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?

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.

Correct Answer: A

Rationale: The correct answer is A: periodontal disease. Periodontal disease is the most common cause of tooth loss in adults due to the severe damage it causes to the supporting structures of the teeth, such as the gums and bone. It leads to progressive destruction of the tissues surrounding the teeth, eventually resulting in tooth loss. Gingivitis (B) and pyorrhea (C) are stages of periodontal disease and not the primary cause of tooth loss. Dental caries (D) primarily affects the enamel and dentin of the teeth, leading to cavities, but it is not as common a cause of tooth loss in adults as periodontal disease.

Correct Answer: D

Rationale: The correct answer is D: oblique smooth muscle. The stomach is unique in the GI tract because it contains an additional layer of muscle fibers called the oblique muscle layer. This layer allows for more efficient mixing and churning of food, aiding in digestion. Circular smooth muscle (choice A) and longitudinal smooth muscle (choice B) are present in various parts of the GI tract but are not unique to the stomach. Skeletal muscle (choice C) is not found in the stomach as the muscles responsible for its movement are smooth muscle.

Correct Answer: C

Rationale: The correct answer is C: duodenum. The pancreas and liver release their secretions, such as pancreatic enzymes and bile, into the duodenum. This is because the duodenum is the first part of the small intestine where digestion primarily occurs. The stomach (A) is responsible for initial digestion of food, while the ileum (B) and jejunum (D) are parts of the small intestine where absorption of nutrients occurs, not secretion release.

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.