Correct Answer: A

Rationale: The correct answer is A: zymogen. Zymogen is an inactive precursor form of an enzyme that is converted to its active form by certain conditions, such as pH or other enzymes. In contrast, chymotrypsin, trypsin, and carboxypeptidase are all pancreatic enzymes directly involved in the breakdown of proteins. Therefore, zymogen does not directly split proteins, making it the exception among the pancreatic factors listed.

Correct Answer: D

Rationale: Bile facilitates digestion by emulsifying fats, breaking them down into smaller droplets for better absorption. Emulsification increases the surface area of fats for enzymes to work on. Hydrolysis (A) is the breakdown of molecules by adding water, not specific to fats. Digestion (B) is a general term encompassing all processes, not specific to fats. Catalysis (C) refers to the process of speeding up chemical reactions but doesn't specifically relate to fats like emulsification does.

Correct Answer: B

Rationale: The correct answer is B: jejunum. The jejunum is a major site of nutrient absorption in the small intestine due to its extensive surface area and presence of villi and microvilli that facilitate absorption of nutrients like carbohydrates, proteins, and fats. The duodenum primarily functions in digestion, the ileum mainly absorbs vitamin B12 and bile salts, and the colon absorbs water and electrolytes. Therefore, the jejunum is the correct choice for being a major site of nutrient absorption.