Roth 10 e Chapter 7

MULTIPLE CHOICE 1. A pregnant client tells the nurse that she is taking megadoses of vitamin A in the hopes that it will keep her complexion clear throughout the pregnancy. What could the nurse say about the clients use of this vitamin supplement? a. Consuming megadoses of vitamin A may c. Taking megadoses of vitamin A are a cause permanent night blindness. good idea during pregnancy because vitamin A supports a healthy immune system. b. Consuming megadoses of vitamin A may result in birth defects. ANS: B Toxic levels of vitamin A may cause birth defects, bone pain, anorexia, and enlargement of the liver. Night blindness can result from a deficiency of vitamin A. Vitamin A does support a healthy immune system, but megadoses during pregnancy would not be advisable due to the risk of birth defects. PTS: 1 REF: Fat Soluble Vitamins d. Taking megadoses of vitamin A will neither help nor hurt her or the fetus during the pregnancy.

2. During an initial nutrition assessment of a client, the client asks about food sources for vitamin D other than fortified milk. The client likes warm, rather than cold milk and is concerned that warming the milk destroys the vitamin D. Which of the following statements could the nurse make about vitamin D and warmed milk? a. About 50% of vitamin D is destroyed by c. The only way to get adequate vitamin D is warming the milk, so drink twice as much. to drink fortified milk. b. Egg yolk contains vitamin D, but since it d. Vitamin D is not harmed by cooking. is destroyed by cooking, the egg yolk must be undercooked. ANS: D Vitamin D is heat-stable and not easily oxidized, so it is not harmed by storage, food processing, or cooking. Egg yolk does contain vitamin D, but it would not be lost in cooking. Also, raw or undercooked eggs are not safe to eat. Other food sources of vitamin D are fish liver oils, butter, and fortified margarine. PTS: 1 REF: Vitamin D

3. A client presents with these symptoms: legs that feel heavy, burning feet, muscle degeneration, headaches, depression, anorexia, constipation, tachycardia, edema, heart failure, and irritability. The nurse recognizes that these symptoms could reflect a deficiency of what B-complex vitamin? a. niacin c. riboflavin b. pantothenic acid d. thiamine ANS: D Beriberi is a deficiency disease caused by a lack of thiamine. The symptoms of beriberi are: legs that feel heavy, burning feet, muscle degeneration, headaches, depression, anorexia, constipation, tachycardia, edema, heart failure, and irritability.

PTS: 1

REF: Vitamin B-complex

4. The nurse notes while assessing a client that the client is taking a vitamin prescribed by a physician for cholesterol lowering. What vitamin has been prescribed? a. niacin c. vitamin D b. pantothenic acid d. vitamin C ANS: A Niacin is sometimes used as a cholesterol lowering agent. When niacin is used as a cholesterol lowering agent, the client must be closely supervised by a physician because of possible adverse side effects such as liver damage and peptic ulcers. PTS: 1 REF: Niacin

5. While completing the initial assessment of a client, the nurse notes that the client does not like to consume fruits and vegetables. Physical findings show that the client has gingivitis, bruised skin, pinpoint hemorrhages of the skin, sore joints and muscles, and involuntary weight loss. What nutrient deficiency should the nurse suspect? a. vitamin A c. Pantothenic Acid b. vitamin C d. vitamin B12 ANS: B Vitamin C is know to prevent scurvy. This disease is characterized by gingivitis; flesh that is easily bruised; tiny, pinpoint hemorrhages of the skin; poor wound healing; sore joints and muscles; and weight loss. Vitamin C is found in fruits and vegetables. The best sources are citrus fruits, melon, strawberries, tomatoes, potatoes, red and green peppers, cabbage, and broccoli. PTS: 1 REF: Vitamin C

6. A family member of an elderly client contacts the nurse and asks why the client is receiving B12 injections. Which of the following answers could the nurse give? a. The injections of B12 are given to prevent c. The injections of B12 are given to prevent blindness. pellagra b. The injections of B12 are given to prevent d. The injections of B12 are given to prevent beriberi pernicious anemia ANS: D MULTIPLE RESPONSE 1. A client asks the nurse how one can be sure they are consuming foods that will provide adequate vitamin A. Which of the following messages would be appropriate for the nurse to convey? Select all that apply. a. Consume at least 5 servings a day of d. Provitamin A carotenoids are found only darkly pigmented fruits and vegetables. in orange vegetables. b. Consume liver, butter, cream, whole milk, e. Spinach and broccoli are goods sources of and whole milk cheeses without provitamin A carotenoids. restriction. c. Eat nuts everyday. f. You must take a vitamin A supplement to ensure adequate intake of this vitamin. ANS: A, E PTS: 1 REF: Vitamin B12

Provitamin A carotenoids can be converted to vitamin A from darkly colored pigments, both green and orange, in fruits and vegetables. Consuming 5 servings a day of darkly pigmented fruits is highly recommended. Liver, butter, cream, whole milk, and whole milk cheeses contain preformed vitamin A, but are high in saturated fats so they should be consumed in moderation. Nuts are a source of vitamin E, not vitamin A. A multivitamin is not necessary to ensure adequate vitamin A intake if adequate darkly pigmented fruits and vegetables are consumed. PTS: 1 2. In reviewing a clients medical record, the nurse notes the client is unable to produce intrinsic factor. The nurse is concerned that this problem could result in the client developing an anemia related to deficiency of what vitamin(s)? a. vitamin B1 d. vitamin B12 b. vitamin B2 e. vitamin A c. vitamin B6 f. vitamin C ANS: D Intrinsic factor is needed for the body to properly absorb vitamin B12. If intrinsic factor is missing, pernicious anemia develops. PTS: 1 REF: Vitamin B12

3. A female client tells the nurse that she is trying to get pregnant and asks if there are any nutrients she should be particularly considered about during the time she is trying to conceive. The nurse tells her that women of childbearing age should consume at least 400 micrograms of folic acid each day. Why will the nurse say this is important? a. Adequate intake of folic acid will help the c. Consuming 400 micrograms of folic acid client to conceive each day will guarantee a healthy baby. b. Consuming at least 400 micrograms of folic acid each day helps prevent major birth defects. d. Research shows that consuming 400 micrograms of folic acid each day helps prevent morning sickness in the first days of pregnancy.

ANS: B The habit of obtaining enough folic acid (400 micrograms) each day will prevent major birth defects if pregnancy occurs. PTS: 1 REF: In The Media (page 127)

4. The nurse tells a healthy client that the American Medical Association (AMA) recommends that everyone take one multiple vitamin a day. The client asks why. Which of the following statements could the nurse make about this recommendation? Select all that apply. a. Almost everyone can take a daily d. Multivitamins will help the client build multivitamin without fear of toxicity. bigger muscles. b. Food no longer contains the right nutrients e. Taking a multivitamin everyday will in adequate quantities. ensure will cure the common cold. c. Many people do not get adequate nutrients f. from their diet because they do not follow a healthy eating plan, relying on fast food and processed foods. Taking a multivitamin will give the client more energy.

ANS: A, C A balanced diet would provide for the nutritional needs of healthy people, but many do not follow a healthy eating plan, relying on fast food, processed foods, and heat, eat, and go foods. Therefore, the (AMA) has recommended that everyone take one multiple vitamin a day. Almost everyone can take a daily multivitamin without fear of toxicity. Taking a multivitamin each day will not build bigger muscles, cure diseases, or provide energy. PTS: 1 REF: Supplements